Substantive dietary intervention requires significant efforts by both patients and healthcare providers. For this reason, potential bias may hinder compliance or even create the appearance of conflicting advice. When nutrition practices are discussed with patients, physicians typically spend an average of five minutes on the topic, which may not provide enough time and detail for success. Unfortunately, pharmacological and procedural interventions are more common than dietary interventions. Diet is often viewed as more difficult to implement as it is an intrinsic part of culture, family, and self-identity. Recommending a diet that is widely divergent from either the patient's or attendant physician's personal choice may be likened to social discordance surrounding smoking in the 1930s through early 1950s.
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