The role of the general practitioner and the dietitian in patient nutrition management.

There is mounting evidence that nutrition plays an important role in the aetiology and management of many diseases affecting Australians. Nutrition counselling provides a strategy for not only reducing patient suffering, but also for reducing the health care costs associated with these illnesses. At the forefront of providing nutrition counselling to Australians are General Practitioners (GPs) and Dietitians. Australian data shows that GPs encounter many patients with the chronic diseases that have nutrition in their aetiology and management. Although this presents opportunities to provide nutrition counselling, overseas literature suggests that often nutrition counselling opportunities are not taken up. At present, there is little evidence to support whether this problem exists in Australia, or the magnitude of the problem. Whilst evidence suggests there are barriers for GPs in providing nutrition counselling, there is conflicting evidence on how these influence the GP's decision to provide such counselling. Overseas studies have also identified barriers for GPs to refer to dietitians to provide nutrition counselling, however there is no evidence to identify whether these barriers exist in Australia. Whilst various strategies have been implemented to aid in the provision of effective nutrition management to the Australian public, there is little evidence on the efficacy of these. Research is needed in the above areas if effective patient nutrition management is to be implemented in Australia.

Dietitian-general practitioner interface: a pilot study on what influences the provision of effective nutrition management.

BACKGROUND: Effective patient nutrition management can both improve people's health and reduce the cost of health care. In Australia, general practitioners (GPs) and dietitians are in a position to provide this service. However, there is a lack of information available on what influences the provision of the service. OBJECTIVE: The objective was to determine qualitative factors that influence nutrition management by GPs and dietitians. DESIGN: A convenience sample of GPs and dietitians was surveyed using a qualitative questionnaire. The questionnaire related to issues including influences on the GP's decision to initiate nutrition management, barriers to providing nutrition counseling, influences on the GP's decision to refer to a dietitian, and barriers to referral. RESULTS: Fourteen of 20 GPs and 15 of 30 dietitians responded with usable data. The primary influence on a GP's decision to initiate nutrition management (GPs' and dietitians' responses) was the presentation of a patient who required nutrition advice. Barriers to providing nutrition counseling were time and knowledge (GP response), whereas dietitians saw time and lack of patient interest as issues. The primary influence on the GP's decision to refer to a dietitian was a patient presenting with complicated nutrition requirements (GP response), whereas dietitians considered a patient seeking nutrition knowledge as the key influencer. GPs identified cost to the patient as the main barrier to referring to a dietitian, whereas dietitians saw lack of knowledge of where to refer as the key issue. CONCLUSIONS: The differing responses suggest that more research is required to understand what influences patient nutrition management by GPs and dietitians in Australia.

Calcium absorption measured by stable calcium isotopes ((42)Ca & (44)Ca) among Northern Chinese adolescents with low vitamin D status.

An adequate calcium intake and vitamin-D status is important for bone mineralization in adolescents. In Northern China, calcium intake and plasma vitamin-D level of adolescents is low due to low consumption of dairy foods and inadequate sunshine exposure. True fractional calcium absorption (TFCA) in Chinese adolescents has never been performed. This study aims to evaluate nutritional adaptation namely, TFCA and urinary calcium excretion among Chinese adolescents in northern China.