Randomized controlled trial: effect of nutritional counselling in general practice.
OBJECTIVE
To investigate the effectiveness of a non-structured 15-min educational intervention by general practitioners (GPs) on modifications of daily diet among healthy adults.


METHODS
Two arms randomized trial lasting 12 months.


METHODS
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.


METHODS
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.
Sacerdote
Carlotta
C
CPO-Piemonte, Torino, Italy.
Fiorini
Laura
L
Rosato
Rosalba
R
Audenino
Michela
M
Valpreda
Mario
M
Vineis
Paolo
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003376:Counseling / Q000379:methods; D004032:Diet; D005194:Family Practice / Q000379:methods*; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D014675:Vegetables