Qualitative research in nutrition and dietetics: assessing quality.

PubMed

Pilnick, A; Swift, J A

2011-06-01

In recent years, qualitative research has become much more widely used in healthcare settings and undoubtedly has much to offer nutrition and dietetics. Its value is, however, still sometimes called into question and, for those unfamiliar with qualitative approaches, it can be difficult to grasp what distinguishes 'good' qualitative research from that which has been less rigorously conceived and conducted. This review, the fourth in the series, aims to highlight some of the key scientific debates around the quality criteria that can be applied to qualitative research, and offers some flexible guidelines that may be used both in producing and assessing qualitative health research, including studies in nutrition and dietetics. Other reviews in this series provide a model for embarking on a qualitative research project in nutrition and dietetics, an overview of the principal techniques of data collection, sampling and analysis and some practical advice relevant to nutrition and dietetics, along with glossaries of key terms. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.

Employers' Perceptions, Attitudes, and Policies on Hiring of Graduates of Online Dietetic Education

ERIC Educational Resources Information Center

Dehpahlavan, Jaleh

2013-01-01

This qualitative explorative study explored dietetic employers' perceptions, attitudes, and policies regarding hiring of online dietetic graduates; how their perceptions were formed; and factors contributing to their development. Higher educational institutions and learners have embraced online education, evidenced by increased online program…

Practice Paper of the Academy of Nutrition and Dietetics: Comprehensive Nutrition Programs and Services in Schools.

PubMed

Hayes, Dayle; Dodson, Linette

2018-05-01

It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association (SNA), and Society for Nutrition Education and Behavior (SNEB) that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. To maximize impact, the Academy, SNA, and SNEB recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus, nutrition initiatives such as Farm to School and school gardens, wellness policies, nutrition education and promotion, and consideration of roles and responsibilities. This paper supports the joint position paper of the Academy of Nutrition and Dietetics, SNA, and SNEB published in the May 2018 Journal of Academy of Nutrition and Dietetics. In alignment with the joint position paper, this practice paper provides registered dietitian nutritionists and nutrition and dietetics technicians, registered with an overview of current school nutrition services and opportunities for professional careers in school settings. The Academy of Nutrition and Dietetics has several position papers related to youth preschool through adolescence that cover specific nutrition needs in more detail at www.eatright.org. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Nutrition and Dietetics Technician, Registered.

PubMed

2018-02-01

The Academy of Nutrition and Dietetics (Academy) is the world's largest organization of food and nutrition professionals and the association that represents credentialed nutrition and dietetics practitioners-nutrition and dietetics technicians, registered (NDTRs) and registered dietitian nutritionists (RDNs). An NDTR's scope of practice in nutrition and dietetics has flexible boundaries to capture the depth and breadth of the individual's practice. The NDTR's practice expands with advances in many areas, including nutrition, food production, food safety, food systems management, health care, public health, community health, and information and communication technology. The Revised 2017 Scope of Practice for the NDTR reflects the position of the Academy on the essential role of the NDTR in the management and delivery of food and nutrition services. The scope of practice for the NDTR is composed of education and credentialing, practice resources, Academy Standards of Practice and Standards of Professional Performance, codes of ethics, accreditation standards, state and federal regulations, national guidelines, and organizational policy and procedures. The Revised 2017 Scope of Practice for the NDTR is used in conjunction with the Revised 2017 Standards of Practice in Nutrition Care and the Standards of Professional Performance for NDTRs. The Standards of Practice address activities related to direct patient and client care. The Standards of Professional Performance address behaviors related to the technical role of NDTRs. These standards reflect the minimum competent level of nutrition and dietetics practice and professional performance for NDTRs. A companion document addresses the scope of practice for the RDN. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

The Weight Management Dietetics Practice Group collecting outcomes mentoring program

USDA-ARS?s Scientific Manuscript database

The is a newsletter article for the Academy of Nutrition and Dietetics (AND), Weight Management Dietetics Practice Group (WM DPG). The article presents the ‘Collecting Outcomes Mentoring Program’ for 2017 that is managed by the Research Section of the WM DPG. Dietitians in the WM DGP are provided wi...

42 CFR 482.28 - Condition of participation: Food and dietetic services.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... However, a hospital that has a contract with an outside food management company may be found to meet this... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Food and dietetic... HOSPITALS Basic Hospital Functions § 482.28 Condition of participation: Food and dietetic services. The...

The Use of Contextual Learning to Teach Biochemistry to Dietetic Students

ERIC Educational Resources Information Center

Macaulay, J. O.; Van Damme, M. -P.; Walker, K. Z.

2009-01-01

This article describes the use of contextualized and "blended" learning to teach biochemistry to dietetic students during the second year of their professional training in a 4-year undergraduate degree (Bachelor of Nutrition and Dietetics). Contextualized content was used to engage students and motivate them to learn biochemistry, which many…

Communication in the Disciplines: Interpersonal Communication in Dietetics

ERIC Educational Resources Information Center

Vrchota, Denise

2011-01-01

This study proposes to expand the scope of oral communication across the curriculum research by exploring oral genres in a dietetics curriculum from the perspective of the dietetics faculty. The goals of this qualitative study, couched within the communication in the disciplines framework, are to identify the oral genres integral to the study and…

New dietetic practitioners' perspectives on their education and training.

PubMed

Brady, Jennifer; Lordly, Daphne; MacLellan, Debbie; Gingras, Jacqui

2012-01-01

To elucidate the complex phenomenon of dietitian professional socialization, we examined factors that influence people's decisions to pursue a career in dietetics and how education and training processes influence the professional socialization of dietitians. Participants (n=12) had less than three years of work experience and included alumni from three Canadian universities representing different models of entry to practice. Three one-on-one interviews were conducted with each participant. The key influencing factor in participants' decision to pursue dietetics was the perceived congruence between dietetics and other aspects of their lives, including early interests and experiences (sports, food and cooking, an eating disorder), career aspirations (science, health care), and social networks (the desire to be a professional). A pivotal experience during high school or while enrolled in or after graduation from another program prompted participants' awareness of and subsequent decision to pursue a career in dietetics. Supportive relationships were vital to participants' professional socialization. Recruitment materials and education opportunities should help aspiring dietitians develop a clear idea of what being a dietitian means. Dietetic educators must attend to the informational and relational aspects involved in shaping future practitioners' dietitian identities.

Dietitians' perceptions of communicating with preadolescent, overweight children in the consultation setting: the potential for e-resources.

PubMed

Raaff, C; Glazebrook, C; Wharrad, H

2015-06-01

There are calls to enhance existing child weight management interventions and to develop new treatment approaches. The potential for interactive electronic resources (e-resources) to support child-dietitian communication has yet to be explored. Towards developing such a tool, the present study aimed to understand dietetic attitudes and approaches to communicating with preadolescent overweight children in individual consultations to support behaviour change. A purposive sample of 18 dietitians, providing weight management advice to overweight 7-11-year-old children, took part in the study. Individual semi-structured telephone interviews were conducted. Data were transcribed and then analysed using inductive thematic analysis. Content analysis was used to interpret dietetic attitude towards e-resources. Six overarching themes were identified describing dietitians' views: the complexity of treating childhood obesity, the strategic balance of dietetic communication focus between child and parent, the child's capacity to communicate affecting their contribution, dietetic approaches to verbal child communication and the features of resources that can support them, as well as dietetic expectations for resources. Independent inter-rater agreement for the themes was 76.9% and 73.1%, respectively. The majority of dietitians (n = 13) supported the concept of introducing an interactive multimedia e-resource into child weight management consultations. Most dietitians sought to engage the preadolescent child in the consultation, using dietetic visual aids to complement verbal strategies and to serve as scaffolding for the conversation. There is scope for interactive e-resources to enhance communication, provided that they are flexibly tailored to meet the needs of the dietitian and the overweight child. © 2014 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of The British Dietetic Association Ltd.

Position of the Academy of Nutrition and Dietetics: oral health and nutrition.

PubMed

Touger-Decker, Riva; Mobley, Connie

2013-05-01

It is the position of the Academy of Nutrition and Dietetics that nutrition is an integral component of oral health. The Academy supports integration of oral health with nutrition services, education, and research. Collaboration between dietetics practitioners and oral health care professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between diet, nutrition, and integrity of the oral cavity in health and disease. Oral health and nutrition have a multifaceted relationship. Oral infectious diseases, as well as acute, chronic, and systemic diseases with oral manifestations, impact an individual's functional ability to eat and their nutrition status. Likewise, nutrition and diet can affect the development and integrity of the oral cavity and progression of oral diseases. As knowledge of the link between oral and nutrition health increases, dietetics practitioners and oral health care professionals must learn to provide screening, education, and referrals as part of comprehensive client/patient care. The provision of medical nutrition therapy, including oral and overall health, is incorporated into the Standards of Practice for registered dietitians and dietetic technicians, registered. Inclusion of didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in education programs for both professional groups. Collaborative endeavors between dietetics, dentistry, medicine, and allied health professionals in research, education, and delineation of practice roles are needed to ensure comprehensive health care. The multifaceted interactions between diet, nutrition, and oral health in practice, education, and research in both dietetics and dentistry merit continued, detailed delineation. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Delegation of clinical dietetic tasks in military and civilian hospitals: implications for practice.

PubMed

Myers, M E; Gregoire, M B; Spears, M C

1991-12-01

The purposes of our research were two-fold: to determine perceptions of the quality of task performance and to identify dietetic personnel currently performing clinical dietetic tasks in military and civilian hospitals. Questionnaires were returned from 309 dietitians and 208 dietetic support personnel at 151 military and civilian hospitals (73% response overall). For tasks completed by support personnel, no task was rated as having optimum quality, 1 was rated as highly acceptable, 6 as acceptable, 19 as somewhat unacceptable, and 4 as unacceptable. Current performance ratings indicated that 1 task was performed solely by dietitians, 21 were completed by dietitians with assistance, 6 were completed jointly by dietitians and support personnel, 2 were completed by support personnel with supervision by dietitians, and no task was completed independently by support personnel. Tasks were grouped into four categories: basic clinical dietetics (11 tasks), intermediate and in-depth clinical dietetics (12 tasks), outpatient nutrition clinic (5 tasks), and nutrition education (community) (4 tasks). Quality scores for the US Air Force (USAF) hospitals were higher for all task categories except intermediate and in-depth clinical dietetic tasks. The quality scores of support personnel were higher than those of dietitians for all task categories. The USAF performance scores indicated significantly more involvement of support personnel. Generally, the performance scores of dietitians increased with experience; the scores of support personnel decreased with experience. Correlations between quality and performance ratings for individual tasks revealed low to moderate relationships. Our results suggest that additional delegation of tasks to dietetic support personnel may be possible without negatively affecting perceptions of the quality of task outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three country study.

PubMed

Chen, J; Lieffers, J; Bauman, A; Hanning, R; Allman-Farinelli, M

2017-08-01

Smartphone health applications (apps) and other mobile health (mHealth) technologies may assist dietitians in improving the efficiency of patient care. The present study investigated the use of health apps and text messaging in dietetic practice and formulated intervention recommendations for supporting app uptake by dietitians based on the behavioural 'COM-B' system, where interactions between capability, opportunity and motivation influence behaviour. A 52-item online survey tool, taking 20 min to complete, was developed and piloted, with questions exploring the use of health apps and text messaging in dietetic practice, types of apps dietitians recommended and that patients used, and barriers and enablers to app use in dietetic practice. The Australian, New Zealand and British dietetic associations distributed the survey to their members. A 5% response rate was achieved internationally, with 570 completed responses included for further analysis. Health apps, namely nutrition apps, were used by 62% of dietitians in their practice, primarily as an information resource (74%) and for patient self-monitoring (60%). The top two nutrition apps recommended were MyFitnessPal ® (62%) and the Monash University Low FODMAP Diet ® (44%). Text messaging was used by 51% of respondents, mainly for appointment-related purposes (84%). Although the reported use of smartphone health apps in dietetic practice is high, health apps and other mHealth technologies are not currently being used for behaviour change, nor are they an integral part of the nutrition care process. Dietetic associations should provide training, education and advocacy to enable the profession to more effectively engage with and implement apps into their practice. © 2017 The British Dietetic Association Ltd.

Collaboration Between Dietetics and Dentistry: Dietetic Internship in Pediatric Dentistry

PubMed Central

More, Frederick G.; Sasson, Lisa M.; Godfrey, Emilie M.; Sehl, Rima B.

2006-01-01

The American Dietetic Association and the American Dental Association share a common interest in improving the health and quality of life of the population. Dental visits present an opportunity to identify nutrition-related issues for both the pediatric and adult population. Traditionally, dental and nutrition students have had little opportunity to learn and work together since little time was spent on nutrition in the dental curriculum. The purpose of this article is to describe the development of a new collaborative training experience for dietetic interns and pediatric dentistry residents. The oral health rotation for dietetic interns also has several objectives, including experience interacting with a culturally diverse population and participating in community nutrition education (Head Start). In its first 18 months, the collaborative program has been viewed as a success by the pediatric dentistry faculty and residents and the nutrition faculty and interns. PMID:16639470

A Study of the Efficacy of an Integrated Nutrition Assessment, Interviewing and Counseling, and Medical Nutrition Therapy (MNT) Course Utilizing Problem-Based Learning

ERIC Educational Resources Information Center

Stanczyk, Kathy K.

2014-01-01

Dietetics graduates have been argued to enter supervised professional practice, or a Dietetic Internship, with deficient clinical reasoning skills. Some researchers have suggested that one factor contributing to deficient clinical reasoning skills has been the fragmented course sequencing of a traditional dietetics curriculum, with multiple…

Practice Paper of the Academy of Nutrition and Dietetics: Selecting Nutrient-Dense Foods for Good Health.

PubMed

Hingle, Melanie D; Kandiah, Jayanthi; Maggi, Annette

2016-09-01

The 2015 Dietary Guidelines for Americans encourage selection of nutrient-dense foods for health promotion and disease prevention and management. The purpose of this Academy of Nutrition and Dietetics practice paper is to provide an update regarding the science and practice of nutrient-dense food identification and selection. Characterization of tools used to identify nutrient density of foods is provided and recommendations for how registered dietitian nutritionists and nutrition and dietetics technicians, registered, might use available profiling tools to help consumers select nutrient-dense foods is discussed. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Expanding undergraduate dietetic education through a health promotion internship program.

PubMed

Rye, J A; Weston, C

1987-05-01

The Lifestyle Assistant Program is a health promotion internship offered by the University of Wisconsin-Stevens Point Health Service. Students majoring in health-related disciplines (e.g., dietetics) gain skills in promoting the six dimensions of wellness: social, occupational, spiritual, physical, intellectual, and emotional. Thirteen competencies provide the basis for training Lifestyle Assistants, who develop, market, present, and evaluate wellness sessions for the university and residential communities. Assistants earn academic credit or a wage. Of particular benefit to assistants majoring in dietetics are studying and operating a self-testing physical assessment unit, which approximates body composition, cardiovascular endurance, muscular strength, and flexibility; using a health hazard appraisal; assisting the University's Nutrition Task Force with its education campaign in the campus cafeterias; and presenting programs on popular nutrition topics (e.g., the athlete's diet). Program evaluation reveals that 84% of participants in programs conducted by assistants gained information of personal benefit. The Lifestyle Assistant competencies support The American Dietetic Association Plan IV minimum competencies in such areas as communication and education. The Lifestyle Assistant experience is in accordance with The American Dietetic Association's Dietetic Manpower Study recommendations: to provide student learning experiences in wellness programs and fitness settings.

The Nature of Competition in Dietetics Education: A Narrative Review.

PubMed

Ruhl, Jillian; Lordly, Daphne

2017-09-01

The impact on student development associated with being part of a competitive program is an emerging finding in dietetics research. As such, a narrative review of relevant literature was conducted pertaining to competition in post-secondary programs and the educational experience of students with respect to developing a career in dietetics. The review was guided by 2 questions: How is competition experienced by students? What strategies can reduce competition among dietetics students within the educational experience? A refined literature screening process justified including 32 articles in the review. The overall review findings suggested that, across dietetics programs, the outcomes of competition negatively impacted students' personal identity, motivation in the learning process, and involvement behaviours, including collaboration among students, participation in academic opportunities, and student relationships with faculty. The implementation of strategies conducive to addressing the effects of excessive competition and building a supportive academic environment, for example increasing collegiality and engaging students in intrinsic learning, are important for continued growth of the dietetics profession. Educators can reflect on the complex nature of competition and how the effects of excessive competition may be in opposition with the competencies that students are expected to develop as professionals.

Dietetic intervention for inpatients on fluid-only diets helps to achieve nutritional requirements.

PubMed

Deacon, Sarah; Moran, Natalie; Laskey-Gilboy, Bonnie; De Jonge, Maree; Rothery, Shonnel; Ahnon, Kristina; Whiting, Melissa; Emeto, Theophilus I; Pain, Tilley

2018-02-01

The present study aimed to assess whether dietetic intervention helps patients on fluid-only diets to meet their energy and protein requirements. This topic has not been previously investigated. A quasi-experimental study of 57 patients receiving fluid-only diets was conducted at The Townsville Hospital. The fluid consumption of participants was observed over 24 hours and was used to calculate total energy and protein intakes. The percentage of protein and energy requirements met was compared between patients receiving dietetic intervention and patients who were not. Patients receiving dietetic interventions met a higher percentage of their energy requirements (75.88) than the control group (18.10) based on median intakes (P < 0.001). Patients receiving dietetic intervention also met a higher percentage of their protein requirements (75.99) than the control group (13.80) based on median intakes (P < 0.001). Stratification for age, body mass index (BMI) and fluid diet type showed no change in effect. This study shows that dietetic intervention enabled patients on fluid-only diets to meet up to 80% more of their energy requirements and up to 95% more of their protein requirements. These results were consistent across age, BMI and fluid diet type. The significance of these differences has resulted in a change of clinical practice at the study hospital. All patients on fluid-only diets for three days or longer are now blanket referred for dietetic intervention. © 2017 Dietitians Association of Australia.

Evolution and trends of the dietetics profession in the United States of America and in Argentina: north and south united by similar challenges.

PubMed

Defranchi, Romina L Barritta de; Nelson, Jennifer K

2009-06-01

Since the early stages the profession of dietetics has been characterized as a multifaceted discipline and influenced by scientific and social changes. Today, health and nutrition-related diseases are becoming more global--as is the dietetics profession. The aim of this article is to review the history, education, work and challenges for dietetic practitioners in North and South America, specifically in the United States and in the Argentinean Republic. It was in Argentina where the first Latin American dietetics school was established. Both countries have since shaped the profession creating standards for education and practice in response to advances in the biopsychosocial sciences and economic and environmental changes. Reviewing both the past and current diversities in both Americas contributes to a better understanding of professional strengths and weaknesses, and can prepare dietetics specialists to meet today's needs. Regardless of local disparities, it is interesting that current and future challenges for the dietetics profession are similar between the two countries, such as growing rates of obesity, limited access to and choice of healthy diets among various income groups, busy lifestyles and decline of family meals. These common issues and the availability of Internet tools offer a unique opportunity for partnership and research that can lead to successful creative nutrition interventions and programs. In turn, such joint initiatives will confirm the essential role for the profession--not only in the western hemisphere--but also globally.

Pushing Past Clichés: Latina and Black Women's Perceptions of the Dietetics Major and Profession during Career Exploration

ERIC Educational Resources Information Center

Whelan, Megan; Ridgeway, Monica; Yerrick, Randy K.

2018-01-01

Diversity in dietetics, like other health professions, has remained stagnant despite the increase of racial and ethnic minority groups in the United States. We examined how Latina and Black women, enrolled in a university outreach program, make sense of a critical media literacy program during career introduction to dietetics. Our findings…

[Research on Japanese monograph of comprehensive dietetic materia medica, the Pao chu bei yong wo ming ben cao (Japanese Materia Medica Prepared for Kitchen)].

PubMed

Zhou, M; Ye, J

2017-11-28

Japanese physicians of Edo Period (1603-1867) wrote many dietetic books, by combining the knowledge system (content and compiling style) and thoughts of diet therapy from China with local condition in Japan. Among them, the Pao chu bei yong wo ming ben cao ( Japanese Materia Medica Prepared for Kitchen ), written by Mukai Genshou, a physician in the early Edo, is the earliest comprehensive work of dietetic materia medica. In this book, the choice and usage of Japanese dietetic materia medica reveals obvious Japanese local color, including the name, morphology, cultivation, collection, identification, nature and flavor, and indication etc., reflecting the sprouting idea of edible herbal plant at the beginning of Edo period and the characteristic of absorbing Chinese diet thoughts by Japanese physician. This is the important first-hand historical material to understand the development of Japanese dietetic herbalism in early Edo and its dietotherapy culture.

The who, what, when, and how of choosing a dietetics career.

PubMed

Lordly, Daphne; Dubé, Nicole

2012-01-01

We describe factors influencing the career choices of students enrolled in Canadian dietetics programs. A survey was administered, in class or online, to core first- and fourth-year classes in seven dietetics programs in various provinces (n=397). Data were analyzed with the use of descriptive statistics. Chi-square testing for independence established significant relationships. Students ranked personal satisfaction, job security, and a professional career as important general career outcomes. These factors were also perceived to be attainable through a dietetics career. The majority of students chose dietetics while they were enrolled in a post-secondary degree program (44%), were primarily influenced by family members (54%), and based their choice on information acquired through the media (50%). Motivations for choosing dietetics included an interest in nutrition (91%) and health (90%), and a desire to help others (82%). Younger students placed more importance on economic rewards and having a position of authority than did older students. Older students identified personal satisfaction as more important in career selection than did younger students. Female respondents placed higher value on job flexibility than did their male counterparts. Career choice is based on a variety of internal and external factors. Opportunities exist for strategic recruitment efforts by educators and the profession.

[Optimization of formulations for dietetic pastry products].

PubMed

Villarroel, M; Uquiche, E; Brito, G; Cancino, M

2000-03-01

Optimized formulations of dietetic pastry products such as cake and sponge cake premixes were formulated using the surface response methodology. % Emulsifier agent and baking time were the selected independent variables for cake, as well as % emulsifier agent % chlorinated flour the variables selected for sponge cake. Three different level of each variable summing up thirteen experimental formulae of each product were assessed to optimize the variables that could have some influence in the sensory characteristics of these dietetic products. The total sensory quality was determined for both dietetic products using the composite scoring test and a panel of 18 trained judges. Looking at the contour graphic and considering economic aspects the best combination of variables for cake formulation was 2% emulsifier agent and 48 minutes for baking time, With respect to sponge cake, the best combination was 6% emulsifier agent and 48% chlorinated flour. Shelf life studies showed that both dietetic formulations remained stable during storage conditions of 75 days at 30 degrees C. During this period, significant differences in sensory characteristics were not found (p < 0.05). Data of peroxide values were kept under the critical value reported for detection of organoleptic rancidity. Reported values of hedonic test showed that these dietetics pastry products had good acceptability, and open up marketing opportunities for new products with potential health benefits to consumers.

Position of the American Dietetic Association: Oral health and nutrition.

PubMed

Touger-Decker, Riva; Mobley, Connie C

2003-05-01

It is the position of the American Dietetic Association (ADA) that nutrition is an integral component of oral health. The ADA supports the integration of oral health with nutrition services, education, and research. Collaboration between dietetics and dental professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between nutrition and the integrity of the oral cavity in health and disease. Oral health is an integral part of systemic and nutritional health. Two primary oral infectious diseases are directly influenced by diet and nutrition. Dental caries or tooth decay is modulated by numerous factors, including diet composition and frequency. Periodontal or gum disease is associated with malnutrition. Chronic diseases such as diabetes and cardiovascular disease that are modulated by diet and nutrition intervention have oral sequelae. As we advance in our discoveries of the links between oral and nutrition health, practitioners of both disciplines must learn to provide screening, baseline education, and referral to each other as part of comprehensive client/patient care. The future of dietetics practice requires dietetics professionals to provide medical nutrition therapy (MNT) that incorporates a person's total health needs, including oral health. Inclusion of both didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in both dental and dietetic education programs. Collaborative endeavors between dietetics and dentistry in research, education, and delineation of health provider practice roles are needed to ensure comprehensive health care to persons with oral infectious disease and/or oral manifestations of systemic diseases.

Bibliometric analysis of nutrition and dietetics research activity in Arab countries using ISI Web of Science database.

PubMed

Sweileh, Waleed M; Al-Jabi, Samah W; Sawalha, Ansam F; Zyoud, Sa'ed H

2014-01-01

Reducing nutrition-related health problems in Arab countries requires an understanding of the performance of Arab countries in the field of nutrition and dietetics research. Assessment of research activity from a particular country or region could be achieved through bibliometric analysis. This study was carried out to investigate research activity in "nutrition and dietetics" in Arab countries. Original and review articles published from Arab countries in "nutrition and dietetics" Web of Science category up until 2012 were retrieved and analyzed using the ISI Web of Science database. The total number of documents published in "nutrition and dietetics" category from Arab countries was 2062. This constitutes 1% of worldwide research activity in the field. Annual research productivity showed a significant increase after 2005. Approximately 60% of published documents originated from three Arab countries, particularly Egypt, Kingdom of Saudi Arabia, and Tunisia. However, Kuwait has the highest research productivity per million inhabitants. Main research areas of published documents were in "Food Science/Technology" and "Chemistry" which constituted 75% of published documents compared with 25% for worldwide documents in nutrition and dietetics. A total of 329 (15.96%) nutrition - related diabetes or obesity or cancer documents were published from Arab countries compared with 21% for worldwide published documents. Interest in nutrition and dietetics research is relatively recent in Arab countries. Focus of nutrition research is mainly toward food technology and chemistry with lesser activity toward nutrition-related health research. International cooperation in nutrition research will definitely help Arab researchers in implementing nutrition research that will lead to better national policies regarding nutrition.

Latina and Black Women's Perceptions of the Dietetics Major and Profession

NASA Astrophysics Data System (ADS)

Whelan, Megan

Racial and ethnic groups remain underrepresented in undergraduate health profession education programs and careers, such as nutrition and dietetics (Sullivan, 2004). Overwhelmingly, 82 percent of dietitians are White, three percent are Latino/Latina, and less than three percent are Black (Commission on Dietetic Registration, 2016). While the calls to increase recruitment of underrepresented minorities are plentiful and federal dollars are allotted to the effort, a critical lens is necessary to investigate the complexity of factors that impact the decision to pursue a career within dietetics. The purpose of this qualitative case study was to investigate how Latina and Black women enrolled in an undergraduate Health Career Opportunity Program (HCOP) narrated and reflected upon the dietetics profession. Through the lens of Critical Race Theory and situated learning, I sought to understand the sociocultural and historical underpinnings that hinder or promote career selection. Data collection methods included participant observation, interviews, artifacts, and reflexive journaling. Data were analyzed using inductive coding techniques. My findings revealed the ways in which Latina and Black women believed dietitians must match the socially constructed role model for body image, physical fitness, and healthy eating to be effective in practice. Using a critical media analysis to confront the stereotypical images of dietitians, the women used cliche messages as a selected discourse to mask perceptions of barriers to the dietetics field. Finally, the women believed a dietitian's professional role was to give diet advice which presented a barrier to the profession. Based on my findings I support early introduction to nutrition science as a means to empower individuals to support their health and the health of their community. Recruitment efforts must explicitly address the culture of dietetics which has embraced the stereotypical image. Collectively, the dietetics field must consider the relationships between nutrition experts, schools and communities to advocate for historically and contemporarily marginalized and disenfranchised groups.

Evaluation of the Introduction of an e-Health Skills Component for Dietetics Students.

PubMed

Rollo, Megan E; Collins, Clare E; MacDonald-Wicks, Lesley

2017-11-01

Appropriate and effective use of technology within practice is a key competency outlined in Australian dietetics training standards. An e-health skills component (lecture and workshop) was introduced to undergraduate students enrolled in an Australian nutrition and dietetics program. The lecture orientated students to key e-health terms and concepts relating to telehealth and m-health technologies, while the workshop provided an opportunity to apply knowledge. The workshop consisted of four stations with activities relating to (1) orientation to telehealth equipment; (2) comparison of dietetic consultation components completed in person versus remotely via video call; (3) quality assessment of mobile apps; and (4) exploration of advantages and disadvantages, and the ethical, security, and privacy issues relating to use of e-health technologies in dietetic practice. Student experience of the training was evaluated via questionnaire. Forty-five students (62.2% aged ≤19-24 years, 86.7% female) completed the survey. Following the workshop, the level of understanding relating to each key e-health concept improved significantly (p < 0.001). The aspects relating to the impact and need for initial training and ongoing professional education to support the use of e-health technologies within dietetic practice were rated a high level of importance by most students (78-80%). The majority of students (93.3% to 97.8%) reported a positive experience at each of the four workshop stations, with "informative" the most common word selected to rate each station (37.8% to 44.4% of students across the four stations). The introduction of an e-health skills component resulted in an improved understanding of concepts for using these technologies. These findings provide preliminary support for integration of further e-health training within the dietetics program.

Position of the American Dietetic Association: Agricultural and food biotechnology.

PubMed

Bruhn, Christine; Earl, Robert

2006-02-01

It is the position of the American Dietetic Association that agricultural and food biotechnology techniques can enhance the quality, safety, nutritional value, and variety of food available for human consumption and increase the efficiency of food production, food processing, food distribution, and environmental and waste management. The American Dietetic Association encourages the government, food manufacturers, food commodity groups, and qualified food and nutrition professionals to work together to inform consumers about this new technology and encourage the availability of these products in the marketplace.

The contribution of dietitians to the primary health care workforce.

PubMed

Howatson, Alexandra; Wall, Clare R; Turner-Benny, Petrina

2015-12-01

Dietetic intervention is effective in the management of nutrition-related conditions and their comorbidities. New Zealand has an increasing need for primary and preventive health care to reduce the burden of non-communicable disease. To review the recent evidence of effectiveness of dietetic intervention in primary health care on health and wider economic outcomes. Health benefits and cost benefits of employing dietitians to perform nutrition intervention in the primary health care setting are evaluated in the areas of obesity in conjunction with diabetes and cardiovascular disease, and malnutrition in older adults. An electronic literature search of four scientific databases, websites of major dietetic associations and high-impact nutrition and dietetic journals was conducted. Randomised controlled trials and non-randomised studies conducted from 2000 to 2014 were included. Dietetic intervention demonstrates statistically and clinically significant impacts on health outcomes in the areas of obesity, cardiovascular disease, diabetes, and malnutrition in older adults, when compared to usual care. Dietitians working in primary health care can also have significant economic benefits, potentially saving the health care system NZ$5.50-$99 for every NZ$1 spent on dietetic intervention. New Zealand must look to new models of health care provision that are not only patient-centred but are also cost-effective. This review demonstrates that dietitians in primary health care can improve patients' health and quality of life. Increasing the number of dietitians working in primary health care has the potential to make quality nutrition care accessible and affordable for more New Zealanders.

Food-safety educational goals for dietetics and hospitality students.

PubMed

Scheule, B

2000-08-01

To identify food-safety educational goals for dietetics and hospitality management students. Written questionnaires were used to identify educational goals and the most important food safety competencies for entry-level dietitians and foodservice managers. The sample included all directors of didactic programs in dietetics approved by the American Dietetic Association and baccalaureate-degree hospitality programs with membership in the Council on Hotel, Restaurant, and Institutional Education. Fifty-one percent of the directors responded. Descriptive statistics were calculated. chi 2 analysis and independent t tests were used to compare educators' responses for discrete and continuous variables, respectively. Exploratory factor analysis grouped statements about food safety competence. Internal consistency of factors was measured using Cronbach alpha. Thirty-four percent of dietetics programs and 70% of hospitality programs required or offered food safety certification. Dietetics educators reported multiple courses with food safety information, whereas hospitality educators identified 1 or 2 courses. In general, the educators rated food-safety competencies as very important or essential. Concepts related to Hazard Analysis and Critical Control Points (HAACP), irradiation, and pasteurization were rated less highly, compared with other items. Competencies related to reasons for outbreaks of foodborne illness were rated as most important. Food safety certification of dietitians and an increased emphasis on HAACP at the undergraduate level or during the practice component are suggested. Research is recommended to assess the level of food-safety competence expected by employers of entry-level dietitians and foodservice managers.

Qualitative research in nutrition and dietetics: data analysis issues.

PubMed

Fade, S A; Swift, J A

2011-04-01

Although much of the analysis conducted in qualitative research falls within the broad church of thematic analysis, the wide scope of qualitative enquiry presents the researcher with a number of choices regarding data analysis techniques. This review, the third in the series, provides an overview of a number of techniques and practical steps that can be taken to provide some structure and focus to the intellectual work of thematic analysis in nutrition and dietetics. Because appropriate research methods are crucial to ensure high-quality research, it also describes a process for choosing appropriate analytical methods that considers the extent to which they help answer the research question(s) and are compatible with the philosophical assumptions about ontology, epistemology and methodology that underpin the overall design of a study. Other reviews in this series provide a model for embarking on a qualitative research project in nutrition and dietetics, an overview of the principal techniques of data collection, sampling and quality assessment of this kind of research and some practical advice relevant to nutrition and dietetics, along with glossaries of key terms. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.

The constellation of dietary factors in adolescent acne: a semantic connectivity map approach.

PubMed

Grossi, E; Cazzaniga, S; Crotti, S; Naldi, L; Di Landro, A; Ingordo, V; Cusano, F; Atzori, L; Tripodi Cutrì, F; Musumeci, M L; Pezzarossa, E; Bettoli, V; Caproni, M; Bonci, A

2016-01-01

Different lifestyle and dietetic factors have been linked with the onset and severity of acne. To assess the complex interconnection between dietetic variables and acne. This was a reanalysis of data from a case-control study by using a semantic connectivity map approach. 563 subjects, aged 10-24 years, involved in a case-control study of acne between March 2009 and February 2010, were considered in this study. The analysis evaluated the link between a moderate to severe acne and anthropometric variables, family history and dietetic factors. Analyses were conducted by relying on an artificial adaptive system, the Auto Semantic Connectivity Map (AutoCM). The AutoCM map showed that moderate-severe acne was closely associated with family history of acne in first degree relatives, obesity (BMI ≥ 30), and high consumption of milk, in particular skim milk, cheese/yogurt, sweets/cakes, chocolate, and a low consumption of fish, and limited intake of fruits/vegetables. Our analyses confirm the link between several dietetic items and acne. When providing care, dermatologists should also be aware of the complex interconnection between dietetic factors and acne. © 2014 European Academy of Dermatology and Venereology.

Professional dietetic education in the U.S. Historical notes.

PubMed

Chambers, M J

1978-06-01

Since its founding in 1917, The American Dietetic Association has been concerned with the development and improvement of educational programs for the professional dietitian. This article traces the evolution of professional dietetic educational programs from its beginning in the early cooking schools in the nineteenth century through the development of educational standards, the requirement for training beyond the bachelor's degree, and the establishment of academic requirements. The continued importance of educating the professional dietitian is evidenced by the inclusion of academic requirements as a prerequisite to membership in the Association.

Queering Educational Practices in Dietetics Training: A Critical Review of LGBTQ Inclusion Strategies.

PubMed

Joy, Phillip; Numer, Matthew

2018-06-01

Lesbian, gay, bisexual, trans, and queer people (LGBTQ) have unique concerns regarding their nutritional health while experiencing disparities within the Canadian healthcare system. Dietetic training programs often do not provide adequate knowledge or skills to students to be competent in meeting the needs of this population. Drawing from literature from other health programs, this paper outlines key strategies to the integration of LGBTQ curriculum into dietetic training programs. LGBTQ training can help students gain cultural competencies, knowledge and understanding of the LGBTQ communities, and the nutritional concerns within them.

Position of the American Dietetic Association: fortification and nutritional supplements.

PubMed

2005-08-01

It is the position of the American Dietetic Association (ADA) that the best nutritional strategy for promoting optimal health and reducing the risk of chronic disease is to wisely choose a wide variety of foods. Additional nutrients from fortified foods and/or supplements can help some people meet their nutritional needs as specified by science-based nutrition standards such as the Dietary Reference Intakes. Dietetics professionals are trained to assess dietary adequacy as well as the need for dietary modification. This position paper addresses increasing the nutrient density of foods or diets through fortification or supplementation when diets fail to deliver consistently adequate amounts of vitamins and minerals. The discussion presents points to consider that relate to both public health and individual applications. Many resources may be used to help guide the dietetics professional to determine responsible, evidence-based recommendations relating to nutrient fortification or supplementation.

Enhancing managerial effectiveness in dietetics.

PubMed

Hoover, L W

1983-01-01

Environmental pressures from such sources as economic conditions, the government, third-party payers, and inter-institutional competition create managerial challenges. Although cost-containment has received considerable attention, long-term cost-effectiveness is probably the significant issue. Dietitians must become more cost-conscious and effective in resource management to attain desired performance outcomes. Some of the skills and characteristics essential to managerial effectiveness are a marketing orientation, systems design skill, quantitative operations management techniques, financial expertise, and leadership. These abilities facilitate decision-making and achievement of long-term cost-effectiveness. Curriculum enhancement and continuing education are two strategies for improving managerial competency in the dietetics profession. In dietetics education, study of management topics should be enhanced to provide more advanced coverage of management theories and quantitative models so that managerial performance can be at a higher level of sophistication and competency. To assure the viability of the dietetics profession, the emphasis on management must be more comprehensive and rigorous.

The contested space: The impact of competency-based education and accreditation on dietetic practice in Australia.

PubMed

Ash, Susan; Palermo, Claire; Gallegos, Danielle

2018-05-06

Competency-based Education (CBE) has underpinned the education of dietitians in Australia since the first Competency Standards (CS) were published; however, little is known about how CBE has influenced dietetic practice. The aim of this paper is to explore how a CBE framework and the CS have influenced dietetic practice in Australia since 1990. A qualitative investigation explored concepts of dietetic practice. Data analysed were original interviews previously undertaken with recent graduate dietitians during 1991 (n = 26), 1998 (n = 23) and 2007 (n = 19) and seven guided discussions with dietitians and employers (n = 28) conducted in 2014 to identify themes. The DAA Competency Standards and Accreditation Manuals/Standards since 1990 were also analysed to triangulate the interview data and to investigate how the CS were interpreted. Themes identified from interviews included: (i) communicating for better care, (ii) scientific enquiry for effective practice, (iii) critical thinking and evidence-based practice and (iv) professionalism, which remained core to dietetic practice over time, but leadership, advocacy, business management and entrepreneurial skills have emerged more strongly as the scope of practice has diversified. The landscape in which dietitians' practice showed increasing complexity and clear boundaries separating professional roles were disappearing. The 2015 CS and the 2017 Accreditation Standards highlighted that competency remains a shifting construct and that professional behaviours change depending on economic and political reasons in the play of power. Accreditation policy and current standards have successfully maintained a standard of dietetic practice across a diverse country but have the potential to constrain innovation. © 2018 Dietitians Association of Australia.

Practice paper of the Academy of Nutrition and Dietetics abstract: ethical and legal issues of feeding and hydration.

PubMed

Schwartz, Denise Baird; Posthauer, Mary Ellen; O'Sullivan Maillet, Julie

2013-07-01

It is the position of the Academy of Nutrition and Dietetics that individuals have the right to request or refuse nutrition and hydration as medical treatment. Registered dietitians should work collaboratively as part of an interprofessional team to make recommendations on providing, withdrawing, or withholding nutrition and hydration in individual cases and serve as active members of institutional ethics committees. This practice paper provides a proactive, integrated, systematic process to implement the Academy's position. The position and practice papers should be used together to address the history and supporting information of ethical and legal issues of feeding and hydration identified by the Academy. Elements of collaborative ethical deliberation are provided for pediatrics and adults and in different conditions. The process of ethical deliberation is presented with the roles and responsibilities of the registered dietitian and the dietetic technician, registered. Understanding the importance and applying concepts dealing with cultural values and religious diversity is necessary to integrate clinical ethics into nutrition care. Incorporating screening for quality-of-life goals is essential before implementing the Nutrition Care Process and improving health literacy with individual interactions. Developing institution-specific policies and procedures is necessary to accelerate the practice change with artificial nutrition, clinical ethics, and quality improvement projects to determine best practice. This paper supports the "Position of the Academy of Nutrition and Dietetics: Ethical and Legal Issues of Feeding and Hydration" published in the June 2013 issue of the Journal of the Academy of Nutrition and Dietetics. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Pigments in fruits and vegetables: genomics and dietetics

USDA-ARS?s Scientific Manuscript database

This comprehensive treatise provides a systemic and insightful overview of current advances in the biosynthetic genomics/genetics and preventive dietetics of carotenoids, flavonoids and betalains, from a general perspective, and in specific fruits and vegetables as well. Genomics/genetics focuses on...

[How can we give quick yet relevant nutritional advice in our daily medical practice?].

PubMed

Girardin, S; Andrey, M; Ruiz, J

2007-06-06

Within our diabetology Unit CHUV-PMU, the dietetic consultation is an integral part of the patients' management, for the majority of diabetic patients. The general practitioner offers very different perspectives. What are the possible modalities of ambulatory dietetic counselling? Are the numerous existing standardized documents really relevant? We bring a critical analysis on such documents, the use of which often engenders a feeling of failure for the patients and the health professionals. We suggest an intervention guide so that the nutritional education work undertaken in an ambulatory consultation may then lead to dietetic management.

Qualitative research in nutrition and dietetics: getting started.

PubMed

Swift, J A; Tischler, V

2010-12-01

Qualitative research is well placed to answer complex questions about food-related behaviour because it investigates how and why individuals act in certain ways. The field of qualitative health research is undoubtedly gaining momentum and, increasingly, there is a recognition that it should be a vital part of the decision-making processes that direct the development of health policy and practice. Much of the guidance available, however, is difficult to navigate for those new to 'qualitative research', and there is little discussion of qualitative research issues specifically in relation to nutrition and dietetics. This review, the first in a series, outlines the field of qualitative enquiry, its potential usefulness in nutrition and dietetics, and how to embark upon this type of research. Furthermore, it describes a process to guide high-quality qualitative research in this area that proceeds from the research question(s) and considers the key philosophical assumptions about ontology, epistemology and methodology that underpin the overall design of a study. Other reviews in this series provide an overview of the principal techniques of data collection and sampling, data analysis, and quality assessment of qualitative work, and provide some practical advice relevant to nutrition and dietetics, along with glossaries of key terms. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.

Qualitative research in nutrition and dietetics: data collection issues.

PubMed

Draper, A; Swift, J A

2011-02-01

The wide scope of qualitative enquiry presents the researcher with a number of choices regarding data collection and sampling. Selecting data collection and sampling techniques can therefore be somewhat daunting, particularly because, often, there is no single, universally accepted 'correct' option. Appropriate research methods are, however, crucial to ensure high-quality research. This review, the second in the series, provides an overview of the principal techniques of data collection and sampling that may be used for qualitative research in nutrition and dietetics. In addition, it describes a process for choosing appropriate data collection and sampling methods that considers the extent to which they provide data that answers the research question(s) and are compatible with the philosophical assumptions about ontology, epistemology and methodology that underpin the overall design of a study. Finally, it discusses the central role that the researcher plays in qualitative data collection and encourages researchers to acknowledge and reflect upon their impact on the data. Other reviews in this series provide a model for embarking on a qualitative research project in nutrition and dietetics, an overview of the principal techniques of data analysis and quality assessment of this kind of research, and some practical advice relevant to nutrition and dietetics, along with glossaries of key terms. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.

[A survey on diet manuals in Italian hospitals].

PubMed

Donini, L M; Riti, M; Castellaneta, E; Ceccarelli, P; Civale, C; Passaretti, S; del Balzo, V; Cannella, C

2009-01-01

Hospital catering is very important to counteract the onset of malnutrition due to either undernutrition or overnutrition and for dietetic treatment. The aim of the study was to evaluate nutritional quality of the hospital dietetic manual used in some Italian hospitals and to analyze the role of the institutional Catering Service and of the Department of Clinical Nutrition. A survey has been carried out, in some Italian hospitals, using a questionnaire to point out the characteristics of hospitals, the typology of catering service, of the diets and of the staff of the Department of Clinical Nutrition. Only 22% of the hospitals has answered; three Italian regions (Umbria, Molise, Basilicata) are completely missing; -each hospital has a specific dietetic manual in most cases completely different from structure and nutritional quality point of view; the staff acting in this field is absolutely insufficient in term of numerousness and of professional typologies. Hospital in-patients are not homogeneous as for age, dietary needs and diseases, so it's necessary to treat them with an ad hoc nutritional intervention not established in advance in a dietetic manual; if from an organisation point of view it is necessary to have such a dietetic manual, it has to be based on nutritional guidelines and recommended dietary allowances.

Position of the American Dietetic Association: the roles of registered dietitians and dietetic technicians, registered in health promotion and disease prevention.

PubMed

Stitzel, Kimberly F

2006-11-01

It is the position of the American Dietetic Association (ADA) that primary prevention is the most effective, affordable course of action for preventing and reducing risk for chronic disease. Registered dietitians and dietetic technicians, registered, are leaders in delivering preventive services in both clinical and community settings, including advocating for funding and inclusion of these services in programs and policy initiatives at local, state, and federal levels. In addition, registered dietitians are leaders in facilitating and participating in research in chronic disease prevention and health promotion. Diet, nutrition, and physical activity are important factors in the promotion and maintenance of good health throughout the life cycle. Cost-effective interventions that produce a change in personal health practices are likely to lead to substantial reductions in the incidence and severity of the leading causes of disease in the United States. In an era of increasing health care expenditures and relative decreases in availability of federal funds, there is increasing demand on health promotion and disease prevention to be economically viable. Through clinical involvement and rigorous participation in research on chronic disease prevention and health promotion, the field of dietetics can lead the way to effectively translate the impact of nutrition on all ages.

Snacking Patterns and Snack Correlates in Third- and Fourth-Year Nursing and Dietetics Students: An Exploratory Study from the Midwestern United States.

PubMed

McArthur, Laura H; Monahan, P L; Sheng, Zhaohui; Holbert, Donald

2016-01-01

To compare snacking behaviors and psychosocial correlates of third- and fourth-year nursing (n=52) and dietetics (n=48) students. Questionnaires assessed snack choices, awareness of healthy snacks, snack recommendations and beliefs, stage of change and perceived benefits/barriers for healthy snacking, and situational snacking. The snacks purchased most often on and off campus by the nursing students were soft drinks/caffeinated beverages (58%) and chips (42%), and for the dietetics students were chips (35%) and fresh fruit (33%). One-third of the nursing and 8% of the dietetics students believed their snack choices would have an unfavorable effect on their long-term health. Two-thirds of the nursing and 75% of the dietetics students self-classified in the action stages for healthy snacking. Snacks considered healthy and recommended by both samples were fresh fruits/vegetables and granola bars. More than 90% of both samples believed their job responsibilities would include modeling and teaching healthy snacking to patients. The barriers to healthy snacking identified most often by both samples were limited budget and not readily available. On-campus vendors should be approached with suggestions about featuring nutrient-dense snacks at discounted prices and offering smaller snack packs of popular products.

Academy of Nutrition and Dietetics: Standards of professional performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems.

PubMed

Tagtow, Angie; Robien, Kim; Bergquist, Erin; Bruening, Meg; Dierks, Lisa; Hartman, Barbara E; Robinson-O'Brien, Ramona; Steinitz, Tamara; Tahsin, Bettina; Underwood, Teri; Wilkins, Jennifer

2014-03-01

Sustainability is the ability of a system to be maintained over the long term. Resilience is the ability of a system to withstand disturbances and continue to function in a sustainable manner. Issues of sustainability and resilience apply to all aspects of nutrition and dietetics practice, can be practiced at both the program and systems level, and are broader than any one specific practice setting or individual intervention. Given an increasing need to apply principles of sustainability and resilience to nutrition and dietetics practice, as well as growing interest among the public and by Registered Dietitian Nutritionists of health issues related to food and water systems, the Hunger and Environmental Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Standards of Professional Performance as a tool for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems to assess their current skill levels and to identify areas for further professional development in this emerging practice area. This Standards of Professional Performance document covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how sustainable, resilient, and healthy food and water systems principles can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Medical nutrition therapy in adults with chronic kidney disease: integrating evidence and consensus into practice for the generalist registered dietitian nutritionist.

PubMed

Beto, Judith A; Ramirez, Wendy E; Bansal, Vinod K

2014-07-01

Chronic kidney disease is classified in stages 1 to 5 by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative depending on the level of renal function by glomerular filtration rate and, more recently, using further categorization depending on the level of glomerular filtration rate and albuminuria by the Kidney Disease Improving Global Outcomes initiative. Registered dietitian nutritionists can be reimbursed for medical nutrition therapy in chronic kidney disease stages 3 to 4 for specific clients under Center for Medicare and Medicaid Services coverage. This predialysis medical nutrition therapy counseling has been shown to both potentially delay progression to stage 5 (renal replacement therapy) and decrease first-year mortality after initiation of hemodialysis. The Joint Standards Task Force of the American Dietetic Association (now the Academy of Nutrition and Dietetics), the Renal Nutrition Dietetic Practice Group, and the National Kidney Foundation Council on Renal Nutrition collaboratively published 2009 Standards of Practice and Standards of Professional Performance for generalist, specialty, and advanced practice registered dietitian nutritionists in nephrology care. The purpose of this article is to provide an update on current recommendations for screening, diagnosis, and treatment of adults with chronic kidney disease for application in clinical practice for the generalist registered dietitian nutritionist using the evidence-based library of the Academy of Nutrition and Dietetics, published clinical practice guidelines (ie, National Kidney Foundation Council on Renal Nutrition, Renal Nutrition Dietetic Practice Group, Kidney Disease Outcomes Quality Initiative, and Kidney Disease Improving Global Outcomes), the Nutrition Care Process model, and peer-reviewed literature. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Abstracts from Dietetic Research Event: June 09-11, 2016.

PubMed

2016-09-01

Winnipeg, Manitoba was the host city of the 2016 Dietitians of Canada Annual Conference. Through the support of Dietitians of Canada and CFDR, the 2016 event was both an exciting and informative exchange of research and experience-sharing efforts that inspired attendees. The submissions for this year's Canadian Foundation for Dietetic Research (CFDR) event represented the diversity of dietetic research conducted within Canada. The topics highlighted from this year's abstracts include Community Based Nutritional Care, Wellness & Public Health, Determinants of Food Choice, Dietary Intake, Nutrition Health & Education, Dietetic Practice & Education, Clinical Research & Patient Service, and Nutrition Social Media & the Web. Each presenter provided an 11-minute oral presentation (8 minutes for presenting and 3 minutes for questions). This allowed for meaningful interaction between the presenters and those attending the sessions. This year there were professional and student oral research presentations on each day of the conference. These presentations offered the newest insights into important research findings that apply to dietetic practice. This research event would not be possible without the commitment and dedication of many people. On behalf of Dietitians of Canada and CFDR, I would like to extend a special thank you to the 2016 Abstract Review Committee who represented research, clinical nutrition, community nutrition, and education: Masha Jessri (Ph.D Candidate, University of Toronto), Joyce Slater (Associate Professor, University of Manitoba) and Miyoung Suh (Associate Professor, University of Manitoba). We would also like to thank all of our moderators who assisted during the conference to keep our research presentation sessions on time: Marcia Cooper, Miyoung Suh, Andrea Buchholz, Dawna Royall, Paul Fieldhouse, Joyce Slater, Isabelle Giroux, and Bethany Hopkins. Finally, a special thank you to Michelle Naraine and Greg Sarney at CFDR for their assistance and support throughout the review process. I enjoyed interacting with many of you at the oral research presentations as we highlighted the findings from our dietetic colleagues across our country! Christina Lengyel, PhD, RD Chair, 2016 Abstracts Review Committee Associate Professor Director of the Dietetics Program Human Nutritional Sciences University of Manitoba.

Strengthening moral reasoning through dedicated ethics training in dietetic preparatory programs.

PubMed

Hewko, Sarah J; Cooper, Sarah L; Cummings, Greta G

2015-01-01

Moral reasoning skills, associated with the ability to make ethical decisions effectively, must be purposively fostered. Among health professionals, enhanced moral reasoning is linked to superior clinical performance. Research demonstrates that moral reasoning is enhanced through dedicated, discussion-based ethics education offered over a period of 3-12 weeks. Current dietetic students and practicing dietitians seeking to strengthen their moral reasoning skills can undertake elective ethics education. Further research within dietetic preparatory programs is warranted to better inform the development and implementation of ethics courses. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Nutrition and women's health: position of the American Dietetic Association and Dietitians of Canada.

PubMed

Affenito, Sandra; Lambert-Lagace, Louise; Kerstetter, Jane; Demark-Wahnefried, Wendy

2004-01-01

It is the position of the American Dietetic Association (ADA) and Dietitians of Canada (DC) that women have specific nutritional needs and vulnerabilities and, as such, are at unique risk for various nutrition-related diseases and conditions that affect the duration and quality of their lives. Although women's health-related issues are multifaceted, nutrition has been shown to influence significantly the risk of chronic disease and assist in maintaining optimal health status. Therefore, the ADA and DC encourage dietetics professionals to strongly support research, health promotion activities, health care services, and advocacy efforts that will enable women to adopt desirable nutrition practices for optimal health.

42 CFR 482.28 - Condition of participation: Food and dietetic services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Food and dietetic services. 482.28 Section 482.28 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION FOR...

Food Service Supervisor. Dietetic Support Personnel Achievement Test.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater.

This guide contains a series of multiple-choice items and guidelines to assist instructors in composing criterion-referenced tests for use in the food service supervisor component of Oklahoma's Dietetic Support Personnel training program. Test items addressing each of the following occupational duty areas are provided: human relations; nutrient…

Food Service Worker.

ERIC Educational Resources Information Center

Barker, Ellen; And Others

This curriculum guide provides instructional materials designed to prepare students for entry-level jobs such as dietetic aide or food service worker in a health care facility. It serves as the basic core of the occupationally sequenced Dietetic Support Personnel Training Program. Five sections and 13 instructional units are included. Each unit of…

Food Production Worker. Dietetic Support Personnel Achievement Test.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater.

This guide contains a series of multiple-choice items and guidelines to assist instructors in composing criterion-referenced tests for use in the food production worker component of Oklahoma's Dietetic Support Personnel training program. Test items addressing each of the following occupational duty areas are provided: human relations; hygiene and…

Dietetic Aide. [Teacher's Copy]. Revised.

ERIC Educational Resources Information Center

Texas Education Agency, Austin. Dept. of Occupational Education and Technology.

The curriculum guide, one of a series prepared to assist teacher-coordinators in promoting and teaching home economics cooperative education programs, provides a course of study for the dietetic aide occupation. In addition to a brief overview, job description, and job analysis of the occupation, the guide's four main sections are: instructional…

Food Service Worker. Dietetic Support Personnel Achievement Test.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater.

This guide contains a series of multiple-choice items and guidelines to assist instructors in composing criterion-referenced tests for use in the food service worker component of Oklahoma's Dietetic Support Personnel training program. Test items addressing each of the following occupational duty areas are provided: human relations; personal…

Educational Requirements for Entry-Level Practice in the Profession of Nutrition and Dietetics

ERIC Educational Resources Information Center

Abad-Jorge, Ana

2012-01-01

The profession of nutrition and dietetics has experienced significant changes over the past 100 years due to advances in nutrition science and healthcare delivery. Although these advances have prompted changes in educational requirements in other healthcare professions, the requirements for entry-level registered dietitians have not changed since…

Geriatric Nutrition Workshop for the Dietetic Assistant.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This workshop guide is a unit of study for teaching dietetic assistants to work with elderly persons. The objective of the unit is to enable the students to apply knowledge of the physiological and psychological effects of aging in providing nutritional care to the elderly in independent living and nursing home situations. Following the unit…

Critical-Thinking Dispositions among Dietetic Interns at the Completion of Their Internship

ERIC Educational Resources Information Center

Schumacher, Julie Raeder

2014-01-01

Critical-thinking skills permeate the ability to pass tests such as the Certification Registration Examination for Dietitians (RD Exam) (Dietetic Educators of Practitioners, 2011). The impact of critical thinking on the RD Exam should be evaluated to assist faculty members when developing curriculum-especially as trends in dispositions emerge.…

Professional Development Portfolio: Perceptions of Nutrition and Dietetics Current Students and Recent Graduates

ERIC Educational Resources Information Center

Vouchilas, Gus; George, Gretchen

2016-01-01

The Professional Development Portfolio (PDP) in family and consumer sciences nutrition and dietetics programs is a tool that can help students in their transition to professionals. Significant issues in the portfolio development process are: content selection, decision to create paper or online formatting, determination of proper timing to begin…

Learning Style Preferences of Undergraduate Dietetics, Athletic Training, and Exercise Science Students

ERIC Educational Resources Information Center

Wagner, Meredith G.; Hansen, Pamela; Rhee, Yeong; Brundt, Ardith; Terbizan, Donna; Christensen, Bryan

2014-01-01

The study assessed the preferred learning style (LS) of college students and compared LS preferences among students majoring in Dietetics, Exercise Science, and Athletic Training. LS questionnaires were distributed to students (N = 693, mean age 20.5 ± 1.7) enrolled in health science courses at three Midwestern universities. Most students…

Position of the American Dietetic Association: Promoting and supporting breastfeeding.

PubMed

James, Delores C S; Dobson, Brenda

2005-05-01

It is the position of the American Dietetic Association (ADA) that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Breastfeeding is also a public health strategy for improving infant and child health survival, improving maternal morbidity, controlling health care costs, and conserving natural resources. ADA emphasizes the essential role of dietetics professionals in promoting and supporting breastfeeding by providing up-to-date, practical information to pregnant and postpartum women, involving family and friends in breastfeeding education and counseling, removing institutional barriers to breastfeeding, collaborating with community organizations and others who promote and support breastfeeding, and advocating for policies that position breastfeeding as the norm for infant feeding. ADA also emphasizes its own role by providing up-to-date information to the public, encouraging empirical research, providing continuing education opportunities, providing cultural sensitivity and cultural competence training to dietetics professionals, and encouraging universities to review and update undergraduate and graduate training programs.

Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance.

PubMed

2016-03-01

It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.

Entrepreneurship of dietetic program graduates.

PubMed

Mann, Linda L; Blum, Ilya

2004-01-01

Successful dietetic program graduates must have an entrepreneurial mindset and skills to respond to environmental changes and consumer trends. The purpose of this study was to determine current or intended entrepreneurship by graduates of a Dietitians of Canada accredited university program, as influenced by self-efficacy stemming from entrepreneurial experiences in education or early career, as well as by internal and external factors. This study employed an exploratory descriptive methodology with a questionnaire mailed to a discrete sample. Ninety graduates completed and returned the questionnaire for a response rate of 55%. Data analysis included descriptive statistics, two-way table analysis, the chi-square test for independence, and Fisher's exact test. Significant relationships were found between self-efficacy scores and entrepreneurial action, specific entrepreneurial experiences and entrepreneurial intent and action, dietetic internship and intent, and belief in the importance of business skills and intent. Those with entrepreneurial intent and/or action identified creativity, dietetic education/internship, persistence, business skills, and family/friend support as helping factors. These results suggest that undergraduate, internship, and continuing education programs for dietitians should incorporate activities that develop entrepreneurial skills and contribute toward an entrepreneurial mindset.

[Multicenter evaluation of the Nutri-Expert Telematic System in diabetic patients].

PubMed

Turnin, M C; Bolzonella-Pene, C; Dumoulin, S; Cerf, I; Charpentier, G; Sandre-Banon, D; Valensi, P; Grenier, J L; Cathelineau, G; Mattei, C

1995-02-01

Nutri-Expert is a system for self-monitoring and dietetic education, accessible through Minitel. A preliminary randomised evaluation of one hundred diabetic patients in the Midi-Pyrénées region showed that Nutri-Expert improved dietetic knowledge, dietary habits and metabolic balance. The aim of the present study was to show that the system can be successfully prescribed to patients by physicians outside the center which originated it, indicating the benefit of a wider use of Nutri-Expert, among the diabetic population. One hundred and fifty-five patients, recruited by six French centres of diabetology, used Nutri-Expert from their homes for six months. Clinical examination, tests of dietetic knowledge and biological tests, including lipid fractions, were carried out before and after six months of use. After six months, there was a significant improvement in the patients' dietetic knowledge and in some biological parameters. Nutri-Expert is thus useful even when prescribed by a centre other than the hospital which devised the system. It is an additional beneficial tool in the ambulatory management of diabetic patients.

The Nutrition and Dietetics Workforce Needs Skills and Expertise in the New York Metropolitan Area

PubMed Central

Gaba, Ann; Shrivastava, Apoorva; Amadi, Chioma; Joshi, Ashish

2016-01-01

Background: There is an increased demand in the Nutrition and Dietetics field which has fostered credentialing to ensure competent graduates. The objective of this study is to conduct an exploratory analysis to identify nutrition/dietetics workforce needs, skills and expertise in the New York metropolitan area as exemplified in position announcements over a 4 year period. Methods: We recorded position announcements for jobs in nutrition and dietetics from the New York State Registered Dietitian Yahoo group, and the Hunter College Nutrition and Food Sciences student and alumni listserv (NFS-L) over a 4 year period. Keywords were identified using job categories defined by the Academy of Nutrition and Dietetics (AND) compensation and benefits survey. This served as a starting point to enumerate the types of positions that have been posted for the New York metropolitan area in recent years. Results: Four hundred and twelve (412) unique job postings were recorded. Various educational levels, credentials, and skills desired by these employers were identified, assessed, and compared with similar data from the “supply side” reports from AND. Conclusions: The credentials and skills most desired by employers are similar to some of the learning objectives set forth for DPD and DI programs by ACEND, but not entirely congruent. The need for both client/customer focus and computer literacy may be implicit in the standards, but a more overt inclusion of these skills would likely be of benefit to ensure these are inculcated into every program and student. PMID:26755482

An observational study investigating the impact of simulated patients in teaching communication skills in preclinical dietetic students.

PubMed

Gibson, S J; Davidson, Z E

2016-08-01

Simulated patients (SPs) are often used in dietetics for the teaching and assessment of communication skills. The present study aimed to determine the impact of a SP encounter on communication skills in undergraduate preclinical dietetic students in the context of the resources required for delivering this educational strategy. This observational study collected assessment data from four cohorts of third-year dietetic students to examine the effect of participation in SP-embedded Objective Structured Clinical Exams. Students completed two SP interviews, 2 weeks apart, and communication skills were measured on both occasions. A subgroup of students received a video of their SP encounter. Differences between the two SP interview scores were compared to assess the impact of the SP encounter on communication skills. The required staff and resources were described. Data were collected involving 215 students. Out of 30 marks, there was a modest mean (SD) improvement in communication skills from the first to the second SP interview of 2.5 (4.2) (P < 0.01). There was an association between student ability and improvement in communication skills, with failing students demonstrating the greatest improvement between SP encounters. There were no observed benefits for the subset of students who received videos. Providing repeat SP interview opportunities results in only modest improvement in communication skills for most students. The use of SPs needs to be considered in context of the substantial costs and resources involved and tailored to student ability. © 2015 The British Dietetic Association Ltd.

Food Production Worker. Dietetic Support Personnel Training Program.

ERIC Educational Resources Information Center

Barker, Ellen; And Others

This curriculum guide, part of a multi-volume dietetic support personnel training program, consists of materials (15 units) for use in training future food production workers. Covered in the first part of the guide are nutrition in food production and diet therapy. The second part of the guide deals with sanitation and safety in food production.…

A Quantitative Assessment of the Cultural Knowledge, Attitudes, and Experiences of Junior and Senior Dietetics Students

ERIC Educational Resources Information Center

McArthur, Laura H.; Greathouse, Karen R.; Smith, Erskine R.; Holbert, Donald

2011-01-01

Objective: To assess the cultural competence of dietetics majors. Design: Self-administered questionnaire. Setting: Classrooms at 7 universities. Participants: Two hundred eighty-three students--98 juniors (34.6%) and 185 seniors (65.4%)--recruited during class time. Main Outcome Measures: Knowledge was measured using a multiple-choice test,…

A Cross-Country Exploration: Dietetic Students' Knowledge, Attitudes, and Intentions to Provide Services to the Elderly

ERIC Educational Resources Information Center

Cha, Myeonghwa; Seo, Sunhee

2009-01-01

This study identified dietetic students' knowledge of aging, attitudes, and intentions to provide services to the elderly and compared the cross-cultural differences between the United States and South Korea. The results show that knowledge about aging and the elderly, coursework experiences, and internship experiences are much greater among…

Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: Comprehensive School Nutrition Services

ERIC Educational Resources Information Center

Briggs, Marilyn; Mueller, Constance G.; Fleischhacker, Sheila

2010-01-01

It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health,…

Dietetics and Nutrition Students Response to Grocery Store Tour Training Program

ERIC Educational Resources Information Center

Hilliard, Elizabeth D.; Brunt, Ardith; Froelich, Christa; Borr, Mari

2018-01-01

Retail dietetics is a growing field, however, there is very little research available on effective teaching strategies for preparing students to enter this part of the profession. This paper is the second paper to report on the results of produce-focused grocery store tour training program. This paper focuses on the trained students' perception of…

Mixed-Methods Research in Nutrition and Dietetics.

