INTRODUCTION Thank you for taking the time to participate in this activity. As you will see from this presentation, effective nutrition counselling by.

INTRODUCTION

Thank you for taking the time to participate in this activity. As you will see from this presentation, effective nutrition counselling by GPs plays an important role in public health.

This presentation contains 47 slides on nutrition counselling and education, and should take 1 hour to complete. During the presentation, you will be asked some questions. Please print the ‘answer sheet’ pdf (to open using hyperlink, place cursor over hyperlinked words, right click mouse and select ‘open hyperlink’) and record your answers on it.

This activity is an RACGP-accredited Category 2 activity. To receive 2 Category 2 points, please print and complete the evaluation form. Please fax this and the completed answer sheet to Discovery Sydney (02 9925 3748).

At the conclusion of this activity, there will be a short presentation (9 slides) on the role of chicken in a healthy diet. We hope the information will be of assistance to you when advising your patients about a healthy diet.

NUTRITION COUNSELLING AND EDUCATION: WHY,WHO & HOW?

Proudly sponsored by the Australian Chicken Meat Federation Inc

LEARNING OBJECTIVES

• Understand the importance of the GP’s role in providing nutrition counselling

• Learn how to optimise patient nutrition counselling sessions

• Consider system changes to improve the effectiveness of nutrition counselling in your practice

PRESENTATION OUTLINE

• Why is nutrition education important?

• Who should deliver nutrition education?

• What do GPs think and do about nutrition counselling?

• How should nutrition counselling be delivered?

• What are the obstacles to nutrition counselling?

WHY IS NUTRITION EDUCATION IMPORTANT?

• Established knowledge: nutrition plays an important role in the aetiology and management of many diseases affecting Australians1

• In 2003, a significant proportion of the burden of disease in Australia was directly attributable to nutrition2:

Health riskProportion of total

burden (%)

High body mass 7.5

Inadequate consumption of vegetables and fruit 2.1

High blood cholesterol 6.2

Reference: 1. National Public Health Partnership. Eat Well Australia. Canberra: Strategic Inter-Governmental Nutrition Alliance (SIGNAL). 2001; 2. Begg S, et al. The burden of disease and injury in Australia 2003. PHE 82. Canberra: AIHW. 2007







WHO SHOULD DELIVER NUTRITION EDUCATION?

• GPs have the potential to decrease morbidity and mortality for many chronic diseases if they provide effective nutrition counselling1

• Reasons include:• GPs are public health agents who see 80% of the population

each year2

• 54.7% of GP/adult encounters involve overweight or obese people3

• GPs are often long-term advisers who gain access to the daily lives and living conditions of all strata of the population4

• GPs are highly regarded as a reliable source of nutrition information5

Reference: 1. Eaton CB et al. J Nutr. 2003 Feb;133:563S-6S; 2. Commonwealth Department of Health and Family Services (CDH & FS): General practice. Changing the future partnerships. Report of the General Practice Strategy Review Group. Canberra: Pine Printers, 1998; 3. Britt H, et al. General practice activity in Australia 2002–2003. AIHW Cat No GEP 14. Canberra: AGPS, 2003. 4. Watt GCM. BMJ. 1996;312:1026-9; 5. Worsley A. Eur J Clin Nutr. 1999;53 Suppl 2:S101-7

GP AS IMPORTANT AS DIETICIANS IN NUTRITION COUNSELLING (1)

• An Australian randomised control trial compared clinical outcomes in patients (N=273) with one or more chronic conditions (overweight, hypertension, Type 2 diabetes)

• Interventions: – Dietician counselled: 6 sessions over 12 months– GP+dietician counselled: 6 sessions with dietician and

GP reviewed progress in 2 of the 6 sessions, over 12 months

– Control: no dietician counselling, usual care by GP

Reference: 1. Pritchard DA, et al. J Epidemiol Community Health. 1999;53:311-6

GP AS IMPORTANT AS DIETICIANS IN NUTRITION COUNSELLING (2)

