NEW YORK, NY — April 17, 1997 — Many Americans regard their physician as their primary source for reliable nutrition advice. So it may come as a surprise to find that most physicians have little or no training in nutrition. The Association of American Medical Colleges reported that in 1995, only 29 out of 129 U.S. medical schools had a required nutrition course. Thirty-two schools offered no nutrition education at all.
Now in a novel approach to focus on the scheduling and academic needs of physicians, a medical school is offering the practicing physician a chance to catch up on the nutrition training they either weren’t offered or skipped during medical school. The Institute of Human Nutrition at Columbia University College of Physicians & Surgeons has developed a master’s of science degree in nutrition for practicing physicians. The degree program targets practicing physicians because in many cases, it is only after physicians start seeing patients daily that they realize they need to know more about nutrition. “Nutrition is now recognized as a key modality for health promotion and disease prevention in the 21st century. Still, education of physicians on nutrition-related matters is abysmal,” says Richard Deckelbaum, M.D., director of the Institute of Human Nutrition at Columbia University. One study found that only 6 percent of medical students took advantage of an elective nutrition course when it was offered. Often, medical students aren’t even aware of the elective or its significance in a clinical setting. “I graduated from medical school in 1963 and back then they didn’t realize the importance nutrition played in many of the major diseases such as cancer and diabetes. It didn’t seem as important then to include courses on nutrition,” said Dr. Mohammed Khonsary, a private practice internist in New Jersey and student of the program. “It would be wise now to place a greater emphasis on nutrition, such as the broad role fruits and vegetables play in disease prevention, and include more classes on the subject, especially since we now have 60 million overweight people in this country.”
Dietetics has a venerable history in medicine that stretches back at least to Hippocrates, who regarded it as virtually inseparable from medicine. In fact, four of the 10 leading causes of death in the United States are diet-related conditions – diabetes, heart disease, stroke and cancer. So when did physicians lose site of nutrition’s role in health, and why are they regaining interest now? “Clinical nutrition has been overlooked because it cannot be identified with any particular physiological system in the body, as most medical specialities can,” says Dr. Deckelbaum. “Now the effort to drive health care costs down has encouraged physicians to shift their focus from the treatment of diseases to their prevention, which, of course, involves nutrition.” He adds that better nutrition can result in delaying the onset of many chronic diseases, such as heart disease or cancer, by five years or more, a factor that will decrease health care costs in the United States by more than $80 billion annually. And with a growing interest in alternative medicine, physicians like Dr. Peter Agho, a student and family practitioner in the Bronx, can apply their knowledge of nutrition to enhanced patient counseling. “This course was exactly what I was looking for,” he says. “I did not have much formal training in the field during medical school, and as someone practicing alternative medicine, I will be able to better counsel my patients about nutrition as a way of disease prevention.”
The master’s of science in nutrition program at Columbia offers physicians an opportunity to augment their training with a foundation in basic and clinical nutritional sciences. Courses on growth and development, the biochemical and physiological bases of nutrition, and essentials of nutrition counseling prepare graduates not only to take care of their patients’ nutritional needs, but also to carry out research linking diet and disease. The program can be completed in one to two years and is designed to accommodate the scheduling needs of practicing physicians. Seven physicians are currently enrolled in the program. They range in age from 28 to 75 years. Most are in private practice, specializing in family practice, internal medicine, cardiology and gastroenterology. Applications and further information are available from the Institute of Human Nutrition at Columbia University College of Physicians & Surgeons at 630 West 168th Street, New York, NY, 10032, 212/305-4808.