PubMed

Zoellner, Jamie; Harris, Jeffrey E

2017-05-01

This work focuses on mixed-methods research (MMR) and is the 11th in a series exploring the importance of research design, statistical analysis, and epidemiologic methods as applied to nutrition and dietetics research. MMR research is an investigative technique that applies both quantitative and qualitative data. The purpose of this article is to define MMR; describe its history and nature; provide reasons for its use; describe and explain the six different MMR designs; describe sample selection; and provide guidance in data collection, analysis, and inference. MMR concepts are applied and integrated with nutrition-related scenarios in real-world research contexts and summary recommendations are provided. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Potential Use of Classroom Response Systems (CRS, Clickers) in Foods, Nutrition, and Dietetics Higher Education.

PubMed

Gould, Susan Martin

2016-10-01

Although hundreds of articles have been published about the use of classroom response systems (CRS, clickers) in higher education, few address the use in foods, nutrition, and dietetics courses, especially upper-division, major courses. This technology has the potential to increase student engagement, motivation, assessment, and, possibly, learning. Thoughtfully designed questions may stimulate discussions, especially about challenging nutrition topics. This article presents the viability and potential benefits for the use of CRS in foods, nutrition, and dietetics classes through a brief literature summary, overview of the author's experiences, and guidance for implementing this technology. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Future Dietitian 2025: informing the development of a workforce strategy for dietetics.

PubMed

Hickson, M; Child, J; Collinson, A

2018-02-01

Healthcare is changing and the professions that deliver it need to adapt and change too. The aim of this research was to inform the development of a workforce strategy for Dietetics for 2020-2030. This included an understanding of the drivers for change, the views of stakeholders and recommendations to prepare the profession for the future. The research included three phases: (i) establishing the context which included a literature and document review (environmental scan); (ii) discovering the profession and professional issues using crowd-sourcing technology; and (iii) articulating the vision for the future using appreciative inquiry. The environmental scan described the current status of the dietetic profession, the changing healthcare environment, the context in which dietitians work and what future opportunities exist for the profession. The online conversation facilitated by crowd-sourcing technology asked the question: 'How can dietitians strengthen their future role, influence and impact?' Dietitians and interested stakeholders (726 and 109, respectively) made 6130 contributions. Seven priorities were identified and fed into the appreciative inquiry event. The event bought together 54 dietitians and analysis of the discussions generated five themes: (i) professional identity; (ii) strong foundations-creating structure and direction for the profession; (iii) amplifying visibility and influence; (iv) embracing advances in science and technology; and (v) career advancement and emerging opportunities. A series of recommendations were made for the next steps in moving the workforce to a new future. The future for dietetics looks bright, embracing technology, as well as exploring different ways of working and new opportunities, as this dynamic profession continues to evolve. © 2017 The British Dietetic Association Ltd.

[Involvement of local dietetics professionals in risk communication program on food safety in municipal governments and their attitude towards the program].

PubMed

Akamatsu, Rie; Nomura, Marika; Horiguchi, Itsuko; Tanaka, Hisako; Marui, Eiji

2009-01-01

The objective of this study is to gather statistical references on food safety education that encourages competence of food choice from the view-point of food safety. A survey on the involvement of the risk communication program on food safety in municipal governments and the attitude of local dietetics professionals towards the program was conducted. In November, 2006, self-reported questionnaires were mailed to 1990 local dietetics professionals who worked in municipal governments in Japan. Descriptive statistics and cross tables were used for data analysis. 1162 questionnaires were mailed and 1130 available surveys were returned. Among the respondents, 41.5% answered that they inform the community about food safety, but 49.9% answered that they did not get information from the community. Most of the respondents answered that risk communication of food safety was important; 21.8% answered "extremely agree" and 62.3% answered "rather agree" on a scale of four from "extremely agree" to "do not agree". More than one-half of the dietetics professionals answered that their confidence in conducting risk communication was low; 20.5% answered "no confidence" and 52.5% answered "hardly have confidence" on a scale of four from "without confidence" to "with confidence". More than 80% of the respondents answered that they needed "professional knowledge" and "support from professional agencies". This study suggests that educating local dietetics professionals about professional knowledge on food safety, and obtaining support from special agencies will be essential in the upgrade of risk communication program on food safety in a community.

[Neurology in medieval regimina sanitatis].

PubMed

de Frutos González, V; Guerrero Peral, A L

2011-09-01

In medical medieval literature some works about dietetics stand out. Dietetics, as a separate branch of medicine, includes not only food or drinks, but other environmental factors influencing on health. They are known as regimina sanitatis or salutis, and specially developed in the Christian west. They generally consisted of a balance between the Galenic "six non-natural things"; factors regulating health and its protection: environment, exercise, food, sleep, bowel movements and emotions. After reviewing the sources and defining the different stages of this genre, we have considered three of the most out-standing medieval regimina, the anonymous Regimen sanitatis salernitanum, Arnaldo de Vilanova's Regimen sanitatis ad regem aragonum and Bernardo de Gordon's Tractatus of conservatione vite humane. In them we review references to neurological disease. Though not independently considered, there is a significant presence of neurological diseases in the regimina. Dietetics measures are proposed to preserve memory, nerves, or hearing, as well as for the treatment of migraine, epilepsy, stroke or dizziness. Regimina are quiet representative among medical medieval literature, and they show medieval physicians vision of neurological diseases. Dietetics was considered useful to preserve health, and therapeutics was based on natural remedies. 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Evaluation of dietetic students' and interns' application of a lifestyle-oriented nutrition-counseling model.

PubMed

Horacek, Tanya M; Salomón, Julia E; Nelsen, Elizabeth K

2007-10-01

To assess dietetic students' and interns' skills to effectively apply a lifestyle-oriented nutrition-counseling model. Between 1999 and 2004, 121 dietetics students and interns (82% retained) were trained to provide nutrition counseling and certified using a standardized patient evaluation format. Supervising registered dietitians and students evaluated transcripts of their counseling sessions using a modified version of the Dietitian's Interviewing Rating Scale (DIRS). Clients evaluated their counselor's skills. t-Tests determined differences between the supervisor and student's DIRS evaluation, and from an acceptable score of "4". ANOVA distinguished differences by student academic category and client group. The student counselors scored >or=4 for five of the six skills sets, but significantly below 4 for "transitions" (the internal summaries between sections). The students rated themselves significantly higher than their supervisor did on rapport building, questioning skills, and approach to plan. The student counselors effectively applied the skills of a lifestyle-oriented nutrition-counseling model, and can benefit from supervisor-provided feedback. Nutrition counseling training/practice through various dietetic curriculums can provide future dietitians with the skills and the confidence they need to successfully assist their clients to make lifestyle behavior changes.

Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance.

PubMed

Thomas, D Travis; Erdman, Kelly Anne; Burke, Louise M

2016-03-01

It is the position of the Academy of Nutrition and Dietetics (Academy), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy, DC, and ACSM, other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's, and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics is a registered dietitian nutritionist and a credentialed sports nutrition expert. Copyright © 2016 Academy of Nutrition and Dietetics, American College of Sports Medicine, and Dietitians of Canada. Published by Elsevier Inc. All rights reserved.

Stronger Together: Use of Storytelling at a Dietetics Conference to Promote Professional Collaboration.

PubMed

Fox, Ann; Gillis, Doris; Anderson, Barb; Lordly, Daphne

2017-03-01

During a Dietitians of Canada conference session (2015), 4 facilitators drew upon "Alice's Adventures in Wonderland" (Alice) to engage participants in discussing the future of dietetic education. The aim was to feature Nova Scotia (NS) collaborative experiences as an example of dietetic education planning that could be implemented elsewhere. Three vignettes from the Alice story were chosen as metaphoric representations of dilemmas and assumptions commonly faced by dietetic educators. Story quotations and facilitator questions related to each vignette-guided discussion. The 3-part story-based arts approach of hearing stories, recognizing stories, and telling stories enabled participants to reflect on their own practice, relate to the challenges of others, and question conventional wisdom. Participants heard the Alice stories, recognized their experiences through the NS examples and had an opportunity to tell their own stories during discussions. Participants identified barriers to and strategies for collaborative planning in their own regions. Evaluation suggests most participants were positively engaged by the storytelling approach. Participants recommended that future offerings allow more time for orientation and for completion of planned activities. Bilingual programming should also be considered. Participants valued the unconventional approach to workshop engagement and planned to implement it in their own workplaces.

Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States.

PubMed

Holben, David H; Marshall, Michelle Berger

2017-12-01

It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A sustainable dietetics bridging program: development and implementation in Atlantic Canada.

PubMed

Lordly, Daphne; Guy, Jennifer; Barry, Paula; Garus, Jennifer

2014-01-01

A provincial focus on immigration and improved foreign credential recognition has led to an investigation of best practices and subsequent recommendations for the development and implementation of a sustainable university-based bridging program for internationally educated dietitians in Atlantic Canada. Data were collected from various sources and used to inform program decisions and direction. An advisory framework was established through a core group representing dietetics education and regulation and internationalization. Subsequently, a key stakeholder group was formed. As a result of this collaboration and research, a dietetics bridging framework was developed and a program pilot tested. Lessons learned may inform similar endeavours and highlight the importance of collaborative leadership and collaboration among multiple stakeholders, and of creatively addressing program sustainability issues while keeping learners (internationally educated dietitians) at the centre.

Users, Uses, and Effects of Social Media in Dietetic Practice: Scoping Review of the Quantitative and Qualitative Evidence.

PubMed

Dumas, Audrée-Anne; Lapointe, Annie; Desroches, Sophie

2018-02-20

Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding of social media in dietetic practice is lacking. The objective of this study was to map and summarize the evidence about the users, uses, and effects of social media in dietetic practice to identify gaps in the literature and inform future research by using a scoping review methodology. Stages for conducting the scoping review included the following: (1) identifying the research question; (2) identifying relevant studies through a comprehensive multidatabase and gray literature search strategy; (3) selecting eligible studies; (4) charting the data; and (5) collating, summarizing, and reporting results for dissemination. Finally, knowledge users (RDs working for dietetic professional associations and public health organizations) were involved in each review stage to generate practical findings. Of the 47 included studies, 34 were intervention studies, 4 were descriptive studies, 2 were content analysis studies, and 7 were expert opinion papers in dietetic practice. Discussion forums were the most frequent social media platform evaluated (n=19), followed by blogs (n=13) and social networking sites (n=10). Most studies targeted overweight and obese or healthy users, with adult populations being most studied. Social media platforms were used to deliver content as part of larger multiple component interventions for weight management. Among intervention studies using a control group with no exposition to social media, we identified positive, neutral, and mixed effects of social media for outcomes related to users' health behaviors and status (eg, dietary intakes and body weight), participation rates, and professional knowledge. Factors associated with the characteristics of the specific social media, such as ease of use, a design for quick access to desired information, and concurrent reminders of use, were perceived as the main facilitators to the use of social media in dietetic practice, followed to a lesser extent by interactions with an RD and social support from fellow users. Barriers to social media use were mostly related to complicated access to the site and time issues. Research on social media in dietetic practice is at its infancy, but it is growing fast. So far, this field of research has targeted few social media platforms, most of which were assessed in multiple-component interventions for weight management among overweight or obese adults. Trials isolating the effects and mechanisms of action of specific social media platforms are needed to draw conclusions regarding the effectiveness of those tools to support dietetic practice. Future studies should address barriers and facilitators related to the use of social media written by RDs and should explore how to make these tools useful for RDs to reach health consumers to improve health through diet. ©Audrée-Anne Dumas, Annie Lapointe, Sophie Desroches. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.02.2018.

Users, Uses, and Effects of Social Media in Dietetic Practice: Scoping Review of the Quantitative and Qualitative Evidence

PubMed Central

2018-01-01

Background Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding of social media in dietetic practice is lacking. Objective The objective of this study was to map and summarize the evidence about the users, uses, and effects of social media in dietetic practice to identify gaps in the literature and inform future research by using a scoping review methodology. Methods Stages for conducting the scoping review included the following: (1) identifying the research question; (2) identifying relevant studies through a comprehensive multidatabase and gray literature search strategy; (3) selecting eligible studies; (4) charting the data; and (5) collating, summarizing, and reporting results for dissemination. Finally, knowledge users (RDs working for dietetic professional associations and public health organizations) were involved in each review stage to generate practical findings. Results Of the 47 included studies, 34 were intervention studies, 4 were descriptive studies, 2 were content analysis studies, and 7 were expert opinion papers in dietetic practice. Discussion forums were the most frequent social media platform evaluated (n=19), followed by blogs (n=13) and social networking sites (n=10). Most studies targeted overweight and obese or healthy users, with adult populations being most studied. Social media platforms were used to deliver content as part of larger multiple component interventions for weight management. Among intervention studies using a control group with no exposition to social media, we identified positive, neutral, and mixed effects of social media for outcomes related to users’ health behaviors and status (eg, dietary intakes and body weight), participation rates, and professional knowledge. Factors associated with the characteristics of the specific social media, such as ease of use, a design for quick access to desired information, and concurrent reminders of use, were perceived as the main facilitators to the use of social media in dietetic practice, followed to a lesser extent by interactions with an RD and social support from fellow users. Barriers to social media use were mostly related to complicated access to the site and time issues. Conclusions Research on social media in dietetic practice is at its infancy, but it is growing fast. So far, this field of research has targeted few social media platforms, most of which were assessed in multiple-component interventions for weight management among overweight or obese adults. Trials isolating the effects and mechanisms of action of specific social media platforms are needed to draw conclusions regarding the effectiveness of those tools to support dietetic practice. Future studies should address barriers and facilitators related to the use of social media written by RDs and should explore how to make these tools useful for RDs to reach health consumers to improve health through diet. PMID:29463487

Prevalence of Exercise Addiction Symptomology and Disordered Eating in Australian Students Studying Nutrition and Dietetics.

PubMed

Rocks, Tetyana; Pelly, Fiona; Slater, Gary; Martin, Lisa Anne

2017-10-01

Previous research has reported the existence of disordered eating in students studying nutrition and dietetics. However, the occurrence of exercise addiction, previously linked to disordered eating, is poorly understood in this group. The main objective of this study was to explore the prevalence of self-reported symptoms of exercise addiction and the association with disordered eating in a sample of students studying nutrition and dietetics. A secondary objective was to compare the prevalence of exercise addiction to students enrolled in another health-related degree. We conducted a cross-sectional study in 165 undergraduate students. Participants were students of both sexes enrolled in nutrition and dietetics and occupational therapy degree programs at an Australian university in August 2013. Participants completed four validated questionnaires for assessment of exercise- and eating-related attitudes and behaviors measuring scores for exercise addiction, weekly volume of physical activity (PA), eating disorder symptoms, and cognitive restraint. Stretch stature and body mass were measured and body composition was assessed using dual energy x-ray absorptiometry. Independent t test, Mann-Whitney U test, and χ 2 test were completed to compare groups of students based on sex, degree, or eating attitudes. Spearman's correlation was performed to explore associations between continuous variables (exercise addiction scores, PA volume, and scores for eating attitudes and cognitive restraint). Approximately 23% of nutrition and dietetics students were found to be at risk of exercise addiction (20% females and 35% males; P=0.205), while the majority demonstrated some symptoms of exercise addiction. A similar proportion of at risk individuals was found in the female occupational therapy group (19%; P=1.000). In females (nutrition and dietetics and occupational therapy combined), the exercise addiction scores were associated with three other outcome measures: PA volume (r s =0.41; P<0.001), eating attitudes scores (r s =0.24; P=0.008), and cognitive restraint (r s =0.32; P<0.001). Comparative analysis indicated that female students with high cognitive restraint had greater exercise addiction scores than those with low cognitive restraint (20.3 [4.8] compared to 17.8 [4.2]; P=0.003). Results suggest high prevalence of exercise addiction in this sample of undergraduate health-related degree students and its link to amount of PA and disordered eating in females. Future research should include larger samples of both sexes to build the existing understanding on these maladaptive behaviors. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Post Graduate Programme in Dietetics & Food Service Management (MSCDFSM) Programme of IGNOU: Access through the Lucknow Regional Centre

ERIC Educational Resources Information Center

Dorothy, J. S.; Kumar, Ashwini

2014-01-01

Indira Gandhi National Open University (IGNOU) which was established initially as a Single mode Distance Teaching Institution (DTI) in the year 1985 opened its campus to face-to-face education in the year 2008 and thus now is a Dual mode Distance Teaching Institution (DTI). The Post Graduate Programme (Master of Science) in Dietetics and Food…

Evaluation of a Nutrition Care Process-based audit instrument, the Diet-NCP-Audit, for documentation of dietetic care in medical records.

PubMed

Lövestam, Elin; Orrevall, Ylva; Koochek, Afsaneh; Karlström, Brita; Andersson, Agneta

2014-06-01

Adequate documentation in medical records is important for high-quality health care. Documentation quality is widely studied within nursing, but studies are lacking within dietetic care. The aim of this study was to translate, elaborate and evaluate an audit instrument, based on the four-step Nutrition Care Process model, for documentation of dietetic care in medical records. The audit instrument includes 14 items focused on essential parts of dietetic care and the documentation's clarity and structure. Each item is to be rated 0-1 or 0-2 points, with a maximum total instrument score of 26. A detailed manual was added to facilitate the interpretation and increase the reliability of the instrument. The instrument is based on a similar tool initiated 9 years ago in the United States, which in this study was translated to Swedish and further elaborated. The translated and further elaborated instrument was named Diet-NCP-Audit. Firstly, the content validity of the Diet-NCP-Audit instrument was tested by five experienced dietitians. They rated the relevance and clarity of the included items. After a first rating, minor improvements were made. After the second rating, the Content Validity Indexes were 1.0, and the Clarity Index was 0.98. Secondly, to test the reliability, four dietitians reviewed 20 systematically collected dietetic notes independently using the audit instrument. Before the review, a calibration process was performed. A comparison of the reviews was performed, which resulted in a moderate inter-rater agreement with Krippendorff's α = 0.65-0.67. Grouping the audit results in three levels: lower, medium or higher range, a Krippendorff's α of 0.74 was considered high reliability. Also, an intra-rater reliability test-retest with a 9 weeks interval, performed by one dietitian, showed strong agreement. To conclude, the evaluated audit instrument had high content validity and moderate to high reliability and can be used in auditing documentation of dietetic care. © 2013 Nordic College of Caring Science.

A cross-cultural investigation of multiple intelligences in university-level nutrition students

NASA Astrophysics Data System (ADS)

Short, Joy E.

Effective strategies for the recruitment and retention of a diverse student body in undergraduate nutrition and dietetics programs are needed in order for graduates to effectively meet the health and nutrition needs of a diverse clientele. One way to promote diversity and improve teaching methods in dietetics education is through a framework based on Howard Gardner's Theory of Multiple Intelligences (MI). The theory suggests that individuals possess varying degrees of eight different intelligences which are shaped by genetics and cultural context. Relatively little research has been conducted to investigate MI approaches in the areas of higher education, cross-cultural education, or dietetics education. Therefore, this study investigated the MI profiles of students within undergraduate nutrition programs at Universidad Iberoamericana in Mexico City, Mexico and Saint Louis University in St. Louis, Missouri, United States. Data were collected through the Multiple Intelligences Developmental Assessment Scales (MIDAS). The findings provide a profile of the intellectual dispositions for the study population and suggest that dietetics students in this cross-cultural study population score highest for the MIDAS scale measuring interpersonal intelligence, with significant differences occurring between scores for the eight intelligences measured by the MIDAS. Not only were there significant differences between scale scores when analyzing the population as a whole, there were also significant differences in scale scores when comparing American and Mexican students. This phenomenon was also true when scores were grouped into five ordinal categories. In addition, the findings suggest that differences exist among the particular skills associated with the intelligences for the students at each university. Results indicate that skills related to social sensitivity and persuasion are significantly higher than many other skills for dietetics students. Further, when comparing the American and Mexican students, significant differences were found between the two populations with regard to skills associated with the eight intelligences. With the exception of the Instrumental subscale, findings for the subscale scores were similar to those for the main scales, in that Mexican students' averaged higher scores. Recommendations related to dietetics education and suggestions for future research are provided.

Rates of adult acute inpatients documented as at risk of refeeding syndrome by dietitians.

PubMed

Owers, Emma L; Reeves, Anneli I; Ko, Susan Y; Ellis, Aleshia K; Huxtable, Shannon L; Noble, Sally A; Porteous, Helen E; Newman, Eli J; Josephson, Christine A; Roth, Rachel A; Byrne, Clare E; Palmer, Michelle A

2015-02-01

Identification of Refeeding Syndrome (RFS) is vital for prevention and treatment of metabolic disturbances, yet no information exists that describes identification rates by dietitians in acute care. We aimed to describe rates and demographics of inpatients identified by dietitians as at-risk of RFS and factors associated with electrolyte levels post-dietetic assessment. Eligible participants were adult (≥ 18 yrs) acute care inpatients reviewed by dietitians between March 2012-February 2013 and not admitted to intensive care prior to first dietetic assessment. Patient information was sourced from medical charts. Chi-squared, t-tests and linear regression analyses were conducted. Of 1661 eligible inpatients (55%F, 65 ± 18 yrs), 9% (n = 151) were documented as at-risk of RFS in the first dietetic medical chart entry. On average, patients identified with RFS-risk had four days greater hospital stay, were 13 kg lighter, more likely classified SGA C (36% vs. 7%), and on a modified diet (52% vs. 35%) than non-RFS patients (p < 0.05). Very low and low electrolyte values occurred within seven days post-dietetic assessment in 7% and 52%, respectively, of inpatients with RFS-risk. Regression analysis showed that electrolyte supplementation was positively associated (β = 0.145-0.594), and number of RFS-related risk factors negatively associated (β = -0.044-0.122), with potassium, magnesium and phosphate levels within seven days post-dietetic assessment (p < 0.05). Nine percent of adult inpatients were documented as at-risk of RFS by dietitians. Identification of at-risk patients was in accordance with RFS guidelines. Electrolyte supplementation was positively associated with electrolyte levels post-assessment. Consistency of RFS-risk identification between dietitians requires determination. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Dietetic practice in refeeding syndrome.

PubMed

Wagstaff, G

2011-10-01

The physiology and consequences of refeeding syndrome have long been recognised, although its management continues to be debated, despite the recommendations made by The National Institute for Health and Clinical Excellence (NICE) in their guideline 'Nutrition Support in Adults' (2006). The present study aims to assess current dietetic opinion and practice in this area, as well as whether the NICE recommendations have been adopted. An anonymous, self-completed Internet survey was designed investigating current practice and opinions on the NICE (2006) guidance on this subject. A link to the questionnaire was distributed with a covering letter via e-mail to the heads of department of National Health Service Trusts in the London region, UK, requesting that it be disseminated to all dietitians working with adults. After the closing date, all responses were collated and analysed. The survey elicited a 30.8% response rate. Some 89.8% of respondents have read the NICE guidance on Nutrition Support in Adults (2006) and 66.9% have changed their practice regarding refeeding syndrome management as a result. Sixty-two percent do not wait for biochemistry to normalise before commencing nutrition. Ninety-two percent of respondents completed the mini case studies indicating that current practice is inconsistent among dietitians. Neither NICE criteria for recognising patients at risk of refeeding, nor the recommended starting rates are universally followed. Seventy-five percent continue to supplement electrolytes reactively. Although limited by a small sample size, the findings of the present study suggest that dietetic practice regarding refeeding syndrome management remains inconsistent with the recommendations made by NICE, although some aspects have been adopted. © 2011 The Author. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Position of the American Dietetic Association and Dietitians of Canada: nutrition and women's health.

PubMed

2004-06-01

It is the position of the American Dietetic Association (ADA) and Dietitians of Canada (DC) that women have specific nutritional needs and vulnerabilities and, as such, are at unique risk for various nutrition-related diseases and conditions. Therefore, the ADA and the DC strongly support research, health promotion activities, health services, and advocacy efforts that will enable women to adopt desirable nutrition practices for optimal health. Women are at risk for numerous chronic diseases and conditions that affect the duration and quality of their lives. Although women's health-related issues are multifaceted, nutrition has been shown to influence significantly the risk of chronic disease and to assist in maintaining optimal health status. Dietetics professionals strongly support research, health promotion activities, health services, and advocacy efforts that will enable women to adopt desirable nutrition practices for optimal health.

Utilization of an Accelerated Queso Fresco Recipe to Teach Concepts of Food Science in a Didactic Program in Dietetics

ERIC Educational Resources Information Center

Therrien, Mona; Calder, Beth L.; Castonguay, Zakkary J.

2018-01-01

Students in the Didactic Program in Dietetics (DPD) at the University of Maine were exposed to the cheese-making process, within a lab setting of two hours, utilizing an accelerated recipe for a Queso Fresco-style cheese. The purpose of this project was to provide students with a novel, hands-on learning experience, which covered concepts of…

Use of mobile device applications in Canadian dietetic practice.

PubMed

Lieffers, Jessica R L; Vance, Vivienne A; Hanning, Rhona M

2014-01-01

A cross-sectional web-based survey of dietitians was used to explore topics related to mobile devices and their applications (apps) in Canadian dietetic practice. A survey was drafted, posted on SurveyMonkey, and pretested with dietitians and dietetic interns. Dietitians of Canada (DC), a supporter of this work, promoted the survey to members through its monthly electronic newsletters from January 2012 to April 2012. Of 139 dietitians who answered some survey questions, 118 finished the survey; this represents a response rate of approximately 3%. Overall, 57.3% of respondents reported app use in practice, and 54.2% had a client ask about or use a nutrition/food app. About 40.5% of respondents had recommended nutrition/food apps to clients. Respondents were enthusiastic about apps, but many described challenges with use. From the survey data, three themes emerged that can affect dietitians' use of apps and whether they recommend apps to clients: mobile device and app factors (access to information/tools, content quality, usability, accessibility/compatibility, and cost), personal factors (knowledge, interest, suitability, and willingness/ability to pay), and workplace factors. Apps are now infiltrating dietetic practice. Several factors can affect dietitians' use of apps and whether they recommend them to clients. These findings will help guide future development and use of apps in practice.

Amount of Genetics Education is Low Among Didactic Programs in Dietetics.

PubMed

Beretich, Kaitlan; Pope, Janet; Erickson, Dawn; Kennedy, Angela

2017-01-01

Nutritional genomics is a growing area of research. Research has shown registered dietitian nutritionists (RDNs) have limited knowledge of genetics. Limited research is available regarding how didactic programs in dietetics (DPDs) meet the genetics knowledge requirement of the Accreditation Council for Education in Nutrition and Dietetics (ACEND®). The purpose of this study was to determine the extent to which the study of nutritional genomics is incorporated into undergraduate DPDs in response to the Academy of Nutrition and Dietetics position statement on nutritional genomics. The sample included 62 DPD directors in the U.S. Most programs (63.9%) reported the ACEND genetics knowledge requirement was being met by integrating genetic information into the current curriculum. However, 88.7% of programs reported devoting only 1-10 clock hours to genetics education. While 60.3% of directors surveyed reported they were confident in their program's ability to teach information related to genetics, only 6 directors reported having specialized training in genetics. The overall amount of clock hours devoted to genetics education is low. DPD directors, faculty, and instructors are not adequately trained to provide this education to students enrolled in DPDs. Therefore, the primary recommendation of this study is the development of a standardized curriculum for genetics education in DPDs.

Comparison of standardized patients and real patients as an experiential teaching strategy in a nutrition counseling course for dietetic students.

PubMed

Schwartz, Vicki S; Rothpletz-Puglia, Pamela; Denmark, Robert; Byham-Gray, Laura

2015-02-01

To compare the quality of communication and behavioral change skills among dietetic students having two nutrition encounters with either a real patient or a standardized patient in the simulation laboratory at Drexel University, Philadelphia, PA, United States. A retrospective analysis of video recordings (n=138) containing nutrition encounters of dietetic students (n=75) meeting with a standardized patient (SP) or a real patient (RP). Trained raters evaluated communication skills with the 28 item Calgary Cambridge Observation Guide (CCOG) and skills promoting behavior change using the 11 item Behavior Change Counseling Index (BECCI) tool. Using the CCOG, there was a significantly greater mean score in the SP group for the category of "Gathering Information" in encounter one (p=0.020). There were good to excellent ratings in all categories of the CCOG and the BECCI scores for the SP and the RP groups at both encounters. There was no significant differences in change scores from encounter one to encounter two between groups. Encounters with SPs and RPs are both effective strategies for dietetic students to demonstrate their communication and behavior change skills. Utilizing SPs is an effective experiential strategy for nutrition counseling curricula. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Biochemistry for dietetic students: course content and format.

PubMed

Sirota, L H

1984-12-01

This article presents the results of a survey of the 251 undergraduate dietetic programs for course content and level of the biochemistry course most frequently used to satisfy competencies in biochemistry under Plan IV of the ADA in 1979-80. It showed that a common core of information was stressed by all biochemistry instructors, but there was great variability in content and level of material covered and the textbook chosen, depending on whether the biochemistry course was offered to dietetic majors only, in classes with other nonchemistry majors, or in classes with chemistry majors. Variability was also seen in the time allotted for biochemistry--39 to 280 hours (total lecture and required laboratory hours); laboratory requirements--only 71%; and departmental affiliation of the instructor--17 different departments, primarily of chemistry (80%), biology (8%), and home economics (4%). Topics given greatest emphasis were descriptive ones, such as definitions, simple structures, and reactions of intermediary metabolism in general terms. Topics given least emphasis were those involving mechanistic and quantitative biochemistry, such as respiratory quotient (RQ), enzyme kinetics, calculations of energy from fat and carbohydrates, and specific structures of vitamins, ketones, and metabolic intermediates. The lack of communication between biochemistry and nutrition instructors and the great differences in the preparation of dietetic majors in biochemistry are sources of concern.

Food and Culinary Knowledge and Skills: Perceptions of Undergraduate Dietetic Students.

PubMed

Cooper, Marcia J; Mezzabotta, Leanne; Murphy, Joseph

2017-03-01

The objective of the current study was to examine food and culinary skills and knowledge of dietetic students. An online bilingual survey was created using Survey Monkey TM to explore the skills, knowledge, and perceptions of undergraduate dietetic students regarding food and cooking. Chi-square and logistic regression analyses were used to compare skills and knowledge of food and culinary concepts. The final sample included second- (n = 22) and third-year (n = 22) students within the Baccalauréat specialisé en sciences de la nutrition program at the University of Ottawa. There were no significant differences (P > 0.05) on 3 of 4 skills (preparing a cake, whipping egg whites, or baking a yeast bread) or knowledge concepts (fold, baste, braise, grill, and poach) amongst second- and third-year students. Third-year students perceived more skill in preparing a béchamel sauce. There was a trend for third-year students (59%) to have higher food and cooking skills and knowledge compared with second-year students (32%). Perceived knowledge and confidence was proportional with the academic year, whereas overall knowledge and skills of food and culinary concepts were moderate among both groups of students. This research suggests that more dedicated time may need to be spent on food and cooking competencies in undergraduate dietetic education.

Management matters.

PubMed

Gould, Rebecca A; Canter, Deborah

2008-11-01

Fewer than 50% of registered dietitians (RDs) supervise personnel and 76% have no budget authority. Because higher salaries are tied to increasing levels of authority and responsibility, RDs must seek management and leadership roles to enjoy the increased remuneration tied to such positions. Advanced-level practice in any area of dietetics demands powerful communication abilities, proficiency in budgeting and finance, comfort with technology, higher-order decision-making/problem-solving skills, and well-honed human resource management capabilities, all foundational to competent management practice. As RDs envision the future of the dietetics profession, practitioners must evaluate management competence in both hard and soft skills. Just as research is needed to support evidenced-based clinical practice, the same is needed to support management practice across the profession. Dietetics educators and preceptors should be as enthusiastic about management practice as they are clinical practice when educating and mentoring future professionals. Such encouragement and support can mean that new RDs and dietetic technicians, registered, will understand what it takes to advance to higher levels of responsibility, authority, and subsequent enhanced remuneration. In the ever-changing social, legal, ethical, political, economic, technological, and ecological environments of work, food and nutrition professionals who are willing to step forward and assume the risks and responsibilities of management also will share in the rewards, and propel the profession to new heights of recognition and respect.

Strengthening the rural dietetics workforce: examining early effects of the Northern Ontario Dietetic Internship Program on recruitment and retention.

PubMed

Hill, Mary Ellen; Raftis, Denise; Wakewich, Pamela

2017-01-01

As with other allied health professions, recruitment and retention of dietitians to positions in rural and isolated positions is challenging. The aim of this study was to examine the early effects of the Northern Ontario Dietetic Internship Program (NODIP) on recruitment and retention of dietitians to rural and northern dietetics practice. The program is unique in being the only postgraduate dietetics internship program in Canada that actively selects candidates who have a desire to live and work in northern and rural areas. Objectives of the survey were to track the early career experiences of the first five cohorts (2008-2012) of NODIP graduates, with an emphasis on employment in underserviced rural and northern areas of Ontario. NODIP graduates (62) were invited to complete a 27-item, self-administered, mailed questionnaire approximately 22 months after graduation. The survey, reflecting issues identified in the rural allied health and dietetics literature, documented their work history, practice locations, employment settings, roles, future career intentions and rural background. Aggregated data were analyzed descriptively to assess their early work experiences, with a focus on their acceptance of positions in rural and northern communities. Items also assessed professional and personal factors influencing their most recent decisions concerning practice locations. Three-quarters of graduates chose organizations serving rural or northern communities for their first employment positions and two-thirds were practicing in rural and underserviced areas when surveyed. Most worked as clinical, community health or public health dietitians, in diverse settings including clinics, hospitals and diabetes care programs. Although most had found permanent positions, working for more than one employer at a time was not uncommon. Factors affecting practice choices included prior awareness of employers, prospects for full-time employment, flexible working conditions, access to interprofessional practice and continuing education, as well as community and family concerns. Intentions to remain in current positions were also shaped by a mixture of professional and personal considerations. Some would relocate in search of opportunities for specialization; a few would leave due to dissatisfaction with employment conditions and disinterest in work; others would move due to personal and family commitments. This study provides early evidence that the NODIP distributed and community-engaged learning model has been very successful in its goal of augmenting the rural and northern dietetics workforce, with a majority of graduates accepting and remaining in rural positions during their first 2 years of practice. Whether graduates remain in rural practice, however, depends on a number of other factors, including career aspirations, availability of professional supports and personal commitments. This suggests that additional supports, above and beyond the NODIP internship, may be needed to encourage graduate dietitians to stay in rural and northern practice locations over the longer term.

University courses, eating problems and muscle dysmorphia: are there any associations?

PubMed

Bo, Simona; Zoccali, Rossana; Ponzo, Valentina; Soldati, Laura; De Carli, Luca; Benso, Andrea; Fea, Elisabetta; Rainoldi, Alberto; Durazzo, Marilena; Fassino, Secondo; Abbate-Daga, Giovanni

2014-08-07

Orthorexia and muscle dysmorphia are disorders affecting above all young adults whose prevalence and social impact are still unclear. We aimed to evaluate the prevalence of the traits of orthorexia and muscle dysmorphia among freshmen attending university courses focused on nutrition (Dietetics) and body care (Exercise and Sport Sciences). Students of Biology were considered as a control group. The prevalence of eating disorder (ED) traits were also evaluated. All participants (n = 440; n = 53 Dietetics school, n = 200 Exercise and Sport Sciences school, n = 187 the Biology school) completed the following questionnaires: ORTO-15, Muscle-Dysmorphic-Disorder-Inventory, and Eating Attitudes Test-26. The prevalence of the traits of EDs, orthorexia, and muscle dysmorphia was 9.1%, 25.9%, and 5.9%, respectively. When compared to other students, those attending the Dietetics school showed a 2-fold higher risk of EDs and those from the Exercise and Sport Sciences school a 10-fold higher risk of muscle dysmorphia. The prevalence of orthorexia traits was high in all schools (35.9%, 22.5%, 26.5% in Dietetics, Biology, and Exercise and Sport Sciences schools, respectively). Overall, individuals with traits of any of these disorders were more frequently on diet or on supplement use. In a logistic regression model, attending the Dietetics school (OR = 2.71; 95% CI 1.14-6.48) was significantly associated with the ED traits, but not with the orthorexia traits (OR = 1.75; 95% CI 0.93-3.29), while attending the Exercise and Sport Sciences school was significantly associated with the muscle dysmorphia traits (OR = 5.15; 95% CI 1.44-18.4). Finally, when evaluating the relationships among the types of study programs as dependent variables and traits of these disturbances, the associations between the traits of ED (OR = 3.35; 95% CI 1.38-8.13) and matriculation at the school of Dietetics, and between the traits of muscle dysmorphia (OR = 4.32; 95% CI 1.16-16.1) and the choice of the Exercise and Sport Sciences school were confirmed. The choice of the university courses might be influenced by pre-existing disorders in eating behaviors, which were relatively frequent in the considered sample.

Criteria for acceptance to preprofessional dietetics programs vs desired qualities of professionals: an analysis.

PubMed

Moore, K K

1995-01-01

The objectives of this analysis were to examine the literature and compare and contrast (a) qualities preferred in preprofessional dietetics students by directors of internships and approved preprofessional practice programs (AP4s), (b) characteristics needed to succeed in a scientific field, (c) traits emphasized by dietetics training programs compared with those most valued by employers, (d) skills needed by high-level managerial dietitians and those in business and communications, and (e) qualities dietitians have aspired to develop for increased competitiveness in the marketplace. Even though the revised Standards of Education have been in place since 1988, recent evaluation of criteria for internship and AP4 admission has shown traditional emphasis on academic performance and the importance of work experience. Success in scientific pursuits has been linked with more than innate intelligence; a drive for success and enthusiasm for learning are also involved. Internships foster mostly technical learning, so development of skills in human and conceptual areas are somewhat lacking. These skills, which have been identified as valuable to employers, need greater development or more consistent identification in the selection and training process. Perhaps serious consideration should be given to applicants for preprofessional programs who have shown leadership qualities through extracurricular activities or who have given themselves the opportunity to develop and improve these skills. Such students might hasten the metamorphosis of dietetics practitioners toward improved levels of compensation and professional fulfillment.

Management matters.

PubMed

Gould, Rebecca A; Canter, Deborah

2012-05-01

Fewer than 50% of registered dietitians (RDs) supervise personnel and 76% have no budget authority. Because higher salaries are tied to increasing levels of authority and responsibility, RDs must seek management and leadership roles to enjoy the increased remuneration tied to such positions. Advanced-level practice in any area of dietetics demands powerful communication abilities, proficiency in budgeting and finance, comfort with technology, higher-order decision-making/problem-solving skills, and well-honed human resource management capabilities, all foundational to competent management practice. As RDs envision the future of the dietetics profession, practitioners must evaluate management competence in both hard and soft skills. Just as research is needed to support evidenced-based clinical practice, the same is needed to support management practice across the profession. Dietetics educators and preceptors should be as enthusiastic about management practice as they are clinical practice when educating and mentoring future professionals. Such encouragement and support can mean that new RDs and dietetic technicians, registered, will understand what it takes to advance to higher levels of responsibility, authority, and subsequent enhanced remuneration. In the ever-changing social, legal, ethical, political, economic, technological, and ecological environments of work, food and nutrition professionals who are willing to step forward and assume the risks and responsibilities of management also will share in the rewards, and propel the profession to new heights of recognition and respect. Copyright © 2012. Published by Elsevier Inc.

[Dietetic assessment of patients with gastroenterologic diseases at the out-patient service of the Institute National of Sciences Medicine and Nutrition Salvador Zubiran].

PubMed

de la Cruz Góngora, Vanesa Vianey; Pando Aguilar, Nancy Esther; Milke García, Pilar; Vargas-Voráková, Florencia

2003-01-01

Assessment of dietetic management is necessary for detection/correction of faults and best care of patients. Our aim was to evaluate dietetic management and nutritional status of gastroenterologic patients. Anthropometric, clinical-nutritional, biochemical, and dietetic parameters were assessed in 110 patients (150 with liver cirrhosis [LC], 30 with inflammatory bowel disease [IBD], and 30 with chronic and skin. In CP, prescribed energy, g and % carbohydrates and lipids were less than ideal and proteins were greater; in cirrhotics, less proteins and a great % of carbohydrates were prescribed; in IBD fewer lipids and more proteins than ideal were prescribed. Cirrhotics usually consumed less fat (g) and more proteins than prescribed, and patients with CP and IBD a greater amount of carbohydrates than prescribed. Cirrhotics consumed more % carbohydrates and < % lipids than ideal; CP patients lipid intake was less and protein intake above ideal and in IBD, carbohydrate intake was greater and lipid intake lower than ideal. Anthropometric and biochemical parameters were not useful for assessment of these patients. Prescribed diet was too restricted regarding proteins in LC and was inadequate in energy/nutrients in patients with CP. Fewer lipids and more proteins were prescribed in IBD. The inadequacy of prescripted diet, lack of information regarding the person who prescribed it, and lack of constant supervision may cause non-adherence to diet and thus may affect nutritional status.

Practice paper of the Academy of Nutrition and Dietetics abstract: nutrition and lifestyle for a healthy pregnancy outcome.

PubMed

Kaiser, Lucia L; Campbell, Christina G

2014-09-01

It is the position of the Academy of Nutrition and Dietetics that women of childbearing age should adopt a lifestyle optimizing health and reducing risk of birth defects, suboptimal fetal development, and chronic health problems in both mother and child.Components leading to healthy pregnancy outcome include healthy pre-pregnancy weight, appropriate weight gain and physical activity during pregnancy, consumption of a wide variety of foods, appropriate vitamin and mineral supplementation, avoidance of alcohol and other harmful substances, and safe food handling. Nutrition assessment needs to encompass changes in anthropometric,biochemical, and clinical indicators throughout pregnancy. Pregnant women should gain weight according to the 2009 Institute of Medicine Guidelines. Energy needs are no higher than the Estimated Energy Requirement for nonpregnant women until the second trimester; thereafter, the extra energy need per day is 340 kcal and 452 kcal in the second and third trimesters,respectively. Using the 2010 Dietary Guidelines for Americans, registered dietitian nutritionists and dietetics technicians, registered,can help pregnant women select a food plan based on age, physical activity, trimester, weight gain, and other considerations.Women are encouraged to participate in at least 150 minutes of moderate-intensity aerobic activity spread throughout the week or 30 minutes of moderately intense exercise on most days of the week.When good food choices are made, food consumption to meet extra energy needs and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy are generally adequate to meet most nutrient needs. However, vitamin and mineral supplementation may be important in vulnerable cases including food insecurity; alcohol, tobacco, or other substance dependency; anemia; strict vegetarian (vegan) diet; or poor eating habits. Multiple strategies are needed to support healthy lifestyles for all women, from preconception through the postpartum period. This practice paper supports the Academy of Nutrition and Dietetics' position paper "Nutrition and Lifestyle for a Healthy Pregnancy Outcome" published in the July 2014 Journal of the Academy of Nutrition and Dietetics.

A computer-assisted personnel data system for a hospital department of dietetics. I. Development of the data base.

PubMed

Shick, G L; Hoover, L W; Moore, A N

1979-04-01

A data base was developed for a computer-assisted personnel data system for a university hospital department of dietetics which would store data on employees' employment, personnel information, attendance records, and termination. Development of the data base required designing computer programs and files, coding directions and forms for card input, and forms and procedures for on-line transmission. A program was written to compute accrued vacation, sick leave, and holiday time, and to generate historical records.

Position of the American Dietetic Association: nutrition standards for child-care programs.

PubMed

1999-08-01

ADA supports achievement of comprehensive nutrition standards in child-care programs. The standards presented in this position paper focus on meeting the child's nutrition needs and providing a safe and pleasant environment that promotes acquisition of eating habits that prevent disease and enable healthy growth and development. Dietetics professionals can play a powerful role in advocating and assisting the acceptance of child-care nutrition standards by parents, caregivers, foodservice personnel, and directors and policy makers for child-care programs.

Practice Paper of the Academy of Nutrition and Dietetics: Role of the Registered Dietitian Nutritionist in the Diagnosis and Management of Food Allergies.

PubMed

Collins, Sherry Coleman

2016-10-01

Incidence of food allergy has increased significantly over the past decade and represents an important health issue for millions of Americans. Diagnosis of immunoglobulin E-mediated food allergies is sometimes difficult because blood and skin tests have high rates of false positives, and oral food challenges are uncommon due to the expense and potential for serious reactions. Accurate diagnosis is crucial to avoid unnecessary dietary restriction, especially in children. Because registered dietitian nutritionists often work independently, receiving referrals for dietary education and guidance for a patient who is followed by one or several other practitioners, navigating the data available and making the appropriate follow-up contact optimizes treatment. The purpose of this paper is to provide guidance to the registered dietitian nutritionists and nutrition and dietetics technician, registered on appropriate and evidence-based nutrition counseling for diagnosis and management of food allergies. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Nutrition education: a survey of practices and perceptions in undergraduate dietetics education.

PubMed

Short, Joy E; Chittooran, Mary M

2004-10-01

Electronic mail messages linked to an online survey were sent to 281 directors of didactic and coordinated programs in dietetics to investigate coverage of nutrition education in undergraduate curriculua, perceived importance of topics, and perceived trends. Descriptive statistics and content analysis were performed on responses from 117 programs. Programs addressed nutrition education through a variety of methods and materials. Fifty-three percent (n=62) offered a course dedicated to nutrition education. The most common teaching methods were didactic (88%) and experiential learning (87%). Most of the topics investigated, including those addressed by the Commission on Accreditation for Dietetics Education Accreditation Manual, were viewed as important, very important, or essential. Perceived trends included increased use of technology, theories/models, client-centered education, cultural awareness, and behavior change. Eighty-eight percent of respondents indicated satisfaction with nutrition education curriculum strategies. Dissatisfaction was associated with inadequate time and resources, need for course improvement, and lack of control over experiences. Results may aid in curriculum development.

American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance.

PubMed

Thomas, D Travis; Erdman, Kelly Anne; Burke, Louise M

2016-03-01

It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.

Inadvertent prescription of gelatin-containing oral medication: its acceptability to patients.

PubMed

Vissamsetti, Bharat; Payne, Mark; Payne, Stephen

2012-09-01

When prescribing, doctors usually only consider the 'active' component of any drug's formulation ignoring the majority of the agents which make up the bulk of the tablet or capsule, collectively known as excipients. Many urological drugs contain the excipient gelatin which is, universally, of animal origin; this may conflict with the dietetic ideals of patients. A questionnaire-based study, undertaken between January and June 2010 in a mixed ethnicity inner-city population presenting with urological symptoms, asked which patients preferred not to ingest animal-based products, who would ask about the content of their prescribed treatment and who would refuse to take that medication if alternatives were available. Ultimately, the authors sought to find out how many patients had been inadvertently prescribed gelatin-containing oral medications and to suggest ways in which prescriptions might be more congruous with an individual patient's dietetic wishes. This study demonstrated that 43.2% of the study population would prefer not to take animal product-containing medication even if no alternative were available. 51% of men with lower urinary tract symptoms were also found to have inadvertently been prescribed gelatin-containing products against their preferred dietary restriction. Education of healthcare professionals about excipients and getting them to ask about a patient's dietetic preferences may help avoid inadvertent prescription of the excipient gelatin in oral medications. Substitution of gelatin with vegetable-based alternatives and clearer labelling on drug packaging are alternative strategies to help minimise the risks of inadvertently contravening a patient's dietetic beliefs when prescribing oral medication.

Transition from tube feeding to oral feeding: experience in a tertiary care paediatric cardiology unit.

PubMed

Shine, Anne Marie; Finn, Daragh Gerard; Allen, Noeleen; McMahon, Colin J

2018-05-02

Home enteral tube feeding (HETF) is imperative for many infants and children with congenital heart disease (CHD). Tube weaning (TW) facilitates the progression from tube feeding to oral diet. There is limited literature on TW practices, protocols and success for children with CHD that have been tube fed. The objective of this study is to assess the process of weaning HETF in a tertiary referral centre for paediatric CHD. Specifically, we aimed to assess the duration of HETF, duration of TW and the interventions involved. We retrospectively reviewed the medical and dietetic records of all infants and children that were successfully weaned off HETF over a 12-month period from January 2015 to December 2015. There were 30 children included in the study, 9 boys and 21 girls. The diagnoses included 15 septal defects, 8 univentricular diagnosis and other diagnoses in 7 children. The median age at initiation of enteral tube feeding was 45 days (range 2-169). The median duration to wean from enteral tube feeding was 52 days (range 2-359). Number of dietetic consults required for successful TW varied among patients, median 5 (range 2-23). The number of days required for successful TW was associated with age and duration on HETF. Dietetic interventions included discontinuation of nutrient dense feeds, altering feed schedule and reduction of feed volume. Weaning HETF is possible in the outpatient setting. Early and frequent dietetic intervention is recommended to ensure prompt discontinuation of HETF when appropriate.

Work-based assessment: qualitative perspectives of novice nutrition and dietetics educators.

PubMed

Palermo, C; Beck, E J; Chung, A; Ash, S; Capra, S; Truby, H; Jolly, B

2014-10-01

The assessment of competence for health professionals including nutrition and dietetics professionals in work-based settings is challenging. The present study aimed to explore the experiences of educators involved in the assessment of nutrition and dietetics students in the practice setting and to identify barriers and enablers to effective assessment. A qualitative research approach using in-depth interviews was employed with a convenience sample of inexperienced dietitian assessors. Interviews explored assessment practices and challenges. Data were analysed using a thematic approach within a phenomenological framework. Twelve relatively inexperienced practice educators were purposefully sampled to take part in the present study. Three themes emerged from these data. (i) Student learning and thus assessment is hindered by a number of barriers, including workload demands and case-mix. Some workplaces are challenged to provide appropriate learning opportunities and environment. Adequate support for placement educators from the university, managers and their peers and planning are enablers to effective assessment. (ii) The role of the assessor and their relationship with students impacts on competence assessment. (iii) There is a lack of clarity in the tasks and responsibilities of competency-based assessment. The present study provides perspectives on barriers and enablers to effective assessment. It highlights the importance of reflective practice and feedback in assessment practices that are synonymous with evidence from other disciplines, which can be used to better support a work-based competency assessment of student performance. © 2013 The British Dietetic Association Ltd.

[Comparison of pravastatin and diet in the treatment of hypercholesterolemia].

PubMed

Palazzuoli, V; Mondillo, S; Faglia, S; D'Aprile, N; Mangiacotti, L

1995-10-01

Aim of this study is to point out a correct therapy for the treatment of poligenic hypercholesterolemia resistant to dietetic treatment. There have been studied 40 patients which, after repeated haematochemical controls, resulted affected by dyslipidaemia with prevalent increase of the cholesterol levels. After 30 days of standard hypo-caloric dietetic treatment were enrolled 23 patients, 13 males and 10 females, who presented a plasmatic cholesterol level superior to 250 mg% and LDL superior to 160 mg%. All the patients continued the dietetic treatment; 10 patients began pravastatin therapy at a dose of 20 mg/die while to the rest of them was given placebo. The 30th, 60th, 120th day were controlled the following haematochemical parameters: lipidic frame haematology, hepatic and renal function, glycemia and CPK. After 4 months of treatment the average plasmatic levels of cholesterol resulted different in the two groups: mg% (p < 0.001) in the pravastatin group and 262 mg% (P = ns) in the control group. Then, the pravastatin therapy was suspended and all 23 patients continued for 30 days, dietetic treatment and placebo. After 6 months a new control of the lipidic frame was performed. Our results showed that the hypocholesterolic therapy must be continued for ever. In fact, the suspension of the treatment is followed by an immediate rebound of the dislipidaemia which plasmatic cholesterol levels even superior to the basic levels with probable negative repercussion on the cardiovascular system.

Do Dutch nutrition and dietetics students meet nutritional requirements during education?

PubMed

van der Kruk, Joke J; Jager-Wittenaar, Harriët; Nieweg, Roos M B; van der Schans, Cees P

2014-06-01

To compare the dietary intakes of Dutch nutrition and dietetics students with the Dutch RDA and the Dutch National Food Consumption Survey (DNFCS), and to assess whether dietary intake changes during education. Cross-sectional and longitudinal research (2004-2010). Data collection by 7 d dietary record and questionnaire. Dutch nutrition and dietetics students. Three hundred and fifty-two first-year and 216 fourth-year students were included. One hundred and thirty-three students in three cohorts were assessed twice. Of first-year students, >80 % met the RDA for all macronutrients. Of these students only 37 % met the RDA for fibre and in 43 % intake of saturated fat was too high. Fourth-year students more often met the RDA for fruits (55 %) and vegetables (74 %) compared with first-year students (32 % and 40 %, respectively). Intake of fruits and vegetables of both first- and fourth-year students was much higher than that of DNFCS participants (where 2 % and 7 %, respectively, met the corresponding RDA). Only <25 % of fourth-year students met the RDA for Fe, Se and vitamin D. In the cohorts, dietary intake for all macronutrients stabilised from the first to the fourth year (>80 %). Intakes of dietary fibre, Ca, Mg, Se, riboflavin, niacin, fruits, vegetables and fish improved significantly during education. Dietary intake of nutrition and dietetics students is much better than that of DNFCS participants and improved during education. However, there is still a gap between actual dietary intake and the RDA, especially for Fe, Se and vitamin D.

Quality circles in a department of dietetics.

PubMed

Treadwell, D D; Klein, J A

1984-06-01

Quality circles can be an excellent approach to managerial effectiveness in the 1980s. For the Department of Dietetics at Miami Valley Hospital, Dayton , Ohio, quality circles have demonstrated excellent return on investment. Their many benefits include increased productivity, improved employee satisfaction and morale, and cost savings. In order to ensure success, the team needs to be selected carefully and trained thoroughly in problem-solving techniques. Initial meetings should be directed to defining the objectives and code of conduct as well as establishing a trusting environment in which to grow and develop.

The marketing concept applied to an education program.

PubMed

Parks, S C; Moody, D L; Barbrow, E P

1984-09-01

Dietetic education programs seeking to maintain their enrollment levels may find it necessary to adopt more sophisticated marketing strategies. This article describes the application of the marketing process to an extended degree dietetic program that serves a national audience. It also presents a strategy for initiating a marketing study and marketing orientation by analyzing its internal program data. The article discusses the specific market characteristics of the program's primary market segments, and it presents further implications for dietitians at work in health care facilities, in businesses, or in private practice.

Food addiction, orthorexia, and food-related stress among dietetics students.

PubMed

Grammatikopoulou, Maria G; Gkiouras, Konstantinos; Markaki, Anastasia; Theodoridis, Xenophon; Tsakiri, Vasiliki; Mavridis, Pantelis; Dardavessis, Theodore; Chourdakis, Michael

2018-05-19

Health sciences, and in particular Nutrition and Dietetics students, have been shown to exhibit an increased prevalence of disordered eating. The aim of the present cross-sectional study was to evaluate other specified feeding and eating disorders (OSFEDs), including stress-related eating, food addiction, and orthorexia, in relation to the dietary intake, among nutrition/dietetics students. A total of 176 undergraduate students from a Department of Nutrition and Dietetics, in Greece, participated in the study. Dietary intake was recorded, and the prevalence of Eating and Appraisal Due to Emotion and Stress (EADES), food addiction (with the modified Yale Food Addition scale mYFAS), and orthorexia were assessed. Chi-square and t tests were performed between sexes, orthorexic and non-orthorexic students, as well as between food-addicted and non-addicted participants. Multiple linear regression analysis assessed relationships between energy intake, BMI or waist circumference, and the food-related psychometric scales. Among participating students, 4.5% had food addiction and 68.2% demonstrated orthorexia. No differences were observed between men and women, concerning the prevalence of food addiction and orthorexia, the sum of mYFAS symptoms, or individual EADES factors. Orthorexic students exhibited increased BMI, reduced energy, and saturated fat intake. In addition, orthorexic men consumed more vegetables. Multiple linear regression analysis revealed that orthorexic behavior was associated with increased BMI, waist circumference and energy intake. Lower BMI was associated with increasing ability to cope with emotion-and-stress-related eating and increasing appraisal of ability and resources to cope with emotions and stress. Emotion-and-stress-related eating was negatively associated with BMI. Appraisal of ability and resources to cope with emotions and stress was associated with the energy intake. Finally, age was positively correlated with the appraisal of outside stressors/influences, indicating increased ability to cope with outside stressors among older students. The study shows that despite the suggested interventions, the problem of OSFEDs among nutrition and dietetics students is still valid. Regular screening, counseling, and education is needed to reduce its prevalence. Level V, cross-sectional descriptive study.

Dietetics trends as reflected in various primary research projects, 1995-2011.

PubMed

Rogers, Dick

2012-03-01

At the behest of the Commission on Dietetic Registration (CDR) Workforce Demand Task Force, a retrospective examination and reanalysis of 12 primary research projects (sponsored by CDR and/or the Academy of Nutrition and Dietetics between 1995 and 2011) was undertaken to identify trends in supply of and demand for registered dietitians (RDs) and dietetic technicians, registered (DTRs). The analysis suggests that supply of RDs (and possibly DTRs) lags slightly behind demand-although, in the case of DTRs, that does not necessarily imply that demand is growing (supply was shrinking throughout most of the study period). The population of both groups is aging, and the number of RDs and DTRs reporting expected retirement in the near future is sure to affect supply/demand relationships. Neither group reflects the US population as a whole in terms of either sex or racial/ethnic diversity, and the trend lines in these areas are essentially flat. RD practice is seen to be moving incrementally toward the clinical arena, in inpatient and (increasingly) outpatient settings. The proportion of RDs in clinical long-term-care, as well as in food/nutrition management and consultation/business practice, is decreasing; a longer-term trend away from foodservice is noted. There is small growth in both the prevalence and the compensation of clinical specialists in areas like renal, pediatrics, and weight management at the expense of more general clinical practitioners. In a trend likely related to the increase in clinical practice, RD positions are gradually losing managerial responsibility. DTRs have experienced a similar phenomenon. For almost all RD positions in the clinical arena, registration as an RD is a requirement for employment, suggesting that clinical employment should continue to grow along with the increasing health care demand from an aging population. The DTR credential is not required at similarly high rates. A major supply issue is the relative shortage of DTRs in certain parts of the country, particularly the South. Major effects from the June 2009 inauguration of the Pathway III route to registration as a DTR have been noted. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study.

PubMed

Heslehurst, Nicola; Dinsdale, Sarah; Brandon, Helene; Johnston, Camilla; Summerbell, Carolyn; Rankin, Judith

2017-06-01

to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity. a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes. one NHS Trust maternity and dietetic services, North East England, UK. fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51kg/m 2 . four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring. women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base. it is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate person-centred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Oncology Nutrition.

PubMed

Charuhas Macris, Paula; Schilling, Karen; Palko, Raymond

2018-04-01

Oncology nutrition encompasses nutrition care for individuals along the cancer care continuum. Nutrition is a vital component of prevention, treatment, and healthy survivorship. The practice of an oncology registered dietitian nutritionist (RDN) reflects the setting and population served with diverse cancer diagnoses, including expanded roles and responsibilities reflecting the RDN's interests and organization's activities. Provision of nutrition services in oncology requires that RDNs have advanced knowledge in the focus area of oncology nutrition. Thus, the Oncology Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as tools for RDNs currently in practice or interested in working in oncology nutrition, to address their current skill level and to identify areas for additional professional development in this practice area. The Standards of Practice address and apply the Nutrition Care Process and workflow elements, which are screening, assessment, diagnosis, intervention, evaluation/monitoring, and discharge planning and transitions of care. The Standards of Professional Performance consist of the following six domains of professionalism including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements and describe three skill levels (competent, proficient, and expert) for RDNs working in oncology nutrition. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Minority recruitment and retention in dietetics: issues and interventions.

PubMed

Greenwald, H P; Davis, R A

2000-08-01

To better understand the reasons why minorities and males are underrepresented among registered dietitians (RDs) and dietetic technicians, registered, (DTRs) and to develop focuses for intervention, the investigators performed a telephone survey of newly credentialed RDs and DTRs and directors of RD and DTR education programs. Using lists of students recruited by the American Dietetic Association for participation in the survey, the investigators interviewed 83 RDs and DTRs and 20 education program directors. RDs and DTRs attributed minority underrepresentation primarily to the field's lack of visibility and underrepresentation of men to the traditional association with women. Education program directors attributed minority underrepresentation to educational disadvantages, particularly in scientific subjects. Findings from this study support program-level interventions such as increasing program flexibility, initiating outreach to K-12 schools and lower-division college students, providing tutoring in a nondemeaning atmosphere, and visibly expressing commitment to minority representation. More fundamental changes in the profession itself appear necessary for large-scale increases in minority representation. These include increasing internship opportunities; raising the profession's level of remuneration, prestige, and independence; increasing scholarship support; and advertising nationally through channels capable of reaching minorities.

A marketing model: applications for dietetic professionals.

PubMed

Parks, S C; Moody, D L

1986-01-01

Traditionally, dietitians have communicated the availability of their services to the "public at large." The expectation was that the public would respond favorably to nutrition programs simply because there was a consumer need for them. Recently, however, both societal and consumer needs have changed dramatically, making old communication strategies ineffective and obsolete. The marketing discipline has provided a new model and new decision-making tools for many health professionals to use to more effectively make their services known to multiple consumer groups. This article provides one such model as applied to the dietetic profession. The model explores a definition of the business of dietetics, how to conduct an analysis of the environment, and, finally, the use of both in the choice of new target markets. Further, the model discusses the major components of developing a marketing strategy that will help the practitioner to be competitive in the marketplace. Presented are strategies for defining and re-evaluating the mission of the profession, for using future trends to identify new markets and roles for the profession, and for developing services that make the profession more competitive by better meeting the needs of the consumer.

Body contouring surgery following bariatric surgery and dietetically induced massive weight reduction: a risk analysis.

PubMed

de Kerviler, S; Hüsler, R; Banic, A; Constantinescu, M A

2009-05-01

This study analyzed the impact of weight reduction method, preoperative, and intraoperative variables on the outcome of reconstructive body contouring surgery following massive weight reduction. All patients presenting with a maximal BMI >/=35 kg/m(2) before weight reduction who underwent body contouring surgery of the trunk following massive weight loss (excess body mass index loss (EBMIL) >/= 30%) between January 2002 and June 2007 were retrospectively analyzed. Incomplete records or follow-up led to exclusion. Statistical analysis focused on weight reduction method and pre-, intra-, and postoperative risk factors. The outcome was compared to current literature results. A total of 104 patients were included (87 female and 17 male; mean age 47.9 years). Massive weight reduction was achieved through bariatric surgery in 62 patients (59.6%) and dietetically in 42 patients (40.4%). Dietetically achieved excess body mass index loss (EBMIL) was 94.20% and in this cohort higher than surgically induced reduction EBMIL 80.80% (p < 0.01). Bariatric surgery did not present increased risks for complications for the secondary body contouring procedures. The observed complications (26.9%) were analyzed for risk factors. Total tissue resection weight was a significant risk factor (p < 0.05). Preoperative BMI had an impact on infections (p < 0.05). No impact on the postoperative outcome was detected in EBMIL, maximal BMI, smoking, hemoglobin, blood loss, body contouring technique or operation time. Corrective procedures were performed in 11 patients (10.6%). The results were compared to recent data. Bariatric surgery does not increase risks for complications in subsequent body contouring procedures when compared to massive dietetic weight reduction.

Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Diabetes Care.

PubMed

Davidson, Patricia; Ross, Tamara; Castor, Chimene

2018-05-01

There are 30.3 million people with diabetes and 86 million with prediabetes in the United States, underscoring the growing need for comprehensive diabetes care and nutrition for the management of diabetes and diabetes-related conditions. Management of diabetes is also critical for the prevention of diabetes-related complications such as cardiovascular and renal disease. The Diabetes Care and Education Dietetic Practice Group along with the Academy of Nutrition and Dietetics Quality Management Committee have updated the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitian Nutritionists (RDNs) in Diabetes Care. The SOP and SOPP for RDNs in Diabetes Care provide indicators that describe three levels of practice: competent, proficient, and expert. The SOP utilizes the Nutrition Care Process and clinical workflow elements for care and management of those with diabetes and prediabetes. The SOPP describes six domains that focus on professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Specific indicators outlined in the SOP and SOPP depict how these standards apply to practice. The SOP and SOPP are complementary resources for RDNs caring for individuals with diabetes or specializing in diabetes care or practicing in other diabetes-related areas, including research. The SOP and SOPP are intended to be used for RDN self-evaluation for ensuring competent practice and for determining potential education and training needs for advancement to a higher practice level in a variety of settings. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Position of the Academy of Nutrition and Dietetics: nutrition guidance for healthy children ages 2 to 11 years.

