The Ontario Public Does Not Understand the Difference Between Registered Dietitians and Unregulated "Nutritionists": Results from a Cross-Sectional Mixed Methods Study.

BACKGROUND: Current Ontario healthcare policy permits anyone to use the title "nutritionist" and practice as a clinician regardless of education and training. The title "dietitian," on the other hand, is protected under the Dietetics Act (1991) for use exclusively by individuals who undergo rigorous education and training in evidence-based nutrition. OBJECTIVES: The objectives of this study were to: identify whether the Ontario general public understands the difference between a registered dietitian (RD) and an unregulated "nutritionist;" understand experiences with RDs and "nutritionists;" and determine if the current nutrition landscape arising from gaps in healthcare policy has the potential to harm the public. METHODS: A cross-sectional mixed methods survey study was carried out using inductive content analysis, descriptive statistics and chi-square tests. RESULTS: Respondents (n = 402) did not understand the difference between RDs and "nutritionists." Overall, public experiences have been significantly more positive when nutrition information/advice stemmed from an RD. IMPLICATIONS: This study provides justification for proposed legislative amendments to the Dietetics Act (1991) and the Regulated Health Professions Act (1991). These proposed amendments have been detailed in the full-text manuscript.

Enteral and Parenteral Order Writing Survey-A Collaborative Evaluation Between the Academy of Nutrition and Dietetics' Dietitians in Nutrition Support Dietetics Practice Group and the American Society for Parenteral and Enteral Nutrition (ASPEN) Dietetics Practice Section.

INTRODUCTION: In 2014 and 2017, the Centers for Medicare and Medicaid Services authorized nutrition-related ordering privileges for registered dietitian nutritionists (RDNs) in hospital and long-term care settings, respectively. Despite this practice advancement, information describing current parenteral nutrition (PN) and enteral nutrition (EN) ordering practices is lacking. Dietitians in Nutrition Support, a dietetic practice group of the Academy of Nutrition and Dietetics and the Dietetics Practice Section of the American Society of Parenteral and Enteral Nutrition (ASPEN) utilized a survey to describe PN and EN ordering practices among RDNs in the United States. METHODS: A cross-sectional study design was utilized to describe RDN PN and EN ordering privileges. Respondents were asked to describe PN and EN ordering privileges, primary practice setting, primary patient population served, nutrition specialty certification, highest degree earned, career length, and if applicable, the nature of prior denials for ordering privileges or reasons for not applying for ordering privileges. RESULTS: Seven hundred two RDNs completed the survey (12% response rate), with 664 RDNs providing complete data. The majority of respondents (n = 558) cared for adult/geriatric patients. Among this subset, 47% had no PN ordering privileges; 14% could order and sign PN; 28% could order PN with provider cosignature; 10% could order partial PN with provider cosignature. Nineteen percent of RDNs had no EN ordering privileges; 37% could order and sign EN; 44% could order EN with provider cosignature. RDNs with ordering privileges were more likely to have a nutrition specialty certification and work in an academic or community hospital setting. CONCLUSION: PN and EN ordering privileges are varied because of institution and state requirements. Future research describing the outcomes associated with RDN ordering privileges is needed. This paper has been approved by the Academy's Research, International, and Scientific Affairs team and Council on Research and the ASPEN Board of Directors. This article has been co-published with permission in the Journal of the Academy of Nutrition and Dietetics. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.

"Detoxify or Die": Qualitative Assessments of Ontario Nutritionists' and Dietitians' Blog Posts Related to Detoxification Diets.

While the title Registered Dietitian (RD) is regulated under provincial legislation in Ontario and other Canadian provinces, the title "nutritionist" is not regulated in Ontario, which poses potential risks to consumers who place misguided trust in those proclaiming to be nutrition experts. This is concerning as nutrition is a complex health care discipline and RDs, the recognized providers of credible nutrition information, must be registered with an accredited regulatory college that requires them to have undergone rigorous training, practicum placements, entrance examinations, and continuous professional development. The purpose of this study was to determine if Ontario-based unregulated nutritionists and RDs are providing safe, evidence-based, information regarding detoxification diets. Content from 10 blog posts were qualitatively analyzed using deductive content analysis with predetermined categorization matrices. The results revealed that Ontario nutritionists promoted detox diets and provided unproven, misleading, and potentially harmful information, whereas Ontario RDs did not promote detox diets and provided evidence-based, harm-reducing information. Additionally, conflicts of interest arose only in nutritionists' blog posts. RDs provided credible references for their information while nutritionists did not. Protecting the term "nutritionist" for use exclusively by RDs under provincial legislation would be a positive step towards ensuring Ontarians are receiving the highest quality evidence-based nutrition information.

