Role of nutritional support provided by qualified dietitians in the prevention and treatment of non-communicable diseases

Abstract

The role of dietitians is to counsel patients on special dietary modifications, develop dietary plans and provide dietary advice for healthy lifestyle in order to promote health and prevent disease. As lifestyle changes have become a primary reason for the increasing prevalence of non-communicable diseases in recent decades, it appears that nutritional therapy should play an important role in the multidisciplinary healthcare system. The aim of the review was to evaluate the role of nutritional support provided by dietitians in the prevention and treatment of chronic diseases in terms of its clinical and cost-effectiveness, according to their range of activity and qualifications. The evaluation was based on the review of the current literature. The costs of the treatment of non-communicable diseases encompass the costs of the treatment of the disease itself, costs of its complications and costs resulting from the decline of the productivity of patients. The results of studies indicate that nutritional support provides not only clinical but also cost benefits in the prevention and treatment of various non-communicable diseases. Every €1 spend on dietary counseling of patients with obesity or obesity-related diseases approximately returns a net €14 to €63 over a period of five years. Dietitians appear to be more effective in counseling overweight or obese patients with present risk factors compared to other specialists, however the barriers to accessing a qualified dietitian and problems with the reimbursement for services still exist. As adequate professional qualifications of dietitians appear to be an important factor determining the effectiveness of implemented dietary care, an additional training courses for dietitians and enhanced cooperation of hospitals and medical universities are needed.

Predictors of Dietitian Referrals in Hospitals

“…The existing literature clearly shows that dietitian involvement has considerable benefits for hospitalized patients, resulting in better health outcomes and improved quality of life [ 18 , 19 , 20 , 33 , 34 ]. For patients with obesity, for example, every Euro invested in dietary counseling by dietitians saves 14 to 63 Euros over five years [ 35 ]. Dietitians appear to be more effective in counselling compared to other healthcare specialists.…”

“…Dietitians appear to be more effective in counselling compared to other healthcare specialists. However, there are still barriers to being referred to a qualified dietitian, and in some countries there are problems with reimbursement for dietitian services, especially in the outpatient setting [ 35 , 36 ]. This reveals and emphasizes the fact that improving dietitian involvement in the care of patients depends, amongst other things, also to a great extent on the respective country’s referral system and therefore its entire healthcare system.…”

“…Nutritional care and dietary counselling must be adapted to the respective patient’s individual needs and social situation, and multidisciplinary cooperation between all healthcare professionals within the clinical team is key for successful nutritional care. Furthermore, the patients’ adherence to their nutritional recommendations is an important factor for success [ 15 , 35 ].…”

Opinions of Dietitians about Factors Affecting Individual Nutrition Counseling and Job Satisfaction

“…Bu ciddi, ancak çoğu zaman gözden kaçan bir sorundur çünkü beslenme tedavisi bulaşıcı olmayan hastalıkların yönetiminde klinik fayda yanında maliyet faydası da sağlamaktadır. Obezitesi ya da obezite ile ilişkili hastalığı olan bireylerin beslenme danışmanlığına harcanan her 1 Euro'nun 5 yıl içerisinde net 14-63 Euro olarak geri döndüğü belirtilmiştir (8). Bu nedenle, sağlığın korunması ve yükseltilmesinde önemli rolü olan diyetisyenler için mesleğin yıpratıcı ve eksik yönlerinin düzeltilmesinin, iş doyumunun artmasını sağlayarak bu rollerini kuvvetlendireceği düşünülmektedir.…”

“…Türkiye Beslenme ve Sağlık Araştırması 2019 verilerine göre; obezite sıklığı erkeklerde %24.9, kadınlarda %35.6; toplamda %30.0'dur (7). Yaşam tarzı değişiklikleri, bulaşıcı olmayan hastalıkların son yıllarda artan yaygınlığının birincil nedeni haline geldiğinden, diyetisyenlerin multidisipliner sağlık ekibinin hayati bir parçası olması gerektiği bilinmektedir (8). Sıklıkla karşılaşılan çalışma alanı olarak bireysel beslenme danışmanlığı yürüten diyetisyenlerin, verdikleri beslenme danışmanlığı ve eğitiminin, obezite ile mücadelede önemli bir basamak olduğu görülmektedir (9).…”