IJE Advance Access originally published online on September 12, 2005
International Journal of Epidemiology 2006 35(2):409-415; doi:10.1093/ije/dyi170
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Nutrition |
Randomized controlled trial: effect of nutritional counselling in general practice
1 CPO-Piemonte, Torino, Italy
2 Health Regional Administration of Piedmont, Torino, Italy
3 Imperial College, London, UK
4 University of Torino, Italy
* Corresponding author. Department of Epidemiology and Public Health, Imperial College of Science, Technology and Medicine, Norfolk Place, W2 1PG London, UK. E-mail: p.vineis{at}imperial.ac.uk
Objectives To investigate the effectiveness of a non-structured 15-min educational intervention by general practitioners (GPs) on modifications of daily diet among healthy adults.
Design Two arms randomized trial lasting 12 months.
Setting Italian general practitioner wards.
Subjects A total of 3186 men and women aged 18–65 years recruited in the medical ward by their GPs.
Interventions 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.
Results 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).
Conclusions 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.
Keywords Randomized controlled trial, general practice, nutrition, health promotion
Accepted 26 July 2005