In January 2026, the U.S. Department of Health and Human Services (HHS) released the Medical Education Nutrition Competency Framework, outlining 10 domains and 71 competencies with a recommended minimum of 40 hours of nutrition education in undergraduate medical curricula. Consistent with the US Department of HHS Competency Framework, UAMS is committed to excellence in nutrition-related education and delivers well over 40 hours of nutrition-related education across the four-year MD curriculum (M1–M4), integrated through basic science, clinical simulations, counseling training, and hands-on culinary medicine experiences. This page provides a detailed crosswalk demonstrating alignment and compliance.
Competency-by-Competency Crosswalk with HHS Medical Education Nutrition Competency Framework
| # | Full HHS Nutrition Competency Text | Mapped UAMS Course/Session |
|---|---|---|
| 1 | Nutritional content of foods, macronutrients and micronutrients | M1 Overview of Metabolism; Fuel Metabolism TBL |
| 2 | Pathological states affecting nutrient absorption | M1 Inborn Errors of Metabolism lectures |
| 3 | Identifies nutrient deficiencies and recommends foods/supplements | M1 Vitamin lectures; Anemias session |
| 4 | Difference between food allergies and intolerance including gluten | Culinary Medicine (CM) Elective |
| 5 | Energy and nutrient requirements across lifespan | M4 Geriatrics Teaching Kitchen (TK); OB/GYN TK |
| 6 | Drug-nutrient interactions | M2 Diabetes TBL |
| 7 | Nutritional differences: minimally processed vs highly processed foods | M2 Obesity Counseling lectures |
| 8 | Interprets nutrition labels and menu labeling | CM Elective |
| 9 | Clinically assisted nutrition (enteral/parenteral) – GME level | |
| 10 | Functions of essential nutrients | M1 Vitamin lectures |
| 11 | Principles of healthy balanced diet per national guidelines | CM Elective |
| 12 | Evidence-based guidance on healthy beverage consumption | |
| 13 | Mitochondrial metabolism and nutrient-driven ATP synthesis; overnutrition and insulin resistance | M1 Fatty Acid Oxidation; Energy & Appetite lecture |
| 14 | Structural components from food building proteins, membranes, hormones | M1 Protein and Amino Acid Metabolism TBL |
| 15 | Micronutrient cofactors in enzymatic function and deficiency impact | M1 Vitamin lectures |
| 16 | Hormonal regulation through food composition (GLP-1, CCK, PYY, leptin, insulin) | M2 Energy & Obesity lecture |
| 17 | Epigenetic modulation through nutrition | |
| 18 | Microbiome-immune crosstalk and fiber fermentation | Limited (GI discussions) |
| 19 | Cognitive and behavioral nutrition; mindful eating | M2 Obesity; M3 MI SP; CM Elective |
| 20 | Food bioavailability and preparation methods | |
| 21 | Chronobiology and circadian nutrition | M2 Energy lecture |
| 22 | Assess nutritional status integrating history, measurements, labs | Pediatrics TBL; Anemia Simulation; Geriatrics TK |
| 23 | Comprehensive nutrition-focused physical examination | Anemia Simulation; GI Nutrition Simulation |
| 24 | Interprets biomarkers for malnutrition risk | Diabetes TBL; CV Simulation; Geriatrics TK |
| 25 | Personalized metabolic biomarker interpretation (insulin, OGTT, lipids, etc.) | Diabetes TBL; Endocrine Simulation |
| 26 | Continuous glucose monitoring interpretation | Diabetes lectures |
| 27 | Early warning sign recognition of nutrition-related symptoms | Anemia Simulation; Endocrine Simulation |
| 28 | Network biology disease assessment | CV Simulation; Endocrine Simulation |
| 29 | Personal biomarker practicum with reflective nutrition plan | |
| 30 | Integrates evidence-based nutrition into patient care | GI Nutrition Simulation; FM didactics |
| 31 | Uses behavior change models for counseling | |
