Monday, March 28, 2016

Counseling patients to eat less meat: should we bring climate change into the conversation?

- Jennifer Middleton, MD, MPH

The current issue of AFP features a Practice Guideline summarizing the Dietary Guidelines Advisory Committee's 2015-2020 Dietary Guidelines for Americans, and its contents are unlikely to surprise readers: 1) choose mostly nutrient-dense foods, 2) don't over-consume them, and 3) limit sugar, saturated fats, and salt intake. An accompanying AFP editorial by Dr. Caroline Wellbery, however, brings up what may be a more controversial angle; reducing meat intake would not only be beneficial for our nation's health, but it may also slow climate change.

This topic seems to be a hot one, lately, with the Washington Post running a similarly themed article this past week asserting many of the same points Dr. Wellbery does. The Washington Post article reviews a recent study titled "Analysis and valuation of the health and climate change cobenefits of dietary change," which ran predictive models of various population diet patterns to see how they might affect healthcare costs and greenhouse gas emissions. The study authors predicted that if we all ate less meat, the longer we would live, the less we would spend on health care, and the less we would contribute to greenhouse gases.

This issue tends to stir up heated emotions on both sides of the climate change debate, as a quick glance at the online comments for both the Washington Post piece and Dr. Wellbery's editorial reveals. Stepping back from the precipice of soapboxes and unbridled passions for a moment, though, how might we as family physicians choose a thoughtful approach to counseling our patients about their nutrition?

I suspect most of us would agree that encouraging our patients to adopt healthier dietary habits is a good thing (even if we disagree about some of the reasons why); unfortunately, our patients receive a lot of mixed messages about just what those habits should be, and finding the time to incorporate that counseling into our busy days can be challenging. Helping our patients focus on evidence-based recommendations, such as consuming less sugar and eating less meat while choosing more fruits, vegetables, and whole grains is a good start; working with them to set even one behavioral change goal (such as drinking less soda pop or eating one less serving of meat a week) per visit may feel more realistic to both docs and patients alike, too.

Here are some additional resources that might make nutrition counseling feel a little more doable:

(Remember that you can add any of these links to your AFP home page "Favorites" button if you'd like to be able to refer to them quickly on the fly.)

What office strategies have you found successful in helping patients choose healthier diets?