Brown Rachel Clare, Gray Andrew Robert, Yong Lee Ching, Chisholm Alex, Leong Sook Ling, Tey Siew Ling
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Biostatistics Unit, Dean's Office, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
PeerJ. 2018 Sep 11;6:e5500. doi: 10.7717/peerj.5500. eCollection 2018.
Nut consumption at the population level remains low despite the well-documented benefits of their consumption, including their cardioprotective effects. Studies have suggested that advice from health professionals may be a means to increase nut consumption levels. Understanding how nuts are perceived by the public and health professionals, along with understanding the public's perceptions of motivators of and deterrents to consuming nuts, may inform the development of initiatives to improve on these low levels of consumption. The aim of this cross-sectional study was to compare perceptions of nuts among three groups of health professionals (dietitians, general practioners, and practice nurses) and the general public in New Zealand (NZ), along with motivators of and deterrents to consuming nuts amongst the general public and their experiences of receiving advice around nut consumption.
The NZ electoral roll was used to identify dietitians, general practitioners (GPs), and practice nurses, based on their free-text occupation descriptions, who were then invited to complete a questionnaire with 318, 292, and 149 respondents respectively. 1,600 members of the general public were randomly selected from the roll with 710 respondents. Analyses were performed using chi-squared tests to look at differences in categorical variables and linear regression for differences in other variables between the four survey groups.
Although there were significant differences between the four groups regarding the perceptions of nuts, in general there was agreement that nuts are healthy, high in protein and fat, are filling, and some nuts are high in selenium. We noted frequent agreement that the general public participants would consume more if nuts: improved health (67%), were more affordable (60%), or improved the nutrient content (59%) and balance of fats (58%) within their diets. Over half the respondents reported they would eat more nuts if they were advised to do so by a dietitian or doctor, despite less than 4% reporting they had received such advice. The most frequently selected deterrents to increasing nut consumption were: cost (67%), potential weight gain (66%), and leading to eating too much fat (63%).
It is concerning that so few among the general public report receiving advice to consume more nuts from health professionals, especially given their apparent responsiveness to such advice. Health professionals could exploit the motivators of nut consumption, while also addressing the deterrents, to promote nut intake. These factors should also be addressed in public health messages to encourage regular nut consumption among the public. Educational initiatives could also be used to improve the nutritional knowledge of GPs and practice nurses with regard to nuts, although even dietitians were unsure of their knowledge in some cases.
尽管食用坚果的诸多益处已有充分记录，包括其对心脏的保护作用，但人群层面的坚果摄入量仍然很低。研究表明，来自健康专业人员的建议可能是提高坚果摄入量的一种方式。了解公众和健康专业人员对坚果的看法，以及公众对食用坚果的动机和阻碍因素的认知，可能有助于制定相关举措，以改善这种低摄入量的情况。这项横断面研究的目的是比较三组健康专业人员（营养师、全科医生和执业护士）以及新西兰公众对坚果的看法，同时了解公众食用坚果的动机和阻碍因素，以及他们接受坚果消费建议的经历。
根据新西兰选民名册中自由填写的职业描述来识别营养师、全科医生和执业护士，然后邀请他们分别填写一份问卷，分别有318名、292名和149名受访者。从名册中随机抽取1600名公众成员，有710名受访者。使用卡方检验分析分类变量的差异，使用线性回归分析四个调查群体之间其他变量的差异。
尽管四个群体对坚果的看法存在显著差异，但总体上一致认为坚果健康、富含蛋白质和脂肪、有饱腹感，并且一些坚果富含硒。我们注意到，公众参与者普遍认为，如果坚果能：改善健康（67%）、价格更实惠（60%）、或改善饮食中的营养成分（59%）和脂肪平衡（58%），他们会增加食用量。超过一半的受访者表示，如果营养师或医生建议他们这样做，他们会多吃坚果，尽管不到4%的人表示他们收到过这样的建议。增加坚果消费最常被提及的阻碍因素是：成本（67%）、可能体重增加（66%）和导致摄入过多脂肪（63%）。
令人担忧的是，很少有公众表示从健康专业人员那里得到过增加坚果消费的建议，特别是考虑到他们显然对这种建议有反应。健康专业人员可以利用食用坚果的动机，同时解决阻碍因素，以促进坚果摄入。这些因素也应在公共卫生信息中加以解决，以鼓励公众经常食用坚果。教育举措也可用于提高全科医生和执业护士关于坚果的营养知识，尽管在某些情况下，即使是营养师也不确定自己的知识水平。
