Towards effective dietary counseling: a scoping review.

OBJECTIVE: The aim of this scoping review was to identify and map available evidence concerning counseling strategies that contribute to effective DC. METHODS: Following the PRISMA SCR-Scoping Reviews Statement and Checklist, a systematic search in electronic databases was performed in March 2020. RESULTS: Synthesis of recurring themes in the 28 included studies revealed seven core counseling strategies that effectively contribute to DC: 1) connecting to motivation, 2) tailoring the modality of DC, 3) providing recurring feedback, 4) using integrated dietetic support tools, 5) showing empathy, 6) including clients' preferences, wishes, and expectations during decision-making, and 7) dietitians having high self-efficacy. CONCLUSIONS: Multiple counseling strategies contributing to effective DC have been identified and mapped. The counseling strategies identified seem to interrelate, and their conceived interrelatedness reveals that strategies can both compliment or contrast each other. Therefore, advancing effective DC requires further development towards an integrated approach to DC that includes combinations of strategies that form a unified whole. PRACTICAL IMPLICATIONS: Insights from this scoping review provide a foundation for dietitians to effectively carry out DC and serve as a starting point to further work towards effective DC.

Nutrition assessment in process-driven, personalized dietetic intervention - The potential importance of assessing behavioural components to improve behavioural change: Results of the EU-funded IMPECD project.

BACKGROUND & AIMS: Although up-to-date definitions for nutrition assessment integrate behavioural components, it is not clear what behavioural components are to be assessed. Since behavioural modification is linked to effective therapeutic dietetic interventions, assessing behaviour and factors influencing behaviour might be beneficial to improve personalized dietetic outcome. The aim of the following report is to emphasize the role of behavioural components and factors affecting behaviour at baseline nutrition assessment in personalized dietetic intervention. METHODS: The present work is part of the EU-funded project IMPECD ("Improvement of Education and Competences in Dietetics", www.impecd.eu). The project aims to improve the clarity and consistency of national dietetic process models to unify education and training of future dietitians. Experts from five European Universities of Applied Sciences (UAS) in Antwerp (BE), Fulda (DE), Groningen (NL), Neubrandenburg (DE) and St. Pölten (AT) developed a Massive Open Online Course (MOOC) consisting of several clinical cases. It warranted a detailed evaluation of all dietetic care process steps, starting with nutrition assessment. RESULTS: Results for motivation assessed during nutrition assessment are not consistently positively associated with outcome and the added value of assessing them at baseline is still unclear. However, depressive symptoms, emotional distress, and anxiety negatively affect eating and physical activity and therefore limit the efficacy of the dietetic intervention. Assessing behavioural components including nutrition literacy is an important precondition for influence on behavioural modification. CONCLUSION: Indisputably, baseline assessment of behavioural components and factors influencing behaviour are important to increase the therapeutic efficacy of personalized dietetic interventions.