PubMed

Ogata, Beth N; Hayes, Dayle

2014-08-01

It is the position of the Academy of Nutrition and Dietetics that children ages 2 to 11 years should achieve optimal physical and cognitive development, maintain healthy weights, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity. Rapid increases in the prevalence of childhood obesity during the 1980s and 1990s focused attention on young children's overconsumption of energy-dense, nutrient-poor foods and beverages and lack of physical activity. While recent data suggest a stabilization of obesity rates, several public health concerns remain. These include the most effective ways to promote healthy weights, the number of children living in food insecurity, the under-consumption of key nutrients, and the early development of diet-related risks for chronic diseases, such as cardiovascular disease, type 2 diabetes, cancer, obesity, and osteoporosis. This Position Paper reviews what children 2 to 11 years old in the United States are reportedly eating, explores trends in food and nutrient intakes, and examines the impact of federal nutrition programs on child nutrition. Current dietary recommendations and guidelines for physical activity are also discussed. The roles of parents and caregivers in influencing the development of life-long healthy eating behaviors are highlighted. The Academy of Nutrition and Dietetics works with other allied health and food industry professionals to translate dietary recommendations and guidelines into positive, practical health messages. Specific recommendations and sources of science-based nutrition messages to improve the nutritional well-being of children are provided for food and nutrition practitioners. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Benefits, Barriers, and Motivators to Training Dietetic Interns in Clinical Settings: A Comparison between Preceptors and Nonpreceptors.

PubMed

AbuSabha, Rayane; Muller, Colette; MacLasco, Jacqueline; George, Mary; Houghton, Erica; Helm, Alison

2018-03-01

The shortage of supervised practice sites in dietetics is associated with fewer numbers of preceptors available to supervise interns, especially in the clinical setting. To identify clinical dietitians' perceived benefits and challenges of training dietetic interns and to determine key motivators that would entice nonpreceptors to volunteer for the role. Registered dietitian nutritionists working in clinical settings completed a semi-structured, audiotaped interview followed by a brief questionnaire. Clinical dietitians working in hospitals, long-term care facilities, and outpatient clinics (n=100) participated: 54 preceptors and 46 nonpreceptors. Qualitative analysis was conducted using an iterative process to identify and code common themes. T tests were used to compare mean differences between the opinions of preceptors and nonpreceptors. Preceptors had approximately 5 more years of experience (mean=14.27±12.09 years) than nonpreceptors (mean=8.83±9.72 years) (P< 0.01). Furthermore, preceptors reported twice as many benefits to mentoring interns (mean=6.7 mentions/participant) as nonpreceptors (mean=3.4 mentions/participant), including knowledge gains and staying current. Lack of time was consistently noted as a barrier in interviews and rated as the greatest barrier in the survey. Both groups rated receiving continuing professional education units (CPEUs) for precepting as the greatest potential motivator for taking on interns. Incentive programs should be developed to entice nonpreceptors to take on interns. These programs should include extensive training on the preceptor role and how to alleviate the burden of time spent supervising interns and should provide a significant number of CPEUs to make the added workload worthwhile. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

[Evolution of the nutritional status of patients with HIV-AIDS. Effects of socioeconomic situation and dietetic counseling].

PubMed

Sánchez Alvarez, M C; Gómez Ramos, M J; Cano Sánchez, A; Pacheco Guevara, R; Nicolás Hernández, M; García Alberola, A

1998-12-01

To know HIV-AIDS patient's nutritional status in different infection's condition and their relation with the socioeconomic situation and, in that case, the nutritional condition improvement through the dietetic advice appropriated for each patient. Prospective study of 79 patients with HIV-AIDS diagnostic in any illness's condition and recopilation of anthropometrics and biochemical variables. At the beginning of the study we got data about socioeconomic situation of patient with a scale of 1 to 5 points each variable and an score top of 35. In the survivors we checked, after dietetic advice, the variables at 6 and 12 months by sanitary personal (physician and nurse) who weren't implicated in direct assistance. The study was analyzed by Student "T" for matched data and the simple correlation test. We have objectivated a lost of initial weight over their habitual's with a progressive impairment in different stage of evolution that weren't modified by dietetic advice. We didn't observed significant variations in the biochemical variables included in advances states and in parameters which are usually affected in malnutrition. In the analysis of relation between nutritional condition and socioeconomic factors, it was estimated a lesser score, that was statistically significative, in patients who had a work, family situation and an affective upset positive. The results obtained induce to think that the nutritional advices appropriated for each patient are not related, in our series, with progressive deterioration of anthropometrics variables, neither biochemical parameters fluctuations at 6, 12 months of follow-up. The patient's socioeconomic situation is not influenced by nutritional condition except for the work, affectivity and family environment.

A qualitative examination of patients experiences of dietitians ' consultation engagement styles within nephrology.

PubMed

Morris, A; Herrmann, T; Liles, C; Roskell, C

2018-02-01

Dietitians provide individuals with tailored, practical nutritional advice. For this reason, skills in effective interpersonal communication are essential. In the case of chronic kidney disease, the specifics of dietary advice may change according to renal function. The conveyance of accurate dietary advice and compliance is critical and requires full engagement with the service. The effect of communication styles on patients ' engagement experiences with renal dietetics is unknown. Accordingly, the present study aimed to explore patients ' engagement experiences with renal dietitians. A qualitative phenomenology study using semi-structured in-depth interviews was undertaken with 20 adult renal service users who had engaged with renal dietitians to receive dietary advice. Interpretive phenomenological analysis was used to analyse data. Two main themes emerged from consultation experiences: helpful and unhelpful engagement styles. Individuals reporting helpful engagement styles experienced dietitians ' communication as empathetic, demonstrating positive regard for their lifestyles. However, individuals who reported experiences of unhelpful engagement styles found dietetic care indifferent and communication styles paternalistic. These individuals continued to engage reluctantly despite unhelpful engagement experiences, but felt disempowered. These diverse experiences of engagement can be interpreted by means of 'ego states' within the theoretical model of transactional analysis (TA). Adult ego states may underpin a helpful engagement style whilst a dietitians ' parental ego state was more likely to precipitate an unhelpful engagement style. Ego states, in the context of TA theory, can help to explain the way in which patients engage with renal dietitians. Attention should be given to the employment of a humanistic approach within dietetic consultations. Dietitans need to ensure that they can demonstrate expertise and confidence in the specific communication skills required for patient-centred care. © 2017 The British Dietetic Association Ltd.

Position of the American Dietetic Association: Liberalization of the diet prescription improves quality of life for older adults in long-term care.

PubMed

Niedert, Kathleen C

2005-12-01

It is the position of the American Dietetic Association (ADA) that the quality of life and nutritional status of older residents in long-term care facilities may be enhanced by liberalization of the diet prescription. The Association advocates the use of qualified dietetics professionals to assess and evaluate the need for medical nutrition therapy according to each person's individual medical condition, needs, desires, and rights. In 2003, ADA designated aging as its second "emerging" area. Nutrition care in long-term settings must meet two goals: maintenance of health and promotion of quality of life. The Nutrition Care Process includes assessment of nutritional status through development of an individualized nutrition intervention plan. Medical nutrition therapy must balance medical needs and individual desires and maintain quality of life. The recent paradigm shift from restrictive institutions to vibrant communities for older adults requires dietetics professionals to be open-minded when assessing risks vs benefits of therapeutic diets, especially for frail older adults. Food is an essential component of quality of life; an unacceptable or unpalatable diet can lead to poor food and fluid intake, resulting in weight loss and undernutrition and a spiral of negative health effects. Facilities are adopting new attitudes toward providing care. "Person-centered" or "resident-centered care" involves residents in decisions about schedules, menus, and dining locations. Allowing residents to participate in diet-related decisions can provide nutrient needs, allow alterations contingent on medical conditions, and simultaneously increase the desire to eat and enjoyment of food, thus decreasing the risks of weight loss, undernutrition, and other potential negative effects of poor nutrition and hydration.

Position of the Academy of Nutrition and Dietetics: nutrition services for individuals with intellectual and developmental disabilities and special health care needs.

PubMed

Ptomey, Lauren T; Wittenbrook, Wendy

2015-04-01

It is the position of the Academy of Nutrition and Dietetics that nutrition services provided by registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs), who work under RDN supervision, are essential components of comprehensive care for adults with intellectual and developmental disabilities (IDD) and children and youth with special health care needs (CYSHCN). Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community based, and culturally competent. Individuals with IDD and CYSHCN have many risk factors requiring nutrition interventions, including growth alterations (eg, failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, drug-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Furthermore, these individuals are also more likely to develop comorbid conditions, such as obesity or endocrine disorders that require nutrition interventions. Poor nutrition-related health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Timely and cost-effective nutrition interventions can promote health maintenance and reduce risk and cost of comorbidities and complications. Public policy for individuals with IDD and CYSHCN has evolved, resulting in a transition from institutional facilities and programs to community and independent living. The expansion of public access to technology and health information on the Internet challenges RDNs and NDTRs to provide accurate scientific information to this rapidly growing and evolving population. RDNs and NDTRs with expertise in this area are best prepared to provide appropriate nutrition information to promote wellness and improve quality of life. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Dietetics students' perceptions and experiences of interprofessional education.

PubMed

Earland, J; Gilchrist, M; McFarland, L; Harrison, K

2011-04-01

Interprofessional education (IPE) is a process through which students are provided with learning opportunities with other professions aiming to improve client care. The need to include effective IPE in preregistration programmes for health professionals is increasingly being recognised. The overall aim of the present study was to explore the perceptions and experiences of final-year dietetics students of IPE delivered through interactive online learning groups. A questionnaire was developed to evaluate the students' satisfaction with the IPE modules, including importance to their clinical placements, and their understanding of the roles of other professions. Six dietetics students took part in a focus group that addressed the impact of participating in the IPE modules. The focus group discussion was recorded, transcribed and subjected to content analysis. Twenty students completed the questionnaire (77% of the cohort). Satisfaction with the IPE modules increased as the programme progressed, with 65%, 90% and 95% of the respondents, respectively, being satisfied with the content, assessment and access of the final module. Participating in the programme enhanced the students' opinions on the value of the roles of other professionals (80%) and enhanced their awareness of interprofessional issues (75%). Four key areas of interest emerged from the focus group analysis: key impressions; understanding the role of the dietitian and other professionals; the advantages and disadvantages of online delivery; and interprofessional working in the work environment. The most important outcome of participating in IPE was that students' knowledge of other professions was enhanced, which had a positive impact on placements. An effective information technology infrastructure and appropriate scenarios are key requirements for the online delivery of IPE. © 2011 The Authors. Journal compilation © 2011 The British Dietetic Association Ltd.

Nutritional advice and treatment by dietitians to patients with amyotrophic lateral sclerosis/motor neurone disease: a survey of current practice in England, Wales, Northern Ireland and Canada.

PubMed

Rio, A; Cawadias, E

2007-02-01

The management of amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) has shifted from an attitude of nihilism to treatments that prolong survival and offer hope. Nutrition is an integral component of ALS/MND care requiring coordination among acute and community multi-disciplinary teams (MDT). Evidence-based nutrition guidelines exist for this patient group but their use among dietitians is unknown. The aim of this study was to survey the knowledge, practice and guideline use of dietitians working in ALS/MND centres/clinics across England, Wales, Northern Ireland (EWNI) and Canada. Dietetic contact details were obtained from the Motor Neurone Disease Association (MNDA) and the ALS Society of Canada (ALSSC) websites. Telephone interviews were conducted with 23 dietitians using a standardized questionnaire. Multi-disciplinary team membership was high (78%). Only 22% dietitians had >4-years experience in ALS/MND care. Dietitians reported using body weight, percentage weight loss (PWL) and body mass index (BMI) to assess nutritional status. Equations used to estimate energy and protein requirements differed. Most frequent dietary advice was high calorie, texture modification and prescription nutritional supplements. Artificial nutrition and hydration (ANH) was discussed when patients developed dysphagia, energy intake was inadequate, weight loss of 10% or forced vital capacity (FVC) was reduced. A percutaneous endoscopic gastrostomy (PEG) service was available at all clinics/centres. Nutritional assessment techniques and dietary advice should be standardized. Dietetic collaboration at national and international level is recommended to reduce professional isolation. Training and support in ALS/MND nutrition should be made available as part of post-dietetic registration. Further dietetic research is required to stimulate nutritional care.

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 Standards of Practice and Standards of Professional Performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Implementation of the Nutrition Care Process and International Dietetics and Nutrition Terminology in a single-center hemodialysis unit: comparing paper vs electronic records.

PubMed

Rossi, Megan; Campbell, Katrina Louise; Ferguson, Maree

2014-01-01

There is little doubt surrounding the benefits of the Nutrition Care Process and International Dietetics and Nutrition Terminology (IDNT) to dietetics practice; however, evidence to support the most efficient method of incorporating these into practice is lacking. The main objective of our study was to compare the efficiency and effectiveness of an electronic and a manual paper-based system for capturing the Nutrition Care Process and IDNT in a single in-center hemodialysis unit. A cohort of 56 adult patients receiving maintenance hemodialysis were followed for 12 months. During the first 6 months, patients received the usual standard care, with documentation via a manual paper-based system. During the following 6-month period (Months 7 to 12), nutrition care was documented by an electronic system. Workload efficiency, number of IDNT codes used related to nutrition-related diagnoses, interventions, monitoring and evaluation using IDNT, nutritional status using the scored Patient-Generated Subjective Global Assessment Tool of Quality of Life were the main outcome measures. Compared with paper-based documentation of nutrition care, our study demonstrated that an electronic system improved the efficiency of total time spent by the dietitian by 13 minutes per consultation. There were also a greater number of nutrition-related diagnoses resolved using the electronic system compared with the paper-based documentation (P<0.001). In conclusion, the implementation of an electronic system compared with a paper-based system in a population receiving hemodialysis resulted in significant improvements in the efficiency of nutrition care and effectiveness related to patient outcomes. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Communication skills for behaviour change in dietetic consultations.

PubMed

Whitehead, K; Langley-Evans, S C; Tischler, V; Swift, J A

2009-12-01

Both the UK's National Health Service (NHS) and the National Institute of health and Clinical Excellence (NICE) have recommended increased training for health professionals in communication skills. There is evidence to suggest that communication skills are important in helping people to change health-related behaviour, which is a key role for dietitians. This study investigated the views of UK dietitians about their training needs and experience in relation to communication skills in dietetic practice. In October 2007, a cross-sectional survey was mailed to all British Dietetic Association members (n = 6013). The survey gathered quantitative data and free-text comments to ascertain the level, type and effect of communication skills training received by dietitians at both the pre- and post-registration level. There were 1158 respondents; a response rate of 19.3%. Ninety-eight percent (n = 1117) rated communication skills as either very or extremely important in client consultations. Post-registration training had been undertaken by 73% (n = 904). Of these, over 90% of respondents perceived that post-registration training had led to improvements in their relationships with patients, their confidence in client interviews and their ability to cope with challenging clients. However, 248 (21.4%) felt time keeping in interviews had worsened. Lack of time for client interviews was also the most commonly identified barrier (19%, n = 216) to implementing the skills. This study has explored an important and under-researched area. Respondents strongly endorsed the importance of good communication skills and the benefits of post-registration training in this area. Some felt that good communication was time consuming but others felt that time management had improved. Further research and training is required to support the implementation of these skills into dietetic practice.

Is vegetarianism healthy for children?

PubMed

Cofnas, Nathan

2018-02-23

According to the Academy of Nutrition and Dietetics' influential position statement on vegetarianism, meat and seafood can be replaced with milk, soy/legumes, and eggs without any negative effects in children. The United States Department of Agriculture endorses a similar view. The present paper argues that the Academy of Nutrition and Dietetics ignores or gives short shrift to direct and indirect evidence that vegetarianism may be associated with serious risks for brain and body development in fetuses and children. Regular supplementation with iron, zinc, and B 12 will not mitigate all of these risks. Consequently, we cannot say decisively that vegetarianism or veganism is safe for children.

[Bodybuilding: hypokalemia and hypophosphatemia].

PubMed

Britschgi, F; Zünd, G

1991-08-17

In preparing for competitive body building, body builders--in addition to continuous and hard muscle training--engage in stringent dietetic manipulations: the first few months of hypercaloric nutrition, rich in proteins, are devoted to the build-up of muscle mass. A second phase of reduced caloric intake is designed reduce subcutaneous fat, while, during the last week of preparations, extreme carbohydrate intake aims at loading muscles with glycogen. Simultaneously, sodium and water restriction results in extracellular and therefore subcutaneous volume deficit and better "definition" of muscle contours and structure. In the course of these dietetic manipulations a young body builder develops hypokalemia, hypophosphatemia, rhabdomyolysis and flaccid tetraparesis. The disturbances are pathophysiologically predictable.

Cyberspace 101: taking a ride on the information superhighway.

PubMed

Hayes, D; Forsell, G; Hansen, K; Homer-Trobaugh, J

1997-10-01

All you need to explore cyberspace is a computer, a modem, a phone line, and a local "on-ramp" to the infohighway. A litserv is an interactive mailing list that distributes information to a large number of people at the same time. Once you subscribe, you receive copies of all messages sent into listserv and have the opportunity to post questions and comments for other subscribers. Dietetics Online: A Network of Dietetic/Nutrition Professionals offers a range of cutting-edge services. Online marketing can reach a potentially larger audience for a fraction of the cost of traditional means and expand your business geographically.

Moving National Breastfeeding Policies into Practice: A Plea to Integrate Lactation Education and Training into Nutrition and Dietetics Programs in the United States.

PubMed

Theurich, Melissa Ann; McCool, Megan Elizabeth

2016-08-01

In 2011, the Surgeon General's Call to Action to Support Breastfeeding called on all health professional organizations, medical schools, and credentialing boards to establish and incorporate minimum lactation education and training requirements into their credentialing, licensing, and certification processes and to include breastfeeding education in undergraduate and graduate education and training programs. Given the commonalities between the fields of nutrition and breastfeeding, it has been proposed that nutrition professionals are an underutilized resource in the field of lactation management. Considering the lack of breastfeeding knowledge and skills among health professionals, nutrition professionals should be afforded opportunities to learn lactation management during their studies. The United States Breastfeeding Committee published Core Competencies in Breastfeeding Care and Services for All Health Professionals in 2010. However, professional nutrition and lactation credentialing boards should cooperate to integrate mandatory minimum standards of lactation education for nutrition professionals. Undergraduate and graduate programs in nutrition and dietetics should incorporate lactation content into their core curricula to comply with such standards. In addition, dietetics programs should offer optional clinical lactation experiences for students who aspire to become an International Board Certified Lactation Consultant. © The Author(s) 2016.

Position of the American Dietetic Association: breaking the barriers to breastfeeding.

PubMed

2001-10-01

It is the position of the American Dietetic Association (ADA) that broad-based efforts are needed to break the barriers to breastfeeding initiation and duration. Exclusive breastfeeding for 6 months and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Increases in initiation and duration are needed to realize the health, nutritional, immunological, psychological, economical, and environmental benefits of breastfeeding. Breastfeeding initiation rates have increased, but cultural barriers to breastfeeding, especially against breastfeeding for 6 months and longer, still exist. Gaps in rates of breastfeeding based on age, race, and socioeconomic status remain. Children benefit from the biologically unique properties of human milk including protection from illness with resulting economic benefits. Mother's benefits include reduced rates of premenopausal breast and ovarian cancers. Appropriate lactation management is a critical component of successful breastfeeding for healthy women. Lactation support and management is even more important in women and children with special needs caused by physical or developmental disability, disease, or limited resources. Dietetics professionals have a responsibility to support breastfeeding through appropriate education and training, advocacy, and legislative action; through collaboration with other professional groups; and through research to eliminate the barriers to breastfeeding.

Designing Health Apps to Support Dietetic Professional Practice and Their Patients: Qualitative Results From an International Survey

PubMed Central

Lieffers, Jessica; Bauman, Adrian; Hanning, Rhona; Allman-Farinelli, Margaret

2017-01-01

Background Dietitians are engaging with mobile health (mHealth) technologies, particularly with diet and nutrition apps in their patient care. Despite the plethora of apps available, the majority are not designed with a dietitian’s input. Objective The aim of this study was to identify the user preferences of dietitians in relation to tools, resources, and design features for smartphone health apps that would support their dietetic professional practice and their patients. Methods As part of a larger international Web-based survey of health-app use among dietitians, three open-ended responses were included for specific exploration of app design features and additional resources or tools that could guide the development of apps for use in dietetic practice and patient care. Inductive thematic analysis of responses was conducted using the qualitative data analysis program, NVivo version 11 (QSR International Pty Ltd), to understand the design preferences and features valued by dietitians. Results The responses from 381 dietitian respondents were analyzed. Five key themes were identified. Dietitians wanted access to credible apps, suggesting that dietetic associations should have greater involvement in reviewing and endorsing evidence-based apps for use in dietary counseling. Improvements to the usability of apps, relating to their ease of use and design, were also raised, as self-monitoring of dietary behaviors using existing nutrition apps was deemed to be burdensome. Furthermore, apps providing dietitian-oriented support were favored, for example, those with the ability to streamline the dietary assessment process, so that dietitians could spend more time on dietary counseling and negotiating patient goals for dietary and lifestyle behavior change. Provision of patient-oriented support, such as functionality to tailor apps to patient-specific needs, was also considered important. Finally, respondents valued apps that could integrate into their work systems to enhance the quality of the dietitian-patient relationship. Conclusions App developers should draw upon the features and characteristics valued by dietitians to guide their development of apps that support dietetic practice and enhance patient care. Moreover, to achieve better dietitian and patient-centered app design, it is imperative that app developers take a collaborative approach with dietitians, their professional associations, and their patients. PMID:28363882

Diet, dietetics and flora of the Holy Bible.

PubMed

Subhaktha, P K J P; Narayana, Ala; Sharma, Bhuvnesh Kumar; Rao, M Mruthyumjaya

2006-01-01

The study of history of medical science from non-medical sources needs no apology. At first the discussion of what was thought in the past rather than what is known now appears to be of merely antiquarian value. The knowledge of Diet, Dietetics, medicinal plants dates back to the remote antiquity of mankind. The Hebrews can be proud of having preserved in the Old Testament many old medical practices and traditions, which throw light on ancient medicine. The Bible is genuinely documented book representing the wisdom, medical knowledge and the culture, of a nomadic race. This article contains information of some medicinal plants, which are useful for treating different kinds of ailments and some with nutritious qualities.

Hippocrates' counselling with regard to physical exercise, gymnastics, dietetics and health.

PubMed

Kritikos, A; Bekiari, A; Nikitaras, N; Famissis, K; Sakellariou, K

2009-09-01

The aim of this study is the investigation of Hippocrates' consultative theory with regard to man's physical exercise, gymnastics, diet and health, on the basis of his work "Regimen" and his other works. The aforementioned issues are thematised in the works in question. By means of this thematisation, a medical counselling is formed, according to which exercise, gymnastics and diet aim at the maintenance and restoration of man's health; dietetics, maintenance of well-being, recovery and amelioration of man's health are involved in this thematisation. Hippocrates' views on the aforementioned issues constitute a basis for the discussion and pedagogical exploitation of them in contemporary education and, particularly, in sports education and physical exercise.

Evaluating sago as a functional ingredient in dietetic mango ice cream.

PubMed

Patel, Ashish S; Jana, Atanu H; Aparnathi, Kishore D; Pinto, Suneeta V

2010-10-01

A low fat mango ice cream (2.4% milk fat) was prepared in a mechanized 'ice and salt' type freezer using powdered sago at 2.5% as a natural bulking agent along with sodium alginate at 0.025% as adjunct. The low fat mango ice cream was compared with control mango ice cream having 10% milk fat and 0.15% sodium alginate as stabilizer. Both control as well as experimental ice creams contained 20% mango pulp solids. To impart richness to low fat mango ice cream, flavour enhancers like Cream Plus and Butter Buds were used at levels of 0.2% and 0.05%, respectively. The dietetic low fat ice creams compared well in sensory colour and appearance, flavour, body and texture, and melting quality to that of control ice cream. Incorporation of 2.5% powdered sago and 0.2% Cream Plus as flavour adjunct is recommended in the manufacture of 'low-fat' mango ice cream. The energy values for control and dietetic mango ice cream was 202.8 and 142.9 kcal/100 g, respectively, which represents about 30% reduction in calorie. The cost of ice cream per liter was Rs 39.9, Rs 37.6 and Rs 49.7 for experimental ice creams containing Cream Plus and Butter Bud, and control, respectively.

Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior, and School Nutrition Association: Comprehensive Nutrition Programs and Services in Schools.

PubMed

Hayes, Dayle; Contento, Isobel R; Weekly, Carol

2018-05-01

It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association, and Society for Nutrition Education and Behavior that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. Through the continued use of multidisciplinary teams, local school needs will be better identified and addressed within updated wellness policies. Updated nutrition standards are providing students with a wider variety of fruits, vegetables, and whole grains, while limiting sodium, calories, and saturated fat. Millions of students enjoy school meals every day in the United States, with the majority of these served to children who are eligible for free and reduced-priced meals. To maximize impact, the Academy, School Nutrition Association, and Society for Nutrition Education and Behavior recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus, nutrition initiatives such as farm to school and school gardens, wellness policies, nutrition education and promotion, food and beverage marketing at school, and consideration of roles and responsibilities. Copyright © 2018 The Academy of Nutrition and Dietetics, the Society for Nutrition Education and Behavior, and School Nutrition Association. Published by Elsevier Inc. All rights reserved.

Successfully Attaining a Dietetic Internship Position in Ontario on the First Attempt: A Descriptive Survey.

PubMed

Siswanto, Olivia; Brady, Jennifer; Gingras, Jacqui

2015-03-01

We explored the characteristics of Ontario-based dietetic internship program applicants who were successful upon their first application attempt, and we made comparisons between those who were successful and unsuccessful on their first internship application attempt. A 32-item online survey was distributed to graduates from nutrition programs in Ontario and to members of the Dietitians of Canada Student Network, Toronto Home Economics Association, and Ontario Home Economists in Business. Data from a previous study examining the characteristics of unsuccessful internship applicants were obtained from the authors to compare the two groups. Respondents (n = 76) were mostly female (97%), 20-25 years of age (67%), and had a previous degree (46%). Compared with those who were unsuccessful on their first internship application attempt, those who were successful had a significantly higher mean cGPA (3.69 ± 0.39 vs. 3.35 ± 0.41), were more likely to have a prior degree (46% vs. 29%), spent more time preparing their internship application package, and perceived their internship application packages to be stronger. Despite some differences, most applicants met the minimum cGPA requirement outlined by internship programs in Ontario. More internship opportunities can help increase the diversity and human potential in the dietetic profession.

Clinical dietetic practice in the treatment of severe acute malnutrition in a high HIV setting.

PubMed

Biggs, C

2013-04-01

In Sub-Saharan Africa, children commonly present with severe acute malnutrition (SAM) complicated by HIV/AIDS. In 2005, the South African Department of Health implemented the World Health Organization (WHO) Ten Step programme for the inpatient treatment of SAM. Dietary management with F75 and F100 (where the terms F75 and F100 refer to a mixture of milk, sugar, oil and a vitamin and mineral mix) may not be appropriate for relatively well resourced settings such as South Africa. A structured questionnaire aiming to determine current clinical practice was e-mailed to all dietitians working in hospitals (n = 53) in KwaZulu-Natal who routinely treated SAM. When initially refeeding with no diarrhoea (ND), F75 was used exclusively by 16% of dietitians to treat infants, and by 42% of dietitians to treat children. If diarrhoea, 16% of dietitians used F75 to treat infants/children. Acidified infant formula (IF) was given if ND and lactose-free IF was given if diarrhoea. Children were often started on a lactose-free F100 equivalent omitting cautious refeeding. Some gave reduced amounts for cautious refeeding; however, the feeds osmolality was too high. The use of partially hydrolysed feeds increased if the child/infant presented with diarrhoea and/or hypoalbuminea. In the post-initial feeding phase, approximately 14% of dietitians used F100 to treat infants/children. Most gave F100 equivalents as high-energy infant/paediatric formulas. The dietetic practices for infants with SAM followed current expert opinion closely rather than the WHO protocol. The omission of cautious refeeding follows neither current expert opinion, nor the WHO protocol, and may predispose to the refeeding syndrome. Limited evidence indicates that partially hydrolysed formulas are less effective than low lactose low osmolality feeds in the treatment of SAM. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior, and School Nutrition Association: Comprehensive Nutrition Programs and Services in Schools.

PubMed

Hayes, Dayle; Contento, Isobel R; Weekly, Carol

2018-05-01

It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association, and Society for Nutrition Education and Behavior that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. Through the continued use of multidisciplinary teams, local school needs will be better identified and addressed within updated wellness policies. Updated nutrition standards are providing students with a wider variety of fruits, vegetables, and whole grains, while limiting sodium, calories, and saturated fat. Millions of students enjoy school meals every day in the US, with the majority of these served to children who are eligible for free and reduced-priced meals. To maximize impact, the Academy, School Nutrition Association, and Society for Nutrition Education and Behavior recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus, nutrition initiatives such as farm to school and school gardens, wellness policies, nutrition education and promotion, food and beverage marketing at school, and consideration of roles and responsibilities. It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association, and Society for Nutrition Education and Behavior that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. To maximize impact, the Academy, School Nutrition Association, and Society for Nutrition Education and Behavior recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus; nutrition initiatives such as farm to school and school gardens; wellness policies; nutrition education and promotion; food and beverage marketing at school; and consideration of roles and responsibilities. Copyright © 2018 The Academy of Nutrition and Dietetics, the Society for Nutrition Education and Behavior, and School Nutrition Association. Published by Elsevier Inc. All rights reserved.

CoQ10 plasmatic levels in breast-fed infants compared to formula-fed infants.

PubMed

Compagnoni, G; Giuffrè, B; Lista, G; Mosca, F; Marini, A

2004-01-01

Coenzyme Q10 has been recognized as an important antioxidant factor besides its main role in bioenergetic metabolism. CoQ10 tissue levels depend both on exogenous dietetic intake and on endogenous biosynthesis, as this compound can be partly synthesized in human cells. Q10 plasma levels reflect the tissue content of the coenzyme and can be used to evaluate the presence of this compound in the human organism. Aim of the study was to measure CoQ10 plasmatic levels in a newborn breast-fed population and to compare them to CoQ10 levels in a newborn formula-fed population in order to verify whether changes in CoQ10 plasmatic contents could be related to a different dietetic intakes. We measured CoQ10 plasmatic levels in 25 healthy term neonates with different dietetic intakes: 15 breast-fed and 10 bottle-fed with a common infant formula. These infants were evaluated prospectively during the first month of life. The analyses were performed on the mothers' blood samples and cord blood samples at the time of delivery, then on infants at 4 and 28 days of age. Our results showed markedly reduced Q10 levels in cord blood samples compared to maternal Q10 plasmatic levels at the time of delivery, suggesting placental impermeability towards this molecule or increased fetal utilization during labor and delivery. At 4 days of age Q10 levels had increased in both groups of neonates, but significantly more in breast-fed infants compared to formula-fed babies (p <0.05). At 4 weeks of age no significant changes occurred in breast-fed infants, while values increased significantly in formula-fed infants (p <0.05). The content of Q10 in breast milk samples was lower than in infant formula. The results of this study show that CoQ10 plasmatic levels are at least partly influenced by the exogenous dietetic supply.

Managing Malnutrition in Older Persons Residing in Care Homes: Nutritional and Clinical Outcomes Following a Screening and Intervention Program.

PubMed

Mountford, Christopher G; Okonkwo, Arthur C O; Hart, Kathryn; Thompson, Nick P

2016-01-01

This study aimed to establish prevalence of malnutrition in older adult care home residents and investigate whether a nutritional screening and intervention program could improve nutritional and clinical outcomes. A community-based cohort study was conducted in five Newcastle care homes. 205 participants entered; 175 were followed up. Residents already taking oral nutritional supplements (ONS) were excluded from interventions. Those with Malnutrition Universal Screening Tool (MUST) score of 1 received dietetic advice and ≥2 received dietetic advice and were prescribed ONS (220 ml, 1.5 kcal/ml) twice daily for 12 weeks. Body mass index (BMI), MUST, mini nutritional assessment score (MNA)®, mid upper arm muscle circumference (MAMC), and Geriatric Depression Scale (GDS) were recorded at baseline and 12 weeks. Malnutrition prevalence was 36.6% ± 6.6 (95% CI). A higher MUST was associated with greater mortality (p = 0.004). Type of intervention received was significantly associated with change in MUST score (p < 0.001); dietetic advice resulting in the greatest improvement. There were no significant changes in BMI (p = 0.445), MAMC (p = 0.256), or GDS (p = 0.385) following the interventions. Dietitian advice may slow the progression of nutritional decline. In this study oral nutritional supplements over a 3-month period did not significantly improve nutritional status in malnourished care home residents.

myPace: an integrative health platform for supporting weight loss and maintenance behaviors.

PubMed

Barnett, Julie; Harricharan, Michelle; Fletcher, Dave; Gilchrist, Becky; Coughlan, Jane

2015-01-01

Obesity is a major health concern caused by unhealthy eating behaviors. Digital weight loss interventions have adopted mobile technology primarily in order to support self-monitoring. However, many available apps are not designed as a part of dietetic practice; therefore, a distinct gap in the research exists relating to technology that supports the patient-practitioner relationship. This paper presents myPace, which is a complete weight loss and management system that is deployed via a smartphone and a PC. It connects dietitians and patients between face-to-face consultations and extends the relationship through patients' regular progress updates and dietitians' tailored and timely advice, for sustained behavior change. The prototype was developed from research into behavior change for weight loss, which furthermore was underpinned by theory and tenets of human support models, such as the supportive accountability framework. We report on an early-phase system design goals via a formative research process, which aimed to implement theoretical principles and match practical dietetic practice. To that end, only the clinical end user's perspective was sought through a coaching think-aloud protocol on the first iteration of the prototype and interviews with dietitians. Findings show that the system has many positive design features, but which require further development in order for the system to be fully acceptable within dietetic practice and motivate patient engagement.

Position of the American Dietetic Association: local support for nutrition integrity in schools.

PubMed

Bergman, Ethan A; Gordon, Ruth W

2010-08-01

It is the position of the American Dietetic Association (ADA) that schools and communities have a shared responsibility to provide students with access to high-quality, affordable, nutritious foods and beverages. School-based nutrition services, including the provision of meals through the National School Lunch Program and the School Breakfast Program, are an integral part of the total education program. Strong wellness policies promote environments that enhance nutrition integrity and help students to develop lifelong healthy behaviors. ADA actively supported the 2004 and proposed 2010 Child Nutrition reauthorization which determines school nutrition policy. ADA believes that the Dietary Guidelines for Americans should serve as the foundation for all food and nutrition assistance programs and should apply to all foods and beverages sold or served to students during the school day. Local wellness policies are mandated by federal legislation for all school districts participating in the National School Lunch Program. These policies support nutrition integrity,including a healthy school environment. Nutrition integrity also requires coordinating nutrition education and promotion and funding research on program outcomes. Registered dietitians and dietetic technicians, registered, and other credentialed staff, are essential for nutrition integrity in schools to perform in policy-making, management, education, and community building roles. A healthy school environment can be achieved through adequate funding of school meals programs and through implementation and evaluation of strong local wellness policies.

Position of the American Dietetic Association: total diet approach to communicating food and nutrition information.

PubMed

Freeland-Graves, Jeanne; Nitzke, Susan

2002-01-01

It is the position of the American Dietetic Association that all foods can fit into a healthful eating style. The ADA strives to communicate healthful eating messages to the public that emphasize the total diet, or overall pattern of food eaten, rather than any one food or meal. If consumed in moderation with appropriate portion size and combined with regular physical activity, all foods can fit into a healthful diet. Public policies that support the total diet approach include Reference Dietary Intakes, Food Guide Pyramid, Dietary Guidelines for Americans, Nutrition Labeling and Healthy People 2010. The value of a food should be determined within the context of the total diet because classifying foods as "good" or "bad" may foster unhealthy eating behaviors. Eating practices are influenced by taste and food preferences, concerns about nutrition and weight control, physiology, lifestyle, environment, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, dietetics professionals plan communications and educational programs that utilize theories and models related to human behavior. Communication campaigns/programs should implement an active, behaviorally focused approach within the larger context of food choices. Nutrition confusion can be reduced by emphasizing moderation, appropriate portion size, balance and adequacy of the total diet over time, the importance of obtaining nutrients from foods, and physical activity.

Position of the American Dietetic Association: food insecurity and hunger in the United States.

PubMed

Holben, David H

2006-03-01

It is the position of the American Dietetic Association that systematic and sustained action is needed to bring an end to domestic food insecurity and hunger and to achieve food and nutrition security for all in the United States. The Association believes that immediate and long-range interventions are needed, including adequate funding for and increased utilization of food and nutrition assistance programs, the inclusion of food and nutrition education in all programs providing food and nutrition assistance, and innovative programs to promote and support the economic self-sufficiency of individuals and families, to end food insecurity and hunger in the United States. Food insecurity continues to exist in the United States, with over 38 million people experiencing it sometime in 2004. Negative nutritional and nonnutritional outcomes have been associated with food insecurity in adults, adolescents, and children, including poor dietary intake and nutritional status, poor health, increased risk for the development of chronic diseases, poor psychological and cognitive functioning, and substandard academic achievement. Dietetics professionals can play a key role in ending food insecurity and hunger and are uniquely positioned to make valuable contributions through provision of comprehensive food and nutrition education, competent and collaborative practice, innovative research related to accessing a safe and secure food supply, and advocacy efforts at the local, state, regional, and national levels.

Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes.

PubMed

Stang, Jamie; Huffman, Laurel G

2016-04-01

It is the position of the Academy of Nutrition and Dietetics that all women of reproductive age receive education about maternal and fetal risks associated with prepregnancy obesity, excessive gestational weight gain, and significant postpartum weight retention, including potential benefits of lifestyle changes. Behavioral counseling to improve dietary intake and physical activity should be provided to overweight and obese women, beginning in the preconception period and continuing throughout pregnancy, for at least 12 to 18 months postpartum. Weight loss before pregnancy may improve fertility and reduce the risk of poor maternal-fetal outcomes, such as preterm birth, gestational diabetes, gestational hypertension, pre-eclampsia, assisted delivery, and select congenital anomalies. Lifestyle interventions that moderate gestational weight gain may reduce the risk of poor pregnancy outcomes, such as gestational diabetes, gestational hypertension, large for gestational age, and macrosomia, as well as lower the risk for significant postpartum retention. Postpartum interventions that promote healthy diet and physical activity behaviors may reduce postpartum weight retention and decrease obesity-related risks in subsequent pregnancies. Analysis of the evidence suggests that there is good evidence to support the role of diet, physical activity, and behavior changes in promoting optimal weight gain during pregnancy; however, there is currently a relative lack of evidence in other areas related to reproductive outcomes. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Position of the American Dietetic Association: Functional foods.

PubMed

Hasler, Clare M; Bloch, Abby S; Thomson, Cynthia A; Enrione, Evelyn; Manning, Carolyn

2004-05-01

It is the position of the American Dietetic Association that functional foods, including whole foods and fortified, enriched, or enhanced foods, have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. The Association supports research to define further the health benefits and risks of individual functional foods and their physiologically active components. Dietetics professionals will continue to work with the food industry, the government, the scientific community, and the media to ensure that the public has accurate information regarding this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, from both phytochemicals and zoochemicals, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk. This position reviews the definition of functional foods, their regulation, and the scientific evidence supporting this emerging area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient content alone. Analyzing the content of other physiologically active components and evaluating their role in health promotion will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet.

42 CFR 483.480 - Condition of participation: Dietetic services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FACILITIES Conditions of Participation for Intermediate Care Facilities for Individuals with Intellectual..., including clients in wheelchairs; (3) Equip areas with tables, chairs, eating utensils, and dishes designed...

42 CFR 483.480 - Condition of participation: Dietetic services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FACILITIES Conditions of Participation for Intermediate Care Facilities for Individuals with Intellectual..., including clients in wheelchairs; (3) Equip areas with tables, chairs, eating utensils, and dishes designed...

42 CFR 483.480 - Condition of participation: Dietetic services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FACILITIES Conditions of Participation for Intermediate Care Facilities for Individuals with Intellectual..., including clients in wheelchairs; (3) Equip areas with tables, chairs, eating utensils, and dishes designed...

Metabolic syndrome

MedlinePlus

... to or higher than 130/85 mm Hg Fasting blood sugar (glucose) equal to or higher than ... Dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet . 2016;116( ...

Evaluation tools for undergraduate program planning in times of financial austerity.

PubMed

O'Palka, J; Harris, P R

1990-05-01

This article describes the administration and outcome of two evaluation tools developed by faculty of the dietetic program for ongoing assessment of a Plan IV dietetic education program over a 4-year period. Interns and internship directors were asked to evaluate the level of skills and knowledge base of interns compared with their internship classmates. Interns were also asked to rate the effectiveness of undergraduate course assignments and activities for internship preparation. As a result of the surveys, the home economics core course work was deleted, credits were shifted from food science to nutrient metabolism courses, and credits in clinical nutrition were increased. Projects in clinical nutrition and food systems management were modified. The surveys justified program requirements and utilization of resources, and provided an additional, effective measure of faculty competence.

[Longlived examples. Function and formal principles of historical exempla of old age in the early-modern dietetic literature].

PubMed

Schäfer, Daniel

2003-01-01

Since antiquity, the exemplum can be proven in numerous types of texts, as it fulfills a notable didactic and rhetorical function: On the one hand it serves to a deductive illustration of common doctrines; on the other it is until the Enlightenment the scientific basis of cognition: in the view of medieval artistotelists, of who FRANCIS BACON was (in a special sense) one of the last champions, the exemplum takes on an inductive function: the sensual perception of the exampla generates the understanding of the universal, as the exemplum always refers to the exemplar, to the original form. Regarding the eminent deductive/inductive significance of the exempla, it is not surprising that they are an essential factor in dietetic literature. Whereas such exemples were very rare in the general literature on health care written by physicians and in specific papers of old-age assistance, they formed an integral part of texts composed for a large public by medical laymen such as (Ps.-) ROGER BACON, MARSILIO FICINO, ALVISE CORNARO or FRANCIS BACON. In these studies, the issue of a natural limit of human life was discussed intensively. In this context the "historical" sources were of high importance, even if, from a todays point of view, their use was completely non-historical. Often their crude instrumentalization and new interpretations can only be understood in the scholarly context of the time: E.g. in debates of specialists with outsiders or when serving as argument for physiological theories and therapeutical regimes. Not until late Renaissance, the historical exemple was replaced by the individual experience. It is striking that most of all historical exemples found in dietetic papers were positive. This humanistic and Christian ideal concept of old age, which completely contradicts the medical reality, had obviously a stronger fascination on the authors of early modern times than the inductive function of negative exempla (which are very important for a rational reasoning). Besides the scientific exemple, it is the idealizing one which, in the dietetic texts, gradually assumes the moral function of not discouraging the often aged readers, but of encouraging them to a constructive way of living.

Vegan Food Guide

MedlinePlus

... Academy of Nutrition and Dietetics (AND), "appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, ... prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of ...

Vegan Food Guide

MedlinePlus

... to the American Dietetic Association (ADA), "appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, ... prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of ...

42 CFR 483.480 - Condition of participation: Dietetic services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FACILITIES Conditions of Participation for Intermediate Care Facilities for the Mentally Retarded § 483.480... wheelchairs; (3) Equip areas with tables, chairs, eating utensils, and dishes designed to meet the...

42 CFR 483.480 - Condition of participation: Dietetic services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FACILITIES Conditions of Participation for Intermediate Care Facilities for the Mentally Retarded § 483.480... wheelchairs; (3) Equip areas with tables, chairs, eating utensils, and dishes designed to meet the...

Tips for Older Dietary Supplement Users

MedlinePlus

... by the government for safety or effectiveness before marketing. Also, unlike drugs, supplements are not intended to ... Others: American Dietetic Association American Pharmacists Association Food Marketing Institute International Food Information Council Foundation National Council ...

Kennedy Educate to Innovate (KETI) Space Food Powerpoint Presentation

NASA Technical Reports Server (NTRS)

Paglialonga, Jessica

2011-01-01

An overview of the science related to the development of production of space food is presented for school students. Students are acquainted with careers in food science, nutrition, dietetics, microbiology, and astrobiology.

Who does the public think should perform health care tasks?

PubMed

Koteski, D R; McKinney, S

1988-10-01

The dietitian was identified as the most appropriate provider of such key nutrition services as nutrition assessment, determination of caloric requirements, provision of diet counseling, and prescription of diets. Several tasks fundamental to nutrition services were not viewed as highly suitable tasks for the dietitian, e.g., plan for care at home, monitor client progress, and check laboratory values. Activities that constitute key nutrition services need to be accentuated to clarify the numerous skills and extensive knowledge that dietitians possess. In the health care system of today, the dietetic profession must be associated with a wider range of health-related tasks than the traditional triad of diet, food, and hospital. Public relations and marketing strategies should focus on activities that provide the public with a clearer understanding of how the dietetic profession contributes to patient/client care.

[Sucessful dietetic-therapy in primary intestinal lymphangiectasia and recurrent chylous ascites: a case report].

PubMed

Martín, C Campos; García, A Fernández-Argüelles; Restrepo, J M Rabat; Pérez, A Sendón

2007-01-01

Primary intestinal lymphangiectasia is a lymphatic system's disorder, where lymphatic drainage is blockaged. Clinically it produces malabsorption, protein-losing enteropathy, hypogammaglobulin in blood, and several degrees of malnutrition. Its treatment is not easy and includes dietetic-therapy and drugs. A 35-year-old-woman case report is exposed. She has recurrent chylosa ascites, requiring several admissions and evacuatory paracentesis. After food-fat was replaced by medium-chain triacyl-glicerol-enriched diet, a clinical, analytical and anthropometric improvement was demonstrated. The major way of treatment in intestinal lymphangiectasia in this case is the employement of specific-diet and adaptaded-basic-food. It's difficult and high collaboration of the patient is required, being necessary medical revisions during the whole life, due to the not well known evolution of this long-standing disease.

The value of empathy in dietetic consultations. A pilot study to investigate its effect on satisfaction, autonomy and agreement.

PubMed

Goodchild, C E; Skinner, T C; Parkin, T

2005-06-01

Forty individuals with diabetes and three dietitians completed a questionnaire concerning their consultation. Empathy was examined using the Empathic Communication Coding System (ECCS) (Bylund & Makoul, 2002). The more empathic the professionals' response to emotional opportunities, the more satisfied patients were with their consultations (r = 0.41, d.f. = 15, P = 0.05). There was a nonsignificant trend that the more empathic opportunities that arise during a consultation, the higher the agreement between patient and dietitian on what was discussed (r = 0.28, P = 0.07). The data also suggest that patients reported more autonomy support when they created more empathic opportunities during their consultation (r = -0.29, P = 0.07). This preliminary study suggests that professionals' responses to empathic opportunities may be a useful component of dietetic consultations.

Marketing strategy: a key leverage point for dietitians.

PubMed

Jensen, T G; Brooks, B J

1981-09-01

The time is right for planned change in the profession of dietetics. The concept of the nutrition support team offers the clinical dietitian a means of increasing the visibility and effectiveness of dietetic services. Dietitians must take advantage of the renewed interest in nutrition and intervene assertively to improve nutritional care through role expansion. By focusing on a systematic marketing strategy to expand their current role, dietitians can become proactive participants in role change, rather than reactive victims to changes dictated by others. When goals, objectives, and plans are made explicit, definite progress toward desired role changes can be recognized. This case study demonstrates that this change in role is possible within the present state of health case systems and that physicians are willing and even eager to allow dietitians to assume a high degree of responsibility for nutritional care.

Interprofessional education for physiotherapy, medical and dietetics students: a pilot programme.

PubMed

Pullon, Sue; McKinlay, Eileen; Beckingsale, Louise; Perry, Meredith; Darlow, Ben; Gray, Ben; Gallagher, Peter; Hoare, Kath; Morgan, Sonya

2013-03-01

Interprofessional education (IPE) has been shown to enhance interprofessional practice among health professionals. Until recently there has been limited opportunity to undertake such initiatives within existing pre-registration degree courses in New Zealand. This study aimed to test the feasibility of delivering an interprofessional component within existing health professional courses for medicine, physiotherapy and dietetics at the University of Otago, Wellington, New Zealand. An interprofessional case-based course component (on chronic condition management) was developed by academic clinical teachers from schools of medicine, physiotherapy and dietetics at the same location. Evaluation was undertaken using a previously validated pre- and post-survey tool, to ascertain changes in attitude among students towards interprofessional practice, IPE and the effectiveness of health care teams. Focus groups were conducted with students and teachers. Survey results indicated pre-existing positive attitudes to interprofessional practice and education among students. There was a statistically significant increase in positive attitude towards such practice and education, and increased confidence in the effectiveness of heath care teams. Focus group findings were consistent with the survey results for students, and highlighted challenges experienced by the teachers. Students and teachers alike enjoyed the interprofessional interaction and benefited from a collaborative approach to chronic condition management. The timing and nature of learning activities and assessment methods created logistical challenges. Such course components have potential to improve collaborative practice and the quality and safety of health care among graduates. Interprofessional course components need to be equitable across disciplines and embedded in the unidisciplinary courses.

Position of the American Dietetic Association and American Society for Nutrition: obesity, reproduction, and pregnancy outcomes.

PubMed

Siega-Riz, Anna Maria; King, Janet C

2009-05-01

Given the detrimental influence of maternal overweight and obesity on reproductive and pregnancy outcomes for the mother and child, it is the position of the American Dietetic Association and the American Society for Nutrition that all overweight and obese women of reproductive age should receive counseling on the roles of diet and physical activity in reproductive health prior to pregnancy,during pregnancy, and in the inter conceptional period, in order to ameliorate these adverse outcomes. The effect of maternal nutritional status prior to pregnancy on reproduction and pregnancy outcomes is of great public health importance. Obesity in the United States and worldwide has grown to epidemic proportions, with an estimated 33% of US women classified as obese. This position paper has two objectives: (a) to help nutrition professionals become aware of the risks and possible complications of overweight and obesity for fertility,the course of pregnancy, birth outcomes, and short- and long-term maternal and child health outcomes;and (b) related to the commitment to research by the American Dietetic Association and the American Society for Nutrition, to identify the gaps in research to improve our knowledge of the risks and complications associated with being overweight and obese before and during pregnancy.Only with an increased knowledge of these risks and complications can health care professionals develop effective strategies that can be implemented before and during pregnancy as well as during the inter conceptional period to ameliorate adverse outcomes.

Position of the American Dietetic Association: total diet approach to communicating food and nutrition information.

PubMed

Nitzke, Susan; Freeland-Graves, Jeanne

2007-07-01

It is the position of the American Dietetic Association that the total diet or overall pattern of food eaten is the most important focus of a healthful eating style. All foods can fit within this pattern, if consumed in moderation with appropriate portion size and combined with regular physical activity. The American Dietetic Association strives to communicate healthful eating messages to the public that emphasize a balance of foods, rather than any one food or meal. Public policies that support the total diet approach include the Dietary Guidelines for Americans, MyPyramid, the DASH Diet (Dietary Approaches to Stop Hypertension), Dietary Reference Intakes, and nutrition labeling. The value of a food should be determined within the context of the total diet because classifying foods as "good" or "bad" may foster unhealthful eating behaviors. Alternative approaches may be necessary in some health conditions. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, lifestyle, time challenges, economics, environment, attitudes and beliefs, social/cultural influences, media, food technology, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, food and nutrition professionals should utilize appropriate behavioral theory and evidence-based strategies. A focus on moderation and proportionality in the context of a healthful lifestyle, rather than specific nutrients or foods, can help reduce consumer confusion. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes.

Position of the American Dietetic Association: Providing nutrition services for people with developmental disabilities and special health care needs.

PubMed

Van Riper, Cynthia L; Wallace, Lee Shelly

2010-02-01

It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.

Underweight? Add Pounds Healthfully

MedlinePlus

... weight. In: Academy of Nutrition and Dietetics Complete Food and Nutrition Guide. 5th ed. New York, N.Y.: Houghton Mifflin Harcourt; 2017. Whitney E, et al. Weight management: Overweight, obesity, and underweight. In: Understanding Nutrition. 14th ...

Healthy food trends -- chia seeds

MedlinePlus

... Healthy snacks - Chia seeds; Weight loss - Chia seeds; Healthy diet - Chia seeds; Wellness - Chia seeds ... of nutrition and dietetics: dietary fatty acids for healthy adults. J Acad Nutr Diet . 2014;114(1):136-153. PMID: 24342605 www. ...

Academy of Nutrition and Dietetics

MedlinePlus

... and Learn Videos View More Understanding the New Nutrition Facts Label The new Nutrition Facts label features updated information to help consumers ... and Tipsheets for Families and Communities 3 National Nutrition Month® 1 How to Fuel Your Workout 2 ...

Attitudes, beliefs and behaviours of Australia dietitians regarding dietary supplements: A cross-sectional survey.

PubMed

Marx, Wolfgang; Kiss, Nicole; McKavanagh, Daniel; Isenring, Elisabeth

2016-11-01

The aim of this study was to investigate the attitudes, beliefs and behaviors of Australian dietitians regarding dietary supplements. An online survey was disseminated through the mailing lists of multiple healthcare organizations. There were 231 Australian dietitians that replied to the online survey. The results indicate that Australian dietitians are interested in dietary supplements (65%); however, the results also indicate that Australian dietitians are tentative about integrating dietary supplements into their dietetic practice. Concerns regarding potential drug-nutrient/herbal interactions were reported as the primary barrier (67%) to utilizing dietary supplements as part of clinical practice. In addition, there was a strong interest in additional training in dietary supplements (79%). In summary, Australian dietitians are interested in the use of dietary supplements; however, due to current barriers, few dietitians utilize dietary supplements as part of dietetic practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Publishing nutrition research: validity, reliability, and diagnostic test assessment in nutrition-related research.

PubMed

Gleason, Philip M; Harris, Jeffrey; Sheean, Patricia M; Boushey, Carol J; Bruemmer, Barbara

2010-03-01

This is the sixth in a series of monographs on research design and analysis. The purpose of this article is to describe and discuss several concepts related to the measurement of nutrition-related characteristics and outcomes, including validity, reliability, and diagnostic tests. The article reviews the methodologic issues related to capturing the various aspects of a given nutrition measure's reliability, including test-retest, inter-item, and interobserver or inter-rater reliability. Similarly, it covers content validity, indicators of absolute vs relative validity, and internal vs external validity. With respect to diagnostic assessment, the article summarizes the concepts of sensitivity and specificity. The hope is that dietetics practitioners will be able to both use high-quality measures of nutrition concepts in their research and recognize these measures in research completed by others. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

[Hormonal and inflammatory impact of different dietetic composition: emphasis on dietary patterns and specific dietary factors].

PubMed

Bressan, Josefina; Hermsdorff, Helen H M; Zulet, María Angeles; Martínez, José Alfredo

2009-07-01

Healthy dietary pattern, characterized by the consumption of fruits, vegetables, white meats, skim dairy products, nuts and moderate intake of vegetable oils and alcohol, is an important factor for a lower risk of chronic disease such as obesity, metabolic syndrome and cardiovascular disease. This beneficial effect can be explained, at least partially, by its modulating role on biomarkers of insulin sensitivity and atherosclerosis as well as of inflammation and endothelial function. On the other hand, the intake of specific dietary factors, such as unsaturated fatty acids (oleic and alpha-linolenic) and micronutrients with antioxidant properties (vitamins A, E and C; selenium, zinc) has been discussed, due to its potential protector action due to chronic disease occurrence and its possible profits in hormonal, metabolic and inflammatory regulations that these dietetic factors can provide within a nutritional treatment to obesity and metabolic syndrome.

[Gerontodietology].

PubMed

Baranovskiĭ, A Iu; Protopopova, O B

2012-01-01

Gerontodietology is one of the most important parts of dietetics studying problems of nutrition of elderly and old persons and persons with high risk of early and pathological aging, developing principles of rational nutrition, prophylactic and curative nutrition and methods of its organization. Functional structure of modern gerontodietology, its scientific-methodical bases, terminological features are presented. Composition and features of healthy nutrition of elderly people is described in details, methods of its optimization and individualization are given. Notions of geriatric dietotherapy, its principal difference from curative nutrition of patients of other ages are described. Large section of the article is devoted to the modern problems of prophylactic gerontodietology, intended more for persons with high risk of early aging than for elderly persons. Theoretic basis and methodological contents of prophylactic gerontodietology are presented; practical recommendations on dietetic means to prevent intensive development of involution processes and organic pathology in the body are described.

Workplace learning and career progression: qualitative perspectives of UK dietitians.

PubMed

Boocock, R C; O'Rourke, R K

2018-06-10

Post-graduate education and continuous professional development (CPD) within dietetics lack clearly defined pathways. The current literature primarily focuses on new graduate perceptions of workplace learning (WPL). The present study raises issues of how CPD is sustained throughout a National Health Service (NHS) career, how informal learning might be made more visible and whether the workplace withholds learning opportunities. Qualified dietitians participated in focus groups (n = 32) and a nominal group technique (n = 24). Data from audio recordings were transcribed and triangulated. Thematic analysis took an interpretative approach. One size for WPL for dietetics and, likely, other allied health professionals (AHPs) did not meet the learning needs of everyone. The informal implicit learning affordances often went unrecognised. A greater emphasis on teaching, picking up on the strong preference for discussion with others voiced in the present study, may improve recognition of all WPL opportunities. Better scaffolding or guided support of entry level dietitians may ease the transition from study to workplace and challenge any perception of 'clipped wings'. Where development and career progression proves difficult for experienced dietitians, mentoring or stepping outside the NHS may revitalise by providing new communities of practice. WPL cannot be understood as a unitary concept. Dietitians engage with WPL differently across their careers. Future visions of WPL, especially explicit post-graduate career and education frameworks, must accommodate these differences to retain the highest calibre dietitians. The implications of a period of learning 'maintenance' rather than CPD among experienced dietitians offers a topic for further research, particularly as the workforce ages. © 2018 The British Dietetic Association Ltd.

Additional benefit of dietitian involvement in dialysis staffs-led diet education on uncontrolled hyperphosphatemia in hemodialysis patients.

PubMed

Tsai, Wan-Chuan; Yang, Ju-Yeh; Luan, Chia-Chin; Wang, Yuh-Jiun; Lai, Yu-Chuan; Liu, Lie-Chuan; Peng, Yu-Sen

2016-10-01

Sustained adherence to dietary phosphorus (P) restriction recommendations among hemodialysis patients is questionable. The aim of this study was to evaluate the effectiveness of additional diet education delivered by a dietitian on the control of hyperphosphatemia. We conducted an 8-month prospective observational study in hemodialysis patients who had uncontrolled hyperphosphatemia. In the first half of the study (experimental) period, the dialysis nurses and physicians provided the routine dietetic education with the control group (n = 31), while the experimental group (n = 30) received the routine dietetic education plus an additional diet education delivered by dietitians. Both groups received the routine dietetic education in the rest of the study period to test whether the improvement of serum P level was sustained. The primary outcomes were changes in serum P level. At baseline, there was no significant difference in serum P levels between groups (P = 0.27). In the experimental period, monthly serum P levels decreased significantly in both groups (P < 0.001) and the magnitudes of reduction were 1.81 ± 1.46 and 0.94 ± 1.33 mg/dL in the experimental and control groups, respectively (P = 0.02), at the end. The experimental group maintained such improvement for one more month (P = 0.02), but faded out over time. Renal diet education guided either by dietitians plus dialysis staffs or dialysis staffs alone reduces serum P level and dietitian-guided diet education provides an additional benefit on controlling hyperphosphatemia in hemodialysis patients.

Understanding Customers: The Jobs to Be Done Theory Applied in the Context of a Rural Food Pantry.

PubMed

Vaterlaus, J Mitchell; Cottle, Natalie Martineau; Patten, Emily Vaterlaus; Gibbons, Robyn

2018-04-28

Food insecurity, and particularly rural food insecurity, has unique challenges associated with it. Understanding the customer or patron needs is increasingly important in resolving this national concern. The Jobs to Be Done Theory posits that when considering customers, it is beneficial to move past demographic profiling and focus on what the customer wants to accomplish by using a particular product or service. This qualitative study aimed to determine customers' jobs to be done at a rural food pantry. In addition, it seeks to demonstrate the application of contemporary management theory to dietetics practice. A case study approach was used in this study. Case study data collection procedures included six male and six female food pantry patrons in Montana completing in-depth, audio-recorded interviews and surveys. Each person's interview and survey were constructed into individual case descriptions; the case descriptions were analyzed using uniform categories determined by researchers. To identify themes in the holistic case, word tables were created for each uniform category and assessed for key themes representing patrons' experiences. The key themes that emerged were the customer in context, customers' food relief needs, connecting with customers, and barriers to utilization. The application of Jobs to Be Done Theory to rural food pantry customers demonstrates that demographic segmentation does not capture the social, emotional, and functional dimensions for this sample. Investigation of customer experiences, circumstances, and obstacles is important for improving dietetics services. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber.

PubMed

Dahl, Wendy J; Stewart, Maria L

2015-11-01

It is the position of the Academy of Nutrition and Dietetics that the public should consume adequate amounts of dietary fiber from a variety of plant foods. Dietary fiber is defined by the Institute of Medicine Food Nutrition Board as "nondigestible carbohydrates and lignin that are intrinsic and intact in plants." Populations that consume more dietary fiber have less chronic disease. Higher intakes of dietary fiber reduce the risk of developing several chronic diseases, including cardiovascular disease, type 2 diabetes, and some cancers, and have been associated with lower body weights. The Adequate Intake for fiber is 14 g total fiber per 1,000 kcal, or 25 g for adult women and 38 g for adult men, based on research demonstrating protection against coronary heart disease. Properties of dietary fiber, such as fermentability and viscosity, are thought to be important parameters influencing the risk of disease. Plant components associated with dietary fiber may also contribute to reduced disease risk. The mean intake of dietary fiber in the United States is 17 g/day with only 5% of the population meeting the Adequate Intake. Healthy adults and children can achieve adequate dietary fiber intakes by increasing their intake of plant foods while concurrently decreasing energy from foods high in added sugar and fat, and low in fiber. Dietary messages to increase consumption of whole grains, legumes, vegetables, fruits, and nuts should be broadly supported by food and nutrition practitioners. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

When foods become remedies in ancient Greece: The curious case of garlic and other substances

PubMed Central

Totelin, Laurence

2015-01-01

Ethnopharmacological relevance The debate on the food-drug continuum could benefit from a historical dimension. This study aims at showing this through one case: the food-drug continuum in Greece in the fifth- and fourth-century BCE. I suggest that at the time the boundary between food and drug – and that between dietetics and pharmacology – was rather blurred. Materials and methods I study definitions of ‘food’ and ‘medicine’ in texts from the fifth- and fourth-century BCE: the Hippocratic texts, the botanical treatises of Theophrastus and the pseudo-Aristotelian Problems. To illustrate these abstract definitions, I focus on two substances: garlic and silphium. Results and discussion The Hippocratics were writing in a context of increased professionalization and masculinization of medicine, a context in which dietetics became the most prestigious branch of medicine, praised above pharmacology and surgery. While medicine was becoming more specialised, professionalised and masculine, it avoided becoming too conspicuously so. The Hippocratic authors sometimes noted that medical discoveries are serendipitous and can be made by anyone, whether medically trained or not. By doing so, they allowed themselves to integrate common knowledge and practice into their writings. Conclusion In the context of the professionalization of ancient medicine, the Hippocratic authors started to address the difference between food and medicine. They saw, however, some advantage in acknowledging the continuum between food and medicine. Scholars should avoid drawing too strict a boundary between ancient dietetics and pharmacology and should instead adopt a multi-disciplinary approach to the therapeutics of the Hippocratic texts. PMID:25173971

Malnutrition in children with food allergies in the UK.

PubMed

Meyer, R; De Koker, C; Dziubak, R; Venter, C; Dominguez-Ortega, G; Cutts, R; Yerlett, N; Skrapak, A-K; Fox, A T; Shah, N

2014-06-01

The mainstay of dietary management of food allergies remains the elimination diet. However, the removal of major food groups may predispose children to an inadequate nutrient intake. We therefore set out to establish growth status in food allergic children receiving dietetic input in the UK. Dietitians were approached via the Food Allergy and Intolerance Specialist Group from the British Dietetic Association and asked to submit anthropometrical data for children with food allergies. Data collected related to the systems involved and number of foods excluded. Malnutrition was defined according to World Health Organization standards. Data from 13 different centres yielded 97 patients (51 male and 46 female) of which 66 excluded ≤2 foods and 31 excluded ≥3 foods. Data indicated that 8.5% had a weight for age ≤ -2 Z-score and, conversely, 8.5% were ≥2 Z-score. For height for age, 11.1% were ≤ -2 Z-score and, for weight for height, 3.7% were ≤ -2 Z-score and 7.5% ≥2 Z-score. Type of allergy, system involved and specific food elimination did not impact on the level of malnutrition. However, the elimination of ≥3 foods significantly impacted on weight for age (P = 0.044). The present study demonstrates that children with food allergies are more underweight than the general UK population, which appears to be linked to the number of foods excluded. However, the impact of the disease process itself should not be disregarded. Additionally, obesity can also occur in this population despite dietary elimination. © 2013 The British Dietetic Association Ltd.

Impact of the Medicare Chronic Disease Management program on the conduct of Australian dietitians' private practices.

