What is it about?

Our online questionnaire went out to 1800 general medical practitioners (GPs) and 108 responded. The style of the questionnaire was a set of seven controversial statements about diet and cardiovascular disease: 1. Once you start a patient on a statin, diet isn’t very important. 2. Omega 3 intake is key to recovery from a cardiac event. 3. LDL cholesterol is more important than HDL cholesterol when interpreting a lipid profile. 4. The latest evidence on dietary fat means that we can now advise that it is safe to consume saturated fat-rich foods. 5. Diet and dyslipidaemia are linked to dysfunction of the endothelium. 6. Non-alcoholic fatty liver disease is a major risk factor for cardiovascular disease. 7. Dietary carbohydrates are neutral with respect to cardiovascular disease. The options were "Agree", "Disagree", "Not sure" in tick boxes and the participants were requested to add comments. For question 1, there was general agreement that good dietary advise was important in addition to prescribing a statin. However there were varying degrees of uncertainty and disagreement in relation to the other six statements with the "Not sure" option varying from 13% to 44%. Comments varied from simple to detailed comments showing some insight such as pointing out the role of trans fatty acids in cardiovascular disease. Analysis indicated that the more experienced GPs had learned about nutrition in the course of their work and certainly not from medical school.

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Why is it important?

There was a good deal of uncertainty about the interpretation of nutrition science and its application in day to day practice. The 44% "Not sure" vote was in relation to the role of dietary omega-3 in cardiovascular health. This reflects alternating reports backing a beneficial role for omega-3 and denying any link. The 26% who were uncertain about the link between endothelial function and dyslipidaemia is unsatisfactory. This should be basic knowledge.The more thoughtful comments came from more experienced GPs who must have learned their nutrition science "on the job".


There is growing unease about the lack of teaching of nutrition science in medical schools and it is to be hoped that this state of affairs will improve. This sample was too small for absolute certainty, but our data suggest that new inexperienced GPs are relatively unlikely to have an understanding of the importance of nutrition in the management of cardiovascular disease. Further research in this area is urgently needed.

Dr John Anthony Alvan Nichols
Royal Society of Medicine

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This page is a summary of: Responses to a GP survey: current controversies in diet and cardiovascular disease, BMC Family Practice, August 2018, Springer Science + Business Media, DOI: 10.1186/s12875-018-0840-4.
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