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Editorial
Volume 52, Issue 6, June 2023

Guest Editorial: Nutrition care – The good news story nourishing Australian general practice

Lauren Ball   
doi: 10.31128/AJGP-03-23-6776   |    Download article
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In a longitudinal series on nutrition and diet, we celebrate the longstanding role of nutrition in general practice and its increasing prominence in clinical practice. To set the scene, here are five ways that nutrition care is positively influencing contemporary general practice:

First, nutrition care is now recognised to be more effective (but more costly) than usual care in supporting patients to pursue health and wellbeing through diet.1 It may seem straightforward, but ultimately a greater investment in nutrition care leads to better outcomes for patients based on changes in diet and subsequent indicators of chronic disease.1 This new evidence enables policy initiatives that involve nutrition care to be developed with confidence that improved outcomes for patients are likely to follow.

Second, nutrition is entering a phase of positive political support. March 2023 saw the establishment of the Parliamentary Friends of Nutrition group, where Members of Parliament from all major parties heralded the importance of nutrition in ensuring Australians live and age well. The group is co-Chaired by Senator Helen Polley and Mrs Bridget Archer MP.2 This group provides a vehicle for communication with parliamentarians and can be used to advocate for strengthened investment in several aspects of general practice that relate to nutrition, including chronic disease prevention and management, mental health, healthy ageing and eating disorders.

Third, nutrition care is not technically exclusive. For the most part, patients view high-quality nutrition care as occurring when general practitioners connect with patients so they feel listened to and understood, rather than relying on technical information about foods and their constituents.3 At minimum, two key messages are to: (i) consume an abundance of fresh vegetables and fruit; and (ii) limit the consumption of processed foods. These messages are evidence-based, non-controversial, and relevant for nearly all population groups, health conditions and dietary philosophies.

Fourth, evidence-based practice guidance for general practitioners exists and is growing. The Handbook for non-drug interventions (HANDI) by The Royal Australian College of General Practitioners (RACGP) comprises a suite of topic-specific guidance showcasing evidence and clinical tips for supporting patients through nutrition care. Recent topics for nutrition include omega-3 fatty acid consumption in pregnancy to reduce the risk of preterm birth, low energy diets to treat type 2 diabetes and viscous fibre for type 2 diabetes.4

Fifth, a strong workforce is available for individualised medical nutrition therapy. Australia has a large workforce of accredited practising dietitians who have proven effectiveness at facilitating health improvements through diet.5 Over 50% of graduate dietitians enter directly into primary care, and the Find a Dietitian website can be used to locate dietitians across the country.

Now, there has never been a greater potential for nutrition care in general practice to support patients in their pursuit of health and wellbeing, as relevant to social context and biological function. Nutrition care is not only about preventing and managing chronic disease. Issues of food insecurity, food allergies/anaphylaxis, swallowing problems and mental health all have roots in nutrition care and create opportunities for general practitioners to have a special interest in nutrition for the benefit of their patients and the wider Australian society.
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References
  1. Barnes KA, Szewczyk Z, Kelly JT, Campbell KL, Ball LE. How cost-effective is nutrition care delivered in primary healthcare settings? A systematic review of trial-based economic evaluations. Nutr Rev 2022;80(6):1480–96. doi: 10.1093/nutrit/nuab082. Search PubMed
  2. Parliament of Australia. Parliamentary Friendship Groups (non-country). 2023. Available at: www.aph.gov.au/About_Parliament/Parliamentary_Friendship [Accessed 12 May 2023]. Search PubMed
  3. Sturgiss E, Advocat J, Ball L, Williams LT, Prathivadi P, Clark AM. Behaviour change for type 2 diabetes: Perspectives of general practitioners, primary care academics, and behaviour change experts on the use of the 5As framework. Fam Pract 2022;39(5):891–96. doi: 10.1093/fampra/cmab182. Search PubMed
  4. The Royal Australian College for General Practitioners. Handbook for non-drug interventions (HANDI). 2023. Available at www.racgp.org.au/clinical-resources/clinical-guidelines/handi [Accessed 12 May 2023]. Search PubMed
  5. Mitchell LJ, Ball LE, Ross LJ, Barnes KA, Williams LT. Effectiveness of dietetic consultations in primary health care: A systematic review of randomized controlled trials. J Acad Nutr Diet 2017;117(12):1941–62. doi: 10.1016/j.jand.2017.06.364. Search PubMed

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