Randomized controlled trial: effect of nutritional counselling in general practice

Università degli Studi di Torino, Torino, Piedmont, Italy
International Journal of Epidemiology (Impact Factor: 9.2). 05/2006; 35(2):409-15. DOI: 10.1093/ije/dyi170
Source: PubMed

ABSTRACT To investigate the effectiveness of a non-structured 15-min educational intervention by general practitioners (GPs) on modifications of daily diet among healthy adults.
Two arms randomized trial lasting 12 months.
Italian general practitioner wards. Subjects A total of 3,186 men and women aged 18-65 years recruited in the medical ward by their GPs.
An educational intervention and a brochure on the basics of a healthy diet based on the Italian Guidelines for a Correct Nutrition, 1998. The main study goal was to attain an intake of fruits and vegetables >5 servings per day. Follow-up visit every 6 months. Main outcome measures Weight, blood pressure, and a 40-items Food Frequency Questionnaire.
The intervention group showed a slightly reduced net intake of meat and a slightly increased net intake of fruits and vegetables, fish products, and olive oil. Body mass index (BMI) changed only in the treatment arm [-0.41 95% confidence interval (95% CI) -0.11 to -0.53]. The net change at 1 year in the intervention arm was +1.31 (CI 0.90-4.39) for fruits and vegetables, and -0.22 (-0.11 to -0.69) for meat (portions per week). We also computed a 'healthy diet score' reflecting compliance with recommended dietary habits. In the intervention group, the mean score at recruitment was significantly lower than the mean score at the end of follow-up (Crude score change = 0.29; CI 0.19-0.48). No differences were observed in the control group (Crude score change = -0.04; CI -0.22-0.02). The difference in score from baseline to the final visit, comparing the intervention vs the control group, was statistically significant (P < 0.001) (MANOVA adjusted by sex, BMI, education, and time).
A brief educational intervention by GPs can induce multiple diet changes that may lower BMI and potentially reduce chronic disease risk in generally healthy adults.

Download full-text


Available from: Rosalba Rosato, Mar 25, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the effects on healthy eating or Mediterranean diet adherence achieved by interventions suitable for implementation in primary care settings.
    Preventive Medicine 12/2014; DOI:10.1016/j.ypmed.2014.12.011 · 2.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Individuals seeking healthcare treatment in the context of obesity often experience difficulty engaging in discussions around their health and face challenges finding consensus with practitioners on care plans that best suit their lives. The complex set of biological, social, and environmental variables that have contributed to the higher prevalence of obesity are well illustrated in the foresight obesity system map. Effectively understanding and addressing key variables for each individual has proven to be difficult, with clinicians facing barriers and limited resources to help address patients' unique needs. However, productive discussions inspired by patient centered care may be particularly effective in promoting behaviour change. Tools based on systems science that facilitate patient centered care and help identify behaviour change priorities have not been developed to help treat adult obesity. This project created and pilot tested a card based clinical communication tool designed to help facilitate conversations with individuals engaged in health behaviour change. The health communication cards were designed to help direct conversation between patients and healthcare providers toward issues relevant to the individual. Use of the cards to facilitate patient driven conversations in clinical care may help to streamline conversations, set realistic care plan goals, and improve long term rates of compliance.
    02/2014; 2014:579083. DOI:10.1155/2014/579083
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In an era of limited resources, cost-effectiveness analysis and cost-benefit analysis (CEA/CBA) can be significant policy-making aids. Because the often stated belief that prevention is cost-effective has not been systematically examined, we surveyed about 250 CEA/CBA articles concerning prevention. We found that few authors have followed generally accepted methodological standards, which raised questions concerning the validity of their findings and conclusions. In addition, prevention itself is a problem in CEA/CBA because of such factors as the long intervals between interventions and outcomes, problems which have rarely been considered in the CEA/CBA prevention literature. At the same time, a number of high quality studies concerning prevention indicates that United States policy makers have not aggressively pursued significant opportunities to improve health through prevention, for example by immunizing the elderly and by screening for and treating hypertension. We recommend that analysts follow general methodological principles in CEA/CBA prevention studies to assure both valid and credible results.
    Journal of Community Health 02/1983; 9(2):145-65. DOI:10.1007/BF01349877 · 1.28 Impact Factor