General practitioners and health promotion
Hippocrate clearly stated that:« let food be your first medicine »
The link between nutrition, physical activity and health is not challenged today. By improving lifestyle, cardiovascular disease risk can be reduced. Most epidemiological studies that analysed nutritional factors involved in non-communicable diseases prevention highlighted the importance of fruit and vegetables (F&V), both in prevention and in management of type 2 diabetes and obesity. Also, World Health Organization (WHO) pinpointed that the prescription of healthy diet and physical activity should be fully integrated in medical consultation. This newsletter states the importance of General Practitioners (GPs) in managing the intervention on patients’ lifestyle changes during medical consultations. In the first two articles, two young GPs reported the results of their Doctor of Medicine dissertation that were presented during the pre-Egea symposium (c.f. GFVN n°45) :
- Estelle Tang has pointed out the potential difficulties to improve the lifestyle of patients suffering from cardiovascular disease, although many studies have clearly shown the efficacy of personnalised nutrition in secondary or tertiary prevention. A multidisciplinary follow-up program allowing constant support to patients, reported a net increase of F&V consumption among ¾ of these patients. The author also emphasized the importance of motivational interviewing to help patients change their behaviour.
- Dariny Rughoo discussed the new trend of vegetarian/ vegan diet. These patients were avidly interested to receive nutritional information and advice from their GPs. However, the latter seemed to be not at ease to do so, somehow probably because of lack of education in this particular controversial area. Therefore, it’s important to envisage better education in clinical nutrition during medical curriculum or continuing education.Another topic of concern is doctors’ stigmatization of patients suffering from obesity. This is mainly linked with the belief that body weight is under voluntary control and that obesity is just the consequence of excessive food intake, imbalanced diet together with physical inactivity. However, lots of studies claimed that obesity is a disease. This stigmatization results in collapsed self-esteem, deteriorated body image, increased eating disorders, avoidance of physical activity, depression, and avoiding medical consultation despite the fact that they need to be supported by their doctors.
Sophie Bucher Della Torre presents a recent study carried out at the University Hospital of Geneva. It aims to delineate knowledge, attitudes and beliefs of the medical/paramedical personnel involved in obesity management. Stigmatization level was lower in this hospital as compared to previous investigations. Moreover, healthcare professionals complained about a lack of education in obesity management. However 80% did know about nutrition guidelines related to F&V consumption.
In conclusion, patients want and need to receive objective support, information and practical advice from their GPs concerning lifestyle and nutrition. That’s why their knowledge in clinical nutrition should be improved. Having an insight and practicing motivational interviewing will help patients to change their behaviour.