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      An Interprofessional Nutrition Education Session for Senior Medical Students on Evidence-Based Diet Patterns and Practical Nutrition Tips

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          Abstract

          Introduction

          Dietary factors are recognized as a major contributor to the global burden of disease, and the obesity epidemic continues to be a major public health problem. Patients rely on doctors for dietary advice and to serve as role models for health behaviors. However, nutrition content is significantly underrepresented in medical school curricula.

          Methods

          We created an interactive session to address this gap during the ambulatory medicine rotation for senior medical students and delivered it as a 90- to 120-minute interactive monthly didactic session. We focused on reviewing evidence-based diet patterns for weight loss and hypertension and on use of practical tools for diet assessment and counseling. Immediately and 1 month after delivery, we administered a knowledge and confidence assessment survey to evaluate the session impact.

          Results

          We incorporated the session into the regular didactic time of the clerkship. Sixty-six students attended over an 8-month period, of whom 42 completed the survey. Immediately and 1 month after delivery, participants reported statistically significant improvements ( p < .001) in their confidence in the domains measured. Participants' knowledge scores increased immediately and 1 month after the session compared to before participation.

          Discussion

          We delivered a single recurring seminar on diet patterns and practical tips that was well received by fourth-year medical students during the ambulatory medicine clerkship. The seminar was a practical and interactive way of delivering important nutrition content to the medical school curriculum, and we demonstrated retention of confidence and knowledge of the delivered content.

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          Most cited references8

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          Differences in Obesity Prevalence by Demographic Characteristics and Urbanization Level Among Adults in the United States, 2013-2016

          Question During 2013-2016, were there differences in the prevalence of obesity and severe obesity by demographics and urbanization level among US adults? Findings In this cross-sectional analysis that included 10 792 adults aged 20 years or older, differences were found in the prevalence of obesity and severe obesity by age group, race and Hispanic origin, and education level. The prevalence of obesity was significantly greater among women living in nonmetropolitan statistical areas (non-MSAs; 47.2%) compared with women living in large MSAs (38.1%), and the prevalence of severe obesity in non-MSAs was higher than in large MSAs among men (9.9% vs 4.1%, respectively) and women (13.5% vs 8.1%, respectively). Meaning Differences in age group, race and Hispanic origin, education level, or smoking status were not related to the differences in the prevalence of obesity and severe obesity by urbanization level. Importance Differences in obesity by sex, age group, race and Hispanic origin among US adults have been reported, but differences by urbanization level have been less studied. Objectives To provide estimates of obesity by demographic characteristics and urbanization level and to examine trends in obesity prevalence by urbanization level. Design, Setting, and Participants Serial cross-sectional analysis of measured height and weight among adults aged 20 years or older in the 2001-2016 National Health and Nutrition Examination Survey, a nationally representative survey of the civilian, noninstitutionalized US population. Exposures Sex, age group, race and Hispanic origin, education level, smoking status, and urbanization level as assessed by metropolitan statistical areas (MSAs; large: ≥1 million population). Main Outcomes and Measures Prevalence of obesity (body mass index [BMI] ≥30) and severe obesity (BMI ≥40) by subgroups in 2013-2016 and trends by urbanization level between 2001-2004 and 2013-2016. Results Complete data on weight, height, and urbanization level were available for 10 792 adults (mean age, 48 years; 51% female [weighted]). During 2013-2016, 38.9% (95% CI, 37.0% to 40.7%) of US adults had obesity and 7.6% (95% CI, 6.8% to 8.6%) had severe obesity. Men living in medium or small MSAs had a higher age-adjusted prevalence of obesity compared with men living in large MSAs (42.4% vs 31.8%, respectively; adjusted difference, 9.8 percentage points [95% CI, 5.1 to 14.5 percentage points]); however, the age-adjusted prevalence among men living in non-MSAs was not significantly different compared with men living in large MSAs (38.9% vs 31.8%, respectively; adjusted difference, 4.8 percentage points [95% CI, −2.9 to 12.6 percentage points]). The age-adjusted prevalence of obesity was higher among women living in medium or small MSAs compared with women living in large MSAs (42.5% vs 38.1%, respectively; adjusted difference, 4.3 percentage points [95% CI, 0.2 to 8.5 percentage points]) and among women living in non-MSAs compared with women living in large MSAs (47.2% vs 38.1%, respectively; adjusted difference, 4.7 percentage points [95% CI, 0.2 to 9.3 percentage points]). Similar patterns were seen for severe obesity except that the difference between men living in large MSAs compared with non-MSAs was significant. The age-adjusted prevalence of obesity and severe obesity also varied significantly by age group, race and Hispanic origin, and education level, and these patterns of variation were often different by sex. Between 2001-2004 and 2013-2016, the age-adjusted prevalence of obesity and severe obesity significantly increased among all adults at all urbanization levels. Conclusions and Relevance In this nationally representative survey of adults in the United States, the age-adjusted prevalence of obesity and severe obesity in 2013-2016 varied by level of urbanization, with significantly greater prevalence of obesity and severe obesity among adults living in nonmetropolitan statistical areas compared with adults living in large metropolitan statistical areas. This national survey study uses National Health and Nutrition Examination Survey data to examine trends in obesity and severe obesity among adults aged 20 years or older by age, sex, race, ethnicity, education level and urbanization level between 2001 and 2016.
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            Nutrition education in U.S. medical schools: latest update of a national survey.

