Klumbiene Jurate, Petkeviciene Janina, Vaisvalavicius Vytautas, Miseviciene Irena
Institute for Biomedical Research, Kaunas University of Medicine, Eiveniu str, 4, 50009 Kaunas 7, Lithuania.
BMC Public Health. 2006 Feb 14;6:30. doi: 10.1186/1471-2458-6-30.
Obesity is a globally spreading health problem. Behavioural interventions aimed at modifying dietary habits and physical activity patterns are essential in prevention and management of obesity. General practitioners (GP) have a unique opportunity to counsel overweight patients on weight control. The purpose of the study was to assess the level of giving advice on diet and physical activity by GPs using the data of Lithuanian health behaviour monitoring among adult population.
Data from cross-sectional postal surveys of 2000, 2002 and 2004 were analysed. Nationally representative random samples were drawn from the population register. Each sample consisted of 3000 persons aged 20-64 years. The response rates were 74.4% in 2000, 63.4% in 2002 and 61.7% in 2004. Self-reported body weight and height were used to calculate body mass index (BMI). Information on advising in primary health care was obtained asking whether GP advised overweight patients to change dietary habits and to increase physical activity. The odds of receiving advice on diet and physical activity were calculated using multiple logistic regression analyses according to a range of sociodemographic variables, perceived health, number of visits to GPs and body-weight status.
Almost a half of respondents were overweight or obese. Only one fourth of respondents reported that they were advised to change diet. The proportion of persons who received advice on physical activity was even lower. The odds of receiving advice increased with age. A strong association was found between perceived health and receiving advice. The likelihood of receiving advice was related to BMI. GPs were more likely to give advice when BMI was high. More than a half of obese respondents (63.3%) reported that they had tried to lose weight. The association between receiving advice and self-reported attempt to lose weight was found.
The low rate of dietary and physical activity advice reported by overweight patients implies that more lifestyle counselling should be provided in primary health care. There is an obvious need for improved training and education of GPs in counselling of overweight patients focusing on methods of giving dietary and physical activity advice.
肥胖是一个在全球范围内蔓延的健康问题。旨在改变饮食习惯和身体活动模式的行为干预对于肥胖的预防和管理至关重要。全科医生（GP）有独特的机会就体重控制问题为超重患者提供咨询。本研究的目的是利用立陶宛成年人群健康行为监测数据，评估全科医生在饮食和身体活动方面提供建议的水平。
分析了2000年、2002年和2004年横断面邮政调查的数据。从人口登记册中抽取具有全国代表性的随机样本。每个样本由3000名20 - 64岁的人组成。2000年的回复率为74.4%，2002年为63.4%，2004年为61.7%。使用自我报告的体重和身高来计算体重指数（BMI）。通过询问全科医生是否建议超重患者改变饮食习惯和增加身体活动，获取在初级卫生保健中提供建议的信息。根据一系列社会人口统计学变量、感知健康状况、看全科医生的次数和体重状况，使用多元逻辑回归分析计算接受饮食和身体活动建议的几率。
近一半的受访者超重或肥胖。只有四分之一的受访者表示他们被建议改变饮食。接受身体活动建议的人群比例更低。接受建议的几率随年龄增加而增加。在感知健康状况和接受建议之间发现了强烈的关联。接受建议的可能性与BMI有关。当BMI较高时，全科医生更有可能提供建议。超过一半的肥胖受访者（63.3%）表示他们曾尝试减肥。发现了接受建议与自我报告的减肥尝试之间的关联。
超重患者报告的饮食和身体活动建议率较低，这意味着初级卫生保健应提供更多的生活方式咨询。显然需要加强对全科医生的培训和教育，使其在为超重患者提供咨询时，重点关注饮食和身体活动建议的方法。
