Fuelling prevention: federal levers to integrate nutrition into primary care

Related to recent federal directives to strengthen physician nutrition education, this paper examines family medicine's leadership in nutrition counseling while identifying modifiable barriers limiting primary care's prevention potential. Family physicians, comprising over 109 000 certified clinicians, provide 20% of U.S. healthcare visits and deliver substantial nutrition counseling, particularly in underserved communities. The American Board of Family Medicine dedicates 5% of certification content to nutrition/obesity and 25% to chronic disease care. However, structural barriers significantly constrain implementation. Medicare only reimburses nutrition counseling for end-stage conditions (diabetes and kidney disease), frustrating key opportunities to help patients. Primary care receives