PubMed

Jansen, Sarah; Ball, Lauren; Lowe, Catherine

2015-04-01

This study explored private practice dietitians' perceptions of the impact of the Australian Chronic Disease Management (CDM) program on the conduct of their private practice, and the care provided to patients. Twenty-five accredited practising dietitians working in primary care participated in an individual semistructured telephone interview. Interview questions focussed on dietitians' perceptions of the proportion of patients receiving care through the CDM program, fee structures, adhering to reporting requirements and auditing. Transcript data were thematically analysed using a process of open coding. Half of the dietitians (12/25) reported that most of their patients (>75%) received care through the CDM program. Many dietitians (19/25) reported providing identical care to patients using the CDM program and private patients, but most (17/25) described spending substantially longer on administrative tasks for CDM patients. Dietitians experienced pressure from doctors and patients to keep their fees low or to bulk-bill patients using the CDM program. One-third of interviewed dietitians (8/25) expressed concern about the potential to be audited by Medicare. Recommendations to improve the CDM program included increasing the consultation length and subsequent rebate available for dietetic consultations, and increasing the number of consultations to align with dietetic best-practice guidelines. The CDM program creates challenges for dietitians working in primary care, including how to sustain the quality of patient-centred care and yet maintain equitable business practices. To ensure the CDM program appropriately assists patients to receive optimal care, further review of the CDM program within the scope of dietetics is required.

Orthorexia nervosa tendency among students of the department of nutrition and dietetics at a university in Istanbul

PubMed Central

Karakus, Betul; Hidiroglu, Seyhan; Keskin, Nese; Karavus, Melda

2017-01-01

OBJECTIVE: The aim of this study was to determine an orthorexia nervosa scale score for and evaluate orthorexic tendency among students of nutrition and dietetics according to various sociodemographic characteristics. METHODS: This cross-sectional study was carried out in May and June of 2016 among 208 students in the nutrition and dietetics department at a university in Istanbul. After receiving the approval of the university ethics committee, of a total of 300 students, 208 agreed to join the study. Participants completed a questionnaire related to individual characteristics and the ORTO-11 scale during a face-to-face interview. The ORTO-11 scale is a verified Turkish scoring system in which a low score indicates orthorexic tendency. The Mann-Whitney U test, independent samples t-test, Kruskal-Wallis test, and analysis of variance were used to assess the data. P<0.05 was accepted as statistically significant. RESULTS: Orthorexic tendency was significantly higher in males (p=0.050) and students who lived with their family (p=0.002). Mean ORTHO-11 scale score did not differ significantly between groups when the participants were grouped by parameters of smoking, alcohol consumption, chronic disease status, body mass index, diet observance, or use of nutritional supplement products. CONCLUSION: The orthorexic tendency was higher in men and in students who lived with their family. Additional assessment of individual eating habits, eating behavior, and personality characteristics would shed light on the reasons for the difference between gender groups. Qualitative studies should be carried out and possible confounding factors should be determined. PMID:28971168

Orthorexia nervosa tendency among students of the department of nutrition and dietetics at a university in Istanbul.

PubMed

Karakus, Betul; Hidiroglu, Seyhan; Keskin, Nese; Karavus, Melda

2017-01-01

The aim of this study was to determine an orthorexia nervosa scale score for and evaluate orthorexic tendency among students of nutrition and dietetics according to various sociodemographic characteristics. This cross-sectional study was carried out in May and June of 2016 among 208 students in the nutrition and dietetics department at a university in Istanbul. After receiving the approval of the university ethics committee, of a total of 300 students, 208 agreed to join the study. Participants completed a questionnaire related to individual characteristics and the ORTO-11 scale during a face-to-face interview. The ORTO-11 scale is a verified Turkish scoring system in which a low score indicates orthorexic tendency. The Mann-Whitney U test, independent samples t-test, Kruskal-Wallis test, and analysis of variance were used to assess the data. P<0.05 was accepted as statistically significant. Orthorexic tendency was significantly higher in males (p=0.050) and students who lived with their family (p=0.002). Mean ORTHO-11 scale score did not differ significantly between groups when the participants were grouped by parameters of smoking, alcohol consumption, chronic disease status, body mass index, diet observance, or use of nutritional supplement products. The orthorexic tendency was higher in men and in students who lived with their family. Additional assessment of individual eating habits, eating behavior, and personality characteristics would shed light on the reasons for the difference between gender groups. Qualitative studies should be carried out and possible confounding factors should be determined.

Vegetarian Diet: How to Get the Best Nutrition

MedlinePlus

Healthy Lifestyle Nutrition and healthy eating A well-planned vegetarian diet is a healthy way to meet your nutritional needs. Find ... marketplace. In: American Dietetic Association Complete Food and Nutrition Guide. 4th ed. Hoboken, N.J.: John Wiley & ...

Gluten-Free Diet: Nutrition and Healthy Eating

MedlinePlus

Healthy Lifestyle Nutrition and healthy eating To follow a gluten-free diet, you must avoid wheat and some other grains, while ... allergies and other food sensitivies. In: Academy of Nutrition and Dietetics Complete Food & Nutrition Guide. 5th ed. ...

Avoiding Gluten Cross-Contamination

MedlinePlus

... are a Key Part of Nutrition for Men's Health Nutrition for the Child with Sickle Cell Anemia Food ... Twitter Youtube True © 2018 eatright.org. Academy of Nutrition and Dietetics, All Rights ... style="display: none;" border="0" height="1" width="1" alt="Quantcast"/>

7 CFR 246.3 - Administration.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN General..., social service, maternal and child health, public health, nutrition, or dietetics; or (ii) Be registered... responsible experience as a nutritionist in education, social service, maternal and child health, public...

7 CFR 246.3 - Administration.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN General..., social service, maternal and child health, public health, nutrition, or dietetics; or (ii) Be registered... responsible experience as a nutritionist in education, social service, maternal and child health, public...

7 CFR 246.3 - Administration.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN General..., social service, maternal and child health, public health, nutrition, or dietetics; or (ii) Be registered... responsible experience as a nutritionist in education, social service, maternal and child health, public...

7 CFR 246.3 - Administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN General..., social service, maternal and child health, public health, nutrition, or dietetics; or (ii) Be registered... responsible experience as a nutritionist in education, social service, maternal and child health, public...

7 CFR 246.3 - Administration.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN General..., social service, maternal and child health, public health, nutrition, or dietetics; or (ii) Be registered... responsible experience as a nutritionist in education, social service, maternal and child health, public...

Comparison of nutritional and antinutritional traits among different species (Lupinus albus L., Lupinus luteus L., Lupinus angustifolius L.) and varieties of lupin seeds.

PubMed

Musco, N; Cutrignelli, M I; Calabrò, S; Tudisco, R; Infascelli, F; Grazioli, R; Lo Presti, V; Gresta, F; Chiofalo, B

2017-12-01

In order to promote the use of lupin in pig nutrition, in this research the nutritional characteristics (i.e. dietary fibre, alkaloid and fatty acid profile) and the in vitro gas production of 12 lupin varieties grown in the Mediterranean basin and belonging to three lupin species (Lupinus albus, Lupinus angustifolius and Lupinus luteus) were assessed. Four varieties of L. albus (Asfer, Lublanc, Lutteur and Multitalia) were grown in South Campania. Three varieties of L. luteus (Dukat, Mister and Taper), three of L. angustifolius (Jindalee, Sonet and Wonga) and two of L. albus (Rosetta and Luxor) were grown in Eastern Sicily. Lupinus albus varieties showed interesting nutritional and dietetic characteristics (i.e. high protein and low fibre content); the lipid fraction, rather elevated, is well represented by monounsaturated fatty acids (544 g/kg), whereas saturated fatty acids (SFAs) are less represented (167 g/kg) and the n-3/n-6 ratio (0.510) is the most favourable. Lupinus luteus varieties presented the most remarkable dietetic aspects, in terms of polyunsaturated fatty acid (PUFA) content (569 g/kg), n-6 PUFA series (490 g/kg), UFA/SFA (5.24) and PUFA/SFA (3.56) ratios and atherogenic (0.059) and thrombogenic (0.100) indices and very low alkaloid content (1.07 mg per 100 g). Lupinus angustifolius varieties showed the least interesting nutritional and dietetic characteristics: low protein and fat content, high fibre level, high SFA amount (248 g/kg) and the lowest favourable nutritional indices (IA: 0.164 and IT: 0.334). Regarding the fermentation process, in L. albus, the tendency to increase the rate of gas production during the early stages of fermentation suggests that the high presence of alkaloids did not affect the in vitro degradability, production of short-chain fatty acids and fermentation process, probably due to their concentration and/or water solubility. Lupinus angustifolius and L. luteus showed intermediate and slightly worse in vitro fermentation patterns respectively. From a nutritional and dietetic point of view, lupin may represent an interesting alternative to soya bean in pig feeding. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.

Dietetics students' ability to choose appropriate communication and counseling methods is improved by teaching behavior-change strategies in computer-assisted instruction.

PubMed

Puri, Ruchi; Bell, Carol; Evers, William D

2010-06-01

Several models and theories have been proposed to help registered dietitians (RD) counsel and communicate nutrition information to patients. However, there is little time for students or interns to observe and/or participate in counseling sessions. Computer-assisted instruction (CAI) can be used to give students more opportunity to observe the various methods and theories of counseling. This study used CAI simulations of RD-client communications to examine whether students who worked through the CAI modules would choose more appropriate counseling methods. Modules were created based on information from experienced RD. They contained videos of RD-patient interactions and demonstrated helpful and less helpful methods of communication. Students in didactic programs in dietetics accessed the modules via the Internet. The intervention group of students received a pretest module, two tutorial modules, and a posttest module. The control group only received the pretest and posttest modules. Data were collected during three semesters in 2006 and 2007. Two sample t tests were used to compare pretest and posttest scores. The influence of other factors was measured using factorial analysis of variance. Statistical significance was set at P<0.05. Eleven didactic programs participated. A total of 350 students were in the intervention group and 102 students were in the control group. Pretest scores were not different (6.30+/-0.26 vs 6.21+/-0.15, control and intervention, respectively). The intervention group's posttest score was higher than its pretest score (6.21+/-0.15 vs 6.65+/-0.16, pretest and posttest, respectively). Change in score from pretest to posttest was higher for the intervention group (-0.02+/-0.20 vs 0.44+/-0.11, control and intervention, respectively). For the 21 questions in the tutorials, those who answered 19 to 21 correctly had a greater increase from pretest to posttest than those who answered <13 correctly (-0.44+/-0.37 vs 0.84+/-0.17, <13 and 19 to 21 correct, respectively). There was no effect of instructor, grade point average, school year, or prior counseling on the results. The study provides evidence that the use of CAI can improve communication and counseling methods for dietetics students. 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Individualized Tailor-Made Dietetic Intervention Program at Schools Enhances Eating Behaviors and Dietary Habits in Obese Hispanic Children of Low Socioeconomic Status

PubMed Central

Moreno-Sànchez, Diana; Gutierrez, Norma G.; Lamadrid-Zertuche, Ana C.; Hernandez-Torre, Martin M.

2014-01-01

Hispanic children and those from low-socioeconomic status are predisposed to unhealthy eating habits and obesity. Aim. to implement an individualized, face-to-face, parent supported, and school-partnership dietetic intervention to promote healthy eating habits and decrease body mass index. Prospective school year dietetic intervention of 101 obese, Hispanic, low-socioeconomic school-age children representative of Monterrey, Mexico, consisted of anthropometrics, dietetic assessment, energy-restriction tailor-made daily menus, and parental education every three weeks. Student's t-test was used for means comparison. A significant decrease was found in body mass index percentile (96.43 ± 3.32 to 93.42 ± 8.12/P = 0.00) and energy intake/day of −755.7 kcal/day (P = 0.00). Among other energy dense foods with significant decline in servings/day and servings/week were processed meats (3.13 ± 1.43 to 2.19 ± 1.04/P = 0.00 and 5.60 ± 1.75 to 4.37 ± 2.10/P = 0.00, resp.), saturated fat (1.47 ± 1.08 to 0.78 ± 0.79/P = 0.00 and 2.19 ± 2.18 to 1.1 ± 1.36/P = 0.00), sweetened beverages (2.79 ± 1.99 to 1.42 ± 1.21 and 6.21 ± 1.72 to 3.89 ± 2.80/P = 0.00), and desserts and refined-grain bakery (1.99 ± 1.54 to 1.32 ± 1.59 and 2.85 ± 2.54 to 1.57 ± 2.20/P = 0.00). There was a significant increase in servings/day and servings/week of water (2.98 ± 2.02 to 4.91 ± 2.37 and 6.62 ± 2.03 to 6.87 ± 0.91/P = 0.00, resp.) and nutrient dense foods such as fruits (1.31 ± 0.89 to 1.66 ± 0.96 and 3.34 ± 2.24 to 4.28 ± 2.43/P = 0.00) and fish and poultry (3.76 ± 2.15 to 4.54 ± 2.25/P = 0.00). This intervention created healthy eating habits and decreased body mass index in a high risk population. Trial registration number: NCT01925976. PMID:24592170

Position of the American Dietetic Association: Addressing world hunger, malnutrition, and food insecurity.

PubMed

Struble, Marie Boyle; Aomari, Laurie Lindsay

2003-08-01

It is the position of the American Dietetic Association (ADA) that access to adequate amounts of safe, nutritious, and culturally appropriate food at all times is a fundamental human right. Hunger continues to be a worldwide problem of staggering proportions. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, and are environmentally and economically sustainable. The Association is aware that hunger exists in a world of plenty and that poverty, gender inequity, ethnocentrism, racism, and the lack of political will are key constraints to solving the problems of global hunger and malnutrition. Recognizing that simplistic approaches are inadequate, the ADA identifies sustainable development as the long-term strategy to ending world hunger and achieving food security. Sustainable development requires political, economic, and social changes that include empowering the disenfranchised, widening access to assets and other resources, narrowing the gap between rich and poor, and adjusting consumption patterns so as to foster good stewardship of nature. Additionally, because the health status of future generations is related to the well-being of their mothers, achieving food security will also require increased access for women to education, adequate health care and sanitation, and economic opportunities. This position paper reviews the complex issues of global food insecurity and discusses long-term solutions for achieving world food security. Achieving the end of world hunger has been and is now within our grasp. There is sufficient food to feed everyone, and solutions can be realized now that will benefit all of humanity. As noted in the paper, most people who examine the costs of ending versus not ending world hunger are bewildered by the question of why humanity did not solve the problem a long time ago. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, respect local cultures, and are environmentally and economically sustainable. The ADA recognizes that decisions and actions that dietetics professionals make as practitioners and consumers can help reduce the extent of poverty and hunger both here and abroad. This paper provides information, resources, and strategies to assist dietetics professionals in improving the public's understanding of key issues, becoming advocates of the poor, and influencing the political will to end world hunger.

Food Labels for Infants under Two

MedlinePlus

... to Make Homemade Baby Food How TV Can Influence What Your Child Eats How TV Can Influence What Your Child Eats Raise Healthy Eaters in ... Dietetics, All Rights Reserved. Contact Us Editorial Policy Media Privacy Policy Site Map Educational Programs in the Health Field.

ERIC Educational Resources Information Center

Hospitals, 1971

1971-01-01

This document lists by location educational programs in the health field in the United States and Canada. Areas covered include Certified Laboratory Assistant Programs, Cytotechnology, Dental Hygiene, Dentistry, Dietetics, Hospital Administration, Inhalation Therapy, Library Science, Medical Illustration, Medical Records, Medical Technology,…

[Anorexia in prepubescent adolescents].

PubMed

Doyen, Catherine

Anorexia in young prepubescent patients is often linked to clinical signs occurring in early childhood. While therapies offer somatic, dietetic or medication-based treatments, the psychotherapeutic approach gives children and their families the opportunity to talk. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Replication of Structure Findings regarding the Interpersonal Reactivity Index.

ERIC Educational Resources Information Center

Carey, John C.; And Others

1988-01-01

Attempted to verify multidimensional nature and item composition of Interpersonal Reactivity Index (IRI) subscales through factor analysis. IRI responses from 365 female clinical dieticians and dietetic interns supported contention that IRI subscales measure four discernibly different empathy dimensions. (NB)

48 CFR 870.115 - Food service equipment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Food service equipment... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.115 Food service equipment. (a) All new food service equipment purchased for Dietetic Service through other than Defense General...

48 CFR 870.115 - Food service equipment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Food service equipment... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.115 Food service equipment. (a) All new food service equipment purchased for Dietetic Service through other than Defense General...

48 CFR 870.115 - Food service equipment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Food service equipment... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.115 Food service equipment. (a) All new food service equipment purchased for Dietetic Service through other than Defense General...

48 CFR 870.115 - Food service equipment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Food service equipment... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.115 Food service equipment. (a) All new food service equipment purchased for Dietetic Service through other than Defense General...

48 CFR 870.115 - Food service equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Food service equipment... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.115 Food service equipment. (a) All new food service equipment purchased for Dietetic Service through other than Defense General...

Interdisciplinary Nutrition Education

ERIC Educational Resources Information Center

Baumslag, Naomi; And Others

1976-01-01

Describes and evaluates a successful one-quarter 26-curriculum hour course in clinical nutrition, which focuses on practical aspects of diet prescriptions, dietary customs, attitudes, and behavior modifications. Required for sophomore medical students and dietetic interns, the course in taught by faculty from several disciplines and includes…

Reference Lists for HECE Occupational Areas.

ERIC Educational Resources Information Center

Texas Education Agency, Austin. Dept. of Occupational Education and Technology.

The annotated bibliography contains citations to appropriate reference books, pamphlets and audiovisual materials for the following 17 occupations: art and craft aide, bridal consultant, child care aide, clothing assistant, companion to the elderly, consumer aide, dietetic aide, fabric coordinator, fashion coordinator, floral designer, food…

Fiber Supplements: Are They Safe to Take Every Day?

MedlinePlus

... be sure to drink plenty of fluids every day. With Michael F. Picco, M.D. Duyff RL. Carbs. In: American Dietetic Association Complete Food and Nutrition Guide. 4th ed. Hoboken, N.J.: John Wiley & Sons; 2012. Slavin JL. Position of ...

Integrating mobile technology with routine dietetic practice: the case of myPace for weight management.

PubMed

Harricharan, Michelle; Gemen, Raymond; Celemín, Laura Fernández; Fletcher, David; de Looy, Anne E; Wills, Josephine; Barnett, Julie

2015-05-01

The field of Mobile health (mHealth), which includes mobile phone applications (apps), is growing rapidly and has the potential to transform healthcare by increasing its quality and efficiency. The present paper focuses particularly on mobile technology for body weight management, including mobile phone apps for weight loss and the available evidence on their effectiveness. Translation of behaviour change theory into weight management strategies, including integration in mobile technology is also discussed. Moreover, the paper presents and discusses the myPace platform as a case in point. There is little clinical evidence on the effectiveness of currently available mobile phone apps in enabling behaviour change and improving health-related outcomes, including sustained body weight loss. Moreover, it is unclear to what extent these apps have been developed in collaboration with health professionals, such as dietitians, and the extent to which apps draw on and operationalise behaviour change techniques has not been explored. Furthermore, presently weight management apps are not built for use as part of dietetic practice, or indeed healthcare more widely, where face-to-face engagement is fundamental for instituting the building blocks for sustained lifestyle change. myPace is an innovative mobile technology for weight management meant to be embedded into and to enhance dietetic practice. Developed out of systematic, iterative stages of engagement with dietitians and consumers, it is uniquely designed to complement and support the trusted health practitioner-patient relationship. Future mHealth technology would benefit if engagement with health professionals and/or targeted patient groups, and behaviour change theory stood as the basis for technology development. Particularly, integrating technology into routine health care practice, rather than replacing one with the other, could be the way forward.

Divination, prognosis and prophylaxis: the Hippocratic work 'on dreams' (De victu 4) and its Near Eastern background.

PubMed

van der Eijk, P J

2004-01-01

Building on the results of recent scholarship concerning the coherence of the Hippocratic work De victu ('On Regimen'), this chapter discusses the close connections between Book 4, which deals with the use of dreams for medical prognosis and especially prophylaxis (which the author claims to be his own innovation), with the rest of the work. It analyses the author's position on dreams and their interpretation and his stance against professional dream interpreters. It distinguishes five categories in the author's discussion: 1. the signs, i.e. the dream images themselves; 2. the significance of the dreams; 3. explanations of the relationship between sign and significance; 4. prophylactic (dietetic) measures to prevent disease; 5. instructions as to the gods one should pray to in order to prevent disease. It explores the rationale underlying these categories and lists a number of parallels with Babylonian dream literature. It concludes that although there are important differences with respect to the use of dreams in Babylonian medicine, it is not implausible that the author of De victu 4 has borrowed some of his material from Near Eastern dream books. At the same time, the author of De victu 4 distances himself from oneiromantic practices that are very similar to what we find in Babylonia; and his elaborate interpretative system linking specific dreams to specific bodily disorders goes far beyond anything found in Near Eastern sources (but also beyond anything else in the Corpus Hippocraticum). He does accept the existence of dreams sent by the gods and of prayer to the gods in combination with dietetic prophylaxis; but his elaborate use of dietetics for preventive purposes marks an important innovation when compared to Babylonian medicine. The author is not concerned with incubation.

British Dietetic Association systematic review of systematic reviews and evidence-based practice guidelines for the use of probiotics in the management of irritable bowel syndrome in adults (2016 update).

PubMed

McKenzie, Y A; Thompson, J; Gulia, P; Lomer, M C E

2016-10-01

Probiotics are often taken by individuals with irritable bowel syndrome (IBS). Which products are effective is unclear, despite an increasing research base. This project will systematically review which strain- and dose- specific probiotics can be recommended to adults with IBS to improve symptoms and quality of life (QoL). It is part of a broader systematic review to update British Dietetic Association guidelines for the dietary management of IBS in adults. CINAHL, Cochrane, Embase, Medline, Scopus and Web of Science were searched for systematic reviews (SRs) of randomised controlled trial (RCT)s recruiting adults with IBS comparing probiotic intervention with placebo. AMSTAR, risk of bias and diet bias tools were used to appraise methodological quality. Symptom and QoL data were appraised to develop probiotic-specific evidence statements on clinically meaningful and marginal outcomes in various settings, graded clinical practice recommendations and practical considerations. Nine systematic reviews and 35 RCTs were included (3406 participants) using 29 dose-specific probiotic formulations. None of the RCTs were at low risk of bias. Twelve out of 29 probiotics (41%) showed no symptom or QoL benefits. Evidence indicated that no strain or dose specific probiotic was consistently effective to improve any IBS symptoms or QoL. Two general clinical practice recommendations were made. Symptom outcomes for dose-specific probiotics were heterogeneous. Specific probiotic recommendations for IBS management in adults were not possible at this time. More data from high-quality RCTs treating specific symptom profiles are needed to support probiotic therapy in the management of IBS. © 2016 The British Dietetic Association Ltd.

A unifying vision for scientific decision making: the Academy of Nutrition and Dietetics' Scientific Integrity Principles.

PubMed

Tappenden, Kelly A

2015-09-01

In 2014, recognizing the need to have a single document to guide scientific decision making at the Academy of Nutrition and Dietetics (Academy), the Council on Research was charged with developing a scientific integrity policy for the organization. From the Council on Research, four members volunteered to lead this workgroup, which reviewed the literature and best practices for scientific integrity from well-respected organizations, including federal funders of research. It became clear that the scope of this document would be quite broad, given the many scientific activities the Academy is involved in, and that it would be unreasonable to set policy for each of these many situations. Therefore, the workgroup set about defining the scope of scientific activities to be covered and envisioned a set of guiding principles, to which policies from every organizational unit of the Academy could be compared to ensure they were in alignment. While many relevant policies exist already, such as the requirement of a signed conflict of interest disclosure for Food & Nutrition Conference & Expo speakers, the Evidence Analysis Library funding policy, and the Academy's sponsorship policy, the scientific integrity principals are unique in that they provide a unifying vision to which future policies can be compared and approved based on their alignment with the principles. The six principles outlined in this article were approved by the full Council on Research in January 2015 and approved by the Academy's Board of Directors in March 2015. This article covers the scope of the principles, presents the principles and existing related resources, and outlines next steps for the Academy to review and revise current policies and create new ones in alignment with these principles. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Case-based learning facilitates critical thinking in undergraduate nutrition education: students describe the big picture.

PubMed

Harman, Tara; Bertrand, Brenda; Greer, Annette; Pettus, Arianna; Jennings, Jill; Wall-Bassett, Elizabeth; Babatunde, Oyinlola Toyin

2015-03-01

The vision of dietetics professions is based on interdependent education, credentialing, and practice. Case-based learning is a method of problem-based learning that is designed to heighten higher-order thinking. Case-based learning can assist students to connect education and specialized practice while developing professional skills for entry-level practice in nutrition and dietetics. This study examined student perspectives of their learning after immersion into case-based learning in nutrition courses. The theoretical frameworks of phenomenology and Bloom's Taxonomy of Educational Objectives triangulated the design of this qualitative study. Data were drawn from 426 written responses and three focus group discussions among 85 students from three upper-level undergraduate nutrition courses. Coding served to deconstruct the essence of respondent meaning given to case-based learning as a learning method. The analysis of the coding was the constructive stage that led to configuration of themes and theoretical practice pathways about student learning. Four leading themes emerged. Story or Scenario represents the ways that students described case-based learning, changes in student thought processes to accommodate case-based learning are illustrated in Method of Learning, higher cognitive learning that was achieved from case-based learning is represented in Problem Solving, and Future Practice details how students explained perceived professional competency gains from case-based learning. The skills that students acquired are consistent with those identified as essential to professional practice. In addition, the common concept of Big Picture was iterated throughout the themes and demonstrated that case-based learning prepares students for multifaceted problems that they are likely to encounter in professional practice. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Using a wiki platform to promote guidelines internationally and maintain their currency: evidence-based guidelines for the nutritional management of adult patients with head and neck cancer.

PubMed

Brown, T; Findlay, M; von Dincklage, J; Davidson, W; Hill, J; Isenring, E; Talwar, B; Bell, K; Kiss, N; Kurmis, R; Loeliger, J; Sandison, A; Taylor, K; Bauer, J

2013-04-01

The present study describes the development of evidence-based practice guidelines for the nutritional management of adult patients with head and neck cancer using a wiki platform to enable wide international stakeholder consultation and maintain currency. A dietitian steering committee and a multidisciplinary steering committee were established for consultation. Traditional methods of evidence-based guideline development were utilised to perform the literature review, assess the evidence and produce a draft document. This was transferred to a wiki platform for stakeholder consultation and international endorsement processes in Australia, New Zealand and the UK. Data were collected on website traffic utilising Google Analytics. In addition to broad stakeholder consultation through the steering committees, an additional twenty comments were received via the wiki by twelve individuals covering six different professions from three different countries, compared to four comments by e-mail. The guidelines were subsequently endorsed by the dietetic associations of Australia, New Zealand and the UK. During a 4-month period monitoring the use of the guidelines, there were 2303 page views to the landing page from 33 countries. The average number of pages accessed per visit was five and the duration of time spent on the website was approximately 6 min. Using a wiki platform for guideline development and dissemination is a successful method for producing high-quality resources that can undergo wide international stakeholder review and include open public consultation. This can replace conventional methods whereby guidelines can quickly become outdated. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Position of the American Dietetic Association: child and adolescent food and nutrition programs.

PubMed

Stang, Jamie; Taft Bayerl, Cynthia; Flatt, Michelle M

2006-09-01

It is the position of the American Dietetic Association that all children and adolescents, regardless of age, sex, socioeconomic status, racial diversity, ethnic diversity, linguistic diversity, or health status, should have access to food and nutrition programs that ensure the availability of a safe and adequate food supply that promotes optimal physical, cognitive, social, and emotional growth and development. Appropriate food and nutrition programs include food assistance and meal programs, nutrition education initiatives, and nutrition screening and assessment followed by appropriate nutrition intervention and anticipatory guidance to promote optimal nutrition status. Food and nutrition programs create a safety net that ensures that children and adolescents at risk for poor nutritional intakes have access to a safe, adequate, and nutritious food supply and nutrition screening, assessment, and intervention. It is important that continued funding be provided for these programs, which consistently have been shown to have a positive impact on child and adolescent health and well-being. Food and nutrition programs serve as a means to prevent or reduce hunger and food insecurity, but also as a vehicle for nutrition education and promotion of physical activity designed to prevent or reduce overweight and prevent chronic disease. It is the role of the registered dietitian to support adequate and sustained funding for food and nutrition programs, universal health care reimbursement for nutrition services, and the use of research and surveillance programs to evaluate and improve these programs. In addition, the registered dietitian and dietetic technician, registered, are responsible for serving as a nutrition resource to all groups and individuals providing services to children and adolescents, acting as an advocate for the establishment of child-care, school, and community settings conducive to the development of good nutrition habits.

Position of the academy of nutrition and dietetics: nutrition security in developing nations: sustainable food, water, and health.

PubMed

Nordin, Stacia M; Boyle, Marie; Kemmer, Teresa M

2013-04-01

It is the position of the Academy of Nutrition and Dietetics that all people should have consistent access to an appropriately nutritious diet of food and water, coupled with a sanitary environment, adequate health services, and care that ensure a healthy and active life for all household members. The Academy supports policies, systems, programs, and practices that work with developing nations to achieve nutrition security and self-sufficiency while being environmentally and economically sustainable. For nations to achieve nutrition security, all people must have access to a variety of nutritious foods and potable drinking water; knowledge, resources, and skills for healthy living; prevention, treatment, and care for diseases affecting nutrition status; and safety-net systems during crisis situations, such as natural disasters or deleterious social and political systems. More than 2 billion people are micronutrient deficient; 1.5 billion people are overweight or obese; 870 million people have inadequate food energy intake; and 783 million people lack potable drinking water. Adequate nutrient intake is a concern, independent of weight status. Although this article focuses on nutritional deficiencies in developing nations, global solutions for excesses and deficiencies need to be addressed. In an effort to achieve nutrition security, lifestyles, policies, and systems (eg, food, water, health, energy, education/knowledge, and economic) contributing to sustainable resource use, environmental management, health promotion, economic stability, and positive social environments are required. Food and nutrition practitioners can get involved in promoting and implementing effective and sustainable policies, systems, programs, and practices that support individual, community, and national efforts. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system.

PubMed

Vivanti, Angela; O'Sullivan, Therese A; Porter, Jane; Hogg, Marion

2017-09-01

Three years following a state-wide Nutrition Care Process Terminology (NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Pre-implementation and three years post-implementation, all Queensland Government hospitals state-wide were invited to repeat a validated NCPT survey. Additionally, a separate survey sought dietetic managers' opinions regarding NCPT's use and acceptance, usefulness for patient care, role in service planning and continued use. A total of 238 dietitians completed the survey in 2011 and 82 dietitians in 2014. Use of diagnostic statement in the previous six months improved (P < 0.001). Perceptions of NCPT's importance (P < 0.020) and benefits of incorporating NCPT into practice (P = 0.029) increased. Time to complete NCPT documentation (P < 0.013) and access to mentors decreased (P < 0.001). Other areas including enhanced attitudes, familiarity, confidence, views, knowledge and incorporation into practice were sustained (P > 0.05). Key elements in sustaining NCPT implementation over three years included ongoing management support, workshops/tutorials, discussion and mentor and peer support. The most valued resources were pocket guides, ongoing workshops/tutorials and mentor support. Dietetic managers held many positive NCPT views, however, opinions differed around the usefulness of service planning, safer practice, improving patient care and facilitating communication. Some managers would not support NCPT unless it was recommended for practice. Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment. © 2017 State of Queensland. Nutrition and Dietetics © 2017 Dietitians Association of Australia.

A pilot outreach physiotherapy and dietetic quality improvement initiative reduces IV antibiotic requirements in children with moderate-severe cystic fibrosis.

PubMed

Ledger, Sean J; Owen, Elizabeth; Prasad, S Ammani; Goldman, Allan; Willams, Jane; Aurora, Paul

2013-12-01

At our hospital the current model of care for children with moderate-severe CF is focused on intensive inpatient intervention, regular outpatient clinic review and specialist outreach care as required. An alternative model providing more regular physiotherapy and dietetic outreach support, in addition to these specialist services, may be more effective. 16 children (4 male; 12 female; mean age 10.9±2.93; range 4-15 years) who required >40days of IV antibiotics in the 12-months pre-intervention were enrolled. Physiotherapy included weekly-supervised exercise sessions, alongside regular review of home physiotherapy regimens. Dietetic management included 1-2 monthly monitoring of growth, appetite, intake and absorption, and nutrition education sessions. There was a 23% reduction in inpatient IV antibiotic requirement and 20% reduction in home IV antibiotic requirement during the intervention year. Cost-benefit analyses showed savings of £113,570. VO(2Peak) increased by 4.9 ml·kg·min(-1) (95%CI 1.01 to 8.71; p=0.02), and 10 m-MSWT distance and increment achieved increased by 229 m (95%CI 109 to 350; p<0.001) and 2 levels (95%CI 1 to 3; p<0.002) respectively. No significant differences in physiological and patient reported outcomes were demonstrated, although there was a possible trend towards improvement in outcomes when compared to the pre-intervention year. This pilot programme demonstrated a reduction in IV and admission requirements with a cost benefit in a small group of children with moderate-severe CF. A fully powered clinical trial is now warranted. Copyright © 2013 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update).

PubMed

McKenzie, Y A; Bowyer, R K; Leach, H; Gulia, P; Horobin, J; O'Sullivan, N A; Pettitt, C; Reeves, L B; Seamark, L; Williams, M; Thompson, J; Lomer, M C E

2016-10-01

The first British Dietetic Association (BDA) guidelines for the dietary management of irritable bowel syndrome (IBS) in adults were published in 2012. Subsequently, there has been a wealth of new research. The aim of this work was to systematically review the evidence for the role of diet in the management of IBS and to update the guidelines. Twelve questions relating to diet and IBS were defined based on review of the previous guideline questions, current evidence and clinical practice. Chosen topics were on healthy eating and lifestyle (alcohol, caffeine, spicy food, elimination diets, fat and fluid intakes and dietary habits), milk and dairy, dietary fibre, fermentable carbohydrates, gluten, probiotics and elimination diets/food hypersensitivity. Data sources were CINAHL, Cochrane Register of Controlled Trials, Embase, Medline, Scopus and Web of Science up to October 2015. Studies were assessed independently in duplicate using risk of bias tools specific to each included study based on inclusion and exclusion criteria for each question. National Health and Medical Research Council grading evidence levels were used to develop evidence statements and recommendations, in accordance with Practice-based Evidence in Nutrition Global protocol used by the BDA. Eighty-six studies were critically appraised to generate 46 evidence statements, 15 clinical recommendations and four research recommendations. The IBS dietary algorithm was simplified to first-line (healthy eating, provided by any healthcare professional) and second-line [low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) to be provided by dietitian] dietary advice. These guidelines provide updated comprehensive evidence-based details to achieve the successful dietary management of IBS in adults. © 2016 The British Dietetic Association Ltd.

Position of the academy of nutrition and dietetics: total diet approach to healthy eating.

PubMed

Freeland-Graves, Jeanne H; Nitzke, Susan

2013-02-01

It is the position of the Academy of Nutrition and Dietetics that the total diet or overall pattern of food eaten is the most important focus of healthy eating. All foods can fit within this pattern if consumed in moderation with appropriate portion size and combined with physical activity. The Academy strives to communicate healthy eating messages that emphasize a balance of food and beverages within energy needs, rather than any one food or meal. Public policies and dietary patterns that support the total diet approach include the 2010 Dietary Guidelines for Americans, DASH (Dietary Approaches to Stop Hypertension) Diet, MyPlate, Let's Move, Nutrition Facts labels, Healthy People 2020, and the Dietary Reference Intakes. In contrast to the total diet approach, classification of specific foods as good or bad is overly simplistic and can foster unhealthy eating behaviors. Alternative approaches are necessary in some situations. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, time and convenience, environment, abundance of foods, economics, media/marketing, perceived product safety, culture, and attitudes/beliefs. To increase the effectiveness of nutrition education in promoting sensible food choices, skilled food and nutrition practitioners utilize appropriate behavioral theory and evidence-based strategies. Focusing on variety, moderation, and proportionality in the context of a healthy lifestyle, rather than targeting specific nutrients or foods, can help reduce consumer confusion and prevent unnecessary reliance on supplements. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A nutrition strategy to reduce the burden of diet related disease: access to dietician services must complement population health approaches.

PubMed

Segal, Leonie; Opie, Rachelle S

2015-01-01

Poor diet quality is implicated in almost every disease and health issue. And yet, in most advanced market economies diet quality is poor, with a minority meeting guidelines for healthy eating. Poor diet is thus responsible for substantial disease burden. Societies have at their disposal a range of strategies to influence diet behaviors. These can be classified into: (i) population level socio-educational approaches to enhance diet knowledge; (ii) pricing incentives (subsidies on healthy foods, punitive taxes on unhealthy foods); (iii) regulations to modify the food environment, and (iv) the provision of clinical dietetic services. There is little evidence that societies are active in implementing the available strategies. Advertising of "junk foods" is largely unchecked, contrasting with strict controls on advertising tobacco products, which also attract punitive taxes. Access to dieticians is restricted in most countries, even in the context of universal health care. In Australia in 2011 there were just 2,969 practicing dieticians/nutritionists or 1.3 clinicians per 10,000 persons, compared with 5.8 physiotherapists per 10,000 persons, 14.8 general practitioners (family physicians) per 10,000 persons or 75 nurses per 10,000 persons. It is time to implement comprehensive national nutrition strategies capable of effecting change. Such strategies need to be multi-component, incorporating both public health approaches and expanded publicly funded dietetic services. Access to individualized dietetic services is needed by those at risk, or with current chronic conditions, given the complexity of the diet message, the need for professional support for behavior change and to reflect individual circumstances. The adoption of a comprehensive nutrition strategy offers the promise of substantial improvement in diet quality, better health and wellbeing and lower health care costs.

Position of the Academy of Nutrition and Dietetics: The Role of Medical Nutrition Therapy and Registered Dietitian Nutritionists in the Prevention and Treatment of Prediabetes and Type 2 Diabetes.

PubMed

Briggs Early, Kathaleen; Stanley, Kathleen

2018-02-01

It is the position of the Academy of Nutrition and Dietetics that for adults with prediabetes or type 2 diabetes, medical nutrition therapy (MNT) provided by registered dietitian nutritionists (RDNs) is effective in improving medical outcomes and quality of life, and is cost-effective. MNT provided by RDNs is also successful and essential to preventing progression of prediabetes and obesity to type 2 diabetes. It is essential that MNT provided by RDNs be integrated into health care systems and public health programs and be adequately reimbursed. The Academy's evidence-based nutrition practice guidelines for the prevention of diabetes and the management of diabetes document strong evidence supporting the clinical effectiveness of MNT provided by RDNs. Cost-effectiveness has also been documented. The nutrition practice guidelines recommend that as part of evidence-based health care, providers caring for individuals with prediabetes or type 2 diabetes should be referred to an RDN for individualized MNT upon diagnosis and at regular intervals throughout the lifespan as part of their treatment regimen. Standards of care for three levels of diabetes practice have been published by the Diabetes Care and Education Practice Group. RDNs are also qualified to provide additional services beyond MNT in diabetes care and management. Unfortunately, barriers to accessing RDN services exist. Reimbursement for services is essential. Major medical and health organizations have provided support for the essential role of MNT and RDNs for the prevention and treatment of type 2 diabetes. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Using best practice to create a pathway to improve management of irritable bowel syndrome: aiming for timely diagnosis, effective treatment and equitable care.

PubMed

Williams, Marianne; Barclay, Yvonne; Benneyworth, Rosie; Gore, Steve; Hamilton, Zoe; Matull, Rudi; Phillips, Iain; Seamark, Leah; Staveley, Kate; Thole, Steve; Greig, Emma

2016-10-01

Irritable bowel syndrome (IBS) costs the National Health Service almost £12 million per annum. Despite national guidelines advising primary care management, these have failed to stem secondary care referrals of patients with likely IBS for unnecessary and costly assessment and investigation without necessarily achieving resolution of their symptoms. In 2011, an integrated team from primary and secondary care developed a business case using baseline data to create a Somerset-wide IBS pathway using Clinical Commissioning Group funding. This provided face-to-face general practitioners (GP) education, developed a diagnostic pathway and funded faecal calprotectin (FC) testing to exclude inflammatory pathology for patients aged 16-45 years with likely IBS and no alarm symptoms. For those with FC≤50 μg/g, we provided a management algorithm and community-based dietetic treatment. Audit results measured usage and outcomes from FC testing, changes in patterns and costs of new patients reviewed in gastroenterology outpatients and dietetic IBS treatment outcomes. The proportion of new patient slots used reduced from 14.3% to 8.7% over 10 months while overall costs reduced by 25% for patients with no alarm symptoms and likely IBS aged 16-45 years. FC results confirmed research findings with no inflammatory pathology, if FC≤50 μg/g over 2 years. 63% of patients had satisfactory control of their IBS after specialist dietetic input with 74% reporting improved quality of life. The combination of GP education, providing diagnosis and management pathways, using FC to exclude inflammatory pathology and providing an effective treatment for patients with likely IBS appeared successful in our pilot. This proved cost-effective, reduced secondary care involvement and improved patient care.

Living status and frequency of eating out-of-home foods in relation to nutritional adequacy in 4,017 Japanese female dietetic students aged 18-20 years: A multicenter cross-sectional study.

PubMed

Kobayashi, Satomi; Asakura, Keiko; Suga, Hitomi; Sasaki, Satoshi

2017-06-01

Living status (e.g., living with family or alone) may affect dietary habits. We compared nutritional adequacy according to living status and the frequency of eating out-of-home foods in young Japanese women. Female dietetic students (aged 18-20 years; n = 4,017) participated in a cross-sectional multicenter study, which was conducted in 85 dietetic schools in 35 of 47 prefectures in Japan. Habitual dietary intake was assessed with a validated diet history questionnaire. Nutritional adequacy was determined based on the Dietary Reference Intakes for Japanese, 2015, for two goals: preventing non-communicable chronic disease (a tentative dietary goal for preventing lifestyle-related diseases [DG] that tracks five nutrients) and avoiding insufficient intake of mainly vitamins and minerals (estimated average requirement [EAR] that tracks 14 nutrients). Women living with their family were less likely to meet DG nutrient levels, but more likely to meet EAR nutrient levels compared with those living alone. In contrast, women living alone had more inadequate nutrients with EAR and fewer nutrients with not-meeting DG than those living with families. A higher frequency of eating out-of-home was significantly associated with a higher prevalence of not-meeting DG nutrient levels only in the women living with their family. The prevalence of nutritional adequacy varied based on living status. In addition, women living with their family and those with a high frequency of eating out-of-home foods had the highest prevalence of not-meeting DG. Effective ways of improving dietary quality among young Japanese women differ by living status. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: food and nutrition programs for community-residing older adults.

PubMed

Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

2010-01-01

Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services. Copyright 2010 The American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

PATHWAYS TO HEALTH CAREERS, EXPLORING HEALTH OCCUPATIONS AND PROFESSIONS.

ERIC Educational Resources Information Center

Health Careers Council of Illinois, Chicago.

CAREERS IN THE AREAS OF DENTISTRY, DIETETICS, MEDICAL RECORD LIBRARY SCIENCE, MEDICAL LABORATORY WORK, MEDICINE, NURSING, OCCUPATIONAL THERAPY, OPTOMETRY, PHARMACY, PHYSICAL THERAPY, PODIATRY, PUBLIC HEALTH, RADIOLOGIC TECHNOLOGY, SOCIAL WORK, VETERINARY MEDICINE, HOSPITAL ADMINISTRATION, AND OTHER HEALTH OCCUPATIONS ARE DESCRIBED IN TERMS OF THE…

Continuing Education for Professionals: A Practice-Oriented Approach.

ERIC Educational Resources Information Center

Toombs, William; Lindsay, Carl A.

The Continuing Professional Education Project at The Pennsylvania State University is described. Five professions were involved: architecture, accounting, clinical psychology, clinical dietetics, and nursing. The objectives were: (1) to bring the university and the professions into collaboration, (2) to focus continuing education activities as…

Defining Deliberate Practice in Supervised Dietetics Education

ERIC Educational Resources Information Center

Haubrick, Kevin D.

2017-01-01

Deliberate practice serves as a potential framework to understand what activities, attributes, and characteristics make an individual an expert in their chosen field or profession. Historically, deliberate practice activities included those that were highly structured with purposeful goals, frequent repetition, and active feedback with immediate…

Recertification and Relicensure--Implications for the University

ERIC Educational Resources Information Center

Strother, George B.; Swinford, David N.

1975-01-01

The study surveyed the extent of the movement to require continuing education in 14 professions: accountancy, architecture, dentistry, dietetics, engineering, law, medicine, nursing, optometry, osteopathy, pharmacy, physical therapy, real estate, social work, and veterinary medicine. The report provides some general conclusions and a summary of…

Nutrition in Nursing Curricula: Recent Developments and Recommendations.

ERIC Educational Resources Information Center

Morse, Winifred; Corcoran-Perry, Sheila

1993-01-01

Analyzes developments regarding nutrition content in nursing curricula before 1960, from 1960 to early 1980s, and currently. Describes nursing education, public policy decisions, and the evolution of the professions of nursing and dietetics. Specifies guidelines for essential content for undergraduate nursing curricula. (Author/JOW)

Spanish Aid in Clinical Dietetics.

ERIC Educational Resources Information Center

Bringas, Juliet G.; Chan, Teresa Y.

Designed to aid dietitians, nutritionists, and other health professionals to better serve the nutritional needs of Hispanics, this bilingual booklet describes the different cultural eating habits of Mexican, Cuban, and Puerto Rican Americans, with in-depth description of Mexican Americans. Written in Spanish and English, the booklet includes…

Obesity with Comorbid Stress Urinary Incontinence in Women: A Narrative Review to Inform Dietetics Practice.

PubMed

Gordon, Barbara; Shorter, Barbara; Isoldi, Kathy Keenan; Moldwin, Robert M

2017-06-01

Stress urinary incontinence (SUI) is a common problem among women; clinical treatment guidelines include weight reduction as a strategy for controlling urinary leakage. The purpose of this review was to gather evidence on the association between obesity and SUI and to ascertain whether there are any special considerations for implementing medical nutrition therapy with community-dwelling, obese, adult females with comorbid SUI. Five key findings emerged: epidemiologic studies consistently report statistically significant associations between obesity and SUI, randomized control trials found that weight loss appears to ameliorate SUI symptoms, the SUI-activity link may affect weight management, there is a potential interplay between SUI and the obesity-sleep connection, and dietary components are associated with the exacerbation of urinary symptoms. The pathogenesis of SUI and obesity-related contributions to urinary leakage is included in the introductory discussion. Lastly, insights on special considerations for implementing nutrition interventions with this population are offered. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Definitions of healthy eating among university students.

PubMed

House, Jennifer; Su, Jenny; Levy-Milne, Ryna

2006-01-01

To identify definitions of healthy eating in terms of food characteristics, eating behaviours, barriers, and benefits in university students. Four focus groups were conducted; verbatim transcripts were analyzed and coded using qualitative methods. Participants were nine students of dietetics and six students of other subjects. All were females in their third or fourth year at the University of British Columbia (UBC). Participants often described healthy eating as consuming all food groups of Canada's Food Guide to Healthy Eating, with the associated notions of moderation and balance. Benefits of healthy eating were cited as a healthy weight, good physical appearance, feeling better, preventing disease, and achieving personal satisfaction. Barriers to healthy eating included lack of time, choice, taste preferences, and finances. There was some discrepancy between what the dietetics students perceived as barriers for clients (e.g., lack of information), and barriers the potential clients (other students) perceived for themselves. As dietitians, we must try to understand our clients' definitions of healthy eating and their barriers to achieving it, which likely differ from our own.

Coordinated school health program and dietetics professionals: partners in promoting healthful eating.

PubMed

Gross, Sandra M; Cinelli, Bethann

2004-05-01

Although research indicates that school meal programs contribute to improved academic performance and healthier eating behaviors for students who participate, fewer than 60% of students choose the National School Lunch Program or School Breakfast Program. School meal programs have a difficult time competing with foods that are marketed to young people through sophisticated advertising campaigns. Youth's preferences for fast foods, soft drinks, and salty snacks; mixed messages sent by school personnel; school food preparation and serving space limitations; inadequate meal periods; and lack of education standards for school foodservice directors challenge school meal programs as well. A coordinated school health program offers a framework for meeting these challenges and provides children and adolescents with the knowledge and skills necessary for healthful eating. This article identifies challenges facing school foodservice directors in delivering healthful meals and acquaints dietetics professionals with the coordinated school health program to be used as a tool for addressing unhealthful weight gain and promoting healthful eating.

Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: comprehensive school nutrition services.

PubMed

Briggs, Marilyn; Mueller, Constance G; Fleischhacker, Sheila

2010-11-01

It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health, and academic performance of our nation's children. Local school wellness policies may strengthen comprehensive nutrition services by encouraging multidisciplinary wellness teams, composed of school and community members, to work together in identifying local school needs, developing feasible strategies to address priority areas, and integrating comprehensive nutrition services with a coordinated school health program. This joint position paper affirms schools as an important partner in health promotion. To maximize the impact of school wellness policies on strengthening comprehensive, integrated nutrition services in schools nationwide, ADA, SNA, and SNE recommend specific strategies in the following key areas: nutrition education and promotion, food and nutrition programs available on the school campus, school-home-community partnerships, and nutrition-related health services.

Paramedical Training in Minnesota; Requiring Two Years or Less Education at Non-Profit Institutions.

ERIC Educational Resources Information Center

Latchaw, Truly Trousdale, Comp.; Miller, G. Dean, Comp.

The directory of Minnesota institutions providing paramedical training is organized by categories of paramedical occupations: child care specialist, dental assistant and hygienist, dietetic assistant, electro medical technician, hospital service coordinator or hospital station secretary, inhalation therapist, laboratory assistant and technician,…

Nutrition Students Enhance School Health Education

ERIC Educational Resources Information Center

Cotugna, Nancy; Vickery, Connie E.

2005-01-01

Purpose: The purpose of the Nutrition Education Students and Teachers (NEST) project was to develop a model of collaboration between University of Delaware dietetics students and elementary teachers to promote nutrition education in the classroom. Design/methodology/approach: Junior and senior level students in a nutrition education course…

Influencers of Career Choice among Allied Health Students.

ERIC Educational Resources Information Center

Brown-West, Anne P.

1991-01-01

Major influences on career choice among 153 allied health students were need to help others, prestige, autonomy, and advancement and income potential. Risk of malpractice suits and Acquired Immune Deficiency Syndrome were negative influences for medical laboratory majors, but not for dietetics and physical therapy majors. (SK)

Computer-Based Instruction in Dietetics Education.

ERIC Educational Resources Information Center

Schroeder, Lois; Kent, Phyllis

1982-01-01

Details the development and system design of a computer-based instruction (CBI) program designed to provide tutorial training in diet modification as part of renal therapy and provides the results of a study that compared the effectiveness of the CBI program with the traditional lecture/laboratory method. (EAO)

Adult Nutrition Education Materials. January 1982-October 1988. Quick Bibliography Series.

ERIC Educational Resources Information Center

Irving, Holly Berry

This annotated bibliography of materials available from the National Agricultural Library through interlibrary loan to local libraries focuses on nutrition and dietetics as they relate to physical health and special health problems. The bibliography was derived from online searches of the AGRICOLA database, and materials include audiovisuals,…

Evaluation of a Computer Assisted Instruction Resource in Nursing Education.

ERIC Educational Resources Information Center

Herriot, Anne M.; Bishop, Jacki A.; Kelly, Mary; Murphy, Margaret; Truby, Helen

2003-01-01

Nine second-year and six final-year nursing students completed a questionnaire and participated in focus groups about STEP-DIET, a computer-based dietetics instructional tool. Students liked the design and content, perceived increased nutritional knowledge and understanding of dietitians' role. However, they were reluctant to accept…

PBL Approach in Web-Based Instruction

ERIC Educational Resources Information Center

ChanLin, Lih-Juan; Chan, Kung-Chi

2004-01-01

Web-Based Instruction is increasingly being recognized as a means of teaching and learning. In dietetics, the interactions between drugs and nutrients are complex due to the wide variety of drugs and their mechanism and interactions with nutrients. How to help student professionals acquired necessary skills and knowledge is important in a dietetic…

Nutrition Education in the Medical Curriculum.

ERIC Educational Resources Information Center

Cardullo, Alice C.

1982-01-01

It is important that nutrition education be made part of the regular and postgraduate curriculum in all medical schools. The medical student should be provided training in nutrition and dietetics, both as part of the basic science syllabus and of the clinical aspects as they apply to disease states. (MSE)

Evaluating Three Allied Health Training Programs: Exploratory Research into Curriculum Relevance and Labor Market Conditions

ERIC Educational Resources Information Center

Appel, Gary L.; And Others

1977-01-01

Presents results of a research effort designed to develop a methodology for assisting dietetic technicians, physical therapist assistants, and medical record technicians curriculum relevance, and to better understand labor market conditions affecting the utilization and distribution of midlevel technicians. (Author/LAS)

Allied Health Leadership in Health Promotion and Disease Prevention Invitational Conference Proceedings (Williamsburg, Virginia, April 17-19, 1986).

ERIC Educational Resources Information Center

Kra, Eleanor, Ed.

The following papers are included: "Opening Remarks" (McTernan); "Conference Goals and Plans" (Douglas); "Challenge to Leadership" (Pearson); "Implications of Health Promotion and Disease Prevention for the Practice of Respiratory Care" (Axton); "Health Promotion Strategies in Dietetic Practice"…

Role Appropriateness of Educational Fields: Bias in Selection.

ERIC Educational Resources Information Center

Smith, Elizabeth P.; And Others

Bias towards women exists in the selection of applicants to professional and other positions. This research investigated the effects of two rater variables--sex and attitude toward women--and three applicant variables--sex, field (engineering-dietetics), and attributes--(feminine-masculine) upon ratings of competency and personal charm. Analyses…

42 CFR 482.28 - Condition of participation: Food and dietetic services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... technical personnel competent in their respective duties. (b) Standard: Diets. Menus must meet the needs of the patients. (1) Therapeutic diets must be prescribed by the practitioner or practitioners... care of the patients. (3) A current therapeutic diet manual approved by the dietitian and medical staff...

42 CFR 482.28 - Condition of participation: Food and dietetic services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... technical personnel competent in their respective duties. (b) Standard: Diets. Menus must meet the needs of the patients. (1) Therapeutic diets must be prescribed by the practitioner or practitioners... care of the patients. (3) A current therapeutic diet manual approved by the dietitian and medical staff...

42 CFR 482.28 - Condition of participation: Food and dietetic services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... technical personnel competent in their respective duties. (b) Standard: Diets. Menus must meet the needs of the patients. (1) Therapeutic diets must be prescribed by the practitioner or practitioners... care of the patients. (3) A current therapeutic diet manual approved by the dietitian and medical staff...

Instructional Strategies That Promote Cultural Competence in Nutrition and Dietetics Education

ERIC Educational Resources Information Center

Adkins, Cecile Marie

2017-01-01

Changing demographics in the United States to a minority-majority culture require health care professionals who are culturally competent to provide appropriate care to patients. In a university in the Mid-Atlantic region of the United States, a gap existed between student education and the culturally competent professional practice of entry-level…

University of Connecticut School of Allied Health Professions: Program Evaluation for the 1979-1980 Academic Year.

ERIC Educational Resources Information Center

Rovezzi-Carroll, Susan

The vocational curricular evaluation model (MCC) developed by the Division of Planning and Development at the Metropolitan Community College Administration Center is used to evaluate the University of Connecticut's School of Allied Health Professions. The three undergraduate programs focused on are physical therapy, clinical dietetics and medical…

A Descriptive Survey of Weight Control Participants at a U.S. Army Community Hospital.

DTIC Science & Technology

1983-08-01

called stimulus control), as well as the act of eating (called contingency management). The ultimate goal of behavior modification is to teach patients...Fletcher, Anne M. "The Nutritionist as the Primary Care Provider in a Team Approach to Obesity." Journal of American Dietetic Association 80 (March 1982

Instilling Success in an Internship Program: A Dietetic Case Study

ERIC Educational Resources Information Center

Shows, Amy R.; Killough, Jill E.; Jackson, Samantha; Lui, Janet

2015-01-01

Educators in the field of family and consumer science (FCS) must be able to foster intellectual curiosity and critical thinking skills in students (Schumacher, 2014), and internships are one way to do so. Internships are formal programs that provide practical experience for beginners in an occupation or profession. Interns are temporarily placed…

Food Allergy Educational Needs of Pediatric Dietitians: A Survey by the Consortium of Food Allergy Research

ERIC Educational Resources Information Center

Groetch, Marion E.; Christie, Lynn; Vargas, Perla A.; Jones, Stacie M.; Sicherer, Scott H.

2010-01-01

Objective: To determine pediatric dietitians' self-reported proficiency, educational needs, and preferences regarding food allergy (FA) management. Design and Setting: An Internet-based, anonymous survey was distributed to the Pediatric Nutrition Practice Group (PNPG) of the American Dietetic Association. Participants: Respondents (n = 311) were…

Project-Based Learning Involving Sensory Panelists Improves Student Learning Outcomes

ERIC Educational Resources Information Center

Lee, Yee Ming

2015-01-01

Project-based, collaborative learning is an effective teaching method when compared to traditional cognitive learning. The purpose of this study was to assess student learning after the completion of a final meal project that involved a group of sensory panelists. A paper survey was conducted among 73 senior nutrition and dietetics students…

Impact of Community College of Philadelphia Allied Health Programs on the Philadelphia Region. Report #117.

ERIC Educational Resources Information Center

Philadelphia Community Coll., PA.

This report discusses the Allied Health programs at Community College of Philadelphia (CCP): (1) Clinical Laboratory Technician; (2) Dental Assisting Hygiene; (3) Dental Assisting Certificate; (4) Diagnostic Medical Imaging; (5) Dietetic Technician; (6) Health Information Technology; (7) Medical Assisting and Office Management; (8) Nursing; and…

Sustainability in Teaching, Research, and Community Practice: The FCS Department at California State University, Northridge

ERIC Educational Resources Information Center

Pontikis, Kyriakos; Martin, Allen; Cai, Yi; Kim, Jongeun; Cao, Wei; Giordano, Angie; Torabian-Riasati, Setareh

2011-01-01

The purpose of this article is to demonstrate how a large comprehensive family and consumer sciences unit has incorporated sustainability into its curriculum and research agenda. It summarizes how each area within the department (Interior Design, Apparel Design and Merchandising, Consumer Affairs, Family Studies, Nutrition, Dietetics, and Food…

Post-Secondary Vocational Home Economics Instructional Materials Needs Assessment Project: State-of-the-Art and Final Report.

ERIC Educational Resources Information Center

Glosson, Linda R.; Bowers, Candice H.

A Texas project assessed postsecondary vocational home economics instructors' needs for instructional media and materials as well as the need for training in the development of curriculum materials. Relevant post-secondary programs identified were child development, food service/dietetics, fashion design/tailoring, and interior design. In…

A Plan to the Future in Home Economics Education. Draft Curriculum.

ERIC Educational Resources Information Center

Ruckes, Nina Tiglio; Mongillo, Michael

This curriculum guide was prepared to help Connecticut high schools offer an opportunity to disadvantaged high school students who are interested in home economics education to earn some college credit toward a degree in dietetic technology. The curriculum guide includes an overview of the course with a course description, recommended textbooks,…

HOSA Competitive Event Guidelines. Health Occupations Students of America. Students with Special Needs.

ERIC Educational Resources Information Center

Candelori, Elaine M.; And Others

Designed for use by instructors and advisors of handicapped students, this guide presents guidelines for judging the performance of special needs students in Health Occupations Students of America (HOSA) competetive events in eight allied health occupations education areas. These areas are dietetics, first aid, hospitality, housekeeping, job…

A Reference Handbook of the Texas Health Professions and their Support Personnel; The Health Professions in Texas.

ERIC Educational Resources Information Center

Texas Nurses Association.

The fields of dentistry, dietetics, medicine, medical technology, nursing, occupational therapy, pharmacy, physical therapy, and social work are defined in the handbook. The entrance requirements, educational institutions, and licensure regulations in Texas are treated for each major and allied support field. The functions or types of…

Group Work and Leadership: Perception of FCS Students

ERIC Educational Resources Information Center

Arendt, Susan W.; Gregoire, Mary B.

2006-01-01

No known studies have examined the perception of family and consumer science (FCS) students related to group work in the classroom and its relationship to leadership. In this qualitative study, two groups of FCS students--hospitality management and dietetics--viewed group projects as exercises in leadership skills that had many barriers.…

A Markov Model for Forecasting Inventory Levels for U.S Navy Medical Service Corps Healthcare Administrators

DTIC Science & Technology

2014-03-01

Administration, Medical Allied Sciences, Optometry , and Pharmacy. Today, the MSC comprises 31 subspecialties, organized under three major categories...Exper Psych 30 4% Clinical Dietetics 26 3% Financial Mgt 78 8% Research Psych 17 3% Optometry 109 11% MPT&E 31 3% Entomology 39 6% Pharmacy, General 136

Practice paper of the academy of nutrition and dietetics: principles of productivity in food and nutrition services: applications in the 21st century health care reform era.

PubMed

Gregoire, Mary B; Theis, Monica L

2015-07-01

Food and nutrition services, along with the health care organizations they serve, are becoming increasingly complex. These complexities are driven by sometimes conflicting (if not polarizing) human, department, organization, and environment factors and will require that managers shift how they think about and approach productivity in the context of the greater good of the organization and, perhaps, even society. Traditional, single-factor approaches to productivity measurements, while still valuable in the context of departmental trend analysis, are of limited value when assessing departmental performance in the context of an organization's goals and values. As health care continues to change and new models of care are introduced, food and nutrition services managers will need to consider innovative approaches to improve productivity that are consistent with their individual health care organization's vision and mission. Use of process improvement tools such as Lean and Six Sigma as strategies for evaluating and improving food and nutrition services efficiency should be considered. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Nutrigenetics and Nutrigenomics: Viewpoints on the Current Status and Applications in Nutrition Research and Practice

PubMed Central

Fenech, Michael; El-Sohemy, Ahmed; Cahill, Leah; Ferguson, Lynnette R.; French, Tapaeru-Ariki C.; Tai, E. Shyong; Milner, John; Koh, Woon-Puay; Xie, Lin; Zucker, Michelle; Buckley, Michael; Cosgrove, Leah; Lockett, Trevor; Fung, Kim Y.C.; Head, Richard

2011-01-01

Nutrigenetics and nutrigenomics hold much promise for providing better nutritional advice to the public generally, genetic subgroups and individuals. Because nutrigenetics and nutrigenomics require a deep understanding of nutrition, genetics and biochemistry and ever new ‘omic’ technologies, it is often difficult, even for educated professionals, to appreciate their relevance to the practice of preventive approaches for optimising health, delaying onset of disease and diminishing its severity. This review discusses (i) the basic concepts, technical terms and technology involved in nutrigenetics and nutrigenomics; (ii) how this emerging knowledge can be applied to optimise health, prevent and treat diseases; (iii) how to read, understand and interpret nutrigenetic and nutrigenomic research results, and (iv) how this knowledge may potentially transform nutrition and dietetic practice, and the implications of such a transformation. This is in effect an up-to-date overview of the various aspects of nutrigenetics and nutrigenomics relevant to health practitioners who are seeking a better understanding of this new frontier in nutrition research and its potential application to dietetic practice. PMID:21625170

A cluster randomised controlled trial of a nutrition education intervention in the community.

PubMed

Madigan, S M; Fleming, P; Wright, M E; Stevenson, M; Macauley, D

2014-04-01

Patients with enteral feeding tubes are increasingly managed in their home environment and these patients require support from a range of healthcare professionals. A cluster randomised trial of an educational intervention was undertaken among General Practitioners and nurses both in the community and in nursing home caring for patients recently discharged to primary care. This was a short, duration (<1 h), nutrition education programme delivered in the work place soon after the patient was discharged from hospital. The primary outcome was an improvement in knowledge immediately after the intervention and the secondary outcome was knowledge at 6 months. Those in the intervention group had improved knowledge, which was significantly greater than those in the control group (P < 0.001), although this knowledge was not sustained at 6 months. A short, work-based targeted nutrition education programme is effective for improving knowledge among general practitioners and nurses both in the community and in nursing homes. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Hospital Malnutrition: Prevalence, Identification and Impact on Patients and the Healthcare System

PubMed Central

Barker, Lisa A.; Gout, Belinda S.; Crowe, Timothy C.

2011-01-01

Malnutrition is a debilitating and highly prevalent condition in the acute hospital setting, with Australian and international studies reporting rates of approximately 40%. Malnutrition is associated with many adverse outcomes including depression of the immune system, impaired wound healing, muscle wasting, longer lengths of hospital stay, higher treatment costs and increased mortality. Referral rates for dietetic assessment and treatment of malnourished patients have proven to be suboptimal, thereby increasing the likelihood of developing such aforementioned complications. Nutrition risk screening using a validated tool is a simple technique to rapidly identify patients at risk of malnutrition, and provides a basis for prompt dietetic referrals. In Australia, nutrition screening upon hospital admission is not mandatory, which is of concern knowing that malnutrition remains under-reported and often poorly documented. Unidentified malnutrition not only heightens the risk of adverse complications for patients, but can potentially result in foregone reimbursements to the hospital through casemix-based funding schemes. It is strongly recommended that mandatory nutrition screening be widely adopted in line with published best-practice guidelines to effectively target and reduce the incidence of hospital malnutrition. PMID:21556200

Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: comprehensive school nutrition services.

