Preventive Medicine 31, 652–657 (2000) doi:10.1006/pmed.2000.0760, available online at http://www.idealibrary.com on Physician–Patient Interactions Regarding Diet, Exercise, and Smoking Haq Nawaz, M.D., M.P.H.,* , † , ‡ ,1 Mary L. Adams, M.P.H.,§ and David L. Katz, M.D., M.P.H.* , † , ‡ *Yale–Griffin Prevention Research Center, †Departments of Preventive and Internal Medicine, Griffin Hospital, Derby, Connecticut; ‡Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut; and §Connecticut Department of Public Health such as quitting smoking, losing weight, changing their Objectives. The objectives were to determine the rate diet, and becoming more active [5–7]. In addition, in- of physician/patient discussions regarding diet, exer- creased levels of physical activity can lead to decreased cise, and smoking and to assess the effect of such dis- cardiovascular mortality [8,9], weight reduction [10], cussions on behavior change. better control of hypertension [11], and a decreased Methods. In a telephone survey of Connecticut adults, chance of developing diabetes [12]. This benefit in respondents who had a routine checkup in the past health outcome is even more pronounced in persons year (n  433) were asked whether their physicians with multiple risk factors. had asked them about their dietary habits, exercise, Physicians can be helpful in promoting healthy be- or smoking, and about any efforts to modify these be- havior simply by counseling their patients against cer- haviors during the preceding year. tain health risk behaviors, such as smoking [13,14]. Results. Diet was addressed with 50% of the subjects, The U.S. Preventive Services Task Force recommends exercise with 56%, and smoking status with 77%. Re- that physicians routinely screen and counsel patients spondents who were asked about their diet were more about important health risk behaviors [15]. Previous likely to have changed their fat or fiber intake in the studies have shown low rates of physician counseling past year than those not asked (64 vs 48%, P  0.002) of patients, however [16–19]. Assuming that physicians and were somewhat more likely to have lost weight (46 would need to determine if a patient engaged in a risky vs 37%; P  0.061); the differences were even greater behavior before they could consider counseling, we as- among 94 overweight subjects (64 vs 47%; P  0.099). sessed the frequency of physician queries about lifestyle No behavior change was associated with discussions of exercise or smoking. risks (smoking, diet, and exercise) in a telephone survey Conclusions. Physicians have the potential to impact of Connecticut adults. We also asked survey respon- health behaviors, especially those related to diet, dents about behavior changes made in the past year. through simple discussions during routine checkups, METHODS but only about half are using this opportunity.  2000 American Health Foundation and Academic Press In May–June of 1995, a telephone survey of randomly Key Words: adult; chronic disease; counseling; exer- selected Connecticut adults, funded by CDC, was con- cise; female; life style; male; physician–patient; rela- ducted to address whether: (a) during the last routine tions; physicians; risk factors; weight loss. checkup, their physician had asked them about their diet, physical activity, and/or smoking, and (b) whether INTRODUCTION they lost weight, increased exercise, or modified fat or fiber intake in the past year. A total of 1,053 eligible Behavioral health risk factors such as smoking, phys- households were contacted to yield 637 (60% response ical inactivity, poor diet, and their sequelae result in rate) complete interviews. Analysis was limited to the substantial morbidity and mortality [1–4], accounting respondents (n = 433, 68%) reporting a routine checkup for nearly one-third of all deaths in the United States. by a physician in the past year. Respondents who were Studies have shown that individuals can reduce their not sure or refused to answer the question regarding risk of chronic diseases by making lifestyle changes their last routine checkup were excluded from the anal- ysis. Data were adjusted for gender and age to be repre- 1 To whom reprint requests should be addressed at Department of sentative of the adult population in Connecticut ac- Preventive Medicine, Griffin Hospital, 130 Division Street, Derby, CT 06418. Fax: 203 732 1264. E-mail: haqnawaz@pol.net. cording to the 1990 census. 652 0091-7435/00 $35.00 Copyright  2000 by American Health Foundation and Academic Press All rights of reproduction in any form reserved.