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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.

Diet changes 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.

According to 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.

The 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 counseling.

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 Eaton.

Some experts 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."

© 2002 Health Resources Publishing