An apple a day keeps the doctor away… at least, the doctor thinks so. But the doctor isn't quite sure. Maybe you should ask the dietitian, actually.
We expect our doctors to be health experts, but surprisingly, when it comes to nutrition, the average family doctor has no more expertise than you or I do. That's because at most of the medical schools in the US, nutrition isn't part of the required curriculum.
In the absence of any expertise, doctors often defer to specialists—registered dietitians, nutritionists—rather than trying to give advice themselves. But when you consider that heart disease is the leading cause of death in the US, and the strong link between nutrition and heart health, shouldn't our doctors be able to give better advice than just "go talk to a dietitian?"
"We go through all of this incredibly rigorous training—four years of medical school, at least four years of residency, a lot of times even more than that—only to get to our office and have patients ask, 'what do you think I should be eating?' and say, 'I never learned a single thing about that. Go ask your mom,'" said Dr. Geeta Maker-Clark, a clinical professor at the University of Chicago Pritzker School of Medicine, during a panel discussion at the James Beard Foundation's Future of Food conference Monday.
A growing number of medical schools are starting to change the norm by adopting a program called culinary medicine, pioneered at Tulane University, which teaches medical students about diet and nutrition through practical training, including in the kitchen.
The culinary medicine program at Tulane was launched in 2012 and is a part of the core curriculum for medical students there. It combines nutrition training with cooking lessons so doctors can give patients practical advice—even recipes—to help meet diet and nutrition goals, rather than relying solely on clinical knowledge (or, most commonly, no knowledge at all).
Now, 17 medical schools across the country have either adopted the program or are in the process of adding it to their curriculum, according to Dr. Timothy Harlan, an internist and the executive director of the program.
"Our intention over the course of the next six years is that this type of programming will be in every single medical school in the country," Harlan said at Monday's conference. "[But] teaching medical students how to cook? It's going to be a long term process for us to prove efficacy in that."
Still, early research shows it's an effective form of training. Doctors trained in culinary medicine are more proficient in their understanding of nutrition than those who only had traditional medical training, according to survey results published in Advances in Preventive Medicine this summer, and they were more likely to consider nutrition advice an important part of regular care.
And it definitely beats the norm. Back in the 1980s, the National Academy of Sciences recognized the lack of nutrition literacy among doctors and called for a change, recommending a minimum 25 hours of nutrition training at all medical schools in the country. But by 2010, only 27 percent of medical schools met this threshold, with only 25 percent making a nutrition course mandatory. Even though some studies have identified our diet as the greatest contributing factor in the risk of disability and death, doctors around the country are still not getting the training needed to help us eat better.
At the University of Chicago, Maker-Clark helped launch a pilot version of the culinary medicine course this past spring and though it was popular among med students, it has yet to be added to the required curriculum. But Maker-Clark said that needs to change.
"I hope there's a day that it's something that we just expect of our doctors," Maker-Clark said. "If we're going to teach about nutrients and macronutrients and fiber and the importance of all these reductionist sort of ways of thinking about nutrition, there's no possible way to make that information practical without teaching [medical] students how to cook."