O nutricionista e a gestão de qualidade de alimentos em serviços de alimentação

A qualidade dos alimentos tem sido cada vez mais monitorada em relação à segurança, tornando indispensável à adoção do controle higienicossanitário. O Nutricionista Responsável Técnico é o profissional habilitado que assume o planejamento, organização, direção, supervisão e avaliação de serviços de alimentação e nutrição. Sendo assim, este estudo objetivou ressaltara importância da atuação deste profissional como promotor de saúde em relação à gestão higienicossanitária em unidades de alimentação. Foi realizada uma pesquisa qualitativa, descritiva, em seis restaurantes comerciais, selecionados aleatoriamente, situados na Região Metropolitana do Recife, relacionando-os à presença do Nutricionista de acordo com a avaliação das condições higienicossanitárias do local. Os dados foram coletados através do checklist,constante no anexo II da RDC n° 275/2002, da ANVISA, enfocando cinco blocos: edificação e instalações; equipamentos, móveis e utensílios; manipuladores; produção e transporte; documentação. Para cada item houve três possibilidades de resposta: "sim", "não" e "não aplicável". Os estabelecimentos que possuíam nutricionista foram nomeados Restaurantes 1A, 2A e 3A e os que não possuíam nutricionista, identificados por Restaurantes 1B, 2B e 3B e classificados, de acordo com a adequação dos itens, em: Grupo I (76 a 100%), Grupo II (51 a 75%) e Grupo III (0 a 50%). Os resultados mostraram que os Restaurantes que tinham nutricionista foram classificados no Grupo I e os que não tinham responsável técnico foram classificados no Grupo 3. A presença do nutricionista é um diferencial para garantir uma alimentação com qualidade nutricional e higienicossanitária.

Food quality has been increasingly monitored in relation to its safety, making it essential the adoption of sanitary-hygienic contraI. The Technical Manager Nutritionist is the professional habilitated for the planning, organization, direction, supervision and evaluation of nutrition and food services. Therefore, this study aims to emphasize the importance of the rale of the nutritionist as a healthcare promoter in relation to the hygienic-sanitary management in food units. We conducted a descriptive, qualitative research in six commercial restaurants, randomly selected, located in Recife metropolitan region, relating them to the presence of Nutritionist according to the evaluation of hygienic-sanitary conditions of the place. Data were collected through checklist contained in Annex II from RDC n° 275/2002, ANVISA, focusing on five blocks: building and facilities, equipment, furniture and utensils; handlers; production and transportation; documentation. For each item there were three possible answers: "yes", "no" and "not applicable". Establishments who had a nutritionist were named Restaurants 1A, 2A and 3A and those who had no nutritionist, identified by Restaurants 1B, 2B and 3B, and classified according to the adequacy of the items in Group I (76 to 100%), Group II (51 to 75%) and Group III (0-50%). The results showed that those Restaurants who had a nutritionist were classified in Group I and those without technical manager were classified in Group III. The presence of a nutritionist is a differential to assure a meal with nutritional and hygienic-sanitary quality.

Escenarios de desarrollo de habilidades de liderazgo para el nutricionista-dietista / Stages of development of leadership skills for dietitians

A partir de una revisión sistemática, se hace una breve presentación de los escenarios de desarrollo de habilidades de liderazgo para el Nutricionista Dietista, con el objetivo de exponer los principales escenarios posibles de formación en liderazgo, dirigidos al desarrollo de habilidades den los profesionales, quienes tienen el desafío de liderar equipos para alcanzar altos grados de desempeño, en múltiples contextos. Se concluye a través de la evidencia disponible la necesidad de los profesionales en nutrición y dietética desarrollar habilidades de liderazgo par influenciar positivamente la sociedad y el entorno en el que prestan sus servicios, y se recomienda a las universidades, organizaciones, agremiaciones y asociaciones desarrollar programas de formación en liderazgo con enfoque de desarrollo de competencias y habilidades, para influenciar el entorno en el que prestan sus servicios, aportando al conocimiento y al quehacer del nutricionista-dietista (AU)

Based ona systematic literature review, scenarios for the development of leadership skills for Nutritionistis-Dietitians are discussesd, with the goal of presenting the main scenarios of leadership training, aimed at developing skills of professionals who face the challenge of leading teams to achieve high levels of performance in multiple contexts. Based on the evidence available, it is concluded the need for nutrition and dietetics professionals to develop leadership skills to positively influence the society and the environment in which they serve, and it is recommended to universities organizations, guilds and associations to develop suitable leadership training programs with a focus on developing skills and competences to influence the environment (AU)