January 29, 2026. By Sally Kuehn.

As a Duke medical student, I have learned plenty about food-related pathologies. For instance, I know that fava beans can trigger hemolytic anemia in patients with G6PD deficiency. I learned about the risk of infant botulism associated with feeding honey to young children. I’ve sworn off reheated rice in fear of a dreaded B. cereus infection. And yet, I didn’t have one lecture or even one test question dedicated to the DASH diet for hypertension, which affects nearly half of U.S adults. The idea of “food as medicine” dates back to ancient Greece, but thousands of years later, nutrition remains sorely lacking from undergraduate medical education (UME).

 It’s time for medical education to embrace a more holistic idea of health, with nutrition as a core tenet. As the prevalence of chronic disease continues to rise, clinicians must be prepared not only to provide basic dietary counseling, but also to partner with patients to help them make healthy food choices that align with their culture and budget. These are skills that—like any other—take time to refine, and they ought to be integrated into medical school curricula before residents set foot into the hospital.

Equipping future generations of doctors with nutrition expertise is more important now than ever before. Amid the 2025 government shutdown, which threatened to leave millions of Americans hungry this holiday season, the Supplemental Nutrition Assistance Program (SNAP) garnered significant media attention. What received less attention, however, was a branch of SNAP called SNAP-Ed, a program that was quietly dismantled earlier this year. Designed to provide nutritional counseling to low-income families, SNAP-Ed was defunded by President Trump’s federal budget changes, forcing school systems, health departments, and food banks to rethink how they deliver nutrition education. In this ever-evolving political landscape, physicians will be increasingly called upon to fill in the gaps that programs like SNAP-Ed left behind.

So where does medical education currently fall short? An AAMC survey of 182 MD- and DO-granting schools across the U.S and Canada found that 100% of respondents cover nutrition content in some form throughout their required curricula. However, while nearly all schools covered “micronutrients and macronutrients,” a significant proportion of schools failed to cover other key concepts and competencies. For instance, only 136 of the surveyed schools cover “interprofessional collaboration in nutrition care (e.g, dietician).” Even fewer cover “evidence-based, culturally sensitive, dietary guidelines for patients and populations” or “community resources (e.g, emergency food provision, meal delivery services.” Notably, a 2024 Delphi study concluded that each of these competencies should be taught and tested at the UME level, achieving at least 70% consensus by the expert panelists of residency program directors and subject matter experts.

From my experience as an Albert Schweitzer Fellow delivering nutritious food to families in my community, I have seen that the patients who need us most benefit not from lectures on macronutrient pathways, but from practical, culturally-grounded support they can actually use. To meet that need, medical education must evolve from memorizing mechanisms to preparing future clinicians to guide patients through the realities of identifying and accessing healthy food. Through curricular changes and innovations, we can start to build a healthcare system where “food as medicine” is not a slogan, but a standard of care, and where physicians can discuss healthy eating just as confidently as they can discuss the steps of glycolysis.

Sally Kuehn

2025-26 NC Schweitzer Fellow

Duke School of Medicine, Class of 2026

The views expressed are those of the author and do not reflect the official stance of the Fellowship or Duke University.