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Khiri N, Howells K. Nutritional Education in Medical Curricula and Clinical Practice: A Scoping Review on the Knowledge Deficit Amongst Medical Students and Doctors. J Hum Nutr Diet 2025; 38:e70031. [PMID: 40047058 PMCID: PMC11883500 DOI: 10.1111/jhn.70031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 02/13/2025] [Accepted: 02/17/2025] [Indexed: 03/09/2025]
Abstract
INTRODUCTION Non-communicable diseases (NCDs), accounting for 74% of deaths worldwide (World Health Organization 2024), are a major health concern and are often the result of poor dietary habits. To reduce the prevalence of chronic diseases healthcare professionals must encourage healthy eating, and therefore require the appropriate nutritional knowledge and skills. This scoping review critically synthesises the literature on nutrition education to understand why there is a gap in nutrition knowledge and skills among medical students and doctors (MSAD) in English-speaking countries, and the solutions which have been proposed in the literature to close this gap. METHODS This scoping review adhered to PRISMA Scr guidelines outlined by Tricco et al. (2018) and used four online databases: PubMed; WebOfScience; Embase and ERIC as well as grey literature sources: Google; Bing and Perplexity AI, published within the last 10 years, from 2014 to 2024. Studies investigating medical students/doctors nutrition education/knowledge were included. Data analysis was guided by Braun and Clarke's (2012) six-step thematic analysis approach and the Delve qualitative coding software analysis tool was used to identify the two principal themes and the 20 sub-themes. The PICO tool was also used for question analysis. RESULTS From the 674 records identified, 28 papers met the inclusion criteria for full data extraction, analysis and synthesis. The results identified four reasons for the gap in nutrition knowledge, including insufficient curriculum time dedicated to nutrition education, perceptions and confidence, stigmas and health habits, and challenges in clinical practice. The review also identified four potential solutions to minimise this gap, including curriculum changes, enforcement of standardised nutrition education guidelines, integration of nutrition in clinical practice and promotion of a multidisciplinary approach to nutrition education. CONCLUSION This scoping review shows that there are multiple complex reasons for the gap in nutrition knowledge and understanding. This is due to education institutional reasons; perceptions and confidence on nutrition; stigmas related to nutrition and being able to talk about nutrition; personal health habits; and challenges in clinical practice. Solutions to reduce the gap were identified and it is recommended that there are curricular innovations to incorporate nutrition education throughout medical training; standardisation and implementation of national competency standards; integration of nutrition into clinical practice; enhancement of postgraduate education pathways in nutrition; and the development of a multidisciplinary approach in medical education involving dietitians and other healthcare professionals. By enacting and supporting the recommendations and solutions would then improve patient care and likely contribute to better eating habits worldwide, thereby reducing the burden of NCDs to both patients and healthcare professionals.
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Affiliation(s)
- Nasr Khiri
- Kent and Medway Medical SchoolCanterburyUK
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Hyży A, Cieślak I, Gotlib-Małkowska J, Panczyk M, Kucharska A, Jaworski M. Employer Actions in Office Settings and Women's Perception of the Workplace as Supportive of Healthy Eating: A Cross-Sectional Pilot Study. Nutrients 2024; 16:3766. [PMID: 39519599 PMCID: PMC11547438 DOI: 10.3390/nu16213766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 10/28/2024] [Accepted: 10/31/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to evaluate how women working in office environments perceive their workplace as promoting healthy eating behaviors through employer-led actions. METHODS This cross-sectional study was conducted among 230 professionally active women employed in office settings in Poland. Data were collected using the Computer-Assisted Web Interview (CAWI) method. Participants were divided into two groups based on their perceived level of workplace support for healthy eating behaviors, as measured by the Workplace Healthy Eating Scale. Group 1 (n = 125; 54.3%; mean score = 15.69, SD = 3.76) and Group 2 (n = 105; 45.7%; mean score = 29.88, SD = 5.15) reflected low and high perceived support, respectively. RESULTS A linear regression model was employed to assess the association between the perceived level of support and specific workplace initiatives, including access to fresh fruits and vegetables, meal preparation facilities, cafeteria usage, lectures on nutrition, cooking workshops, and individual dietary consultations. For Group 1, access to fresh fruits and vegetables was the only factor significantly associated with a positive perception of the workplace as promoting healthy eating (p = 0.003), explaining 6.5% of the variance (adjusted R2 = 0.065). In Group 2, both access to fresh produce and participation in cooking workshops were significantly associated with positive workplace perceptions (p < 0.001), explaining 41% of the variance (adjusted R2 = 0.410). CONCLUSIONS Access to fresh produce is a key determinant of employees' perceptions of workplace support for healthy eating behaviors, with a notably greater impact observed when combined with additional activities such as cooking workshops. Employer-led initiatives focusing on practical dietary engagement appear to be effective in enhancing workplace perceptions of health promotion.