| 32 | Guides lifelong dietary patterns for chronic disease | FM didactics; CV Simulation |
| 33 | Brief counseling for visceral adiposity/metabolic syndrome | Endocrine Simulation; M2 Obesity Counseling |
| 34 | Motivational interviewing for nutrition change | |
| 35 | Food journaling guidance | |
| 36 | Mindfulness-based eating interventions | MI SP; Teaching Kitchen |
| 37 | Patient empowerment and dietary autonomy | GI Nutrition Simulation |
| 38 | Interoceptive awareness training | |
| 39 | Works with other health professionals for multidisciplinary care | GI Nutrition Simulation |
| 40 | Makes appropriate nutrition referrals | GI Nutrition Simulation |
| 41 | Health coach/functional nutrition collaboration | |
| 42 | Digital health technology integration for nutrition | Limited (diabetes tech discussion) |
| 43 | Functional medicine clinic rotations | |
| 44 | Screens for food/nutrition needs and access | M1 Social Determinants of Health |
| 45 | Agricultural systems and health outcomes | |
| 46 | Food systems-disease linkage | Limited (SDOH discussion) |
| 47 | Policy advocacy and nutrition programs | |
| 48 | Regenerative agriculture as clinical intervention | |
| 49 | Dietary Guidelines analysis and translation | CM Elective |
| 50 | Creates culinary nutrition SMART goals | |
| 51 | Nutrient-preserving cooking techniques | |
| 52 | Personalized meal planning from clinical data | Geriatrics and OB/GYN M3/M4 Teaching Kitchens; CM elective |
| 53 | Anti-inflammatory meal preparation | |
| 54 | Teaching kitchen participation | M4 Teaching Kitchens; CM Elective |
| 55 | GLP-1 agonist counseling with lifestyle guidance | |
| 56 | Responsible use of AI for nutrition advice | |
| 57 | Disease-specific nutritional reversal protocols | |
| 58 | Nutraceutical and anti-inflammatory interventions | |
| 59 | Medication-nutrition synergy | Endocrine; CV Simulation |
| 60 | Food-based medicine prioritization | Diabetes; CV; FM |
| 61 | Longitudinal biomarker monitoring | Endocrine lab monitoring |
| 62 | Identifies factors affecting personal health and nutrition status | CM Elective |
| 63 | Modeling patient-centered self-care behaviors | CM Elective |
| 64 | Personal metabolic optimization using own health data | |
| 65 | Promotes healthy food environments in healthcare | |
| 66 | Soil health and nutrient density relationship | |
| 67 | Regenerative agriculture immersion | |
| 68 | Toxicology in food supply chain | |
| 69 | Food quality determinants and additives | CM Elective |
| 70 | Environmental contaminant case studies | |
| 71 | Billing for nutrition services and culinary medicine consultations |
Domain 1 – Foundational Nutrition Knowledge
Extensive coverage in M1 Molecules to Cells (metabolism TBLs, vitamin lectures, inborn errors, fatty acid oxidation, cholesterol metabolism), Hematology (iron, B12, folate), Brain & Behavior (B12-related disorders), and metabolic regulation lectures.
Domain 2 – Nutrition Assessment & Diagnosis
Strong coverage through Anemia simulation, GI Nutrition simulation, Pediatrics TBL (growth and assessment), Diabetes TBL, CV and Endocrine simulations, including biomarker interpretation and nutritional counseling.
Domain 3 – Food & Nutrition Communication Skills
Longitudinal training through Obesity Counseling lectures (M2), Motivational Interviewing SP experience (M3), GI Nutrition simulation, CV and Endocrine simulations, and Family Medicine didactics.
Domain 4 – Interprofessional Referral & Patient Management
Addressed through GI Nutrition simulation and Practice of Medicine curriculum emphasizing teamwork and referral strategies.
Domain 5 – Public Health Nutrition
Covered in Social Determinants of Health (M1), stroke prevention education, ambulatory preventive care review, and discussions of food access and disparities.
