Letter to the editor: Medical school nutrition-training requirement is overdue

OPINION:

Our food has been making us sick. This overdue acknowledgement underpins the recently updated dietary guidelines.

The Department of Health and Human Services and dozens of medical schools have committed to including meaningful nutrition training in the curriculum for future doctors, signaling a vital shift. We must address root causes of chronic metabolic diseases like diabetes and cholesterol, not just their symptoms.

Medical education has long required pre-med students to master basic sciences that underpin disease mechanisms. Physicians are trained not merely to follow algorithms, but to understand pathophysiology, enabling them to reason through complex cases.

Yet nutrition — the most consistent biological driver of metabolic disease — has been sidelined, often limited to an hour or two of coursework, if they’re offered at all.

Nutritionists and dietitians excel at behavioral counseling and helping patients navigate daily food choices. But metabolic science is distinct: Physicians must grasp how diet influences disease at the cellular and biochemical levels, just as they study pharmacology. Without it, their understanding of chronic conditions remains incomplete.

Even with optimal nutrition, medication will remain essential for many patients. Pharmaceutical therapies are powerful, but optimal care for metabolic diseases cannot rely on drugs alone. Comprehensive treatment must include diet.

Prescribing multiple medications for conditions like diabetes demands knowledge of interactions — including those with food. We cannot expect physicians to account for nutrition’s impact if they lack rigorous training in its biochemistry, parallel to their pharmacology education.

Unlike optional behaviors such as exercise, alcohol or tobacco use, food is inescapable. Treating diet as peripheral to the biology of metabolism defies logic, especially as metabolic diseases dominate American medicine.

Formalizing nutrition as a core component of medical training does not replace dietitians or turn physicians into meal planners. It ensures that graduates understand how food interacts with the metabolic systems they treat pharmacologically.

MONIQUE YOHANAN

Senior fellow for health policy, Independent Women

San Mateo, California