Most Patients Not Provided With Necessary Nutrition Counseling
"The need for
nutrition counseling is pressing in light of the epidemic of chronic
diseases such as hypertension, diabetes mellitus, obesity and
hyperlipidemia [excessive fat content in the blood]," said Charles B.
Eaton, M.D., of the family medicine department at Brown Medical School
and the Center for Primary Care and Prevention at the Memorial Hospital
of Rhode Island.
have enormous potential to reduce the risks of death and illness but
few studies have examined nutrition counseling in primary care,
according to the study. Nutrition-related diseases such as heart
disease, stroke, high blood pressure, diabetes and obesity claim the
lives of an estimated 300,000 to 800,000 every year.
Data from a
study of 138 physicians based in Ohio was analyzed by Eaton and his
colleagues. For the study, research nurses were given permission to
observe 3,475 patient examinations, and administer a questionnaire to
patients following their visit. The nurses recorded any discussion of
food intake or nutrition during the examination.
the study data, about a quarter of patients received nutrition
counseling during their doctor visit. Patients who were seeing their
doctor for an acute illness were less likely to receive it at 17
percent, than those with chronic illness which constituted 30 percent.
percentage of chronically ill patients receiving counseling falls short
of the Healthy People 2010 national nutritional objectives, which
suggests that 75 percent of office visits for hyperlipidemia,
cardiovascular disease and diabetes should include nutrition
An average of
less than one minute was spent by physicians on nutrition counseling.
This finding suggests "that more in-depth nutrition counseling visits
will need to occur outside a typical primary care office visit," said
say registered dieticians are best suited or giving nutrition
counseling, while others say physicians can be trained to offer
patients tailored nutrition messages supplemented with written
educational materials, the study found.
Eaton and his
team of researchers hope that their findings help medical educators
create concise nutrition counseling tools "to help physicians optimize
nutrition counseling within the context of the time constraints found
in real-world, primary care practice."