PubMed

Briggs, Marilyn; Fleischhacker, Sheila; Mueller, Constance G

2010-01-01

It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health, and academic performance of our nation's children. Local school wellness policies may strengthen comprehensive nutrition services by encouraging multidisciplinary wellness teams, composed of school and community members, to work together in identifying local school needs, developing feasible strategies to address priority areas, and integrating comprehensive nutrition services with a coordinated school health program. This joint position paper affirms schools as an important partner in health promotion. To maximize the impact of school wellness policies on strengthening comprehensive, integrated nutrition services in schools nationwide, ADA, SNA, and SNE recommend specific strategies in the following key areas: nutrition education and promotion, food and nutrition programs available on the school campus, school-home-community partnerships, and nutrition-related health services. Copyright © 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Nutrigenetics and nutrigenomics: viewpoints on the current status and applications in nutrition research and practice.

PubMed

Fenech, Michael; El-Sohemy, Ahmed; Cahill, Leah; Ferguson, Lynnette R; French, Tapaeru-Ariki C; Tai, E Shyong; Milner, John; Koh, Woon-Puay; Xie, Lin; Zucker, Michelle; Buckley, Michael; Cosgrove, Leah; Lockett, Trevor; Fung, Kim Y C; Head, Richard

2011-01-01

Nutrigenetics and nutrigenomics hold much promise for providing better nutritional advice to the public generally, genetic subgroups and individuals. Because nutrigenetics and nutrigenomics require a deep understanding of nutrition, genetics and biochemistry and ever new 'omic' technologies, it is often difficult, even for educated professionals, to appreciate their relevance to the practice of preventive approaches for optimising health, delaying onset of disease and diminishing its severity. This review discusses (i) the basic concepts, technical terms and technology involved in nutrigenetics and nutrigenomics; (ii) how this emerging knowledge can be applied to optimise health, prevent and treat diseases; (iii) how to read, understand and interpret nutrigenetic and nutrigenomic research results, and (iv) how this knowledge may potentially transform nutrition and dietetic practice, and the implications of such a transformation. This is in effect an up-to-date overview of the various aspects of nutrigenetics and nutrigenomics relevant to health practitioners who are seeking a better understanding of this new frontier in nutrition research and its potential application to dietetic practice. Copyright © 2011 S. Karger AG, Basel.

Triacylglycerols profiling in plant oils important in food industry, dietetics and cosmetics using high-performance liquid chromatography-atmospheric pressure chemical ionization mass spectrometry.

PubMed

Lísa, Miroslav; Holcapek, Michal

2008-07-11

Optimized non-aqueous reversed-phase high-performance liquid chromatography method using acetonitrile-2-propanol gradient elution and the column coupling in the total length of 45 cm has been applied for the high resolution separation of plant oils important in food industry, dietetics and cosmetics. Positive-ion atmospheric pressure chemical ionization mass spectrometry is used for the unambiguous identification and also the reliable quantitation with the response factors approach. Based on the precise determination of individual triacyglycerol concentrations, the calculation of average parameters important in the nutrition is performed, i.e. average carbon number, average double bond number, relative concentrations of essential, saturated, monounsaturated and polyunsaturated fatty acids. Results are reported in the form of both chromatographic fingerprints and tables containing relative concentrations for all triacylglycerols and fatty acids in individual samples. In total, 264 triacylglycerols consisting of 28 fatty acids with the alkyl chain length from 6 to 26 carbon atoms and 0 to 4 double bonds have been identified in 26 industrial important plant oils.

Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionals.

PubMed

Kennedy, L A; Milton, B; Bundred, P

2008-06-01

Community-based food initiatives have developed in recent years with the aim of engaging previously 'hard to reach' groups. Lay workers engaged in community nutrition activities are promoted as a cost-effective mechanism for reaching underserved groups. The main objective of the study was to explore perceptions and definitions of lay food and health worker (LFHW) helping roles within the context of National Health Service (NHS) community nutrition and dietetic services in order to define the conceptual and practical elements of this new role and examine the interface with professional roles. Interpretive qualitative inquiry; semi-structured interviews with LFHW and NHS professionals employed by community-based programmes, serving 'hard-to-reach' neighbourhoods, across England. A total sampling framework was used to capture all existing and 'fully operational' lay food initiatives in England at the commencement of fieldwork (January 2002). In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Although all 15 projects shared a universal goal, to promote healthy eating, this was achieved through a limited range of approaches, characterized by a narrow, individualistic focus. Lay roles spanned three broad areas: nutrition education; health promotion; and administration and personal development. Narratives from both professionals and LFHWs indicated that the primary role for LFHWs was to encourage dietary change by translating complex messages into credible and culturally appropriate advice. This research confirms the emerging discipline involving lay helping within the NHS and community dietetics. The primary role of LFHWs in the 15 projects involved was to support existing NHS services to promote healthy eating amongst 'hard to reach' communities. The activities undertaken by LFHWs are strongly influenced by professionals and the NHS. Inherent to this is a fairly narrow interpretation of health, resulting in a limited range of practice.

Nutritional status of iodine in pregnant women in Catalonia (Spain): study on hygiene-dietetic habits and iodine in urine.

PubMed

Prieto, Gemma; Torres, Maria Teresa; Francés, Lidia; Falguera, Gemma; Vila, Lluis; Manresa, Josep María; Casamitjana, Roser; Barrada, Juan Ramón; Acera, Amèlia; Guix, Dolors; Torrent, Anna; Grau, Josep; Torán, Pere

2011-03-08

It is a priority to achieve an adequate nutritional status of iodine during pregnancy since iodine deficiency in this population may have repercussions on the mother during both gestation and post partum as well as on the foetus, the neonate and the child at different ages. According to the WHO, iodine deficiency is the most frequent cause of mental retardation and irrreversible cerebral lesions around the world. However, few studies have been published on the nutritional status of iodine in the pregnant population within the Primary Care setting, a health care level which plays an essential role in the education and control of pregnant women. Therefore, the aim of the present study is: 1.- To know the hygiene-dietetic habits related to the intake of foods rich in iodine and smoking during pregnancy. 2.- To determine the prevalence of iodine deficiency and the factors associated with its appearance during pregnancy. We will perform a cluster randomised, controlled, multicentre trial. Randomisation unit: Primary Care Team. 898 pregnant women over the age of 17 years attending consultation to a midwife during the first trimester of pregnancy in the participating primary care centres. consumption of iodine-rich foods and iodine deficiency. Points of assessment: each trimester of the gestation. group education during the first trimester of gestation on healthy hygiene-dietetic habits and the importance of an adequate iodine nutritional status. descriptive analysis of all variables will be performed as well as multilevel logistic regression. All analyses will be done carried out on an intention to treat basis and will be fitted for potential confounding factors and variables of clinical importance. Evidence of generalised iodine deficiency during pregnancy could lead to the promotion of interventions of prevention such as how to improve and intensify health care educational programmes for pregnant women. ClinicalTrials.gov: NCT01301768.

Position of the American Dietetic Association: nutrition services in managed care.

PubMed

Chima, Cinda S; Pollack, Harold A

2002-10-01

It is the position of the American Dietetic Association that medical nutrition therapy is an essential component of disease management and healthcare provided by managed care organizations, and that such care must be provided by qualified nutrition professionals. Compared with traditional fee-for-service reimbursement systems, managed care presents new opportunities for dietetics professionals. Until recently, the lack of billing infrastructure has handicapped nutrition providers who wish to bill for their services and has made it difficult to track the outcomes of nutrition care. With the publication of current procedure terminology codes for medical nutrition therapy (MNT) and the implementation of MNT benefits in Medicare part B for diabetes and nondialysis kidney disease, commercial payers, including managed care organizations (MCOs) are likely to implement or expand their coverage of MNT. A large body of evidence supports the efficacy and cost-effectiveness of MNT coverage within managed care plans. This evidence includes cost analyses of conditions treated by MNT, and clinical trial data confirming the efficacy of MNT in improving patient outcomes. MNT is also an important part of national standards of care for many chronic disease conditions. Based on evidence supporting the role of MNT in improving patient outcomes, the Institute of Medicine (IOM) recommended that MNT services be reimbursed by Medicare when patients are referred by a physician. Provision of appropriate MNT can also help MCOs meet accreditation and quality standards established by entities such as the National Committee for Quality Assurance and the Joint Commission for the Accreditation of Health Care Organizations. Much of the work required to secure a place for MNT in MCOs will be done at the practitioner level, by nutrition professionals themselves. Registered dietitians must market MNT to their customers in managed care by addressing the needs of each player. By emphasizing the importance of MNT and other cost-effective forms of preventive care and disease management, MCOs will be well positioned to improve population health at modest cost.

Managing Complexity in Evidence Analysis: A Worked Example in Pediatric Weight Management.

PubMed

Parrott, James Scott; Henry, Beverly; Thompson, Kyle L; Ziegler, Jane; Handu, Deepa

2018-05-02

Nutrition interventions are often complex and multicomponent. Typical approaches to meta-analyses that focus on individual causal relationships to provide guideline recommendations are not sufficient to capture this complexity. The objective of this study is to describe the method of meta-analysis used for the Pediatric Weight Management (PWM) Guidelines update and provide a worked example that can be applied in other areas of dietetics practice. The effects of PWM interventions were examined for body mass index (BMI), body mass index z-score (BMIZ), and waist circumference at four different time periods. For intervention-level effects, intervention types were identified empirically using multiple correspondence analysis paired with cluster analysis. Pooled effects of identified types were examined using random effects meta-analysis models. Differences in effects among types were examined using meta-regression. Context-level effects are examined using qualitative comparative analysis. Three distinct types (or families) of PWM interventions were identified: medical nutrition, behavioral, and missing components. Medical nutrition and behavioral types showed statistically significant improvements in BMIZ across all time points. Results were less consistent for BMI and waist circumference, although four distinct patterns of weight status change were identified. These varied by intervention type as well as outcome measure. Meta-regression indicated statistically significant differences between the medical nutrition and behavioral types vs the missing component type for both BMIZ and BMI, although the pattern varied by time period and intervention type. Qualitative comparative analysis identified distinct configurations of context characteristics at each time point that were consistent with positive outcomes among the intervention types. Although analysis of individual causal relationships is invaluable, this approach is inadequate to capture the complexity of dietetics practice. An alternative approach that integrates intervention-level with context-level meta-analyses may provide deeper understanding in the development of practice guidelines. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Position of the American Dietetic Association: food and nutrition misinformation.

PubMed

Wansink, Brian

2006-04-01

It is the position of the American Dietetic Association (ADA) that food and nutrition misinformation can have harmful effects on the health, well-being, and economic status of consumers. Nationally credentialed dietetics professionals working in health care, academia, public health, the media, government, and the food industry are uniquely qualified to advocate for and promote science-based nutrition information to the public, function as primary nutrition educators to health professionals, and actively correct food and nutrition misinformation. Enormous scientific advances have been made in the area of food and nutrition, leading to a fine-tuning of recommendations about healthful eating. Consumers have become increasingly aware of the nutrition-health link and reliant on nutrition information to base their decisions, and have assumed partial responsibility for changing their eating behaviors. Unfortunately, these same trends also create opportunities for food and nutrition misinformation to flourish. News reports rarely provide enough context for consumers to interpret or apply the advice given, and preliminary findings often attract unmerited and misleading attention. Effective nutrition communication must be consumer-friendly and contain sufficient context to allow consumers to consider the information and determine whether it applies to their unique health and nutritional needs. Consistent with ADA's organizational vision that members "are the leading source of nutrition expertise," ADA recognizes its responsibility to help consumers identify food and nutrition misinformation in the following ways: (a) ADA members should provide consumers with sound, science-based nutrition information and help them to recognize misinformation; (b) ADA members need to be the primary source of sound, science-based nutrition information for the media and to inform them when misinformation is presented; and (c) ADA members should continue to diligently work with other health care practitioners, educators, policy makers, and food and dietary supplement industry representatives to responsibly address the health and psychological, physiological, and economic effects of nutrition-related misinformation.

Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition).

PubMed

Becker, Patricia; Carney, Liesje Nieman; Corkins, Mark R; Monczka, Jessica; Smith, Elizabeth; Smith, Susan E; Spear, Bonnie A; White, Jane V

2015-02-01

The Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), utilizing an evidence-informed, consensus-derived process, recommend that a standardized set of diagnostic indicators be used to identify and document pediatric malnutrition (undernutrition) in routine clinical practice. The recommended indicators include z scores for weight-for-height/length, body mass index-for-age, or length/height-for-age or mid-upper arm circumference when a single data point is available. When 2 or more data points are available, indicators may also include weight gain velocity (<2 years of age), weight loss (2-20 years of age), deceleration in weight for length/height z score, and inadequate nutrient intake. The purpose of this consensus statement is to identify a basic set of indicators that can be used to diagnose and document undernutrition in the pediatric population ages 1 month to 18 years. The indicators are intended for use in multiple settings (eg, acute, ambulatory care/outpatient, residential care). Several screening tools have been developed for use in hospitalized children. However, identifying criteria for use in screening for nutritional risk is not the purpose of this paper. Clinicians should use as many data points as available to identify and document the presence of malnutrition. The universal use of a single set of diagnostic parameters will expedite the recognition of pediatric undernutrition, lead to the development of more accurate estimates of its prevalence and incidence, direct interventions, and promote improved outcomes. A standardized diagnostic approach will also inform the prediction of the human and financial responsibilities and costs associated with the prevention and treatment of undernutrition in this vulnerable population and help to further ensure the provision of high-quality, cost-effective nutritional care. © 2014 American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics.

Health professionals' and dietetics practitioners' perceived effectiveness of fruit and vegetable parenting practices across six countries.

PubMed

O'Connor, Teresia; Watson, Kathy; Hughes, Sheryl; Beltran, Alicia; Hingle, Melanie; Baranowski, Janice; Campbell, Karen; Canal, Dolors Juvinyà; Lizaur, Ana Bertha Pérez; Zacarías, Isabel; González, Daniela; Nicklas, Theresa; Baranowski, Tom

2010-07-01

Fruit and vegetable intake may reduce the risk of some chronic diseases. However, many children consume less-than-recommended amounts of fruit and vegetables. Because health professionals and dietetics practitioners often work with parents to increase children's fruit and vegetable intake, assessing their opinions about the effectiveness of parenting practices is an important step in understanding how to promote fruit and vegetable intake among preschool-aged children. Using a cross-sectional design, collaborators from six countries distributed an Internet survey to health and nutrition organization members. A self-selected sample reported their perceptions of the effectiveness of 39 parenting practices intended to promote fruit and vegetable consumption in preschool-aged children from May 18, 2008, to September 16, 2008. A total of 889 participants (55% United States, 22.6% Mexico, 10.9% Australia, 4.4% Spain, 3.3% Chile, 2.2% United Kingdom, and 1.6% other countries) completed the survey. The fruit and vegetable intake-related parenting practices items were categorized into three dimensions (structure, responsiveness, and control) based on a parenting theory conceptual framework and dichotomized as effective/ineffective based on professional perceptions. The theoretically derived factor structures for effective and ineffective parenting practices were evaluated using separate confirmatory factor analyses and demonstrated acceptable fit. Fruit and vegetable intake-related parenting practices that provide external control were perceived as ineffective or counterproductive, whereas fruit and vegetable intake-related parenting practices that provided structure, nondirective control, and were responsive were perceived as effective in getting preschool-aged children to consume fruit and vegetables. Future research needs to develop and validate a parent-reported measure of these fruit and vegetable intake-related parenting practices and to empirically evaluate the effect of parental use of the parenting practices on child fruit and vegetable consumption. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Nutritional status of iodine in pregnant women in Catalonia (Spain): study on hygiene-dietetic habits and iodine in urine

PubMed Central

2011-01-01

Background It is a priority to achieve an adequate nutritional status of iodine during pregnancy since iodine deficiency in this population may have repercussions on the mother during both gestation and post partum as well as on the foetus, the neonate and the child at different ages. According to the WHO, iodine deficiency is the most frequent cause of mental retardation and irrreversible cerebral lesions around the world. However, few studies have been published on the nutritional status of iodine in the pregnant population within the Primary Care setting, a health care level which plays an essential role in the education and control of pregnant women. Therefore, the aim of the present study is: 1.- To know the hygiene-dietetic habits related to the intake of foods rich in iodine and smoking during pregnancy. 2.- To determine the prevalence of iodine deficiency and the factors associated with its appearance during pregnancy. Methods/design We will perform a cluster randomised, controlled, multicentre trial. Randomisation unit: Primary Care Team. Study population: 898 pregnant women over the age of 17 years attending consultation to a midwife during the first trimester of pregnancy in the participating primary care centres. Outcome measures: consumption of iodine-rich foods and iodine deficiency. Points of assessment: each trimester of the gestation. Intervention: group education during the first trimester of gestation on healthy hygiene-dietetic habits and the importance of an adequate iodine nutritional status. Statistical analysis: descriptive analysis of all variables will be performed as well as multilevel logistic regression. All analyses will be done carried out on an intention to treat basis and will be fitted for potential confounding factors and variables of clinical importance. Discussion Evidence of generalised iodine deficiency during pregnancy could lead to the promotion of interventions of prevention such as how to improve and intensify health care educational programmes for pregnant women. Trial Registration ClinicalTrials.gov: NCT01301768 PMID:21385426

Using best practice to create a pathway to improve management of irritable bowel syndrome: aiming for timely diagnosis, effective treatment and equitable care

PubMed Central

Williams, Marianne; Barclay, Yvonne; Benneyworth, Rosie; Gore, Steve; Hamilton, Zoe; Matull, Rudi; Phillips, Iain; Seamark, Leah; Staveley, Kate; Thole, Steve; Greig, Emma

2016-01-01

Background Irritable bowel syndrome (IBS) costs the National Health Service almost £12 million per annum. Despite national guidelines advising primary care management, these have failed to stem secondary care referrals of patients with likely IBS for unnecessary and costly assessment and investigation without necessarily achieving resolution of their symptoms. Methods In 2011, an integrated team from primary and secondary care developed a business case using baseline data to create a Somerset-wide IBS pathway using Clinical Commissioning Group funding. This provided face-to-face general practitioners (GP) education, developed a diagnostic pathway and funded faecal calprotectin (FC) testing to exclude inflammatory pathology for patients aged 16–45 years with likely IBS and no alarm symptoms. For those with FC≤50 μg/g, we provided a management algorithm and community-based dietetic treatment. Audit results measured usage and outcomes from FC testing, changes in patterns and costs of new patients reviewed in gastroenterology outpatients and dietetic IBS treatment outcomes. Results The proportion of new patient slots used reduced from 14.3% to 8.7% over 10 months while overall costs reduced by 25% for patients with no alarm symptoms and likely IBS aged 16–45 years. FC results confirmed research findings with no inflammatory pathology, if FC≤50 μg/g over 2 years. 63% of patients had satisfactory control of their IBS after specialist dietetic input with 74% reporting improved quality of life. Conclusions The combination of GP education, providing diagnosis and management pathways, using FC to exclude inflammatory pathology and providing an effective treatment for patients with likely IBS appeared successful in our pilot. This proved cost-effective, reduced secondary care involvement and improved patient care. PMID:27761233

Feasibility of home-based dietetic intervention to improve the nutritional status of older adults post-hospital discharge.

PubMed

Hamirudin, Aliza Haslinda; Walton, Karen; Charlton, Karen; Carrie, Amanda; Tapsell, Linda; Milosavljevic, Marianna; Pang, Glen; Potter, Jan

2017-07-01

To determine if a model of home-based dietetic care improves dietary intake and weight status in a specific group of older adults post-hospitalisation. The Department of Veterans' Affairs clients aged 65 years and over were recruited from hospitals in a regional area of New South Wales, Australia (n = 32 men, n = 36 women). Nutritional status was assessed at home at baseline (within two weeks post-discharge) and three months post-discharge using a diet history, a food frequency checklist and Mini Nutritional Assessment (MNA). Personalised dietary advice was provided by a single dietitian according to participants' nutritional status. Mean body weight improved significantly (P = 0.048), as well as mean MNA score (21.9 ± 3.5 vs 25.2 ± 3.1) (P < 0.001). Mean energy, protein and micronutrient intakes were adequate at baseline and three months, except for vitamin D. At three months, the underweight group (body mass index (BMI) < 23 kg/m 2 ) had significantly higher mean protein intake per body weight (1.7 ± 0.4 g/kg) compared to those who were a desirable weight (BMI 23-27 kg/m 2 ) (1.4 ± 0.3 g/kg) or overweight (BMI>27 kg/m 2 ) (1.1 ± 0.3 g/kg) peers (P < 0.001). There was significant improvement in energy intake contributed from oral nutrition supplements (+95.5 ± 388.2 kJ/day) and milk (+259.6 ± 659.8 kJ/day). Dietetic intervention improved nutritional status 3 months after hospital discharge in older adults living in the community. © 2016 Dietitians Association of Australia.

State of the evidence regarding behavior change theories and strategies in nutrition counseling to facilitate health and food behavior change.

PubMed

Spahn, Joanne M; Reeves, Rebecca S; Keim, Kathryn S; Laquatra, Ida; Kellogg, Molly; Jortberg, Bonnie; Clark, Nicole A

2010-06-01

Behavior change theories and models, validated within the field of dietetics, offer systematic explanations for nutrition-related behavior change. They are integral to the nutrition care process, guiding nutrition assessment, intervention, and outcome evaluation. The American Dietetic Association Evidence Analysis Library Nutrition Counseling Workgroup conducted a systematic review of peer-reviewed literature related to behavior change theories and strategies used in nutrition counseling. Two hundred fourteen articles were reviewed between July 2007 and March 2008, and 87 studies met the inclusion criteria. The workgroup systematically evaluated these articles and formulated conclusion statements and grades based upon the available evidence. Strong evidence exists to support the use of a combination of behavioral theory and cognitive behavioral theory, the foundation for cognitive behavioral therapy (CBT), in facilitating modification of targeted dietary habits, weight, and cardiovascular and diabetes risk factors. Evidence is particularly strong in patients with type 2 diabetes receiving intensive, intermediate-duration (6 to 12 months) CBT, and long-term (>12 months duration) CBT targeting prevention or delay in onset of type 2 diabetes and hypertension. Few studies have assessed the application of the transtheoretical model on nutrition-related behavior change. Little research was available documenting the effectiveness of nutrition counseling utilizing social cognitive theory. Motivational interviewing was shown to be a highly effective counseling strategy, particularly when combined with CBT. Strong evidence substantiates the effectiveness of self-monitoring and meal replacements and/or structured meal plans. Compelling evidence exists to demonstrate that financial reward strategies are not effective. Goal setting, problem solving, and social support are effective strategies, but additional research is needed in more diverse populations. Routine documentation and evaluation of the effectiveness of behavior change theories and models applied to nutrition care interventions are recommended. 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

9 CFR 381.480 - Label statements relating to usefulness in reducing or maintaining body weight.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INSPECTION REGULATIONS Nutrition Labeling § 381.480 Label statements relating to usefulness in reducing or... special dietary use because of usefulness in reducing body weight shall bear: (1) Nutrition labeling in...) and (e)(3) of this section, a product may be labeled with terms such as “diet,” “dietetic...

9 CFR 381.480 - Label statements relating to usefulness in reducing or maintaining body weight.

Code of Federal Regulations, 2012 CFR

2012-01-01

... INSPECTION REGULATIONS Nutrition Labeling § 381.480 Label statements relating to usefulness in reducing or... special dietary use because of usefulness in reducing body weight shall bear: (1) Nutrition labeling in...) and (e)(3) of this section, a product may be labeled with terms such as “diet,” “dietetic...

9 CFR 317.380 - Label statements relating to usefulness in reducing or maintaining body weight.

Code of Federal Regulations, 2013 CFR

2013-01-01

... DEVICES, AND CONTAINERS Nutrition Labeling § 317.380 Label statements relating to usefulness in reducing... represented for special dietary use because of usefulness in reducing body weight shall bear: (1) Nutrition... as “diet,” “dietetic,” “artificially sweetened,” or “sweetened with nonnutritive sweetener” only if...

9 CFR 381.480 - Label statements relating to usefulness in reducing or maintaining body weight.

Code of Federal Regulations, 2013 CFR

2013-01-01

... INSPECTION REGULATIONS Nutrition Labeling § 381.480 Label statements relating to usefulness in reducing or... special dietary use because of usefulness in reducing body weight shall bear: (1) Nutrition labeling in...) and (e)(3) of this section, a product may be labeled with terms such as “diet,” “dietetic...

9 CFR 381.480 - Label statements relating to usefulness in reducing or maintaining body weight.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INSPECTION REGULATIONS Nutrition Labeling § 381.480 Label statements relating to usefulness in reducing or... special dietary use because of usefulness in reducing body weight shall bear: (1) Nutrition labeling in...) and (e)(3) of this section, a product may be labeled with terms such as “diet,” “dietetic...

9 CFR 317.380 - Label statements relating to usefulness in reducing or maintaining body weight.

Code of Federal Regulations, 2012 CFR

2012-01-01

... DEVICES, AND CONTAINERS Nutrition Labeling § 317.380 Label statements relating to usefulness in reducing... represented for special dietary use because of usefulness in reducing body weight shall bear: (1) Nutrition... as “diet,” “dietetic,” “artificially sweetened,” or “sweetened with nonnutritive sweetener” only if...

9 CFR 317.380 - Label statements relating to usefulness in reducing or maintaining body weight.

Code of Federal Regulations, 2011 CFR

2011-01-01

... DEVICES, AND CONTAINERS Nutrition Labeling § 317.380 Label statements relating to usefulness in reducing... represented for special dietary use because of usefulness in reducing body weight shall bear: (1) Nutrition... as “diet,” “dietetic,” “artificially sweetened,” or “sweetened with nonnutritive sweetener” only if...

Entrance Qualifications Affect the Performance of Nutrition Students at University: A Pilot Study

ERIC Educational Resources Information Center

Owusu-Apenten, Richard; Xu, Wen Li

2012-01-01

This study assessed the effect of admissions qualifications on the subsequent academic performances of BSc nutrition students at a UK university. Entrance qualifications for three groups (Grp01, Grp02, Grp03) reading for a BSc(Hons) degree in, Dietetics, Food & Nutrition or Human Nutrition (n = 105) were determined from their UCAS…

Mechanism of Action of a Novel Analog of Vitamin D3, 1alpha-hydroxy-24-ethyl Cholecalciferol (D5), in Normal and Transformed Human Breast Epithelial Cells

DTIC Science & Technology

2003-05-01

retinoids, deltanoids (vitamin D derivatives), phytoestrogens, flavonoids , and aromatase inhibitors among others (Kelloffet al, 1996). On a global basis...Dietetics, University of Illinois at Chicago, Chicago. Responsibilities included development and validation of MDA-TBA assay by HPLC with fluorometric

Applying the Post-Modern Double ABC-X Model to Family Food Insecurity

ERIC Educational Resources Information Center

Hutson, Samantha; Anderson, Melinda; Swafford, Melinda

2015-01-01

This paper develops the argument that using the Double ABC-X model in family and consumer sciences (FCS) curricula is a way to educate nutrition and dietetics students regarding a family's perceptions of food insecurity. The Double ABC-X model incorporates ecological theory as a basis to explain family stress and the resulting adjustment and…

Inside the Actors' Studio: Exploring Dietetics Education Practices through Dialogical Inquiry

ERIC Educational Resources Information Center

Fox, Ann L.; Gingras, Jacqui

2012-01-01

Two colleagues, Ann and Jacqui, came together, within the safety of an imagined actors' studio, to explore the challenges that Ann faced in planning a new graduate program in public health nutrition. They met before, during, and after program implementation to discuss Ann's experiences, and audio-taped and transcribed the discussions. When all…

Methodological Orientations of Articles Appearing in Allied Health's Top Journals: Who Publishes What and Where

ERIC Educational Resources Information Center

Alderman, Pamela Lea McCloud

2012-01-01

This study examined articles published in the major peer-reviewed journals, either hard copy, web, or both formats, in five allied health professions from January 2006 to December 2010. Research journals used in this study include: "Journal of Dental Hygiene," "Journal of the American Dietetic Association," "Journal of…

Task Lists for Home Economics Occupations, 1988: Cluster Matrices for Home Economics Occupations. Education for Employment Task Lists.

ERIC Educational Resources Information Center

Below, Virginia

This document contains information for home economics occupations in Illinois in seven sections. The first part provides lists of employability skills for the following: food preparation and service worker, fashion designer, dietetic technician, and service coordinator/consumer assistant/concierge. The second section contains task analyses for the…

The Use of an Active Learning Approach to Teach Metabolism to Students of Nutrition and Dietetics

ERIC Educational Resources Information Center

Gonzalez-Sancho, Jose Manuel; Sanchez-Pacheco, Aurora; Lasa, Marina; Molina, Susana; Vara, Francisco; del Peso, Luis

2013-01-01

This article describes the transition from a traditional instructor-centered course, based on lectures, to a student-centered course based on active learning methodologies as part of the reform of the Spanish higher education system within the European Higher Education Area (EHEA). Specifically, we describe the use of active learning methodologies…

Making Large Class Basic Histology Lectures More Interactive: The Use of Draw-Along Mapping Techniques and Associated Educational Activities

ERIC Educational Resources Information Center

Kotzé, Sanet Henriët; Mole, Calvin Gerald

2015-01-01

At Stellenbosch University, South Africa, basic histology is taught to a combination class of almost 400 first-year medical, physiotherapy, and dietetic students. Many students often find the amount of work in basic histology lectures overwhelming and consequently loose interest. The aim was to determine if a draw-along mapping activity would…

[Experiences with the enzymatic determination of sugar and sugar substitutes in dietetic cake for diabetics (author's transl)].

PubMed

Klingebiel, L; Grossklaus, R; Pahlke, G

1979-11-01

Sorbitol and fructose were determined enzymatically in home-made and commercially produced cake for diabetics. In some commercial products, a loss of fructose depending upon the baking period was found. This loss of fructose is to be attributed to the Maillard reaction. The findings were confirmed by comparative studies will a reference cake.

Continuing Education Credits | Division of Cancer Prevention

Cancer.gov

We are pleased to be able to offer continuing education credits to Registered Dietitians. Registered Dietitians This event is pending for approval by the Commission on Dietetic Registration for 2 CPEUs.  Procedure  Immediately after the event, a link to a short questionnaire will be sent to you by email. Please complete the questionnaire online and print out your certificate

Improving Metabolic Health Through Precision Dietetics in Mice

PubMed Central

Barrington, William T.; Wulfridge, Phillip; Wells, Ann E.; Rojas, Carolina Mantilla; Howe, Selene Y. F.; Perry, Amie; Hua, Kunjie; Pellizzon, Michael A.; Hansen, Kasper D.; Voy, Brynn H.; Bennett, Brian J.; Pomp, Daniel; Feinberg, Andrew P.; Threadgill, David W.

2018-01-01

The incidence of diet-induced metabolic disease has soared over the last half-century, despite national efforts to improve health through universal dietary recommendations. Studies comparing dietary patterns of populations with health outcomes have historically provided the basis for healthy diet recommendations. However, evidence that population-level diet responses are reliable indicators of responses across individuals is lacking. This study investigated how genetic differences influence health responses to several popular diets in mice, which are similar to humans in genetic composition and the propensity to develop metabolic disease, but enable precise genetic and environmental control. We designed four human-comparable mouse diets that are representative of those eaten by historical human populations. Across four genetically distinct inbred mouse strains, we compared the American diet’s impact on metabolic health to three alternative diets (Mediterranean, Japanese, and Maasai/ketogenic). Furthermore, we investigated metabolomic and epigenetic alterations associated with diet response. Health effects of the diets were highly dependent on genetic background, demonstrating that individualized diet strategies improve health outcomes in mice. If similar genetic-dependent diet responses exist in humans, then a personalized, or “precision dietetics,” approach to dietary recommendations may yield better health outcomes than the traditional one-size-fits-all approach. PMID:29158425

Opportunities and Challenges for Practical Training in Public Health: Insights from Practicum Coordinators in Ontario.

PubMed

Wegener, Jessica; Petitclerc, Marilyne

2018-06-12

Dietetic educators and practicum coordinators (PC) play critical roles in preparing students for practice. Dietitians have made significant progress in the development of educational curricula, competencies, and other resources to support knowledge and skill attainment in public health. There are identified gaps in the literature concerning practical training in sustainable food systems and public health, creating barriers in knowledge exchange and improvements in practicum programs in Canada. This paper discusses the potential opportunities and challenges associated with the number of placements for practical training in public health based on interviews with PCs in Ontario. The findings are limited to the perspectives of 7 PCs with experience in practical training and are a starting point for ongoing evaluation. Identified opportunities within traditional and "emerging settings" for practical training in public health included: the uniqueness of the experience, the potential for students to learn outside their comfort zones, and greater possibilities for dietitians in new roles and settings. Challenges included the need for significant PC engagement with nondietetic preceptors and a narrow view of dietetic practice among some dietitians. Interprofessional teams, emerging settings, and flexible learning approaches may create and support practical training opportunities in food systems and public health going forward.

Use of an Experiential Learning Assignment to Prepare Future Health Professionals to Utilize Social Media for Nutrition Communications.

PubMed

Twynstra, Jasna; Dworatzek, Paula

2016-03-01

Social media has become a popular platform for reputable health organizations to disseminate health information to the public. However, future health professionals may receive little training in social media communication. To train future dietetic professionals, we incorporated a social media assignment into a Communications course curriculum to facilitate effective use of social media for the profession. For the assignment, students were instructed to make 2 posts on Facebook. The posts were due 3 weeks apart so that students received feedback on their first post before making their second post. To demonstrate the type of social media communication commonly used by reputable health organizations, the first post raised awareness or provided nutrition education. The second post used Facebook's "comment" feature, to respond to another student's first post, demonstrating the use of social media for community engagement. Both posts included a hyperlink that the user could click to get more information. Students were evaluated on the hook, main points, professionalism, credibility, and effectiveness of inviting the reader to the hyperlinked website and its ease of navigation. Dietetics educators should be encouraged to incorporate social media education into their curriculums for the benefit of future dietitians and their clients.

Examining the Cultural Competence of Third- and Fourth-Year Nutrition Students: A Pilot Study.

PubMed

Hack, Rebekah; Hekmat, Sharareh; Ahmadi, Latifeh

2015-12-01

The purpose of this study was to provide preliminary Canadian research assessing nutrition students' cultural competence and to identify areas for future education initiatives in dietetic education that could ultimately improve dietitians' cultural competence. A mixed-methods study was conducted using a 24-item questionnaire that was administered to students enrolled in third- and fourth-year undergraduate nutrition classes (n = 133). In total, 115 questionnaires were analyzed for quantitative data, and 109 were analyzed for qualitative data. The students scored an overall medium-high level of cultural competence. Out of the 5 areas examined (skills, attitudes, awareness, desires, knowledge), students' multicultural knowledge scores were the lowest. It was found that a lower number of barriers to learning about other cultures were significantly associated with a higher overall cultural competence score, and taking a course in cultural foods significantly increased the students' knowledge and overall cultural competence (P ≤ 0.05). The qualitative data found that students felt the cultural competence curriculum had gaps and identified several ideas for improvement. In conclusion, this research data provides novel insights into the cultural competence of Canadian dietetic students and additionally supports future research and curriculum development to enhance cultural competence.

Effect of modified atmospheric packaging on chemical and microbial changes in dietetic rabri during storage.

PubMed

Ghayal, Gajanan; Jha, Alok; Kumar, Arvind; Gautam, Anuj Kumar; Rasane, Prasad

2015-03-01

Rabri is a dairy based sweet popular in the Indian subcontinent. The high sugar and fat content impose restrictions on its consumption due to health reasons. Dietetic rabri was prepared by the replacement of sugar with aspartame. Inulin was added to partially replace the milk fat and to improve the consistency of rabri. The rabri samples were packed in the polyethylene bags filled with different gaseous compositions (Air, 50 % CO2:50 % N2 and 100 % N2) and stored at 10 °C. The shelf life was evaluated on the basis of changes in the chemical quality parameters such as HMF, TBA and FFA and microbial content such as total plate count, yeast and molds and coliform counts. The chemical parameters and microbial spoilage increased in all the samples with the progression of storage period. The samples packed with air showed significantly higher chemical deterioration and microbial spoilage as compared to the other two combinations. The samples packed with 100 % N2 were more shelf stable than with air and 50 % CO2:50 % N2 combinations.

Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association--Nutrition services: an essential component of comprehensive school health programs.

PubMed

Briggs, Marilyn; Safaii, SeAnne; Beall, Deborah Lane

2003-04-01

It is the position of the American Dietetic Association (ADA), the Society for Nutrition Education (SNE), and the American School Food Service Association (ASFSA) that comprehensive nutrition services must be provided to all of the nation's preschool through grade twelve students. These nutrition services shall be integrated with a coordinated, comprehensive school health program and implemented through a school nutrition policy. The policy should link comprehensive, sequential nutrition education; access to and promotion of child nutrition programs providing nutritious meals and snacks in the school environment; and family, community, and health services' partnerships supporting positive health outcomes for all children. Childhood obesity has reached epidemic proportions and is directly attributed to physical inactivity and diet. Schools can play a key role in reversing this trend through coordinated nutrition services that promote policies linking comprehensive, sequential nutrition education programs, access to and marketing of child nutrition programs, a school environment that models healthy food choices, and community partnerships. This position paper provides information and resources for nutrition professionals to use in developing and supporting comprehensive school health programs. J Am Diet Assoc. 2003;103:505-514.

Acquisition and utilisation of anthropometric measurements on admission in a paediatric hospital before and after the introduction of a malnutrition screening tool.

PubMed

Milani, S; Wright, C; Purcell, O; Macleod, I; Gerasimidis, K

2013-06-01

Acquisition of anthropometric measurements and assessment of growth in paediatric inpatients remains poor. The introduction of malnutrition screening tools that incorporate weight and height/length measurements might improve their acquisition and utilisation in other aspects of patient care. Documentation of weight and/length measurements and their plotting on growth charts was evaluated using a case notes review in paediatric inpatients who were admitted before (n = 146), during (n = 154) and after the pilot (n = 151) and official (n = 128) clinical use of a screening tool. Documentation of weight was high in all periods (> 97% of patients). Height/length measurement documentation was negligible (4% of patients) but improved after the introduction of the screening tool (> 62%; P < 0.0001), except in infants, who were not part of the screening programme. Introduction of a screening tool improved the acquisition of anthropometric measurements by nursing staff, although its utilisation by medical staff remained poor. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Nutritional treatment of advanced CKD: twenty consensus statements.

PubMed

Cupisti, Adamasco; Brunori, Giuliano; Di Iorio, Biagio Raffaele; D'Alessandro, Claudia; Pasticci, Franca; Cosola, Carmela; Bellizzi, Vincenzo; Bolasco, Piergiorgio; Capitanini, Alessandro; Fantuzzi, Anna Laura; Gennari, Annalisa; Piccoli, Giorgina Barbara; Quintaliani, Giuseppe; Salomone, Mario; Sandrini, Massimo; Santoro, Domenico; Babini, Patrizia; Fiaccadori, Enrico; Gambaro, Giovanni; Garibotto, Giacomo; Gregorini, Mariacristina; Mandreoli, Marcora; Minutolo, Roberto; Cancarini, Giovanni; Conte, Giuseppe; Locatelli, Francesco; Gesualdo, Loreto

2018-05-24

The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and/or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis. The DNT includes modulation of protein intake, adequacy of caloric intake, control of sodium and potassium intake, and reduction of phosphorus intake. For all dietary-nutritional therapies, and in particular those aimed at the patient with chronic renal failure, the problem of patient adherence to the dietetic-nutritional scheme is a key element for the success and safety of the DNT and it can be favored by an interdisciplinary and multi-professional approach of information, education, dietary prescription and follow-up. This consensus document, which defines twenty essential points of the nutritional approach to patients with advanced chronic renal failure, has been written, discussed and shared by the Italian nephrologists together with representatives of dietitians (ANDID) and patients (ANED).

[Dietetics and health by Pliny the younger].

PubMed

Biffino, Giovanna Galimberti

2005-01-01

In Rome, at the time of Pliny (whose writings about health were scarcely received in the history of medicine), the close relationship between health and life style had already become a commonplace, as well as the idea of mesótes, that is to say health intended as the balance of opposites: several documents prove it, as for example the works of Celsus, Cicero and Plutarch. In De sanitate tuenda, Plutarch emphasizes the importance of a metría díaita, and presents a list of suggestions concerning the periods of rest, diet, training exercises, hygiene. In the letters, Pliny goes back to facts of the past and to personal experiences, explaining the concept of cura sui by means of a precise valetudinis ratio: he suggests moderatio and temperantia as the only ways to reach a perfect life style, that is to say the results of a specific behaviour that he considers as fundamental: temperare. From the examples given by Pliny in his letters we can understand the principles of dietetics inspired by temperamentum, that has to be the basis of every part of our life: day planning, choice of an appropriate home, balance between otium and negotium, diet.

Institutional Readiness for Interprofessional Education Among Nutrition and Dietetics and Athletic Training Education Programs.

PubMed

Eliot, Kathrin; Breitbach, Anthony; Wilson, Mardell; Chushak, Maria

2017-01-01

Organizations recommend interprofessional education (IPE) as a means of promoting collaborative patient-centered care. In turn, various external accreditors in the health professions have integrated IPE competencies into their standards. However, little is known about how athletic training (AT) and nutrition and dietetics (ND) have incorporated IPE into their educational programs. This study examined institutional factors that affect the level of IPE participation within ND and AT programs in the United States. The Interprofessional Education Assessment and Planning Instrument for Academic Institutions was distributed electronically to directors of accredited programs in ND and AT. In addition to gathering demographic information, survey questions addressed the institutions' level of involvement and commitment to IPE. Differences emerged between ND and AT programs for several items in the instrument. Factors that affected the differences included program level and academic unit in which the program resides. Results also suggest that ND and AT programs have similar levels of IPE participation, but there are great opportunities for growth. Institutional factors such resource commitment, academic unit type, and level of program may affect implementation and contribute to the development and success of IPE initiatives.

Dimensions of managerial work in hospital dietetic services.

PubMed

Palacio, J P; Spears, M C; Vaden, A G; Downey, R G

1985-07-01

The objective of this study was to identify underlying dimensions of the managerial work of hospital dietetic services professional staff. A survey instrument was developed on the basis of Mintzberg's role theory of management. Respondents were asked to rate 80 activity statements on the relative importance and time demand of each. Principal component analysis was used to determine whether items could be conceptualized meaningfully by a smaller number of components capable of accounting for interrelationships. Reliabilities and correlations were computed for the resulting managerial factor scores. Six factors were identified from the importance ratings: Upper Management, Interaction with Subordinates, Outside Activities, Quality Assurance, Communication Activities, and Personnel Activities. Similar dimensions were identified from the time-demand ratings. Findings from this analysis suggest that managers in different functional specialties and at various organizational levels tend to vary in their allocation of time and to stress different roles. As a person rises on the administrative ladder of responsibility, concentration on extramural affairs and involvement in planning are greater, and concern with specific operational problems decreases. The importance of conceptual skills was especially evident in upper administrative positions, as was the critical need for intergroup skills.

Dietetic Professionals' Perceptions of the Learning Environment, Perceived Learning, and Actual Learning of Online and Face-to-Face Journal Clubs

ERIC Educational Resources Information Center

Schumacher, Julie Raeder

2009-01-01

A journal club is defined as a group of individuals who meet regularly to discuss current trends in literature and have been advocated to bridge the gap of research and practice. With the popularity of the Internet, there are a variety of tools available for online learning through journal clubs including asynchronous discussions, which the…

Are Grocery Store Tours Capturing the Right Audience? Characteristics of Students Who Volunteer to Receive a Grocery Store Tour

ERIC Educational Resources Information Center

Hilliard, Elizabeth; Brunt, Ardith; Stangl, Christa; Borr, Mari

2016-01-01

The goal of this research is to examine the demographics of students volunteering to receive a grocery store tour in order to assess if these students represent those most in need of the information. Dietetics students trained in giving grocery store tours through a Produce for Better Health grant provided store tours to college student…

Job Satisfaction of Dietitians in the Army Medical Specialists Corps

DTIC Science & Technology

1981-01-01

in the clinical branches while only 3.&% were assigned as staff administrative dietitians in the production and service branches. Distribution of the...Leavenworth, Kansas and the U.S. Amy-Baylor University Program in Health Care Administration , Fort Sam Houston, Texas. Test of analysis of variance of mean...Chief, Food Service Division; Chief, Production and Service Branch; Chief, Clinical Dietetic Branch; Staff Administrative Dietitian; Staff Clinical

Dietitians. Careers. The revolution continues.

PubMed

1991-09-18

Freelance consulting and specialty diversification are vital today as the demand for dietetic services increases. In fact, the common bond between the members of your profession that we've profiled here is that none of them is tied down to one segment or one company. The dietitians described in our third annual compendium have risen to the challenge and met the needs of a changing society and a changing profession.

A cluster randomised feasibility trial evaluating six-month nutritional interventions in the treatment of malnutrition in care home-dwelling adults: recruitment, data collection and protocol.

PubMed

Stow, Ruth; Rushton, Alison; Ives, Natalie; Smith, Christina; Rick, Caroline

2015-01-01

Protein energy malnutrition predisposes individuals to disease, delays recovery from illness and reduces quality of life. Care home residents are especially vulnerable, with an estimated 30%-42% at risk. There is no internationally agreed protocol for the nutritional treatment of malnutrition in the care home setting. Widely used techniques include food-based intervention and/or the use of prescribed oral nutritional supplements, but a trial comparing the efficacy of interventions is necessary. In order to define outcomes and optimise the design for an adequately powered, low risk of bias cluster randomised controlled trial, a feasibility trial with 6-month intervention is being run, to assess protocol procedures, recruitment and retention rates, consent processes and resident and staff acceptability. Trial recruitment began in September 2013 and concluded in December 2013. Six privately run care homes in Solihull, England, were selected to establish feasibility within different care home types. Residents with or at risk of malnutrition with no existing dietetic intervention in place were considered for receipt of the allocated intervention. Randomisation took place at the care home level, using a computer-generated random number list to allocate each home to either a dietetic intervention arm (food-based or prescribed supplements) or the standard care arm, continued for 6 months. Dietetic intervention aimed to increase daily calorie intake by 600 kcal and protein by 20-25 g. The primary outcomes will be trial feasibility and acceptability of trial design and allocated interventions. A range of outcome assessments and data collection tools will be evaluated for feasibility, including change in nutrient intake, anthropometric parameters and patient-centric measures, such as quality of life and self-perceived appetite. The complexities inherent in care home research has resulted in the under representation of this population in research trials. The results of this feasibility trial will be used to inform the development and design of a future cluster randomised controlled trial to compare food-based intervention with prescribed oral nutritional supplements (ONS) in the treatment of malnutrition within the care home population. Current Controlled Trials ISRCTN38047922.

Implementing the Academy of Nutrition and Dietetics Benchmarks for Nutrition Education for Children: Child-Care Providers' Perspectives.

PubMed

Dev, Dipti A; Carraway-Stage, Virginia; Schober, Daniel J; McBride, Brent A; Kok, Car Mun; Ramsay, Samantha

2017-12-01

National childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited. Using the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years). Using a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached. The study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois. Child-care providers' perspectives regarding implementation of NE. Thematic analysis to derive themes using NVivo software. Three overarching themes emerged, including providers' motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children's knowledge of healthy and unhealthy foods, and NE is consistent with children's tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods. Present study findings offer insights regarding providers' perspectives on implementing NE in child care. Drawing from these perspectives, registered dietitian nutritionists can train providers about the importance of NE for encouraging healthy eating in children, integrating NE with mealtime conversations, and practicing low-cost, hands-on NE activities that meet the food safety standards for state licensing. Such strategies may improve providers' ability to deliver NE in child-care settings. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Is it possible to enhance the confidence of student dietitians prior to professional placements? A design-based research model.

PubMed

Ross, L J; Mitchell, L J; Williams, L T

2017-10-01

Student confidence is an important contributor to a successful professional placement experience. The present study aimed to evaluate a placement preparation program for student dietitians and to assess the impact on self-rated confidence with respect to commencing placements. The present study is part of a design-based research approach that involves students in a cyclic enquiry to evaluate and improve curricula. Nutrition and Dietetics students at an Australian university participated in a 1-week mandatory workshop - Pre-Placement week (PrePW), N = 98 students: in 2015 (n = 54) and 2016 (n = 44). An online survey was conducted before and after PrePW using a five-point Likert scale (1 = not confident; 5 = very confident) to assess self-rated confidence to commence placements. Mean (SD) scores were calculated. Paired and independent t-tests evaluated within- and between-group differences, respectively. Before PrePW, the mean (SD) for student confidence to commence placements overall (in all areas of practise) was 'somewhat confident' [2.9 (0.6) in 2015 and 3.0 (0.7) in 2016]. Students were least confident to commence Clinical Practice [2015: 2.5 (0.6); 2016: 2.8 (0.6)] compared to Food Service Management (FSM) [2015: 3.2 (0.9); 2016: 3.1 (0.9)] and Community and Public Health Nutrition (CPHN) [2015: 3.3 (0.9); 2016: 3.2 (0.8)]. Student feedback from PrePW 2015 was used to change the curriculum and PrePW program. The 2016 students reported significantly greater confidence within all areas of practice: Clinical Practice [3.4 (0.6)], FSM [3.7 (0.6)] and CPHN [3.8 (0.6)], including confidence to commence placements overall [3.6 (0.6)] (P < 0.05). Design-based research provides a useful framework for improvement to curricula and, in this case, was successful in enhancing student confidence in preparation for professional placement. © 2017 Commonwealth of Australia. Journal of Human Nutrition and Dietetics © 2017 The British Dietetic Association Ltd.

USSR Report, Translations from Kommunist, Number 3, February 1985.

DTIC Science & Technology

1985-05-02

biotechnological methods of obtaining valuable, physiologically active preparations— insulin , interferon and others. Considerable success in the...goods and sugar will remain on the 1955 level and that of meat and dairy products on the level of 1962 prices. Low payments for housing and communal...and dairy products for fats. Eggs may be sold only for children and individuals on dietetic food as prescribed with a physician’s certificate and

The Past, Present and Future of Army Dietetics

DTIC Science & Technology

1989-03-17

THIS PAGE ("olin Data En ~tered) REPOT DCUMNTATON ~dEREAD INSTRUCTIONSREPOT DCUMNTATON AGEBEFORE COMPLETING FORM I. REPORT NUMBER 2. GOVT ACCESSION No...JAN , 1473 EoTlomorI bOV GSIS OSOLETE UNCLASSIFIED SECURITY CLASSIFICATIOpt OF THIS PAsE (W?? en 0ate Entered) UNCLASSIFIED SECURITY CLASSIFICATION...began to perform the following duties: *instruction of patients with diabetes in measuring and weighing food *supervision of mess personnel assigned to

[Medical and dietetic management of congenital and inherited nephropathies (author's transl)].

PubMed

Canonaco, F; Guerra, A; Chiossi, C; Cappellini, T; Angeli, G

1981-01-01

The management of the congenital and inherited nephropathies is, still today, almost exclusively symptomatic. The authors relate the most important drugs and the dose used for the principal complications of these nephropathies: hypertension, hypo-dysprotidoemia, oedema, anemia, metabolic acidosis, polyuria, hypoevolutism, recurrent urinary infections. Particular care must be taken in order to provide an adequate caloric-protein allowance principally when the renal insufficiency is reached.

Productivity and time use during occupational therapy and nutrition/dietetics clinical education: a cohort study.

PubMed

Rodger, Sylvia; Stephens, Elizabeth; Clark, Michele; Ash, Susan; Hurst, Cameron; Graves, Nicholas

2012-01-01

Currently in the Australian higher education sector higher productivity from allied health clinical education placements is a contested issue. This paper will report results of a study that investigated output changes associated with occupational therapy and nutrition/dietetics clinical education placements in Queensland, Australia. Supervisors' and students' time use during placements and how this changes for supervisors compared to when students are not present in the workplace is also presented. A cohort design was used with students from four Queensland universities, and their supervisors employed by Queensland Health. There was an increasing trend in the number of occasions of service delivered when the students were present, and a statistically significant increase in the daily mean length of occasions of service delivered during the placement compared to pre-placement levels. A novel method for estimating productivity and time use changes during clinical education programs for allied health disciplines has been applied. During clinical education placements there was a net increase in outputs, suggesting supervisors engage in longer consultations with patients for the purpose of training students, while maintaining patient numbers. Other activities were reduced. This paper is the first time these data have been shown in Australia and form a sound basis for future assessments of the economic impact of student placements for allied health disciplines.

Starch Origin and Thermal Processing Affect Starch Digestion in a Minipig Model of Pancreatic Exocrine Insufficiency.

PubMed

Mößeler, Anne; Vagt, Sandra; Beyerbach, Martin; Kamphues, Josef

2015-01-01

Although steatorrhea is the most obvious symptom of pancreatic exocrine insufficiency (PEI), enzymatic digestion of protein and starch is also impaired. Low praecaecal digestibility of starch causes a forced microbial fermentation accounting for energy losses and meteorism. To optimise dietetic measures, knowledge of praecaecal digestibility of starch is needed but such information from PEI patients is rare. Minipigs fitted with an ileocaecal fistula with (n = 3) or without (n = 3) pancreatic duct ligation (PL) were used to estimate the rate of praecaecal disappearance (pcD) of starch. Different botanical sources of starch (rice, amaranth, potato, and pea) were fed either raw or cooked. In the controls (C), there was an almost complete pcD (>92%) except for potato starch (61.5%) which was significantly lower. In PL pcD of raw starch was significantly lower for all sources of starch except for amaranth (87.9%). Thermal processing increased pcD in PL, reaching values of C for starch from rice, potato, and pea. This study clearly underlines the need for precise specification of starch used for patients with specific dietetic needs like PEI. Data should be generated in suitable animal models or patients as tests in healthy individuals would not have given similar conclusions.

Wheat flour confectionery products as a source of inorganic nutrients: zinc and copper contents in hard biscuits.

PubMed

Sebecić, Blazenka; Vedrina-Dragojević, Irena

2004-04-01

Cereal-based confectionery products being consumed through whole human life are considered mainly to be a source of carbohydrates, that is energy, although cereals are a rich source of minerals as well. To evaluate some hard biscuits produced in Croatia as a source of different trace elements in nutrition, in this study Zn and Cu contents were determined in classic wheat flour biscuits and in dietetic biscuits enriched with whole wheat grain flour or whole wheat grain grits, soya flour and skimmed milk. Zn was determined by flame atomic absorption spectrometry (AAS); Cu was determined by inductively coupled plasma atomic emission spectroscopy (ICP-AES). The results show that the Zn content in different kinds of biscuits ranges from 5.89 up to 17.64 mg/kg and the Cu content ranges from 1.15 up to 2.79 mg/kg depending on the type of wheat milling products and mineral content of other ingredients used. Enriched dietetic biscuits produced from wheat flour type 850 and whole wheat grain flour and/or soya flour and skimmed milk were almost 200% and 150% higher in Zn and Cu, respectively, in comparison to classic white wheat flour biscuits and can be considered as good sources of Zn and Cu in nutrition.

Smartphone apps and the nutrition care process: Current perspectives and future considerations.

PubMed

Chen, Juliana; Gemming, Luke; Hanning, Rhona; Allman-Farinelli, Margaret

2018-04-01

To provide dietitians with practical guidance on incorporating smartphone applications (apps) in the nutrition care process (NCP) to optimize patient education and counseling. The current evidence-base for mobile health (mHealth) apps was searched using PubMed and Google Scholar. Where and how apps could be implemented by dietitians across the four steps of the NCP is discussed. With functionality to automatically convert patient dietary records into nutrient components, nutrition assessment can be streamlined using nutrition apps, allowing more time for dietitians to deliver education and nutrition counseling. Dietitians could prescribe apps to provide patients with education on nutrition skills and in counseling for better adherence to behavior change. Improved patient-provider communication is also made possible through the opportunity for real-time monitoring and evaluation of patient progress via apps. A practical framework termed the 'Mobile Nutrition Care Process Grid' provides dietitians with best-practice guidance on how to use apps. Including apps into dietetic practice could enhance the efficiency and quality of nutrition care and counseling delivered by dietitians. Apps should be considered an adjunct to enable dietetic counseling and care, rather than to replace the expertise, social support and accountability provided by dietitians. Copyright © 2017 Elsevier B.V. All rights reserved.

A Qualitative Investigation to Underpin the Development of an Electronic Tool to Assess Nutrition Literacy in Australians Adults.

PubMed

Cassar, Alyssa M; Denyer, Gareth S; O'Connor, Helen T; Gifford, Janelle A

2018-02-23

Nutrition literacy is linked to health via its influence on dietary intake. There is a need for a tool to assess nutrition literacy in research and dietetic practice. We sought guidance from nutrition professionals on topic areas and features of an electronic nutrition literacy assessment tool for Australian adults. 28 experienced nutrition professionals engaged in a range of nutrition and dietetic work areas participated in six focus groups using a semi-structured interview schedule. Data were analysed using an inductive approach using NVivo 10 (QSR International, Pty Ltd., Doncaster, Australia, 2012). Key areas identified to assess nutrition literacy included specific nutrients versus foods, labels and packaging, construction of the diet, knowledge of the Australian Dietary Guidelines and Australian Guide to Healthy Eating, understanding of serve and portion sizes, ability to select healthier foods, and demographics such as belief systems and culture. Exploitation of electronic features to enhance visual and auditory displays, including interactive animations such as "drag and drop" and virtual reality situations, were discussed. This study provided insight into the most relevant topic areas and presentation format to assess the nutrition literacy of adult Australians. The visual, auditory, and interactive capacity of the available technology could enhance the assessment of nutrition literacy.

If DSME Were a Pill, Would You Prescribe It?

PubMed

Powers, Margaret A

2017-02-01

EDITOR'S NOTE : This address was delivered by Margaret A. Powers, PhD, RD, CDE, President, Health Care & Education, of the American Diabetes Association (ADA), at the ADA's 76th Scientific Sessions in New Orleans, La., on 11 June 2016. Dr. Powers conducts research and has a clinical practice as a registered dietitian and diabetes educator at the International Diabetes Center at Park Nicollet in Minneapolis, Minn. Her research focuses on improving diabetes outcomes, including factors that affect the clinical, psychosocial, and behavioral aspects of diabetes. Dr. Powers has been an ADA volunteer for more than 25 years, including serving as a founding editor of Diabetes Spectrum . She is the lead author of the 2015 joint Position Statement on Diabetes Self-management Education and Support published by the ADA, American Association of Diabetes Educators, and Academy of Nutrition and Dietetics. She is the recipient of the ADA's Outstanding Educator in Diabetes Award and has published research, authored numerous articles and chapters, published five books, and is an international presenter. Dr. Powers holds a doctorate in education with a focus on performance improvement from Capella University. She received her Master of Science from the University of Illinois at Chicago and her Bachelor of Science from Michigan State University. She completed her dietetic internship at Cook County Hospital in Chicago.

If DSME Were a Pill, Would You Prescribe It?

PubMed Central

2017-01-01

EDITOR’S NOTE: This address was delivered by Margaret A. Powers, PhD, RD, CDE, President, Health Care & Education, of the American Diabetes Association (ADA), at the ADA’s 76th Scientific Sessions in New Orleans, La., on 11 June 2016. Dr. Powers conducts research and has a clinical practice as a registered dietitian and diabetes educator at the International Diabetes Center at Park Nicollet in Minneapolis, Minn. Her research focuses on improving diabetes outcomes, including factors that affect the clinical, psychosocial, and behavioral aspects of diabetes. Dr. Powers has been an ADA volunteer for more than 25 years, including serving as a founding editor of Diabetes Spectrum. She is the lead author of the 2015 joint Position Statement on Diabetes Self-management Education and Support published by the ADA, American Association of Diabetes Educators, and Academy of Nutrition and Dietetics. She is the recipient of the ADA’s Outstanding Educator in Diabetes Award and has published research, authored numerous articles and chapters, published five books, and is an international presenter. Dr. Powers holds a doctorate in education with a focus on performance improvement from Capella University. She received her Master of Science from the University of Illinois at Chicago and her Bachelor of Science from Michigan State University. She completed her dietetic internship at Cook County Hospital in Chicago. PMID:28270715

Biotransformation of pineapple juice sugars into dietetic derivatives by using a cell free oxidoreductase from Zymomonas mobilis together with commercial invertase.

PubMed

Aziz, M G; Michlmayr, H; Kulbe, K D; Del Hierro, A M

2011-01-05

An easy procedure for cell free biotransformation of pineapple juice sugars into dietetic derivatives was accomplished using a commercial invertase and an oxidoreductase from Zymomonas mobilis. First, pineapple juice sucrose was quantitatively converted into glucose and fructose by invertase, thus increasing the concentration of each monosaccharide in the original juice to almost twice. In a second step, glucose-fructose oxidoreductase (GFOR) transformed glucose into gluconolactone, and fructose into the low calorie sweetener sorbitol. The advantage of using GFOR is simultaneous reduction of fructose and oxidation of glucose, allowing the continuous regeneration of the essential coenzyme NADP(H), that is tightly bound to the enzyme. The yield of GFOR catalyzed sugar conversion depends on initial pH and control of pH during the reaction. At optimal conditions (pH control at 6.2) a maximum of 80% (w/v) sugar conversion was obtained. Without pH control, GFOR is inactivated rapidly due to gluconic acid formation. Therefore, conversion yields are relatively low at the natural pH of pineapple juice. The application of this process might be more advantageous on juices of other tropical fruits (papaya, jackfruit, mango) due to their naturally given higher pH. Copyright © 2010 Elsevier Inc. All rights reserved.

Nutrition claims in British women's magazines from 1940 to 1955.

PubMed

Barker, M E; Burridge, J D

2014-04-01

The present study examined dietary messages conveyed in articles and advertising in two popular British women's magazines, Woman and Home and Woman's Own, between 1940 and 1954. A qualitative analysis of written content was performed, focusing on regularities evident in content, and addressing the construction of the role of women in relation to food provision, as well as assertions for nutritional health. The setting comprised a desk-based study. The study sample encompassed 37 magazines, and yielded a corpus of 569 articles concerned with food or dietary supplements, of which 80.1% were advertisements. Ministry of Food dietary advice featured prominently up to 1945 and advocated food consumption according to a simple nutrient classification. Advertising and article content also used this classification; advocating consumption of food and supplements on the grounds of energy, growth and protection of health was customary. Providing food to meet nutritional needs was depicted as fundamental to women's war effort and their role as dutiful housewives. Advertising in 1950s magazines also focused on nutritional claims, with a particular emphasis on energy provision. These claims reflected the prevailing food policy and scientific understanding of nutritional health. This analysis of food messages in women's magazines provides lessons for contemporary nutrition policy. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Exploring the Meanings that Dietitians Associate with their Role of Mother and Dietitian and How They Translate into Child-feeding Practices.

PubMed

Coughlin, Rebecca; Lordly, Daphne

2015-03-01

To explore the meanings that dietitians associate with their role of mother and dietitian and how they translate into child-feeding practices. The ideological case-study approach of Interpretative Phenomenological Analysis, a qualitative research design, was utilized. A convenience sample of 3 dietitians was recruited from the faculty of a university nutrition department. Dietitians participated in semi-structured interviews that were voice-recorded and transcribed. Data were thematically organized and interpreted using the theory of Symbolic Interactionism. Five themes were developed: the evolution of food-related practices, tensions between the role of dietitian and mother, mealtime interaction, integration of dietetic values in child-feeding practices, and the individuality of the mother. Dietitian mothers used various parenting styles when interacting with their children. Their beliefs about best practice in child-feeding correspond with the recommendations of their dietetic profession. Their perception of what it meant to be a good mother was influenced by their identity as a dietitian. Dietitian mothers need to be aware of the influence of professional discourse; professional thoughts can influence personal thoughts and actions related to child-feeding practices. Further exploration of the topic including maternal and child-feeding practices from the child's perspective is warranted.

[Cinnamon in type 2 diabetics].

PubMed

Ammon, Hermann P T

2008-05-01

At present numerous preparations containing cinnamon are in the market. And it is claimed that they are suitable as dietetic food or food additive to regulate glucose metabolism in patients with type 2 diabetes. Background for this proposition are the results of some pharmacological and clinical studies, showing improvement of glucose tolerance in streptozotocin-diabetic animals, stimulation of insulin secretion in vitro and lowering blood glucose in type 2 diabetic patients during simultaneous treatment with oral antidiabetics. This led to a controversy between producers of food additives on the one side and scientists in the field of pharmacology and diabetology on the other. In this connection in a scientific statement the German Diabetes Association (DDG) and the German Pharmaceutical Society (DPhG) kept on distance from the use of cinnamon as a dietetic food/food supplement. The point is the interpretation of what is considered to be a food and what is a drug for medical purposes. Since cinnamon has been used for long as a spice, the nutrition site claims cinnamon as a food. In contrary the medical site in this case claims cinnamon as a drug because of its pharmacological effects on glucose tolerance, insulin resistance, insulin release and blood-sugar. In the meantime this is a case of jurisdiction.

