The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Original Article

Nutrition Care of Older Adults with Chronic Disease: Attitudes and Practices of Physicians and Patients

Authors: John B. Coombs, MD, MNS, Albert Barrocas, MD, Jane V. White, PHD, RD

Abstract

Objectives: Eighty percent of older adults have at least one chronic disease. Most conditions could be improved with nutritional intervention. This scientific study assessed physician and patient knowledge of, and behaviors about nutrition, resulting in tools to guide physicians in nutrition management of chronic diseases.


Methods: Surveys were conducted of 300 practicing physicians and 600 older adults to identify current attitudes and practices regarding the role of nutrition in chronic disease management.


Results: Ninety percent of physicians surveyed recognize the relationship between nutrition and chronic disease. Yet nutrition care occurs only sporadically in primary care settings.


Conclusions: Most physicians are aware of nutrition in managing chronic disease, but a significant percentage do not routinely include nutrition in their practice. This research led to the development of tools to assist in identifying and managing the nutritional aspects of chronic disease.

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References

1. Administration on Aging, U.S. Department of Health and Human Services. A Profile of Older Americans: 2002. Available at: http://www.ao-a.gov/prof/Statistics/profile/2002profile.pdf. Accessed November 15, 2003.
 
2. Kramarow E, Lentzner H, Rooks R, et al. Health and Aging Chartbook. Health, United States, 1999. Hyatttsville, MD, National Center for Health Statistics, 1999. Available at:http://www.cdc.gov/nchs/data/hus/hus99cht.pdf. Accessed November 15, 2003.
 
3. Nutrition Screening Initiative. The Role of Nutrition in Chronic Disease Care. Washington, DC, Nutrition Screening Initiative, 1997.
 
4. Krauss RM, Eckel RH, Howard B, et al. AHA Dietary Guidelines: Revision 2000 —a statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation2000;102:2284–2299.
 
5. Sacks FM, Svetkey LP, Vollmer WM, et al; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 2001;344:3–10.
 
6. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).JAMA 2001;285:2486–2497.
 
7. Franz MJ, Bantle JP, Beebe CA, et al; American Diabetes Association. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications.Diabetes Care 2002;25(Suppl 1):S50–S60.
 
8. Committee on Nutrition Services for Medicare Beneficiaries, Food and Nutrition Board, Institute of Medicine. The Role of Nutrition in Maintaining Health in the Nation’s Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population. Washington, DC, National Academy Press, 2000.
 
9. American Dietetic Association. Position of the American Dietetic Association: nutrition, aging, and the continuum of care. J Am Diet Assoc 2000;100:580–595.
 
10. Cornuz J, Ghali WA, Di Carlantonio D, et al. Physicians’ attitudes towards prevention: importance of intervention-specific barriers and physicians’ health habits. Fam Pract 2000;17:535–540.
 
11. Schulman JA. Nutrition education in medical schools: trends and implications for health care educators. Med Educ Online [serial online] 1999; 4,4. Available at: http://www.med-ed-online.org/f0000015.htm. Accessed November 15, 2003.
 
12. Marrero DG, Kraft SK, Mayfield J, et al. Nutrition management of type 2 diabetes by primary care physicians: reported use and barriers. J Gen Intern Med 2000;15:818–821.
 
13. Mihalynuk TV, Scott CS, Coombs JB. Self-reported nutrition proficiency is positively correlated with the perceived quality of nutrition training of family physicians in Washington State. Am J Clin Nutr2003;77:1330–1336.
 
14. Greenlund KJ, Giles WH, Keenan NL, et al. Physician advice, patient actions, and health-related quality of life in secondary prevention of stroke through diet and exercise. Stroke 2002;33:565–570.
 
15. Potter MB, Vu JD, Croughan-Minihane M. Weight management: what patients want from their primary care physicians. J Fam Pract 2001;50:513–518.
 
16. Lambert BL, Butin DN, Moran D, et al. Arthritis care: comparison of physicians’ and patients’ views.Semin Arthritis Rheum 2000;30:100–110.
 
17. Kenner MM, Taylor ML, Dunn PC, et al. Primary care providers need a variety of nutrition and wellness patient education materials. J Am Diet Assoc 1999;99:462–466.
 
18. Nutrition Screening Initiative. A Physician’s Guide to Nutrition Management in Chronic Disease for Older Adults. Washington, DC, Nutrition Screening Initiative, 2002.
 
19. Frank E, Wright EH, Serdula MK, et al. Personal and professional nutrition-related practices of US female physicians. Am J Clin Nutr 2002;75:326–332.
 
20. Fiscella K, Goodwin MA, Stange KC. Does patient educational level affect office visits to family physicians?J Natl Med Assoc 2002;94:157–165.
 
21. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. Baltimore, Williams & Wilkins, 1996, ed 2.