Semistrukturoitu haastattelututkimus UK:sta:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258033/Lainaa:
Much of the science behind dietary guidelines for risk reduction and chronic disease management is equivocal, and there are well-accepted uncertainties and complexities relating to diet in everyday life, as well as physiological processes. Guidelines have therefore stopped short of aligning with one particular approach, instead highlighting several evidence-based options. Have increasing traction in the media and with patients, practitioners and the general public. This qualitative study examines healthcare practitioner (HCP) experiences of implementing a reduced carbohydrate diet.
BMJ Nutrition, Prevention & Health
NNEdPro Global Centre for Nutrition and Health and BMJ Publishing Group
Supporting people to implement a reduced carbohydrate diet: a qualitative study in family practice
Caroline Cupit and Emma Redman
Introduction
Much of the science behind dietary guidelines for risk reduction and chronic disease management is equivocal, and there are well-accepted uncertainties and complexities relating to diet in everyday life, as well as physiological processes. Guidelines have therefore stopped short of aligning with one particular approach, instead highlighting several evidence-based options. However, reduced carbohydrate, or ‘low-carb’, diets have increasing traction in the media and with patients, practitioners and the general public. This qualitative study examines healthcare practitioner (HCP) experiences of implementing a reduced carbohydrate diet.
Methods
Semistructured, qualitative interviews were conducted with 19 HCPs in the UK family practice (including general practitioners, practice nurses and non-medical practitioners), recruited through a special interest forum, and social media. Data analysis employed social science theory and methods to produce key themes.
Results
All participants self-identified as ‘low-carb practitioners’ who, over time, had introduced a specific focus around carbohydrate reduction into their work. They reported transformations in patients’ metabolic markers, patient enthusiasm for the approach and renewed job satisfaction. Key themes highlight experiences of: (1) discovering low-carb as a new ‘tool-in-the-box’; (2) promoting and supporting incremental low-carb experimentation; and (3) diverging from established dietary guidelines.
Conclusions
This study provides important experience-based evidence on a topical dietary intervention. Participants strongly advocated for the use of low-carb diets. The successes described draw attention to the need for pragmatic, formative evaluation of low-carb advice and support as a ‘complex intervention’ (alongside physiological research), to justify, challenge and/or shape low-carb intervention in clinical practice. The findings raise important questions about the contribution of particular care practices to the apparent success of low-carb. Social science analyses can elucidate how dietary intervention is carried out across different healthcare settings (eg, dietetics, endocrinology) and patient groups, how healthcare practices intersect with people’s everyday self-management and how different forms of evidence are invoked and prioritised.
Keywords: dietary patterns, weight management, diabetes mellitus, nutritional treatment, preventive counselling
What this paper adds
Healthcare practitioners in family practice reported that implementing low-carb has transformed many patients’ metabolic health—and their own experience of practice.
Low-carb practitioners were unusually-attentive to patients’ diets, adapting models of care to help patients experiment and address tensions between low-carb and dietary guidelines.
Further research should prioritise pragmatic and formative social-science analyses of low-carb approaches as ‘complex interventions’ across different healthcare settings and patient groups.