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OBJECTIVE: To provide data on medical students' multivitamin and calcium supplement use during medical school. DESIGN: Medical students were anonymously surveyed at three time points: freshman orientation, orientation to wards, and during senior year. SUBJECTS: Medical students (n = 2,316) at 16 US medical schools (response rate = 80.3%). OUTCOME MEASURES: Prevalence and correlates of multivitamin and calcium supplement use throughout medical school. STATISTICAL ANALYSES: Chi2 tests with associated P values, and logistic regression with associated odds ratios and confidence intervals. RESULTS: Half of medical students surveyed used multivitamins, and 19% used calcium supplements, at least once per week as freshmen. Consumption of calcium, but not multivitamin, supplements increased during subsequent years (P = 0.0001) and both supplements were more commonly used by women (P < 0.0003). Of 970 students tracked across all three time points, 14% of women, compared with only 2% of men (P < 0.0001), took calcium at all three time points. Using multivariate models, we found that medical students were more likely to use multivitamins if they exercised regularly, had children, were underweight, or were women who were not heavy users of alcohol (P < 0.0001 to P < 0.05). Similarly, students who were women, underweight, exercised regularly, or had a personal or family history of osteoporosis were more likely to consume supplemental calcium (P < 0.0001 to P = 0.04). CONCLUSIONS: Medical students of all types used supplements at moderate rates, and women used supplements more commonly and consistently than did men. Medical students, especially nonunderweight and nonexercising students, may be particularly important targets for messages regarding appropriate and adequate vitamin/mineral use.

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BACKGROUND: Nutrition counseling by physicians can improve patients' dietary behaviors and is affected by physicians' nutrition practices and attitudes, such as the perceived relevance of nutrition counseling. OBJECTIVE: The objective was to provide data on medical students' perceived relevance of nutrition counseling, reported frequency of nutrition counseling, and frequency of fruit and vegetable intakes. DESIGN: Students (n = 2316) at 16 US medical schools were surveyed and tracked at freshmen orientation, at the time of orientation to wards, and in their senior year. RESULTS: Freshmen students were more likely (72%) to find nutrition counseling highly relevant than were students at the time of ward orientation (61%) or during their senior year (46%; P for trend = 0.0003). Those intending to subspecialize had lower and declining perceptions of counseling relevance (P for trend = 0.0009), whereas the perceived relevance of counseling by primary care specialists remained high (P for trend = 0.5). Students were significantly more likely to find nutrition counseling highly relevant if they were female, consumed more fruit and vegetables, believed in primary prevention, had personal physicians who encouraged disease prevention, or intended to specialize in primary care. Only 19% of students believed that they had been extensively trained in nutrition counseling, and 17% of seniors reported that they frequently counseled their patients about nutrition. Students who consumed more fruit and vegetables, believed that they would be more credible if they ate a healthy diet, were not Asian or white, or intended to specialize in primary care counseled patients about nutrition more frequently. Medical students consumed an average of 3.0 fruit and vegetable servings/d, which declined over time. CONCLUSIONS: The perceived relevance of nutrition counseling by US medical students declined throughout medical school, and students infrequently counseled their patients about nutrition. Interventions may be warranted to improve the professional nutritional practices of medical students.

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Our objective was to assess the reproducibility and accuracy of fat and of fruit and vegetable items on a 43-item food frequency questionnaire (FFQ) previously self-administered by students at 16 US medical schools. Five in-person, 24-hour recalls were administered between two FFQ administrations to 88 medical students. Reported fat intake decreased from the first (34.7%) to the second (33.1%) FFQ administration ( P <.001); the reproducibility correlation was r =0.63. Fat intake from recalls (28.4%) was lower than that from the FFQ (33.8%, P <.001). The Pearson correlation was r =0.36. Fruit and vegetable servings per day were 3.9 and 3.7 from the first and second FFQ, respectively ( P =.5); the reproducibility correlation was r =0.77. Fruit and vegetable servings were marginally higher from recalls (4.3) than from the FFQ (3.8, P =.06). The Pearson correlation for fruit and vegetable servings was r =0.50. This brief FFQ provides acceptably reproducible and valid estimates of fruit and vegetable servings per day among most groups of medical students, but overestimates fat as a percentage of energy intake.

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BACKGROUND: McDonald's has sold >100 billion beef-based hamburgers worldwide with a potentially considerable health impact. This paper explores whether there would be any advantages if the next 100 billion burgers were instead plant-based burgers. METHODS: Nutrient composition of the beef hamburger patty and the McVeggie burger patty were obtained from the McDonald's website; sales data were obtained from the McDonald's customer service. RESULTS: Consuming 100 billion McDonald's beef burgers versus the same company's McVeggie burgers would provide, approximately, on average, an additional 550 million pounds of saturated fat and 1.2 billion total pounds of fat, as well as 1 billion fewer pounds of fiber, 660 million fewer pounds of protein, and no difference in calories. CONCLUSIONS: These data suggest that the McDonald's new McVeggie burger represents a less harmful fast-food choice than the beef burger.

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