Trends and disparities in the prevalence of physicians' counseling on diet and nutrition among the U.S. adult population, 2000-2011

Prev Med. 2016 Aug;89:70-75. doi: 10.1016/j.ypmed.2016.05.014. Epub 2016 May 16.


Background: Although healthy eating plays a crucial role in addressing the obesity and chronic disease epidemics, a few Americans have diets that meet dietary guidelines. Because physicians-delivered counseling is a strong predictor for behavioral modification among patients, the Healthy People Objectives have emphasized diet counseling since 2000. However, research on impact of physicians' counseling over time on a national level has been limited.

Methods: We used data from the 2000 and 2011 National Health Interview Surveys to apply a logistic regression model to identify predictors of physicians' counseling and examine any changes in disparities over a decade.

Results: In 2000, only 23.7% of our national sample had received dietary counseling, it increased to 32.6% in 2011. Hispanics were less likely than Whites to receive advice on diet in 2000 (adjusted odds ratio [AOR]=0.74, 95% confidence interval [CI]=0.62-0.88). By 2011, Hispanics 18% (AOR=1.18, CI=1.09-1.28) and Blacks were 42% (AOR=1.42, CI=1.32-1.54) more likely to receive advice from their physicians on diet than Whites. In both years, men were significantly less likely than women to receive counseling. The uninsured patients were increasingly less likely than insured patients in receiving diet counseling, being 60% less likely in 2011 (AOR=0.40, CI=0.37-0.40). Obese patients were substantially (88% in 2000 to 290% in 2011) more likely to receive counseling than normal-weight patients.

Conclusions: The overall prevalence of physicians' counseling on diet increased moderately between 2000 and 2011. However, substantial disparities in dietary counseling related to access to care and gender continue to exist.

Keywords: Body mass index; Counseling; Diet; Disparities; Gender; Healthy people objectives; Insurance coverage; Nutrition; Physicians; Racial and ethnic minorities.

MeSH terms

  • Adult
  • Aged
  • Counseling / statistics & numerical data*
  • Diet*
  • Ethnicity
  • Exercise
  • Feeding Behavior
  • Female
  • Health Behavior
  • Healthcare Disparities / trends*
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status*
  • Obesity / epidemiology
  • Obesity / ethnology
  • Practice Patterns, Physicians' / trends*
  • Prevalence
  • Sex Factors
  • United States / epidemiology