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Review
. 2025 Jan-Dec:16:21501319251338566.
doi: 10.1177/21501319251338566. Epub 2025 May 23.

The 5 A's Approach to Promoting Nutrition Counseling in Primary Care

Farhad Mehrtash  1 , JoAnn E Manson  2   3   4
Affiliations
Review

The 5 A's Approach to Promoting Nutrition Counseling in Primary Care

Farhad Mehrtash et al. J Prim Care Community Health. 2025 Jan-Dec.

Abstract

Poor dietary habits are a major contributor to chronic disease burden, yet nutrition counseling remains underutilized in primary care settings despite proven effectiveness. This article presents a novel adaptation of the 5 A's framework (Assess, Advise, Agree, Assist, Arrange) titled 'The 5 A's Approach to Promoting Nutrition Counseling in Primary Care', by incorporating validated assessment tools and evidence-based strategies to support implementation in clinical settings. To address practical challenges, implementation approaches are proposed including alternative delivery and payment models. The 5 A's adaptation can be a tool used to address the critical need for standardized nutrition counseling in primary care.

Keywords: chronic diseases; diet; nutrition counseling; prevention; primary care.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The 5 A’s approach to promoting nutrition counseling in primary care (flowchart with all 5 components, actions, and scripts).
Figure 2.
Figure 2.
REAP-S v.2 (rapid eating assessment for PARTICIPANTS, Shortened version, v.2).
Figure 3.
Figure 3.
Reasonable target changes, small substitutions, and cultural adaptations for dietary counseling. -, Abbreviations: Increase (↑) Decrease (↓)
See this image and copyright information in PMC

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