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A Simple Dietary Questionnaire Correlates With Formal Dietitian Evaluation and Frequently Identifies Specific Clinical Interventions in an Outpatient Gastroenterology Clinic

Dubin, Sterling M. MD; Vadivelu, Jaya MD; Copur-Dahi, Nedret MD; Miranda, Leslie MS; Palermo, Dana BS; Pandey, Braj MD; Groessl, Erik J. PhD; Ho, Samuel B. MD

Journal of Clinical Gastroenterology: September 2016 - Volume 50 - Issue 8 - p e71–e76
doi: 10.1097/MCG.0000000000000523
ONLINE ARTICLES: Original Articles

Background: The spectrum of gastroenterology-related diseases related to obesity is growing. Few clinical tools exist to aid in clinician-guided dietary counseling.

Goals: (1) Develop and validate a 1-page diet history form that would provide information on dietary factors that can contribute to gastrointestinal (GI) illness and to assess adherence to the Mediterranean diet; and (2) evaluate the form in a general GI clinic to determine its potential utility as a clinical tool.

Study: A 1-page diet history form was developed and underwent qualitative and quantitative validation in comparison to a formal diet evaluation by a registered dietitian. The form was then evaluated in consecutive patients attending a general GI clinic, and analyzed for overall diet content, compliance with a Mediterranean diet, and presence of high-risk (red flag) dietary behaviors.

Results: The form was evaluated in 134 patients. In a validation cohort (n=30) the qualitative dietary components measured were highly concordant with a formal dietary interview. Total daily calorie intake correlated with formal dietary review (R=0.61), but tended to underestimate total calories due to less precision in portion size. The prospective cohort (n=104) patients had a mean body mass index of 29.8. Overall, 52.9% were obese, 50% had metabolic syndrome, and 51% had a primary GI illness directly impacted by dietary factors (gastroesophageal reflux, irritable bowel, fatty liver). Overall, 85.6% of patients documented red flag behaviors. Patients with obesity trended for more red flags than overweight or normal body mass index groups.

Conclusion: A 1-page diet questionnaire correlated well with formal dietary assessment and identified clinically relevant dietary interventions in a high percentage of GI patients.

Supplemental Digital Content is available in the text.

*Departments of Medicine, Nutrition, and Health Services Research and Development, VA San Diego Healthcare System

Department of Medicine, University of California, San Diego, CA

Supported by the Research Service of the Department of Veterans Affairs and Veterans Affairs HSR&D.

S.B.H.: research and grant support: Genetech, Inc.; Gilead Pharmaceuticals Inc.; speakers fees: Prime Education Inc., Abbvie Pharmaceuticals Inc.; consulting: Gilead Pharmaceuticals Inc.; Ventria Inc. The remaining authors declare that they have nothing to disclose.

Address correspondence to: Samuel B. Ho, MD, Departments of Medicine, Nutrition, and Health Services Research and Development, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161 (e-mail:

Received June 4, 2015

Accepted February 28, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.