Domain 6 – Culinary Medicine
Direct experiential learning in M4 Geriatrics Teaching Kitchen, including adaptive nutrition strategies for aging populations and the OB/GYN Teaching Kitchen for unique nutrition needs at various life stages.
Domain 7 – Medical Interventions + Lifestyle Integration
Strong integration within Diabetes, Endocrine, Cardiovascular, NAFLD, and Family Medicine curricula, emphasizing food-first approaches and medication-nutrition synergy.
Domain 8 – Personal Food & Lifestyle Behaviors
Addressed through reflective components of teaching kitchen and motivational interviewing exercises.
Domain 9 – Food Systems & Environmental Impacts
Addressed through Social Determinants of Health discussions.
Domain 10 – Billing, Coding, Reimbursement
Opportunities for future integration are being explored.
Department of Health & Human Services Nutrition Competencies Framework (PDF)
By-Year Curriculum Summary
| Year and Course | Session Title | Nutrition related learning objective | Session time |
|---|---|---|---|
| M1 Molecules to Cells | Fuel Metabolism and Nutrition TBL | — Apply the concepts of metabolism and nutrition in the fed and fasting state — Practice nutrition calculations | 3 hours |
| M1 Molecules to Cells | Carbohydrate Metabolism TBL | –Integrate the pathways of carbohydrate metabolism– Describe clinical applications– Describe inborn errors of carbohydrate metabolism | 3 hours |
| M1 Molecules to Cells | Lipid Metabolism TBL | –Describe the lipoproteins, their classifications and metabolism –Relate defective lipoprotein processing to the formation of an atherosclerotic plaque —– Describe clinically relevant dyslipidemias, including hyperlipoproteinemia and hypercholesterolemia | 3 hours |
| M1 Molecules to Cells | Protein and Amino Acid Metabolism TBL | –Describe the basic principles of amino acid biosynthesis, including key synthetic pathways, enzymes, and co-factors. –Describe the flow of nitrogen from proteins in peripheral tissues to the liver and through the urea cycle. –Explain how amino acids are catabolized to glucogenic and ketogenic intermediates. –Discuss clinical disorders associated with enzyme deficiencies in amino acid metabolism and the urea cycle | 3 hours |
| M1 Molecules to Cells | Purine and Pyrimidine Metabolism TBL | –Describe the biosynthetic pathways for the purine and pyrimidine nucleotides, including the source of atoms in the purine and pyrimidine rings –Describe the metabolic control of purine and pyrimidine biosynthesis –Discuss disorders of purine and pyrimidine metabolism –Discuss purine, pyrimidine, and folate analog drugs | 3 hours |
| M1 Molecules to Cells | PKU patient presentation | –Describe the day to day issues involved in living with and treating a metabolic disorder –Describe the broader economic and social implications of PKU | 2 hours |
| M1 Molecules to Cells | Lipid soluble vitamins lecture | –Identify the biochemical active moieties in the structure of the lipid-soluble vitamins –Describe the functions of each lipid-soluble vitamin –Describe the signs and symptoms of deficiency –Relate the sources and circumstances leading to deficiency –Describe the signs and symptoms of toxicity | 1 hour |
| M1 Molecules to Cells | Water soluble vitamins, 2 lectures | –Identify the biochemical active moieties in the structure of the water-soluble vitamins –Describe the functions of each water-soluble vitamin –Describe the signs and symptoms of deficiency” –Relate the sources and circumstances leading to deficiency –Describe the signs and symptoms of toxicity | 2 hours |
| M1 Molecules to Cells | Inborn errors of metabolism, 2 lectures | –Recognize the frequency of inborn errors of metabolism –Describe the different categories of inborn errors of metabolism in the simplified categorization system –Identify conditions which result in intoxication and form (acute vs. chronic) –Distinguish common characteristics of small molecule, complex molecule, and energy disorders –Identify reasons for considering an inborn error of metabolism in individuals –Describe the purpose of common metabolic tests including plasma amino acid analysis, urine organic acid analysis, and blood acylcarnitine profile analysis | 2 hours |
