Position of the Academy of Nutrition and Dietetics: Interprofessional Education in Nutrition as an Essential Component of Medical Education


      It is the position of the Academy of Nutrition and Dietetics that registered dietitian nutritionists (RDNs) should play a significant role in educating medical students, residents, fellows, and physicians in practice. The more physicians learn about the effectiveness of nutrition for the prevention and treatment of noncommunicable diseases, the more likely they are to consult with RDNs and refer patients for medical nutrition therapy. The more interprofessional education that occurs between medical students, other health professional students, and RDNs, the more likely all health care professionals will understand and value the role of the RDN in improving the quality of care provided to patients. The training and experience of RDNs make them uniquely qualified for the role of educating medical students about nutrition as it relates to health and disease. This position paper provides RDNs with the tools and language to emphasize to medical educators, course directors, curriculum committees, medical school deans, residency and fellowship directors, physicians, and other health professionals in training and practice how ongoing nutrition counseling and management, conducted by an RDN, can benefit their patients. Specific teaching settings and examples for RDNs to take a leadership role (paid and unpaid positions) in ensuring that future physicians discuss nutrition, healthy lifestyle, and physical activity with their patients, consult with RDNs, and refer patients for medical nutrition therapy are presented. This position paper supports interprofessional education in nutrition as an essential component of medical education.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Lopez S.A.
        • Read M.S.
        • Feldman E.B.
        1987 ASCN workshop on nutrition education for medical/dental students and residents—Integration of nutrition and medical education-strategies and techniques.
        Am J Clin Nutr. 1988; 47: 534-550
        • Committee on Nutrition in Medical Education, Food and Nutrition Board, Council on Life Sciences, National Research Council
        Nutrition Education of US Medical Schools.
        National Academy Press, Washington, DC1985
      1. American Medical Association concepts of nutrition and health. Council on Scientific Affairs.
        JAMA. 1979; 242: 2335-2338
        • Weinsier R.L.
        • Boker J.R.
        • Brooks C.M.
        • et al.
        Priorities for nutrition content in a medical school curriculum: A national consensus of medical educators.
        Am J Clin Nutr. 1989; 50: 707-712
        • Weinsier R.L.
        Nutrition education in the medical school: Factors critical to the development of a successful program.
        J Am Coll Nutr. 1982; 1: 219-226
        • Weinsier R.L.
        National Dairy Council Award for Excellence in Medical/Dental Nutrition Education Lecture, 1995: Medical-nutrition education—Factors important for developing a successful program.
        Am J Clin Nutr. 1995; 62: 837-840
        • Kushner R.F.
        • Thorp F.K.
        • Edwards J.
        • Weinsier R.L.
        • Brooks C.M.
        Implementing nutrition into the medical curriculum: A user's guide.
        Am J Clin Nutr. 1990; 52: 401-403
      2. National Nutrition Monitoring and Related Research Act of 1990. Pub L No. 1101-445/HR16081990.

        • Hark L.
        • Deen Jr., D.
        Taking a nutrition history: A practical approach for family physicians.
        Am Fam Physician. 1999; 59 (1531-1522): 1521-1528
      3. Medical education in the United States. Council on Medical Education of the American Medical Association. Chicago, IL: American Medical Association. Accessed March 26, 2017.

        • Sullivan L.W.
        Skills necessary for contemporary health professionals.
        Med Educ. 1992; 26: 3-6
      4. American Academy of Family Physicians. Recommended core educational guidelines in nutrition (reprint no. 275) in 1989, 1995, and 2000. 1989, 1995, 2000. Accessed March 26, 2017.

      5. Kolasa KK, Deen DD, eds. Physicians Curriculum in Clinical Nutrition: Primary Care. 3rd ed. Leawood, KS: Society of Teachers of Family Medicine, Group on Nutrition; 2001. Accessed March 26, 2017.

      6. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2020. Accessed March 26, 2017.

        • American College of Physicians
        Position Paper of the American College of Physicians on Nutrition.
        American College of Physicians, Philadelphia, PA1985
        • American Dietetic Association
        Position of the American Dietetic Association: nutrition—An essential of medical education.
        J Am Diet Assoc. 1994; 94: 555-557
        • Pearson T.A.
        • Stone E.J.
        • Grundy S.M.
        • McBride P.E.
        • Van Horn L.
        • Tobin B.W.
        Translation of nutritional sciences into medical education: The Nutrition Academic Award Program.
        Am J Clin Nutr. 2001; 74: 164-170
      7. National Heart, Lung, and Blood Institute. Nutrition Academic Award Program. Accessed March 26, 2017.

      8. National Heart, Lung, and Blood Institute. Curriculum Committee of the Nutrition Academic Award Program. Nutrition curriculum guide for training physicians: Practice behavior skills and attitudes across the curriculum. Accessed March 26, 2017.

