Life

The GP's View: Doctors must ask about lifestyle and diet

GP practices should have a greater role in steering patients towards a healthy diet
GP practices should have a greater role in steering patients towards a healthy diet GP practices should have a greater role in steering patients towards a healthy diet

‘LET food be thy medicine and let medicine be thy food’ – the words, it’s thought, of Hippocrates of Kos, the Ancient Greek physician known as the father of medicine (he also wrote the Hippocratic Oath, the doctors’ code of ethics).

Diet and lifestyle were key themes in Hippocrates’ writings, and he insisted both were central to a doctor’s work.

But despite the fact that unhealthy eating is a major cause of heart disease, type 2 diabetes and other conditions linked to early death, few of us are routinely asked by our doctors about what we eat.

The only tool I know for this is the dietitian’s food diary – a detailed record you keep for a week, setting out how much and what kind of food and drink you consume.

Dietitians, however, appear to be an under-utilised resource.

Regardless, it’s surprising doctors take so little interest in what their patients eat. It doesn’t help that the Quality Outcomes Frame-work, which rewards GPs for providing certain services (such as vaccinations), does not incentivise them to focus on healthy diets.

Now the American Heart Association is proposing that routine consultations should always aim to include dietary assessment (the best tools for this are being evaluated).

There’s no reason why the same should not occur here in the NHS. We need a professional dietitian in every GP surgery, or evidence-based reliable tools for GPs and practice nurses to help prevent and treat the myriad conditions linked to diet and lifestyle.

Part of the reason for this vast hole in the world of medicine is a lack of knowledge about the huge array of molecules in food and how they affect health (we’re still learning, for instance, just how much the bacteria in our intestines absorb and modify the food molecules we’ve eaten).

But we can’t wait until we know everything – rising obesity levels and the enormous associated cost to the NHS mean we need to get the ball rolling now.

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