Effects of a dietetic treatment in older, undernourished, community-dwelling individuals in primary care: a randomized controlled trial.

Purpose: Undernutrition is a prevalent problem in older, community-dwelling individuals. Aim of this study was to determine the effects of a dietetic treatment in older, undernourished, community-dwelling individuals.

Methods: A parallel randomized controlled trial was performed in 146 non-institutionalized, undernourished individuals aged ≥65 years in primary care.

Nutrition and physical activity guidance practices in general practice: a critical review.

Objective: The aim of this critical review is to provide insight into the main outcomes of research on communication about nutrition and/or physical activity between GPs and patients for prevention or treatment of overweight and obesity.

Methods: Relevant studies were identified by a computerized search of multiple electronic databases (MEDLINE, PsycINFO) for all available papers between 1 January 1995 and 1 January 2012. In addition, two independent reviewers judged all studies on ten quality criteria.

Generalizability of systematic reviews of the effectiveness of health care interventions to primary health care: concepts, methods and future research.

Background: There is a push to make clinical decision making more evidence based and patient oriented. However, current systematic reviews are limited by the lack of consideration of generalizability.

Objective: To develop a guide for investigators (systematic reviewers) on how to adapt the methodology of a systematic review to facilitate the exploration of the results to primary care.

A longitudinal study of changes in noticing and treating patients' overweight by Dutch GPs between 1997 and 2007.

Background: One of the stakeholders in tackling the rise and health consequences of overweight and obesity is the general practice physician (GP). GPs are in a good position to inform and give nutrition guidance to overweight patients.

Objective: Assessment of working mechanism of determinants of the nutrition guidance practice: noticing patients' overweight and guidance of treatment by GPs [linear analysis of structural relations (LISREL) path model] in a longitudinal study.

Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

The prevalence of obesity and overweight is increasing globally and forms a huge public health problem. On the other hand, the prevalence of malnutrition or undernutrition is substantial, especially in nursing homes or in the elderly at home. Primary care and public health are separate disciplines.

Weight loss in head and neck cancer patients little noticed in general practice.

Introduction: In head and neck cancer patients, weight loss increases morbidity and mortality, and decreases treatment tolerance and quality of life. Early nutritional intervention has beneficial effects on these factors.

Aim: We observed patients' weight courses after specialists' care and surveyed nutrition-related documentation by general practitioners (GPs).

[Summary of the Dutch College of General Practitioners' practice guidelines on obesity].

Adults with obesity have a decreased life expectancy and an increased risk of disease. Preferred treatment is a combination of lifestyle interventions, consisting of changes in diet, physical exercise and psychological support. Normal weight is not an achievable target in most adults, but even a 5-10% weight loss yields significant health gains.

Improving nutritional management within high-risk groups.

The current pitfalls and future possibilities of nutritional management are discussed by two patients with tongue cancer who have suffered from substantial weight loss. Their nutritional problems are illustrative of those among other (cancer) patient groups. The main concerns are the lack of early case finding and dietary treatment, and insufficient nutritional information transfer through referral letters.

Encounters for common illnesses in general practice increased in obese patients.

Background: Obese patients are known to have more chronic medical conditions.

Objective: To compare the frequency of encounter for episodes of the 10 most common illnesses in general practice between obese and non-overweight patients.

Methods: Data were derived from the Continuous Morbidity Registration, containing data from four general practices in and around Nijmegen (The Netherlands).

A prospective study on malnutrition and quality of life in patients with head and neck cancer.

The objective of this observational prospective study in patients with squamous cell carcinoma (SCC) of the oral, oropharyngeal and hypopharyngeal cavity was to look into the relation between malnutrition (>or=10% unintended weight loss within 6 months) and specific quality of life (QoL) parameters longitudinally. Bodyweight and QoL were monitored in 47 patients with SCC at diagnosis, end of treatment and six months after treatment. EORTC QoLQ-C30 and H&N 35 questionnaires were used to assess QoL.

Nutrition in primary care: scope and relevance of output from the Cochrane Collaboration.

There is a lack of randomized controlled nutritional intervention studies with objective clinical endpoints conducted from primary care. Therefore, evidence-based nutritional advice is hampered by 3 factors: (1) a lack of nutritional intervention studies, (2) the difficulty of translating nutritional interventions into practice, and (3) the difficulty of translating to the setting of primary care. A search was made within the publications of the Cochrane Library with potential nutritional aspects.

Patient information letters on nutrition: development and implementation.

Background: In 1998 the Dutch College of General Practitioners (NHG) began developing patient information letters (PILs), based on the practice guidelines for family physicians (FPs) (NHG standards). Five nutritional guidance letters have since been developed with the Dutch Nutrition Center.

Methods: In August-September 2001 a survey was done among a random sample of 200 FPs who subscribe to the PILs.