Your doctor probably had about 20 hours of nutrition training. Here’s what they don’t tell you:

The number that surprised me

In 2010, researchers at the University of North Carolina surveyed US medical schools about how much nutrition they actually teach.

The answer: about 19.6 hours. Across the entire medical degree.

Not per year. In total. Some schools reported none at all.

For context, a report from the National Academy of Sciences back in 1985 said doctors should get at least 25 hours of nutrition education, as a bare minimum. Twenty-five years later, only about a quarter of medical schools were meeting it.

The same team ran the survey again a few years later, and it hadn’t improved. About 7 in 10 schools still fell short of the 25-hour minimum, and more than a third taught less than half of it. On average, less than 5 hours were spent on nutrition in actual clinical practice, meaning how to talk to a real patient about food.

Think about that. A doctor will spend years learning anatomy, drugs, surgery and disease. And roughly the length of a single working week, spread across four years, learning about the thing you put into your body three times a day.

It isn’t just an American problem, either. Reviews of medical training around the world have found the same pattern: doctors leave medical school feeling unprepared to give nutrition advice, and many say so themselves.

How did this happen?

There’s no villain here. A few things combined.

1. Medical school is completely packed. There’s an enormous amount to learn, and every subject is fighting for time. Nutrition kept losing that fight to things that seemed more urgent.

2. Nutrition got seen as “soft.” Medicine is brilliant at things you can measure and treat directly: a drug that lowers a number, a surgery that fixes a problem. Food works slowly, over years, and the research is messy. That made it easy to treat as optional.

3. Doctors are trained to treat disease, not prevent it. Most of medical training is about what to do once someone is sick. Nutrition matters most long before that.

4. There’s no time in the appointment. Even a doctor who knows a lot about food often only gets 10 to 15 minutes with you. You can’t explain a new way of eating in that time, so “eat a balanced diet” becomes the shortcut.

5. The system doesn’t reward it. A doctor gets paid for tests, prescriptions and procedures. A 30-minute conversation about lentils doesn’t fit neatly into any of that.

So when your doctor says “eat a balanced diet,” it’s usually not a brush-off. It’s often the honest limit of what they were trained to say and what the appointment allows.

Here’s what’s finally changing (some of it right now)

This is the part that makes this email timely.

In 2025, the US health and education secretaries announced that 53 medical schools across 31 states had committed to at least 40 hours of nutrition education, starting with students who began this autumn, in 2026. That’s double the old average.

Texas and Louisiana went further and passed laws on nutrition education for doctors and other health professionals. In Texas, doctors will have to complete continuing education in nutrition and metabolic health to renew their licence, starting January 1st, 2027. Other states are following.

That’s genuinely good news. But do the maths: the doctors who start medical school this year won’t be treating patients for several years.

In the meantime, the doctor you see next month was probably trained the old way. So for now, a lot of this is on you.

What this means for you

Let me be really clear about what this does and doesn’t mean.

It does NOT mean:

• Your doctor is wrong about your health.

• You should ignore their advice, stop your medication, or “do your own research” instead of seeing them.

• Anyone on the internet who says they know better than doctors is right. (Often, they’re selling something.)

It DOES mean:

• When it comes to the details of what to eat, you may need to ask more specific questions.

• Some important food advice may never come up in a short appointment unless you bring it up.

• There are people who are fully trained in this, and you can ask to see one.

That last point matters a lot, so let’s start there.

The nutrition expert your doctor can refer you to

There’s a professional whose entire training is in food and health: a registered dietitian (sometimes written RD or RDN).

Dietitians study nutrition for years, do supervised clinical training, and are regulated. In many countries, “dietitian” is a protected title, so not just anyone can use it.

Compare that with “nutritionist,” which in many places (including the UK and parts of the US) isn’t a protected title. Some nutritionists are highly qualified. Others did a weekend course online. The title alone doesn’t tell you which.

