Dietary Behaviors, Eating Attitudes and Patient Satisfaction Outcomes of Diettian Intervention

Data were culled retrospectively from the medical records of 81 ambulatory patients, 68 females and 13 males age 52 ± 13.0 years (mean ± SD) who received at least 2 individualized dietitian sessions {medical nutrition therapy (MNT)} for hyperlipidemia 31%, diabetes 27%, glucose intolerance 42%. hypertension 16%, weight reduction 84% and coronary heart disease 10%. Patients received 6 ± 4 sessions (median = 4, range = 2–18) over 10 ± 8 weeks (median = 6, range = 2–30). Time spent was 206 ± 141.5min (median = 150, range = 90–570). A telephone survey was conducted with a previously validated instrument (J Am Diet Assoc. 1994; 94: 437–440). Patients reported: a) dietitian's advice was suited to their special needs 96%, b) knew what to eat after MNT 90%, c) made recommended dietary changes 69%, d) did not have trouble changing diet 86% , e) felt in control of diet 69%. f) MNT helped achieve positive health changes 68%. g) noted positive health changes due to diet modification 68% and h) noted improvement in clinical conditions 69%. Results were similar by gender (p =NS). Patients attributed MNT to an improvement in eating behaviors such as increased consumption of fruits (69%), vegetables (69%), whole grains (61%), high calcium foods (43%) and planning meals and snacks (77%). Patients reported MNT helped to achieve the following positive eating attitudes: not to feel guilty after an occasional splurge (82%), eat healthfully and exercise instead of obsessing about one's weight and diet(81%), eat fat in moderation (81%), eat a balanced diet (63%) and variety, balance and moderation are the keys to a healthful diet (73%). Only 17% stated they had difficulty changing their diet as suggested. Stated barriers to change were preparing meals and snacks (31%), high cost of foods suggested (18%). taste of the foods suggested (20%), finding the foods needed in the store (22%), knowing what to eat (11%) and getting to the store (11%). Only 5% received but 96% wanted coverage of MNT by their health care plans. MNT leads to positive dietary behaviors, eating attitudes and patient satisfaction. This study supports the inclusion of MNT by health care plans as a value added service.