        • Kushner R.F.
        • Van Horn L.
        • Rock C.L.
        • et al.
        Nutrition education in medical school: A time of opportunity.
        Am J Clin Nutr. 2014; 99: 1167S-1173S
      9. Hark L.A. Deen D.D. Morrison G. Medical Nutrition and Disease: A Case-Based Approach. 5th ed. Wiley-Blackwell Publishing, Malden, MA2014
        • Hark L.H.
        One programs’ experiences in nutrition in medical education.
        Top Clin Nutr. 1997; 12: 42-48
        • Hark L.H.
        The development of a case-based, integrated curriculum for medical students.
        Am J Clin Nutr. 2000; 72: 890S-897S
      10. Bipartisan Polcy Center, American College of Sports Medicine, Alliance for a Healthier Generation. Teaching nutrition and physical activity in medical school: Training doctors for prevention-oriented care. Published June 2014. Accessed March 26, 2017.

        • Hivert M.F.
        • Arena R.
        • Forman D.E.
        • et al.
        Medical training to achieve competency in lifestyle counseling: An essential foundation for prevention and treatment of cardiovascular diseases and other chronic medical conditions: A scientific statement from the American Heart Association.
        Circulation. 2016; 134: 1-21
        • Coats K.G.
        • Morgan S.L.
        • Bartolucci A.A.
        • Weinsier R.L.
        Hospital-associated malnutrition: A reevaluation 12 years later.
        J Am Diet Assoc. 1993; 93: 27-33
        • O'Flynn J.
        • Peake H.
        • Hickson M.
        • Foster D.
        • Frost G.
        The prevalence of malnutrition in hospitals can be reduced: Results from three consecutive cross-sectional studies.
        Clin Nutr. 2005; 24: 1078-1088
      11. A.S.P.E.N. Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients.
        JPEN J Parenter Enteral Nutr. 2002; 26: 1SA-138SA
        • Brantley S.L.
        • Russell M.K.
        • Mogensen K.M.
        • et al.
        American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: Revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nutrition support.
        J Acad Nutr Diet. 2014; 114: 2001-2008
        • Finkelstein E.A.
        • Trogdon J.G.
        • Cohen J.W.
        • Dietz W.
        Annual medical spending attributable to obesity: Payer-and service-specific estimates.
        Health Aff (Millwood). 2009; 28: w822-w831
      12. Centers for Disease Control and Prevention. Chronic disease overview. Updated February 23, 2016. Accessed March 26, 2017.

        • Ward B.W.
        • Schiller J.S.
        • Goodman R.A.
        Multiple chronic conditions among US adults: A 2012 update.
        Prev Chron Dis. 2014; 11: E62
      13. Centers for Disease Control and Prevention, National Center on Health Statistics. Obesity and overweight. Updated June 13, 2016. Accessed March 26, 2017.

        • Eisenberg D.M.
        • Burgess J.D.
        Nutrition education in an era of global obesity and diabetes: Thinking outside the box.
        Acad Med. 2015; 90: 854-860
        • Flegal K.M.
        • Carroll M.D.
        • Kit B.K.
        • Ogden C.L.
        Prevalence of obesity and trends in the distribution of body mFass index among US adults, 1999-2010.
        JAMA. 2012; 307: 491-497
        • Hurt R.T.
        • Kulisek C.
        • Buchanan L.A.
        • McClave S.A.
        The obesity epidemic: Challenges, health initiatives, and implications for gastroenterologists.
        Gastroenterol Hepatol (N Y). 2010; 6: 780-792
        • Cawley J.
        The economics of obesity.
        NBER Reporter. 2013; 4: 7-10
        • Eckel R.H.
        • Jakicic J.M.
        • Ard J.D.
        • et al.
        2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
        Circulation. 2014; 129: S76-S99
        • Cogswell M.E.
        • Zhang Z.
        • Carriquiry A.L.
        • et al.
        Sodium and potassium intakes among US adults: NHANES 2003-2008.
        Am J Clin Nutr. 2012; 96: 647-657
        • Tsai A.G.
        • Williamson D.F.
        • Glick H.A.
        Direct medical cost of overweight and obesity in the USA: A quantitative systematic review.
        Obes Rev. 2011; 12: 50-61
        • Lenders C.
        • Gorman K.
        • Milch H.
        • et al.
        A novel nutrition medicine education model: The Boston University experience.
        Adv Nutr. 2013; 4: 1-7
        • Hark L.A.
        Lessons learned from nutrition curricular enhancements.
        Am J Clin Nutr. 2006; 83: 968S-970S
      14. Liason Committee on Medical Education. Functions and structure of a medical school: Standards for Accreditation of Medical Education Programs Leading to the MD Degree. 2014. Accessed March 26, 2017.

