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According to a recently published study in the Journal of Preventive Medicine, when it comes to counseling patients on diet and physical activity, some patients may be overlooked because they appear healthy.
Findings from the study, which was conducted by Dr. Matthew W. Kreuter, assistant professor of community health at the School of Public Health, suggest that it is difficult, if not impossible, for physicians to do a complete health assessment to determine which patients eat a diet high in fat, or which patients don't get enough exercise.
"The reality is there are many people who are asymptomatic for disease who are headed down a potentially dangerous path," Kreuter said. "Their diets are not healthy, and they are inactive, even though their bodies may not show it from the outside."
Typically a physicians has only a few minutes to spend with a patient. Kreuter said physicians don't have time to go through a complete dietary history. Instead, he said the health care system needs to do a better job of systematically identifying people who have inactive lifestyles or unhealthy diets so that their health care providers can take the appropriate actions with those patients.
"The more risk a person had, the more likely he or she was to get counseling to eat less fat or to become more physically active," Kreuter said. "That tells us the people who are the sickest are the most likely to get counseling. Those who aren't sick and don't have symptoms are the least likely to be advised to change. That makes some sense from a medical perspective of focusing on the people with the biggest problems, but it misses an opportunity for prevention because the people who have no risks now may have several later. This essentially is the old Ôounce of prevention worth a pound of cure' adage."
Kreuter recommends that a health care assessment should be utilized, much like the financial paperwork that patients fill out. There are dietary and physical activity assessments that are effective and useful for physicians, Kreuter said.
"A doctor carries a lot of credibility," Kreuter said. "So if the doctor knows that a person is eating unhealthily, even though he or she appears to be fit, the patient can be counseled effectively and can receive the kind of guidance that would be helpful."
The study polled more than 900 adult patients and 27 physicians from four community-based family medicine clinics in southeastern Missouri. To participate, patients completed a self-administered behavioral and health questionnaire while waiting to see their doctors. The study was funded by the Centers for Disease Control and Prevention.