Nutrition Counseling in the Promoting Cancer Prevention in Primary Care Study

Background. Little is known about the influence of personal and practice-level factors on physiciansʹ dietary counseling practices. Methods. Primary care physicians (n = 130) were surveyed regarding the frequency that they “ask” patients about their diet, “assess” patientsʹ reasons for and against dietary changes, “advise” patients to eat less fat and more fiber, “assist” patients in changing their diet, and “arrange” a follow-up contact to discuss their diet. In addition, physicians were asked their personal dietary practices, counseling confidence, practice demographics, and medical specialty. Results. Physicians who (a) reported consistently avoiding dietary fat, (b) were more confident in their diet counseling abilities, and (c) were sole owners of their practice were more likely to counsel than physicians who were employees or part owners of the practice. For example, physicians who reported consistently avoiding dietary fat (50.7% of physicians) were 3.2 (95% CI: 1.3–7.9) times more likely to “ask” their patients about their diet and 3.5 (95% CI: 1.5–8.6) times likely to “advise” their patients to eat less fat and more fiber. Conclusions. Given the strong and consistent effects of a physicianʹs dietary pattern on their counseling practices, future studies should examine the impact of modifying a physicianʹs diet on their patientsʹ dietary behavior.