Results: – Both intervention groups reduced weight and

blood pressure compared with controls– Compared with patients counselled by

dietician alone, patients counselled by GP+dietician were:

• More likely to complete the intervention programme

• Lost more weight (6.7kg vs 5.6kg)

Reference: 1. Pritchard DA, et al. J Epidemiol Community Health. 1999;53(5):311-6







WHAT DO GPS THINK AND DO ABOUT NUTRITION COUNSELLING? (1)

• A survey of GPs showed 72% thought it was their responsibility to perform nutrition counselling1

• On average, in 10-15 min consultations, the time spent on nutrition counselling was found to be 1 min2,3

• In Australia, nutrition counselling is below a desirable level and/or national targets4

Reference: 1. Kushner RF. Prev Med 1995;24: 546–50 ; 2. Eaton CB, et al. Am J Prev Med. 2002; 23: 174–9; 3. Glanz K, et al. J Gen Intern Med. 1995;10:89–92; 4. RACGP ‘Green Book’ Project Advisory Committee. Putting prevention into practice: Guidelines for the implementation of prevention in the general practice setting. 2nd edn. South Melbourne: RACGP. 2006

WHAT DO GPS THINK AND DO ABOUT NUTRITION COUNSELLING? (2)

• A survey of GPs in NSW showed nutrition counselling was provided mostly for diabetes, lipid disorders and obesity1:

Reference: 1. Nicholas L, et al. Eur J Clin Nutr. 2005;59 Suppl 1:S140-5

Disease % of GPs who ‘strongly agreed’ to providing nutrition counselling

Diabetes 79

Lipid disorders 71

Obesity 68

Ischaemic heart disease 46

Overweight 45

Hypertension 22

QUESTION 1

• The Australian study by Pritchard et al. showed that patients counselled by GP+dietician were equally likely to complete the intervention programme, compared with patients counselled by dietician alone

True False







HOW SHOULD NUTRITION COUNSELLING BE DELIVERED?

To maximise patient motivation and adherence:• Consider factors that increase the effectiveness

of patient education• Take a patient-centred approach• Assess patient’s readiness to change: ‘stages of

change’ model• Use motivational interviewing

(These topics are covered in the following few slides)

FACTORS THAT INCREASE THE EFFECTIVENESS OF PATIENT EDUCATION (1)

• A patient’s sense of trust in their GP1

• Face-to-face delivery2

• Patient involvement in the decision-making3,4

– See “A patient-centred approach”

• Highlighting the benefits and costs5,6

– See “Motivational interviewing”

Reference: 1. Trachtenberg F, et al. J Fam Pract. 2005;54:344–52; 2. Ellis S. Pat Educ Couns. 2004;52:97–105; 3.Mead N, et al. Patient Educ Counsel. 2002;48(1):51–61; 4. Rao J, et al. Arch Fam Med. 2000;9:1148–55; 5. Littel J, et al. Behav Modif. 2002;26:223–73; 6. Schauffler H, et al. J Fam Pract. 1996;42:62–8

FACTORS THAT INCREASE THE EFFECTIVENESS OF PATIENT EDUCATION (2)

• Strategies to assist patients remembering what they have been told1

e.g. patient leaflet, summarise goals at the end of the consultation

• Tailoring information to the patient’s interest in change2

• Strategies that address the difficulty in adherence3,4

Reference: 1. Ley P. Patients’ understanding and recall in clinical communication failure. In: Pendleton D, Hasler J, editors. Doctor-patient communication. London: Academic Press, 1983; 2. Steptoe A, et al. Am J Public Health. 2001;91:265–9; 3. Rao J, et al. Arch Fam Med. 2000;9:1148–55 ; 4. Branch L, et al. Med Care. 2000;38:70–7

A PATIENT-CENTRED APPROACH (1)