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Affiliation(s)
- Aleksandra Hyży
- Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, 00-581 Warsaw, Poland; (A.H.); (I.C.); (J.G.-M.); (M.P.)
| | - Ilona Cieślak
- Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, 00-581 Warsaw, Poland; (A.H.); (I.C.); (J.G.-M.); (M.P.)
| | - Joanna Gotlib-Małkowska
- Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, 00-581 Warsaw, Poland; (A.H.); (I.C.); (J.G.-M.); (M.P.)
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, 00-581 Warsaw, Poland; (A.H.); (I.C.); (J.G.-M.); (M.P.)
| | - Alicja Kucharska
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 27 Erazma Ciołka Street, 01-445 Warsaw, Poland;
| | - Mariusz Jaworski
- Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, 00-581 Warsaw, Poland; (A.H.); (I.C.); (J.G.-M.); (M.P.)
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Lawler O, Masterson T, Petersen K, Hopfer H, Gettings MA, Denmon A, Zlotorzynski S, Kris-Etherton P. Online Nutrition Education Videos Teaching How to Use Herbs and Spices to Improve Diet Quality. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:672-677. [PMID: 38934961 DOI: 10.1016/j.jneb.2024.05.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Olivia Lawler
- Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA
| | - Travis Masterson
- Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA.
| | - Kristina Petersen
- Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA
| | - Helene Hopfer
- Department of Food Science, College of Agricultural Sciences, Pennsylvania State University, University Park, PA
| | | | - Amber Denmon
- Penn State Extension, Pennsylvania State University, University Park, PA
| | | | - Penny Kris-Etherton
- Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA
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Lavelle F, McKernan C, Shrewsbury V, Wolfson JA, Taylor RM, Duncanson K, Martins CA, Elliott C, Collins CE. An online qualitative study exploring wants and needs for a cooking programme during pregnancy in the UK and Ireland. J Hum Nutr Diet 2024; 37:927-942. [PMID: 38606553 DOI: 10.1111/jhn.13307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Optimal maternal nutrition is associated with better pregnancy and infant outcomes. Culinary nutrition programmes have potential to improve diet quality during pregnancy. Therefore, this research aimed to understand the experiences of cooking and the wants and needs of pregnant women regarding a cooking and food skills programme in the United Kingdom (UK) and Republic of Ireland (ROI). METHODS Online focus group discussions with pregnant women and those who had experienced a pregnancy in the UK or ROI were conducted between February and April 2022. Two researchers conducted a thematic analysis. Seven focus groups with ROI participants (n = 24) and six with UK participants (n = 28) were completed. RESULTS Five themes were generated. These were (1) cooking during pregnancy: barriers, motivators and solutions; (2) food safety, stress and guilt; (3) need for cooking and food skills programmes and desired content; (4) programme structure; (5) barriers and facilitators to programme participation. Overall, there was support for a programme focusing on broad food skills, including planning, food storage, using leftovers and to manage pregnancy-specific physiological symptoms such as food aversions. Participants emphasised the importance of inclusivity for a diverse range of people and lifestyles for programme design and content. CONCLUSIONS Current findings support the use of digital technologies for culinary nutrition interventions, potentially combined with in-person sessions using a hybrid structure to enable the development of a support network.
