The link between what Americans eat and their state of health has long been hiding in plain sight. Diet-related chronic diseases, obesity, type 2 diabetes, cardiovascular disease, account for a staggering share of preventable illness and death in the United States. Yet the physicians tasked with treating these conditions have often graduated medical school with only a cursory understanding of nutrition.
That’s starting to change, driven by institutional rethinking, student advocacy, and a professional community that has decided the status quo is no longer acceptable.
In March, 53 medical schools across 31 states pledged to require at least 40 hours of comprehensive nutrition education, or its competency equivalent, before graduation, a commitment made in conjunction with a federal recognition event hosted by the U.S. Department of Health and Human Services (HHS).
The numbers underscoring the need are stark. An estimated 90% of the nation’s $4.5 trillion in annual healthcare spending goes toward managing chronic disease, according to the HHS, and poor nutrition is frequently at the core of those conditions. Approximately 60% of American adults live with at least one chronic disease and nearly 40% have two or more. Meanwhile, medical students have historically averaged fewer than two hours of nutrition education per year.
A Long-Overdue Reckoning
The Association of American Medical Colleges (AAMC) has been building toward this moment for years. Over the past decade, the AAMC has worked to catalyze what it calls a national shift toward integrated, competency-based nutrition education, convening stakeholders, generating data, and encouraging locally driven innovation across its member institutions.
In November 2025, it issued a formal call to action urging medical school deans and curriculum leaders to evaluate their current practices and identify opportunities to further weave nutrition into their programs. This spring, the AAMC hosted a national convening of medical educators, organized by the Teaching Kitchen Collaborative with participation from the National Board of Medical Examiners, to share effective strategies for teaching and assessing nutrition competencies.
“We’ve made significant progress over the past ten years, reflected in the dedication of our medical school deans and curriculum leaders across the country,” says David J. Skorton, MD, AAMC president and CEO. “Today is about recognizing the important work medical schools have already done and their commitment to further progress in the future.”
American Medical Association president Bobby Mukkamala, MD, offered a candid assessment of why medicine lagged so long. The body of knowledge required for a nutrition curriculum has grown enormously, from perhaps two volumes to ten.
His answer was to reconsider how specialty rotations are structured. If a student knows they want to be a pediatrician, there may be little value in a neurosurgical rotation, time that could be reclaimed for foundational topics like nutrition that affect every patient, regardless of specialty.
“So the question then is, how do we teach them that stuff and this stuff in a 4-year period?” he says. “This isn’t about turning doctors into dieticians. It’s about making sure that physicians feel confident having productive conversations with patients about nutrition, conversations that can truly change lives.”
Building Nutrition Into the Curriculum
The schools now stepping up aren’t starting from scratch, but many are substantially deepening what they offer. At the University of Miami Miller School of Medicine, the approach is deliberately longitudinal.
The school’s NextGenMD curriculum integrates 63.5 hours of nutrition education across all four years, embedded into cardiology, gastroenterology, and endocrinology lectures during the preclinical years, then extended into clinical clerkships where students practice nutritional counseling with standardized patients, and culminating in a culinary medicine elective with hands-on cooking sessions.
The initiative grew partly from the bottom up. Medical students at Miller launched nutrition education advocacy in 2023, and what began as a small push eventually became a 50-member interdisciplinary working group of students, physicians, dietitians, researchers, and educators.
“Diet and nutrition represent one of the strongest drivers of the cardiometabolic diseases that deeply affect our society and health care system,” says Akash Patel, a Miller School student who helped lead the curriculum integration effort. “As one of the key players in improving patient health, physicians have a huge opportunity to address many preventable and reversible diseases with an expanded understanding of the modifiable risk factors that influence our patients.”
Associate Dean for Curriculum Gauri Agarwal, MD, was careful to frame the overhaul not as piling more content onto an already crowded program but as a fundamental rethinking.
“This wasn’t about adding more content to an already packed curriculum,” says Agarwal. “It was about rethinking how nutrition fits naturally into clinical reasoning and informs diagnosis, treatment decisions, and conversations with patients in real clinical settings.”
Harvard’s Deep Roots, Recent Growth
Harvard Medical School (HMS) brings a particularly long history to the issue. In 1942, the school established the first nutrition department at any medical or public health school in the world. But like many institutions, HMS saw its nutrition emphasis ebb and flow over the following decades.
By 2007, curricular reforms that brought students to clinics earlier inadvertently reduced nutrition instruction from the equivalent of seven days to three. By 2015, the subject had been folded into other courses rather than standing on its own.
Since 2019, HMS has been working to reverse that drift. A nutrition and lifestyle curriculum theme was established, and changes have accumulated steadily, with new required courses, updated electives, quick-reference healthy eating sheets for first-year students, and most recently a Culinary Medicine and Nutrition elective launched in 2024 in which students prepare heart-healthy meals while studying the science behind dietary interventions.
“Good nutrition and healthy lifestyle habits are a cornerstone for managing pretty much every medical condition,” says Eliza Leone, a registered dietitian and instructor in the course.
HMS faculty have also taken a national leadership role in defining what nutrition competency should actually look like. Working with educators from nearly three dozen institutions, they published recommendations in JAMA Network Open in September 2024 outlining 36 nutritional competencies for medical school graduates, everything from providing evidence-based dietary guidance to communicating with patients in a compassionate and nonjudgmental way.
This spring, HMS is expected to formally adopt competencies based on those recommendations and integrate them across all four years of its MD programs.
What Comes Next
For medical schools like Indiana University School of Medicine and Geisinger Commonwealth School of Medicine, which have embedded nutrition into their curricula for years, the current moment offers a chance to compare notes and raise the bar collectively.
The AAMC’s spring convening was designed for exactly that, a forum where institutions could share what’s working and refine assessment methods for competency-based nutrition training.
The broader cultural moment is also shifting. “Food as medicine” has moved from wellness-world language into mainstream clinical discourse, carried by mounting evidence that ultra-processed foods high in sodium and added sugar are direct drivers of the chronic disease burden overwhelming the American healthcare system. The goal, as Miller School faculty framed it, extends well beyond contact hours or credit requirements.
“The physicians we train will see nutrition as a powerful, evidence-based tool they can use every day to improve patients’ lives,” says Agarwal.
Ultimately, the push is about more than curriculum hours. It’s about training a generation of doctors who are as comfortable talking about diet as they are reviewing a lab result.
