ADA responds to med school nutrition failings

By Stephen Daniells

- Last updated on GMT

Related tags Nutrition

The American Dietetic Association has responsed to results from a
study, reported on NutraIngredients-USA.com, that many medical
schools fail to give adequate nutrition education to medical
students.

"The physician is usually the health care provider a patient turns to first so a basic understanding is crucial,"​ said Christine Gerbstadt, MD, RD, spokesperson for the American Dietetic Association.

A survey, published in The American Journal of Clinical Nutrition​ (Vol. 83, pp. 941S-944S), revealed that almost 60 per cent of the medical schools surveyed provided the minimum 25 hours that were recommended by the National Academy of Sciences in 1985.

Gerbstadt said that such recommendations for nutrition education in medical school for was a reasonable goal.

"Equally important is the ability of the physician to recognize the registered dietitian as the food and nutrition expert and to refer patients for personalized and science-based information,"​ she stressed.

The ADA is expected to release a statement soon, which will reinforce a statement from 2004 stressing the importance of consulting a registered dietitian.

The 2004 statement read: "No other health professional has the combination of education and science-based nutrition expertise to work with [the public] in developing a personalized plan that is right."

One of the big drawbacks, said Gerbstadt, was that not all physicians immediately referred people to dietitians and that some people need to be proactive and ask for a referral.

The need for a physician's referral is also key to qualify for insurance cover.

"Nearly all diabetes and most heart patients can see a registered dietitian under Medicare or insurance coverage. Many other insurances cover other consultations. The American Dietetic Association is working to get better coverage for other disease conditions,"​ said Gerbstadt.

Dr Daniel Fabricant, vice president of scientific affairs for the industry association, the National Nutritional Foods Association told NutraIngredients-USA.com that the NNFA hoped that studies such as the AJCN survey would be the "impetus for major wholesale changes in medical education to implement curriculum and instructors that provide the tools to best serve the public with."

The article, published last week on NutraIngredients-USA.com, also elicited other feedback from readers:

"Doctors, just like dietitians/nutritionists, and other health professionals have an overwhelming task to keep current on all medical research and for that reason, specialization is necessary,"​ said Mary DeBernardis, MS, RD, LN.

"When I worked for the AMA over 30 years ago, this was a topic of discussion even then. At that time, the AMA was encouraging nutrition for pre-med students and select colleges/med schools were offering courses in nutrition. I strongly feel that all health professionals would benefit from taking nutrition courses, if not just for their own personal gain, but also realizing the importance of nutrition in preventative health.

It is my sincere hope that more physicians and other health professionals would work as a team with nutrition professionals such as licensed nutritionists and RD's. While our local hospital has an excellent team of dietitians who receive referrals from physicians, their counseling is limited by certain insurance reimbursable health conditions such as diabetes and heart surgery.

How nice it would be if a patient could go to their doctor's office, find out that their problems could be helped by a qualified nutrition counselor, and have the doctor set up an appointment with their own office nutrition specialist! We have physician's assistants, nurse practitioners, nurses at most clinics/doctor's offices-- but why not hire more dietitians!

Think of the cost savings alone if insurance companies would cover nutrition counseling to prevent obesity, type-2 diabetes - two of the 'epidemics' that are sweeping this country into health and financial ruin,"​ she said.

When the AMA was contacted by NutraIngredients-USA.com they refused to comment since the study was published in a non-AMA journal.

"This does not present any new news to those of us with nutrition degrees....how about the insurance companies recognizing and reimbursing for nutritional care services as they do for physician services!"​ said Michelle Kelly from New Hope Natural Media.

"Thanks for your article...it offers great explanation into physicians lack of nutrition knowledge - however, please, please follow-up by reminding and informing people that there is an entire profession devoted, trained, and expertly providing nutritional care services to people!"​ said Kelly.

"Thank you for reporting this study,"​ said Clinical Research Coordinator, Debbie Hudak. "I completely agree with this article and the fact that the majority of physicians and, consequently the general public, lack the knowledge and understanding of the importance in nutrition and diseases related to nutritional deficiencies."

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