Nutrition Education in an Era of Global Obesity and Diabetes

Abstract

In an era when rates of obesity, diabetes, and other lifestyle-related diseases challenge medical educators and governments worldwide, it is necessary to consider novel educational strategies, both didactic and experiential, whereby current and future health professionals can be better prepared to proactively advise and teach patients enhanced self-care skills (e.g., diet, movement, stress management, and enhanced behavioral change).In this Perspective, the authors summarize current circumstances involving rising rates of obesity and diabetes worldwide, the lack of nutrition- and lifestyle-related curricular requirements for professional medical certification, societal trends regarding modern food culture and food availability in health care settings, and the misalignment of financial incentives to promote health.The authors assess what elements of self-care should or should not be required within future curricula and certification exams. They consider how best to educate trainees about diet and how to "translate" nutrition, exercise, and behavioral science knowledge into practical advice. They explore several ideas for reforming nutrition education, including "teaching kitchens" as required laboratory classes for nutrition and lifestyle instruction, wearable technologies for tracking behaviors and physiological data relating to lifestyle choices, and the prospect of hospitals and other medical venues serving as exemplars of healthy, delicious food options. Finally, the authors argue that "salutogenesis"-the study of the creation and maintenance of health and well-being-should assume its rightful position alongside the study of "pathogenesis"-disease diagnosis and treatment-in medical education and practice.

Contribuições do tratamento não-farmacológico para diabetes mellitus tipo II

“…O maior consumo de tais alimentos concorre para uma elevação na concentração de glicose na corrente sanguínea, com efeitos maléficos para saúde destes indivíduos. 9,21,23 Merece destaque a influência das doenças gengivais na trilha causal da diabetes bem como potencializadora da sua progressão. Estudos têm revelado que tais doenças dificultam a ação de substâncias hipoglicemiantes.…”

Nutrition Education in 2040—An Imagined Retrospective

“…An imagined ''Health System of the Future'' was sketched out in a recent article in Academic Medicine by Eisenberg and Burgess. 2 In that model, the bedrock stress in an increasingly overstimulated, technologydriven world. By 2040, medical and allied health schools will require standardized competency examinations with patients, which will test factual knowledge, advisory, and communication skills in nutrition, physical activity, stress management, and sleep hygiene.…”

“…It is important to note that this model already exists at some sites. 2 By 2040, wearable or implantable devices to track movement, exercise, and perceived stress alongside a broad range of continuously monitored biomarkers (eg, electrocardiogram, blood pressure, blood glucose) may be a standard component of one's ongoing portable medical record. The skills to interpret these data in the context of advising patients about their day-to-day activities will also have become essential.…”

“…It is worth noting that these topics are currently the basis of an existing continuing education conference, ''Healthy Kitchens, Healthy Lives,'' and are beginning to take shape in the form of ''culinary medicine'' courses at various US medical and allied health schools. 2,3 Teaching kitchens, with built-in or portable stoves and ovens for demonstrations and hands-on cooking instruction, now exist or are being built in several dozen hospitals, medical schools, and corporate worksites across the United States. 2 These sites could become learning laboratories, where nutrition science is actively translated into practical advice for patients (and health care providers) through experiential learning, which is a critical adjunct to didactic presentations.…”

“…2,3 Teaching kitchens, with built-in or portable stoves and ovens for demonstrations and hands-on cooking instruction, now exist or are being built in several dozen hospitals, medical schools, and corporate worksites across the United States. 2 These sites could become learning laboratories, where nutrition science is actively translated into practical advice for patients (and health care providers) through experiential learning, which is a critical adjunct to didactic presentations. It is conceivable that teaching kitchen nutrition laboratories may be comparable to the chemistry, biology, and computer laboratories considered necessary for the training of primary care medical professionals.…”