27 March 2018

Celia Laur, PhD(c)
RNutr (Public Health)

NNEdPro Global Innovation Panel Co-Lead

Dr Harrison Carter
Co-Lead of the Junior Doctor and Medical Student Representatives
NNEdPro Global Innovation Panel Member

and

Prof Sumantra Ray, RNutr (Public Health)
NNEdPro Founding Chair and Executive Director

Last summer, we (Harrison Carter and Celia Laur) had the pleasure of co-leading the 3rd Annual International Summit on Medical Nutrition Education and Research in Cambridge, UK.

For the past 3 years, NNEdPro1 has invited speakers and attendees from all over the world to discuss and share our passion for how we can work together to improve nutrition education for healthcare professionals (HCPs). Over this time, the message from the Summit has been clear and consistent – despite the growing complexities of the triple burden of malnutrition (overnutrition, undernutrition, and micronutrient deficiencies), there is woefully little nutrition in Medical/HCP curricula across the globe. However, consensus developed via the Summits has led to a more coordinated strategy through the development of an ‘International Knowledge Application Network in Nutrition 2025’ (I-KANN-25) in line with the United Nations Decade of Action on Nutrition 2016-25. After the Summit last summer, we took some time to reflect on why this area is so important, and wish to share some of our thinking.

Importance to patients and the public
Nutrition education for HCPs is important in improving standards of nutrition across all health and social care. There is increasing recognition of the adverse impact of malnutrition on mortality, morbidity, and quality of life, and the need for improved nutrition status and care in hospitals, care homes and the community. Identification of risk of malnutrition through screening and the provision of appropriate nutrition care that recognises individual patient needs can benefit outcome. We are also faced with the burden of non-communicable diseases such as obesity, cardiovascular disease, type 2 diabetes and some cancers where nutrition care (as well as other lifestyle issues) are so important in prevention and management.  Nutrition education for HCPs is therefore critically important in public health. Providing adequate and evidence-based nutrition support, messages, and resources to the public could clearly have a positive impact and we need to educate our healthcare professionals to meet this challenge.

Importance to the practitioner
People typically trust their doctors and other HCPs, and so they are ideally placed to provide evidence-based advice and support their patients. For nutrition, that can include recognizing that poor dietary habits or nutrition intake may be contributing to poorer health outcomes and that addressing these issues may be important for improving the individual’s health. We don’t expect all practitioners to be experts (in the UK we have Registered Dietitians and Registered Nutritionists for that!), but we do encourage all HCPs, particularly doctors, to have enough knowledge to know when dietary intake and nutrition status might be impacting an individual’s health or quality of life, and be able to give some top line advice or refer appropriately. Taking a holistic approach, treating a person rather than a chart or looking for a more all-round approach rather than focussing purely on pharmacological solutions to a symptom, is useful in addressing the nutritional needs of an individual.

Importance to the taxpayer
Moving away from the individual level, we also need to recognize that poor nutrition management has far-reaching economic consequences. These are devastating for a health service with limited resources such as the NHS. For example, it has been estimated that malnutrition costs the UK economy £13 billion annually. Therefore, even if a 1% reduction in the prevalence of hospital malnutrition may seem small, in reality it represents a large absolute saving. We also know that the estimated NHS in England spend on overweight and obesity-related ill-health was £6.1 billion in 2014 to 2015. Annual spend on the treatment of obesity and diabetes is greater than the amount spent on the police, the fire service and the judicial system combined.

To wrap up, we hope we’ve given you something to think about regarding the need to make sure that HCPs have evidence-based and practical nutrition knowledge and skills. Nutrition professionals are crucial, but they can’t do it alone. All HCPs should be aware of the importance of nutrition for their patients and the public. We need to continue to work together to make sure they are providing evidence-based and practical advice to their patients.

1The Need for Nutrition Education/Innovation Programme (NNEdPro) led by Professor Sumantra Ray aims to improve nutrition-related health outcomes by training professionals, strengthening research, implementing solutions and addressing inequalities, in line with the United Nations' Sustainable Development Goals and Decade of Action on Nutrition 2016-2025.