Lack of Knowledge Hinders Heart Healthy Diet Education

While many doctors have long believed diet to be the key component in preventing and managing cardiovascular disease, significant gaps in their knowledge often hindering proper education about heart healthy diets.

Researchers from New York University presented results Sunday, March 15 at the American College of Cardiology meeting of a 28-question survey of 236 cardiologists and internal medicine physicians at a large tertiary academic medical center. Although physicians rate nutrition to be as important as statins in terms of reducing the risk of cardiovascular disease, only 13.5% agreed or strongly agreed that they were adequately trained to discuss nutrition with patients.

Only 2 of 3 fact-based questions were correctly answered.

The Mediterranean diet was most recommended (55%), followed by low-fat (40%), DASH (38%), and low-glycemic index (18%).

Cardiologists and internal medicine physicians received approximately the same scores. Nearly 89.7% knew the Mediterranean diet was reported to reduce cardiovascular disease in randomized controlled trials, but less than half (45.5%) knew that low-fat diets never had similarly positive results.

Researchers were primarily surprised with how many physicians were seemingly unequipped to give accurate and practical recommendations for choosing heart healthy foods. For instance, while the physicians knew about the blood pressure lowering effects of fruits and vegetables and LDL-cholesterol lowering effects of soluble fiber (81.7 and 87.6%, respectively), only a fraction of respondents could correctly identify which foods were high in soluble fiber or an oily fish (69.5 and 30.8%, respectively).

Eugenia Gianos, MD, assistant professor of medicine in the Leon H. Charney Division of Cardiology at NYU Langone Medical Center and a study investigator, said, “It is one thing to know an oily fish is a good thing, but being able to advise patients on which types of fish are high in omega-3 fatty acid is another.”

Also, it was noted that only 2 of 3 doctors spent less than 3 minutes counseling patients about diet and lifestyle modifications.

Gianos commented, “In some ways we were pleased to see that most doctors were spending any time discussing diet and exercise given how short medical appointments are these days, but we would have liked to see more referrals to dieticians.”

While the data might be limited due to a low response rate of 26.7% and was only conducted at a single center, Gianos fully believed there is great potential to improve patient care through “physician education with more extensive emphasis on diet in their core curriculum, self-learning opportunities, and collaboration with dietitians or other health care professionals”.

The results concluded, “Physicians believe diet is important in CVD prevention, but practical knowledge and self-reported training in nutrition is suboptimal.” The authors remarked the study emphasized the necessity for additional nutritional training for cardiologists and other physicians, as well as increased opportunities to for patient education.