A patient-centred approach involves1:– Actively involving the patient in the

consultation– Respecting the patient’s autonomy – Encouraging the patient’s role in decision

making– Embracing a more holistic approach that

includes health promotion and disease prevention

Reference: 1. RACGP ‘Green Book’ Project Advisory Committee. Putting prevention into practice: Guidelines for the implementation of prevention in the general practice setting. 2nd edn. South Melbourne: RACGP. 2006

A PATIENT-CENTRED APPROACH (2)

Encouraging more active patient involvement and inclusion in the consultation has a number of benefits:

– Clarification of what is expected of you by the patient1

– Stronger patient autonomy, patient responsibility and patient self management2,3

– Increased patient and doctor satisfaction1

– Enhances the quality of communication4,5

– Better adherence to the recommended prevention activities5,6

Reference: 1. Grol R. Improving practice. A systematic approach to implementation of change in patient care. Oxford:Elsevier Science, 2004; 2. Shortell S, et al. Milbank Q. 1998;76:1–37; 3. Gold M, et al. J Fam Prac. 1990;30:639–44; 4. Tan S. The collaborative method: ensuring diffusion of quality improvement in health care: Report on the Collaborative Workshop, June 2003; 5. King L. Review of literature on dissemination and research on health promotion and illness/injury prevention activities. In: Sydney National Centre for Health Promotion, Department Public Health and Community Medicine, University of Sydney, 1995; 6. Ferrence R. Can J Public Health. 1996;87:S24–7

PATIENT’S READINESS TO CHANGE: ‘STAGES OF CHANGE’ MODEL (1)

“The ‘stages of change’ model1 identifies 5 basic stages of change that are viewed as a cyclical, ongoing process during which the person has differing levels of motivation and readiness to change and the ability to relapse or repeat a stage.

Each time the stage is repeated, the person learns from the experience and gains skills to help them move onto the next stage.”2

Reference: 1. Tenove S. Can J Nurs Res. 1999;31:95–9; 2. RACGP ‘Green Book’ Project Advisory Committee. Putting prevention into practice: Guidelines for the implementation of prevention in the general practice setting. 2nd edn. South Melbourne: RACGP. 2006

PATIENT’S READINESS TO CHANGE: ‘STAGES OF CHANGE’ MODEL (2)

Stages of change1:• Precontemplation: the person

does not consider the need to change

• Contemplation: the person considers changing a specific behaviour

• Determination: the person makes a serious commitment to change

• Action: change begins (large or small)

• Maintenance: change is sustained over a period of timeAdapted from RACGP ‘Green Book’2

Reference: 1. RACGP ‘Red Book’ Taskforce. Guidelines for preventive activities in general practice. 6th edn. South Melbourne: RACGP. 2005; 2. RACGP ‘Green Book’ Project Advisory Committee. Putting prevention into practice: Guidelines for the implementation of prevention in the general practice setting. 2nd edn. South Melbourne: RACGP. 2006

QUESTION 2

Patient comment Stage of change

“I don’t feel the need to adjust my diet”

“I have started to drink water instead of soft drinks”

“I think I should start reducing my salt intake”

• Which stage of change is reflected in these comments?

MOTIVATIONAL INTERVIEWING (1)

• Definition: ‘a directive, patient centred counselling style for eliciting behaviour change by helping patients to explore and resolve ambivalence’1

• Motivational interviewing1:– Has been shown to be effective in a number of areas

in the primary care setting, including nutrition and diet– Is a useful approach when patients show a degree of

ambivalence


Motivational Interviewing

Systematically directing the patient toward motivation

to change

Offering advice and feedback when appropriate

Selectively using empathetic reflection to reinforce certain

processes

Seeking to elicit and amplify the patient’s discrepancies about their health related

behaviour to enhance motivation to change


MOTIVATIONAL INTERVIEWING (2)

MOTIVATIONAL INTERVIEWING STRATEGIES (1)

