Evidence-Based Practice Competencies among Nutrition Professionals and Students: A Systematic Review.

BACKGROUND: Evidence-based practice (EBP) promotes shared decision-making between clinicians and patients. OBJECTIVE: The aim was to determine EBP competencies among nutrition professionals and students reported in the literature. METHODS: We conducted a systematic review by searching Medline, Embase, CINAHL, ERIC, CENTRAL, ProQuest Dissertations and Theses Global, BIOSIS Citation Index, and clinicaltrials.gov up to March 2023. Eligible primary studies had to assess one of the 6 predefined EBP competencies: formulating clinical questions; searching literature for best evidence; assessing studies for methodological quality; effect size; certainty of evidence for effects; and determining the applicability of study results considering patient values and preferences. Two reviewers independently screened articles and extracted data, and results were summarized for each EBP competency. RESULTS: We identified 12 eligible cross-sectional survey studies, comprising 1065 participants, primarily registered dietitians, across 6 countries, with the majority assessed in the United States (n = 470). The reporting quality of the survey studies was poor overall, with 43% of items not reported. Only 1 study (8%) explicitly used an objective questionnaire to assess EBP competencies. In general, the 6 competencies were incompletely defined or reported (e.g., it was unclear what applicability and critical appraisal referred to and what study designs were appraised by the participants). Two core competencies, interpreting effect size and certainty of evidence for effects, were not assessed. CONCLUSIONS: The overall quality of study reports was poor, and the questionnaires were predominantly self-perceived, as opposed to objective assessments. No studies reported on competencies in interpreting effect size or certainty of evidence, competencies essential for optimizing clinical nutrition decision-making. Future surveys should objectively assess core EBP competencies using sensible, specific questionnaires. Furthermore, EBP competencies need to be standardized across dietetic programs to minimize heterogeneity in the training, understanding, evaluation, and application among dietetics practitioners. This study was registered at PROSPERO as CRD42022311916.

The impact of nutrition on visual cognitive performance in the nutrition, vision, and cognition in sport study.

Introduction: The purpose of this study was to examine the influence of nutritional intake on visual perceptual-cognitive performance (VCP) in young healthy adults. Methods: Ninety-eight healthy men (n = 38) and women (n = 60) aged 18-33 years participated and maintained their usual dietary intake throughout the study. VCP was measured using the NeuroTracker™ CORE (NT) 3-Dimensional (3-D) software program (15 training sessions) over a 15-day period. Food logs and extensive lifestyle measures including body composition, cardiovascular health, sleep and exercise patterns, and general readiness to perform were collected. Mean intake from 10 food logs collected over the 15 days were analyzed using Nutribase software. Statistical analyses were performed in SPSS using repeated measures ANOVA including significant covariates when appropriate. Results: Males consumed significantly more calories, macronutrients, cholesterol, choline, and zinc and performed significantly better on VCP than the females. Participants who consumed more than 40% of kcals from carbohydrates (p = 0.038), less than 24% of kcals from protein (p = 0.009), more than 2,000 µg/day lutein/zeaxanthin or more than 1.8 mg/ day vitamin B2 performed significantly better on VCP than those who consumed less than those amounts, respectively. Discussion: VCP is an important dimension of cognitive function and in the present study is influenced by higher carbohydrate, lutein/ zeaxanthin, and vitamin B2 dietary intake while high protein consumption and the female sex negatively impacted VCP.

Nutrition, lifestyle, and cognitive performance in esport athletes.

Introduction: Electronic sports, termed esports, is a growing athletic activity in which high levels of attention and cognitive performance are required. With its increasing popularity and competitiveness, interest in strategies to improve performance have emerged. Improving esports athlete performance, namely cognitive endurance, and resilience, may lie in nutritional or lifestyle factors. The Nutrition, Vision, and Cognition in Sport Studies (IONSport) investigated nutritional and behavioral factors that can influence cognition via 3-dimensional multiple objects tracking test (3DMOT) via Neurotracker X (NTx) software. The purpose of this study was to characterize the lifestyle of high level esports athletes with detailed nutrition, sleep, and physical activity assessments, and their association to gaming related cognitive performance. Methods: 103 male and 16 elite female esports athletes aged 16 to 35 years old completed surveys, food records, and cognitive testing sessions over 10 days. Participants were instructed to maintain their normal dietary and lifestyle habits. Results: There were positive significant associations between average NTx scores and the following nutrients: magnesium, phosphorous, potassium, sodium, zinc, selenium, thiamin, niacin, vitamins B6 and B12, folate, cholesterol, saturated, polyunsaturated, and monounsaturated fats, omega-6 and omega-3 fatty acids, and choline. Majority of participants did not meet recommended dietary allowances (RDAs) for these micronutrients nor the recommended intakes for dairy, fruit, and vegetables. There was a significant (p = 0.003) positive (r = 0.272) association between total vegetable intake and average NTx score. There was a significant negative association (p = 0.015) with our final sustain session, which measured cognitive resilience, and the Stanford Sleepiness Scale score. Repeated measures analysis was done with these groups over the 18 core NTx sessions. There were significant (p = 0.018) differences between the two groups with those who consumed the recommended amount of protein or more performing significantly better on NTx over the 18 sessions than those that did not consume enough protein. Those who consumed the recommended intakes for riboflavin, phosphorous, vitamin B12, and selenium performed significantly better over the 18 core NTx sessions than those that did not meet the recommended amounts. Discussion: The need for a nutrition intervention that is rich in protein, vitamins, and minerals is warranted in this population.