ALLIED HEALTH
Why disease management should mirror dentistry Amy Sarcevic
After smoking and obesity, poor diet is the largest contributor to Australia’s disease burden, yet it is uncommon for patients to be offered personalised, nutrition-related interventions when seeking health care.
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or people with chronic disease management plans, only 1–2% of allied health services include referrals to Accredited Practising Dietitians (APDs); and for pregnant women there are no routine APD referrals. One side effect of this is that intakes of discretionary (aka ‘energy-dense, nutrientpoor’) foods are twice that recommended by the Australian Guide to Healthy Eating, contributing half the burden of heart disease. The burden of conditions like bowel cancer, diabetes and stroke would also reduce by up to 25% if healthy eating habits were the default. Laureate Professor Clare Collins, Director of the Food and Nutrition Research Program at the Hunter Medical Research Institute and the University of Newcastle, would like to see dietary check-ups introduced to our healthcare system in a model that more closely mirrors dentistry. 18
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She believes several key events should trigger a nutrition intervention, particularly early pregnancy and the detection of a chronic disease risk. “If I was in charge of the health department, I would introduce a Medicare item that would allow people to have dietary checkups at these key life stages,” she told Hospital + Healthcare. “At present, the system only offers this to people who already live with chronic disease — and even then it can be an afterthought. “Yes, we see dietitians central in management of kidney disease and diabetes, but so many other conditions are falling through the cracks. “The role nutrition currently plays in disease management pales in comparison to its impact on disease burden.” SUMMER 2024
Surprising findings Collins believes more work is also needed to ensure medical colleagues are giving evidence-based messages surrounding dietary intake. She says nutrition is an ostensibly complex area, with many of the latest research findings unintuitive. “It’s possible that some of our medical colleagues are contributing to misinformation. Some may not know the answers but are having a crack at giving advice. Then there are those who were trained many years ago, who may not be abreast with the latest guidelines.” Among the most surprising of recent findings is that the under-consumption of legumes, like beans and chickpeas, poses the highest dietary risk factor to chronic disease. The second-highest dietary risk factor is a diet low in wholegrains or fibre.
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