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Nutrition Education for Cardiologists: The Time Has Come

  • Public Health Policy (E Klodas, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Nutrition is a cornerstone of cardiovascular health, yet the training of cardiovascular specialists in nutrition has been called into question. This report summarizes the current state of nutrition education in the training of cardiovascular specialists and offers recommendations for curricular enhancements.

Recent Findings

Medical students receive an average of fewer than 20 h of nutrition education, largely confined to basic sciences and discussion of vitamin deficiency states. Current guidelines for Internal Medicine residency and cardiovascular fellowship training do not contain any specific requirement for nutrition education. A recent survey showed that the vast majority of cardiologists report having received minimal nutrition training, although most cardiologists believe it is their personal responsibility to provide nutritional counseling to their patients.

Summary

Cardiologists typically receive minimal training in nutrition and are not well equipped to deliver effective nutritional counseling and recognize opportunities for appropriate referral. The potential for cardiologists to become more effective team members in delivering nutritional interventions is considerable.

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. •• U. S. Burden of Disease Collaborators. The state of US health, 1990–2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310:591–608. This report characterizes the growing non-communicable disease epidemic (i.e. CVD), and shows how poor lifestyle choices may be a major contributor.

    Article  Google Scholar 

  2. Sidney S, Quesenberry CP Jr, Jaffe MG, et al. Recent trends in cardiovascular mortality in the united states and public health goals. JAMA Cardiol. 2016;1:594–9.

    Article  PubMed  Google Scholar 

  3. Micha R, Penalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. JAMA. 2017;317:912–24.

    Article  PubMed  Google Scholar 

  4. Council NR. Nutrition education in U.S. medical schools. Washington: The National Academies Press; 1985.

    Google Scholar 

  5. Adams KMBW, Kohlmeier M. The state of nutrition education at US medical schools. J Biomed Educ. 2015:1–7.

  6. Weinsier RL, Boker JR, Morgan SL, et al. Cross-sectional study of nutrition knowledge and attitudes of medical students at three points in their medical training at 11 southeastern medical schools. Am J Clin Nutr. 1988;48:1–6.

    CAS  PubMed  Google Scholar 

  7. Adams KM, Kohlmeier M, Powell M, Zeisel SH. Nutrition in medicine: nutrition education for medical students and residents. Nutr Clin Pract. 2010;25:471–80.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Polak R, Phillips EM, Nordgren J, et al. Health-related culinary education: a summary of representative emerging programs for health professionals and patients. Glob Adv Health Med. 2016;5:61–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kahn RF. Continuing medical education in nutrition. Am J Clin Nutr. 2006;83:981S–4S.

    CAS  PubMed  Google Scholar 

  10. Smith S, Seeholzer EL, Gullett H, et al. Primary care residents’ knowledge, attitudes, self-efficacy, and perceived professional norms regarding obesity, nutrition, and physical activity counseling. J Grad Med Educ. 2015;7:388–94.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Internal Medicine. 2017. http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/140_internal_medicine_2017-07-01.pdf.

  12. Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Cardiovascular Disease (Internal Medicine). 2017. http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/141_cardiovascular_disease_2017-07-01.pdf.

  13. Pack QR, Keteyian SJ, McBride PE, Weaver WD, Kim HE. Current status of preventive cardiology training among United States cardiology fellowships and comparison to training guidelines. Am J Cardiol. 2012;110:124–8.

    Article  PubMed  Google Scholar 

  14. American Dietetic Association. Nutrition and you: trends. 2008.

  15. Qaseem A, Fihn SD, Dallas P, Williams S, Owens DK, Shekelle P. Management of stable ischemic heart disease: summary of a clinical practice guideline from the American College of Physicians/American College of Cardiology Foundation/American Heart Association/American Association for Thoracic Surgery/Preventive Cardiovascular Nurses Association/Society of Thoracic Surgeons. Ann Intern Med. 2012;157:735–43.

    Article  PubMed  Google Scholar 

  16. •• Stone NJ, Robinson JG, Lichtenstein AH, et al. ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2013;2014:63. In this major paradigm shift in managing lipids and dyslipdiemia, the power of lifestyle to improve outcomes serves as a preamble to the use of medicines. This guideline higlights the need to educate cardiologists on these approaches.

    Google Scholar 

  17. Centers for Medicare and Medicaid Services. Episode Payment Models: General Information. 2017.

  18. OECD. Health at a Glance. Organization for Economic Cooperation and Development. 2009.

  19. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation. 2017;135:e146–603.

    Article  PubMed  Google Scholar 

  20. •• Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998;280:2001–7. This study is one of the pivotal studies which shows how lifestyle medicine, with a large emphasis on nutrition can halt or even reverse coronary disease.

    Article  CAS  PubMed  Google Scholar 

  21. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99:779–85.

    Article  PubMed  Google Scholar 

  22. Frank E, Segura C, Shen H, Oberg E. Predictors of Canadian physicians’ prevention counseling practices. Canadian journal of public health Revue canadienne de santé publique. 2010;101:390–5.

    PubMed  Google Scholar 

  23. •• Dalen JE, Devries S, Alpert JS, Willett W. It’s time to replace organic chemistry with nutrition as a pre-med requirement. Am J Med. 2015;128:1048–9. This article highlights the need to emphasize nutrition training in the pre-clinical years, and how giving a practical education lays the framework for how medical providers will deliver care in the future.

    Article  PubMed  Google Scholar 

  24. Mitchell PWM, Golden R, McNellis B, Okun S, Webb E, Rohrbach V, Von Kohorn I. Core principles & values of effective team-based health care. Discussion Paper, Washington: Institute of Medicine; 2012.

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Correspondence to Stephen Devries.

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Conflict of Interest

Stephen Devries declares that he has no conflict of interest.

Andrew M. Freeman reports personal fees from Boehringer-Ingleheim.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Public Health Policy

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Devries, S., Freeman, A.M. Nutrition Education for Cardiologists: The Time Has Come. Curr Cardiol Rep 19, 77 (2017). https://doi.org/10.1007/s11886-017-0890-6

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  • DOI: https://doi.org/10.1007/s11886-017-0890-6

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