Nutrition in primary care: scope and relevance of output from the Cochrane Collaboration

There is a lack of randomized controlled nutritional intervention studies with objective clinical endpoints conducted from primary care. Therefore, evidence-based nutritional advice is hampered by 3 factors: (1) a lack of nutritional intervention studies, (2) the difficulty of translating nutritional interventions into practice, and (3) the difficulty of translating to the setting of primary care. A search was made within the publications of the Cochrane Library with potential nutritional aspects. The key words and free text words "nutrition," "food," "foodstuff," "nonpharmacologic," "weight," "body weight," "diet," "dietitian," "general practitioner," and "family physician" were used with the Internet version of the Cochrane Library. Common clinical problems in primary care that have at least some nutritional aspects, are not currently well covered in existing Cochrane reviews. In only 6 cases was nutrition mentioned to some extent. Clinical practice could benefit from a more rigorous approach to nutritional advice. Review groups should be approached to encourage reviewers to cover these aspects in future updates. The existing "comments and criticisms" procedure available on the Cochrane website could be used for this purpose. Having a streamlined Heelsum Workshop Group, based at a university with roots within the various disciplines, linking the experience of daily practical work of the family physician is important, but a small group will need to take overall responsibility for coordination and updating Cochrane reviews on nutrition.