The Manifesto for the Implementation of Nutrition Education was agreed after a recent survey by ESPEN (Cuerda et al, Clin Nutr) found that there is an extreme variability in the educational standards of nutrition in medical schools worldwide.
The recently published ESPEN position paper has identified the “minimum curriculum knowledge” in nutrition that serves to improve the training of the future doctors including basic nutrition, applied or public health nutrition and clinical nutrition.
This has been transferred into the Manifesto which was issued and signed by the 51 participants, including delegates of 13 European Medical Schools, representing 34 countries.
Professor Rocco Barazzoni, ESPEN Chairman, points out that more than 2 billion adults are overweight, 600 million obese and 462 million malnourished globally, contributing to 60% of cardiovascular death and 35% of tumor death.
But he adds that even less known is that 35% of hospitalised patients develop disease-related malnutrition.
“Weight loss in chronic, oncological, elderly and frail patients is an underestimated and under-diagnosed problem," he says.
"Loss of weight and muscle mass leads to a higher rate of complications, worse response to therapies, higher mortality and increase in healthcare expenditures. This occurs in spite of the well documented positive and cost-effective impact of nutritional therapy on treatment side effects and disease outcomes."
Professor Maurizio Muscaritoli, co-ordinator of the NEMS (Nutrition Education in Medical Schools) initiative, adds: "Implementing training is urgent. Learning nutrition is mandatory for future doctors. Seeking political support, forming ad hoc committees for the development of curricula and teaching modalities are among the key factors to allow for the implementation of nutrition training in universities.
"Nutrition education in undergraduate medical schools is heterogeneous and largely under-powered. Teachers and students believe that the time dedicated to nutrition teaching is insufficient and far from what would be needed”.
The NEMS manifesto says that the nutritional field is often dominated by confusion: researchers, clinicians, patients and media have inconsistent ideas related to nutritional issues in health and disease.
It states: "The complexity of the matter and the apparent confusion, however, should not represent an obstacle in acknowledging the relevance of nutrition in both preventive and clinical medicine.
“While research has clearly documented that nutrition can positively impact on disease onset, prognosis, treatment side effects and outcomes, there is a great neglect regarding the prevention, diagnosis and treatment of malnutrition (including over- and under-nutrition) and low priority is currently given to nutritional activities by other disciplines in the competition for healthcare budget.
“The training of healthcare professionals (HCPs), and in particular of medical doctors, becomes crucial both for a correct take-up of the problem and for effectively combating the confounding environment that prevails in the domains of human nutrition. Currently, clinical nutrition education in undergraduate medical schools is heterogeneous and largely under-powered.
“Medical students are trained to consider the scientific evidence for pharmaceutical decision-making and clinical guidelines promoted by scientific institutions in specialties such as cardiology or surgery, while the evidence for nutritional interventions and the guidelines in clinical nutrition are often under-evaluated.”