Reprinted from the summer 2018 issue of The Ohio Family Physician.
By: Anne Worth, DO, Riverside Methodist Hospital Family Medicine Residency
Nutrition in medical education tends to focus on treating chronic illnesses in adult medicine, such as hypertension, diabetes, or obesity. However, family physicians have the additional challenge of understanding childhood nutrition as well.
Recently, the Riverside Family Medicine Residency Program in Columbus, OH, piloted a pediatric nutrition curriculum to support nutrition education by focusing on infants and toddlers. Residents at this practice have a strong need to understand pediatric nutrition, with 15-20% of their appointments dedicated to providing care for children under the age of 10.
During many pediatric appointments, parental concerns focus on their child’s diet, including comments such as “My child is a picky eater,” or “I’m worried about feeding my child peanuts,” or “Is my baby old enough to eat solid foods?”
Despite the demand for physicians to provide counseling on childhood nutrition, medical training lacks sufficient education in this field, even in family medicine. One study of medical schools found that 71% of schools do not provide the recommended 25 hours of nutrition education.1
Residency programs do not fare much better, with an average of seven hours of nutrition education per year reported on a survey of family medicine residency programs.2 The curricular time dedicated to pediatric nutrition specifically was not explored in these studies, but likely this number would be even lower. “Medical school dedicates limited time to teaching pediatric nutrition, which can make it difficult as a new physician to deliver nutrition suggestions to parents with confidence,” said Ryan Brinn, MD, a first year resident in Columbus.
With a curriculum titled “Eat Your Peas and Prunes,” the class aims to improve patient nutrition practices by exposing residents to nutrition topics commonly encountered during the first three years of a child’s life. Physicians with a smaller percentage of children in their practice may also benefit from review of pediatric nutrition in order to better counsel their patients on age-appropriate nutrition recommendations.
Given the looming challenges of pediatric obesity and changing food landscapes, family physicians must be more ready than ever to address these problems. The American Academy of Family Physicians (AAFP) provides a recommended nutrition curriculum outline for family medicine residency programs, which includes knowledge of infant, childhood, and adolescent nutrition.6 This outline can serve as a useful starting place for residency programs seeking to improve their nutrition curricula.
The AAFP also provides live and online pediatric medicine courses, which include nutritional topics, so physicians out of residency training can access this education as well.7 The Choose MyPlate website provided by the U.S. Department of Agriculture serves as a useful resource for practicing physicians and parents alike.8 This website provides nutrition recommendations according to a child’s age, and includes printable food charts with suggested serving sizes and examples of positive food choices. Healthy eating can start with the first infant feed, as long as family physicians are equipped with the knowledge to support their youngest patients.
Article references are available on the OAFP website.