A scoping review of nutrition education interventions to improve competencies, lifestyle and dietary habits of medical students and residents

Abstract

We reviewed the available research and gave an overview of the effects of nutrition education interventions (NEIs) on medical students’ and residents’ knowledge of nutrition, attitudes towards nutrition care, self-efficacy, dietary practices and readiness to offer nutrition care. From 28 May through 29 June 2021, we searched Google Scholar, PubMed, ProQuest, Cochrane and ProQuest to retrieve 1807 articles. After conducting de-duplication and applying the eligibility criteria and reviewing the title and abstract, 23 papers were included. The data were descriptively and narratively synthesised, and the results were displayed as frequencies, tables and figures. Twenty-one interventions were designed to increase participants’ knowledge of nutrition-related topics, and eighteen studies found that nutrition knowledge had significantly improved post-intervention. Only four of the eleven studies that reported on attitudes about nutrition post-intervention showed a meaningful improvement. The self-efficacy of participants was examined in more than half of the included studies (n 13, 56⋅5 %), and eleven of these studies found a significant increase in the participants’ level of self-efficacy to offer nutrition care post-intervention. At the post-intervention point, seven interventions found that dietary and lifestyle habits had significantly improved. The review demonstrated the potential of NEIs to enhance participants’ dietary habits and nutrition-related knowledge, attitudes and self-efficacy. Reduced nutrition knowledge, attitude and self-efficacy scores during the follow-up, point to the need for more opportunities for medical students and residents to learn about nutrition after the intervention.

Medical Nutrition Education for Health, Not Harm: BMI, Weight Stigma, Eating Disorders, and Social Determinants of Health

“…Increasing an individual’s nutritional knowledge can lead to dietary improvements, such as increased consumption of fruits, vegetables, and fiber [ 7 , 25 , 113 , 114 ], but elevated awareness can also be problematic. Nutrition education can foster weight dissatisfaction and encourage behaviors that can increase risk for disordered eating [ 106 ].…”

“…We identify problematic practices in nutrition education from the perspective of both learners and patients, including limited evidence-based approaches to nutrition education, improper emphasis on body mass index (BMI), reinforcement of weight stigma, omission of eating disorders, lack of recognition of social determinants of health, and inadequate communication skills coaching. Nutrition and lifestyle medicine curricula have made significant progress in these areas in recent years, yet additional work remains [ 8 – 25 ]. We make recommendations (Table 1 ) and propose specific, actionable alternatives to address failings in nutrition curricula (Tables 2 and 3 ).…”

There and Back Again: A Forty-Year Perspective on Physician Nutrition Education

“…Moving the needle forward on physician nutrition education training has been hampered by the lack of oversight, guidance, and mandates by the bodies that oversee and accredit their training [ 5 , 73 , 74 ]. Specifically, there are limited or absent current requirements by the Liaison Committee on Medical Education (LCME) or ACGME for specific learner training on lifestyle management, exercise, and nutrition, leading to heterogenous elective-based experiences that vary widely across programs [ [75] , [76] , [77] ]. With an often packed medical school and residency curriculum and no required curricular focus on nutrition, there is no “stick” to reinforce the “carrot” of the call for a nutrition curriculum recommended by the 1985 report [ 1 ].…”