Effects of nutritional status and dietetic interventions on survival in Cystic Fibrosis patients before and after lung transplantation.

PubMed

Hollander, F M; van Pierre, D D; de Roos, N M; van de Graaf, E A; Iestra, J A

2014-03-01

This study retrospectively investigated nutritional status, dietetic intervention and intake in Cystic Fibrosis (CF) patients before and after lung transplantation (LTX). Body Mass Index (BMI), Fat Free Mass Index (FFMI) and nutritional intake were retrieved from 75 out-patients aged 15-53 years. Patients were seen every 3-4 months during the waiting list time (range 0-81 months) and up to 116 months after LTX. Survival was measured in months. The median BMI at baseline was 19.2 kg/m(2) (range: 15.3 to 28.4 kg/m(2)) with 29 patients (39%) below ≤18.5 kg/m(2). FFMI (measured in 65 patients) had a median of 15.2 kg/m(2) (range: 11.1 to 22.4 kg/m(2)) with 39 patients (60%) ≤16.7 kg/m(2) (men) or ≤14.6 kg/m(2) (women). Median energy intake was 2800 kcal, 239 kcal higher than the estimated energy requirement. However, 8 patients consumed ≥500 kcal less than recommended. Protein intake was 104 (range 60-187) g or 1.9 g/kg per day. Despite dietetic intervention with oral nutritional supplements (ONS) (36 patients), tube feeding (12 patients), or both (13 patients), BMI and FFMI hardly improved pre-LTX. LTX was performed in 51 patients (68%); 10 patients died during follow-up, median survival time was 41 months. A BMI ≤18.5 kg/m(2) was more prevalent in patients who died before LTX (6/9) or who died after LTX (4/10) than in patients who were still alive on the waiting list (5/15) or who survived LTX (14/41). Results for FFMI were comparable. From 6-12 months post-LTX, BMI and FFMI markedly improved, especially in underweight patients. A BMI ≤18.5 kg/m(2) and an FFMI ≤16.7 kg/m(2) (men) or ≤14.6 kg/m(2) (women) appears to impair survival in LTX candidates with CF. Patients maintained a low body weight before LTX. After LTX weight gain is achieved. © 2013. Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society. All rights reserved.

Evidence analysis library review of best practices for performing indirect calorimetry in healthy and non-critically ill individuals.

PubMed

Fullmer, Susan; Benson-Davies, Sue; Earthman, Carrie P; Frankenfield, David C; Gradwell, Erica; Lee, Peggy S P; Piemonte, Tami; Trabulsi, Jillian

2015-09-01

When measurement of resting metabolic rate (RMR) by indirect calorimetry is necessary, following evidence-based protocols will ensure the individual has achieved a resting state. The purpose of this project was to update the best practices for measuring RMR by indirect calorimetry in healthy and non-critically ill adults and children found the Evidence Analysis Library of the Academy of Nutrition and Dietetics. The Evidence Analysis process described by the Academy of Nutrition and Dietetics was followed. The Ovid database was searched for papers published between 2003 and 2012 using key words identified by the work group and research consultants, studies used in the previous project were also considered (1980 to 2003), and references were hand searched. The work group worked in pairs to assign papers to specific questions; however, the work group developed evidence summaries, conclusion statements, and recommendations as a group. Only 43 papers were included to answer 21 questions about the best practices to ensure an individual is at rest when measuring RMR in the non-critically ill population. In summary, subjects should be fasted for at least 7 hours and rest for 30 minutes in a thermoneutral, quiet, and dimly lit room in the supine position before the test, without doing any activities, including fidgeting, reading, or listening to music. RMR can be measured at any time of the day as long as resting conditions are met. The duration of the effects of nicotine and caffeine and other stimulants is unknown, but lasts longer than 140 minutes and 240 minutes, respectively. The duration of the effects of various types of exercise on RMR is unknown. Recommendations for achieving steady state, preferred gas-collection devices, and use of respiratory quotient to detect measurement errors are also given. Of the 21 conclusions statements developed in this systemic review, only 5 received a grade I or II. One limitation is the low number of studies available to address the questions and most of the included studies had small sample sizes and were conducted in healthy adults. More research on how to conduct an indirect calorimetry measurement in healthy adults and children and in sick, but not critically ill, individuals is needed. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Position of the American Dietetic Association: health implications of dietary fiber.

PubMed

Marlett, Judith A; McBurney, Michael I; Slavin, Joanne L

2002-07-01

Dietary fiber consists of the structural and storage polysaccharides and lignin in plants that are not digested in the human stomach and small intestine. A wealth of information supports the American Dietetic Association position that the public should consume adequate amounts of dietary fiber from a variety of plant foods. Recommended intakes, 20-35 g/day for healthy adults and age plus 5 g/day for children, are not being met, because intakes of good sources of dietary fiber, fruits, vegetables, whole and high-fiber grain products, and legumes are low. Consumption of dietary fibers that are viscous lowers blood cholesterol levels and helps to normalize blood glucose and insulin levels, making these kinds of fibers part of the dietary plans to treat cardiovascular disease and type 2 diabetes. Fibers that are incompletely or slowly fermented by microflora in the large intestine promote normal laxation and are integral components of diet plans to treat constipation and prevent the development of diverticulosis and diverticulitis. A diet adequate in fiber-containing foods is also usually rich in micronutrients and nonnutritive ingredients that have additional health benefits. It is unclear why several recently published clinical trials with dietary fiber intervention failed to show a reduction in colon polyps. Nonetheless, a fiber-rich diet is associated with a lower risk of colon cancer. A fiber-rich meal is processed more slowly, which promotes earlier satiety, and is frequently less calorically dense and lower in fat and added sugars. All of these characteristics are features of a dietary pattern to treat and prevent obesity. Appropriate kinds and amounts of dietary fiber for the critically ill and the very old have not been clearly delineated; both may need nonfood sources of fiber. Many factors confound observations of gastrointestinal function in the critically ill, and the kinds of fiber that would promote normal small and large intestinal function are usually not in a form suitable for the critically ill. Maintenance of body weight in the inactive older adult is accomplished in part by decreasing food intake. Even with a fiber-rich diet, a supplement may be needed to bring fiber intakes into a range adequate to prevent constipation. By increasing variety in the daily food pattern, the dietetics professional can help most healthy children and adults achieve adequate dietary fiber intakes.

Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets.

PubMed

2003-06-01

It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred, and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians, including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life cycle, including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits, including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fiber, magnesium, potassium, folate, and antioxidants such as vitamins C and E and phytochemicals. Vegetarians have been reported to have lower body mass indices than nonvegetarians, as well as lower rates of death from ischemic heart disease; vegetarians also show lower blood cholesterol levels; lower blood pressure; and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. Although a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because of the variability of dietary practices among vegetarians, individual assessment of dietary intakes of vegetarians is required. Dietetics professionals have a responsibility to support and encourage those who express an interest in consuming a vegetarian diet. They can play key roles in educating vegetarian clients about food sources of specific nutrients, food purchase and preparation, and any dietary modifications that may be necessary to meet individual needs. Menu planning for vegetarians can be simplified by use of a food guide that specifies food groups and serving sizes.

Position of the American Dietetic Association and Dietitians of Canada: vegetarian diets.

PubMed

2003-01-01

It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life-cycle including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fibre, magnesium, potassium, folate, antioxidants such as vitamins C and E, and phytochemicals. Vegetarians have been reported to have lower body mass indices than non-vegetarians, as well as lower rates of death from ischemic heart disease, lower blood cholesterol levels, lower blood pressure, and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. While a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because of the variability of dietary practices among vegetarians, individual assessment of dietary intakes of vegetarians is required. Dietetics professionals have a responsibility to support and encourage those who express an interest in consuming a vegetarian diet. They can play key roles in educating vegetarian clients about food sources of specific nutrients, food purchase and preparation, and any dietary modifications that may be necessary to meet individual needs. Menu planning for vegetarians can be simplified by use of a food guide that specifies food groups and serving sizes.

Efficacy of Lactobacillus reuteri DSM 17938 for infantile colic

PubMed Central

Gutiérrez-Castrellón, Pedro; Indrio, Flavia; Bolio-Galvis, Alexis; Jiménez-Gutiérrez, Carlos; Jimenez-Escobar, Irma; López-Velázquez, Gabriel

2017-01-01

Abstract Background: 5% to 40% of infants cry excessively, usually accompanied by fussiness and excessive of gas. There are no uniform criteria for treatment of infantile colic. Lactobacillus reuteri DSM 17938 has been used with promising results. The objective of this network-meta-analysis (NMA) is to compare the efficacy of L reuteri DSM 17938 with other interventions for infantile colic. Methods: RCTs, published between 1960 and 2015 for the treatment of infantile colic were included. Primary outcome was duration of crying after 21 to 28 days of treatment. Different databases were searched. Information was analyzed using control group as central axis. A random effect model was used. Hedges standard mean difference (SMD) and odds ratio (OR) were calculated. A SUCRA analysis was performed to evaluate superiority for each intervention. Results: 32 RCTs were analyzed, including 2242 patients. Studies with L reuteri DSM 17938 versus Ctrl., Diet versus Ctrl. and Acupuncture versus Ctrl. were the most influential studies in the NMA. L reuteri DSM 17938 [WMD −51.3 h (CI95% −72.2 to −30.5 h), P .0001] and dietetic approaches [WMD −37.4 h (CI95% −56.1 to −18.7 h), P .0001] were superior compared to the other treatments. Conclusions: L reuteri DSM 17938 and some dietetic approaches are better to other interventions for treatment of infantile colic. PMID:29390535

[Eating behavior and life styles: research and action on nutrition in a rural area].

PubMed

Grand-Filaire, A; Monnier, E; Grand, A; Pous, J; Douste-Blazy, P; Palustran, N

1986-12-01

Nutrition education has sometimes been portrayed as a normative discourse, forgetting that nutrition is at the heart of basic lifestyle habits. In fact, eating not only satisfies a basic need, it is a social and communication action that develops an interaction with a person's socio-economic and cultural framework. This article describes an educational programme that involved all 2,200 inhabitants of a small rural town in the south of France. The purpose of the study was to better define what was involved in the development of eating behaviours in order to adapt information for the population. Two hundred families, 28% of the town, were provided with a survey questionnaire. Questions about socio-economic and cultural data of the families, types of food provisions, cooking initiation, perceived knowledge of dietetics, and ways of sociability were included. This research permitted the identification of different profiles of eaters: working class families, the elderly, families without children, etc... The subsequent information campaign attempted to adapt its message to each category identified, taking into consideration economic and psychosocial factors, the attachment of the population to its culinary patrimony, and the pejorative vision of dietetics perceived by part of the population. The entire community collaborated at each stage of the programme. Conceived as a research project, it contributed to motivating the population to take an active role in the management of its health problems.

The influence of sociocultural factors on the eating attitudes of Lebanese and Cypriot students: a cross-cultural study.

PubMed

Zeeni, N; Gharibeh, N; Katsounari, I

2013-07-01

The present comparative cross-cultural study aimed to explore the relationship between eating behaviour and sociocultural influences with respect to appearance and body image in female university students from two cultural contexts, namely Cyprus and Lebanon. The Dutch Eating Behavior questionnaire (DEBQ) and the Perceived Sociocultural Influences on Body Image and Body Change Questionnaire were used to assess sociocultural influences and body image, respectively, in 200 students from each country. The results indicated that the Lebanese students were more likely to engage in emotional and external eating and their body image was impacted to a larger extent by sociocultural agents, including media influences, compared to the Cypriot students. Also, a positive relationship was found between emotional and external eating in both cultures. Finally, sociocultural influences correlated positively with external eating only in the Cypriot sample. Culture-specific factors, such as the societal values and norms, as well as the Westernisation history of each country, are discussed as underpinnings for the differences found. These findings are significant for understanding the rise of eating pathology in these two cultures and provide evidence for a need to consider cultural environment when designing public health policies addressing the negative aspects of nutrition transition. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Merging dietary assessment with the adolescent lifestyle.

PubMed

Schap, T E; Zhu, F; Delp, E J; Boushey, C J

2014-01-01

The use of image-based dietary assessment methods shows promise for improving dietary self-report among children. The Technology Assisted Dietary Assessment (TADA) food record application is a self-administered food record specifically designed to address the burden and human error associated with conventional methods of dietary assessment. Users would take images of foods and beverages at all eating occasions using a mobile telephone or mobile device with an integrated camera [e.g. Apple iPhone, Apple iPod Touch (Apple Inc., Cupertino, CA, USA); Nexus One (Google, Mountain View, CA, USA)]. Once the images are taken, the images are transferred to a back-end server for automated analysis. The first step in this process is image analysis (i.e. segmentation, feature extraction and classification), which allows for automated food identification. Portion size estimation is also automated via segmentation and geometric shape template modeling. The results of the automated food identification and volume estimation can be indexed with the Food and Nutrient Database for Dietary Studies to provide a detailed diet analysis for use in epidemiological or intervention studies. Data collected during controlled feeding studies in a camp-like setting have allowed for formative evaluation and validation of the TADA food record application. This review summarises the system design and the evidence-based development of image-based methods for dietary assessment among children. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Transgenic mammalian species, generated by somatic cell cloning, in biomedicine, biopharmaceutical industry and human nutrition/dietetics--recent achievements.

PubMed

Samiec, M; Skrzyszowska, M

2011-01-01

Somatic cell cloning technology in mammals promotes the multiplication of productively-valuable genetically engineered individuals, and consequently allows also for standardization of transgenic farm animal-derived products, which, in the context of market requirements, will have growing significance. Gene farming is one of the most promising areas in modern biotechnology. The use of live bioreactors for the expression of human genes in the lactating mammary gland of transgenic animals seems to be the most cost-effective method for the production/processing of valuable recombinant therapeutic proteins. Among the transgenic farm livestock species used so far, cattle, goats, sheep, pigs and rabbits are useful candidates for the expression of tens to hundreds of grams of genetically-engineered proteins or xenogeneic biopreparations in the milk. At the beginning of the new millennium, a revolution in the treatment of disease is taking shape due to the emergence of new therapies based on recombinant human proteins. The ever-growing demand for such pharmaceutical or nutriceutical proteins is an important driving force for the development of safe and large-scale production platforms. The aim of this paper is to present an overall survey of the state of the art in investigations which provide the current knowledge for deciphering the possibilities of practical application of the transgenic mammalian species generated by somatic cell cloning in biomedicine, the biopharmaceutical industry, human nutrition/dietetics and agriculture.

Exploring approaches to dietetic assessment of a common task across different universities through assessment moderation.

PubMed

Palermo, C; Volders, E; Gibson, S; Kennedy, M; Wray, A; Thomas, J; Hannan-Jones, M; Gallegos, D; Beck, E

2018-02-01

Assessment presents one of the greatest challenges to evaluating health professional trainee performance, as a result of the subjectivity of judgements and variability in assessor standards. The present study aimed to test a moderation procedure for assessment across four independent universities and explore approaches to assessment and the factors that influence assessment decisions. Assessment tasks designed independently by each of the four universities to assess student readiness for placement were chosen for the present study. Each university provided four student performance recordings for moderation. Eight different academic assessors viewed the student performances and assessed them using the corresponding university assessment instrument. Assessment results were collated and presented back to the assessors, together with the original university assessment results. Results were discussed with assessors to explore variations. The discussion was recorded, transcribed, thematically analysed and presented back to all assessors to achieve consensus on the emerging major learnings. Although there were differences in absolute scores, there was consistency (12 out of 16 performances) in overall judgement decisions regarding placement readiness. Proficient communication skills were considered a key factor when determining placement readiness. The discussion revealed: (i) assessment instruments; (ii) assessor factors; and (iii) the subjectivity of judgement as the major factors influencing assessment. Assessment moderation is a useful method for improving the quality of assessment decisions by sharing understanding and aligning standards of performance. © 2017 The British Dietetic Association Ltd.

2016 Health Care & Education Presidential Address: If DSME Were a Pill, Would You Prescribe It?

PubMed

Powers, Margaret A

2016-12-01

This address was delivered by Margaret A. Powers, PhD, RD, CDE, President, Health Care & Education, of the American Diabetes Association (ADA), at the ADA's 76th Scientific Sessions in New Orleans, LA, on 11 June 2016. Dr. Powers conducts research and has a clinical practice as a registered dietitian and diabetes educator at the International Diabetes Center at Park Nicollet in Minneapolis. Her research focuses on improving diabetes outcomes including factors that affect the clinical, psychosocial, and behavioral aspects of diabetes. Dr. Powers has been an ADA volunteer for more than 25 years, including serving as a founding editor of Diabetes Spectrum She is the lead author of the 2015 joint Position Statement on Diabetes Self-management Education and Support published by the ADA, American Association of Diabetes Educators, and Academy of Nutrition and Dietetics. She is the recipient of the ADA's Outstanding Educator in Diabetes Award and has published research, authored numerous articles and chapters, published five books, and is an international presenter. Dr. Powers holds a doctorate in education with a focus on performance improvement from Capella University. She received her Master of Science from the University of Illinois at Chicago and her Bachelor of Science from Michigan State University. She completed her dietetic internship at Cook County Hospital in Chicago. © 2016 by the American Diabetes Association.

Position of the American Dietetic Association and Dietitians of Canada: dietary fatty acids.

PubMed

Kris-Etherton, Penny M; Innis, Sheila; Ammerican Dietetic Assocition; Dietitians of Canada

2007-09-01

It is the position of the American Dietetic Association (ADA) and Dietitians of Canada (DC) that dietary fat for the adult population should provide 20% to 35% of energy and emphasize a reduction in saturated fatty acids and trans-fatty acids and an increase in n-3 polyunsaturated fatty acids. ADA and DC recommend a food-based approach for achieving these fatty acid recommendations; that is, a dietary pattern high in fruits and vegetables, whole grains, legumes, nuts and seeds, lean protein (ie, lean meats, poultry, and low-fat dairy products), fish (especially fatty fish high in n-3 fatty acids), and use of nonhydrogenated margarines and oils. Implicit to these recommendations for dietary fatty acids is that unsaturated fatty acids are the predominant fat source in the diet. These fatty acid recommendations are made in the context of a diet consistent with energy needs (ie, to promote a healthful body weight). ADA and DC recognize that scientific knowledge about the effects of dietary fats on human health is incomplete and take a prudent approach in recommending a reduction in those fatty acids that increase risk of disease, while promoting intake of those fatty acids that benefit health. Registered dietitians play a pivotal role in translating dietary recommendations for fat and fatty acids into healthful dietary patterns for different population groups.

Evolution of food provision to athletes at the summer Olympic Games.

PubMed

Pelly, Fiona E; O'Connor, Helen T; Denyer, Gareth S; Caterson, Ian D

2011-06-01

The history of food provision at the summer Olympic Games (OG) over the past century (1896-2008) provides insight into the evolution of sports nutrition research and the dietary strategies of athletes. Early research favoring protein as the main fuel for exercise was reflected in OG menus from 1932 to 1968. Despite conclusive research from the 1960s demonstrating the clear benefit of carbohydrate on exercise performance, a specific emphasis on carbohydrate-rich foods was not noted until the 1970s. Athlete food preferences and catering complexity evolved rapidly between 1970 and 2000, driven predominantly by a dramatic expansion of the OG and the emergence of systematic sports nutrition research. Nutritional advice by experts and sponsorship by food companies became increasingly important beginning with the 1984 Los Angeles OG. More recent developments include nutritional labeling of menu items and provision of a nutrition information desk (Barcelona 1992), demand for a "high-starch, low-fat menu" (Atlanta 1996), the addition of a dedicated menu website and the systematic gathering of information on athletes' apparent consumption (Sydney 2000), and appointment of the first international dietetic review committee (Beijing 2008). The history of catering at the OG tracks the evolution of sports nutrition practice from anecdotes and myth towards an established specialty in nutrition and dietetics grounded in evidence-based science. © 2011 International Life Sciences Institute.

The impact of instrumental feeding on children's responses to taste exposure.

PubMed

Añez, E; Remington, A; Wardle, J; Cooke, L

2013-10-01

In a recent study, we showed that nonfood incentives combined with taste exposure increase children's acceptance of vegetables. However, the impact of children's previous experience of receiving food rewards is unknown. The present study investigated whether the experience of food rewards affects responses to an exposure-plus-reward intervention. One hundred and thirty-seven parents of 4-6-year-old children taking part in an exposure-based intervention study completed an instrumental feeding (IF) questionnaire aiming to assess their use of food rewards. Based on these scores, children were categorised as frequently or rarely instrumentally-fed. Intervention groups were given 12 daily tastes of a target vegetable combined with no reward, a tangible reward, (sticker) or a verbal reward (praise). A no-treatment control group received no tastings. Liking and intake of a target vegetable were measured at baseline and post-intervention. Irrespective of experience of IF, children in all intervention groups increased liking compared to controls (all P < 0.001) and both reward groups increased intake compared to controls (both P < 0.05). However, in the nonrewarded exposure group, only children with a limited experience with food rewards increased consumption (P < 0.05). Experience of IF may limit the benefits of 'mere exposure'. However, exposure with nonfood rewards can increase the acceptance of vegetables, regardless of previous experience. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Trying to lose weight: diet strategies among Americans with overweight or obesity in 1996 and 2003.

PubMed

Andreyeva, Tatiana; Long, Michael W; Henderson, Kathryn E; Grode, Gabrielle M

2010-04-01

Health professionals recommend that individuals with overweight and obesity lose weight by reducing energy intake while maintaining a healthful diet. This study was designed to examine trends in weight loss attempts and strategies for adults with overweight or obesity among different sociodemographic groups. Data from the 1996 and 2003 Behavioral Risk Factor Surveillance System were used to estimate changes in weight loss attempts and strategies across population groups. Data were analyzed in 2009. Slightly more adults with overweight or obesity attempted weight loss in 2003 compared to 1996. There were substantial changes in the diet approaches reported: rates of those using energy restriction to lose weight doubled between 1996 and 2003, whereas low-fat dieting decreased by one third. Hispanic and less-educated adults did not shift away from low-fat diets. Attempted weight loss was associated with higher fruit and vegetable consumption for most population groups. Increasingly more adults with overweight or obesity tried to lose weight through energy reduction, but some at-risk groups did not follow this beneficial trend between 1996 and 2003. Dietetics practitioners and public health campaigns should target such groups with concrete recommendations to reduce energy intake while maintaining a healthful diet, including adequate consumption of fruit and vegetables. Copyright (c) 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

[Dietetic factors associated with prostate cancer: protective effects of Mediterranean diet].

PubMed

Ferrís-Tortajada, J; Berbel-Tornero, O; García-Castell, J; Ortega-García, J A; López-Andreu, J A

2012-04-01

To review diet risk factors (RF) implied, more or less evidence-based, in the etiopathology of prostate carcinoma (PC), especially those that characterize the traditional Mediterranean diet (MD). Literature review of PC related diet RF in MedLine, CancerLit, Science Citation Index y Embase. Search profiles were "Dietetic Factors/Nutritional Factors/Mediterranean Diet/Primary Prevention", and "Prostate Cancer". Diet RF are associated with 35% of cancer mortality and 10-12% of PC mortality. The main diet RF, implied in the development of PC but with a protective effect, which are considered characteristic of MD are: high daily ingestion of vegetarian products (cereals, legumes, dried and fresh fruits, tubers, vegetables..); olive oil as main lipid source; low intake of animal saturated fat, processed red meat, milk and dairy products; regular consumption of small fish; and low alcohol intake (wine with meals). The MD contains many phytoactive compounds (lycopene, lupeol, quercetin, genistein, carnosol, resveratrol, catechins, vitamins..) with PC protective effects. Diet RF have a role on prostatic carcinogenesis. Further epidemiologic studies with better designs are needed to clarify PC related diet RF. PC risk is reduced in persons on MD compared with those on Western diet. The preventive effect of MD is due to the great number and quality of phytochemicals with antioxidant and antinflammatory properties that contains. Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.

[Nocturnal spasmodic cough in the infant. Evolution after antireflux treatment].

PubMed

Dordal, M T; Baltazar, M A; Roca, I; Marques, L; Server, M T; Botoy, J

1994-02-01

Several studies have shown the relationship between gastro-oesophageal reflux, bronchial asthma and chronic nocturnal cough and this should not be neglected, particularly in patients who present an unfavourable development in spite of conventional treatment. For diagnosis of gastroesophageal reflux, amongst other investigations, esophageal gammagraphy of swallowing, that detects alterations in the mobility of the oesophagus, secondary to a possible oesophagitis. The objective of this study was to evaluate the clinical progress and gammagraphy of a group of children with chronic predominantly nocturnal cough (with or without bronchial asthma) with initially pathological esophageal gammagraphy, after three months of treatment with gastrokinetic drugs (cisapride against domperidone) and postural dietetic limits, in comparison with a reference group who, although having followed the limits in question had not received the pharmacological treatment. From the clinical viewpoint, cough disappeared in 64.5% of cases without significant statistical differences between the two groups. Gammagraphy became normal in 20/55 cases, improved in 10/55 cases and was unchanged in 25/55. Although there was no significant difference, gammagraphy development was better in children who received domperidone. The agreement between clinical progress and gammagraphy was 60% with a large number of false positives in the gammagraphy. We believe that the simple introduction of the postural-dietetic measures may improve the clinical control in the type of patients who present with a chronic nocturnally predominant cough that does not yield to conventional treatment.

Food choice and nutrient intake amongst homeless people.

PubMed

Sprake, E F; Russell, J M; Barker, M E

2014-06-01

Homeless people in the UK and elsewhere have typically been found to consume a nutritionally inadequate diet. There is need for contemporary research to update our understanding within this field. The present study aimed to provide an insight into the nutrient intake and food choice of a sample of homeless adults. In this mixed-methods study, 24 homeless individuals accessing two charitable meal services in Sheffield, UK, participated in up to four 24-h dietary recalls between April and August 2012. Twelve individuals took part in a semi-structured interview focusing on food choice. Energy intake was significantly lower than the estimated average requirement. Median intakes of vitamin A, zinc, magnesium, potassium and selenium were significantly lower than reference nutrient intakes. Contributions of saturated fat and nonmilk extrinsic sugars to total energy intake were significantly higher, whereas dietary fibre was significantly lower, than population average intakes. Charitable meals made an important contribution to intakes of energy and most micronutrients. Thematic analysis of interview transcripts revealed three major themes: food aspirations; constraints over food choice; and food representing survival. The present study reveals risk of dietary inadequacies amongst homeless people alongside a lack of control over food choices. Charitable meal services are suggested as a vehicle for improving the dietary intake and nutritional health of homeless people. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Productivity and Time Use during Occupational Therapy and Nutrition/Dietetics Clinical Education: A Cohort Study

PubMed Central

Rodger, Sylvia; Stephens, Elizabeth; Clark, Michele; Ash, Susan; Hurst, Cameron; Graves, Nicholas

2012-01-01

Background Currently in the Australian higher education sector higher productivity from allied health clinical education placements is a contested issue. This paper will report results of a study that investigated output changes associated with occupational therapy and nutrition/dietetics clinical education placements in Queensland, Australia. Supervisors’ and students’ time use during placements and how this changes for supervisors compared to when students are not present in the workplace is also presented. Methodology/Principal Findings A cohort design was used with students from four Queensland universities, and their supervisors employed by Queensland Health. There was an increasing trend in the number of occasions of service delivered when the students were present, and a statistically significant increase in the daily mean length of occasions of service delivered during the placement compared to pre-placement levels. Conclusions/Significance A novel method for estimating productivity and time use changes during clinical education programs for allied health disciplines has been applied. During clinical education placements there was a net increase in outputs, suggesting supervisors engage in longer consultations with patients for the purpose of training students, while maintaining patient numbers. Other activities were reduced. This paper is the first time these data have been shown in Australia and form a sound basis for future assessments of the economic impact of student placements for allied health disciplines. PMID:22952964

[Common competencies and contents in public health in graduate programs].

PubMed

Davó, M A Carmen; Vives-Cases, Carmen; Benavides, Fernando García; Alvarez-Dardet, Carlos; Segura-Benedicto, Andreu; Icart, Teresa; Astasio, Paloma; Gil, Angel; Ortiz, M Del Rocío; García, Angel; Ronda, Elena; Bosch, Félix

2011-01-01

To identify fundamental public health competencies and contents in nursing, pharmacy, teaching, medicine, human nutrition and dietetics, optics and optometry, labor relations and human resources, and social work in graduate programs and to formulate proposals for their improvement. The workshop on Public health contents in graduate programs in the XXI Menorca Public Health School was organized as follows: eight groups were set up, coordinated by 37 Spanish university teachers participating in the workshop and selected through key informants and snowball techniques. Two studies on public health professional competencies and the participants' own graduate programs were used to discuss public health professional competencies and contents and establish recommendations to improve public health programs. Each group worked on a particular degree course and the results were shared in plenary. Professional competencies for the three essential public health functions were indentified in all the degrees, except teaching, optics and optometry, and social work. Some of the competencies included in degrees in nursing, teaching, human nutrition and dietetics, and social work were rewritten to highlight the role of each type of professional in public health functions. The groups agreed on the introductory topics (basic concepts and health determinants) and intervention strategies. Common competencies and contents were identified in graduate programs. Updating public health contents in graduate programs would help to define and promote the profile of public health professionals. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Aneurysmal portahepatic venous fistula: Report of two cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chagnon, S.F.; Vallee, C.A.; Barge, J.

1986-06-01

Two cases are reported of congenital intrahepatic portacaval shunts in middle-aged women who had encephalopathy or hypoglycemia. Real-time ultrasound (US) investigations revealed vascular communication between the left portal and hepatic veins in one patient and communication between the right portal and hepatic veins in the other. These findings were confirmed using angiography with pressure measurement. One patient underwent surgery; the other received dietetic treatment. The findings in these two cases are compared with those of three previously reported cases.

PSA-Based Screening Outcomes, Dietary Heterocyclic Amine Exposure, and Prostate Cancer Risk in African Americans

DTIC Science & Technology

2008-06-01

al., 1993; Kaderlik et al., 1994a-b; Takahashi et al., 1998; Schut and Snyderwine, 1999; Gooderham et al., 2002). In male lacI trangenic rats, a diet ...Detailed data on diet and meat consumption continue to be obtained by in-person interviews using established questionnaires, each followed by PSA...questionnaire for use in diet and cancer studies. J. Am. Dietetic Assoc. 107, 1356-62. [see Appendix of this report] Bogen KT, GA Keating II, JM

Diet and dietetics in al-Andalus.

PubMed

Salas-Salvadó, Jordi; Huetos-Solano, Maria D; García-Lorda, Pilar; Bulló, Mònica

2006-08-01

Al-Andalus society (711-1492) based its idea of health on the wisdom of Classical Greece, the Hippocratic-Galenic theories, as well as the Persian and Hindu cultures. The twelfth century in al-Andalus is considered to be the most prolific period for works of a scientific and technical nature. At the time, the main treatises on dietetics were written and this science reached its widest expression with such leading figures as Ibn Wāfīd, Avenzoar, Averroes and Maimonides, whose works revealed the first scientific knowledge on the nutritional processes of the human body. Diet was regarded as being essential for health and the prevention of disease. Dietary guidelines were written for different age groups, different body types and different seasons of the year. The amount of food to be ingested, the number of meals recommended and the order in which the food should be consumed were all issues that were discussed. A variety of foods were thought to have medicinal properties, some of which are known today. The diet in al-Andalus was varied and very probably made a substantial contribution to the origin of the present-day Mediterranean diet, rich in olive oil, wholemeal cereals, fruit and vegetables, fish, lamb, poultry, nuts and spices. We also find that many of the terms in current use in diet and agriculture are a living testimony to the Arabic influence, as are many of the dishes of our varied Mediterranean gastronomy.

A Consensus Model: Shifting assessment practices in dietetics tertiary education.

PubMed

Bacon, Rachel; Kellett, Jane; Dart, Janeane; Knight-Agarwal, Cathy; Mete, Rebecca; Ash, Susan; Palermo, Claire

2018-02-21

The aim of this research was to evaluate a Consensus Model for competency-based assessment. An evaluative case study was used to allow a holistic examination of a constructivist-interpretivist programmatic model of assessment. Using a modified Delphi process, the competence of all 29 students enrolled in their final year of a Master of Nutrition and Dietetics course was assessed by a panel (with expertise in competency-based assessment; industry and academic representation) from a course e-portfolio (that included the judgements of student performance made by worksite educators) and a panel interview. Data were triangulated with assessments from a capstone internship. Qualitative descriptive studies with worksite educators (focus groups n = 4, n = 5, n = 8) and students (personal interviews n = 29) explored stakeholder experiences analysed using thematic analysis. Panel consensus was achieved for all cases by the third-round and corroborated by internship outcomes. For 34% of students this differed to the 'interpretations' of their performance made by their worksite educator/s. Emerging qualitative themes from stakeholder data found the model: (i) supported sustainable assessment practices; (ii) shifted the power relationship between students and worksite educators and (iii) provided a fair method to assess competence. To maximise benefits, more refinement, resources and training are required. This research questions competency-based assessment practices based on discrete placement units and supports a constructivist-interpretivist programmatic approach where evidence across a whole course of study is considered by a panel of assessors. © 2018 Dietitians Association of Australia.

Agreement between different methods of measuring height in elderly patients.

PubMed

Frid, H; Adolfsson, E Thors; Rosenblad, A; Nydahl, M

2013-10-01

The present study aimed to examine the agreement between measurements of standing height and self-reported height, height measured with a sliding caliper, and height estimated from either demispan or knee height in elderly patients. Fifty-five patients (mean age 79 years) at a Swedish hospital were included in this observational study. The participants' heights were evaluated as the standing height, self-reported height, height measured in a recumbent position with a sliding caliper, and height estimated from the demispan or knee height. The measurements made with a sliding caliper in the recumbent position agreed most closely with the standing height. Ninety-five percent of the individuals' differences from standing height were within an interval of +1.1 to -4.8 cm (limits of agreement). Self-reported height and height estimated from knee height differed relatively strongly from standing height. The limits of agreement were +5.2 to -9.8 cm and +9.4 to -6.2 cm, respectively. The widest distribution of differences was found in the height estimated from the demispan, with limits of agreements from +11.2 to -9.3 cm. When measuring the height of patients who find it difficult to stand upright, a sliding caliper should be the method of choice, and the second choice should be self-reported height or the height estimated from knee height. Estimating height from the demispan should be the method of last resort. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Body fat distribution, serum glucose, lipid and insulin response to meals in Alström syndrome.

PubMed

Paisey, R B; Hodge, D; Williams, K

2008-06-01

Alström syndrome is an autosomal recessive condition characterized by obesity, insulin resistance and hypertriglyceridaemia. Responses to fat and carbohydrate ingestion are important in planning dietetic advice and may help to explain the mechanism of metabolic disorder in the syndrome. After a 12-h fast, five Alström subjects received a 3.1 MJ (742 kcal), 75.8% fat breakfast on day 1, and a 3.3 MJ (794 kcal), 77.5% carbohydrate breakfast on day 2. Serum glucose, triglyceride and insulin levels were measured at baseline, and 2 and 3.5 h post-meal. Abdominal computerized tomography in three subjects and magnetic resonance imaging in one demonstrated distribution of abdominal fat. Body fat was distributed subcutaneously, as well as viscerally. There were no changes in serum glucose, insulin or triglycerides after the high fat meal. Triglycerides remained stable after the high carbohydrate meal but glucose and log insulin levels increased [8.4 +/- 4.1 to 13.4 +/- 6.9 mmol L(-1) (P < 0.05) and 2.6 +/- 0.27 to 3.15 +/- 0.42 pmol L(-1) (P < 0.05), respectively]. Dietetic advice in Alström syndrome must include calorie restriction to reduce obesity, which is predominantly subcutaneous. This study has shown that low carbohydrate advice may prove more effective than fat restriction in control of hyperglycaemia and hyperinsulinism. A single high energy meal does not exacerbate hypertriglyceridaemia.

A systematic review of the unit costs of allied health and community services used by older people in Australia.

PubMed

Farag, Inez; Sherrington, Cathie; Ferreira, Manuela; Howard, Kirsten

2013-02-20

An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. A comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made. The number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72. Utilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation.

Premorbid dietetic habits and risk for Parkinson's disease.

PubMed

Ayuso-Peralta, L; Jiménez-Jiménez, F J; Cabrera-Valdivia, F; Molina, J; Javier, M R; Almazán; De Pedro-Cuesta, J; Tabernero, C; Giménez-Roldán, S

1997-01-01

To evaluate the possible role of antioxidant (vitamins A, E, C, beta-carotene, zinc, selenium) or pro-oxidant (iron, copper, manganese) factors present in the diet, in the risk for Parkinson's disease (PD), we conducted a dietetic study (pre- and postmarriage) which included 91 foodstuffs. We interviewed separately 119 PD patients (64 males, 55 females, age 65.3 +/- 8.5 years, age at marriage 27.8 +/- 5.9 years) and their spouses (age 65.0 +/- 9.2 years, age at marriage 27.2 +/- 5.9 years) as the control group (C). Premarriage consumption for each foodstuff was classified into: (1) rarely of annually, (2) monthly, or (3) weekly; and postmarriage consumption (which included the period between age at marruage and age 40 years; only concordant answers were considered to be valid) into: (1) PD > Control, (2) Control > PD, and (3) PD = Control. The premarriage interview showed a trend towards a lower consumption of peas in PD patients as compared to controls. The postmarriage interview in PD patients showed a higher tendency for the consumption of rice, bluefish, liver paté and eggs, and a less consumption of tea than controls. We were unable to find any consistent trend towards a lower consumption of vitamins E and C during adulthood in PD patients, but they seemed to have eaten selenium-rich foodstuffs more frequently than controls. These results differ from those obtained by previous studies, and question the possible role of premorbid dietary habits on the risk for PD.

High-protein goat's milk diet identified through newborn screening: clinical warning of a potentially dangerous dietetic practice.

PubMed

Maines, Evelina; Gugelmo, Giorgia; Tadiotto, Elisa; Pietrobelli, Angelo; Campostrini, Natascia; Pasini, Andrea; Ion-Popa, Florina; Vincenzi, Monica; Teofoli, Francesca; Camilot, Marta; Bordugo, Andrea

2017-10-01

Breast-feeding is an unequalled way of providing optimal food for infants' healthy growth and development and the WHO recommends that infants should be exclusively breast-fed for the first 6 months of life. For mothers who are unable to breast-feed or who decide not to, infant formulas are the safest alternative. Despite recommendations, it is possible that parents make potentially harmful nutritional choices for their children because of cultural beliefs or misinformation on infant nutrition. We describe a possible health risk of not breast-feeding, highlighting a potentially dangerous dietetic practice. Design/Setting/Subjects We report the case of a newborn who was fed with undiluted goat's milk because her mother could not breast-feed and was not aware of infant formulas. The dietary mistake was detected because of a positive expanded newborn screening result, characterized by severe hypertyrosinaemia with high methionine and phenylalanine levels, a pattern suggestive of severe liver impairment. The pattern of plasma amino acids was related to a goat's milk diet, because of its very different composition compared with human milk and infant formula. Our experience demonstrates that, when breast-feeding is not possible or is not exclusive, infants may be at risk of dangerous nutritional practices, including diets with very high protein content, such as a goat's milk diet. Families of not breast-fed infants may need appropriate advice on safe alternatives for infant nutrition to avoid the risks of inappropriate diets.

Examples and experience: on the uncertainty of medicine.

PubMed

Pender, Stephen

2006-03-01

After a brief account of the uncertainty of medicine in early modern thought, this paper focuses on two supple, sophisticated accounts of medicine by 'non-medical' writers--Michel de Montaigne's views of medical theory and medical practice and Francis Bacon's proposals for renovating both--in which the claims of individual sufferers are set against the normativity of medicine as a whole. From around 1500 to around 1680, in the common ensemble of both learned and popular invective, medicine was disparaged as poor philosophy and worse practice, even as the 'lowest of professions'. In remarkably broad, elegant interventions, Montaigne argues that medicine is based on 'examples and experience' (and 'so is my opinion', he adds), impugning its universalizing claims with the tractable experience of his own embodiment, with his own historia and consilium, while Francis Bacon enlists dietetics, Hippocratic case-taking and medical history in his broad programme for the reform of medicine. He more or less accepts Montaigne's argument for particularity in medical theory and practice, but presses the particular into service in his reformist programme. Like many sixteenth- and early seventeenth-century scholars and physicians frustrated with Galenic methods and models, both turn to Hippocratic practice and to hygiene and dietetics as salves for an ailing discipline. Finally, I argue that both writers enquire into viable means for inflecting learned medicine with particular experience, and both settle on rhetorical tools - analogy and exemplarity - as the means by which universalized medical models might be particularized or reformed.

Effect of dietary protein on post-prandial glucose in patients with type 1 diabetes.

PubMed

Borie-Swinburne, C; Sola-Gazagnes, A; Gonfroy-Leymarie, C; Boillot, J; Boitard, C; Larger, E

2013-12-01

In flexible insulin therapy, determination of the prandial insulin dose only takes into account the carbohydrate content of the evening meal, and not the protein content. Protein can, however, contribute to gluconeogenesis. We compared the glycaemic effect of a standard evening meal with that of a test evening meal enriched in protein. The present study was conducted in 28 C-peptide negative patients with type 1 diabetes. Two evening meals that were similar in content, except that one was enriched by the addition of 300 g of 0%-fat fromage frais, were taken on two consecutive days. Insulin doses were maintained exactly the same before both evening meals. Patients were monitored with a continuous glucose-monitoring device. Patients ate similar quantities at both evening meals, except for protein (21.5 g more at the test evening meal). The preprandial insulin dose was 0.96 (0.4) U per 10 g carbohydrates. After correction for differences of interstitial glucose at the start of the evening meals, both interstitial and capillary glucose levels were similar after both evening meals, except for the late-post-prandial interstitial glucose level. We found no effect of dietary protein on post-prandial-, overnight- or late-night glucose levels in patients with type 1 diabetes. This confirms that dietary proteins need not be included in the calculation of prandial insulin dose. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders.

PubMed

2006-12-01

It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling, by a registered dietitian (RD) is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care. Diagnostic criteria for eating disorders provide important guidelines for identification and treatment. However, it is thought that a continuum of disordered eating may exist that ranges from persistent dieting to subthreshold conditions and then to defined eating disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder. Understanding the complexities of eating disorders, such as influencing factors, comorbid illness, medical and psychological complications, and boundary issues, is critical in the effective treatment of eating disorders. The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists. The RD is an integral member of the treatment team and is uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. RDs provide nutritional counseling, recognize clinical signs related to eating disorders, and assist with medical monitoring while cognizant of psychotherapy and pharmacotherapy that are cornerstones of eating disorder treatment. Specialized resources are available for RDs to advance their level of expertise in the field of eating disorders. Further efforts with evidenced-based research must continue for improved treatment outcomes related to eating disorders along with identification of effective primary and secondary interventions.

A culinary laboratory for nutrition education.

PubMed

Jacob, Michael; Stewart, Patricia; Medina-Walpole, Annette; Fong, Chin-To

2016-06-01

Proficiency in medical nutrition requires an understanding of food-related biochemistry and the application of this knowledge in the context of culinary, cultural, psychosocial and interprofessional components. Our aim was to develop a teaching format where medical students could learn the biochemistry of nutrition in the context of patient narratives, interactive cooking and dialogues with nutrition professionals. We designed and implemented a day-long culinary laboratory intervention (lab), which is taught to first-year medical students at the University of Rochester with the help of dietetic interns from Cornell University. Here, we present the details of the intervention, the resources used and the preliminary outcomes on student attitudes. We designed and implemented a day-long culinary lab, which is taught to first-year medical students A questionnaire with quantitative rating scales and open-ended questions was used to probe student attitudes regarding the educational approach used in the lab. Our preliminary findings suggest that the lab was well received and that the dietetic interns were viewed as effective teachers in this context. A culinary lab is a feasible educational environment for integrating the breadth of topics within the discipline of nutrition. The experiential, food-based format appears to stimulate questions central to current nutritional controversies, particularly challenges related to translating biochemical mechanism into practical nutrition interventions. Close involvement with basic science faculty members, clinical faculty members and allied health professions are essential for this type of endeavour. © 2015 John Wiley & Sons Ltd.

Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review.

PubMed

Campagnolo, N; Johnston, S; Collatz, A; Staines, D; Marshall-Gradisnik, S

2017-06-01

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is characterised by unexplained fatigue for at least 6 months accompanied by a diverse but consistent set of symptoms. Diet modification and nutritional supplements could be used to improve patient outcomes, such fatigue and quality of life. We reviewed and discussed the evidence for nutritional interventions that may assist in alleviating symptoms of CFS/ME. Medline, Cinahl and Scopus were systematically searched from 1994 to May 2016. All studies on nutrition intervention were included where CFS/ME patients modified their diet or supplemented their habitual diet on patient-centred outcomes (fatigue, quality of life, physical activity and/or psychological wellbeing). Seventeen studies were included that meet the inclusion criteria. Of these, 14 different interventions were investigated on study outcomes. Many studies did not show therapeutic benefit on CFS/ME. Improvements in fatigue were observed for nicotinamide adenine dinucleotide hydride (NADH), probiotics, high cocoa polyphenol rich chocolate, and a combination of NADH and coenzyme Q10. This review identified insufficient evidence for the use of nutritional supplements and elimination or modified diets to relieve CFS/ME symptoms. Studies were limited by the number of studies investigating the interventions, small sample sizes, study duration, variety of instruments used, and studies not reporting dietary intake method. Further research is warranted in homogeneous CFS/ME populations. © 2017 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

Promotion of nutrition care by Australian fitness businesses: a website analysis.

PubMed

Barnes, K; Ball, L; Desbrow, B

2016-11-01

To investigate the intention of fitness businesses to promote the provision of nutrition care from personal trainers. Cross-sectional evaluation of webpage content. Fitness businesses within two Australian federal electorates were identified using the Fitness Australia list of registered fitness businesses. Inductive content analysis of these fitness business websites and associated social media sites was undertaken to compare website content to the Fitness Australia Position Statement outlining the Roles and Responsibilities of Registered Fitness Professionals. Fitness businesses were classified as 'within scope of practice' if they referred to national nutrition guidelines or dietetic services. 'At risk of being beyond scope' included websites which did not include enough information to definitively state within or beyond scope. Fitness businesses were classified as 'definitely beyond scope of practice' if they advertised nutrition care which clearly extended beyond translation of the national dietary guidelines. Of the businesses reviewed, 15% were within scope despite none referring to a dietitian; 34% were at risk of being beyond scope; and 51% were beyond scope as they advertised nutrition care such as personalized diets without indicating dietetic input. A considerable portion of fitness businesses reviewed advertised their personal trainers as able to provide nutrition care outside the recommended scope of practice. Strategies that help fitness businesses and personal trainers to support clients to have healthy dietary behaviours without extending outside the scope of practice are warranted. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Faecal short chain fatty acids in healthy subjects participating in a randomised controlled trial examining a soluble highly viscous polysaccharide versus control.

PubMed

Reimer, R A; Pelletier, X; Carabin, I G; Lyon, M R; Gahler, R J; Wood, S

2012-08-01

Short chain fatty acids (SCFA) are produced by the bacterial fermentation of dietary fibre and have been linked with intestinal health. The present study examined faecal SCFA concentrations in subjects consuming a novel soluble highly viscous polysaccharide (HVP) or control for 3 weeks. A total of 54 healthy adults participated in a randomised, double-blind, placebo-controlled study. Subjects were randomised to consume HVP or control (skim milk powder). A dose of 5 g day(-1) was consumed in the first week, followed by 10 g day(-1) in the second and third weeks (n = 27 per group). The primary outcome was SCFA concentrations in faecal samples collected at baseline (visit 1, V1), at 1 week (V2) and at 3 week (V3). The reduction in faecal acetate from V1 to V3 in control subjects was not observed in subjects consuming HVP. There were no differences in propionate, butyrate, valerate or caproate concentrations. There was a significant treatment effect (P = 0.03) for total SCFA, with higher concentrations observed in subjects consuming HVP versus control. HVP is a viscous functional fibre that may influence gut microbial fermentation. Further work is warranted to examine the fermentative properties of HVP and possible links with appetite regulation and reduced serum low-density lipoprotein cholesterol concentrations. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Longitudinal prospective observational type study about determinants of renal resistive index variations in chronic renal failure patients treated with conventional medical and dietetic therapy.

PubMed

Brardi, Simone; Cevenini, Gabriele; Giovannelli, Vanni; Romano, Giuseppe

2017-12-31

This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo. The study population (84 patients: 47 males and 37 females) was randomly selected among the chronic kidney patients (with various degrees of renal impairment) affected by hypertension and or diabetes mellitus. After a comprehensive medical examination these patients were submitted to determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and finally renal Doppler ultrasonography. Then the patients were submitted to a full therapeutic and dietetic intervention to ameliorate the renal impairment by a wide range of actions and after on average a one-year interval were submitted again to a new medical examination and a second determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and a new renal Doppler ultrasonography too. The comparison between basal and final data revealed a slight reduction in the mean of bilateral renal resistance indices (Delta RRI: -0.0182 ± 0.08), associated to a slight increase in the mean glomerular filtration rate (Delta GFR: 0.8738 ± 10.95 ml/min/1.73 m2), a reduction in mean body weight (Delta weight: -1.9548 ± 5.26 Kg) and mean BMI (Delta BMI: -0.7643 ± 2.10 Kg/m2) as well as a reduction in the mean systolic blood pressure (Delta systolic blood pressure: -8.8333 ± 25.19 mmHg). Statistical analysis showed statistically significant correlations (p < 0.05) between Delta RRI and Delta weight (p < 0.03), Delta BMI (p < 0.02) and Delta systolic blood pressure (p < 0.05). Despite the many limitations the our study clearly identifies the targets (yet widely known) to act on to prevent kidney alterations related to RRI and provides further evidence, if any, of the utility of RRI as a key parameter in monitoring patients with chronic renal failure and as a valuable tool to drive the clinical efforts to contrast the kidney disease.

Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance.

PubMed

Rodriguez, Nancy R; DiMarco, Nancy M; Langley, Susie

2009-03-01

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of foods and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This updated position paper couples a rigorous, systematic, evidence-based analysis of nutrition and performance-specific literature with current scientific data related to energy needs, assessment of body composition, strategies for weight change, nutrient and fluid needs, special nutrient needs during training and competition, the use of supplements and ergogenic aids, nutrition recommendations for vegetarian athletes, and the roles and responsibilities of sports dietitians. Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and repair tissue. Fat intake should be sufficient to provide the essential fatty acids and fat-soluble vitamins, as well as contribute energy for weight maintenance. Although exercise performance can be affected by body weight and composition, these physical measures should not be a criterion for sports performance and daily weigh-ins are discouraged. Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density, may require supplements. Because regulations specific to nutritional ergogenic aids are poorly enforced, they should be used with caution, and only after careful product evaluation for safety, efficacy, potency, and legality. A qualified sports dietitian and in particular in the United States, a Board Certified Specialist in Sports Dietetics, should provide individualized nutrition direction and advice subsequent to a comprehensive nutrition assessment.

A cross-sectional survey of the opinions on weight loss treatments of adult obese patients attending a dietetic clinic.

PubMed

Thompson, R L; Thomas, D E

2000-02-01

To investigate the views and opinions on weight loss treatments of adult obese patients attending a dietetic clinic. Cross-sectional survey. 161 adults attending dietetic outpatients clinics in Portsmouth for obesity with a body mass index of at least 30 kg/m2. Self-administered questionnaire developed from a series of focus groups with obese adults. Key topics were previous attempts to lose weight, methods used, the role of physical activity and patients' views about treatment from health professionals. The preferences and usefulness of different methods to lose weight varied according to the number of attempts to lose weight, gender, age, body mass index and medical condition of the patient. Men were less likely to use special slimming products, attend slimming groups and swimming than women (odds ratios (95% confidence interval), 0.1 (0.03-0.6) for slimming groups other than Weight Watchers, 0.3 (0.1-0.80) for special slimming products and 0.3 (0.1-0.6) for swimming). Men were more likely to use physical activity (2.6 (1.1-6.2)) and in particular walking (3.7 (1.0-13.6)) and cycling (2.8 (1.0-7.6)) and were more likely to see the dietitian (3.8 (1.4-9.9)) than women. Those with more than 10 attempts to lose weight were more likely to see the dietitian (3.6(1.6-8.2)), use Weight Watchers (2.5 (1.1-5. 6)) and newspapers and magazines (4.4 (1.8-10.9)) than those with fewer attempts. The younger age group were more likely to use more vigorous forms of exercise (4.2 (1.6-11.2) for keep fit and 3.7 (1. 5-9.6) for cycling) than the older subjects. The most obese were more likely to have negative views on their treatment by health professionals (4.4 (1.9-9.8) 'chairs are never big enough' and 4.0 (1.8-8.8) 'I am regarded as a second class citizen') than those who were less obese. Those without a medical condition were more likely to exercise (2.8 (1.3-6.3)) and use books (4.8 (2.0-11.2)) than those with a medical condition. The views of obese people should be considered when planning services for the treatment of obesity and a variety of options should be available. International Journal of Obesity (2000) 24, 164-170

Non-alcoholic beverages, unknown influence on cell proliferation - an in vitro study.

PubMed

Nowacki, Maciej; Adamowicz, Jan; Olkowska, Joanna; Pietkun, Katarzyna; Kloskowski, Tomasz; Bajek, Anna; Drewa, Tomasz

2014-01-01

The aim of the presented study was to check differences between 'Diet' and 'non-Diet' soft drinks on cell proliferation. Coca Cola and Pepsi Cola of different origin and their dietetic versions were examined at concentrations of 2% and 4%. Fructose and glucose as well as medium alone (control) were examined. Cell number was higher in media supplemented with soft drinks, compared to control. Proliferation depended on the soft drink concentration and its origin, but not on sugar and calorific content. An unknown factor is responsible for the increase in proliferation.

[Use of the microalgae Spirulina platensis and its selenium-containing form in nutrition of patients with nonspecific ulcerative colitis].

PubMed

Kodentsova, V M; Gmoshinskiĭ, I V; Vrzhesinskaia, O A; Beketova, N A; Kharitonchik, L A; Nizov, A A; Mazo, V K

2001-01-01

The vitamin security and selenium status were measured in the patients with unspecific ulcerative colitis. There were used food microalgae Spirulina platensis and it's preparation enriched with selenium as auxiliary tools of dietetic treatment for these patients. It's shown that there is a combined deficiency of beta-carotene and selenium and occasionally some other micronutrients in a significant part of the patients. The doses used of said food supplements were not enough sufficient for a dietary correction of deficiency of micronutrients with antioxidative properties.

The VA Computerized Patient Record — A First Look

PubMed Central

Anderson, Curtis L.; Meldrum, Kevin C.

1994-01-01

In support of its in-house DHCP Physician Order Entry/Results Reporting application, the VA is developing the first edition of a Computerized Patient Record. The system will feature a physician-oriented interface with real time, expert system-based order checking, a controlled vocabulary, a longitudinal repository of patient data, HL7 messaging support, a clinical reminder and warning system, and full integration with existing VA applications including lab, pharmacy, A/D/T, radiology, dietetics, surgery, vitals, allergy tracking, discharge summary, problem list, progress notes, consults, and online physician order entry. PMID:7949886

Psychological predictors of dietary intentions in pregnancy.

PubMed

Gardner, B; Croker, H; Barr, S; Briley, A; Poston, L; Wardle, J

2012-08-01

Consuming a healthy diet in pregnancy has the potential to improve obstetric outcome, including minimising the risk of macrosomia. Effective promotion of dietary change depends on identifying and targeting determinants of gestational diet. The present study aimed to model psychological predictors of intentions to reduce intake of high-fat and high-sugar foods, and increase fruit and vegetable consumption, among pregnant women. One hundred and three pregnant women completed questionnaire measures of intentions to modify the consumption of the target foods, current intake, perceived vulnerability to and severity of adverse outcomes of unhealthful consumption of these foods (i.e. 'threat'), benefits of dietary change to mother and baby, barriers to dietary changes, and social approval for dietary change ('subjective norms'). A cross-sectional design was used. Logistic regression analyses were undertaken to model dietary change intentions. Participants who reported excessive current intake of high-fat and high-sugar foods were more likely to intend to reduce the intake of these foods. Perceived benefits for mother and baby enhanced intentions to eat more fruit and vegetables and eat less high-fat, and marginally significantly increased high-sugar reduction intentions. There were no effects of threat, barriers or subjective norms. Lack of effects for barriers, threat and subjective norms may indicate that pregnant women discount barriers to health-promoting behaviour, understand the threat posed by unhealthy eating and perceive social approval from others. Dietary change interventions for pregnant women should emphasise likely positive outcomes for both mother and child. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Impact of eating and drinking on body composition measurements by bioelectrical impedance.

PubMed

Androutsos, O; Gerasimidis, K; Karanikolou, A; Reilly, J J; Edwards, C A

2015-04-01

Bioelectrical impedance analysis would be a more practical tool to measure body composition in clinical settings, dietetic practice and epidemiological studies if patients/subjects did not have to fast before measurements. The present study assessed whether the ingestion of food or drink had any biologically significant effect on bioimpedance measurements and body composition by the foot-to-foot method. Fifty-five healthy adults [30 males and 25 females; mean (SD) age 27.7 (7.1) years; mean (SD)body mass index 24 (3.8) kg m(-2)] were randomly assigned to a 2-day food trial (high-fat meal or high-carbohydrate meal) or a 2-day drink trial (water or high electrolyte drink). Body composition measurements were carried out in the fasting state, immediately after meal consumption and every 30 min for 2 h by the foot-to-foot single frequency bioimpedance technique. Bioimpedance increased significantly after the ingestion of food and fluid, although the changes were small. The electrolyte drink, high-fat and high-carbohydrate meals significantly increased the percentage body fat and fat mass. In all cases, the median percentage changes from baseline were approximately 1% in body fat percentage units. Although there were statistically significant changes in body composition estimates after food or drink consumption, these were small and within the imprecision of the impedance technique, and so are unlikely to be of clinical significance. The present study suggests that impedance measures of body fatness in clinical settings do not require strict adherence to fasting, and this should increase the opportunities for clinical application. © 2014 The British Dietetic Association Ltd.

The use of genetic engineering techniques to improve the lipid composition in meat, milk and fish products: a review.

PubMed

Świątkiewicz, S; Świątkiewicz, M; Arczewska-Włosek, A; Józefiak, D

2015-04-01

The health-promoting properties of dietary long-chain n-3 polyunsaturated fatty acids (n-3 LCPUFAs) for humans are well-known. Products of animal-origin enriched with n-3 LCPUFAs can be a good example of functional food, that is food that besides traditionally understood nutritional value may have a beneficial influence on the metabolism and health of consumers, thus reducing the risk of various lifestyle diseases such as atherosclerosis and coronary artery disease. The traditional method of enriching meat, milk or eggs with n-3 LCPUFA is the manipulation of the composition of animal diets. Huge progress in the development of genetic engineering techniques, for example transgenesis, has enabled the generation of many kinds of genetically modified animals. In recent years, one of the aims of animal transgenesis has been the modification of the lipid composition of meat and milk in order to improve the dietetic value of animal-origin products. This article reviews and discusses the data in the literature concerning studies where techniques of genetic engineering were used to create animal-origin products modified to contain health-promoting lipids. These studies are still at the laboratory stage, but their results have demonstrated that the transgenesis of pigs, cows, goats and fishes can be used in the future as efficient methods of production of healthy animal-origin food of high dietetic value. However, due to high costs and a low level of public acceptance, the introduction of this technology to commercial animal production and markets seems to be a distant prospect.

Exploring extended scope of practice in dietetics: A systems approach.

PubMed

Ryan, Dominique; Pelly, Fiona; Purcell, Elizabeth

2017-09-01

The aim of this study was to explore health professionals' perceptions of an extended scope of a practice clinic, and develop a framework using a systems approach to facilitate extended scope models across various health settings. A qualitative investigation using semi-structured interviews with four health professionals involved in an extended scope dietitian-led gastroenterology clinic in a hospital in regional Queensland was conducted. A case study design was utilised to investigate interviewees' perceptions of the clinic. Participants were conveniently, purposively sampled. Transcript analysis involved a descriptive analytical approach. Interviewee responses were coded and categorised into themes, and investigator triangulation was used to ensure consistency between individual analyses. A secondary interpretative analysis was conducted where relationships between key themes were mapped to the Systems Engineering Initiative for Patient Safety work system model. Interviewees identified various factors as vital inputs to the work system. These were categorised into the four key elements: stakeholder support, resources, planning and the dietitian. Clinic outcomes were categorised into the impact on four key groups: patients, the dietitian, the multidisciplinary team and the health system. Mapping of the relationships between inputs and outcomes resulted in an implementation framework for extended scope of practice. Extended scope of practice in dietetics may provide positive outcomes for various stakeholders. However, further development of extended scope roles for dietitians requires increased advocacy and support from governments, professional bodies, training institutions and dietitians. We have developed an implementation framework which can be utilised by health professionals interested in embracing an extended scope model of care. © 2016 Dietitians Association of Australia.

Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.

PubMed

Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L

2014-04-01

Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

Online continuing education course enhances nutrition and health professionals' knowledge of food safety issues of high-risk populations.

PubMed

Wallner, Stephanie; Kendall, Patricia; Hillers, Virginia; Bradshaw, Eva; Medeiros, Lydia C

2007-08-01

To develop and evaluate the efficacy of an online continuing education course for professionals who provide food safety information to high-risk populations. A 2-credit graduate-level class was converted into six web-based modules (overview of foodborne illness, immunology, pregnancy, human immunodeficiency virus, cancer and transplants, and lifecycle) and offered to nutrition and health professionals. Participants had 8 weeks to complete the modules, pre and post questionnaires, and course evaluation. Those who successfully completed the protocol received six continuing education units from one of three professional associations. Change in knowledge was measured using pre and post questionnaires. Course efficacy was evaluated using a post-course questionnaire. A convenience sample of 140 registered dietitians/dietetic technicians registered, nurses, and extension educators were recruited through professional conferences and electronic mailing lists to take the course. Analysis of variance was used to evaluate differences in knowledge scores for all groups across five main effects (attempt, module, profession, age, and education). Course evaluation responses were used to assess course effectiveness. For each module, knowledge scores increased significantly (P<0.001) from pre to post questionnaire. Overall, knowledge scores increased from 67.3% before the modules to 91.9% afterwards. Course evaluation responses were favorable, and participants indicated that course objectives were met. Online continuing education courses, such as "Food Safety Issues for High Risk Populations," seem to be a convenient, effective option for dietetics professionals, nurses, and extension educators seeking knowledge about food safety issues of high-risk populations. Online learning is a promising delivery approach for the continuing education of health professionals.

An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce.

PubMed

Palermo, C; Hughes, R; McCall, L

2010-06-01

Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On-the-job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty-two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7-month period. Pre- and post-intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self-reported competence of 15% (range 3-48% change; P < 0.05) across a broad range of competency elements. Many participants described re-orienting their practice towards population prevention, with quantifiable increases in work time allocated to preventive work post-intervention. Mentoring supported service re-orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.

Paediatric nutrition risk scores in clinical practice: children with inflammatory bowel disease.

PubMed

Wiskin, A E; Owens, D R; Cornelius, V R; Wootton, S A; Beattie, R M

2012-08-01

There has been increasing interest in the use of nutrition risk assessment tools in paediatrics to identify those who need nutrition support. Four non-disease specific screening tools have been developed, although there is a paucity of data on their application in clinical practice and the degree of inter-tool agreement. The concurrent validity of four nutrition screening tools [Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), Screening Tool for Risk On Nutritional status and Growth (STRONGkids), Paediatric Yorkhill Malnutrition Score (PYMS) and Simple Paediatric Nutrition Risk Score (PNRS)] was examined in 46 children with inflammatory bowel disease. Degree of malnutrition was determined by anthropometry alone using World Health Organization International Classification of Diseases (ICD-10) criteria. There was good agreement between STAMP, STRONGkids and PNRS (kappa > 0.6) but there was only modest agreement between PYMS and the other scores (kappa = 0.3). No children scored low risk with STAMP, STRONGkids or PNRS; however, 23 children scored low risk with PYMS. There was no agreement between the risk tools and the degree of malnutrition based on anthropometric data (kappa < 0.1). Three children had anthropometry consistent with malnutrition and these were all scored high risk. Four children had body mass index SD scores < -2, one of which was scored at low nutrition risk. The relevance of nutrition screening tools for children with chronic disease is unclear. In addition, there is the potential to under recognise nutritional impairment (and therefore nutritional risk) in children with inflammatory bowel disease. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Validity and reliability of a short questionnaire for assessing the impact of cooking skills interventions.

