Dietary and exercise assessment in general practice.

BACKGROUND Diet and physical activity are important in many conditions managed in primary care. Dietary and physical activity assessment is complex, has inherent inaccuracies related to self-reporting, and is only a small part of a larger context of developing effective intervention in primary care. However, for personalized assessment in routine clinical care, and for the assessment of different intervention strategies in a general practice research setting, validated life-style assessment tools are needed. OBJECTIVE We aimed to discuss the requirements for assessment tools and to identify feasible validated assessment instruments for use in primary care. METHOD Potential tools were identified from a Medline search, UK Research Intelligence, and contact with groups known to be working in the area. RESULTS Several brief instruments assess mainly fat in the US diet, but the limited range of foods covered and the setting of studies limits their generalizability. Only one tool developed for UK use--'DINE', which scores total fat, fibre and unsaturated fat--was identified which is both feasible and has documented reasonable validated characteristics. Even for this tool there are doubts about the validation "standard'. No diet or physical activity validation studies have used both subjects and health professionals from general practice settings. CONCLUSION There are very few feasible and validated dietary or physical activity assessment tools for use in clinical care or research in general practice, and doubts about the design and settings of published validation studies. Further research is needed to validate and develop a range of feasible life-style assessment tools with specified time and training requirements for use in primary care.