• Regard the person’s behaviour as their personal choice– Ambivalence is normal

• Let the patient decide how much of a problem they have– Explore both the benefits and costs associated with the problem

as perceived by the patient– Encourage the patient to rate their motivation to change out of

10 and explore how to increase this score


MOTIVATIONAL INTERVIEWING STRATEGIES (2)

• Avoid arguments and confrontation– Confrontation, making judgments or moving ahead of the patient

generates resistance and tends to entrench attitudes and behaviour

• Encourage discrepancy– Change is likely when a person’s behaviour conflicts with their

values and what they want– The aim of motivational interviewing is to encourage this

confrontation to occur within the patient, not between the doctor and patient

– Highlighting any discrepancy encourages a sense of internal discomfort (cognitive dissonance) and helps to shift the patient’s motivation

– When highlighting the discrepancy, in the first instance, let the patient make the connection


QUESTION 3

What are the four components of motivational interviewing?(Insert the correct words in the spaces below. Record your answers on your answer sheet.)

WORDS: motivation, elicit, advice, discrepancies, feedback, empathetic, amplify, processes, change, systematically.

i. ________directing the patient toward _______to change.

ii. Seeking to ______and ______the patient’s __________about their health related behaviour to enhance motivation to ______.

iii. Selectively using _______reflection to reinforce certain _________.

iv. Offering ______ and _______when appropriate.

THE 5-STEP MODEL

An effective way to incorporate the elements of nutrition counselling presented in the last few slides is to use the 5As1,2:

1. Ask (or address)

2. Assess

3. Advise

4. Assist

5. Arrange

Reference: 1. Ockene I, et al. Arch Intern Med 159:725-31; 2. RACGP National Standing Committee. SNAP: A population health guide to behavioural risk factors in general practice. South Melbourne: RACGP. 2004

CASE SCENARIO: USING THE 5As

1. Address the agenda:

“Your blood test results show your cholesterol levels have increased

substantially since your last test. I think we should review your eating habits and try to

make some improvements.”

Reference: 1. Ockene I, et al. Arch Intern Med. 1999;159:725-31

2. Assess patient’s readiness to change and relevant diet experience:

“How do you feel about making some changes to

your diet?”

“Can you think of some recent changes in your eating habits that may have contributed to

the rise in cholesterol?”

3. Advise:

Reference: 1. Hu FB, et al. Am J Clin Nutr 2000; 72: 912-921

“To help you understand how important this is for your heart, I’ll tell you about a study that was done in America a few years back. The study looked at about

45,000 men over an 8-year period. They found that those who were most likely to

develop heart disease ate more red meat, processed meat, refined grains, sweets, French fries, and high-fat dairy products.

In comparison, the group that had the lowest risk of heart disease ate more

vegetables, fruit, legumes, whole grains, fish, and poultry.1”

“Based on your health risks and current diet, let’s focus on lowering your fat intake and adding a few more vegies to your diet.”

EATING FOR A HEALTHY HEARTFor many years, the traditional Australian diet has been too high in

meat and animal fat and lacking in vegetables, fruits and grains. This

has made us very vulnerable to heart and blood vessel disease, not to

mention a whole range of other diseases.

You can make a huge difference to your heart and to your general

health just by making a few simple changes in your way of eating. Start

gradually, and see how many of these changes you can incorporate

into your daily diet.Make vegetables a major part of at least one meal each day and eat fruit

frequently. Choose wholegrain breads instead of white varieties more often.

Eat more cereals (rice, pasta and other grains) and legumes (dried peas

and beans). Try flavouring these with small amounts of lean meat,

rather than basing the whole meal around meat.

Use only very small amounts of very lean meats, and eat poultry

without skin. Choose low-fat dairy products (milk, yoghurt and cheese).

Eat fish (fresh or canned and not fried) at least twice a week.

Make high-fat and/or high-sugar bakery products, fast foods, desserts,

soft drinks and confectionery occasional treats rather than everyday

food. Use monounsaturated or polyunsaturated oils (e.g. olive, canola,

sunflower and safflower) for cooking.

