ACN
Applied Cardiometabolic Nutrition
ACNCurriculum.org
40 HOURS · ONE HOSTED PORTAL · NO LOCAL COURSE BUILD
Nutrition education too often stops at knowledge. ACN operationalizes it.
In Applied Cardiometabolic Nutrition, residents learn not only what to recommend, but how to implement nutrition therapy safely in clinic: assess, select, individualize, prescribe, address medication safety and deprescribing, and monitor response over time. ACN is a two-week, 40-hour residency elective built around repeated practice, culminating in an Applied Nutrition Prescription for a continuity-clinic patient. Lectures, clinical activities, simulated-patient encounters, rubrics, safety gates, and completion tracking arrive prebuilt in one hosted portal. No nutrition-subspecialty faculty are required.
40 hrs
structured instruction
2 weeks · fits an existing elective slot
14
expert lectures
prerecorded, with decks & scripts
69/71
HHS competencies
incl. the full recommended foundational set
5
adoption tiers
paper to fully hosted
6.5 hrs
scheduled faculty time
lean configuration
calibrated core faculty faciliate
0
nutrition-subspecialty faculty required
Three questions program directors ask. Three answers.
THE 30-SECOND VERSION
Can we actually run this?
Yes. ACN supplies the complete course build. Enroll residents, designate one core-faculty course lead, and use an existing elective slot. No local LMS construction, content upload, or nutrition-subspecialty faculty is required.
What do we get?
A complete hosted elective — not a resource library. Lectures, readings, applied workshops, simulated-patient practice, assignments, rubrics, safety gates, submissions, progress tracking, and completion documentation are already assembled in one curriculum hub.
What does it cost — in time and dollars?
It fits an existing elective slot: no new curricular time. ≈6.5 scheduled faculty hours per cohort in the lean configuration. The hosted core carries no curriculum or platform fee.
THE OPPORTUNITY
Close the gap between clinical nutrition care and residency training.
26%
of programs report a formal nutrition curriculum
And residents feel it: 94% of interns believe physicians should counsel patients on nutrition — only 14% believe physicians are adequately trained to do it.
Sources: Daley 2016 (JPEN) · Antognoli 2017 · Vetter 2008 · full citations in Appendix F of the curriculum overview.
77%
of program directors say required nutrition education goals are not being met
≈ 3 h/yr
mean nutrition-related didactics across 25 primary-care programs
26%
of programs report a formal nutrition curriculum
42%
of programs teach health-behavior counseling techniques
14 prerecorded expert lectures — with complete slide decks and talk-track scripts for local delivery if desired
THE DELIVERABLES
Everything arrives prebuilt and ready to implement.
Your program adds one course lead and an existing elective slot. ACN supplies the rest:
Facilitator guides & expert answer keys for every journal club, workshop, and debrief
Scoring rubrics, benchmark responses & critical safety gates — expert-standard grading by any core faculty
4 journal-club kits + 3 embedded appraisals — assigned articles, worksheets, study-specific answer keys
8 applied workshop protocols — where the Applied Nutrition Prescription is assembled
AI simulated-patient cases — unlimited practice, plus a version for paper tiers
Culinary-medicine session protocol — teaching-kitchen or structured at-home format; designed to be RDN-co-led
CGM practicum protocol — n-of-1 experiment guides, metrics worksheets, reflection tools
Pre/post knowledge instrument + 100-point scored capstone — the complete assessment package
HHS competency crosswalk + ACGME Milestones evidence map — accreditation mapping done for you
WHAT GOES IN THE PORTFOLIO
Evidence of clinical performance — not just course completion.
Each resident finishes with scored article appraisals, module and continuity-clinic Applied Nutrition Prescriptions, counseling transcripts with rubric feedback, a 100-point scored capstone, and a course-completion report mapping performance to HHS competencies and ACGME domains. This is competency documentation without building it yourself.
Final toolkit posts here on release — sample module available now by request.
