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1、DirectObservationofNutritionCounselinginCommunityFamilyPracticeCharlesB.EatonMD,MS,MeredithA.Goodwin,MS,KurtC.Stange,MD,PhDBackground:Despitethelargepotentialofdietarychangestoreducemorbidityandmortality,thefrequency,timespent,andfactorsassociatedwithnutritioncounselinginprimarycarearenot
2、wellstudied.Methods:Inacross-sectionalstudyof84familyphysicianpracticesinnortheastOhio,nutritioncounselingwasmeasuredbydirectobservationon2daysforallconsecutiveambulatoryvisits.Thefrequency,timespent,andpatientandvisitcharacteristicsassociatedwithnutritioncounselingweredetermined.Results:
3、Among138familyphysicians,only6%includednutritioncounselinginthemajority(50%)ofpatientencounters.Among3475consecutiveoutpatientvisitsinadults,nutritioncounselingoccurredin24%ofallpatientvisits,17%ofvisitsforacuteillnesses,30%ofchronicillnessvisits,and41%ofwell-carevisits.Theaveragetimespe
4、ntonnutritioncounselingwas55seconds,rangingfrom20secondsto6minutes.Nutritioncounselingoccurredin45%ofvisitsfordiabetes,25%ofvisitsforcardiovasculardisease,31%ofvisitsforhypertension,26%ofprenatalvisits,and33%ofvisitsbyobesepatients(bodymassindex30).Nutritioncounselingwasmorelikelytoocc
5、urduringvisitsbypatientswhowereolderorhaddiabetesmellitus,duringvisitsforwellcareorchronicillness,andduringlongervisits.Conclusion:Despiteconsiderablevariabilityfromphysiciantophysician,nutritioncounselingoccursinapproximatelyonefourthofallofficevisitstofamilyphysicians.Theobservedeffortsb
6、yfamilyphysicianstofocusnutritioncounselingonhigh-riskpatientsmayincreaseitsimpact.MedicalSubjectHeadings(MeSH):counseling,familypractice,nutrition,preventivehealthservices(AmJPrevMed2002;23(3):174–179)Introductionenumeratespecificrecommendationsregardingnutri-tionandnutritioncounseling.Re
7、centclinicalguide-utritioncounselinghasthepotentialtoplayanlines—theJointNationalCommitteeonPrevention,importantroleinthenation’shealthpromo-NDetection,Evaluation,andTreatmentofHighBloodtionanddiseasepreventioneffortsinthe21st4Pressure;reportsoftheNationalCholestero
