Nutrition guidance by primary-care physicians: perceived barriers and low involvement

To investigate the activities of general practitioners (GPs) in nutritional matters and the factors that influence their attitudes, knowledge and behaviour, especially perceived barriers.

Postal questionnaires (result of focus group discussions and in-depth interviews) were sent to a nationwide random sample of GPs in the Netherlands.

1000 GPs, in practice for between 5 and 15 years.

The identification of GPs' perceived barriers to nutritional guidance of their patients, their nutritional attitudes and behaviours.

Net response rate was 64% (633/990). GPs perceived smoking to be the greatest health hazard, followed by dietary pattern and genome. 70% expressed considerable interest in the role of nutrition in health. In daily practice nutrition plays a minor role in the work of the GP. 28% of GPs gave daily nutrition information to about 10% of their patients and 48% to about 5% of their patients. It is found that GPs do perceive strong barriers of being involved in nutrition issues during their practice. The most important barriers expressed were: not being trained in nutrition, lack of time to address nutrition issues and the perception that patients lack motivation to change lifestyle and/or dietary patterns.

The involvement of GPs in nutritional matters is very low. The fact that lack of training is considered as the most important barrier is, however, unexpected. This finding offers possibilities for improvement in which in-service courses and inter-active distant-learning programmes on nutrition for GPs should get special attention.