| M1 Molecules to Cells | Fatty acid oxidation & ketone bodies lecture | –Define the role of triacylglycerols as fuel and explain the energy yield from fatty acid oxidation–Describe how hormones control fatty acid mobilization in the fed and fasted state–Explain the mechanism and products of fatty acid catabolism by: beta-oxidation in mitochondria and peroxisomes; omega-oxidation in endoplasmic reticulum; alpha-oxidation in peroxisomes–Describe the mechanism by which ketone bodies are formed–Identify the molecular basis of diseases linked to defects of fatty acid oxidation such as: primary and secondary carnitine deficiencies, XALD, Zellweger syndrome, Refsum’s disease.–Explain the mechanism of hypoketotic hypoglycemia and dicarboxylic aciduria in diseases linked to defects of fatty acid metabolism | 1 hour |
| M1 Molecules to Cells | Cholesterol and Bile Acids lecture | –Follow and understand the synthesis of cholesterol –Identify the control of cholesterol and bile salt metabolism –Describe the importance of non-cholesterol intermediates in the cholesterol synthesis pathway –Follow the structure, synthesis and function of bile salts | 1 hour |
| M1 Molecules to Cells | Glycogen metabolism and control lecture | –Describe the steps in glycogen degradation and synthesis –Indicate how glycogen metabolism is regulated in liver and muscle by changes in intracellular calcium, AMP, ATP, cAMP, glucose and glucose 6P and by hormones such as insulin, glucagon, and epinephrine –Describe the glycogen storage diseases, identify the enzyme deficiency involved in each disease, –Explain how such deficiency leads to signs and symptoms characteristic of each disease | 1 hour |
| M1 Molecules to Cells | Sugar catabolism and biosynthesis | –Describe sugar interconversions (glucose, fructose, mannose, galactose, fucose, sialic acid, glucuronic acid, xylose, amino sugars) –To describe the metabolic basis of diseases that have defects of sugar interconversions: —Congenital disorders of glycosylation (CDG); Hereditary Fructose Intolerance; Essential fructosuria (mostly asymptomatic); Cataract in diabetic patients; Galactosemias; Congenital familial nonhemolytic jaundice (Crigler-Najjar syndrome); Physiological jaundice of the newborn (not a disease); I-cell disease | 1 hour |
| M1 Molecules to Cells | Overview of metabolism | Define the major types of metabolism: caabolism, anabolism, and amphibolic pathways. Describe the relationship of macronutrients and micronutrients to metabolism. Describe the relationship of organs to metabolism and their specific functions as conferred by special biochemical capabilities Explain the basic concepts of blood glucose homeostasis. | 1 hour |
| M1 Hematology | Hemostasis 1 lecture | –Explain the biochemical regulation of coagulation and the source of clotting factors –Summarize the role of vitamin K in coagulation | 1 hour |
| M1 Hematology | Anemias peer instruction | –Explain the differential diagnosis for microcytic anemia –Describe the physiology of iron homeostasis (daily requirements and dietary factors, site of absorption, hepcidin, ferroportin, ferritin, etc.) –Describe the clinical presentation, pathophysiology and laboratory findings in iron deficiency anemia (IDA) –Explain the differential diagnosis for macrocytic anemia –Describe the clinical presentation, pathophysiology and laboratory findings in B12 and folate deficiency | 2 hours |
| M1 Brain and Behavior | Spinal cord diseases lecture | –Describe nutritional spinal cord disorders, such as subacute combined degeneration, due to B12 or copper deficiency. | 1 hour |
| M1 Brain and Behavior | Neuroembryology lecture | –Explain early neural tube formation. Include gestational days when the neuropores close and how to detect elevation of two proteins when closure is faulty. Tell what vitamin when given on time prevents faulty closure, and list risk factors for neural tube defects. | 1 hour |
| M1 Practice of Medicine | Social determinants of health | –Identify how determinants like poverty and exclusion affect nutrition, access to care, and health outcomes –Differentiate between social determinants of health, health disparities, and health inequities –Define adverse childhood events (ACEs) and the outcomes associated with them | 1.5 hours |
