DALLAS – Nov. 26, 2024 – Poor diets have been linked to seven of the 10 leading causes of death in the United States, from heart disease to diabetes and certain types of cancer. Yet many physicians are not equipped to counsel patients about healthy food choices, and most medical students and trainees do not receive adequate training in this discipline.
Addressing this concern, a national panel of nutrition and education experts, including the Director of Culinary Medicine at UT Southwestern Medical Center, has proposed 36 competencies to incorporate into the medical education of physician trainees.
Jaclyn Albin, M.D., Associate Professor of Pediatrics and Internal Medicine and in the Peter O’Donnell Jr. School of Public Health at UT Southwestern, co-authored the consensus statement published in JAMA Network Open. Currently, she said, medical training programs lack nationally required, uniform nutrition training competencies. The proposed competencies cover areas including foundational nutritional knowledge; assessment and diagnosis; communication skills; public health; collaborative support and treatment for specific conditions; and indications for referral.
“Our goal was to create standardization, and this was the first national effort pairing nutrition experts and educational leaders to define what medical students and residents need to know about the impact of nutrition on health,” said Dr. Albin, who launched UTSW’s Culinary Medicine Program in 2017. “Fundamentally, the rate of chronic disease is so inextricably linked to eating patterns that if we are not teaching physicians properly, we cannot help people in a holistic or meaningful way. This is an opportunity to make people well, rather than simply managing illness.”
What’s more, academic literature suggests that health care workers who receive targeted training in nutrition change their own lifestyle and exhibit greater confidence in discussing food and dietary choices with their patients, according to the panel’s findings.
The issue has gained attention in Congress in recent years due to the growing impact of obesity and diet-related diseases. Peer-reviewed research estimates the total Medicare cost for these conditions was about $800 billion in 2019 and federal spending on graduate medical education surpassed $16 billion in 2020. Another source with the Rockefeller Foundation, a philanthropic science research organization, reported that the U.S. spends approximately $1.1 trillion on treating diet-sensitive diseases.
In May 2022, the U.S. House of Representatives passed Resolution 1118, calling for enhanced training to better prepare physicians to provide practical, evidence-based, and culturally sensitive advice about food and diet. In response, 37 national medical educators and residency directors, nutrition scientists, registered dietitian nutritionists, and practicing physicians gathered and identified 36 areas for curriculum improvement after four rounds of thorough deliberations.
“In many ways, UT Southwestern is ahead of the curve when it comes to culinary medicine, which is a marriage of food, nutrition, and medical science that empowers people to develop and sustain a delicious and nourishing dietary pattern,” Dr. Albin said.
Following the philosophy that “food is medicine,” Dr. Albin co-created UT Southwestern’s Eat for Health nutrition education curricular strategy and advocated for its current integration into the required coursework for medical students.
UTSW was the first medical center in the country to license the Health Meets Food curriculum to strengthen students’ understanding of nutrition principles and practical skills. The experiential course led by a physician-dietitian team teaches medical and other health profession students essential culinary skills and explores the link between diet and health outcomes. Launched in 2017, the class remains one of the most popular electives at UTSW, year after year.
Culinary medicine goes beyond “nebulous ideas about what is good or bad food,” said second-year medical student Sahej Bhatia, who completed the course and remains involved as a student leader. “In medicine, we have some exposure to the idea that high-sodium diets and saturated fats are associated with cardiovascular disease, but what does that actually mean? If I tell a patient this, what changes can they implement based on this information alone?
“There remains a reluctance, an anxiety, about what to do,” Bhatia said. “Culinary medicine dismantles this barrier because it presents examples of delectable and health-conscious meals that are realistic.That’s really what it is: teaching people how to make delicious food while empowering them with a knowledge of ingredients and techniques that encourage vitality.”
The success of UTSW’s instructional initiatives has carried over to direct patient care. Dr. Albin co-founded a culinary medicine clinical service line with Milette Siler, RD, LD, a registered dietitian and lead dietetic instructor at UTSW. Their work attempts to remove barriers to health, such as a lack of understanding and food access, and patients benefit from three primary services:
- E-consults with a physician and dietitian to address specific questions and provide information on how to better manage individual health
- Personalized coaching with a physician and dietitian to develop dietary strategies that work with specific health conditions, circumstances, and goals
- Shared medical appointments or local community classes that offer pragmatic lessons in food preparation and health benefits
UTSW was also the first medical center in the country to adopt a new cost-efficient model for sustainable community partnerships. Faith-based organizations offer space for instructional classes while the cost of services is covered by insurance-billable medical care due to the application of group experiences to individual needs.
“It’s not nutrition until people eat it,” Dr. Albin said. “Food has to taste good. It has to be culturally relevant and affordable.”
These considerations are reflected in the final recommendations from the research team, which called for greater awareness of food insecurity; environmental, psychological, emotional, and cultural factors that influence diet; internal biases and judgment; food allergies and sensitivities; and socioeconomic status.
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 24 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 120,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5 million outpatient visits a year.
