Ideas for boosting exercise and nutrition education in medical school

Ever since I first stepped foot in a gym as a teenager, I’ve seen signs that say “Consult your physician before using this piece of equipment.” They are on practically every apparatus. There are a few reasons for this statement—some related to medicine, some not so much. Nevertheless, having finished my core clinical rotations a few months ago, I’ve reflected on that phrase. What would the typical physician’s response be to a patient inquiring about a piece of equipment or an exercise program? On a different note, how would a physician answer questions about nutrition?

As a fourth-year medical student, I don’t have clear answers to those questions. I suspect many practicing physicians wouldn’t either. A study from the University of Alabama at Birmingham (UAB) department of family and community medicine showed that most medical students receive instruction on the benefits of physical activity and healthy eating during med school, but typically only around 12 hours total. Clinically applying this information by providing specific recommendations to patients proves more difficult. Some medical schools have shown leadership in this area by offering specialized tracks or elective courses in lifestyle medicine and culinary medicine, but this should be the standard rather than the exception.

More nutrition education is needed

The fact that many medical students are becoming resident physicians without first learning how to properly advise patients on diet and physical activity is concerning for several reasons. In 2020, the Centers for Disease Control and Prevention (CDC) estimated the prevalence of adult and childhood obesity to be 41.9% and 19.7% in the U.S., respectively. The CDC also reported physical inactivity and poor nutrition as risk factors for developing chronic diseases like cardiovascular disease, diabetes and cancer. But counseling patients to exercise and eat healthily isn’t enough.

More concrete recommendations are necessary to improve the nation’s health for current and future generations. As such, physical activity and nutrition must be further ingrained into medical school curricula to progress in the right direction and tackle the multifaceted issue of chronic disease.

Intertwining the subjects into current lessons

This can be accomplished in several ways. First, schools can intertwine both exercise and nutrition subjects more heavily into courses like biochemistry, physiology and osteopathic medicine. Homing in more on these topics aligns with an osteopathic approach to one’s health, supporting the body as it works along our biochemistry to support the body’s ability to heal. When reviewing anabolic and catabolic pathways in biochemistry, professors can highlight specific foods related to the metabolic pathways in the discussion, to provide more context and give students an idea on how to convey the necessary tips to their future patients. Alternatively, culinary medicine is a growing field and can be used to complement existing educational infrastructure.

I still remember learning that cheese was our diet’s highest source of saturated fat. Having been a lifelong cheese lover, after class I immediately threw away the bag of cheese lying around in my fridge. While a complete fridge clean-out might not be the necessary move for everybody, getting our patients thinking about the real effects of their food choices can help our population head in the right direction.

Secondly, exercise regimens, routines and proper techniques could also be discussed in the laboratory portion of osteopathic medicine. Following this, specific osteopathic manipulative medicine treatments could be covered, addressing the body parts or muscles used within the exercises. For example, when covering the causes of knee pain, demonstrating squats, lunges and box step-ups could precede the discussion on quadriceps muscle energy or piriformis counterstrain. This would teach medical students the proper form of preventative strength techniques, while also addressing how we can help patients feel better immediately.

Finally, an elective nutrition course could be created discussing the most common health-conscious diets (i.e., DASH diet, Mediterranean diet, etc.) within the U.S., and the nutrition facts behind them. Through an online video platform, the class could meet and cook recipes from the diets alongside the instructor. This would help teach students nutritional information and practical cooking experiences that could be conveyed to patients in the future. In fact, much of the information that may be covered in this course is publicly available through the Health Meets Food Culinary Medicine website. Although no singular diet is right for every person, understanding these healthy diets can give students a clearer idea of which lifestyle choices will work best for each type of patient.

Taking action

There are many ways to increase physical activity and nutritional education in the medical curriculum while complementing existing subject matter, and the above are just a few examples. I recognize this change is easier said than done, as altering the curriculum can be time-consuming. If you’re a student interested in helping the med student body learn about exercise and nutrition, creating a lifestyle or culinary medicine interest group could be the first step. Alternatively, students can contact peers with positions in their school’s student government to advocate for change, or can take matters into their own hands by researching the topics themselves.

Despite the obstacles, it’s clear that it’s time to provide medical students and physicians with the tools necessary to improve patients’ health and well-being naturally through physical activity and nutrition.

Related reading:

Where nutrition meets osteopathic medicine: New York DO/RD supports area youth and patients

Food from the soul: A history of African American culture and nutrition