So if you have a health condition linked to food, like diabetes, high cholesterol, kidney problems, digestive issues or a big weight change, ask your doctor: “Can you refer me to a registered dietitian?” In many health systems that referral is free or covered.

It’s one of the most useful questions you’ll ever ask, and most people never ask it.

6 things your doctor might not have time to tell you

These are all well-established, but they often don’t come up in a 10-minute appointment.

1. Prediabetes can often be reversed, and food beats the pill.
In the US, roughly 1 in 3 adults has prediabetes, and most of them don’t know it. In a major trial called the Diabetes Prevention Program, people with prediabetes who changed their diet and got more active cut their risk of developing type 2 diabetes by 58%. People given the diabetes drug metformin cut it by 31%. Lifestyle change worked almost twice as well. If your blood sugar or HbA1c is “borderline,” that’s not a “wait and see.” It’s your best window to act.

2. Your cholesterol has food levers.
The soluble fibre in oats, beans and barley helps lower LDL (“bad”) cholesterol. Swapping some butter, fatty meat and processed foods for olive oil, nuts and fish helps too. And if your triglycerides are high, alcohol and sugar are often the first things to look at. None of that replaces a statin if you need one, but it can make a real difference to the numbers.

3. Blood pressure can respond to food within weeks.
In the famous DASH trial, a diet rich in vegetables, fruit, beans, wholegrains and low-fat dairy lowered blood pressure noticeably within about two weeks. And here’s the part people miss: most of the salt you eat doesn’t come from your salt shaker. It comes from bread, ready meals, sauces, processed meat and restaurant food.

4. Some of your medications interact with food.
This is one of the most important and least discussed. A few common examples:

• Grapefruit can interact with some statins and blood pressure medications.

• Warfarin (a blood thinner) is affected by vitamin K, found in leafy greens. You don’t have to avoid greens, but you should eat a consistent amount.

• Metformin, taken long term, can lower your vitamin B12.

• Thyroid medication (levothyroxine) usually needs to be taken on an empty stomach, away from coffee, calcium and iron.

• Acid-reducing pills (like omeprazole), taken for years, can affect B12 and magnesium.

If you take any regular medication, ask your doctor or pharmacist: “Is there anything I should eat, avoid or time differently with this?” Pharmacists are brilliant at this, and they’re often easier to get hold of than a doctor.

5. After 40, protein and muscle matter more than you think.
We naturally lose muscle as we age, and losing too much affects strength, balance and metabolism. Getting enough protein, spread across your meals, plus some strength exercise, is one of the best things you can do to slow it. This matters even more if you’re on a weight-loss medication, because losing weight fast can mean losing muscle too.

6. Feeling tired all the time can have a food cause worth testing.
Low iron (especially in women), low vitamin D, and low B12 (especially in vegans, vegetarians, older adults and people on certain medications) can all cause fatigue. These won’t always be tested unless you mention your symptoms. If you feel exhausted for no clear reason, it’s reasonable to ask whether these are worth checking.

The 10 questions to take to your next appointment

Screenshot this or print it out. You don’t need to ask all ten. Pick the ones that fit you.

1. “Is there anything in my blood test results I could improve with diet?”

2. “Am I in the prediabetes range, and what would you suggest I change?”

3. “Are there foods I should avoid, or time differently, with my medications?”

4. “Could any of my medications affect my vitamin levels?”

5. “Is it worth checking my iron, vitamin D or B12?”

6. “Is there a specific diet that’s been shown to help my condition?”

7. “How much protein should I be aiming for at my age?”

8. “Is my weight actually a concern, or are there better numbers to focus on?”

9. “Can you refer me to a registered dietitian?”

10. “When should we re-check this, and what would ‘better’ look like?”

That last one is underrated. Agreeing on a clear goal (“let’s get your HbA1c from X to Y in six months”) turns vague advice into something you can actually work towards.

Tip: write your questions down before you go and put the most important one first. Appointments go fast, and it’s easy to forget everything once you’re in the room.

