The Role of Malnutrition in Nutrition Counseling

Dr. Lynette Staplefoote-Boynton has developed a curriculum that provides tools for psychiatry trainees to talk with patients about food insecurity

A fruit and vegetable display next to a medical stethoscope

A doctor counseling a patient about a healthy diet faces a unique challenge if the patient does not know where their next meal is coming from.

Dr. Lynette Staplefoote-Boynton, a resident in internal medicine and psychiatry, wants to provide primary care and psychiatry trainees at Duke University — and beyond the campus — with tools to effectively counsel their patients on nutrition and food insecurity. 

To this end, she’s developed a curriculum on these topics and the health risks of malnutrition, one of the leading contributing factors for illness and deaths in the United States.

Counseling on recommended diets may mean little to a patient if they lack access to healthy foods. Staplefoote-Boynton’s curriculum aims to help physicians learn how to talk with their patients in a manner where respect and humility are at the forefront of that conversation. 

“We’re trying to communicate to physicians that when it comes to determinants of a person’s health, there are ‘downstream’ factors that affect the patient — such as their diet — that you can potentially address through one-on-one interactions,” said Staplefoote-Boynton. “And then there are ‘upstream’ factors — like whether nutritious, affordable food is available in the patient’s immediate community—that impact their ability to stay healthy.”

Not getting enough food, eating too much food with little nutritional value, or consuming too many foods high in sodium, saturated fats or added sugars increases risk for high blood pressure, diabetes, heart disease, stroke and death. 

Staplefoote-Boynton aimed to address challenges posed by malnourishment as part of her resident fellowship from the American Psychiatric Association and the Substance Abuse and Mental Health Services Administration.

Staplefoote-Boynton developed the training in collaboration with two Duke faculty members, three East Carolina University medical students, and a six-member community advisory board. 

The work is the first part of a broader curriculum that seeks to understand and address a range of health-related social needs, which Staplefoote-Boynton plans to develop over time. 

For the full story, go to the Duke Psychiatry and Behavioral Sciences news website.