Use small amounts of margarine spreads or olive oil instead of butter.

Grill, boil, steam, bake or microwave rather than fry.

Reduce your salt intake.

Look for the Heart Foundation Tick for healthy food choices.

Drink plenty of water. Rediscover the joy of cooking wholesome meals at home, and teach

your kids!

EATING FOR A HEALTHY HEARTFor many years, the traditional Australian diet has been too high in

meat and animal fat and lacking in vegetables, fruits and grains. This

has made us very vulnerable to heart and blood vessel disease, not to

mention a whole range of other diseases.

You can make a huge difference to your heart and to your general

health just by making a few simple changes in your way of eating. Start

gradually, and see how many of these changes you can incorporate

into your daily diet.Make vegetables a major part of at least one meal each day and eat fruit

frequently. Choose wholegrain breads instead of white varieties more often.

Eat more cereals (rice, pasta and other grains) and legumes (dried peas

and beans). Try flavouring these with small amounts of lean meat,

rather than basing the whole meal around meat.

Use only very small amounts of very lean meats, and eat poultry

without skin. Choose low-fat dairy products (milk, yoghurt and cheese).

Eat fish (fresh or canned and not fried) at least twice a week.

Make high-fat and/or high-sugar bakery products, fast foods, desserts,

soft drinks and confectionery occasional treats rather than everyday

food. Use monounsaturated or polyunsaturated oils (e.g. olive, canola,

sunflower and safflower) for cooking.

Use small amounts of margarine spreads or olive oil instead of butter.

Grill, boil, steam, bake or microwave rather than fry.

Reduce your salt intake.

Look for the Heart Foundation Tick for healthy food choices.

Drink plenty of water. Rediscover the joy of cooking wholesome meals at home, and teach

your kids!

“Here are some information sheets to

get you started. On the back, there are

suggestions about how you can reduce your fat intake and other healthy

eating habits.”

Reference: 1. National Heart Foundation of Australia. Dietary fats and heart disease. 2004. Available at: http://www.heartfoundation.org.au/document/NHF/nrcr_diet_fats_mar04.pdf; 2. myDr.com.au. Eating for a healthy heart. Available at:: http://www.mydr.com.au/default.asp?article=3105

Decision Balance1

Like Dislike

Stay the same e.g. get to eat what I want, tastes nice

e.g. continue increasing my health risks

Change (e.g. changing diet)

e.g. better for my heart and overall health, lose weight?

e.g. inconvenient to prepare food, always having to think about what I eat

“I’m going to give you some fill out at home…This is something that I get my patients to fill out when they have to change their behaviour. It’s called a decision balance. Think about what you would like and dislike about not making any changes to your diet and then do the same for making changes. It helps you to weigh up the pros and cons. We can

talk about your answers when you bring it back at your next visit.”


Click here to open and print a blank Decision Balance form, which you can give to your patients

4. Assist:

“How about we try to start with two or

three of these Heart Foundation

recommendations.1”

“Which of these do you feel you are most likely

to stick to?”

Reference: 1. National Heart Foundation of Australia. Dietary fats and heart disease. 2004

“What do you think will be the main difficulties in changing

your diet?”

5. Arrange follow-up:

“If you feel you need more help, I can refer

you to a dietician.”

“Otherwise, I’d like to see how you’re going in about a month’s time.”







WHAT ARE THE OBSTACLES TO NUTRITION COUNSELLING?

Common obstacles identified by GPs

Lack of time

Lack of confidenceLack of knowledge

Patients’ attitudesFinancial obstacles

Reference: 1. Nicholas L. Aus Family Phys 2004;33:957-9; 2. Judd H, et al. Management of obesity in general practice: Report from the nutrition fellowship 1987. Sydney, Australia: RACGP, 1988.

