Medical Science Educator

, Volume 29, Issue 1, pp 71–77 | Cite as

Nutrition as Medicine, Food Sensitivities, and Chronic Disease: a Mini Curriculum Shaped by Transformative Learning Theory

  • Andrew J. Yanik
  • Douglas McHughEmail author
Short Communication


Nutrition-related diseases are preventable twenty-first-century health problems. Students report being underprepared for nutritional therapeutics. We developed a mini, spiral curriculum shaped by transformative learning theory and centered on nutrition as medicine, food sensitivities, and chronic disease to kick-start a shift in cognition, attitudes, and skills. Seven demographically representative students participated in the 3-week curriculum. Visual, textual, and verbal data were captured and analyzed qualitatively. We found the curriculum evoked paradigm transformation that persisted 6 months later and facilitated opportunities for our cohort to self-identify learning gaps and consider how they related to their current and future goals for patient care.


Chronic disease Food sensitivities Intestinal permeability Lifestyle medicine Nutrition Medical students 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Aff. 2009;28:w822–31.CrossRefGoogle Scholar
  2. 2.
    Centers for Disease Control and Prevention. Death and mortality. 2018 Accessed 15 Feb 2018.
  3. 3.
    Levine BS, Wigren MM, Chapman DS, Kerner JF, Bergman RL, Rivlin RS. A national survey of attitudes and practices of primary-care physicians relating to nutrition: strategies for enhancing the use of clinical nutrition in medical practice. Am J Clin Nutr 1993;57:115–119.Google Scholar
  4. 4.
    Kushner RF. Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners. Prev Med. 1995;24:546–52.CrossRefGoogle Scholar
  5. 5.
    Flynn M, Sciamanna C, Vigilante K. Inadequate physician knowledge of the effects of diet on blood lipids and lipoproteins. Nutr J. 2003;2:article 19.CrossRefGoogle Scholar
  6. 6.
    Darer JD, Hwang W, Pham HH, Bass EB, Anderson G. More training needed in chronic care: a survey of U.S. physicians. Acad Med. 2004;79:541–8.CrossRefGoogle Scholar
  7. 7.
    Vetter ML, Herring SJ, Sood M, Shah NR, Kalet AL. What do resident physicians know about nutrition? An evaluation of attitudes, self-perceived proficiency and knowledge. J Am Coll Nutr. 2008;27:287–98.CrossRefGoogle Scholar
  8. 8.
    Taren DL, Thomson CA, Koff NA, Gordon PR, Marian MJ, Fulginiti JV, et al. Effect of an integrated nutrition curriculum on medical education, student clinical performance, and student perception of medical-nutrition training. Am J Clin Nutr. 2001;73:1107–12.CrossRefGoogle Scholar
  9. 9.
    Adams KM, Lindell KC, Kohlmeier M, Zeisel SH. Status of nutrition education in medical schools. Am J Clin Nutr. 2006;83:941S–4S.CrossRefGoogle Scholar
  10. 10.
    Adams KM, Kohlmeier M, Zeisel SH. Nutrition education in U.S. medical schools: latest update of a national survey. Acad Med. 2010;85:1537–42.CrossRefGoogle Scholar
  11. 11.
    Sacks GS. The shrinking of formalized nutrition education in health professions curricula and postgraduate training. J Parenter Enter Nutr. 2017;41:217–25.CrossRefGoogle Scholar
  12. 12.
    Nuno NB, Heuberger R. Nutrigenomic associations with cardiovascular disease. Rev Cardiovasc Med. 2014;15:217–25.Google Scholar
  13. 13.
    Sales NMR, Pelegrini PB, Goersch MC. Nutrigenomics: definitions and advances of this new science. J Nutr Metab. 2014;2014:1–6. Scholar
  14. 14.
    Rauschert S, Uhl O, Koletzko B, Hellmuth C. Metabolomic biomarkers for obesity in humans: a short review. Ann Nutr Metab. 2014;64:314–24.CrossRefGoogle Scholar
  15. 15.
    Viennois E, Baker MT, Xiao B, Wang L, Laroui H, Merlin D. Longitudinal study of circulating protein biomarkers in inflammatory bowel disease. J Proteome. 2015;112:166–79.CrossRefGoogle Scholar
  16. 16.
    Harden RM, Stamper N. What is a spiral curriculum? Med Teach. 1999;21:141–3.CrossRefGoogle Scholar
  17. 17.
    McGonigal K. Teaching for transformation: from learning theory to teaching strategies. Center for Teaching and Learning: Stanford University. 2005. Accessed 6 Jul 2018.
  18. 18.
    Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res. 1999;34:1189–208.Google Scholar
  19. 19.
    Anderson LW, Krathwohl DR, Airasian PW, Cruikshank KA, Mayer RE, Pintrich PR, Raths J, Wittrock MC. A taxonomy for learning, teaching, and assessing: a revision of Bloom’s taxonomy of educational objectives. New York: Longman; 2001.Google Scholar
  20. 20.
    Gulmans, J. Mapping for the constructivistic acquisition of concepts? In Kommers P. Cognitive support for learning. Amsterdam: IOS Press; 2004. pp. 31–45.Google Scholar
  21. 21.
    Nesbit JC, Adesope OO. Concept maps for learning. Learning through visual displays, Charlotte: Information Age Publishing; 2013. pp. 303–328.Google Scholar
  22. 22.
    Mu Q, Kirby J, Reilly CM, Luo XM. Leaky gut as a danger signal for autoimmune diseases. Front Immunol. 2017;8:598.CrossRefGoogle Scholar
  23. 23.
    Fasano A, Shea-Donohue T. Mechanisms of disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nat Clin Pract Gastroenterol Hepatol. 2015;2:416–22.CrossRefGoogle Scholar
  24. 24.
    Fasano A. Zonulin, regulation of tight junctions, and autoimmune diseases. Ann N Y Acad Sci. 2012;1258:25–33.CrossRefGoogle Scholar

Copyright information

© International Association of Medical Science Educators 2019

Authors and Affiliations

  1. 1.Department of Medical Sciences, Frank H. Netter MD School of MedicineQuinnipiac UniversityNorth HavenUSA

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