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IJE Advance Access published online on September 12, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyi170
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.
Accepted July 26, 2005

Original paper

Randomized controlled trial: effect of nutritional counselling in general practice

Carlotta Sacerdote 1, Laura Fiorini 1, Rosalba Rosato 1, Michela Audenino 2, Mario Valpreda 2, and Paolo Vineis 3*

1 CPO-Piemonte, Torino, Italy
2 Health Regional Administration of Piedmont, Torino, Italy
3 Imperial College, London, UK; University of Torino, Italy

* To whom correspondence should be addressed.
Paolo Vineis, E-mail: p.vineis{at}imperial.ac.uk


  Abstract

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.
A Commentary has been commissioned to accompany this article and will appear with this paper in the printed issue.
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