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UW School of Medicine and Public Health Ready for a Food Fight

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MADISON – When you go to medical school in America's Dairyland – home of brats, fries and cheese curds – you're going to have to learn how to deal with obesity.

But students coming out of the University of Wisconsin School of Medicine and Public Health (SMPH) are well-nourished for the fight.

That's because the school has made nutrition education more than just another class in the med-school curriculum. Here, learning about nutrition starts early - and gets personal.

"Research tells us that students who are aware of their own nutrition and adopt healthy eating habits will be the most likely to talk to their future patients about it," says Gail Underbakke, a registered dietitian with UW Hospital and Clinics.

Nutrition education is integrated into every year of medical training, from first-year students to practicing physicians.

Underbakke introduces the topic in a first-semester course called "Patient, Doctor and Society," where, among other things, students learn how to communicate with patients. Patrick McBride, MD, associate dean of students and a family physician specializing in preventive cardiology, discusses nutrition in first- and second-year basic science courses. He goes out of his way to illustrate how relevant the science is to clinical situations students can expect when they begin seeing patients.

"Diet is key to preventing and treating some of the most common - and devastating - ailments in the Western world, including diabetes, heart disease, kidney disease and gastrointestinal disorders," says McBride.

And, of course, overweight and obesity rates in American children have tripled in the past 25 years.

But it isn't just classroom time. Medical students are served a hot buffet-style lunch that meets all the national nutrition guidelines and demonstrates a healthy eating plan.

"We want students to see that healthy food can be very tasty," says Underbakke.

But students also learn that they can make unhealthy choices - three bran muffins or double portions of chicken - even when healthy food is presented.

Other instructional approaches round out the message:

Students log food they've eaten in the previous two days and enter the information into a computer program that tells them how closely their selections match the national food pyramid.
Students examine their eating habits through the eyes of a person who may have diabetes or high cholesterol, to see what they might need to alter to follow nutrition recommendations for these conditions.
By the time they finish their four years, they have studied the biochemistry of nutrition and learned how to scientifically evaluate confusing claims about nutrition.

Perhaps most important, students are prepared to be doctors who get involved in community efforts that promote healthy eating.

The SMPH's recent transformation into a school that combines medicine and public health has added a new dimension to nutrition study: looking at the impact of nutritional choices on groups of people - including different subsets of the population - and infusing a prevention perspective.

"The obesity epidemic is really a population health issue; it will not be solved by clinicians alone," he says. "Our country and the developing world as a whole will have to make some serious decisions about this. Most of the important health care issues that affect our globe are related to either under- or over-nutrition."

Several years ago, McBride and Underbakke received a National Institutes of Health grant to develop a nutrition curriculum that's relevant to the youngest medical student and the most mature health care practitioner alike.

And McBride most recently served as chair of the American Association of Medical Colleges (AAMC) committee that drafted curriculum guidelines for teaching students about overweight and obesity. All medical schools in the country are urged to use the new instructional guidelines.

Date Published: 04/30/2009