Healthcare professionals' role in nutritional care

Improving medical students’ dietary habits and their competency and self-efficacy in providing nutrition care through a nutrition education intervention in Ghana

medical students -nutrition education intervention in Ghana
Bright. Y. Amoore Department of Health Professions Education and Innovative Learning, School of Medicine, University for Development Studies, Tamale, Ghana
Patience K. Gaa Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
Victor Mogre Department of Health Professions Education and Innovative Learning, School of Medicine, University for Development Studies, Tamale, Ghana

Doctors play a crucial role in the healthcare system, acting as primary sources of referrals and being widely trusted for nutrition advice. Previous research suggests that doctors following healthy dietary habits are more likely to provide nutrition care to their patients. Thus, this study aimed to assess the impact of a nutrition education intervention on the dietary habits, competencies and self-efficacity of Ghanaian medical students. This intervention led to improved nutrition care knowledge, self-efficacy in providing nutrition care, increased consumption of vegetables, enhanced dietary diversity, and greater engagement in moderate-to-vigorous physical activity among medical students.

Nutrition is a cost-effective strategy for preventing and managing chronic diseases. Malnutrition in all of its forms is a leading global cause of poor health outcomes, with nutrition-related issues accounting for a significant portion of primary healthcare visits (nearly 25%) (Swinburn et al., 2019, Keaver et al., 2018). Healthy dietary and lifestyle choices have been proven to reduce the incidence of chronic diseases. While doctors acknowledge the importance of nutrition care and can effectively influence patients’ behavior, they often lack the necessary competencies due to inadequate nutrition training and education. Nutrition education is often insufficiently integrated into medical school curriculum, resulting in under-trained doctors and medical students who lack the skills to deliver nutritional advice (Hark et al., 2015).

Various interventions have been implemented in developed countries to enhance nutrition education for medical professionals (Rothman et al., 2020). However, in regions like Ghana and other African countries, similar challenges exist with inadequate nutrition education and provision of nutrition care (Mogre et al., 2018). Therefore, a recent study (Amoore et al., 2023). aims to evaluate the impact of a nutrition education intervention on Ghanaian medical students’ lifestyle habits, dietary diversity, nutrition care knowledge, attitude towards nutrition care, and their level of self-efficacy in the provision of nutrition care.

Medical students improved their vegetable consumption and moderate-to-vigorous physical activity after intervention

Medical students participating in this study showed significant improvements in vegetables consumption. In fact, the average number of days per week during which participants consumed vegetables increased significantly from 2.36 days at baseline to 3.16 days after the intervention. Although it decreased to 2.69 days four weeks after the intervention, it remained higher than the baseline results.

Participants also demonstrated significant improvements in moderate-to-vigorous physical activity at both post-intervention and four-week follow-up. The mean number of days per week in which participants engaged in moderate-to-vigorous physical activity for at least 30 minutes increased significantly from 1.77 days to 2.40 days after the intervention. However, four weeks later, it has slightly decreased to 2.14 days. These results are in accordance with the findings of other similar study (Tavolacci et al., 2018).

Additionally, this 5-week intervention positively impacted the dietary diversity scores of the medical students, indicating that their diets became more varied following the intervention. These results are consistent with previous research that reported significant improvements in dietary behaviors, such as increased fruit consumption, greater preference for homemade meals among restaurant and pre-prepared meals, reduced consumption of fatty foods and processed meat, and increased intake of wholegrain foods, following nutrition education interventions.

Improved nutrition care knowledge and self-efficacity to provide nutrition care after intervention

Nutrition care knowledge scores increased significantly by 3.27 points, from 19.49 at baseline to 24.78 post-intervention and 22.76 at the four-week follow-up. This outcome is consistent with a similar work (Bertz et al., 2015) reporting a significant improvement in knowledge immediately and 1 month after an interactive nutrition education session among a sample of US seniors’ medical students .

Mean levels of self-efficacy in providing nutrition care significantly improved by 1.73 at both post-intervention and four-week follow-up, compared to baseline. This increase implies that the intervention enhanced students’ ability, confidence, and awareness to provide nutrition care.

Furthermore, the improved self-efficacy score demonstrates the intervention’s potential to equip participants for future nutrition care in their medical practice, given that this self-efficacy level persists throughout their medical training. This can be achieved by integrating continued nutrition education opportunities into the curriculum. There is evidence that student’s familiarity with evidence-based nutrition interventions and understanding of the role of interprofessional engagement further amplify their efficacy in addressing lifestyle-related illnesses (Magallanes et al., 2021).

A 5-week intervention nutrition education is effective in pre-clinical year, yet further research is needed in clinical years

A five-week nutrition education intervention effectively enhances medical students’ readiness for future nutrition care. Improvements in knowledge, attitude, self-efficacy, lifestyle, and dietary habits highlight the intervention’s efficacy (students’ confidence, awareness, and ability to provide nutrition care and promote healthy habits). Thus, as already mentioned, integrating nutrition education modules into the university curriculum of medical students is essential for improving preventive nutrition skills.

Notably, this study focuses on pre-clinical year students and excludes those in clinical years, a critical phase with potential unhealthy habits due to workload and stress. These factors can impact attitudes and preparedness for providing nutrition care. Consequently, future research should encompass clinical year students to comprehensively understand and compare the effects of nutrition education. Such expansion would contribute valuable insights into enhancing students’ nutrition care capabilities.

Based on: Amoore BY, et al. Nutrition education intervention improves medical students’ dietary habits and their competency and self-efficacy in providing nutrition care: A pre, post and follow-up quasi-experimental study. Front Nutr. 2023 Mar 2;10:1063316. 

Key messages
  • Medical doctors are trusted actors when it comes to answering patients’ questions about nutrition and helping them to adopt healthier eating habits.
  • Interventions in nutrition education among medical student are efficient, improving their lifestyle habits (physical activity and dietary habits), competencies and self-efficacity to deliver nutritional advice.
  • Integrating nutrition education modules into the university curriculum of medical students is essential to improve preventive nutrition skills.
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