        • Adams K.M.
        • Kohlmeier M.
        • Zeisel S.H.
        Nutrition education in U.S. medical schools: Latest update of a national survey.
        Acad Med. 2010; 85: 1537-1542
        • Adams K.M.
        • Lindell K.C.
        • Kohlmeier M.
        • Zeisel S.H.
        Status of nutrition education in medical schools.
        Am J Clin Nutr. 2006; 83: 941S-944S
        • Taren D.L.
        • Thomson C.A.
        • Koff N.A.
        • et al.
        Effect of an integrated nutrition curriculum on medical education, student clinical performance, and student perception of medical-nutrition training.
        Am J Clin Nutr. 2001; 73: 1107-1112
        • Kushner R.F.
        Barriers to providing nutrition counseling by physicians: A survey of primary care practitioners.
        Prev Med. 1995; 24: 546-552
        • Hark L.A.
        • Deen D.D.
        • Morrison M.
        Learner-directed nutrition content for medical schools to meet LCME standards.
        J Biomed Educ. 2015; (Article ID 469351:12)
      15. US Medical Licensing Examination. USLME content outline. Accessed March 26, 2017.

        • Hark L.A.
        • Iwamoto C.
        • Melnick D.E.
        • et al.
        Nutrition coverage on medical licensing examinations in the United States.
        Am J Clin Nutr. 1997; 65: 568-571
        • Levine B.S.
        • Wigren M.M.
        • Chapman D.S.
        • Kerner J.F.
        • Bergman R.L.
        • Rivlin R.S.
        A national survey of attitudes and practices of primary-care physicians relating to nutrition: Strategies for enhancing the use of clinical nutrition in medical practice.
        Am J Clin Nutr. 1993; 57: 115-119
        • Lenders C.M.
        • Deen D.D.
        • Bistrian B.
        • et al.
        Residency and specialties training in nutrition: A call for action.
        Am J Clin Nutr. 2014; 99: 1174S-1183S
      16. American Board of Medical Specialties. Steps toward initial certification and MOC. Accessed March 26, 2017.

      17. Association of American Medical Colleges. The core entrustable professional activities for entering residency. Accessed March 26, 2017.

      18. Interprofessional Education Collaborative. Core competencies for interprofessional collaborative practice: Report of an expert panel. National Network of Libraries of Medicine website. Published May 2011. Accessed March 26, 2017.

        • Blue A.V.
        • Mitcham M.
        • Smith T.
        • Raymond J.
        • Greenberg R.
        Changing the future of health professions: Embedding inter-professional education within an academic health center.
        Acad Med. 2010; 85: 1290-1295
        • Edwards M.S.
        • Rosenfeld G.C.
        A problem-based learning approach to incorporating nutrition into the medical curriculum.
        Med Educ Online. 2006; 11: 4611
        • Sacks F.M.
        • Svetkey L.P.
        • Vollmer W.M.
        • et al.
        Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group.
        N Eng J Med. 2001; 344: 3-10
        • Rees K.
        • Hartley L.
        • Flowers N.
        • et al.
        “Mediterranean” dietary pattern for the primary prevention of cardiovascular disease.
        Cochrane Database Syst Rev. 2013; 8: CD009825
        • Blumenthal J.A.
        • Babyak M.A.
        • Hinderliter A.
        • et al.
        Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: The ENCORE study.
        Arch Intern Med. 2010; 170: 126-135
        • Walsh C.O.
        • Ziniel S.I.
        • Delichatsios H.K.
        • Ludwig D.S.
        Nutrition attitudes and knowledge in medical students after completion of an integrated nutrition curriculum compared to a dedicated nutrition curriculum: A quasi-experimental study.
        BMC Med Educ. 2011; 11: 58
        • Institute of Medicine
        Accelerating Progress in Obesity Prevention.
        National Academies Press, Washington, DC2012
        • DiMaria-Ghalili R.A.
        • Mirtallo J.M.
        • Tobin B.W.
        • Hark L.A.
        • Van Horn L.
        • Palmer C.A.
        Challenges and opportunities for nutrition education and training in the health care professions: Intraprofessional and inter-professional call to action.
        Am J Clin Nutr. 2014; 99: 1184S-1193S
        • Eliot K.A.
        • Kolasa K.M.
        The value in interprofessional, collaborative-ready nutrition and dietetics practitioners.
        J Acad Nutr Diet. 2015; 115: 1578-1588
        • Kolasa K.M.
        • Rickett K.
        Barriers to providing nutrition counseling cited by physicians: A survey of primary care practitioners.
        Nutr Clin Pract. 2010; 25: 502-509
        • Hark L.A.
        • Delisser D.H.
        Achieving Cultural Competency: A Case-Based Approach.
        Wiley-Blackwell Publishing, Malden, MA2009
        • James D.C.
        Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: Application of a culturally sensitive model.
        Ethn Health. 2004; 9: 349-367
        • Hark L.A.
        • Deen D.D.
        The Nurse Practitioner’s Guide to Nutrition.
        Wiley-Blackwell Publishing, Malden, MA2012
        • Kris-Etherton P.M.
        • Akabas S.R.
        • Bales C.W.
        • et al.
        The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness.
        Am J Clin Nutr. 2014; 99: 1153S-1166S