| M1 Practice of Medicine | Anemia simulation | –Complete a focused patient encounter, including history, physical exam and interpretation of laboratory values. –Correctly recognize a patient presentation consistent with iron deficiency anemia and complete an oral presentation of this patient that demonstrates appropriate clinical reasoning and differential diagnosis. | 1.5 hours |
| M1 Practice of Medicine | HPCL stroke | –Recognize the signs & symptoms of stroke. –Distinguish the difference between stroke & TIA. –Explain the role of nutrition in stroke prevention. | 1.5 hours |
| M2 CV | Dyslipidemias lecture | Describe the basics of lipoprotein and cholesterol metabolism, manifestations of abnormal metabolism, and relationship to CV disease List the dietary approaches and prototype drugs used to treat hyperlipoproteinemias, describe their mechanism of action, clinical uses and contraindications, and major adverse effects. | 1 hour |
| M2 GI | Nonalcoholic Fatty Liver Disease, Hepatic Storage Diseases, and Liver Transplantation lecture | –Outline nonalcoholic fatty liver disease (NAFLD) and the spectrum of disease/pathology it encompasses. –Be able to recall common risk factors, prevalence, and potential outcomes of NAFLD. –Recall the potential adverse consequences of NAFLD. –Summarize the approach to diagnosis and treatment of NAFLD/NASH. –Describe the progression of chronic liver disease to end-stage severity. –Be able to recognize patients with compensated and decompensated cirrhosis. –Explain methods of determining prognosis in patients with cirrhosis. –Describe the role of liver transplantation in managing chronic liver disease as well as other metabolic diseases. | 1 hour |
| M2 Endocrine | Energy, appetite control, and obesity lecture | –Describe calories, energy equivalents, and the respiratory quotient–Define metabolic syndrome –Discuss basal metabolic rate (BMR) –Discuss hormonal control of appetite –Describe adipokines and lipokines –Discuss causes of obesity and health problems associated with diabetes –Discuss treatments for obesity | 1 hour |
| M2 Endocrine | Type 1 and 2 diabetes mellitus lecture | –Compare and contrast the clinical presentation of type I vs. type II diabetes –Compare and contrast the risk factors and epidemiology of type I and Type II diabetes –Compare and contrast the pathophysiology of type I vs. type II diabetes –Compare and contrast the complications of type I vs. type II diabetes –Compare and contrast the treatment type I and type II diabetes | 1 hour |
| M2 Endocrine | Diabetes TBL | –List the various drugs used to treat both type 1 and type 2 diabetes, their mechanisms of action and side effects– Describe dietary management of diabetes –Describe the difference between metabolic syndrome and diabetes –Describe the 2 different types of diabetes and their signs and symptoms –List and describe the common complications of diabetes –List the interactions between diabetes medications and other drugs | 3 hours |
| M2 Practice of Medicine | GI Nutrition simulation | –Describe the signs and symptoms of the patient to arrive at a diagnosis. –Describe the short term and long-term treatment options for the patient –Demonstrate effective communication skills with the patient. –Explain the importance of interprofessional teamwork. –Discuss the prevention strategies for the patient. –Demonstrate how to perform nutritional counseling for a patient. | 1.5 hours |
| M2 Practice of Medicine | Obesity and nutritional counseling, 2 lectures | –Describe the physician’s role in obesity counseling –Define the Bias in obesity –Discuss clinical nutrition –Explain the different assessments for obesity –Discuss different weight loss options –Identify the SMART goals and different stages of changes –Define the concept of Motivational interviewing | 2 hours |
| M3 Practice of Medicine | Motivational interviewing SP experience | –Discuss patient conditions with compassion and without stigma –Employ motivational interviewing techniques to build patient agency –Utilize scales with patient to understand importance to change and confidence –Gather and incorporate feedback from SPs and faculty to improve future patient outcones –Identify the SMART goals and different stages of changes | 2 hours |
