Eating behaviors among low-income obese adults in the United States: Does health care provider's advice carry any weight.
Eating behaviors among low-income obese adults in the United States: Does health care provider's advice carry any weight.
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DOI：
10.1016/j.ypmed.2016.02.015
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发表时间：
2016-06
影响因子：
5.1
通讯作者：
Ohri-Vachaspati P
中科院分区：
文献类型：
--
作者：
Lorts C;Ohri-Vachaspati P
美国预防工作组建议，所有患者都应接受肥胖筛查，并在必要时给予适当的减肥建议，因为初级保健医生的营养咨询是2020年健康人群的关键目标。本研究评估了健康护理提供者（HCP）建议减肥和肥胖个体饮食行为之间的关联。数据是通过2009- 2010年对新泽西五个城市的成年人进行家庭调查收集的。分析仅限于548名肥胖参与者。负二项回归分析确定了参与者的饮食行为和HCP的减肥建议之间的关联，调整了参与者的减肥尝试和人口统计学变量。尽管肥胖，但只有48%的参与者从他们的HCP那里得到了减肥建议，而68%的参与者表示他们正在尝试减肥。HCP的减肥建议与沙拉和水果消费量增加有关（p=0.03和p=0.01）。在调整HCP的建议后，试图减肥与水果（p=0.004），蔬菜（p=0.01）的摄入量增加以及将水果和蔬菜作为零食（p<0.001）呈正相关。尝试减肥与甜食（p=0.03），含糖饮料（p=0.002）和快餐（p=0.04）的消费呈负相关。HCP的建议和减肥尝试之间没有显著的相互作用。肥胖成年人的减肥尝试，而不是HCP的减肥建议，是健康饮食行为的预测指标。医疗实践中的干预措施应培训HCP有效的策略，以激励肥胖患者采取更健康的生活方式。
The U.S. Preventive Task Force recommends that all patients be screened for obesity and given appropriate weight loss advice, if needed, as nutrition counseling by primary care physicians is a key objective for Healthy People 2020. This study assesses the association between health care provider’s (HCP) advice to lose weight and eating behaviors among obese individuals. Data were collected using a household survey of adults in five New Jersey cities in 2009–10. Analyses presented are limited to 548 obese participants. Negative-binomial regression analysis determined the association of participants’ eating behaviors and HCP’s advice to lose weight, after adjusting for the participant’s attempt to lose weight and demographic variables. Despite being obese, only 48% of the participants received weight loss advice from their HCP while 68% stated they were attempting to lose weight. HCP’s advice to lose weight was associated with increased salad and fruit consumption (p=0.03 and p=0.01). Attempting to lose weight, after adjusting for HCP’s advice, was positively associated with a higher consumption of fruit (p=0.004), vegetables (p=0.01), and with eating fruits and vegetables as snacks (p<0.001). Attempting to lose weight was negatively associated with consumption of sweet snacks (p=0.03), sugar sweetened beverages (p=0.002) and fast food (p=0.04). There were no significant interactions between HCP’s advice and attempts to lose weight. Obese adult’s attempt to lose weight, and not HCP’s advice to lose weight, is a predictor for healthy eating behaviors. Interventions in medical practices should train HCPs on effective strategies for motivating obese patients to adopt healthier lifestyles.