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Increasing pulse intake in primary care patients

Show, don’t tell, to boost pulses in health-minded diets

For many people, hearing about the health benefits of pulses only helps so much. This project is testing the role of professional support in changing nutritional behaviour.

Once people are told about the role of pulses in a healthy diet, they’ll naturally bring pulses into their diet in a bigger way.

No, not in Dr. Doug Klein’s experience. He’s found that sparking behavioral change can take longer and be more difficult than that.

“As a family physician, I work with patients ranging from kids to older adults,” said Klein, who’s also a Professor at the University of Alberta’s Department of Family Medicine. “In that practice, I see a lot of chronic disease. I like to look at what we can do to prevent some of those issues around heart attack and stroke that are difficult for patients and their families, and add significantly to health care costs.”

Combining his roles as family doctor and researcher, Klein is leading a study – funded by Alberta Pulse Growers, Alberta Health Services and others – to test how best to encourage adoption of a healthier diet and more regular exercise.

Prevention before treatment

When Klein treats patients with signs of metabolic disease, associated with heart disease and stroke, he advises them to eat better and exercise more. His clinical experience suggests that such advice, on its own, is unlikely to be acted upon.

“I’ve talked about this with my patients for my whole career,” Klein said. “Simply telling people, go eat more pulses, does not work. I believe you actually have to equip people with tools and resources around nutrition and physical activity. That’s the idea behind this study.”

Klein is now selecting people for the intervention and control groups of this study. The intervention group will receive counselling and encouragement to set a personal plan around diet (including pulses) and exercise. Supporting this plan are resources such as recipes, reflecting Klein’s view that lack of knowledge of how to prepare pulses is a barrier to their use. The control group will not receive this guidance and these resources.

To the extent that health status differs between the two groups, Klein may be able to show that guidance-plus-resources can be effective in creating change. Initial results should be available by the end of 2020.

The output of this study will include both hard data and patients’ stories. Using both, Klein would like to show that with the right approach, health outcomes can be enhanced through improved diet and exercise. His own patients, and Albertans more generally, have much to gain.

“It sounds fairly easy, but habits are hard to change,” Klein said. “The more we support the population in eating better, and moving in a way that our bodies were designed to do, the less chronic disease is going to emerge. With this project, I’m really excited that we have an opportunity to support people to make good choices for their health.”