Integrating the sustainable development goals into health professions' curricula: using the nominal group technique to guide their contextualisation.

BACKGROUND: To embed the Sustainable Development Goals in health profession education, educators must contextualise them to their profession and geographical region. This study used the nominal group technique to contextualise the SDGs for Australian nutrition and dietetics tertiary education programs by determining the specific knowledge, skills, and values required for graduating dietitians to practise sustainably. METHODS: In 2022, 23 experts in food and sustainability attended a group session that employed the nominal group technique to discuss the Sustainable Development Goals knowledge, skills, and values Australian dietetic students should develop. After the group session, participants ranked the Sustainable Development Goals according to their perceived level of importance for student dietitians. These data were analysed using multi-methods, including a summation of the rankings, directed qualitative content analysis and reflexive thematic analysis. RESULTS: The three highest-priority Sustainable Development Goals identified were (1) Zero Hunger, (2) Good Health and Well-Being, and (3) Responsible Consumption and Production, which were then considered with the qualitative findings. The main categories that were generated from the content analysis reflected the broad knowledge, skills, and values student dietitians should develop. The preliminary codes provided specific details for each of the main categories. The thematic analysis generated two additional themes: the importance of Indigenous ways of knowing, being and doing, and authentic experiential learning activities. CONCLUSIONS: The method employed for this study provides a useful framework for health professions to contextualise the Sustainable Development Goals to their profession and geographical region. For this study, the ranking process and the qualitative data analysis enabled the Sustainable Development Goals to be reframed in a way that would be meaningful for dietetic educators and students and demonstrate the interrelatedness of the goals. The direct qualitative content analysis and reflexive thematic analysis identified the knowledge, skills, and values student dietitians should develop.

How do dietetics students learn about sustainability? A scoping review.

AIM: Globally, sustainability and planetary health are emerging as areas of critical importance. In 2015, the 2030 Agenda for Sustainable Development was adopted by the United Nations member states. Since then, the United Nations Educational, Scientific and Cultural Organization and the Commonwealth Secretariat have published guidelines for educators to embed sustainability content into curricula. This scoping review aims to identify how student dietitians learn about sustainability, how learning opportunities are evaluated, their outcomes, and whether these guidelines have translated into teaching activities contained in dietetic degrees. METHODS: A scoping review was used to address the aims. Eight electronic databases and Google Scholar were searched from inception to March 2022 for articles describing dietetics students' participation in learning activities focused on sustainability. Data that addressed the research aims were charted independently by two researchers, then narratively synthesised. RESULTS: Twelve articles met the inclusion criteria. A range of teaching approaches and evaluation methods were used, from passive learning in lectures to experiential learning activities. A change in knowledge or behaviour was found for experiential learning activities (n = 5). For articles published after 2015 (n = 9), two mentioned the Sustainable Development Goals and no articles referenced the published guidelines. CONCLUSIONS: A paucity of evidence exists describing how dietetics students learn about sustainability and their learning outcomes. Of the 12 articles published, varied teaching approaches and evaluation methods have resulted in inconsistencies in the reporting of outcomes. The minimal reference to the Sustainable Development Goals and published guidelines suggests a slow translation of knowledge to practice.

How do foodservice dietitians and dietetic students learn about environmental sustainability? A scoping review protocol.

