So, how many of you have had doctors discuss nutrition with you? How about your cardiologist? "No"...many of you answer. Well, that shouldn't be surprising according to a new survey of 930 cardiologists, cardiologists-in-training, and cardiovascular health professionals. Among practicing cardiologists, fully 90% reported that they received either no or minimal nutrition education during their cardiology training. And currently there is no requirement that nutrition needs to be taught in cardiology training. Most also reported that they spend less than 3 minutes discussing nutrition per appointment. What does that really mean? Is it just a few words like: lose weight, eat better, and eat less salt? That's not enough to be real nutrition advice.
Why is nutrition important? Among the top 17 risk factors, poor diet quality has been identified by the US Burden of Disease Collaborators as the leading cause of premature deaths and disability in the United States. Heart health is influenced by the diet. Many studies have shown that people following such healthy diets as the Mediterranean diet (with an emphasis on fruits, vegetables, whole grains, seeds, nuts, legumes, and olive oil) have a significantly lower incidence of heart disease and major cardiovascular events (especially strokes). One recent study (an analysis of other studies) linked eating 8 to 10 portions of fruits and vegetables daily with a lower risk of early death, cancer, heart disease, and stroke. From Medscape:
Hello. My name is Dr Stephen Devries and I'm a cardiologist and executive director of the nonprofit Gaples Institute for Integrative Cardiology. It's a pleasure to have an opportunity to share with you some interesting findings related to a new study I was involved in regarding nutrition education in cardiology. I'm sure you are aware that patients increasingly want to take more charge of their own health. In order to do so, they are asking their doctors more questions about nutrition. But how prepared are physicians to address those questions? Specifically, we asked: How prepared are cardiologists to deal with nutrition questions in their own practice?
In order to get at that question, my colleagues and I, members of the Nutrition Working Group of the American College of Cardiology, surveyed over 900 practicing cardiologists, cardiologists-in-training, and cardiovascular health professionals and asked them a wide range of questions relating to their experience with nutrition education, their attitudes about nutrition and practice, and a little bit about their own personal nutrition habits.
What did we find? Among practicing cardiologists, fully 90% reported that they received either no or minimal nutrition education during their cardiology training. When we inquired a bit about their attitudes regarding nutrition and practice, 95% of cardiologists reported that they believed it was their personal responsibility to deliver at least basic nutrition education to their patients. We were a bit surprised. We had wondered whether cardiologists felt that it was someone else's job to do; but no, they felt that it was their own personal responsibility to at least deliver basic diet counseling to their patients.
We then asked cardiologists about their own personal health habits and inquired about their personal intake of vegetables and fruit. We found that only 20% of practicing cardiologists reported eating a total of five or more servings of vegetables and fruit per day. That is an important finding, not only because it speaks to opportunities to improve cardiologists' own health, but also because there are data showing that physicians who adopt healthy lifestyle practices are more likely to counsel patients to do so as well.
Where do we go from here? It's paradoxical that nutrition and lifestyle are identified in many of our clinical care guidelines as the foundations of good cardiovascular care, yet how can our cardiologists implement those guidelines without receiving adequate nutrition training? Obviously, we need to address that problem by providing meaningful nutrition education in all phases of medical training, beginning in medical school through internal medicine residency, and extending into cardiovascular training itself. Currently there is no requirement that nutrition needs to be taught in cardiology training—and that needs to change. We also should include more nutrition content on board exams so that there will be additional motivation to teach nutrition to help pass the exam.