How to spot nutrition advice you can trust

Since doctors don’t always have the time, a lot of people end up getting food advice from social media, influencers and podcasts. Some of it is great. A lot of it isn’t.

Here’s my quick filter. Be careful if someone:

• Says one food, supplement or ingredient fixes everything. Real health is never that simple.

• Is selling the solution they’re warning you about. “Your gut is broken, and here’s my $79 powder.”

• Says all doctors are wrong and only they know the truth. Doctors may lack nutrition training, but that doesn’t mean every self-appointed expert is right.

• Uses one study, or a study on mice, as proof. Good advice is built on many studies in real people.

• Never says “it depends” or “we’re not sure yet.” Honest experts admit what isn’t known.

Good nutrition advice usually sounds a bit boring: more vegetables, beans, fibre and protein, less ultra-processed food, cook more of your own meals. It doesn’t go viral. It just works.

Your one job this week

Find your most recent blood test results. Most health systems let you see them online now, or you can ask your GP’s surgery or doctor’s office.

Look at four numbers: cholesterol, blood sugar or HbA1c, blood pressure, and anything flagged as low or high.

Then pick two or three questions from the list above and write them down for your next appointment.

That’s it. You’re not overhauling your health this week. You’re just making sure your next 10 minutes with your doctor are the most useful 10 minutes you’ve ever had.

Advice is free. A plan is the hard part.

Here’s what usually happens next.

Your doctor (or a dietitian, or this email) tells you to eat more vegetables, more fibre, more beans, more protein and less processed food. You completely agree. You leave determined.

Then it’s 6pm on a Wednesday. You’re tired, there’s nothing planned, and “eat a balanced diet” doesn’t tell you what to put in the pan. So it’s toast, a takeaway, or the same three meals you always make.

The advice was never the problem. The missing piece is a plan: what to actually cook, every day, that follows that advice and tastes good.

That’s exactly why I put together Eat Well Every Day.

It’s six recipe ebooks in one bundle: 180 healthy recipes for every meal and every craving:

• 30 breakfasts: including high-protein options that keep you full until lunch, and 5-minute choices for busy mornings

• 30 lunches: Mediterranean bowls, Asian wraps and hearty soups, perfect for meal prep

• 30 dinners: family-friendly meals in 45 minutes or less, many in one pot or one pan

• 30 smoothies: energy boosters and recovery drinks

• 30 snacks: for the 3pm slump, office-friendly and travel-ready

• 30 desserts: because a healthy diet you can actually stick to has room for them

Simple ingredients from any supermarket, no specialty powders, and lots of gluten-free, dairy-free and vegan options throughout.

Plus 4 bonuses that turn the advice into a routine:

• The 4-Week Meal Plan + Shopping Lists. A done-for-you month of meals with a grocery list for every week. That’s “eat a balanced diet,” turned into an actual menu.

• The 2-Hour Sunday Meal Prep Guide, with storage and reheating charts, so healthy food is ready on the nights you’re exhausted.

• Healthy Swaps & Pantry Cheat Sheets: simple swaps that make any meal healthier, plus a starter pantry list.

• The Kids & Picky Eaters Guide, so the whole family eats the same dinner.

That’s $194 of material for $29.99. One payment, instant download, no subscription, and it works on any device.

Your doctor can tell you what to change. This gives you a month of meals that already does it, so the next time you get your blood test back, you’ve got something to show for it.

👉 Get Eat Well Every Day: 180 recipes + 4 bonuses

Find your blood test results this week. Write down two questions. That’s how this starts.

Talk soon,
The Healthy Mail 🩺

This email is for general information and isn’t medical advice. Please don’t stop or change any medication without talking to your doctor or pharmacist first.

P.S. I’d love to know: what’s the most useful (or least useful) thing a doctor has ever told you about food? Hit reply and tell me. I’ll share some of the answers (anonymously) in a future email. And if “eat a balanced diet” is all you’ve ever been told, Eat Well Every Day turns it into a 4-week meal plan with the shopping lists done, for $29.99. 👉 Get it here