INTRODUCTION: Healthcare services are responsible for 7% of Australia's carbon emissions, or 35 772 kt per annum, with 44% of these attributed to hospitals and an unknown proportion originating from the kitchen. Carbon emissions contribute to climate change that is predicted to adversely impact health outcomes. Healthcare professionals and institutions have an opportunity to reduce their impact on the climate. Australian dietitians, however, are not required to learn about environmental sustainability during their tertiary education. This scoping review will identify pedagogical frameworks employed by educational institutions and providers of professional development, to describe how foodservice dietitians and dietetic students develop environmental sustainability capabilities. METHODS AND ANALYSIS: The scoping review methodology established by Arksey and O'Malley will be used for this review. Papers will be included if they focus on dietitians or dietetic students learning about environmental sustainability in the foodservice domain. Nine databases, Business Source Complete, CINAHL, Cochrane, Edge (via informit), EMBASE, MEDLINE, Proquest, Scopus and Web of Science, will be searched from their inception. Grey literature will also be identified by searching theses databases, professional bodies databases and Google Scholar. Eligible articles will be identified by screening papers by their title and abstract, followed by a full-text review. The study selection process will be completed independently by the primary investigator and the research team. Any discrepancies will be resolved through discussion. The extracted data including citation information, information on the intervention and outcomes will be summarised using descriptive statistics. Themes describing the pedagogical underpinnings of the interventions, the measurement tools and the impact of the learning activities will be synthesised narratively. ETHICS AND DISSEMINATION: The results will inform the development of evidence-based pedagogical frameworks to enhance the capabilities of foodservice dietitians and dietetic students in environmental sustainability. Dissemination will occur through conference presentations, peer-reviewed journals and distribution through national accrediting bodies.

The impact of MTHFR 677 C/T genotypes on folate status markers: a meta-analysis of folic acid intervention studies.

PURPOSE: Methylenetetrahydrofolate reductase (MTHFR) is a key folate pathway enzyme with the T variant of the MTHFR gene increasing the risk of low folate status, particularly coupled with low folate intake. As genetic variability of MTHFR influences folate status, it is important to ensure an adequate intake that overrides genetic effects but minimises any adverse effects. Our aim was to assess the influence of MTHFR genotype on folate status followed by response to supplementation. METHODS: We performed a meta-analysis of ten folate intervention studies to assess the degree to which MTHFR C677T genotype influenced plasma homocysteine and serum folate levels as measures of folate status. We then examined response after supplementation at intake values up to the upper tolerable limit. RESULTS: The MTHFR 677TT genotype was associated with higher plasma homocysteine (2.7 µmol/L, TT vs. CT/CC; 2.8 µmol/L, TT vs. CC) and lower serum folate (2.5 nmol/L, TT vs. CT/CC; 3.6 nmol/L, TT vs. CC). In two studies, the TT groups had mean plasma Hcy >15 µmol/L. Serum folate levels were >7 nmol/L for all genotype groups. After supplementation of 400 up to 1670 µg DFEs of folic acid or folic acid + fortified foods and/or natural food folates for a minimum of 4 weeks, there were no significant differences in plasma homocysteine levels; however, individuals with the TT genotype had a lower serum folate response to supplementation (7.2 nmol/L, TT vs. CT/CC; 8.7 nmol/L, TT vs. CC). CONCLUSIONS: This meta-analysis confirms observations from observational and intervention studies that MTHFR TT genotype is associated with increased plasma homocysteine and lowered serum folate and less response to short-term supplementation. The results can be used for modelling and guiding personalised intake recommendations for the nutrient folate.

Sports Dietitians Australia position statement: sports nutrition for the adolescent athlete.

It is the position of Sports Dietitians Australia (SDA) that adolescent athletes have unique nutritional requirements as a consequence of undertaking daily training and competition in addition to the demands of growth and development. As such, SDA established an expert multidisciplinary panel to undertake an independent review of the relevant scientific evidence and consulted with its professional members to develop sports nutrition recommendations for active and competitive adolescent athletes. The position of SDA is that dietary education and recommendations for these adolescent athletes should reinforce eating for long term health. More specifically, the adolescent athlete should be encouraged to moderate eating patterns to reflect daily exercise demands and provide a regular spread of high quality carbohydrate and protein sources over the day, especially in the period immediately after training. SDA recommends that consideration also be given to the dietary calcium, Vitamin D and iron intake of adolescent athletes due to the elevated risk of deficiency of these nutrients. To maintain optimal hydration, adolescent athletes should have access to fluids that are clean, cool and supplied in sufficient quantities before, during and after participation in sport. Finally, it is the position of SDA that nutrient needs should be met by core foods rather than supplements, as the recommendation of dietary supplements to developing athletes over-emphasizes their ability to manipulate performance in comparison with other training and dietary strategies.