PubMed

Barton, K L; Wrieden, W L; Anderson, A S

2011-12-01

Food skills programmes are widely used as a means to improve confidence in food preparation, the use of basic food skills and food selections amongst low income communities. However, the impact of such interventions are rarely evaluated as a result of a lack of validated assessment tools appropriate for use within this target group. A two-page questionnaire utilising a closed-question format was designed based on key domains known to be influenced by cooking skills programmes. Content validity was assessed by a panel of public health experts and face validity by individuals, typical of those who may attend cooking skills classes. Internal and repeat reliability were assessed with groups of adults attending community-based classes. The feasibility of using the tool in community settings was also assessed. The draft questionnaire was amended as appropriate subsequent to content and face validity testing. Cronbach's alpha for confidence and knowledge sections was 0.86 and 0.84, respectively, indicating good internal consistency. Spearman correlation coefficients for repeat reliability testing between time 1 and time 2 for each item were in the range 0.46-0.91 (all significant at P < 0.001), indicating that the questionnaire elicited stable responses for repeated use. Feasibility testing highlighted the need for detailed instructions for course tutors on how to distribute and check questionnaires for completion. This tool provides a standardised method of evaluating cooking skills interventions that could be utilised in the development and evaluation of multicentre cooking skills interventions. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Survey of contemporary feeding practices in critically ill children in the Asia-Pacific and the Middle East.

PubMed

Wong, Judith J M; Ong, Chengsi; Han, Wee Meng; Mehta, Nilesh M; Lee, Jan Hau

2016-01-01

Nutrition is a fundamental component of care of critically ill children. Determining variation in nutritional practices within paediatric intensive care units (PICUs) allows for review and improvement of nutrition practices. The aim was to survey the nutrition practices and perspectives of paediatric intensivists and dieticians in Asia-Pacific and the Middle East. A questionnaire was developed to collect data on (1) the respondent's and institution's characteristics, (2) nutritional assessments and nutrient delivery practices, and (3) the perceived importance and barriers to optimal enteral feeding in the PICU. We analysed 47 responses from 35 centres in 18 different countries. Dedicated dietetic services were only present in 13 (37%) centres and regular nutrition assessments were conducted in only 12 (34%) centres. In centres with dedicated dieticians, we found greater use of carbohydrate, fat additives and special formulas. Two thirds [31 (66%)] of respondents used total fluids to estimate energy requirements. Only 11 (31%) centres utilized feeding protocols. These centres had higher use of small bowel feeding, acid suppressants, laxatives and gastric residual volume thresholds. When dealing with feed intolerance, they were also more likely to start a motility agent. There was also a lack of consensus on when feeding should start and the use of adjuncts. Nutrition practices and barriers are unique in Asia-Pacific and the Middle East and strongly reflect a lack of dietetic services. Future effort should focus on developing a uniform approach on nutrition practices to drive paediatric critical care nutrition research in these regions.

The effect of phosphatidylserine administration on memory and symptoms of attention-deficit hyperactivity disorder: a randomised, double-blind, placebo-controlled clinical trial.

PubMed

Hirayama, S; Terasawa, K; Rabeler, R; Hirayama, T; Inoue, T; Tatsumi, Y; Purpura, M; Jäger, R

2014-04-01

Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed behavioural disorder of childhood, affecting 3-5% of school-age children. The present study investigated whether the supplementation of soy-derived phosphatidylserine (PS), a naturally occurring phospholipid, improves ADHD symptoms in children. Thirty six children, aged 4-14 years, who had not previously received any drug treatment related to ADHD, received placebo (n = 17) or 200 mg day(-1) PS (n = 19) for 2 months in a randomised, double-blind manner. Main outcome measures included: (i) ADHD symptoms based on DSM-IV-TR; (ii) short-term auditory memory and working memory using the Digit Span Test of the Wechsler Intelligence Scale for Children; and (iii) mental performance to visual stimuli (GO/NO GO task). PS supplementation resulted in significant improvements in: (i) ADHD (P < 0.01), AD (P < 0.01) and HD (P < 0.01); (ii) short-term auditory memory (P < 0.05); and (iii) inattention (differentiation and reverse differentiation, P < 0.05) and inattention and impulsivity (P < 0.05). No significant differences were observed in other measurements and in the placebo group. PS was well-tolerated and showed no adverse effects. PS significantly improved ADHD symptoms and short-term auditory memory in children. PS supplementation might be a safe and natural nutritional strategy for improving mental performance in young children suffering from ADHD. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Registered Dietitian Nutritionists' Perspectives on Integrating Food and Water System Issues into Professional Practice.

PubMed

Heidelberger, Lindsay; Smith, Chery; Robinson-O'Brien, Ramona; Earthman, Carrie; Robien, Kim

2017-02-01

Sustainable agriculture encompasses economic, environmental, and social aspects of the food system. Members of the Academy of Nutrition and Dietetics (Academy) play an important role in promoting sustainable agriculture because they work in areas where they can influence the food purchasing decisions of foodservice operations and the public. To investigate behavior of registered dietitian nutritionists (RDNs) toward incorporating sustainable agriculture principles into professional practice using the Theory of Planned Behavior. This cross-sectional study surveyed RDNs nationwide about their perspectives on incorporating sustainable agriculture issues into practice. The survey questions were based on a survey originally administered to Minnesota RDNs during 2002. The sample (N=626) was drawn from a randomly selected, national sample of Academy members. Data were analyzed using descriptive statistics, independent t tests, Pearson correlations, and stepwise regression. The sample was mostly white, female, and the average age was 45.4±12.2 years. Almost half of Academy RDNs (47%) reported incorporating environmental issues into their practice. All four Theory of Planned Behavior variables (intention, attitude, perceived behavior control, and subjective norm) were predictive of behavior to include sustainable agriculture issues into practice. Barriers to incorporating this topic into practice included lack of knowledge, ability, time, and employer support. This study found that most of the RDN respondents had heard of sustainable agriculture and nearly half reported including this topic in their professional practice. To integrate this topic into practice more consistently, RDNs need more knowledge, time, and employer support. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Recovery to resting metabolic state after walking.

PubMed

Frankenfield, David C; Coleman, Abigail

2009-11-01

Metabolic rate is usually measured in a resting state. To achieve this, a period of up to 30 minutes is given to recover from walking prior to the test. A work group from the American Dietetic Association recommends that 10 to 20 minutes is sufficient to achieve rest, but supporting data are limited. The purpose of this prospective observational study then was to determine how much time is needed for adults to recover to rest after walking 300 meters. Each participant's metabolic rate was measured with indirect calorimetry for 30 minutes after a 30-minute rest. The participant then walked 300 meters on a measured course, and metabolic rate was measured again for 30 minutes. Recovery to rest was considered to have occurred when the measured metabolic rate returned to a level of less than 6% above the resting measurement. Forty healthy ambulatory adults completed this study. Analysis of variance indicated that after a 300-meter walk, resting level of metabolic rate was achieved by the 10th minute of rest. However, it took 20 minutes for 95% of all participants to meet the 6% threshold (the remaining 5% who did not reach the threshold were observed to be moving during the measurement). The results of this study indicate that if a person lies still, recovery to rest after walking occurs by 20 minutes, validating the recommendation made by the expert panel of the American Dietetic Association's work group on indirect calorimetry. Rest periods of 30 minutes are not required, but the person should be observed for movement.

The influence of vitamin B2 intake on the activation coefficient of erythrocyte glutation reductase in the elderly.

PubMed

López-Sobaler, A M; Ortega, R M; Quintas, M E; Navarro, A R; Aparicio, A; Gomez-Rodriguez, N; Cocho, M; Requejo, A M

2002-01-01

To evaluate the influence of dietetic vitamin B2 on the activation coefficient of erythrocyte glutation reductase (alpha-EGR) of a group of elderly people. The study subjects were 133, independently-living elderly people, between 65 and 90 years of age. A dietetic study was performed using a 7-day food record. Riboflavin status was measured by determining the alpha-EGR. Some 23.9% of subjects had riboflavin intakes lower than those recommended. At the biochemical level, 9.8% of subjects (7.7% of men and of 10.6% women) showed alpha-EGR>1.2. Those subjects with riboflavin intakes below 90% of those recommended showed significantly higher alpha-EGR levels (1.15+/-0.16), an indication of a poorer riboflavin status at the biochemical level. Those with greater intakes showed lower alpha-EGR values (1.05+/-0.10). Furthermore, the mean consumption of dairy products (an important source of this vitamin) by subjects is insuficiente (341.1+/-159.8 g/day, 2.1+/-1 servings/day). The data show that those with riboflavin intakes below those recommended took 204.7+/-89.4 g/day of milk products (1.3+/-0.5 servings/day) compared to the 384+/-153.1 g/day (2.4+/-1 servings/day) (p<0.001) consumed by those with higher riboflavin intakes. Although the mean riboflavin intake is acceptable, there remain some insufficiencies that require attention. It would seem advisable to recommend the elderly increase their intake of milk products. This would be especially important for subjects who take less than two rations per day.

A qualitative study to investigate the drivers and barriers to healthy eating in two public sector workplaces.

PubMed

Pridgeon, A; Whitehead, K

2013-02-01

Workplaces are a key setting for improving the health of employees and influencing the health of the local population. The present study aimed to provide a deeper understanding of the perceptions and views of staff on the drivers and barriers to the provision, promotion and consumption of healthier food choices in two public sector workplaces. A mixture of catering and other staff (n = 23) employed by either Barnsley Metropolitan Borough Council or Barnsley Primary Care Trust were interviewed. Purposive sampling was used to ensure representation of different grades, job roles, hours worked, gender and age groups. All interviews were conducted in the workplace and were audio recorded, transcribed verbatim and analysed using framework analysis. Four themes that influence food and healthy eating in the workplace were identified: workplace structures and systems; cost, choice and availability of food; personal versus institutional responsibility; and food messages and marketing. Interviewees perceived that foods promoted in the workplace were traditional 'stodgy' foods and that there was a limited availability of affordable healthy choices. Catering staff were driven to run their service as a business rather than promote health. Time constraints and tight deadlines imposed on staff led to some not eating at midday. There is little qualitative research published about food in the workplace. This unique qualitative study has elicited staff views and experiences and suggests complexity around healthy eating and food provision in the workplace. The findings may inform the planning of future workplace interventions. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Living with coeliac disease: a grounded theory study.

PubMed

Rose, C; Howard, R

2014-02-01

Coeliac disease can be controlled only through adherence to a gluten-free diet. This diet is highly restrictive and can be challenging to maintain. It has been linked with elevated levels of psychological distress, including depression, anxiety and social phobia. Narratives on living with coeliac disease were written by 130 adult members of Coeliac UK (mean age 52.7 years; mean time since diagnosis 10.2 years; 67% sample female; 28% male). Qualitative analysis using grounded theory methods identified five key categories: living with widespread ignorance; social invisibility; creating a coeliac community; a changed identity; grief - and accepting the trade-off. A psychosocial model of living with coeliac disease was constructed from the findings, the central category of which was the changed identity of those diagnosed with the condition. Grief was experienced in relation to a loss of the former diet, changed personal and social identities, loss of social confidence and loss of social activities. Grief was generally mitigated over time as adjustments were made to changes in identity and lifestyle. Creating (or becoming part of) a coeliac community was a strategy enabling those with coeliac disease to re-establish their identities and increase social recognition and acceptance of the condition. Gluten-free living entails a substantial restriction of food choice. The losses and changes entailed impact on the personal and social identities of those living with coeliac disease, and on the behaviour of others towards them. Psychosocial interventions focussed on facilitating coping and adjustment may benefit those experiencing difficulties. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

[Food habits and body composition of Spanish elite athletes in combat sports].

PubMed

Ubeda, N; Palacios Gil-Antuñano, N; Montalvo Zenarruzabeitia, Z; García Juan, B; García, A; Iglesias-Gutiérrez, E

2010-01-01

There is a scarcity of information about the dietary intake and food selection of combat sport people. Optimizing nutritional status, body weight, and body composition are key factors for their performance. The assessment of dietary intake, food habits, and body composition in elite combat sport people. 22 sportsmen were recruited from the Spanish National Teams of Tae kwon do, Judo, and Boxing. Food intake (FFQ), food habits and body composition (DXA and Bioimpedance) were analyzed. Weight and body composition of the individuals assessed were similar to that previously described, although almost half of them were moderately over their desired competition weight. A lower than the recommended intake of vegetables (77% of individuals), cereals, bread, rice, potatoes, and pasta (73%), while red meat and derivatives intake exceeded the recommendations. Their main preferences were pasta, meat, and cereals. Legumes, vegetables, and fish were their main dislikes. A statistically significant relationship between food preferences and intakes was only observed for legumes, yogurt, and nuts. The athletes reported that reducing the intake of biscuits and confectionery (68% of individuals), high-fat foods (36%), and/or bread (27%) would be a good dietetic strategy for losing weight. None of them reported that voluntary dehydration would be a good strategy for this purpose. food offer to which this sport people have access and their choices are adequate, although the intake of some food groups (vegetables, red meat and derivatives) does not follow the recommendations. Their body weight slightly exceeds their competition weight, what it is frequently found in these sports. Nevertheless, their knowledge about nutrition and dietetics applied to exercise are acceptable.

An exploration of the experiences and perceptions of people who have maintained weight loss.

PubMed

Hindle, L; Carpenter, C

2011-08-01

  In clinical weight-loss trials, the majority of those who lose weight will regain almost all of it within 5 years, yet there is limited evidence about effective strategies to support weight maintenance. The present study aimed to increase understanding of the experiences of those who have been successful at weight maintenance.   This qualitative study used a phenomenological approach. Semi-structured interviews were undertaken with a purposive sample of 10 participants who had maintained a minimum of 10% weight loss for at least 1 year. Interviews were transcribed and then analysed using a foundational thematic approach based on the Colaizzi method.   Participants believed that a more relaxed approach to weight management with realistic, long-term goals was more appropriate for long-term control. They had a strong reason to lose weight often with a medical trigger and had elicited support to help them. Most described the presence of saboteurs. Participants took personal responsibility for their weight management and were in tune with their nutrition and activity needs. Self-monitoring was a strategy commonly used to support this. They described the lack of positive reinforcement in the maintenance phase as a major difficulty.   This small-scale study provides evidence to suggest the importance of a medical prompt to lose weight; planning for how to manage saboteurs and identifying methods of minimising the impact of a reduction in positive reinforcement. It reinforces the importance of many of the strategies known to support the weight-loss phase. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

A qualitative analysis of the nutritional requirements of palliative care patients.

PubMed

Muir, C I; Linklater, G T

2011-10-01

The National Health Servive (NHS) Quality Improvement Scotland developed nutritional Clinical Standards to address the problem of malnutrition in hospitals. NHS palliative care units are obliged to incorporate these standards into nutritional aspects of care. The nutritional needs of this patient population are under-researched. The present study aimed to explore patients' views of nutrition, to begin to understand their concerns and to determine whether such standards meet the needs of patients in the palliative care setting. A qualitative study was conducted in 2009 in an NHS Palliative Care Unit. Six inpatients were involved in one-to-one interviews, which were audiotaped and transcribed verbatim. The transcripts were subject to qualitative data analysis in accordance with a previous framework. A recurring theme that emerged was that of change and uncertainty. Four main areas subject to change were: disease state, symptoms, oral dietary intake and weight. Each change could exert control over, or be controlled by, the patient. When patients were eventually unable to exert control, they accepted the change, either willingly or enforced, thereby unintentionally setting their own targets. The present study enables a deeper understanding of the concerns that palliative care patients have regarding their oral dietary intake and weight. Their 'malnutrition' not only refers to physical malnutrition alone, but also incorporates psychological and social 'malnutrition'. When applying standards or protocols regarding nutritional care, these wider issues must be taken into account to meet patients' nutritional needs. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Nutrition and prevalence of undernutrition assessed by different diagnostic criteria in nursing homes for elderly people.

PubMed

López-Contreras, M J; Torralba, C; Zamora, S; Pérez-Llamas, F

2012-06-01

Undernutrition is the state produced by the intake of insufficient energy, macronutrients or micronutrients. The present study aimed to assess the prevalence of undernutrition using 10 different diagnostic criteria described in the literature and to assess its association with energy intake in an institutionalised elderly population. The cross-sectional study included 213 subjects, aged 65-96 years (135 women and 78 men), who lived in seven nursing homes in the province of Murcia, on the Mediterranean coast of Spain. Dietary intake and anthropometric and biochemical parameters were assessed, and 10 different diagnostic criteria, taken from studies of elderly subjects similar to our population, were applied. The mean dietary intakes appeared to cover the recommended dietary intake for a Spanish elderly population. However, only 58.2% of the studied subjects consumed 100% of the recommended dietary intake and 15.5% of the subjects had an energy intake below 80% of the recommended dietary intake. Depending on the criteria used for the diagnosis, the proportion of patients with undernutrition varied between 2% and 57%. When the relationship between undernourishment, as defined by the different methods and intake deficiency, was assessed, a statistically significant relationship was only found for five of the 10 diagnostic criteria assessed.   Research needs to focus on the development and evaluation of specific nutritional assessment tools for application to older people aiming to improve the detection of those suffering (or who are at risk of suffering) undernutrition. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Telematic expert system Diabeto. New tool for diet self-monitoring for diabetic patients.

PubMed

Turnin, M C; Beddok, R H; Clottes, J P; Martini, P F; Abadie, R G; Buisson, J C; Soulé-Dupuy, C; Bonneu, M; Camaré, R; Anton, J P

1992-02-01

To evaluate Diabeto, a computer-assisted diet education system. One hundred five patients with insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM) were divided into two randomized groups to participate in the evaluation of Diabeto. With free access through Minitel, the French public videotex network, Diabeto helps diabetic patients self-monitor their diets and balance their meals with personalized counseling. During the first 6-mo study, group A (54 patients) used Diabeto, whereas group B (51 patients) were control subjects. For the second 6-mo study, group B used the system. Evaluation was based on patients' dietetic knowledge, dietary habits, and metabolic balance. Diabeto led to a significant improvement of dietetic, knowledge in group A (P less than 0.0005) and also to improved dietary habits; decreased caloric intake in patients initially overeating (P less than 0.05), increase of dietary carbohydrate from 39.7 +/- 0.7 to 42.9 +/- 0.9% in patients with an initial intake less than 45% carbohydrate, and decrease of fat intake from 41.9 +/- 0.9 to 37.4 +/- 1.1% in patients with an initial intake of greater than 35% fat (P less than 0.0005). In the second study, in addition to similar improvements to those observed in the first study, HbA1 decreased from 11.0 +/- 0.4 to 9.9 +/- 0.4% (P less than 0.005) and fructosamine from 5.00 +/- 0.17 to 4.57 +/- 0.17% (P less than 0.001). Diabeto appears to be an effective therapeutic tool in the control of metabolic diseases.

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and nutrition programs for community-residing older adults.

PubMed

Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

2010-03-01

Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services.

Highly sweet compounds of plant origin.

PubMed

Kim, Nam-Cheol; Kinghorn, A Douglas

2002-12-01

The demand for new alternative "low calorie" sweeteners for dietetic and diabetic purposes has increased worldwide. Although the currently developed and commercially used highly sweet sucrose substitutes are mostly synthetic compounds, the search for such compounds from natural sources is continuing. As of mid-2002, over 100 plant-derived sweet compounds of 20 major structural types had been reported, and were isolated from more than 25 different families of green plants. Several of these highly sweet natural products are marketed as sweeteners or flavoring agents in some countries as pure compounds, compound mixtures, or refined extracts. These highly sweet natural substances are reviewed herein.

[Inpatient rehabilitation of adults with atopic dermatitis].

PubMed

Breuer, K; Kapp, A

2006-07-01

Atopic dermatitis is a chronic inflammatory skin disease which often persists until adulthood. In severe cases, eczematous lesions and pruritus are resistant to therapy and result in depression, impairment of professional activities and social withdrawal. The goal of inpatient rehabilitation measures is to keep the patient involved and active in professional and social activities. Rehabilitative measures include diagnostics and medical therapy according to current guidelines, instruction in basic medical information, psychological intervention (relaxation techniques, improvement of self-confidence), dietetic measures, exercise, and social advice. Patients with atopic dermatitis often have work-related problems which should be identified as early as possible during rehabilitation.

Reducing the cost of dietary assessment: self-completed recall and analysis of nutrition for use with children (SCRAN24).

PubMed

Foster, E; Hawkins, A; Delve, J; Adamson, A J

2014-01-01

Self-Completed Recall and Analysis of Nutrition (scran24) is a prototype computerised 24-h recall system for use with 11-16 year olds. It is based on the Multiple Pass 24-h Recall method and includes prompts and checks throughout the system for forgotten food items. The development of scran24 was informed by an extensive literature review, a series of focus groups and usability testing. The first stage of the recall is a quick list where the user is asked to input all the foods and drinks they remember consuming the previous day. The quick list is structured into meals and snacks. Once the quick list is complete, additional information is collected on each food to determine food type and to obtain an estimate of portion size using digital images of food. Foods are located within the system using a free text search, which is linked to the information entered into the quick list. A time is assigned to each eating occasion using drag and drop onto a timeline. The system prompts the user if no foods or drinks have been consumed within a 3-h time frame, or if fewer than three drinks have been consumed throughout the day. The food composition code and weight (g) of all items selected are automatically allocated and stored. Nutritional information can be generated automatically via the scran24 companion Access database. scran24 was very well received by young people and was relatively quick to complete. The accuracy and precision was close to that of similar computer-based systems currently used in dietary studies. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

A qualitative investigation of adherence to nutritional therapy in malnourished adult AIDS patients in Kenya.

PubMed

Dibari, Filippo; Bahwere, Paluku; Le Gall, Isabelle; Guerrero, Saul; Mwaniki, David; Seal, Andrew

2012-02-01

To understand factors affecting the compliance of malnourished, HIV-positive adults with a nutritional protocol using ready-to-use therapeutic food (RUTF; Plumpy'nut®). Qualitative study using key informant interviews, focus group discussions and direct observations. Ministry of Health HIV/programme supported by Médecins Sans Frontièrs (MSF) in Nyanza Province, Kenya. Adult patients (n 46) currently or previously affected by HIV-associated wasting and receiving anti-retroviral therapy, their caregivers (n 2) and MoH/MSF medical employees (n 8). Thirty-four out of forty-six patients were receiving RUTF (8360 kJ/d) at the time of the study and nineteen of them were wasted (BMI < 17 kg/m2). Six of the thirteen wasted out-patients came to the clinic without a caregiver and were unable to carry their monthly provision (12 kg) of RUTF home because of physical frailty. Despite the patients' enthusiasm about their weight gain and rapid resumption of labour activities, the taste of the product, diet monotony and clinical conditions associated with HIV made it impossible for half of them to consume the daily prescription. Sharing the RUTF with other household members and mixing with other foods were common. Staff training did not include therapeutic dietetic counselling. The level of reported compliance with the prescribed dose of RUTF was low. An improved approach to treating malnourished HIV-positive adults in limited resource contexts is needed and must consider strategies to support patients without a caregiver, development of therapeutic foods more suited to adult taste, specific dietetic training for health staff and the provision of liquid therapeutic foods for severely ill patients.

A review of sugar consumption from nationally representative dietary surveys across the world.

PubMed

Newens, K J; Walton, J

2016-04-01

Government and health organisations worldwide have recently reviewed the evidence on the role of dietary sugars in relation to health outcomes. Hence, it is timely to review current intakes of dietary sugars with respect to this guidance and as a benchmark for future surveillance. This review collates data from nationally representative dietary surveys across the world and reports estimates of intakes of total and added sugars, and sucrose in different population subgroups. Total sugars includes all mono- and disaccharides; namely, glucose, fructose, lactose, sucrose and maltose. Added and free sugars differ in the quantity of natural sugars included in their definitions. Free sugars include sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, whereas added sugars typically only refer to those added during processing. Most countries reported intakes of total sugars, with fewer reporting intakes of added sugars and sucrose. No country reported intakes of free sugars. The available data suggest that total sugars as a percentage of energy were highest in the infant (<4 years), with mean values ranging from 20.0% to 38.4%, and decreased over the lifespan to 13.5-24.6% in adults. Intakes of added sugars were higher in school-aged children and adolescents (up to 19% of total energy) compared to younger children or adults. Further research into the dietary patterns contributing to added sugars intake in children and adolescents is warranted. It would also be beneficial to policy guidance if future dietary surveys employed a uniform way of expressing sugars that is feasible to measure and has public health significance. © 2015 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of The British Dietetic Association Ltd.

WebDASC: a web-based dietary assessment software for 8-11-year-old Danish children.

PubMed

Biltoft-Jensen, A; Trolle, E; Christensen, T; Islam, N; Andersen, L F; Egenfeldt-Nielsen, S; Tetens, I

2014-01-01

  The present study describes the development and formative evaluation of the Web-based Dietary Assessment Software for Children (WebDASC). WebDASC is part of the OPUS project ('Optimal well-being, development and health for Danish children through a healthy New Nordic Diet') and was intended to measure dietary change resulting from a school-based intervention.   WebDASC was developed as a self-administered tool that could be used by 8-11-year-old children with or without parent's aid. The development of WebDASC followed a prototyping approach: focus groups, informal interviews, literature review, and usability tests preceded its release. Special consideration was given to age-appropriate design issues.   In WebDASC an animated armadillo guides respondents through six daily eating occasions and helps them report foods and beverages previously consumed. A database of 1300 food items is available either through category browse or free text search, aided by a spell check application. A type-in format is available for foods not otherwise found through category browse or text search. Amount consumed is estimated by selecting the closest portion size among four different digital images. WebDASC includes internal checks for frequently forgotten foods, and the following features to create motivation: a food-meter displaying cumulative weight of foods reported, a most popular food ranking, and a computer game with a high score list.   WebDASC was developed as an intuitive, cost-effective, and engaging method to collect detailed dietary data from 8- to 11-year-old children. Preliminary testing demonstrated that it was well accepted among children. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Dietary intake, nutritional status and rehabilitation outcomes of stroke patients in hospital.

PubMed

Nip, W F R; Perry, L; McLaren, S; Mackenzie, A

2011-10-01

Nutrition affects rehabilitation through its influence on physical and mental functioning, although little attention has been paid to effects on rehabilitation outcomes. The present study aimed to describe nutritional status and food consumption in stroke patients within 2 weeks of hospital admission and before discharge, as well as to investigate the effects of nutritional and dietary factors on rehabilitation outcomes. One hundred patients from a consecutive cohort admitted to a metropolitan hospital with acute stroke were recruited and assessed by a single researcher, with 38 reassessed at discharge. Nutritional status was assessed using Mini-Nutritional Assessment and anthropometric indices and dietary intake was assessed by 1-day weighed dietary records. Rehabilitation outcomes were changes in Barthel index scores and the rehabilitation efficiency index. Few (n = 9; 10%) consumed ≥100% of the estimated average requirement (EAR) for energy within 2 weeks of admission and 13 (33%) had energy intakes <50% of EAR before discharge. A small but increasing proportion (7% at admission, 13% at discharge) were identified as being malnourished across the inpatient stay. Younger age, lower Barthel index and a higher energy intake in the early stages of admission predicted the extent and rate of restoration of functional abilities by discharge (F = 7.503, P = 0.001; F = 14.558, P < 0.001). Given a general finding of nutritional deterioration identified for these patients, as well as the identification of energy intake as a modifiable influence on the extent and rate of recovery, there is clearly scope for the multidisciplinary development of nutritional support for stroke patients to improve rehabilitation outcomes. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Nutrient intakes, major food sources and dietary inadequacies of Inuit adults living in three remote communities in Nunavut, Canada.

PubMed

Sharma, S; Hopping, B N; Roache, C; Sheehy, T

2013-12-01

Inuit in Nunavut, Canada, are currently undergoing a nutritional transition that may contribute to an increased prevalence of chronic disease. Information is lacking about the extent to which contemporary Inuit diets are meeting current dietary recommendations. A culturally appropriate quantitative food frequency questionnaire (QFFQ) developed and validated for Inuit in Nunavut, Canada, was used to assess food and nutrient intake in a cross-sectional sample of adults. Participants included 175 women and 36 men with mean (SD) ages of 42.4 (13.2) and 42.1 (15.0) years, respectively. The response rate for those who completed the study was 79% with 208 QFFQs included for analysis. Reported mean daily energy intakes were: men 15,171 kJ (3626 kcal); women 11,593 kJ (2771 kcal). Dietary inadequacy was expressed as the percentage of participants reporting intakes below the sex- and age-specific estimated average requirements (EARs). For nutrients without EARs, adequate intakes were used. Energy and sodium intakes exceeded the recommendations. Less than 10% of participants met recommendations for dietary fibre intake. Vitamin E intakes were below EARs for ≥97% of participants, whereas >20% reported inadequate vitamin A, folate and magnesium intakes. Among women, >50% reported inadequate calcium and vitamin D intakes. Non-nutrient-dense foods contributed 30% of energy, 73% of sugars and 22% of fat. Traditional foods contributed 56% of protein and 49% of iron. The present study demonstrates a relatively high prevalence of inadequate nutrient intakes among Inuit. The results may be used to monitor the nutrition transition among Inuit, evaluate nutritional interventions, and inform public health policy decision-making. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Developing an interactive portion size assessment system (IPSAS) for use with children.

PubMed

Foster, E; Hawkins, A; Simpson, E; Adamson, A J

2014-01-01

Novel methods of assessing dietary intake are required to reduce the participant burden in dietary surveys, improve participation rates and thereby improve the representativeness of the sample and minimise the impact of measuring dietary intake on a subject's food intake during the recording period. One method of reducing the burden placed on participants in recording dietary intake is to replace weighing of foods with estimation of portion size using tools such as food photographs. The interactive portion size assessment system (IPSAS) is an interactive portion size assessment system for use in assessing portion sizes of foods consumed by children aged 18 months to 16 years. The system is computer-based and is designed to be administered during an interview for a food diary or 24-h recall. The portion sizes depicted are age-specific and based on the weights of foods served to children during the UK National Diet and Nutrition Surveys. The system displays digital images of food used to estimate the amount of each food served to the child and the amount of any food left over. Foods are categorised within the system using a three-tier structure. Twenty-seven food group icons are used with two further drop-down menus to select first the food group, then the food category and, finally, the actual food product. Each food is linked to UK food composition codes and all photographs are linked to the weight of the food depicted. Nutritional output is via a companion database. The present study describes the development of the IPSAS and the structure of the system. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Clinical nutrition managers have access to sources of empowerment.

PubMed

Mislevy, J M; Schiller, M R; Wolf, K N; Finn, S C

2000-09-01

To ascertain perceived access of dietitians to power in the workplace. The conceptual framework was Kanter's theory of organizational power. The Conditions for Work Effectiveness Questionnaire was used to measure perceived access to sources of power: information, support, resources, and opportunities. Demographic data were collected to identify factors that may enhance empowerment. The questionnaire was sent to a random sample of 348 dietitians chosen from members of the Clinical Nutrition Management dietetic practice group of the American Dietetic Association. Blank questionnaires were returned by 99 (28.4%) people not working as clinical nutrition managers, which left 249 in the sample. Descriptive statistics were used to organize and summarize data. One-way analysis of variance and t tests were performed to identify differences in responses based on levels of education, work setting, and information technology skills. Usable questionnaires were received from 178 people (71.5%). On a 5-point scale, scores for access to information (mean +/- standard deviation [SD] = 3.8 +/- 0.7), opportunity (mean +/- SD = 3.6 +/- 0.7), support (mean +/- SD = 3.2 +/- 0.9), and resources (mean +/- SD = 3.1 +/- 0.8) demonstrated that clinical nutrition managers perceived themselves as having substantial access to sources of empowerment. Those having higher levels of education, working in larger hospitals, having better-developed information technology skills, and using information technology more frequently had statistically significant higher empowerment scores (P = < or = .05) than contrasting groups in each category. Clinical nutrition managers are empowered and able to assume leadership roles in today's health care settings. Their power may be enhanced by asserting more pressure to gain greater access to sources of power: support, information, resources, and opportunities.

Dietetic Treatment of Diabetes Mellitus with Special Reference to High Blood-pressure

PubMed Central

Embleton, Dennis

1938-01-01

The error in a diabetic is essentially a carbohydrate intolerance, and correction of this defect should be aimed at in treatment. Dietetic treatment of diabetes is more readily studied in early cases or cases in the pre-diabetic state, before arterial degeneration and other catastrophes have become manifest. It is suggested that such a condition exists in obese subjects with a carbohydrate intolerance. A high protein diet based on a study of these cases is brought forward. This diet has been shown to operate favourably in diabetic states. Many cases of reasonable severity can be brought to develop a normal or nearly normal glucose tolerance curve and retain this state over a period of years. Cases in this state are better able to resist concomitant infections without deterioration of their tolerance than cases imperfectly balanced with insulin. The high protein diet can be used in cases of hyperpiesia in the absence of gross kidney damage. These cases show a steady and lasting drop in blood-pressure without the necessity of employing rest. The value of the pure fruit diet in increasing tolerance of certain diabetics to carbohydrate is demonstrated. The indiscriminate use of insulin in hyperglycæmic states is deprecated on the grounds that it is frequently unnecessary, and though it may balance it does not necessarily rectify the main deficiency of carbohydrate intolerance. By the use of this simple high protein diet, where no weighing, &c., is required, a large number of diabetics at present on insulin could be readily dealt with, a return to a normal or nearly normal glucose tolerance curve being obtained and maintained. PMID:19991654

Practitioner and lay perspectives of the service provision of nutrition information leaflets in primary care.

PubMed

McClinchy, Jane; Dickinson, Angela; Barron, Duncan; Thomas, Hilary

2011-12-01

In primary care, leaflets are often used to communicate health information. Increasingly, primary healthcare practitioners need to provide dietary advice. There is limited research exploring how nutrition information leaflets are used in primary care. The present study explored practitioner and lay experiences with respect to providing and receiving nutrition information in primary care, focusing in particular on the use of leaflets for nutrition information. A qualitative design was used incorporating focus groups with 57 practitioners based at seven general practitioner practices and a purposive sample of 30 lay participants attending six Consumer Health Organisations within one primary care trust. Focus groups were taped and transcribed verbatim and data were analysed thematically, assisted by computer software n6® (QSR International Pty Ltd, Melbourne, Australia). Practitioners discussed barriers to giving nutritional advice, access to leaflets, lay receptiveness to advice and their perceptions about the value of leaflets to lay people. Food was not considered in terms of its nutritional components by lay participants and the need for nutritional information was not perceived to be relevant until they had received a medical diagnosis. Lay participants discussed the importance of receiving nutritional advice relating to their medical diagnosis and the altered status of written information that was delivered personally. Practitioner and lay groups suggested improvements to ensure that nutritional advice be supported by relevant and appropriate written information. This research has underlined the continuing importance of nutrition information leaflets and concludes that there is particular value in involving lay participants in the development of nutrition information leaflets. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Clinical and immunological profile of children aged 5-9 years with persistent egg allergy before oral immunotherapy with egg. A multicenter, randomized controlled trial of the Spanish Society of Pediatric Allergy, Asthma and Clinical Immunology (SEICAP).

PubMed

Echeverria, L; Martin-Muñoz, M F; Martorell, C; Belver, M T; Alonso Lebrero, E; Zapatero, L; Fuentes, V; Piqué, M; Plaza, A; Muñoz, C; Martorell, A; Blasco, C; Villa, B; Gómez, C; Nevot, S; García, J M; Madero, R

2018-05-24

In children with egg protein allergy (EA), the probability of overcoming the allergy decreases with age, and the possibility of suffering severe adverse reactions as a consequence of dietetic transgressions results in worsened quality of life. One treatment option in such cases is oral immunotherapy (OIT) with foods. We present a cohort of children with EA scheduled for OIT with pasteurized raw egg white, describing their clinical and allergic characteristics before the start of OIT. The median age was six years, and 93% of the patients also suffered other allergies (58% asthma and 38.6% allergy to more than two food groups). In the last year, 14.8% had suffered a severe reaction due to dietetic transgression with egg. The median IgE specific of egg white titer was 38.5kU/l. A double-blind placebo-controlled food challenge with cooked egg white was performed, and if the test proved positive, it was repeated with pasteurized raw egg white. The mean symptoms-provoking dose was 1.26g and 0.55g for cooked egg white and raw egg white, respectively. An IgE specific of ovomucoid titer of <2.045kU/l differentiated those patients that tolerated cooked egg white. OIT with egg is regarded as an option in patients with persistent egg allergy. In the previous challenge test, an IgE specific of ovomucoid titer of <2.045kU/l differentiates those patients that tolerate cooked egg white. Copyright © 2018 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

A systematic review and meta-analysis of interventions for weight management using text messaging.

PubMed

Siopis, G; Chey, T; Allman-Farinelli, M

2015-02-01

Obesity prevalence continues to increase worldwide, with significant associated chronic disease and health cost implications. Among more recent innovations in health service provision is the use of text messaging for health behaviour change interventions including weight management. This review investigates the efficacy of weight management programmes incorporating text messaging. Medical and scientific databases were searched from January 1993 to October 2013. Eligibility criteria included randomised controlled trials (RCTs), pseudoRCTs and before and after studies of weight management, among healthy children and adults, that used text messaging and included a nutrition component. Data extraction and quality assessment followed guidelines from PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and the Evidence Analysis Manual of the American Academy of Nutrition and Dietetics. From 512 manuscripts retrieved, 14 met the inclusion criteria (five manuscripts in children and nine in adults). Duration of interventions ranged from 1 to 24 months. Frequency of text messaging was from daily to fortnightly. Six studies in adults were included in a meta-analysis with mean body weight change as the primary outcome. The weighted mean change in body weight in intervention participants was -2.56 kg (95% confidence interval = -3.46 to -1.65) and in controls -0.37 kg (95% confidence interval = -1.22 to 0.48). The small body of evidence indicates that text messaging interventions can promote weight loss. However, lack of long-term results indicate that further efficacy studies are required. Future investigations should elucidate the determinants, such as intervention duration, text message frequency and level of interactivity that maximise the success and cost effectiveness of the delivery medium. © 2014 The British Dietetic Association Ltd.

A kitchen-based intervention to improve nutritional intake from school lunches in children aged 12-16 years.

PubMed

Madden, A M; Harrex, R; Radalowicz, J; Boaden, D C; Lim, J; Ash, R

2013-06-01

School lunches potentially provide an important source of nutrients for children, although studies have shown that their food choices are not always associated with health benefits. The present study aimed to evaluate the effects of a kitchen-based intervention on intake from school lunches undertaken in 2005. The three-phase study comprised a pre-intervention observation, the intervention itself and a post-intervention observation. Children aged 12-16 years attending a large, inner-city, secondary school in London were invited to participate. The intervention consisted of small, practical changes to the school menu with the purpose of reducing total and saturated fat and increasing fruit and vegetable consumption. Intake was evaluated using a weighed technique. One hundred and eighty and 198 children participated in the pre- and post-intervention phases, respectively. After the intervention, a significant reduction was observed in mean (SD) intake of total fat [44% (8%) versus 40% (9%) total energy, P < 0.01] and of saturated fat [13% (6%) versus 10% (6%), P < 0.01]. The children also ate significantly more fruit and vegetables [12.0 (10.4) g versus 30.0 (30.5) g total weight, P < 0.001]. However, after the intervention, the mean intakes of total and saturated fat, fruit and vegetables were still significantly below the Caroline Walker Trust guidelines for school lunches. The present study shows that total and saturated fat and fruit and vegetable intake from school lunches can be significantly improved by a short, kitchen-based intervention. Although the benefits were limited, the results support further work in this area. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

[Nutritional and metabolic factors as risk factors for cardiovascular diseases in an adult population in the city of Maracibo, Estado Zulia, Venezuela].

PubMed

García-Araujo, M; Semprún-Fereira, M; Sulbarán, T A; Silva, E; Calmón, G; Campos, G

2001-03-01

To analyze the nutritional and metabolic risk factors for Cardiovascular Diseases (CVD) present in a group of people in the city of Maracaibo a study was performed with 209 volunteers (145 women and 64 men) between 20 and 89 years of age who underwent: a) Anthropometric Evaluation: Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR) and Physical Examination: Systolic (SBP) and Diastolic Blood Pressure (DBP); b) Dietetic Evaluation (24 hours recall), and c) Biochemical Evaluation: Glycemia (GLYC), Triglycerides (TG), Total Cholesterol (CHOL), HDL-C, LDL-C and VLDL-C, applying enzymatic methods. It was also investigated, their Age, Family History of Metabolic Alterations (FHMA), physical activity, smoking habits and alcohol consumption. More than 50% of the individuals showed a BMI > 25; 64% of women showed a WHR value > 0.8; 34 and 28% of men and women respectively had a high fat ingestion (HFI); 36% of men had hypertriglyceridemia and high levels of VLDL-C; 41% of women and 30% of men showed decreased HDL-C. A high frequency of FHMA was found in 85% of women and 78% of men followed by sedentary life in 64% of men and 79% of women. The age significantly (p < 0.05) affected the values for WHR, SBP, DBP, GLYC, CHOL, TG, HDL-C, LDL-C and VLDL-C. The dietetic evaluation showed a diet that was low in calories, high in protein, normal in fat and low in carbohydrates. It is concluded that the population elected for this study might be considered under a high risk for CVD, since both nutritional and metabolic factors, as well as the other risk factors analyzed, were present in a high percentage of the individuals studied.

Consumer acceptability and understanding of front-of-pack nutrition labels.

PubMed

Mejean, C; Macouillard, P; Péneau, S; Hercberg, S; Castetbon, K

2013-10-01

Front-of-pack (FOP) nutrition labelling has been proposed as a tool for helping consumers make healthy choices. Before determining its effects on consumer behaviour, factors involved in its use must be elucidated, i.e. understanding and acceptability on the part of the consumer. Among five FOP labels, we sought to determine which formats were most easily understood and accepted by a large sample of adults. Among 39 370 adults who participated in the French Nutrinet-Santé cohort study, understanding and indicators of acceptability (attitude, liking, visual attractiveness and perceived cognitive workload) were measured for five FOP labels: The currently used 'multiple traffic lights' (MTL) and 'simple traffic lights' (STL), and the 'colour range' logo (CR), the 'green tick' and the PNNS logo. We investigated the contribution of the different elements to consumer perception of FOP labels using multiple correspondence analyses. Over half of the sample population showed a high level of understanding and perceived no discomfort in terms of the different logos. Label formats were positioned along an acceptability gradient ranging from acceptance to rejection, consisting of 'liking', 'attractiveness' and indicators of perceived cognitive workload. MTL was significantly more often liked and was viewed as reliable and informative. MTL, STL and the green tick performed better than the CR and PNNS logos in terms of ease of identification and comprehension. CR was clearly the least appreciated and it had the most complex format. Consumers prefer FOP labels which give complete, reliable and simplified information on the nutrient quality of foods. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Weight loss expectations and body dissatisfaction in young women attempting to lose weight.

PubMed

Siervo, M; Montagnese, C; Muscariello, E; Evans, E; Stephan, B C M; Nasti, G; Papa, A; Iannetti, E; Colantuoni, A

2014-04-01

Unrealistic weight loss expectations (WLEs) and greater body dissatisfaction may be associated with the poor long-term outcomes of dietary and lifestyle weight loss treatments. We evaluated the association between body size, WLEs and body dissatisfaction in young women attempting to lose weight. Forty-four young healthy women [age range 18-35 years, body mass index (BMI) range 23-40 kg/m2] were recruited. Women were classified as obese (BMI ≥ 30.0 kg/m2) and non-obese (BMI <30.0 kg/m2). The Body Dissatisfaction scale of the Eating Disorder Inventory-2 and the Body Image Assessment for Obesity silhouette charts were used to assess body dissatisfaction. WLEs were categorised according to personal (ideal, happiness, satisfaction, weight history), lifestyle (fitness) and social (career, family acceptance, peer acceptance, mass media, social pressure) factors. Individual WLEs were compared with recommended clinical targets (5%, 10% and 20%) for weight loss. Body dissatisfaction was lower in non-obese subjects and was directly associated with BMI (P < 0.05). WLEs were directly associated with BMI and the obese group reported greater expectations. Five non-obese subjects (23%) desired to lose more than 20% of their body weight, whereas the proportion was significantly higher in the obese group (17 subjects; 74%). Subjects derived the greatest WLEs from mass media, whereas they perceived that family and friends were supportive of a lesser degree of weight loss. We observed a mismatch between clinical and personal expectations, and social pressure and interpersonal relationships appear to have a prominent role with respect to influencing the association. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Weight management strategies for those with chronic kidney disease - a consensus report from the Asia Pacific Society of Nephrology and Australia and New Zealand Society of Nephrology 2016 renal dietitians meeting.

PubMed

Lambert, Kelly; Beer, Jo; Dumont, Ruth; Hewitt, Katie; Manley, Karen; Meade, Anthony; Salamon, Karen; Campbell, Katrina

2017-07-25

Develop a consensus report to guide dietetic management of overweight or obese individuals with Chronic Kidney Disease (CKD). Six statements relating weight management in CKD guided a comprehensive review of the literature. A summary of the evidence was then presented at the renal nutrition meeting of the 2016 Asia Pacific Society of Nephrology and Australia and New Zealand Society of Nephrology. Majority agreement was defined as group agreement on a statement of between 50-74%, and consensus was considered ≥ 75% agreement. The recommendations were developed via a mini Delphi process. Two statements achieved group consensus: the current guidelines used by dietitians to estimate energy requirements for overweight and obese people with CKD are not relevant and weight loss medications may be unsafe or ineffective in isolation for those with CKD. One statement achieved group agreement: Meal replacement formulas are safe and efficacious in those with CKD. No agreement was achieved on the statements of whether there is strong evidence of benefit for weight loss prior to kidney transplantation; whether traditional weight loss strategies can be used in those with CKD and if bariatric surgery in those with end stage kidney disease is feasible and effective. There is a limited evidence base to guide the dietetic management of overweight and obese individuals with CKD. Medical or surgical strategies to facilitate weight loss are not recommended in isolation and require a multidisciplinary approach with the involvement of a skilled renal dietitian. This article is protected by copyright. All rights reserved.

From weight management goals to action planning: identification of a logical sequence from goals to actions and underlying determinants.

PubMed

van Genugten, L; van Empelen, P; Oenema, A

2012-08-01

Weight gain prevention (WGP) among adults who are overweight is an important target in the prevention of obesity. However, little is known about the process from WGP as a goal to successful weight-management. The present study aimed to: (i) gain more insight into this process; (ii) identify cognitive predictors of intention for WGP; and (iii) examine WGP as a potential predictor for the intention to change weight-related behaviours [dietary intake (DI) and physical activity (PA)] and specific action planning. In this cross-sectional study, overweight adults [n = 510; body mass index 25-30 kg m(-2); mean (SD) age 48 (9.5) years; 30.8% male] completed an online questionnaire, assessing goal intention for WGP, behavioural intention for DI and PA, planning for change in DI and PA and socio-cognitive correlates. Ordinal regression analyses were used to analyse the data. In 89% of the sample, (parts of) the proposed sequence from goal intention (for WGP), behavioural intention (for DI/PA) and planning (for DI/PA) was observed. Attitude, social norm and perceived control towards WGP, and perceived weight status and risk perception, were associated with intention for WGP. Behaviour-specific perceived control and preferences were more strongly associated with intention to change DI or PA and planning for change than intention for WGP was. Intention for WGP is important in the process toward weight-management because, for most people, intention for WGP precedes behavioural intention, which precedes planning. Intention for WGP is associated with behavioural intention but behaviour-specific factors are the strongest correlates of behavioural intention and planning. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Polymorphism in the CLOCK gene may influence the effect of fat intake reduction on weight loss.

PubMed

Loria-Kohen, Viviana; Espinosa-Salinas, Isabel; Marcos-Pasero, Helena; Lourenço-Nogueira, Thais; Herranz, Jesús; Molina, Susana; Reglero, Guillermo; Ramirez de Molina, Ana

2016-04-01

The aim of this study was to assess the effect of a weight loss treatment on obesity- associated variables with respect to the CLOCK and FTO genotypes. In all, 179 volunteers (78% female) participated in a 12-week calorie-restriction program; hypocaloric diets of between 5442 and 10048 kJ/d were individually prescribed to all participants. Dietetic, anthropometric, and biochemical data were collected at baseline and at the end of the intervention. When treatment was over, five single nucleotide polymorphisms (SNPs) were sought in CLOCK and FTO in all participants who provided consent. Bonferroni-corrected linear regression models were used to examine the influence of interactions of the type genotype × dietetic change on obesity-associated variables. Variation in the CLOCK and FTO genotypes had no significant influence on the change in obesity-associated variables. The interaction genotype × percentage intake of dietary fat had a significant influence on body mass index (BMI; adjusted P = 0.03). Participants carrying CLOCK rs3749474 (TT + CT) showed a positive association between the change in percentage intake of dietary fat and change in BMI (β = 0.044; 95% confidence interval [CI], 0.0119-0.0769; P = 0.008), whereas participants homozygous for the wild-type allele (CC) showed a negative, although nonsignificant association (β = -0.032; 95% CI, -0.0694 to 0.036; P = 0.077). The possession of CLOCK rs3749474 may influence the effect of reducing the percentage intake of dietary fat on obesity-associated variables. Participants carrying this SNP might benefit more than others from weight loss treatment involving dietary fat restriction. The treatment of obesity might therefore be customized, depending on the alleles carried. Copyright © 2016 Elsevier Inc. All rights reserved.

Reduction of Caloric Intake Might Override the Prosteatotic Effects of the PNPLA3 p.I148M and TM6SF2 p.E167K Variants in Patients with Fatty Liver: Ultrasound-Based Prospective Study.

PubMed

Krawczyk, Marcin; Stachowska, Ewa; Milkiewicz, Piotr; Lammert, Frank; Milkiewicz, Malgorzata

2016-01-01

The adiponutrin (PNPLA3) p.I148M and transmembrane 6 superfamily member 2 (TM6SF2) p.E167K variants represent risk factors for non-alcoholic fatty liver disease (NAFLD). In this study, we assessed the effects of caloric restriction on liver phenotypes in NAFLD patients in relation to the PNPLA3 and TM6SF2 genotypes. We genotyped both variants in 143 individuals with NAFLD (55 females, age 18-74 years) and 180 controls (85 females, age 33-66 years). Liver steatosis was assessed using the ultrasound-based Hamaguchi score. A 4-month dietetic intervention, consisting of restriction of daily caloric intake without changes in physical activity, was performed. Both PNPLA3 (p = 0.002) and TM6SF2 (p = 0.041) variants were associated with NAFLD before intervention. Overall, 88 patients completed the intervention, which led to a significant decrease of steatosis, ALT activities, body mass index, hip and waist circumferences, and waist-hip ratio (all p < 0.0001). Hepatic steatosis and anthropometric traits improved significantly (p < 0.05) in carriers of either PNPLA3 or TM6SF2 risk genotype. The improvement of phenotypic traits, apart from WHR (p = 0.02), was not modified by the presence of PNPLA3 or TM6SF2 variants. The PNPLA3 and TM6SF2 polymorphisms are associated with NAFLD assessed by the Hamaguchi score. Neither PNPLA3 nor TM6SF2 risk alleles impair the response to dietetic intervention in NAFLD. © 2016 S. Karger AG, Basel.

Nutritional and clinical associations of food cravings in pregnancy.

PubMed

Hill, A J; Cairnduff, V; McCance, D R

2016-06-01

Cravings in pregnancy are considered to alter dietary intake; however, the nutritional consequences are unknown. The present study aimed to investigate the prevalence of food cravings in pregnancy, and their contribution, as a potentially modifiable determinant of weight gain and the development of obesity in pregnancy. Healthy pregnant women were participants in the Belfast cohort of the Hyperglycaemia and Adverse Pregnancy Outcome study (HAPO), a prospective observational study examining maternal glycaemia and pregnancy outcome. Diet was assessed at an average of 29 weeks of gestation using a self-administered validated food frequency questionnaire over the previous 2 weeks that included questions on food cravings experienced at any time during pregnancy. Clinical measurements collected included, height, weight, blood glucose and neonatal outcomes. Mean daily nutrient intakes were analysed with appropriate software. Food cravings were reported by 39% (n = 635) of women, with sweet foods, fruit and dairy products most frequently consumed. Those who craved foods had a higher mean (SD) energy intake [9721 (3016) kJ] (P = 0.002) even when under-reporters were removed [10131 (2875) kJ] (P = 0.008). However, no differences were found in nutrient or food intake between groups when adjusted for energy. Similarly, no differences were observed between groups and glycaemic control, anthropometric measurements or offspring outcome measures. Cravings commonly occur in pregnancy and contributed to a small increase in energy intake; however, this did not impact on overall dietary intake, nor was it associated with excessive gestational weight gain, maternal glycaemia or offspring outcome measurements. © 2015 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of The British Dietetic Association Ltd.

Dietetic treatment with hypercaloric and hyperprotein intake in patients following severe brain injury.

PubMed

Balzola, F; Boggio Bertinet, D; Solerio, A; Rizzonato, P; Urciuoli, R; Piazza, A

1980-01-01

Sixty four patients, following severe acute brain injury were fed according to a strict dietetic therapy at the Intensive Care Unit at the Institute of Neurological Surgery, University of Turin. We used mixtures composed of simple nutritional elements consisting of carbohydrate as glucose polymers from 7 to 15 units, free aminoacids and MCT oil, integrated with natural elements. The solutions were administered via a nasogastric tube with the maximum caloric intake of 6.000 Kcal and 186 grams proteins/24 hr. After recording a series of hematochemical and clinical parameters we obtained the following results: 1) the average blood sugar level was always found to be pathological among the 11 patients who eventually died during their hospitalization, while 30% of the discharged patients had normal blood sugar values; 2) kidney function was significantly more affected among eventually deceased patients than among discharged ones; 3) the hospitalization time had a negative influence on the hepatic functions. Total serum albumins and proteins cease their decline respectively at average values of 2 and 5.5% gr, cholesterol maintains a constant level between 180 and 200% gr, calcium between 8 and 9 mg% and phosphorous around 3 mg%. Alkaline phosphatase in all patients rose significantly to pathological values only after a week of hospitalization. All other tests presented an irregular course. The survival period of our group of patients was significantly longer than that of control group. Within our group the survival rate was better among patients who received, within 10 days from cerebral damages, a hypercaloric and hyperprotein diet of more than 5.000 Kcal and 120 grams of proteins in 24 h, as compared to those whom the same diet was administered more gradually or following a longer period of time after having sustained cerebral damage.

Comparing the effectiveness of a multi-component weight loss intervention in adults with and without intellectual disabilities.

PubMed

Spanos, D; Hankey, C; Boyle, S; Melville, C

2014-02-01

The prevalence of obesity in adults with intellectual disabilities (ID) is rising, although the evidence base for its treatment in this population group is minimal. Weight management interventions that are accessible to adults with ID will reduce the inequalities that they frequently experience in health services. This short report compared the effectiveness of weight management in those with and without ID who completed nine sessions of a multi-component weight management programme. TAKE 5 is a 16-week multi-component weight management intervention for adults with ID and obesity [body mass index (BMI) ≥30 kg m(-2) ]. This intervention is an adaption of the weight management programme provided by the Glasgow & Clyde Weight Management Service (GCWMS) for adults without ID and obesity (National Health Service based). Fifty-two participants of the TAKE 5 programme were individually matched by baseline characteristics (sex, age and BMI) with two participants without ID of the GCWMS programme. Comparisons in terms of weight and BMI change and rate of weight loss were made for those who attended all nine sessions. There were no significant differences between the groups in the amount of weight loss (median: -3.6 versus -3.8 kg, respectively, P = 0.4), change in BMI (median: -1.5 versus -1.4 kg m(-2) , P = 0.9), success of achieving 5% weight loss (41.3% versus 36.8%, P = 0.9) and rate of weight loss across the 16-week intervention. A multi-component weight loss intervention can be equally effective for adults with and without ID and obesity. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

A 24-h a la carte food service as support for patients at nutritional risk: a pilot study.

PubMed

Munk, T; Seidelin, W; Rosenbom, E; Nielsen, A L; Klausen, T W; Nielsen, M A; Thomsen, T

2013-06-01

Undernutrition and insufficient energy and protein intake is a common problem in hospitalised patients. The aim of this pilot study was to investigate whether a novel hospital menu would be an effective strategy for increasing nutritional intake in patients at nutritional risk. A historically controlled intervention pilot study was conducted. Forty patients at nutritional risk were offered a novel hospital menu as a supplement to the ordinary hospital menu. The menu consisted of 36 naturally energy-enriched small dishes served on demand 24 h a day. Energy and protein intake were calculated as the mean over a period of 3 days. No significant difference in energy and protein intake was observed between the groups; however, a significant (P = 0.001) time gradient in total energy intake was observed in the intervention group. Moreover, a significant (P = 0.03) time gradient in energy intake received from the novel menu was observed. The dishes from the novel menu were mainly ordered from 11.00 h to 14.00 h and from 17.00 h to 18.00 h. No overall significant differences in energy and protein intake between the groups were found. However, the present pilot study revealed a significant time gradient in total energy intake (P = 0.001) and in energy intake from the novel menu (P = 0.03). This indicates the need to include a run-in period when investigating novel hospital menus as a support for patients at nutritional risk. Additionally, food service, available 24 h a day, appears to be unnecessary. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Getting a taste for food waste: a mixed methods ethnographic study into hospital food waste before patient consumption conducted at three New Zealand foodservice facilities.

PubMed

Goonan, Sarah; Mirosa, Miranda; Spence, Heather

2014-01-01

Foodservice organizations, particularly those in hospitals, are large producers of food waste. To date, research on waste in hospitals has focused primarily on plate waste and the affect of food waste on patient nutrition outcomes. Less focus has been placed on waste generation at the kitchen end of the hospital food system. We used a novel approach to understand reasons for hospital food waste before consumption and offer recommendations on waste minimization within foodservices. A mixed methods ethnographic research approach was adopted. Three New Zealand hospital foodservices were selected as research sites, all of which were contracted to an external foodservice provider. Data collection techniques included document analyses, observations, focus groups with kitchen staff, and one-on-one interviews with managers. Thematic analysis was conducted to generate common themes. Most food waste occurred during service and as a result of overproduction. Attitudes and habits of foodservice personnel were considered influential factors of waste generation. Implications of food waste were perceived differently by different levels of staff. Whereas managers raised discussion from a financial perspective, kitchen staff drew upon social implications. Organizational plans, controls, and use of pre-prepared ingredients assisted in waste minimization. An array of factors influenced waste generation in hospital foodservices. Exploring attitudes and practices of foodservice personnel allowed an understanding of reasons behind hospital food waste and ways in which it could be minimized. This study provides a foundation for further research on sustainable behavior within the wider foodservice sector and dietetics practice. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A cross-sectional exploration of the personality traits of dietitians.

PubMed

Ball, L; Eley, D S; Desbrow, B; Lee, P; Ferguson, M

2015-10-01

Personality traits refer to habitual patterns of behaviour, thought and emotions, and have been shown to influence health professionals' career decisions, career development, job satisfaction and retention. There is an opportunity to better understand and support the career pathways of dietitians by exploring their personality traits. The two primary aspects of personality are: (i) temperament traits, which determine automatic emotional responses to experiences, and are generally stable over lifetime, and (ii) character traits, which reflect personal goals and values, and tend to develop with life experience. The present study explored the levels of temperament and character traits of dietitians, as well as their relationship to demographic variables. The study comprised a cross-sectional online survey of 346 Australian dietitians [95% female; mean (SD) age 32 (10) years; mean (SD) time since graduation 7 (9) years]. Temperament and character traits were measured by the Temperament and Character Inventory. Key demographic variables were measured to describe career decisions and pathways of dietitians. Multivariate analyses of variance was used to investigate the relationship between demographic variables and personality traits. Levels of several traits were significantly associated with gender, age and highest level of education. In comparison to the general population, the dietitians displayed average levels of Novelty Seeking; high levels of Harm Avoidance, Reward Dependence, Persistence, Self-Directedness and Cooperativeness; and low levels of Self-Transcendence. The dietitians in the present study displayed levels of personality traits that were similar to other health professionals, although they differed from the general population. These findings are the precursor to further work that may inform recruitment strategies and career counselling in dietetics. © 2014 The British Dietetic Association Ltd.

Glycemic control and lipid profile of children and adolescents undergoing two different dietetic treatments for type 1 diabetes mellitus.

PubMed

Dalsgaard, Haline; Saunders, Cláudia; Padilha, Patrícia de C; Luescher, Jorge Luiz; Szundy Berardo, Renata; Accioly, Elizabeth

2014-03-01

To compare the glycemic control and lipid profile of children and adolescents undergoing two different dietetic treatments for type 1 Diabetes Mellitus assisted at the Children and Adolescent's Diabetes Mellitus Health Center-UFRJ. A retrospective longitudinal study conducted between 2002 and 2006. We evaluated the same subjects in two different periods: after 1 year in TD and subsequently after 1 year in CCHO. The evolution of the nutritional status during the dietary treatments was evaluated using Body Mass Index (BMI) for age. The lipid panel was evaluated according to the 1st Guideline for Prevention of Atherosclerosis in Childhood and Adolescence, used in Brazil, and the glycemic control was evaluated by measuring glycated hemoglobin (HbA1c). We evaluated 93 individuals, 38.7% children and 61.3% adolescents. The mean age at study entry was 11.1 (± 2.66) years and the mean disease duration was 6.1 (± 3.2) years. A significant difference in the percentage of adequacy of HbA1c (p = 0.000) and in the values of total plasma cholesterol (p = 0.043) was found after 1 year of CCHO diet, which did not happen during the observation time of TD. The evolution of anthropometric nutritional status showed no significant difference between the beginning and the end of both dietary treatments. The results of this study suggest that a more flexible food orientation program can contribute to the improvement of blood glucose levels without causing deterioration of the lipid profile when compared to TD. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Nutritional practices in full-day-care pre-schools.

PubMed

Jennings, A; McEvoy, S; Corish, C

2011-06-01

Full-day-care pre-schools contribute significantly to the nutritional intake and acquisition of dietary habits of the pre-school child. The present study investigated nutritional practices in full-day-care pre-schools in Dublin, Ireland, aiming to determine the nutritional support that pre-school managers deem necessary, thereby facilitating the amelioration of existing pre-school nutritional training and practices. A telephone questionnaire completed by pre-school managers (n=54) examined pre-school dietary practices, food provision and the association between these and pre-school size, nutritional training attendance, possession of the Food and Nutrition Guidelines for Pre-school Services and having a healthy eating policy. Nutritional training needs were also investigated. Twenty-five pre-schools provided all food for attending children; parents were sole providers in six. Thirty-four pre-schools had a written healthy eating policy. Attendance at nutritional training was reported by 40. Possession of the Guidelines (n=40) did not consistently result in their use. Poor parental and staff involvement in policy and menu development was cited. Although the delayed introduction of iron-containing foods and a feeding beaker in infants was clearly evident, inappropriate beverages and snacks were served to children aged 1-5 years in 43 and 37 pre-schools, respectively. Training priorities cited by managers included parental education and the provision of information regarding menu planning and healthy food choices. Nutritional training should advocate whole staff familiarity with and use of current guidelines, in addition to encouraging nutritional policy development and enforcement. Parental education is warranted. Dietary education should focus specifically on appropriate weaning practices, healthy beverage and snack provision and menu planning. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Dietary intake in population-based adolescents: support for a relationship between eating disorder symptoms, low fatty acid intake and depressive symptoms.

PubMed

Allen, K L; Mori, T A; Beilin, L; Byrne, S M; Hickling, S; Oddy, W H

2013-10-01

Relatively little is known about the dietary intake and nutritional status of community-based individuals with eating disorders. This research aimed to: (i) describe the dietary intake of population-based adolescents with an eating disorder and (ii) examine associations between eating disorder symptoms, fatty acid intake and depressive symptoms in adolescents with and without an eating disorder. Data were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a population-based cohort study that has followed participants from birth to young adulthood. This research utilised self-report data from the 17-year Raine Study assessment. Participants comprised 429 female adolescents who completed comprehensive questionnaire measures on dietary intake, eating disorder symptoms and depressive symptoms. Adolescents with an eating disorder (n = 66) reported a significantly lower intake of total fat, saturated fat, omega-6 fatty acid, starch, vitamin A and vitamin E compared to adolescents without an eating disorder (n = 363). Adolescents with an eating disorder and pronounced depressive symptoms (n = 23) also reported a significantly lower intake of polyunsaturated fat and omega-3 and omega-6 fatty acid than adolescents with an eating disorder but no marked depression (n = 43). In the eating disorder sample but not the control sample, omega-3 and omega-6 fatty acid correlated significantly and negatively with eating disorder symptoms and with depressive symptoms. Support is provided for a relationship between low omega-3 and omega-6 fatty acid intake and depressive symptoms in adolescents with eating disorders. Research is needed to examine the feasibility and effectiveness of fatty acid supplementation in this high-risk group. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Development, reproducibility and validity of the food frequency questionnaire in the Poland arm of the Prospective Urban and Rural Epidemiological (PURE) study.

