Dietary and exercise assessment in general practice

BACKGROUND: Diet and physical activity are important in many conditionsmanaged in primary care. Dietary and physical activity assessmentis complex, has inherent inaccuracies related to self-reporting,and is only a small part of a larger context of developing effectiveintervention in primary care. However, for personalized assessmentin routine clinical care, and for the assessment of differentintervention strategies in a general practice research setting,validated life-style assessment tools are needed. OBJECTIVE: We aimed to discuss the requirements for assessment tools andto identify feasible validated assessment instruments for usein primary care. METHODS: Potential tools were identified from a Medline search, UK ResearchIntelligence, and contact with groups known to be working inthe area. RESULTS: Several brief instruments assess mainly fat in the US diet butthe limited range of foods covered and the setting of studieslimits their generalizability. Only one tool developed for UKuse—‘DINE’, which scores total fat, fibreand unsaturated fat—was identified which is both feasibleand has documented reasonable validated characteristics. Evenfor this tool there are doubts about the validation ‘standard’.No diet or physical activity validation studies have used bothsubjects and health professionals from general practice settings. CONCLUSION: There are very few feasible and validated dietary or physicalactivity assessment tools for use in clinical care or researchin general practice, and doubts about the design and settingsof published validation studies. Further research is neededto validate and develop a range of feasible life-style assessmenttools with specified time and training requirements for usein primary care. Keywords. Nutrition assessment, primary health care, exercises.