| M3 Family medicine | FM didactics 2 lectures | –Define the different types of hypertension. — Discuss common first line recommendations for hypertension treatment, including nutritional and medication — Differentiate between Hypertensive Emergency and Urgency. — Discuss common medical management strategies for those with known CAD. — Perform an accurate Cardiovascular risk factor assessment for patients seen. — Identify risk factors for ASCVD and discuss prevention and management strategies. | 2 hours |
| M3 Family medicine | FM didactics, 2 lectures | –List common screening tests and the cutoffs to identify those with Diabetes. — Discuss screening/preventive measures taken to reduce Diabetic complications. — Identify best choice of diabetic management taking into account individual patient factors. | 2 hours |
| M3 Internal medicine | CV simulation | –Identify clinical manifestations, work-up, and risk factor associated with a patient presenting with chest pain –Identify clinical manifestations, work-up, and risk factors for a patient presenting with congestive heart failure –Describe treatment guidelines for chronic CHF management — Describe treatment measures for acute CHF exacerbation — Describe nutritional counseling and lifestyle modifications for CHF –Describe specific preventative health care measures for patients with CHF — Identify clinical manifestations, work-up, and risk factors associated with a patient presenting with carotid artery disease –Describe primary vs secondary stroke prevention measures — Identify clinical manifestations, work-up, and risk factors associated with a patient presenting with peripheral vascular disease —Describe lifestyle modifications and pharmacologic measures for management of peripheral vascular disease –Identify the clinical manifestations, work-up, and risk factors for metabolic syndrome — Describe the counseling advice for lifestyle modifications related to cardiovascular disease — Describe dietary counseling advise for a patient with coronary artery disease, congestive heart failure, and metabolic syndrome | 3 hours |
| M3 Internal medicine | Endocrine simulation | — Identify clinical manifestations, work-up, and risk factors for a patient presenting with hyperglycemia –Define diabetic ketoacidosis and hyperosmolar non-ketotic hyperglycemic state b. Identify etiology behind acute hyperglycemia — Describe treatment strategies for acute hyperglycemia in diabetic ketoacidosis and hyperosmolar non-ketotic state –Identify pharmacologic strategies for long term maintenance of type I and type II diabetes mellitus — Identify regular maintenance needs for diabetic patients including eye examination, foot examination, routine lab monitoring, nutritional counseling, and pharmacologic counseling — Identify screening and immunization needs for preventative care of patients with diabetes — Describe lifestyle modifications and non-pharmacologic treatment of fibromyalgia including sleep hygiene, physical therapy, exercise, nutritional counseling, and depression screening/treatment. | 3 hours |
| M3 Internal medicine | Preventive and ambulatory care review | Describe preventative health care screening guidelines in ambulatory care for blood pressure, cholesterol, breast cancer, colon cancer, prostate cancer, cervical cancer, and abdominal aortic aneurysm | 1.5 hours |
| M3 Pediatrics | General pediatrics TBL | –Discuss nutrition counseling, assessment, obesity and eating disorders in adolescent patients–REcognize the importance of preventative care in Pediatrics,including health supervision visit schedule, anticipatory guidance and age-appropriate patient safety issues. –Demonstrate knowledge of normal and abnormal growth parameters in pediatric patients and how to complete a thorough nutritional assessment | 2 hours |
| M4 Geriatrics | Culinary medicine teaching kitchen | –Recognize the physiologic changes that occur as a patient ages –Describe the changes in nutritional needs as a patient ages –Describe ways that food is a tool for community building as well as fighting disease –List causes of “anorexia of aging” and possible interventions –Describe adaptive methods for elderly patients to maintain a healthy diet Identify types of recipes that may be easily prepared by elderly patients –Recognize the pros and cons of various nutrition replacement strategies | 2 hours |