OVERCOME OBSTACLES THROUGH PRACTICE ORGANISATION (1)

The above obstacles can be overcome to some extent by the development of a preventive program that includes1:

– Setting practice priorities– Listing what roles each practice member

currently undertakes and how nutrition counselling can be integrated into existing roles and responsibilities

Reference: 1. RACGP National Standing Committee. SNAP: A population health guide to behavioural risk factors in general practice. South Melbourne: RACGP. 2004

OVERCOME OBSTACLES THROUGH PRACTICE ORGANISATION (2)

– Reviewing the way in which appointments and follow up are arranged

– Establishing information systems to support nutrition counselling (e.g. updating and managing tools and patient education materials)

– Conducting ongoing quality improvement programs (e.g. audits)

– Developing links with local services (e.g. dieticians)


FINANCIAL INCENTIVES (1)

Interventions for behavioural risk factors, such as nutrition, can be part of a successful business model for GPs. It can be an attractive component of practice programs to encourage patients to attend the practice.1


FINANCIAL INCENTIVES (2)

There are a number of commonwealth programs that may help provide financial support. These include:

– Practice Incentive Program (PIP) incentives to incentives for establishment of chronic disease register and recall systems (www.hic.gov.au/providers/incentives_allowances/pip/new_incentives.htm)

– The program to help fund practice nurses in rural practices (www.hic.gov.au/providers/incentives_allowances/pip/new_incentives/nurse_incentive.htm)

– Under Medicare, EPC care planning services attract a Medicare rebate. An EPC multidisciplinary care plan may only be provided to patients with at least one chronic or terminal medical condition AND complex care needs requiring multidisciplinary care from a team of health care providers including the patient’s GP (www.health.gov.au/epc/careplan.htm)

QUESTION 4

i. How often do you assess diet in patient’s with health risks?

ii. How often do you provide verbal nutrition advice to these patients?

iii. How often do you offer referral for nutrition counselling?

Answers to be indicated on answer sheet as:

Very frequently Frequently Sometimes Rarely Don’t know

QUESTION 5

What types of patient education materials does your practice have concerning nutrition? (Tick all applicable)

A. Pamphlet/booklet

B. Computerised leaflet (e.g. pdf files)

C. Posters

D. Videos

E. Other

QUESTION 6

What proportion of your patients from culturally and linguistically diverse backgrounds are able to read and/or understand the patient nutrition information materials?

Answers to be indicated on answer sheet as:

All Most Some Few Don’t know

QUESTION 7

Think of two changes that you can make to your practice systems to better support or improve the effectiveness of nutrition counselling sessions. Write these down in the space provided.

SUMMARY

• Nutrition plays an important role in the aetiology and management of many diseases affecting Australians1

• GPs, along with dieticians, are at the forefront of providing nutrition management in Australia2

• In Australia, nutrition counselling is below a desirable level and/or national targets3

• When counselling about nutrition, use strategies and tools that maximise patient motivation and adherence4

• Some obstacles to effective nutrition counselling can be overcome through practice organisation4

• There are financial incentives for the management of behavioural risk factors4

1. National Public Health Partnership. Eat Well Australia. Canberra: Strategic Inter-Governmental Nutrition Alliance (SIGNAL). 2001; 2. Nicholas L. Aus Family Phys 2004;33:957-9; 3. RACGP ‘Green Book’ Project Advisory Committee. Putting prevention into practice: Guidelines for the implementation of prevention in the general practice setting. 2nd edn. South Melbourne: RACGP. 2006 ; 4. RACGP National Standing Committee. SNAP: A population health guide to behavioural risk factors in general practice. South Melbourne: RACGP. 2004

THANK YOU FOR COMPLETING THIS ACTIVITY!

The next few slides will highlight the role of chicken in a healthy diet. We hope this update

is useful when advising your patients.

Printable PDFs of patient education materials are available at the end of this presentation.