Residents learn not only what to recommend, but how to make nutrition therapy work in practice: assess the patient, select and individualize an evidence-based approach, write an actionable prescription, address medication safety, coordinate deprescribing when clinically indicated, and monitor the response over time. They repeat this workflow in cases and then apply it with a patient from their own continuity panel.
THE CLINICAL MODEL
Nutrition knowledge is the foundation. Clinical implementation is the focus.
A repeatable point-of-care workflow for turning nutrition evidence into patient care.
THE APPLIED NUTRITION PRESCRIPTION (ANP)
Assess
metabolic status, goals, readiness, barriers, and contraindications
Residents do not stop at “recommend a healthy diet.” They produce a complete, patient-specific care plan — including implementation steps, monitoring measures, medication-safety contingencies, and criteria for adjustment or deprescribing.
→
→
→
→
Select
an evidence-based dietary approach suited to the clinical indication
Individualize
culture, preferences, budget, comorbidities, and treatment burden
Prescribe
specific foods, substitutions, targets, resources, and follow-up
Monitor
symptoms, biomarkers, adherence, medication safety, and opportunities for deprescribing
Understand the full evidence-based landscape
WEEK 1 · BUILD THE EVIDENCE BASE
Mediterranean, DASH, plant-predominant, calorie-restricted, meal-replacement, and carbohydrate-reduction approaches — along with metabolic physiology and the clinical nutrition assessment toolkit.
Turn evidence into safe, individualized patient care
WEEK 2 · IMPLEMENT NUTRITION THERAPY
Residents construct actionable prescriptions, address behavior and access barriers, establish monitoring plans, anticipate medication effects, coordinate deprescribing, and demonstrate the full workflow in the capstone.
The curriculum is anchored to the 2025–2030 Dietary Guidelines for Americans and its "Eat Real Food" framing, with insulin resistance as the organizing framework connecting obesity, prediabetes and type 2 diabetes, MASLD, hypertriglyceridemia, and PMOS. Therapeutic carbohydrate reduction is emphasized for these conditions based on HHS Competency #57.
What operationalization means in ACN
1 A documented point-of-care workflow for every nutriton encounter.
4 Sequenced medication adjustment and deprescribing as physiology changes
2 Translation of dietary patterns into specific, feasible patient prescriptions
5 Explicit monitoring targets, follow-up intervals, and escalation criteria
3 Contraindication screening and prevention of nutrition-related medication harm
6 Reassessment and individualization based on clinical response and patient goals
THE TWO-WEEK STRUCTURE
Eight instructional days. One repeated cycle from evidence to practice.
Across two weeks, residents progress from evidence appraisal to clinical implementation. Each day pairs expert-authored instruction with locally facilitated application in a consistent sequence:
→
PREPARE
LEARN
→
APPLY
→
INTEGRATE
8:00–9:00 preparation and critical appraisal → morning instruction → afternoon application → 3:00–5:00 ANP development, reflection, and optional practicum review. All activities occur within the protected training day. One day per week reserved for continuity clinic and required residency activities.
4+3
Journal clubs + critical appraisals
Compare multiple evidence-based dietary patterns and therapeutic approaches
Six core learning experiences
8
Applied workshops
Construct and refine the ANP step by step
1
Culinary medicine session
RDN co-led; teaching-kitchen or structured at-home format
3
Simulated-patient cases
AI-enabled or role-play; local faculty assigns the final score
1
NCI DHQ III food freq. questionnaire exercise
Dietary-assessment methods; personal results remain confidential and ungraded
14d
Optional CGM practicum
Voluntary and ungraded; shared-data alternative available
Journal clubs examine landmark evidence — including PREDIMED, DASH, DiRECT, continuous remote-care studies, and carbohydrate–insulin versus energy-balance models — using study-specific appraisal guides. Recorded patient interviews and an interprofessional case conference incorporate perspectives from medicine, dietetics, pharmacy, and behavioral health.
