American Association of Clinical Endocrinologists' position statement on clinical nutrition and health promotion in endocrinology

An Assessment of Nutrition Education in Endocrinology Fellowship Programs in the United States

OBJECTIVE

Counseling patients about nutrition significantly improves chronic disease outcomes. Endocrinologists are uniquely positioned to educate patients regarding nutrition. The purpose of this study was to define the current state of nutrition education in endocrinology fellowship programs in the United States and assess the needs for future nutrition training.

METHODS

Endocrinology program directors were surveyed via an online questionnaire between February-April 2021.

RESULTS

Thirty-eight program directors responded (25% response rate) to the survey. Twenty-two (58%) programs offered nutrition education. Existing nutrition education offerings were 1-5 total hours (13, 34%), primarily didactic (20, 53%), and often led by registered dietitian nutritionists (RDNs) (15, 39%). Only three (8%) programs rated their current nutrition education as extremely effective; 95% of respondents believed further nutrition education was needed. According to respondents, the ideal nutrition education for endocrine trainees should be 1-5 total hours (19, 50%) over multiple sessions (25, 66%), be interactive (24, 63%), and be led by RDNs (26, 68%). The most important topics for independent practice included diet-related behavior modification (21, 55%), components of a healthful diet (19, 50%), and energy expenditure/intake (18, 47%).

CONCLUSION

Although the majority of the program directors believe that further nutrition education is needed, almost half of the surveyed programs do not offer such training. Programs that do offer nutrition education primarily rely on a didactic format. There is an unmet need for interactive, multidisciplinary nutrition education in these programs.

Residency and specialties training in nutrition: a call for action

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The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness

Nutrition is a recognized determinant in 3 (ie, diseases of the heart, malignant neoplasms, cerebrovascular diseases) of the top 4 leading causes of death in the United States. However, many health care providers are not adequately trained to address lifestyle recommendations that include nutrition and physical activity behaviors in a manner that could mitigate disease development or progression. This contributes to a compelling need to markedly improve nutrition education for health care professionals and to establish curricular standards and requisite nutrition and physical activity competencies in the education, training, and continuing education for health care professionals. This article reports the present status of nutrition and physical activity education for health care professionals, evaluates the current pedagogic models, and underscores the urgent need to realign and synergize these models to reflect evidence-based and outcomes-focused education.

Molecular and transcultural nutrition

Nutritional medicine presents significant educational and clinical challenges worldwide. Major issues include physician shortages as a result of inadequate training, increasing prevalence of metabolic diseases, such as obesity, diabetes, and atherosclerosis, incorporation of molecular medicine into our understanding of nutrition, and lastly, an emergent transcultural variable that affecting implementation strategies. Examples of translating specific molecular targets to culturally sensitive food-based therapies are given.