What Are Physicians’ Nutrition Competencies Around the World?

The Role of Nutrition in Healthcare

Proper nutrition is a cornerstone of chronic disease prevention and management. According to WHO, non-communicable diseases account for 74% of all global deaths. Unhealthy dietary habits are a key risk factor, yet physicians often feel unprepared to provide dietary guidance.

Macaninch et al. found that over 90% of surveyed UK medical students and junior doctors believe nutrition is important for health and medical practice. However, only 26% felt confident in their nutrition knowledge, and three-quarters reported giving dietary advice to patients less than once per month.

The main reason is lack of education. Medical students in English-speaking countries typically receive less than 25 hours of nutrition education over the course of their studies—often less than two hours per year. Only a quarter of U.S. schools meet the recommended 25-hour minimum; the situation is even worse in Europe and elsewhere.

The Role of Knowledge and Confidence

A test conducted in Greece revealed that 65% of doctors lacked basic knowledge of clinical nutrition, and one-third overestimated their competence. This knowledge gap translates directly into practice.

According to Grammatikopoulou et al., physicians struggle with basic calculations and identifying malnutrition risks, leading to inadequate nutritional support for hospitalized patients.

Lack of time, knowledge, and confidence in communicating with patients means only a minority of doctors regularly include nutrition advice in treatment plans. Khiri and Howells also highlight persistent stigmatization of obesity and nutrition topics, which hinders open doctor-patient dialogue.

Barriers to Quality Nutrition Counseling

In addition to time constraints and lack of education, studies point to other systemic barriers that hinder effective nutrition counseling. These include the low prioritization of nutrition in clinical settings, absence of national standards, and lack of trained educators.

Blunt and Kafatos describe a paradox: it’s impossible to train nutrition specialists without qualified teachers. They also note confusion within healthcare teams about who is responsible for nutrition, as well as public uncertainty about whom to consult for nutrition advice.

Examples of Good Practice

Despite the challenges, some studies highlight successful models—such as the online “Nutrition in Medicine” courses or programs at Boston University and the University of Crete—which demonstrate that integrating nutrition into undergraduate and postgraduate education is both feasible and effective.

Proposed solutions across studies include:

• Greater integration of nutrition into core medical curricula,
• Inclusion of nutrition knowledge in medical licensing exams,
• Development of a physician nutrition specialist track,
• Implementation of national competency frameworks,
• Stronger interdisciplinary collaboration with registered dietitians and nutrition therapists.

Although there are encouraging examples and recommendations for improvement, implementing these changes remains a challenge. Given the importance of nutrition to population health, ensuring high-quality nutrition education is a key step toward more effective, prevention-oriented healthcare.

Editorial Team, Medscope.pro

Sources:

1. Khiri N., Howells K. Nutritional Education in Medical Curricula and Clinical Practice: A Scoping Review on the Knowledge Deficit Amongst Medical Students and Doctors. Journal of Human Nutrition and Dietetics, 38: e70031, doi: 10.1111/jhn.70031.

2. Macaninch E., Buckner L., Amin P. et al. Time for nutrition in medical education. BMJ Nutrition, Prevention & Health 2020; 3:e000049, doi: 10.1136/bmjnph-2019-000049.

3. Blunt S. B., Kafatos A. Clinical Nutrition Education of Doctors and Medical Students: Solving the Catch 22. Advances in Nutrition 2019 Mar 1;10(2):345-350, doi: 10.1093/advances/nmy082.

4. Grammatikopoulou M. G., Katsouda A., Lekka K. et al. Is continuing medical education sufficient? Assessing the clinical nutrition knowledge of medical doctors. Nutrition 2019 Jan;57 : 69-73, doi: 10.1016/j.nut.2018.05.013.