WEEK 1 · DAY 1
Foundations & the ANP
Eight Day Progression
WEEK 1 · DAY 2
Evidence Appraisal & Mechanisms
Nutrition Assessment & Measurement
WEEK 1 · DAY 3
WEEK 1 · DAY 4
Energy Balance & Culinary Medicine
WEEK 1 · DAY 1
Therapeutic Carbohydrate Reduction
WEEK 1 · DAY 1
Cardiometabolic Risk & Behavior Change
Safety, Implementation & Simulation
WEEK 1 · DAY 1
WEEK 1 · DAY 1
Interprofessional Practice & Capstone
INNOVATIONS
Six design innovations that make ACN clinically applied and portable.
ACN combines a visit-ready clinical workflow, immersive practice, and a prebuilt delivery system so programs can teach implementation
The Applied Nutrition Prescription
Residents apply a repeatable clinical workflow across cases and in continuity clinic: Assess → Select → Individualize → Prescribe → Monitor. Medication safety and coordinated deprescribing are built in.
FROM EVIDENCE TO MONITORED CARE
Ready-to-Run Curriculum Hub
Lectures, readings, applied activities, facilitator materials, learner submissions, rubrics, and completion tracking will be available on demand through one hosted portal. Downloadable and print-ready materials preserve local delivery options
BUILT FOR SCALABILITY
Guided Faculty Support
Facilitator guides, benchmark responses, rubrics, critical-safety gates, and calibration cases support a designated core faculty lead in teaching and scoring against expert-authored criteria. No local nutrition subspecialist is required.
EXPERTISE, BUILT IN
AI-Enabled Simulated-Patient Practice
Three counseling encounters provide repeatable practice, transcripts, and structured feedback. Local faculty reviews each transcript and assigns the grade of record; parallel role-play materials are included.
REPEATABLE PRACTICE BEFORE PATIENT CARE
The CGM Practicum
A voluntary, confidential, ungraded practicum uses structured educational comparisons to teach interpretation and counseling. Opt-out residents meet the same objectives using shared, de-identified data; no learner metric is diagnostic or used to prescribe a diet.
EXPERIENCE THE FEEDBACK LOOP
Interprofessional Perspectives Guide
An expert-authored guide embeds nutrition/dietetics, pharmacy, behavioral-health, and medical reasoning at each ANP stage. It supports local interprofessional collaboration.
TEAM REASONING, BUILT IN
OPTIONAL 14-DAY CGM METABOLIC SELF EXPERIENCE
Residents experience the data before counseling patients.
Residents who opt in complete structured educational comparisons involving meal composition, carbohydrate source, meal sequence, activity, sleep, or timing. They examine within-person variability and descriptive response measures, then practice translating the data into patient-centered counseling.
Voluntary, confidential, and ungraded
Opt-out learners have equivalent learning pathway using shared, de-identified data
Sensors provided through an education program, when available
No manufacturer role in curriculum design, content, or assessment
FEASIBILITY
One course lead. Approximately 12 recurring faculty hours per cohort.
"How difficult will it be for us?" — quantified.
In the planned lean configuration, expert-recorded instruction and prebuilt facilitation tools carry most of the course. No local nutrition-subspecialty faculty are required for routine delivery.
WHAT YOUR COURSE LEAD ACTUALLY DOES
Scheduled (6.5 h): Day-1 orientation · Day-4 interim feedback ·
Day-8 capstone day.
Asynchronous (~4–6 h per cohort): score written work against expert answer keys.
Once, ever (~90 min): a calibration exercise before grading the first cohort.
No nutrition-subspecialty training required. (+2 h of RDN time if you run the in-person teaching kitchen.)
6.5 scheduled hours + ~4-6 scoring hours
≈ 12 hrs
Total faculty time per two-week elective (lean configuration). A reference configuration with full faculty facilitation (~22 h) is also specified — your choice.