            To quantify the number of required hours of nutrition education at U.S. medical schools and the types of courses in which the instruction was offered, and to compare these results with results from previous surveys. The authors distributed to all 127 accredited U.S. medical schools (that were matriculating students at the time of this study) a two-page online survey devised by the Nutrition in Medicine Project at the University of North Carolina at Chapel Hill. From August 2008 through July 2009, the authors asked their contacts, most of whom were nutrition educators, to report the nutrition contact hours that were required for their medical students and whether those actual hours of nutrition education occurred in a designated nutrition course, within another course, or during clinical rotations. Respondents from 109 (86%) of the targeted medical schools completed some part of the survey. Most schools (103/109) required some form of nutrition education. Of the 105 schools answering questions about courses and contact hours, only 26 (25%) required a dedicated nutrition course; in 2004, 32 (30%) of 106 schools did. Overall, medical students received 19.6 contact hours of nutrition instruction during their medical school careers (range: 0-70 hours); the average in 2004 was 22.3 hours. Only 28 (27%) of the 105 schools met the minimum 25 required hours set by the National Academy of Sciences; in 2004, 40 (38%) of 104 schools did so. The amount of nutrition education that medical students receive continues to be inadequate.
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              The state of US health, 1990-2016: Burden of diseases, injuries, and risk factors among US states

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                Author and article information

                Journal
                MedEdPORTAL
                MedEdPORTAL
                MEP
                MedEdPORTAL : the Journal of Teaching and Learning Resources
                Association of American Medical Colleges
                2374-8265
                2020
                07 February 2020
                : 16
                : 10876
                Affiliations
                [1 ]Assistant Professor, Department of Medicine, Boston University School of Medicine
                [2 ]Clinical Dietitian, Department of Pediatrics, Boston Medical Center
                [3 ]Postdoctoral Researcher, Department of Medicine, Boston University School of Medicine
                Author notes
                *Corresponding author: jonathan.berz@ 123456bmc.org
                Article
                10.15766/mep_2374-8265.10876
                7012311
                32051854
                8759eb50-252b-4462-a9a6-bb84f097a53d
                Copyright © 2020 Berz et al.

                This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial license.

                History
                : 02 April 2019
                : 14 September 2019
                Page count
                Tables: 2, References: 10, Pages: 5
                Categories
                Original Publication

                nutrition assessment,healthy diet,diet patterns,nutrition education,prevention,case-based learning

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