Diet checkup tool, counseling can help heart health

A quick, simple questionnaire in the doctor's office can help fight one of the leading causes of cardiovascular disease – a poor diet, a new report says.

What and how much you eat can affect other heart risk factors, such as high cholesterol, high blood pressure, diabetes and being overweight. About 11 million deaths – and about half the heart disease deaths globally – can be blamed on a poor diet, according to the 2017 Global Burden of Disease Study, a look at the health impact of diet in 195 countries.

The new scientific statement from the American Heart Association, published Friday in its journal Circulation: Cardiovascular Quality and Outcomes, calls for routine health care visits to include some form of dietary assessment and counseling. The diet screening tool could be integrated into electronic health records across all health care settings, the statement said.

"Dietary patterns and quality are not sufficiently prioritized when addressing modifiable risk factors during regular health care office visits," nutritional epidemiologist Maya Vadiveloo, chair of the statement writing group, said in a news release. "Given the evidence that diet contributes to disease and mortality, it is a risk factor worth screening for continuously."

The statement authors reviewed 15 existing screening tools, which ask questions about consumption of fruits, vegetables, sugary and processed food, juice and alcohol.

The statement didn't endorse specific tools but said an effective screening should be quick to use, be based in scientific evidence, and ask about the whole diet pattern, not just single foods or nutrients.

The tool also should give guidance and support, the authors said.

"An important component in addition to evaluating diet quality is targeting actionable changes – helping patients set achievable dietary goals – and then following up at the next visit," Alice H. Lichtenstein, vice-chair of the writing group, said in the release. She is senior scientist of the Cardiovascular Nutrition Team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.

According to the statement, diet patterns can be overlooked during an office visit because of lack of training and knowledge; lack of time and reimbursement; competing demands during the often-short office visit; and because nutrition services aren't integrated into many health care settings.

"However, these barriers can be overcome," said Vadiveloo, an assistant professor of nutrition and health sciences at the University of Rhode Island in Kingston. "We want a valid, reliable way to assess diet that reflects the best science, and most of the tools assessed take under 10 minutes to use."

If you have questions or comments about this story, please email [email protected].