How 40 structured instructional hours are delivered in the lean model:
11.0 h
22.5 h
6.5 h
Prerecorded expert lectures
no local delivery required
Peer-led by residents
using ACN faciliator guides & expert answer keys
Scheduled faculty presence
lean configuration
No teaching kitchen? Use the structured at-home protocol.
Need longitudinal delivery? Run one module per week.
Limited technology? Tier 1 runs entirely on paper.
No new curricular slot? Use an existing elective or adopt longitudinally.
ADOPTION
Five delivery tiers. Start where your program is.
Start anywhere and mix tiers by component. The same core content, rubric criteria, and critical-safety gates are preserved; technology and implementation support change, and local faculty assigns every final grade.
Tier 1 · Local, paper, self-delivered
Slides, talk tracks, printable assessments, role-play cases, and paper scoring. The program delivers approximately 11 hours of lectures locally.
NO PLATFORM · NO CONNECTIVITY
Tier 2 · Recorded + paper
Expert-recorded lectures eliminate local lecturing; assessments remain printable and faculty-scored.
NO LOCAL LECTURING
Tier 3 · Hosted online
Online learning software adds completion tracking, readings, AI-enabled simulated-patient links, online submission, and local faculty grading.
Minimal institutional lift.
RECOMMENDED FOR MOST PROGRAMS
Tier 4 · + AI-assisted first pass — planned pilot
AI drafts rubric-aligned feedback and flags possible omissions or safety concerns. Faculty reviews every output and assigns the final score.
Tier 5 · Hosted + implementation support — planned
Planned services include de-identified analytics, benchmarking, faculty development, and managed multisite implementation.
At release, Tier 1–2 core instructional and assessment materials will be free under CC BY-NC. Programs may adopt individual modules or mix delivery tiers. Prize money from NIH Nutrition Challenge will be used for hosting servicesHosted services may carry future costs; released core materials remain free.
ASSESSMENT & COMPETENCY MAPPING
Evidence your CCC can actually use.
Residents complete a scored portfolio and receive a course-completion report cross-walked to HHS nutrition competencies and nine ACGME Family Medicine subcompetencies. Faculty assigns every grade; all formal Milestones and progression decisions remain with the home program.
THE PREBUILT ASSESSMENT SUITE
Pre/post knowledge instrument (Days 1 & 8)
Scored critical appraisals with study-specific guides and benchmark responses
Module + continuity-clinic Applied Nutrition Prescriptions (100-pt rubric)
Faculty-scored simulated-patient encounters with transcripts and structured feedback
Day 8 capstone with a 100-point rubric and critical-safety gate
Completion report cross-walked to HHS competencies and ACGME domains
MILESTONE EVIDENCE — MAPPED FOR YOU
The elective generates assessable evidence for nine Family Medicine subcompetencies:
PC-2
PC-3
MK-1
MK-2
PBLI-1
PBLI-2
ICS-1
ICS-2
SBP-2
The crosswalk identifies where ACN artifacts may inform local review. It does not establish a Milestone level or replace direct observation, CCC judgment, or the home program’s progression decisions.
Quality is engineered in: facilitators calibrate to ≥80% agreement with expert consensus before grading · 20% of scored work is double-scored against a target of weighted κ ≥ 0.60 · critical-safety items are tracked to 100% detection. Every scored activity requires ≥80% of rubric criteria plus every safety gate.
THE TEAM
Built by experts and educators.
Developed at Wake Forest Family Medicine by Erin Saner, MD, DABOM; Matt Calkins, MD, DABOM; Laura Buchanan, MD, DABOM; and Julie Kirk, PharmD. Recorded lectures are delivered by domain-expert faculty from across the nation; a registered dietitian nutritionist co-authors the culinary and interprofessional materials.
Bring ACN to your residency.
Two weeks. One course lead. Everything prebuilt. Be part of the first national cohort of adopting programs.