Frontiers in the Nutrition Sciences Proceedings of a Symposium (1989) / Chapter Skim
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Nutrition in Medicine: What Is Its Place?
Nutrition in Medicine: What Is Its Place?
Pages 191-204
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From page 191... ...
With the closure of the field of active identification and isolation of the major vitamins, many people thought that nutritional problems had come to an end and that the scientific basis for nutrition could be taught to physicians through courses in biochemistry and physiology. Scientific and clinical developments in the last quarter century, however, have shown that there are still many unsolved nutritional problems with important clinical implications that need to be included in the curriculum.
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From page 192... ...
Senate Select Committee on Nutrition and Human Needs (1977) published Dietary Goals for the United States.
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From page 193... ...
Although blood transfusions were well established by World War II, the use of other intravenous fluids was limited to volume expanders and isotonic solutions. During the past quarter century, the development of improved catheters, the ability to place such catheters in the major veins, and the potential for long-term maintenance of energy and nutritional needs have added a new dimension to the importance of nutrition education and clinical care for physicians.
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From page 194... ...
The American Medical Association (AMA) and the Nutrition Foundation sponsored a 1962 conference on the teaching of nutrition in medical schools, after an AMA survey found that "medical education and medical practice have not kept abreast of the tremendous advances in nutritional knowledge" and "there is-inadequate recognition, support, and attention given to this subject in medical schools." The quality of the nutritional curriculum in medical schools was reevaluated 10 years later.
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From page 195... ...
Medical- Schools by a Food and Nutrition Board Committee (National Research Council, Committee on Nutrition in Medical Education, 1985~. In 1979, 24% of medical schools had a nutrition course identified~as such; this value increased to only 27% in 1983.
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From page 196... ...
However, the relationship of nutrition to the immune system, renal disease, cancer, the central nervous system, and various phases of the life cycle was taught in less than 60% and in some cases as little as 30% of the medical schools (National Research Council, Committee on Nutrition in Medical Education, 1985~. While some nutrition appears to be taught in more than half of the medical schools, strengthening of the nutrition curriculum is necessary.
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From page 197... ...
, in a paper with the catchy title The Skeleton in the Hospital Closet, n pointed out that as many as three-fourths of the patients with normal nutritional status at the time of admission to the hospital were found to have an abnormal 197
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From page 198... ...
The realization that malnutrition could occur in a substantial number of patients in American hospitals and the development of techniques for delivering nutritional support to medical and surgical-patients by enteral and parenteral methods led to the expansion of postgraduate training programs in clinical nutrition. Data from the University of Pennsylvania Hospital showed that the number of patients receiving nutritional support in 1979-1980 totaled 13,749 patient-days, a figure that nearly doubled to 23,245 patient-days by 1983-1984 (American Society for Clinical Nutrition, Committee on Education and Training, Subcommittee on Postdoctoral Training, 1986~.
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From page 199... ...
In the most recent survey published in 1987 (Merritt et al., 1987) , there appears to have been very little further growth in the number of clinical nutrition training programs available at medical schools at the postgraduate level.
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From page 200... ...
· Postgraduate training programs for physicians interested in clinical nutrition should become more widely available to meet the geographic and educational needs of the entire nation. · Hospital malnutrition should be reduced by 50% by the year 2000 by implementing clinical nutrition teams, including a physician, in every hospital that receives Medicare funds.
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From page 201... ...
· Third-party providers of health care should require that those physicians and other support personnel delivering nutritional services meet minimum standards of training and that this be certified by an examination process. REFERENCES American Society for Clinical Nutrition.
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From page 202... ...
1983. A survey of physician clinical nutrition training programs in the United States.
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From page 203... ...
1972. Conference on Guidelines for Nutritional Education in Medical Schools and Postdoctoral Training Programs, June 25-27, 1972, Williamsburg, Va.
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