PubMed

Dehghan, M; Ilow, R; Zatonska, K; Szuba, A; Zhang, X; Mente, A; Regulska-Ilow, B

2012-06-01

A food frequency questionnaire (FFQ) is the most commonly used method in large epidemiological studies. The validation of an FFQ is essential for specific populations because foods are culture-dependent. The present study aimed to develop an FFQ and evaluate its validity and reproducibility in estimating the intake of nutrients in urban and rural areas of Poland. Adult participants (n = 146) in the Polish arm of the ongoing Prospective Urban and Rural Epidemiological (PURE) study completed FFQs on two occasions, as well as four 24-h dietary recalls (DRs) during a 12-month period. Correlation coefficients (r) and de-attenuated correlation coefficients between dietary recalls and both FFQs were calculated for selected macro- and micronutrients. Agreement between the two methods was evaluated by classification into quartiles and the Bland-Altman method. Reproducibility was assessed by the intra-class correlation coefficient (ICC). The final food list contained 134 food items. For urban participants, FFQ2 generally underestimated energy, protein and fat compared to the FFQ1 and mean of DRs. In rural areas, compared to DRs, both FFQs overestimated energy and macronutrients. For both urban and rural settings, de-attenuated correlation exceeded 0.4 for almost all nutrients and the exact agreement in quartile categorisation was >66%. When assessing repeatability, ICC varied from 0.39-0.63 in an urban setting and 0.19-0.45 in a rural setting. This 134-item FFQ has good validity and reproducibility in relation to the reference method and can be used to rank individuals based on their macro- and micronutrient intake. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Difference in Composite End Point of Readmission and Death Between Malnourished and Nonmalnourished Veterans Assessed Using Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Clinical Characteristics.

PubMed

Hiller, Lynn D; Shaw, Robert F; Fabri, Peter J

2017-11-01

Previous studies have demonstrated an association between malnutrition and poor outcomes. The primary objective of this study was to explore the difference in the composite end point of readmission rate or mortality rate between hospitalized veterans with and without malnutrition. This was a retrospective chart review comparing veterans with malnutrition based on a modified version of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus characteristics that used 5 of the 6 clinical characteristics to a matched control group of nonmalnourished veterans based on age, admitting service, and date of admission who were admitted between August 1, 2012, and December 1, 2014. Data were extracted from the medical record. Multivariate analysis was used to identify predictors of outcomes. In total, 404 patients were included in the final analysis. All end points were found to be statistically significant. The malnourished group was more likely to meet the composite end point (odds ratio [OR], 5.3), more likely to be readmitted within 30 days (OR, 3.4), more likely to die within 90 days of discharge (OR, 5.5), and more likely to have a length of stay >7 days (OR, 4.3) compared with the nonmalnourished group. Length of stay was significantly longer in the malnourished group, 9.80 (11.5) vs 4.38 (4.5) days. Malnutrition was an independent risk factor for readmission within 30 days or death within 90 days of discharge. Malnourished patients had higher rates of readmission, higher mortality rates, and longer lengths of stay and were more likely to be discharged to nursing homes.

Agreement between student dietitians' identification of refeeding syndrome risk with refeeding guidelines, electrolytes and other dietitians: a pilot study.

PubMed

Matthews, K; Owers, E; Palmer, M

2015-12-01

Limited research exists concerning how consistently and accurately student and newly-graduated dietitians are identifying refeeding syndrome risk in hospitalised patients. The present study aimed to determine the consistency of students' and newly-graduated dietitians' classification of refeeding syndrome risk, as well as agreement with the application of comparison tools such as the National Institute for Health and Care Excellence guidelines, patients' electrolytes and supplementation, and clinical dietitians previously surveyed. Recently-graduated and final-year Griffith University dietetics students were invited to complete an online survey. The survey questioned demographics and asked respondents to classify the level of refeeding syndrome risk (i.e. none, some, high, unsure) in 13 case studies. Electrolytes and supplementation data were sourced from electronic patient records. Chi-squared tests, t-tests and linear regression analyses were conducted. Fifty-three eligible people responded [n = 53 of 112, mean (SD) age 26 (4) years, 89% female, 34% graduates]. Respondents' answers were generally more consistent and more likely to agree with comparison tools when two tools showed the same level of refeeding syndrome risk (49-98%, β = 0.626-1.0994, P < 0.001) than when they differed (11-49%). Respondents' level of agreement with refeeding identification guidelines, electrolyte levels, supplementation and dietitians previously surveyed did not differ by graduate status, degree level, clinical placement status or having read refeeding syndrome guidelines recently (P > 0.05). Students' and new graduates' identification of refeeding syndrome risk improved when there was consistency between guidelines, electrolytes and dietitians' responses. More research is needed to improve the evidence behind refeeding guidelines, with the aim of enhancing the accuracy and consistency of assessment. © 2014 The British Dietetic Association Ltd.

Living with coeliac disease and a gluten-free diet: a Canadian perspective.

PubMed

Zarkadas, M; Dubois, S; MacIsaac, K; Cantin, I; Rashid, M; Roberts, K C; La Vieille, S; Godefroy, S; Pulido, O M

2013-02-01

Strict adherence to a gluten-free diet is the only treatment for coeliac disease. The gluten-free diet is complex, costly and impacts on all activities involving food, making it difficult to maintain for a lifetime. The purpose of this cross-sectional study was to evaluate the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet among Canadians with coeliac disease. A questionnaire was mailed to all members (n = 10 693) of both the Canadian Celiac Association and the Fondation québécoise de la maladie cœliaque in 2008. The overall response rate was 72%. Results are presented for the 5912 respondents (≥18 years) reporting biopsy-confirmed coeliac disease and/or dermatitis herpetiformis. Two-thirds never intentionally consumed gluten. Women reported significantly greater emotional responses to a gluten-free diet but, with time, were more accepting of it than men. Difficulties and negative emotions were experienced less frequently by those on the diet for >5 years, although food labelling and eating away from home remained very problematic. Frustration and isolation because of the diet were the most common negative emotions experienced. The present study quantifies the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet. It highlights the need to improve the training and education of dietitians, other health providers and the food service industry workers about coeliac disease and a gluten-free diet, with the aim of better helping individuals improve their adherence to a gluten-free diet and their quality of life. © 2012 Canadian Celiac Association and Food Directorate Health Canada Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Dietary adequacy and alcohol consumption of Inuvialuit women of child-bearing age in the Northwest Territories, Canada.

PubMed

Kolahdooz, F; Spearing, K; Corriveau, A; Sharma, S

2013-12-01

Previous studies highlight a possible association between alcohol-drinking patterns and dietary inadequacies, which may have negative implications, particularly for women of child-bearing age. The present study aimed to compare dietary adequacy among alcohol drinkers versus nondrinkers in Inuvialuit women of child-bearing age. A cross-sectional survey of 92 randomly selected women of childbearing age (19-44 years) was conducted in three communities in the Northwest Territories of Arctic Canada, using a validated quantitative food frequency questionnaire. Data were analysed to compare mean daily energy and nutrient intakes, dietary adequacy and nutrient densities (per 4184 kJ) between alcohol drinkers and nondrinkers, as well as heavy drinkers and nonheavy drinkers, using the nonparametric Wilcoxen rank sum test. The response rate was between 65% and 85% depending on the community sampled. Of the study participants, 54% (n = 49) were drinkers and 46% (n = 42) were nondrinkers. Of the drinkers, 45% (n = 22) were heavy drinkers. Mean energy intakes were high among all women, although they were significantly higher among drinkers [17,179 kJ (4106 kcal)] compared to nondrinkers [13,317 kJ (3183 kcal)]. There were no significant differences in nutrient intake between the two groups; however, drinkers had a lower nutrient density for most nutrients. Heavy drinkers had a significantly lower nutrient density for all nutrients, except protein, iron, and vitamins B6 , C and D, compared to nonheavy drinkers. The findings of the present study provide evidence of inadequate dietary intake among Inuvialuit of child-bearing age, regardless of alcohol-drinking behaviour. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Development and validation of a knowledge test for health professionals regarding lifestyle modification.

PubMed

Talip, Whadi-ah; Steyn, Nelia P; Visser, Marianne; Charlton, Karen E; Temple, Norman

2003-09-01

We wanted to develop and validate a test that assesses the knowledge and practices of health professionals (HPs) with regard to the role of nutrition, physical activity, and smoking cessation (lifestyle modification) in chronic diseases of lifestyle. A descriptive cross-sectional validation study was carried out. The validation design consisted of two phases, namely 1) test planning and development and 2) test evaluation. The study sample consisted of five groups of HPs: dietitians, dietetic interns, general practitioners, medical students, and nurses. The overall response rate was 58%, resulting in a sample size of 186 participants. A test was designed to evaluate the knowledge and practices of HPs. The test was first evaluated by an expert group to ensure content, construct, and face validity. Thereafter, the questionnaire was tested on five groups of HPs to test for criterion validity. Internal consistency was evaluated by Cronbach's alpha. An expert panel ensured content, construct, and face validity of the test. Groups with the most training and exposure to nutrition (dietitians and dietetic interns) had the highest group mean score, ranging from 61% to 88%, whereas those with limited nutrition training (general practitioners, medical students, and nurses) had significantly lower scores, ranging from 26% to 80%. This result demonstrated criterion validity. Internal consistency of the overall test demonstrated a Cronbach's alpha of 0.99. Most HPs identified the mass media as their main source of information on lifestyle modification. These HPs also identified lack of time, lack of patient compliance, and lack of knowledge as barriers that prevent them from providing counseling on lifestyle modification. The results of this study showed that this test instrument identifies groups of health professionals with adequate training (knowledge) in lifestyle modification and those who require further training (knowledge).

Position of the American Dietetic Association: food irradiation.

PubMed

Wood, O B; Bruhn, C M

2000-02-01

Food irradiation has been identified a sa safe technology to reduce the risk of foodborne illness as part of high-quality food production, processing, handling, and preparation. Food irradiation's history of scientific research , evaluation, and testing spans more than 40 countries around the world and it has been endorsed or support by numerous national and international food and organizations and professional groups. Food irradiation utilizes a source of ionizing energy that passes through food to destroy harmful bacteria and other organism. Often referred to as "cold pasteurization," food irradiation offers negligible loss of nutrients or sensory qualities in food as it does not substantially raise the temperature of the food during processing. Food irradiation does not replace proper food production, processing, handling, or preparation, nor can it enhance the quality of or prevent contact with foodborne bacteria after irradiation. In the United States, manufacturers are required to identify irradiated food sold to consumers with an international symbol (Radura) and and terminology describing the process on product labels. In addiction, food irradiation facilities are thoroughly regulated and monitored for worker and environmental safety. Members of The American Dietetic Association (ADA) and other food, nutrition, and health professionals have a responsibility to educate consumers, food processors, manufacturers and retailers about the safety and application of the technology. When consumers are educated about food irradiation, many prefer irradiated products because of their increased safety. It is the position of ADA that food irradiation enhances the safety and quality of the food supply and helps protect consumers from foodborne illness. The ADA encourages the government, food manufactures, food commodity groups, and qualified food and nutrition professionals to work together to educate consumers about this additional food safety tool and make this choice available in the marketplace.

Position of the American Dietetic Association: functional foods.

PubMed

Hasler, Clare M; Brown, Amy C

2009-04-01

All foods are functional at some physiological level, but it is the position of the American Dietetic Association (ADA) that functional foods that include whole foods and fortified, enriched, or enhanced foods have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. ADA supports research to further define the health benefits and risks of individual functional foods and their physiologically active components. Health claims on food products, including functional foods, should be based on the significant scientific agreement standard of evidence and ADA supports label claims based on such strong scientific substantiation. Food and nutrition professionals will continue to work with the food industry, allied health professionals, the government, the scientific community, and the media to ensure that the public has accurate information regarding functional foods and thus should continue to educate themselves on this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, from plant, animal, and microbial food sources, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk and health promotion. This position paper reviews the definition of functional foods, their regulation, and the scientific evidence supporting this evolving area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient content alone. Analyzing the content of other physiologically active components and evaluating their role in health promotion will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet.

Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight.

PubMed

2006-06-01

The American Dietetic Association (ADA), recognizing that overweight is a significant problem for children and adolescents in the United States, takes the position that pediatric overweight intervention requires a combination of family-based and school-based multi-component programs that include the promotion of physical activity, parent training/modeling, behavioral counseling, and nutrition education. Furthermore, although not yet evidence-based, community-based and environmental interventions are recommended as among the most feasible ways to support healthful lifestyles for the greatest numbers of children and their families. ADA supports the commitment of resources for programs, policy development, and research for the efficacious promotion of healthful eating habits and increased physical activity in all children and adolescents, regardless of weight status. This is the first position paper of ADA to be based on a rigorous systematic evidence-based analysis of the pediatric overweight literature on intervention programs. The research showed positive effects of two specific kinds of overweight interventions: a) multicomponent, family-based programs for children between the ages of 5 and 12 years, and b) multicomponent, school-based programs for adolescents. Multicomponent programs include behavioral counseling, promotion of physical activity, parent training/modeling, dietary counseling, and nutrition education. Analysis of the literature to date points to the need for further investigation of promising strategies not yet adequately evaluated. Furthermore, this review highlights the need for research to develop effective and innovative overweight prevention programs for various sectors of the population, including those of varying ethnicities, young children, and adolescents. To support and enhance the efficacy of family- and school-based weight interventions, community-wide interventions should be undertaken; few such interventions have been conducted and even fewer evaluated.

Weight loss in a UK commercial all meal provision study: a randomised controlled trial.

PubMed

Mellor, D D; Whitham, C; Goodwin, S; Morris, M; Reid, M; Atkin, S L

2014-08-01

Effective approaches are needed to address the increasing prevalence of overweight and obesity. The present study investigated whether all meal provision was a more effective and acceptable method for weight loss than a self-directed diet. This randomised controlled trial recruited 112 men and women with a body mass index in the range 27-35 kg m(-2), who had no comorbidities, from the local area of Hull. Participants were randomised to receive either meal provision or follow a self-directed diet for a 12-week period that resulted in an estimated 2928 kJ day(-1) (700 kcal day(-1)) deficit. A dietitian supervised both dietary interventions. At 12 weeks [mean (SEM)], percentage weight loss in the meal provision group was 6.6% (0.5%) compared to 4.3% (0.6%) for those on the self-directed diet. In terms of clinically relevant weight loss, 61% of participants lost 5% or more of their body weight with meal provision compared to 22% on the self-directed diet (P < 0.001). Weight loss was associated with wellbeing in both groups. Attrition was less apparent with 7% of those participants receiving meal provision withdrawing from the study compared to 41% of those following the self-directed diet (P < 0.001). Meal provision was a more effective and accepted method for weight loss over a 12-week period compared to a self-directed diet. This may in part represent the difference between being given the meal provision food free of charge. However, longer-term maintenance studies need to be undertaken to ascertain their effects on the maintenance of weight loss. © 2013 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association Ltd.

[The evaluation of organizational structure and work hygiene in milk kitchen centers in Poland on the basis of questionnaire].

PubMed

Weker, H; Rudzka-Kańtoch, Z

1999-01-01

On the basis of available publications and obligatory legal regulations regarding the organisation of collective feeding patterns in Social Service Health Centres a questionnaire study was established to examine the way milk kitchen function in Poland. The study covered 533 milk kitchen centres (in hospitals, orphanages and crèches) from February to December 1997. The afore-mentioned study analysed the general characteristics of the milk kitchen centre, its type of work, supervisory methods and the personnel's hygiene. From the results of this research it can be concluded that the organisational structure of the milk centres was appropriate, appliances and equipment in the majority centres were adequate but basis utensils were insufficient. It is obvious that dietetic feeding methods for this particular group of children are insufficiently applied. Only 22.2% of the centres apply the recommended proposals i.e. without boiling, without pasteurisation, ready for consumption when preparing, infant formulae, follow-up formulae and other mixed products. Work hygiene and health quality of production in the milk kitchen centres is subject to systematic controls by competent individuals from the State Sanitary Inspection services. In the years 1995-96, 72 samples of infant food that mainly came from hospital milk kitchen centres were taken due to the poor microbiological quality of the food. The considerable changes that have taken place over the last few years as far as infant feeding is concerned, for example, the promotion of breast-feeding, taking advantage of prepared dietetic products for infants (infant formulae, follow-up formulae, vegetable products, fruits, vegetable-meat products, cereal products) require changes at the organisational level of infant collective feeding which was confirmed by the afore-mentioned study.

Engagement with the National Healthy Schools Programme is associated with higher fruit and vegetable consumption in primary school children.

PubMed

Keyte, J; Harris, S; Margetts, B; Robinson, S; Baird, J

2012-04-01

  Improving children's diets is currently a government focus. However, fruit and vegetable consumption, a key target, is still far below the government guidelines of five portions per day. The present study aimed to assess the impact of engagement with the National Healthy Schools Programme (NHSP) on fruit and vegetable consumption in a sample of primary school children.   A sample of 511 children, aged 7-9 years, who were attending 10 randomly selected schools in Hampshire, completed the Day in the Life Questionnaire, a validated 24-h recall method of dietary assessment. Fruit and vegetable intake in pupils attending schools engaged with the NHSP was compared with that of pupils attending schools not engaged with the programme.   Children attending schools engaged with the NHSP ate a median of two (interquartile range, 0-8.0) portions of fruit and vegetables, compared to one portion (interquartile range, 0-8.0) consumed by pupils attending a school not engaged with the programme (P=0.001). Gender was also a significant predictor of fruit and vegetable consumption, with girls being 1.68 times more likely to consume 2.5 or more portions of fruit and vegetables. After adjustment for free school meal eligibility (as a measure of socio-economic status) and gender, pupils attending schools engaged with NHSP were twice as likely to eat 2.5 portions of fruit and vegetables or more per day.   Engagement with the NHSP may be an effective way of increasing fruit and vegetable consumption in primary school children. Further evaluation of the programme is recommended to determine which aspects of the NHSP are successful in achieving this. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Nutrition labelling and the choices logo in Israel: positions and perceptions of leading health policy makers.

PubMed

Gesser-Edelsburg, A; Endevelt, R; Tirosh-Kamienchick, Y

2014-02-01

Based on the Social Marketing approach and Diffusion of Innovations Theory that indicates the importance of opinion leaders with respect to the spreading of new ideas, concepts or practices within a community, the present study aimed to examine positions and perceptions of Israeli leading dietitians and health officials regarding nutrition labelling and the Choices logo, before it was launched in Israel in February 2011, as well as how they would communicate it to the public as agents of influence. The study involved in-depth face-to-face and telephone interviews with 15 senior dietitians and Health Ministry officials using semi-structured protocols including questions about nutrition labelling and the Choices logo. The respondents considered that the nutrition facts panels usually found on the backs of packages are too complicated for the average consumer. Simiularly, fronts of packages are cluttered with advertisements and health claims, causing confusion. The study participants would like to see an integrative label on the front of the package to facilitate consumers' decisions. However, the Choices logo raises ethical and social questions about the conflict between corporate interests and public health: (i) the label's relativity versus objectivity; (ii) the consumer's responsibility to create a balanced diet; (iii) the label's credibility; and (iv) bias against companies, products and audiences. The results of the present study highlight the importance of a need for an integrated programme of nutrition promotion, including the use of social marketing based on a cooperative effort between the food industry, regulators and professionals, to recommend changes and adjustments in nutritional front of package labelling with the aim of promoting healthier nutrition consumption. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP©) for use by healthcare staff.

PubMed

McCarthy, H; Dixon, M; Crabtree, I; Eaton-Evans, M J; McNulty, H

2012-08-01

The early identification of malnutrition and nutrition risk through nutrition screening is common practice in adult clinical care but, in children, this has been hampered by the lack of an appropriate nutrition screening tool. The present study aimed to develop and evaluate a simple, child-specific nutrition screening tool for administration by non-nutrition healthcare professionals. In a two-phase observational study, significant predictors of nutrition risk were identified using a structured questionnaire. These were then combined to produce a nutrition screening tool. For evaluation purposes, the reliability, sensitivity and specificity of the newly-developed Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP(©)) were estimated by comparing the classification of nutrition risk using the tool with that determined by a full nutritional assessment by a registered dietitian. A total of 122 children were recruited for development phase and a separate cohort of 238 children was recruited for the evaluation phase. Low percentile weight for age, reported weight loss, discrepancy between weight and height percentile and recently changed appetite were all identified as predictors of nutrition risk. These predictors, together with the expected nutrition risk of clinical diagnoses, were combined to produce STAMP(©). Evaluation of STAMP(©) demonstrated fair to moderate reliability in identifying nutrition risk compared to the nutrition risk classification determined by a registered dietitian (κ = 0.541; 95% confidence interval = 0.461-0.621). Sensitivity and specificity were estimated at 70% (51-84%) and 91% (86-94%), respectively. The present study describes the development and evaluation of a new nutrition screening tool specifically for use in a UK general paediatric inpatient population. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Barriers and Strategies for Healthy Food Choices among American Indian Tribal College Students: A Qualitative Analysis.

PubMed

Keith, Jill F; Stastny, Sherri; Brunt, Ardith; Agnew, Wanda

2018-06-01

American Indian and Alaskan Native individuals experience disproportionate levels of chronic health conditions such as type 2 diabetes and overweight and obesity that are influenced by dietary patterns and food choices. Understanding factors that influence healthy food choices among tribal college students can enrich education and programs that target dietary intake. To build an understanding of factors that influence healthy food choices among tribal college students at increased risk for college attrition. A nonexperimental cohort design was used for qualitative descriptive analysis. Participants (N=20) were purposively sampled, newly enrolled, academically underprepared tribal college students enrolled in a culturally relevant life skills course at an upper Midwest tribal college between September 2013 and May 2015. Participant demographic characteristics included various tribal affiliations, ages, and number of dependents. Participant responses to qualitative research questions about dietary intake, food choices, self-efficacy for healthy food choices, psychosocial determinants, and barriers to healthy food choices during telephone interviews were used as measures. Qualitative analysis included prestudy identification of researcher bias/assumptions, audiorecording and transcription, initial analysis (coding), secondary analysis (sorting and identifying meaning), and verification (comparative pattern analysis). Qualitative analysis revealed a variety of themes and subthemes about healthy food choices. Main themes related to barriers included taste, food gathering and preparation, and difficulty clarifying healthy food choices. Main themes related to strategies included taste, cultural traditions and practices, and personal motivation factors. Qualitative analysis identified barrier and strategy themes that may assist nutrition and dietetics practitioners working with tribal/indigenous communities, tribal college educators and health specialists, and tribal community health workers who target health and dietary intake of American Indian and Alaskan Native students. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Pediatric obesity-related curricular content and training in dental schools and dental hygiene programs: systematic review and recommendations.

PubMed

Divaris, Kimon; Bhaskar, Vaishnavi; McGraw, Kathleen A

2017-06-01

The authors conducted a systematic review to determine: a) What dental schools and dental hygiene programs are doing to promote knowledge and skills related to addressing childhood obesity and to reduce consumption of sugar-sweetened beverages (SSBs) and b) What else these schools and programs could do to better equip future oral health professionals to address childhood obesity and reduce consumption of SSBs. The authors searched PubMed, Scopus, Education Full Text (EBSCOHost), and ERIC (EBSCOHost) to identify peer-reviewed publications reporting on obesity or dietetic-related curricula in dental and dental hygiene education within the last 20 years. Three studies met inclusion and exclusion criteria. Outcomes of the identified studies were abstracted and summarized independently by two investigators. The first study describes a 2009 survey of pediatric dentistry residents. Approximately, half had received formal training yet they lacked essential knowledge or skills for managing children who were obese. The second study describes nutrition-related coursework offered in the second year of a predoctoral dental school curriculum in Saudi Arabia, and the third study reports on the development of an "oral health rotation" dietetic internship in a pediatric dentistry clinic, in the context of interprofessional education (IPE). Evidence of dental schools' and dental hygiene programs' efforts to address obesity and SSB consumption in children in their curricula is scant, while Commission on Dental Accreditation standards make sporadic mentions of diet and nutrition. Opportunities exist to leverage existing resources and innovative, experiential approaches, including IPE, to formally, and effectively address this important issue in predoctoral oral health education. © 2017 American Association of Public Health Dentistry.

Energy balance at a crossroads: translating the science into action.

PubMed

Manore, Melinda M; Brown, Katie; Houtkooper, Linda; Jakicic, John; Peters, John C; Smith Edge, Marianne; Steiber, Alison; Going, Scott; Gable, Lisa Guillermin; Krautheim, Ann Marie

2014-07-01

One of the major challenges facing the United States is the high number of overweight and obese adults and the growing number of overweight and unfit children and youth. To improve the nation's health, young people must move into adulthood without the burden of obesity and its associated chronic diseases. To address these issues, the American College of Sports Medicine, the Academy of Nutrition and Dietetics, and the US Department of Agriculture/Agriculture Research Service convened an expert panel meeting in October 2012 titled "Energy Balance at a Crossroads: Translating the Science into Action." Experts in the fields of nutrition and exercise science came together to identify the biological, lifestyle, and environmental changes that will most successfully help children and families attain and manage energy balance and tip the scale toward healthier weights. Two goals were addressed: 1) professional training and 2) consumer/community education. The training goal focused on developing a comprehensive strategy to facilitate the integration of nutrition and physical activity (PA) using a dynamic energy balance approach for regulating weight into the training of undergraduate and graduate students in dietetics/nutrition science, exercise science/PA, and pre-K-12 teacher preparation programs and in training existing cooperative extension faculty. The education goal focused on developing strategies for integrating dynamic energy balance into nutrition and PA educational programs for the public, especially programs funded by federal/state agencies. The meeting expert presenters and participants addressed three key areas: 1) biological and lifestyle factors that affect energy balance, 2) undergraduate/graduate educational and training issues, and 3) best practices associated with educating the public about dynamic energy balance. Specific consensus recommendations were developed for each goal.

Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.

PubMed

Lindsay, K L; Gibney, E R; McAuliffe, F M

2012-12-01

Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Assisted-living elderly and the mealtime experience.

PubMed

Mahadevan, M; Hartwell, H J; Feldman, C H; Ruzsilla, J A; Raines, E R

2014-04-01

Although there is increasing evidence of barriers to nutritional health among elderly assisted-living residents, there has not been the same emphasis when examining the ways in which these individuals experience their mealtimes, as well as the factors that they perceive as contributing to their overall sense of health and well-being. Mealtimes may be disregarded as being particularly unimportant or hurried and overlooked, especially for those residents who may be lonely and have feelings of isolation, ultimately leading to a reduced food intake and poor nutrition. A convenience sample of 38 men and women, aged ≥65 years, were selected from four assisted-living facilities in and around Montclair, NJ, USA, to participate in focus group discussions. Data were analysed using content analysis procedures. Participants described their experiences of mealtimes, and the factors contributing to an overall sense of well-being during these occasions. The ability to make healthy food choices, socialise, interact with staff, friends and family members, and enjoy a tasty meal in a warm and inviting dining environment, may provide a dignity that is unmatched by other services. The findings of the present study highlight the importance of maintaining the health of elderly assisted-living residents through strategies that enhance their mealtime experiences. Listening to the food voice of elderly through research such as that carried out in the present study will help policy makers develop a plan that will effectively deal with systemic barriers prevalent in these facilities, and incorporate strategies to motivate and encourage their residents to increase their food intake and improve their health and well-being. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Effects of chronic consumption of fruit and vegetable puree-based drinks on vasodilation, plasma oxidative stability and antioxidant status.

PubMed

George, T W; Paterson, E; Waroonphan, S; Gordon, M H; Lovegrove, J A

2012-10-01

Fruit and vegetable-rich diets are associated with a reduced cardiovascular disease (CVD) risk. This protective effect may be a result of the phytochemicals present within fruits and vegetables (F&V). However, there can be considerable variation in the content of phytochemical composition of whole F&V depending on growing location, cultivar, season and agricultural practices, etc. Therefore, the present study investigated the effects of consuming fruits and vegetables as puree-based drinks (FVPD) daily on vasodilation, phytochemical bioavailability, antioxidant status and other CVD risk factors. FVPD was chosen to provide a standardised source of F&V material that could be delivered from the same batch to all subjects during each treatment arm of the study. Thirty-nine subjects completed the randomised, controlled, cross-over dietary intervention. Subjects were randomised to consume 200 mL of FVPD (or fruit-flavoured control), daily for 6 weeks with an 8-week washout period between treatments. Dietary intake was measured using two 5-day diet records during each cross-over arm of the study. Blood and urine samples were collected before and after each intervention and vasodilation assessed in 19 subjects using laser Doppler imaging with iontophoresis. FVPD significantly increased dietary vitamin C and carotenoids (P < 0.001), and concomitantly increased plasma α- and β-carotene (P < 0.001) with a near-significant increase in endothelium-dependent vasodilation (P = 0.060). Overall, the findings obtained in the present study showed that FVPD were a useful vehicle to increase fruit and vegetable intake, significantly increasing dietary and plasma phytochemical concentrations with a trend towards increased endothelium-dependent vasodilation. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Fruit and vegetables on prescription: a brief intervention in primary care.

PubMed

Buyuktuncer, Z; Kearney, M; Ryan, C L; Thurston, M; Ellahi, B

2014-04-01

Increasing fruit and vegetable consumption is a goal for the U.K. Therefore, the effectiveness of a fruit and vegetable voucher scheme coupled with key 'five-a-day' consumption messages as a brief intervention in primary care consultations was assessed in the present study. One thousand one hundred and eighty-eight vouchers as a prescription for fruits and vegetables were routinely distributed to patients attending a primary healthcare centre in a deprived area, and 124 volunteer patients routinely attending the centre were included. Telephone-based questionnaires were used to examine changes in consumption over the short and medium term. Other key aspects assessed in the evaluation related to fruit and vegetable purchasing behaviour, knowledge relating to what constitutes a portion size, the relationship between food and health, and barriers to consumption. Although 76.2% of participants used the prescription vouchers when purchasing fruits and vegetables, a significant change in the consumption or purchasing behaviour was not observed (P > 0.05). Participants' level of knowledge relating to the number of portions recommended and the portion size of different fruits and vegetables showed a moderate increase from baseline over the short and medium term. The primary barriers to fruit and vegetable consumption were reported as 'the quality of fresh fruits and vegetables' and 'the money available to spend on food'. The use of 'the fruit and vegetable on prescription' scheme was an effective method of engaging participants in improving awareness of key diet-related health messages. However, further intervention is required to produce a significant impact on the actual behaviour change. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Lower polyamine levels in breast milk of obese mothers compared to mothers with normal body weight.

PubMed

Ali, M Atiya; Strandvik, B; Palme-Kilander, C; Yngve, A

2013-07-01

Obesity is associated with risks for mother and infant, and the mothers' dietary habits influence breast milk composition. Polyamines are secreted in breast milk and are essential for the regulation of intestinal and immune function in newborns and infants. The present study aimed to investigate the level of polyamines in human milk obtained from obese and normal weight mothers at different times of lactation. Breast milk from 50 mothers was obtained at day 3, and at 1 and 2 months after delivery. The mothers had normal body weight [body mass index (BMI) < 25 kg m(-2) ] or were obese (BMI > 30 kg/m(2) ). A subgroup of obese mothers participated in a weight reduction programme during pregnancy. Polyamines were analysed using high-performance liquid chromatography. The total polyamine content was significantly lower at all times in breast milk from obese mothers compared to milk from controls. Spermine levels did not differ between groups at any time in contrast to the levels of putrescine and spermidine. Putrescine concentrations were highest on day 3 and spermidine and spermine were highest at 1 month of lactation. The obese mothers, who received dietary advice during pregnancy based on the Nordic Nutrition Recommendations, had higher concentrations of putrescine and spermidine in their milk than the obese mothers without any intervention. Polyamine concentrations were lower in breast milk from obese mothers compared to mothers with a normal weight. General dietary intervention in obese mothers increased the polyamine levels, suggesting that the low levels in obesity were at least partly associated with food habits. However, the consistency of spermine suggests a special metabolic function of this polyamine. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Beyond sports nutrition: the diverse role of dietitians at the Delhi 2010 Commonwealth Games.

PubMed

Burkhart, S J; Pelly, F E

2014-12-01

Although registered sports dietitians commonly assist athletes with training and competition nutrition advice, an emerging area of practice is focused around food provision and nutrition support provided at major competition events. The present study aimed, first, to identify the dietetic skills and scope of practice that dietitians may require to work in this environment as determined by the occasions of service provided by dietitians at a nutrition kiosk located in the dining hall at a major competition event and, second, to investigate athletes' opinion and usage of the nutrition services and the association with their type of sport and previous source of nutrition information. Dietitians based at a nutrition kiosk recorded all enquiries (n = 383) and consultations (n = 60) from 23 September to 14 October 2010. A questionnaire was also distributed to athletes in the main dining hall over this period to investigate their opinion and use of nutrition support, as well as their previous source of nutrition information. Although athletes from Western regions made up the majority of the enquiries regarding food provision and special/therapeutic dietary requirements (predominately food allergy and intolerance), athletes from non-Western regions, and those in weight category sports, had more sports nutrition enquiries and were more likely to request a consultation. A number of athletes (32%) reported no previous or one source of nutrition information, whereas only eight of 52 athletes who requested a consultation had prior nutrition assistance. In addition to sport nutrition knowledge and experience, dietitians working in this environment are likely to require an understanding of cultural eating styles, food beliefs and customs, large-scale food service operation, and local food availability. © 2013 The British Dietetic Association Ltd.

Dietary practices and influences on diet intake among women in a Woodland Cree community.

PubMed

Bruner, B G; Chad, K E

2014-04-01

Overweight and obesity are increasing concerns among Aboriginal women, and lifestyle behaviours (i.e. dietary patterns and physical activity) are considered to be contributing factors. The present study aimed to explore the social, cultural, behavioural and environmental factors influencing diet intake from a trans-generational perspective and to characterise the dietary practices among Woodland Cree women. A mixed methods design using a concurrent triangulation approach explored the factors influencing diet intake and healthy eating among First Nations women on a reserve community in northern Saskatchewan, Canada. Dietary practices were assessed using 24-h recalls. Dietary analysis revealed low intake of fruits and vegetables and milk and alternatives in the sample, with high intake of 'other' foods. Limited amounts of traditional food (TF) were reported. Taste primarily influenced food choice, with a preference for TF highlighted among older participants. Healthy eating was considered to be a health-promoting behaviour, yet a lack of availability, high costs and difficulties accessing various foods were the most noted barriers to healthy eating. The dietary practices in this sample indicate the limited consumption and variety of TF and fruits and vegetables, and a high consumption of 'other' foods, which suggests inadequate intakes of various vitamins and nutrients. The findings from a trans-generational perspective highlight various barriers across the age groups that can substantially impact food choices, and reinforces the need for community and age-specific strategies to address issues of exposure, accessibility and affordability to nutritious foods that improve the diet and preserve cultural identity among residents living in reserve communities. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Perceptions of healthy eating and physical activity in an ethnically diverse sample of young children and their parents: the DEAL prevention of obesity study.

PubMed

Rawlins, E; Baker, G; Maynard, M; Harding, S

2013-04-01

Ethnicity is a consistent correlate of obesity; however, little is known about the perceptions and beliefs that may influence engagement with obesity prevention programmes among ethnic minority children. Barriers to (and facilitators of) healthy lifestyles were examined in the qualitative arm of the London (UK) DiEt and Active Living (DEAL) study. Children aged 8-13 years and their parents, from diverse ethnic groups, were recruited through schools and through places of worship. Thirteen focus group sessions were held with 70 children (n = 39 girls) and eight focus groups and five interviews with 43 parents (n = 34 mothers). Across ethnic groups, dislike of school meals, lack of knowledge of physical activity guidelines for children and negativity towards physical education at school among girls, potentially hindered healthy living. Issues relating to families' wider neighbourhoods (e.g. fast food outlets; lack of safety) illustrated child and parental concerns that environments could thwart intentions for healthy eating and activity. By contrast, there was general awareness of key dietary messages and an emphasis on dietary variety and balance. For ethnic minorities, places of worship were key focal points for social support. Discourse around the retention of traditional practices, family roles and responsibilities, and religion highlighted both potential facilitators (e.g. the importance of family meals) and barriers (reliance on convenience stores for traditional foods). Socio-economic circumstances intersected with key themes, within and between ethnic groups. Several barriers to (and facilitators of) healthy lifestyles were common across ethnic groups. Diversity of cultural frameworks not only were more nuanced, but also shaped lifestyles for minority children. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Therapeutic alliance in dietetic practice for weight loss: Insights from health coaching.

PubMed

Nagy, Annaliese; McMahon, Anne; Tapsell, Linda; Deane, Frank; Arenson, Danielle

2018-02-13

The psychological construct of 'therapeutic alliance' can be used to better understand the effectiveness of consultations, particularly goal setting for weight management. We analysed audio-recorded health coaching sessions during a weight loss trial to explore relationships between therapeutic alliance and various contextual factors. Audio recordings of 50 health coaching sessions were analysed. After assessing fidelity to the protocol, therapeutic alliance was measured using an adapted Working Alliance Inventory Observer-rated Short Version (WAI-O-S), and examined by (i) identifying relationships between contextual factors and WAI-O-S scores (Spearman's coefficients); (ii) testing the impact of preparatory exercises and body mass index on WAI-O-S scores (one-way analysis of variance and least-squared differences tests) and (iii) comparing differences in WAI-O-S scores based on relationship status, gender and follow-up session completion (independent samples t-tests). Fidelity was high (mean 88%). WAI-O-S total scores ranged from 55 to 70 (out of 84). Session duration was significantly correlated with WAI-O-S component of 'Bond' (r = 0.42, P = 0.002). Those who completed preparatory exercises had significantly higher total WAI-O-S scores, 'Goal' and 'Task' scores. Participants who completed the follow-up session scored significantly higher for 'Goal' compared to no follow-up. Spending more time in a session appears related to increased bonding, a key component of therapeutic alliance. Preparatory work may help build therapeutic alliance and agreement on goals appears to influence follow-up completion. These exploratory findings provide directions for research addressing the professional relationship in dietetic consultations for weight loss. © 2018 Dietitians Association of Australia.

Assessing the Influence of Vegan, Vegetarian and Omnivore Oriented Westernized Dietary Styles on Human Gut Microbiota: A Cross Sectional Study.

PubMed

Losasso, Carmen; Eckert, Ester M; Mastrorilli, Eleonora; Villiger, Jorg; Mancin, Marzia; Patuzzi, Ilaria; Di Cesare, Andrea; Cibin, Veronica; Barrucci, Federica; Pernthaler, Jakob; Corno, Gianluca; Ricci, Antonia

2018-01-01

Diet and lifestyle have a strong influence on gut microbiota, which in turn has important implications on a variety of health-related aspects. Despite great advances in the field, it remains unclear to which extent the composition of the gut microbiota is modulated by the intake of animal derived products, compared to a vegetable based diet. Here the specific impact of vegan, vegetarian, and omnivore feeding type on the composition of gut microbiota of 101 adults was investigated among groups homogeneous for variables known to have a role in modulating gut microbial composition such as age, anthropometric variables, ethnicity, and geographic area. The results displayed a picture where the three different dietetic profiles could be well distinguished on the basis of participant's dietetic regimen. Regarding the gut microbiota; vegetarians had a significantly greater richness compared to omnivorous. Moreover, counts of Bacteroidetes related operational taxonomic units (OTUs) were greater in vegans and vegetarians compared to omnivores. Interestingly considering the whole bacterial community composition the three cohorts were unexpectedly similar, which is probably due to their common intake in terms of nutrients rather than food, e.g., high fat content and reduced protein and carbohydrate intake. This finding suggests that fundamental nutritional choices such as vegan, vegetarian, or omnivore do influence the microbiota but do not allow to infer conclusions on gut microbial composition, and suggested the possibility for a preferential impact of other variables, probably related to the general life style on shaping human gut microbial community in spite of dietary influence. Consequently, research were individuals are categorized on the basis of their claimed feeding types is of limited use for scientific studies, since it appears to be oversimplified.

Assessing the Influence of Vegan, Vegetarian and Omnivore Oriented Westernized Dietary Styles on Human Gut Microbiota: A Cross Sectional Study

PubMed Central

Losasso, Carmen; Eckert, Ester M.; Mastrorilli, Eleonora; Villiger, Jorg; Mancin, Marzia; Patuzzi, Ilaria; Di Cesare, Andrea; Cibin, Veronica; Barrucci, Federica; Pernthaler, Jakob; Corno, Gianluca; Ricci, Antonia

2018-01-01

Diet and lifestyle have a strong influence on gut microbiota, which in turn has important implications on a variety of health-related aspects. Despite great advances in the field, it remains unclear to which extent the composition of the gut microbiota is modulated by the intake of animal derived products, compared to a vegetable based diet. Here the specific impact of vegan, vegetarian, and omnivore feeding type on the composition of gut microbiota of 101 adults was investigated among groups homogeneous for variables known to have a role in modulating gut microbial composition such as age, anthropometric variables, ethnicity, and geographic area. The results displayed a picture where the three different dietetic profiles could be well distinguished on the basis of participant’s dietetic regimen. Regarding the gut microbiota; vegetarians had a significantly greater richness compared to omnivorous. Moreover, counts of Bacteroidetes related operational taxonomic units (OTUs) were greater in vegans and vegetarians compared to omnivores. Interestingly considering the whole bacterial community composition the three cohorts were unexpectedly similar, which is probably due to their common intake in terms of nutrients rather than food, e.g., high fat content and reduced protein and carbohydrate intake. This finding suggests that fundamental nutritional choices such as vegan, vegetarian, or omnivore do influence the microbiota but do not allow to infer conclusions on gut microbial composition, and suggested the possibility for a preferential impact of other variables, probably related to the general life style on shaping human gut microbial community in spite of dietary influence. Consequently, research were individuals are categorized on the basis of their claimed feeding types is of limited use for scientific studies, since it appears to be oversimplified. PMID:29556222

Roles of National and Local Governments and the Dietetic Association in Nutrition Assistance Response to Natural Disasters: Systems and Experiences in Japan and the USA.

PubMed

Sudo, Noriko

2015-01-01

In the first half of this symposium, the disaster response system in Japan will be introduced. The ultimate aim of nutrition assistance is to keep people in disaster areas healthy. This is a task for the Ministry of Health, Labour and Welfare and the health departments of prefectural governments. Our first speaker, Dr. Yasuhiro Kanatani, National Institute of Public Health, will briefly overview the disaster response system in Japan and its related laws. He will also mention how the Ministry responded to the Great East Japan Earthquake. In the second presentation, I will play one chapter of DVD that we released in last September. In that chapter, Ms. Makiko Sawaguchi, a registered dietitian working for a public health center in the area affected by the Great East Japan Earthquake, talks about her experience in supporting disaster victims. As an employee of Iwate Prefectural Government, she helped affected municipal governments and coordinated outside support. One type of outside support was registered dietitians dispatched by the Japan Dietetic Association (JDA). Dr. Nobuyo Tsuboyama-Kasaoka will report what those dietitians did in the affected areas. She will also explain the aim and training of the JDA-Disaster Assistance Team. Provision of food is essential in nutrition assistance. This is a task for the Ministry of Agriculture, Forestry and Fisheries. Our fourth speaker, Mr. Kunihiro Doi, analyzed the government procurement data and will discuss the limitations of government emergency food supplies and lessons learned from the Great East Japan Earthquake. As for the systems and experiences in the US, we invited Ms. Toni Abernathy from the Office of Emergency Management, Food and Nutrition Service (FNS), United States Department of Agriculture.

Ten-year changes in positive and negative marker food, fruit, vegetables, and salad intake in 9-10 year olds: SportsLinx 2000-2001 to 2010-2011.

PubMed

Boddy, L M; Abayomi, J; Johnson, B; Hackett, A F; Stratton, G

2014-06-01

To investigate changes in intakes of 'negative' and 'positive' foods, fruit, vegetables, and salad in serial cohorts of 9-10-year-old children from 2000-2001 to 2010-2011. For this serial, cross-sectional study, children in school year 5 (9-10 years of age) completed the SportsLinx Lifestyles Survey [n = 30,239 (15,336 boys and 14,903 girls)]. Changes in positive and negative food scores, and the proportion of boys and girls reportedly consuming fruit, vegetables and salad on the previous day to surveying, were investigated annually from 2000 to 2011. The consumption of negative foods declined and positive foods increased significantly compared to baseline. Positive changes in fruit, vegetables and salad consumption were observed over time, with the most recent cohort more likely to consume fruit, vegetables and salad compared to the 2000-2001 baseline. Girls displayed more favourable positive and negative food scores and were more likely to consume fruit, salad and vegetables across several study years compared to boys. The consumption of negative and positive foods, fruit, vegetables, and salad has improved over the last 10 years. In addition, girls appear to have better positive and negative food scores, and were more likely to consume fruit, vegetables and salad, across a number of study years or cohorts compared to boys. These encouraging findings suggest that children's food intake has improved since 2000. Furthermore, the data indicate that boys and girls may require separate or different healthy eating messages to further improve food intake. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

The rise of clinical nutrition science in North-East Asia.

PubMed

Wahlqvist, Mark L

2016-01-01

Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental science and the skills to diagnose, prevent and manage the health problems related to food patterns, energy equilibrium (mostly to do with physical activity) and nutrient metabolism. Its delivery needs to be accessible, equitable, affordable and sustainable. Ordinarily, this will require both local and widely distributed health services. In North-East (NE) Asia, these requisites are being met to an ever increasing extent. The roots of this progress are steeped in cultures which acknowledge the food-health connections and support education which pays regard to these connections. As elsewhere, however, the food and health systems, their safety and security are threatened by exploitative operatives. In China, a concerted effort was made in the mid-1980s to foster clinical nutrition in major hospitals throughout the country by programs directed at medical graduates, nursing and kitchen staff; dietetics has appeared much more recently. By contrast, Japan has had an extensive and well-trained dietetic workforce for much longer, alongside a vibrant basic nutrition science constituency in its universities and foodnutraceutical industry. South Korea and Taiwan have traversed a similar course to that in Japan. Now, all of these NE Asian economies have gathered rapid momentum in the publication of innovative approaches to public health and clinical nutrition which have the prospect of not only improving health outcomes, but also reducing the societal and financial burden of health care. This is particularly important in rapidly ageing societies, which they are. It is also a growing challenge where climate change threatens to engulf the lives and destinies of hundreds of millions of Asians on account of natural disasters, water and food insecurity.

An investigation into the Professional Quality of Life of dietitians working in acute care caseloads: are we doing enough to look after our own?

PubMed

Osland, E J

2015-10-01

The development of compassion fatigue (CF) has been described across a variety of acute care caseloads in some health professions. The present study was undertaken to determine whether dietitians working in these caseloads also experience CF. A voluntary, anonymous survey incorporating the Professional Quality of Life tool was developed in an online format, and was e-mailed to dietitians working in public acute care settings. Eighty-seven completed surveys were returned. Average rates of compassion satisfaction (CS) and burnout and low rates of secondary traumatic stress (STS) were reported. Dietitians in high-risk workloads reported higher levels of STS than those with low-risk workloads (χ2 = 5.4, P = 0.02). Differences in STS were found between those practising in paediatric compared to adult caseloads (χ2 = 16.6, P < 0.01). Dietitians in smaller facilities reported higher STS (χ2 = 10.6, P < 0.01) and lower CS (P = 0.05) than larger facilities. Working for >5 years as a dietitian was associated with higher rates of STS and burnout than in those working for <5 years (χ2 = 7.9, P = 0.05 and χ2 = 3.8, P = 0.05, respectively). Those who perceived greater levels of support reported lower rates of burnout (r(s) = -0.41, P < 0.01) and higher rates of CS (r(s) = 0.39, P < 0.01) than those not feeling supported. All dietitians reported undertaking self-care practices; however, up to 24% reported practices that may represent maladaptive coping methods. Although the present study suggests dietitians experience a good professional quality of life, vulnerable areas were identified, suggesting the need for additional support in some areas of dietetic practice. © 2014 The British Dietetic Association Ltd.

Relationship between soy and isoflavone intake and periodontal disease: The Freshmen in Dietetic Courses Study II

PubMed Central

Tanaka, Keiko; Sasaki, Satoshi; Murakami, Kentaro; Okubo, Hitomi; Takahashi, Yoshiko; Miyake, Yoshihiro

2008-01-01

Background Much research has shown that soy products inhibited various diseases. However, no published studies have examined the effects of consumption of soy and isoflavones on periodontal disease. The aim of this study was to investigate whether soy and isoflavone intake is associated with the prevalence of periodontal disease. Methods The subjects were 3956 Japanese female students, aged 18 to 22 years, who were taking a dietetic course. Periodontal disease was defined as present when a subject reported diagnosis of the disorder by a dentist. Information on dietary factors was collected using a validated diet history questionnaire. Logistic regression analysis was used to estimate the odds ratios and their confidence intervals of periodontal disease. Adjustment was made for cigarette smoking, toothbrushing frequency, region of residence, and body mass index. Results The prevalence of periodontal disease was 8.0%. Intake of total soy product and tofu was independently associated with a decreased prevalence of periodontal disease; multivariate odds ratios in comparison of the highest with the lowest quintile were 0.68 and 0.68, respectively (95% confidence intervals = 0.47–0.97 and 0.47–0.98, P for trend = 0.01 and 0.004, respectively). A significant inverse dose-response relationship between the intake of isoflavones and the prevalence of periodontal disease was observed, although the difference in the adjusted odds ratio between the extreme quintiles was of borderline significance (P for trend = 0.04). There were no measurable dose-response relationships between consumption of tofu products, fermented soybeans, boiled soybeans, miso, or miso soup and the prevalence of periodontal disease. Conclusion Our findings suggest that soy and isoflavone intake may decrease the likelihood of periodontal disease. Further investigations with objective measures for periodontal disease are needed to confirm our findings. PMID:18226266

The effectiveness of a specialised oral nutrition supplement on outcomes in patients with chronic wounds: a pragmatic randomised study.

PubMed

Bauer, J D; Isenring, E; Waterhouse, M

2013-10-01

Nutrition supplements enriched with immune function enhancing nutrients have been developed to aid wound-healing, although evidence regarding their effectiveness is limited and systematic reviews have lead to inconsistent recommendations. The present pragmatic, randomised, prospective open trial evaluated a wound-specific oral nutrition supplement enriched with arginine, vitamin C and zinc compared to a standard supplement with respect to outcomes in patients with chronic wounds in an acute care setting. Twenty-four patients [11 males and 13 females; mean (SD) age: 67.8 (22.3) years] with chronic wounds (14 diabetic or venous ulcers; 10 pressure ulcers or chronic surgical wounds) were randomised to receive either a wound-specific supplement (n = 12) or standard supplement (n = 12) for 4 weeks, with ongoing best wound and nutrition care for an additional 4 weeks. At baseline, and at 4 and 8 weeks, the rate of wound-healing, nutritional status, protein and energy intake, quality of life and product satisfaction were measured. Linear mixed effects modelling with random intercepts and slopes were fitted to determine whether the wound-specific nutritional supplement had any effect. There was a significant improvement in wound-healing in patients receiving the standard nutrition supplement compared to a wound-specific supplement (P = 0.044), although there was no effect on nutritional status, dietary intake, quality of life and patient satisfaction. The results of the present study indicate that a standard oral nutrition supplement may be more effective at wound-healing than a specialised wound supplement in this clinical setting. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Low levels of food involvement and negative affect reduce the quality of diet in women of lower educational attainment.

PubMed

Jarman, M; Lawrence, W; Ntani, G; Tinati, T; Pease, A; Black, C; Baird, J; Barker, M

2012-10-01

Women of lower educational attainment tend to have poorer quality diets and lower food involvement (an indicator of the priority given to food) than women of higher educational attainment. The present study reports a study of the role of food involvement in the relationship between educational attainment and quality of diet in young women. The first phase uses six focus group discussions (n = 28) to explore the function of food involvement in shaping the food choices of women of lower and higher educational attainment with young children. The second phase is a survey that examines the relationship between educational attainment and quality of diet in women, and explores the role of mediating factors identified by the focus group discussions. The focus groups suggested that lower food involvement in women of lower educational attainment might be associated with negative affect (i.e. an observable expression of negative emotion), and that this might mean that they did not place a high priority on eating a good quality diet. In support of this hypothesis, the survey of 1010 UK women found that 14% of the effect of educational attainment on food involvement was mediated through the woman's affect (P ≤ 0.001), and that 9% of the effect of educational attainment on quality of diet was mediated through food involvement (P ≤ 0.001). Women who leave school with fewer qualifications may have poorer quality diets than women with more qualifications because they tend to have a lower level of food involvement, partly attributed to a more negative affect. Interventions to improve women's mood may benefit their quality of diet. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

[Breast-feeding (part IV): Therapeutic uses, dietetic and addictions--guidelines for clinical practice].

PubMed

Marcellin, L; Chantry, A A

2015-12-01

To describe the practical aspects of the use of the most commonly prescribed drugs during the postpartum period, the dietetic measures and the management of breast-feeding in case of addictive behaviors. Review of the literature between 1972 and May 2015 from the databases Medline, Google Scholar, Cochrane Library, and international recommendations of learned societies. The precaution to stop breast-feeding when drugs are necessary is not justified in many situations (professional consensus). Aspirin at antiaggregant dose is allowed during breast-feeding while high doses are not recommended; NSAIDs with short half-life can be used (professional consensus). Precautions are needed in cases of use of morphonics (professional consensus). There is no justification to delay the initiation of breast-feeding in case of locoregional or general analgesia or for caesarean section. Antibiotic treatment does not justify discontinuing breast-feeding (professional consensus). Anxiolytics of the class of antihistaminic sedating H1 such as hydroxyzine (Atarax®) should not be prescribed in case of breast-feeding (professional consensus). Imaging does not justify to stop breast-feeding (professional consensus). Tobacco consumption is discouraged but is not a contraindication to breast-feed (professional consensus). It is recommended to avoid the consumption of alcohol (professional consensus). In case of occasional and moderate consumption of alcohol, delaying breast-feeding for a minimum of two hours is recommended (professional consensus). Cocaine consumption is a contraindication of breast-feeding (professional agreement), and breast-feeding is not recommended in case of cannabis use (professional consensus). Few drug treatments are not compatible with breast-feeding that can be continued in most of the cases. Copyright © 2015. Published by Elsevier Masson SAS.

Year 7 dietary intake: a comparison of two schools with middle-high socio-economic status.

PubMed

Greatwood, H C; Daly-Smith, A; McGregor, S; McKenna, J

2013-12-01

With an established, yet avoidable, link between dietary intake and poor health, the nutritional habits of adolescents remains a public health concern. Previous studies report an inverse relationship between dietary intake and socio-economic status (SES), although few studies have considered the influence of the SES gradient. The present study compared the nutritional profiles of neighbouring schools with pupils from middle to high economic backgrounds. One hundred and ninety pupils from a high SES school (HSESS) and 159 pupils from a middle SES school (MSESS) (aged 11-12 years) completed a 63-item validated food frequency questionnaire. Pupils rated their diet quality and this was compared with a composite Healthy Eating Index (HEI). Children attending MSESS consumed significantly higher intakes of energy (P < 0.001), carbohydrate (P = 0.001), fat (P < 0.001) and protein (P = 0.001). As a percentage of energy contribution, pupils in both schools consumed excess saturated fat (HSESS, +5% boys, +4% girls; MSESS, +4% both boys and girls) and sugar (HSESS, +9% boys, +11% girls; MSESS, +10% boys, +11% girls). When HEI was compared with self-report diet quality, 96% HSESS pupils and 94% MSESS pupils over-rated the quality of their diet. The present study identified that, although pupils from MSESS consume a significantly higher intake of energy and macronutrient compared to a nearby HSESS, the percentage of energy contribution of saturated fat and sugar is above government recommendations for pupils from both schools. Additionally, the majority of pupils from both schools substantially over-rated their diet quality compared to a HEI. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Contribution of meat to vitamin B₁₂, iron and zinc intakes in five ethnic groups in the USA: implications for developing food-based dietary guidelines.

PubMed

Sharma, S; Sheehy, T; Kolonel, L N

2013-04-01

To describe the sources of meat and their contributions to vitamin B₁₂, iron and zinc in five ethnic groups in the USA. Dietary data for the Multiethnic Cohort, established in Hawaii and Los Angeles, were collected using a quantitative food frequency questionnaire from more than 215,000 subjects, aged 45-75 years at baseline (1993-1996). Participants included African American, Latino, Japanese American, Native Hawaiian and Caucasian men and women. Servings of meat items were calculated based on the US Department of Agriculture recommendations and their contributions to intakes of total meat, red meat, vitamin B₁₂, iron and zinc were determined. Of all types of meat, poultry contributed the most to meat consumption, followed by red meat and fish among all ethnicities, except for Latino (born in Mexico and Central/South America) men who consumed more beef. Lean beef was the most commonly consumed red meat for all ethnic-sex groups (9.3-14.3%), except for Native Hawaiian and Japanese American men, and Japanese American women whose top contributor was stew/curry with beef/lamb and stir-fried beef/pork with vegetables, respectively. The contribution of meat was most substantial for zinc (11.1-29.3%) and vitamin B₁₂ (19.7-40%) and, to a lesser extent, for iron (4.3-14.2%). This is the first large multiethnic cohort study to describe meat sources and their contributions to selected nutrients among ethnic minorities in the USA. These findings may be used to develop ethnic-specific recommendations for meat consumption aiming to improve dietary quality among these groups. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Promoting dietary diversity to improve child growth in less-resourced rural settings in Uganda.

PubMed

Kabahenda, M K; Andress, E L; Nickols, S Y; Kabonesa, C; Mullis, R M

2014-04-01

Analyses of global trends indicate that childhood undernutrition is more prevalent in rural areas, and also that maternal education and decision-making power are among the key factors significantly associated with child growth. The present study comprised a controlled longitudinal study aiming to assess the effectiveness of nutrition education with respect to improving growth patterns of young children of less-literate, low income caregivers in a rural subsistence farming community. Caregivers in the intervention group (n = 52) attended a structured nutrition education programme, whereas the control group (n = 45) participated in sewing classes. Weights and lengths/heights were measured for children in the intervention and control groups every month for 1 year to assess changes in growth patterns. Repeated measures analysis of covariance was used to access differences between the two groups over time and across age groups. Variability in growth patterns of individual children and clustering of caregiver effects were controlled for during the statistical analysis. After 12 months, children in the intervention group had significant improvements in weight-for-age compared to the controls [mean (SD): 0.61 (0.15) versus -0.99 (0.16), P = 0.038]. Changes in height-for-age, weight-for-height and mid-upper arm circumference-for-age showed a positive trend for children in the intervention group. Changes in weight-for-height were statistically significant across age groups and negatively related to caregiver's age. Educating caregivers has the potential to improve young children's nutritional status and growth, especially among less literate populations where households subsist on what they produce. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Establishing a Multidisciplinary Head and Neck Clinical Pathway: An Implementation Evaluation and Audit of Dysphagia-Related Services and Outcomes.

PubMed

Messing, Barbara Pisano; Ward, Elizabeth C; Lazarus, Cathy; Ryniak, Keri; Kim, Melissa; Silinonte, Jessica; Gold, Dorothy; Thompson, Carol B; Pitman, Karen T; Blanco, Ray; Sobel, Ryan; Harrer, Karen; Ulmer, Karen; Neuner, Geoffrey; Patel, Kruti; Tang, Mei; Lee, Gregory

2018-06-19

Head and neck cancer (HNC) guidelines recommend regular multidisciplinary team (MDT) monitoring and early intervention to optimize dysphagia outcomes; however, many factors affect the ability to achieve these goals. The aims of this study were to explore the barriers/facilitators to establishing and sustaining a MDT HNC care pathway and to examine the dysphagia-related speech-language pathology (SLP) and dietetic components of the pathway. Using the Consolidated Framework for Implementation Research (CFIR), a mixed methods study design was used to evaluate an established MDT HNC pathway. Ten MDT members provided perceptions of facilitators/barriers to implementing and sustaining the pathway. Patients attending the SLP and dietetic components of the pathway who commenced treatment between 2013 and 2014 (n = 63) were audited for attendance, outcome data collected per visit, and swallowing outcomes to 24-month post-treatment. Dysphagia outcomes were compared to a published cohort who had received intensive prophylactic dysphagia management. Multiple CFIR constructs were identified as critical to implementing and sustaining the pathway. Complexity was a barrier. Patient attendance was excellent during treatment, with low rates of non-compliance (< 15%) to 24 months. Collection of clinician/patient outcome tools was good during treatment, but lower post-treatment. Dysphagia outcomes were good and comparable to prior published data. The pathway provided patients with access to regular supportive care and provided staff opportunities to provide early and ongoing dysphagia monitoring and management. However, implementing and sustaining a HNC pathway is complex, requiring significant staff resources, financial investment, and perseverance. Regular audits are necessary to monitor the quality of the pathway.

A systematic review of financial incentives for dietary behavior change.

PubMed

Purnell, Jason Q; Gernes, Rebecca; Stein, Rick; Sherraden, Margaret S; Knoblock-Hahn, Amy

2014-07-01

In light of the obesity epidemic, there is growing interest in the use of financial incentives for dietary behavior change. Previous reviews of the literature have focused on randomized controlled trials and found mixed results. The purpose of this systematic review is to update and expand on previous reviews by considering a broader range of study designs, including randomized controlled trials, quasi-experimental, observational, and simulation studies testing the use of financial incentives to change dietary behavior and to inform both dietetic practice and research. The review was guided by theoretical consideration of the type of incentive used based on the principles of operant conditioning. There was further examination of whether studies were carried out with an institutional focus. Studies published between 2006 and 2012 were selected for review, and data were extracted regarding study population, intervention design, outcome measures, study duration and follow-up, and key findings. Twelve studies meeting selection criteria were reviewed, with 11 finding a positive association between incentives and dietary behavior change in the short term. All studies pointed to more specific information on the type, timing, and magnitude of incentives needed to motivate individuals to change behavior, the types of incentives and disincentives most likely to affect the behavior of various socioeconomic groups, and promising approaches for potential policy and practice innovations. Limitations of the studies are noted, including the lack of theoretical guidance in the selection of incentive structures and the absence of basic experimental data. Future research should consider these factors, even as policy makers and practitioners continue to experiment with this potentially useful approach to addressing obesity. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Nutritional status, dietary habits, nutritional knowledge and self-care assessment in a group of older adults attending community centres in Pavia, Northern Italy.

PubMed

Turconi, G; Rossi, M; Roggi, C; Maccarini, L

2013-02-01

The population of industrialised countries is ageing as a consequence of an increase in life expectancy. As a result of the increasing ageing process, the assessment of nutritional status and dietary habits, as well as the assessment of self-care, is needed to plan selected actions aimed at improving the quality of life in the third and fourth life spans. A cross-sectional study was carried out on a randomly selected sample of 200 healthy older adults (≥65 years old), attending community centres for older people in Pavia, Northern Italy. Ninety-two percent of the recruited subjects participated in the survey. Anthropometric measurements and the Mini Nutritional Assessment were performed. Dietary habits, nutritional knowledge and self-care were investigated using a questionnaire administered by two dietitians. The majority of subjects were low socio-economic status and overweight [mean (SD) body mass index = 28.4 (4.3) kg/m(2) ], 12% were malnourished according to their Mini Nutritional Assessment score and the majority of the arm muscle circumference measurements were below the 10th percentile, predicting accelerated loss of lean mass, even in the healthy independently living older adults. Only 30% of the sample had adequate dietary habits, whereas the ability to self-care was good for the whole sample. The unhealthy and unbalanced diet, frequently too rich in sugar and fats and low in protein intake, might explain being overweight and the loss of lean mass in the study subjects. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Dietary fat intake, circulating and membrane fatty acid composition of healthy Norwegian men and women.

PubMed

Min, Y; Blois, A; Geppert, J; Khalil, F; Ghebremeskel, K; Holmsen, H

2014-02-01

The present study aimed to assess the dietary fat intake and blood fatty acid status of healthy Norwegian men and women living in Bergen whose habitual diet is known to be high in long-chain omega-3 fat. Healthy men (n = 41) and women (n = 40) aged 20-50 years who were regular blood donors completed 7-day food diaries and their nutrient intake was analysed by Norwegian food database software, kbs, version 4.9 (kostberegningssystem; University of Oslo, Oslo, Norway). Blood samples were obtained before blood donation and assessed for the fatty acid composition of plasma triglycerides and cholesterol esters, phosphatidylcholine, and red cell phosphatidylcholine and phosphatidylethanolamine. There was no difference in dietary fat intake between men and women. Total and saturated fat intakes exceeded the upper limits of the recommendations of the National Nutrition Council of Norway. Although polyunsaturated fat intake was close to the lower limit of the recommended level, the intake varied greatly among individuals, partly as a result of the use of supplementary fish oil. Moreover, the proportional fatty acid composition of plasma and red cell lipids was similar between men and women. Enrichment of docosahexaenoic acid in red cell phosphatidylethanolamine was found in fish oil users. The results of the present study provide a snapshot of the current nutritional status of healthy Norwegian adults. Moreover, the detailed blood fatty acid composition of men and women whose habitual diet constitutes high long-chain polyunsaturated omega-3 fat as well as saturated fat could be used as reference value for population studies. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Influencers of career choice among allied health students.

PubMed

Brown-West, A P

1991-01-01

This study focused on the factors that influence students' choice of an allied health profession. A survey of 153 students in three allied health programs at the University of Connecticut revealed that "the need to help others," "prestige," "professional autonomy," "opportunities for advancement," "income potential," and "the effect of the specialty on family and personal life," were the major influencers of career choice among allied health students. Only a few students regarded malpractice suits and AIDS as negative influencers. While medical laboratory science majors regarded these as important factors, dietetics and physical therapy majors did not. The article suggests further use of these findings by program directors and career counselors.