The Mismatch of Nutrition and Lifestyle Beliefs and Actions Among Physicians: A Wake-Up Call

Abstract

Background. There is a notable lack of education on nutrition and physical activity guidelines in medical schools and postgraduate training. The purpose of this study is to assess the nutrition and exercise knowledge and personal health behaviors of physicians in the Department of Medicine at a large academic center. Methods. We conducted a survey study in the Department of Medicine at the University of Florida in 2018. The survey instrument included questions on demographics, medical comorbidities, baseline perception of health and fitness, and knowledge of nutrition concepts. The Duke Activity Status Index assessed activity/functional capacity and the validated 14-point Mediterranean Diet Survey evaluated dietary preferences. Data were analyzed using descriptive statistics and the χ2 test was used to perform comparisons between groups. Statistical significance was determined at P < .05. Results. Out of 331 eligible physicians, 303 (92%) participated in the study. While all respondents agreed that eating well is important for health, less than a fourth followed facets of a plant-based Mediterranean diet. Only 25% correctly identified the American Heart Association recommended number of fruit and vegetable servings per day and fewer still (20%) were aware of the recommended daily added sugar limit for adults. Forty-six percent knew the American Heart Association physical activity recommendations and 52% reported more than 3 hours of personal weekly exercise. Reported fruit and vegetable consumption correlated with perceived level of importance of nutrition as well as nutrition knowledge. Forty percent of physicians (102/253) who considered nutrition at least somewhat important reported a minimum of 2 vegetable and 3 fruit servings per day, compared with 7% (3/44) of those who considered nutrition less important (“neutral,” “not important,” or “important, but I don’t have the time to focus on it right now”; P < .0001). Conclusions. This study highlights the need for significant improvement in education of physicians about nutrition and physical activity and need for physicians to focus on good personal health behaviors, which may potentially improve with better education.

Nutrition, a Tenet of Lifestyle Medicine but Not Medicine?

“…Is it okay that no clinician thought to help this patient through dietary and lifestyle changes (directly or indirectly by referring them to an RD)? Dr. Barnard and I would both argue that this is no longer acceptable even though the majority of clinicians report poor or no nutrition training [ 6 , 8 , 13 , 14 ]—61% in one survey of internal medicine residents [ 15 ]. A multinational systematic review of qualitative and quantitative studies concluded that nutrition is poorly incorporated into medical education at best no matter the location or student seniority despite student desire for nutrition education [ 16 ].…”

“…Further, the literature shows that the understandings health care providers have currently may be inaccurate. In a 2018 survey of University of Florida physicians (92%), only 25% knew the American Heart Association recommendation for vegetable and fruit intake while 46% knew the recommendation for physical activity [ 14 ]. While neither statistic is comforting, the meager 1 in 4 practicing physicians with such fundamental nutrition knowledge is alarming.…”

“…While neither statistic is comforting, the meager 1 in 4 practicing physicians with such fundamental nutrition knowledge is alarming. When getting into more detailed nutrition recommendations, the results were even less impressive: only 20% new the recommended daily limit for sugar [ 14 ].…”

The Health of Health Care Professionals

“…3 Similarly, physicians in multiple settings report agreement that eating well and being physically active are beneficial to personal health, but less than 25% reported actually engaging in these activities. 10 Finally, although smoking in health care settings has dramatically decreased since the 1970s, 25% of licensed practical nurses still smoke. 11 Often, nurses begin smoking prior to starting their job and, consistent with the general population, have trouble quitting.…”

Wellness Review 2020, Part 1

“…While healthcare providers are more engaged in healthy lifestyle behaviors compared to the general public, they lack the education and training in these areas. The authors call for improved medical education in the areas of nutrition and physical activity [8].…”