Hello Pablo,  The way I learnt the topic was not always clinically-relevant.  To me, it is time to move away from the strict RDA approach and include examples of cases that can personalise the content to an individual's genotype in terms of the presence of polymorphisms.  

MTHFR is a good place to start as it shows that where an individual carries SNPs for this gene, nutrient requirements for folate are quite different.   The solution to this SNP is also quite different in that only 5-methyl folate as a supplement will be of use to such individuals.  I also think it is important to tie the nutrient to the relevant metabolic pathway where known.  If an individual carries a SNP that compromises the methylation cycle, clinicians need to know how to overcome the adverse effects contributed by such a SNP.

I learnt about the role of NADPH in many pathways such as the Kreb's Cycle without anyone ever saying that this is dependent on niacin (Vit B3).  I think what must change our approach to teaching about vitamins and minerals is the rapidly-evolving field of Nutrigenomics.  The example of MTHFR is in this category and so many micronutrients are cofactors in enzymes that are coded by genes.  This is enormously clinically-relevant - and yet is not appropriately addressed in traditional teaching approaches.

I suppose the point I want to make here is that Nutrigenomics brings us closer to providing more personalised solutions to nutrient requirements and we need to update the way we teach nutrition to reflect this.

Thank you so much Christine, you are right.

Nutrition advances every day. We prepare dieticians of 2022 with a focus of past decades, that needs to change.

Thank you for your wonderful idea of teach in teh real world.

Following on Pablo, do you have an opportunity to change the curriculum in your university?  I would really like to see us change the way we teach biochemistry to medical students.  If we were to do so with a focus on teaching nutrition science as I mentioned above, I think we would see doctors with a far more rounded approach to treating their patients.  

Too often, the script pad is the primary focus when the patient's diet and other lifestyle factors may be the most appropriate way to address a condition, at least initially.  I would contend that every disease has a nutrition component; even a broken bone, which may seem to be just a mechanical injury,  requires appropriate nutrition for proper repair. 

A very good idea Christine. Unfortunately Venezuela is in a terrible economical, social, political, and obviously, nutritional crisis. Change the curriculum is important but not urgent. We need to solve many problems first. But when Venezuela change, I will impulse your idea in our Medicine Faculty. 

Sad but true - the world over!  Best wishes,  Christine

Hello Pablo,for this subject, first of all we could integrate the notion of tables of food compositions and software calculating the daily vitamin and mineral intakes of individuals

Teach vitamins s a topic , minerals as a topic. Design your learning objectives using the A,B,C,D method of stating behavioral objectives. Vitamins should include meaning , Classes, Chemistry, sources, functions, vitamins and antioxidant, vitamins and health, vitamins and metabolism , Vitamins and diseases , Vitamins and clinical manifestations, vitamins and laboratory analysis using qualitative and quantitative techniques. Employ models and maps to make your teaching interesting, Evaluate and review your methodology.