The prescription pad can be the short and easy answer for treating patients with chronic disease states. However, it is not always the best treatment for patients, and it may even lead to more problems due to interactions with other drugs; side effects; and as we have seen recently in the media, serious adverse events causing drugs to be pulled off the market. The American Dietetic Association (ADA) maintains that medical nutrition therapy (MNT) and lifestyle counseling are vital to specific diseasestates such as diabetes mellitus, hypertension, and cardiovascular disease, and it often should be the initial step in their management. Although more complex chronic conditions clearly require phar-macotherapy from the start, MNT also is vital to providing optimal therapy. Nutrition therapy as part of the team approach may result in successful disease control with reduced need for medications. Accordingly, the cost of the therapy will be lower, and the incidence of side effects may be reduced.
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