THE ROLE OF CHICKEN IN HEALTHY DIETS

CHICKEN DELIVERS IMPORTANT NUTRIENTS

Lean chicken meat:

Reference: 1. Food, Health and Nutrition: Where Does Chicken Fit? www.chicken.org.au

An excellent source of protein

Over 55% of the total fat content is unsaturated fat

Delivers essential vitamins and minerals

HOW DOES LEAN CHICKEN COMPARE WITH OTHER LEAN MEATS?

Stir-fried lean chicken breast has the lowest total fat content compared to other meat sources

Stir-fried lean chicken breast contains more than 55% unsaturated fatty acids

Stir-fried lean chicken breast provides higher amounts of niacin equivalents than

other lean stir-fry cuts of meat


CHICKEN CONTRIBUTES TO NUTRIENT REQUIREMENTS

Baked lean chicken breast provides 110–147% of daily niacin requirements

Lean chicken breast provides >50% RDI of protein for most people

Lean chicken breast is a good source of magnesium and zinc for pre-pubescent children


Lean chicken for cardiovascular health

A diet that emphasised chicken and fish, rather than red meat, and included nuts, low-fat diary products and high proportions of fruit and vegetables, was shown to be effective in lowering blood pressure, particularly in people with hypertension.1

Reference: 1. Sacks FM, et al. Clin Cardiol. 1999 Jul;22(7 Suppl):III6-10.

POULTRY CONSUMPTION IS INCREASING IN AUSTRALIA

Reference: 1. Australian Bureau of Agricultural and Resource Economics, ABARE Australian Commodity Statistics, 2007

1

BUSTING THE MYTHS ABOUT CHICKEN (1)

• Size: Through generations of selective breeding and careful attention to optimal nutrition, today’s chickens are faster growing, larger and stronger birds

• No added hormones: Hormones are not administered in any form. Hormone use in growing chickens has been banned in Australia for many decades

• Responsible use of antibiotics: Antibiotics are used to prevent and treat disease and their use is carefully managed to minimise development of resistance and to ensure no residues are detectable in meat. (Avoparcin and vancomycin are not used by the Australian chicken meat industry)


BUSTING THE MYTHS ABOUT CHICKEN (2)

• No cages: Meat chickens are free to roam on the floor of large sheds – they are never caged

• Organic and free range production: Free range and organic chickens are also housed in sheds but may also roam outside the shed for part of the day. Organic and free range chickens are not given antibiotics. Organic chickens are only given feed that is certified organic

• Australian grown: Except for a small proportion of fully cooked tinned or retorted product, all chicken available for purchase in Australia is grown in Australia


CHICKEN AND AVIAN INFLUENZA

• In recent years a highly pathogenic strain of avian influenza, H5N1, an animal disease, has spread widely among poultry in Asia and some other countries, but not in Australia.

• The likelihood of an outbreak of this strain of AI in Australian poultry is extremely low.

• This strain is highly unusual amongst avian influenza strains, in that, under exceptional circumstances, it can infect humans.

• A high level of preparedness and past experience with AI outbreaks provide confidence that should the H5N1 strain, or any other AI strain, get into a local flock, it would be identified and eradicated quickly.

• In the event of an outbreak in Australian poultry, chicken meat from infected birds would not reach consumers.

• AI cannot be contracted by eating cooked poultry as the virus would be destroyed during normal cooking.


THANK YOU FOR YOUR ATTENTION

Please remember to complete your answer sheet and evaluation form and fax to:

Discovery Sydney(02) 9925 3748

PRINTABLE PDFs

• Answer sheet• Evaluation form• Decision Balance form• The Facts About Chicken: A Patient’s Guide • Fact Sheet: Busting the myths about chicken• Fact Sheet: Food Safety• Food, Health and Nutrition: Where Does

Chicken Fit?• The Facts About Chicken: A Dietitian’s Guide• www.chicken.org.au

INTRODUCTION Thank you for taking the time to participate in this activity. As you will see from this presentation, effective nutrition counselling by.

Documents

nutrition education

gps role

important role

presentation outline

practice slide

short presentation

role of chicken

answer sheet pdf