Doctors who specialize in nutrition have access to special tools that can measure body muscle and how many calories you burn, but most of them rarely use these tools. Researchers surveyed 36 nutrition experts in Canada and found that even though many had learned about these measurements in training, they didn’t feel confident using them and didn’t have clear guidelines for when to use them. After attending a 4-hour training class, doctors improved their knowledge about body composition measurements by 20%, but their knowledge about calorie-burning measurements stayed the same. The study shows that better training and clearer guidelines are needed to help doctors use these helpful health measurements more often.

The Quick Take

  • What they studied: Why nutrition doctors don’t use special body measurement tools even when they have access to them, and whether a training class could help them use these tools more often.
  • Who participated: 36 nutrition specialists (97% women) who work in hospitals in Alberta, Canada. Most worked with regular hospital patients (36%) or cancer patients (31%), and all had at least 1 year of experience.
  • Key finding: 86% of the nutrition doctors never used body composition measurements (tools that measure muscle and fat), even though many had access to them. After a 4-hour training class, their knowledge about these measurements improved by 20%, but they still faced barriers like lack of confidence and unclear guidelines.
  • What it means for you: If you’re a patient, your doctor may not be using all the available tools to understand your body composition and metabolism, even though these measurements could help with your care. This suggests that healthcare systems need better training and clearer guidelines to help doctors use these helpful tools more often.

The Research Details

Researchers asked 36 nutrition doctors in Alberta hospitals to fill out online surveys about their access to body measurement tools, how often they used them, and how confident they felt using them. The survey asked about four different types of body measurement tools: CT scans, ultrasound, bioelectrical impedance analysis (a device that measures body composition by sending a small electrical signal through your body), and DXA scans (a special type of x-ray that measures bone and body composition). The survey also asked about tools that measure how many calories your body burns at rest.

Before and after a 4-hour online training class about these measurement tools, the researchers tested the doctors’ knowledge with questions to see if the training helped them learn. They compared the before and after scores to see if the training made a difference.

The researchers also asked about whether the doctors’ hospitals had clear guidelines or protocols for using these measurements, and whether the doctors felt confident in their knowledge.

Understanding why doctors don’t use available tools is important because it helps identify what’s preventing better patient care. By finding out whether the problem is lack of access, lack of knowledge, low confidence, or missing guidelines, healthcare systems can fix the right problem. This study helps show that just having tools available isn’t enough—doctors also need good training and clear instructions on when and how to use them.

This study surveyed a relatively small group (36 people) from one region in Canada, so the results may not apply everywhere. The study was done with nutrition specialists in hospitals, so results might be different for doctors in other settings. However, the study directly asked doctors about their real experiences and barriers, which makes the findings realistic and practical. The researchers used a statistical test (Wilcoxon signed rank test) that is appropriate for comparing before-and-after scores in small groups.

What the Results Show

The biggest finding was that most nutrition doctors (86%) never used body composition measurements, even though some had access to them. About 31% had access to CT scans, 25% had ultrasound, 6% had bioelectrical impedance analysis, and only 3% had DXA scans available. Interestingly, 67% of the doctors had received some education about body composition measurements during their training, but 64% still didn’t feel confident using them.

For energy metabolism measurements (tools that measure how many calories your body burns), the situation was similar. Most doctors (58%) never used these tools, and another 19% used them only occasionally. About 28% had access to a device called Q-NRG and 19% had access to standard metabolic carts. Even though 67% had received education about these tools, 50% weren’t confident in using them.

When the doctors attended the 4-hour training class, their knowledge about body composition improved significantly—the median improvement was 20 percentage points (meaning the average doctor’s score went up by 20%). However, their knowledge about energy metabolism measurements didn’t improve after the training, which was surprising.

The study also found that most doctors (67%) knew about protocols for identifying malnutrition, but only 8% knew about protocols for identifying sarcopenia (loss of muscle mass), suggesting a major gap in awareness.

The study found that lack of confidence was a major barrier even when doctors had received education. This suggests that the education they received may not have been practical enough or didn’t include enough hands-on experience. The study also showed that clear clinical guidelines were missing—most doctors didn’t know when they should use these measurements or how to interpret the results. The fact that the energy metabolism knowledge didn’t improve after training suggests that the training may have focused more on body composition, or that energy metabolism is more complex and requires different teaching methods.

Previous research has shown that nutrition assessments are important for patient care, but many doctors don’t use all available tools. This study confirms that pattern and goes deeper to explain why. It shows that the problem isn’t just lack of access to equipment—even when doctors have access, they don’t use it. This is consistent with other research showing that education alone isn’t enough to change practice; doctors also need confidence, clear guidelines, and ongoing support.

The study only included 36 doctors from one region in Canada, so the results may not apply to other countries or regions with different healthcare systems. The study included mostly women (97%), so results might be different for male doctors. The study only measured knowledge improvement right after the training, not whether doctors actually started using these tools more in their daily work. The 4-hour training class was relatively short, and it’s unclear if longer or more intensive training would have better results. The study didn’t explore all possible barriers, such as time constraints, cost, or patient factors that might affect whether doctors use these measurements.

The Bottom Line

If you’re a patient receiving nutrition care, you could ask your doctor whether body composition or energy metabolism measurements would be helpful for your specific situation. Healthcare systems should invest in better training programs for nutrition doctors and develop clear guidelines for when these measurements should be used. Hospitals should ensure that doctors have access to these tools and feel confident using them. (Confidence level: Moderate—based on a small study from one region)

Patients with cancer, malnutrition, or muscle loss should care about this research because body composition and metabolism measurements could help their doctors provide better care. Healthcare administrators and hospital leaders should care because this research shows a gap between available tools and their actual use. Nutrition education programs should care because the study suggests that current training isn’t preparing doctors well enough. People who are overweight or underweight might benefit from these measurements, but they should discuss this with their doctor.

If your doctor starts using body composition measurements, you might see improvements in your nutrition care plan within a few weeks. However, changes in your body composition or metabolism typically take several months to see significant results. The training showed that doctors can improve their knowledge quickly (within 4 hours), but changing actual practice habits takes longer—usually several months of consistent use.

Want to Apply This Research?

  • Track your body composition measurements (muscle mass, fat mass, or body fat percentage) if your doctor recommends them. Record the date, measurement type, and results. If you don’t have access to professional measurements, track simple metrics like weight, waist circumference, and how your clothes fit as proxy measures.
  • Ask your doctor at your next appointment whether body composition or metabolism measurements would be helpful for your health goals. If your doctor recommends them, work with your healthcare team to schedule these measurements and understand what the results mean for your nutrition plan.
  • If you’re getting body composition measurements, track them every 3-6 months rather than more frequently, since changes happen slowly. Keep a record of your measurements over time to see trends. Also track how you feel—energy levels, strength, and how your clothes fit—as these practical signs often matter more than the numbers themselves.

This research describes barriers that nutrition doctors face when using body composition and energy metabolism measurements. It does not provide medical advice. Whether these measurements are appropriate for you depends on your individual health situation, medical history, and goals. Always consult with your healthcare provider or registered dietitian to determine which assessments and measurements are right for you. This study was conducted in Canada and results may not apply to all healthcare settings or regions. The findings suggest areas for improvement in healthcare systems but do not change current medical recommendations.