Heart Group: Let Digital Tools Carry Weight of Dietary Counseling

Conversations with patients about healthy eating habits would be facilitated by the adoption of a rapid diet assessment and counseling tool in the doctor’s office, according to the American Heart Association (AHA).

“It is evident that clinicians generally view dietary counseling as within their scope of practice, and clinician-delivered dietary counseling modestly improves diet quality and diet-related cardiometabolic risk factors. However, clinicians are constrained by lack of nutrition knowledge and time for patient counseling,” said a group chaired by Maya Vadiveloo, PhD, RD, of the University of Rhode Island in Kingston.

“With more widespread use of electronic health records [EHRs], there is an enormous unmet opportunity to provide evidence-based clinician-delivered dietary guidance using rapid diet screener tools that must be addressed,” the authors highlighted in an AHA scientific statement published online in Circulation: Cardiovascular Quality and Outcomes.

They suggested that practitioners without adequate nutrition training are likely to find value in brief tools that provide clinical decision support (CDS), for immediate guidance on healthy food modifications, and are tracked through EHRs for better workflow integration.

Hypothetically, the ideal tool would evaluate total diet quality, show test-retest reliability, have validity tested against other assessment tools (such as food questionnaires), have validity tested across different populations, and show links between diet scores and health biomarkers, Vadiveloo and colleagues said.

From 15 available tools, they identified three that were most promising:

• The 14-item Mediterranean Diet Adherence Screener and its variations

• The shortened, 16-item Rapid Eating Assessment for Participants

• The eight-item version of the Starting the Conversation tool

Diets are generally said to be poor if they are low in fruits, vegetables, and whole grains; and high in red and processed meat, added sugars, sodium, and total calories. These eating patterns have been linked to cardiovascular disease (CVD), Alzheimer’s disease, some cancers, and diabetes, the authors said.

“Although the largest body of evidence emphasizes the need for nutrition training in medical schools and residencies, training for physician assistants, nurses, pharmacists, and others is also limited and important. In the absence of such training, a valid rapid diet screener tool with CDS can help bridge the gap in conducting diet assessment and providing feedback in clinical settings,” stated the AHA group.

“In the future, providing regular diet assessment and recommendations based on validated clinical tools will help patients address the lifestyle changes they need for healthier lives and reduce the public health and economic burdens from CVD and other chronic diseases linked to poor diet quality,” Vadiveloo’s team concluded.

Last Updated August 07, 2020