Morbidity in family medicine: The potential for individual nutritional counseling, an analysis from the Nijmegen continuous morbidity registration

Abstract

Nutritional counseling is a common primary care intervention but few empirical data are available. This study analyzed morbidity in family medicine practices and the relevance of nutritional counseling. Morbidity data from the Nijmegen University family medicine Continuous Morbidity Registration were studied. Since 1967 four practices (seven family physicians) have recorded all new episodes of illness. Physicians were trained and supervised monthly in their coding and classification of morbidity with diagnostic criteria. Two experienced family physicians assessed the nutrition sensitivity of all 400 diagnostic rubrics of the classification list. Incidence and prevalence of all morbidity and of nutrition-sensitive morbidity were calculated. The most common (chronic) diseases in family practice were a mixture of diseases of organ and body systems: hypertension, obesity, cardiovascular disease, chronic arthritis, asthma, chronic obstructive pulmonary disease, eczema, and diabetes mellitus. The prevalence of these diseases gradually increased in the past decade. Forty-eight diagnostic rubrics were considered to be nutrition sensitive, accounting for 16.5% of diagnoses recorded. Their prevalence also increased in the past decade. The survey supports the importance of nutrition-related interventions in family medicine but underlines that these interventions are directed at a variety of illnesses and patient groups. Common nutritional intervention techniques that can be applied in the personal care of patients in the context of their family life should be developed.