Nutrition Education Lacking Among Cardiologists

Many cardiovascular specialists do not receive adequate training or education regarding nutrition in patients, according to a study from the ACC’s Lifestyle and Nutrition Work Group published May 25 in The American Journal of Medicine.

Stephen Devries, MD, FACC, et al., developed and distributed surveys to cardiologists, Fellows in Training (FIT) and cardiovascular team members who were asked about their personal dietary habits, history of nutrition education and attitudes regarding nutrition interventions. A total of 930 surveys (4.5 percent) were completed.

Overall, 31 percent of cardiologists and 21 percent of FITs did not recall receiving any nutrition education during medical school, while 21 percent of cardiologists and 39 percent of FITs received more extensive nutrition education, consisting of a series of lectures. Additionally, 59 percent of cardiologists did not recall receiving any nutrition lectures, nine percent recalled only a single lecture, and six percent reported receiving a series of nutrition lectures during internal medicine residency training. Ninety percent of cardiologists reported receiving no or minimal nutrition education during fellowship training (57 percent and 33 percent, respectively). Only eight percent felt they had a “solid nutrition education” that they considered “adequate” and one percent reported a “high level of nutrition education that gave me excellent skills for counseling patients.” Following cardiovascular fellowship training, 56 percent of cardiologists described receiving no formal education in nutrition. Cardiologists who ate more servings of fruits and vegetables were more likely to feel that their role included provided patients with dietary information.

During an average patient appointment, four percent of cardiologists reported not discussing nutrition, 18 percent reported spending one minute or less on nutrition, 40 percent spent two to three minutes per visit, 25 percent estimated five minutes per visit, eight percent reported 10 minutes per visit and four percent spent 15 minutes or more. Female cardiologists spent more time on nutrition counseling than male cardiologists.

While the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults emphasizes the importance of a healthy diet, Devries and colleagues write these findings show that cardiologists may not be effectively implementing them.

“The current report, while highlighting deficiencies in nutrition education and practice, can also be viewed as spotlighting tremendous opportunities to improve cardiovascular care,” the authors write. “The urgency to act quickly is brought to light by the recent plateau in the previous declining trend in cardiovascular mortality – fueled largely by substantial increases in the prevalence of obesity and diabetes. It is hoped that the survey presented in this report will serve as a call to action for much greater emphasis on nutrition in the training and practice of cardiovascular specialists, and serve as a template for similar engagement in a wide range of lifestyle interventions.” 

Clinical Topics: Dyslipidemia, Lipid Metabolism, Nonstatins

Keywords: Attitude, Cardiovascular Diseases, Cholesterol, Counseling, Diabetes Mellitus, Feeding Behavior, Fellowships and Scholarships, Fruit, Internal Medicine, Internship and Residency, Life Style, Obesity, Risk Factors, Schools, Medical, Specialization

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