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Affiliation(s)
- Fiona Lavelle
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
- Department of Nutritional Sciences, School of Life Course & Population Sciences, King's College London, London, UK
| | - Claire McKernan
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Vanessa Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachael M Taylor
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kerith Duncanson
- School of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Carla A Martins
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
- Institute of Food and Nutrition, Federal University of Rio de Janeiro, Macaé, Brazil
| | - Christopher Elliott
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Staffier KL, Holmes S, Karlsen MC, Kees A, Shetty P, Hauser ME. Evaluation of the reach and utilization of the American College of Lifestyle Medicine's Culinary Medicine Curriculum. Front Nutr 2024; 11:1338620. [PMID: 38567252 PMCID: PMC10985187 DOI: 10.3389/fnut.2024.1338620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Despite the growing interest in "food as medicine," healthcare professionals have very limited exposure to nutrition as part of their training. Culinary medicine (CM), an evidence-based field integrating nutrition education with culinary knowledge and skills, offers one approach to fill this training gap. The American College of Lifestyle Medicine published a complimentary Culinary Medicine Curriculum (CMC) in 2019, and the objective of this study is to evaluate its reach and utilization, as well as to collect feedback from users. Methods Individuals who downloaded the CMC prior to March 1, 2022 (N = 6,162) were emailed an invitation to participate in an online, cross-sectional survey. The survey included both multiple choice and free-text questions about whether CM sessions were conducted, if and how the CMC was used, if and how it was modified for use, and additional requested resources. Free-text responses were inductively coded, and quantitative data was summarized using descriptive statistics. Results A total of 522 respondents provided consent, indicated that they had downloaded the curriculum, and completed the survey. Of the 522, 366 (70%) reported that they had not led or created any CM sessions. The top-reported reason for not leading a session was lack of time (29%). The remaining respondents who did create a CM session did so across various settings, including academic, clinical, coaching, and other settings, and a variety of professionals delivered the CMC sessions, including physicians (50%), registered dietitian nutritionists (30%), and chefs (25%). The majority of respondents (81%) modified the CMC in some way, with many using the curriculum for guidance or ideas only. Patient education materials (66%) and cooking technique instruction videos (59%) were among top requested resources. Discussion The CMC is a versatile resource that can be successfully adapted for use across various settings and by various types of health professionals and practitioners. Future research should investigate whether training in CM results in improved health outcomes for patients/clients. The curriculum will continue to grow to address the needs of users by expanding to include more digital content such as curriculum videos and cooking technique videos.
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Affiliation(s)
| | - Shannon Holmes
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | | | - Alexandra Kees
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Paulina Shetty
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Michelle E. Hauser
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA, United States
- Internal Medicine-Obesity Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
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French ML, Christensen JT, Estabrooks PA, Hernandez AM, Metos JM, Marcus RL, Thorpe A, Dvorak TE, Jordan KC. Evaluation of the Effectiveness of a Bilingual Nutrition Education Program in Partnership with a Mobile Health Unit. Nutrients 2024; 16:618. [PMID: 38474746 PMCID: PMC10934044 DOI: 10.3390/nu16050618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
There are limited reports of community-based nutrition education with culinary instruction that measure biomarkers, particularly in low-income and underrepresented minority populations. Teaching kitchens have been proposed as a strategy to address social determinants of health, combining nutrition education, culinary demonstration, and skill building. The purpose of this paper is to report on the development, implementation, and evaluation of Journey to Health, a program designed for community implementation using the RE-AIM planning and evaluation framework. Reach and effectiveness were the primary outcomes. Regarding reach, 507 individuals registered for the program, 310 participants attended at least one nutrition class, 110 participants completed at least two biometric screens, and 96 participants attended at least two health coaching appointments. Participants who engaged in Journey to Health realized significant improvements in body mass index, blood pressure, and triglycerides. For higher risk participants, we additionally saw significant improvements in total and LDL cholesterol. Regarding dietary intake, we observed a significant increase in cups of fruit and a decrease in sugar sweetened beverages consumed per day. Our findings suggest that Journey to Health may improve selected biometrics and health behaviors in low-income and underrepresented minority participants.
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Affiliation(s)
- Madeleine L. French
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA; (J.M.M.); (T.E.D.); (K.C.J.)
| | - Joshua T. Christensen
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84112, USA; (J.T.C.); (A.T.)
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Paul A. Estabrooks
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Alexandra M. Hernandez
- Osher Center for Integrative Health, University of Utah Health, Salt Lake City, UT 84112, USA;
| | - Julie M. Metos
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA; (J.M.M.); (T.E.D.); (K.C.J.)
| | - Robin L. Marcus
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT 84108, USA;
| | - Alistair Thorpe
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84112, USA; (J.T.C.); (A.T.)
| | - Theresa E. Dvorak
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA; (J.M.M.); (T.E.D.); (K.C.J.)
| | - Kristine C. Jordan
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA; (J.M.M.); (T.E.D.); (K.C.J.)
- Osher Center for Integrative Health, University of Utah Health, Salt Lake City, UT 84112, USA;
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Mellor D, Ball L. The role of dietitians in educating and training future dietitians and other healthcare professionals. J Hum Nutr Diet 2023; 36:17-19. [PMID: 36647804 DOI: 10.1111/jhn.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Duane Mellor
- Centre for Health and Society, Aston University, Birmingham, UK.,Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Lauren Ball
- Centre for Community Health and Wellbeing, The University of Queensland, Herston, QLD, Australia
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