The majority of chronic illnesses that people face can be controlled or prevented through diet and lifestyle changes. However, during your average wellness visit, food is rarely part of the conversation for many doctors.
You have a lot of challenges -- particularly time -- when it comes to talking about nutritional information with patients, but by providing it, you're sending a message that their diet is just as important as blood pressure, BMI, and other numbers you regularly discuss.
Why Take the Time to Talk About Nutrition?
The amount of time doctors spend talking about nutrition with their patients varies. Some doctors regularly discuss lifestyle habits, while some find it more worthwhile to talk about food only with obese patients.
But given all we know about nutrition and its link to disease, physicians should broach the subject with every patient. Cardiologist James Rippe points out that, when you don't talk to patients about diet and exercise, you're subtly sending the message that it's not important.
Time is always a challenge. It never feels like there's enough time to cover all you need to discuss with each patient. In addition, many patients don't want to hear nutritional information.
Another more unforeseen challenge is that medical school alone likely doesn't adequately prepare physicians to feel confident in providing that sort of guidance. One study from The American Journal of Clinical Nutrition found that medical schools spend an average of 20 hours on nutrition over four years, with little of that devoted to understanding the link between food and health. More data from The Journal of the American College of Nutrition shows that only 14 percent of resident physicians felt confident in providing nutrition counseling to their patients, although 94 percent felt it was their obligation to talk to patients about nutrition.
Patients may also make it challenging for you. Food is so often tied to memories, emotions, and social events. This makes many people resistant to dietary changes -- or even to discussing the potential for them.
How Do You Talk About Food?
Every patient can benefit from hearing a brief pitch about healthy eating, along with the opportunity to talk more about it. Don't reserve the conversation just for overweight patients. It's important to reach all patients early regarding this topic, as lifestyle changes can prevent or delay many illnesses.
Have a brief mental script that takes you only a minute or two to say. You can rely on one script or have different talking points tailored for kids, parents, older patients, or people with existing conditions. Each script can follow similar guidelines.
Keep It Simple
Your patients are inundated regularly with dietary guidance from news reports, commercials, friends, social media, blogs, and many other places. Too often, the advice is conflicting: Avoid saturated fat; wait, it turns out saturated fat is not so bad. Eat a Paleo diet; no, reduce your meat consumption. Why not go gluten-free? It's thus understandable for patients to feel frustrated and give up trying to figure out what to eat.
Don't overwhelm the patient. Simply focus your talk on what to eat and the benefits. If the person is generally healthy, you can begin by saying, "Healthy eating can help prevent diabetes, heart disease, cancer, and other chronic illnesses."
If the person already has a chronic condition, remind them that eating healthy can help them manage their illness or side effects and possibly reduce the number of drugs they take. Let them know it's easy: "Eating well isn't as complicated as it may seem. Just get plenty of fruits and vegetables, drink water, and limit sugar and salt for starters."
Watch Your Tone
People are often emotionally attached to their food, and telling them that they are eating wrong may immediately cause them to put up a wall and stop listening. Keep your advice in a positive tone, and avoid the word "don't."
Also, keep weight and age out of the discussion. The same general healthy-eating tips apply no matter what age or size a person is. The focus should always be on staying healthy.
Lastly, don't make assumptions. Just because someone runs regularly doesn't mean they always eat great!
Consider the Subtle Messaging
Patients likely spend more time in the waiting room than they do visiting with you. Take stock of your waiting-room materials, and consider adding more healthy-living or cooking magazines.
Offer brochures or printouts on nutrition, and place index cards with nutritious recipes on waiting-room tables. Hang posters with general dietary guidelines on exam-room walls.
Keep a List of Resources Handy
You don't need to have all the answers, but you certainly should be ready to provide a list of resources where patients can find out what they need to know. Be prepared to share reputable websites, and have some of those aforementioned printouts available for patients curious about their diet. Have contact information handy for nutritionists or dietitians nearby that can provide more in-depth guidance.
There's a lot of competing health information on the Internet, even from reputable sources. Here's a list of websites you can share with patients and use to develop your talking points or find printouts:
- ChooseMyPlate has printable daily food plans for a range of ages and calorie levels.
- eatright.org gives simple tips for healthy living you and your patients can use.
- Author Michael Pollan offers a comprehensive page of links and FAQs on nutrition, cooking, and food in general.
- The American Medical Association has a helpful presentation that discusses how to talk to patients about healthier lifestyles.
- Today's Dietitian gives advice on how to communicate health information to patients with low health literacy.