Remote nutrition care during the first wave of COVID-19 pandemic: Did it impact nutrition therapy goals?

BACKGROUND AND AIMS: Nutrition societies recommended remote hospital nutrition care during the coronavirus disease 2019 (COVID-19) pandemic. However, the pandemic's impact on nutrition care quality is unknown. We aimed to evaluate the association between remote nutrition care during the first COVID-19 wave and the time to start and achieve the nutrition therapy (NT) goals of critically ill patients. METHODS: A cohort study was conducted in an intensive care unit (ICU) that assisted patients with COVID-19 between May 2020 and April 2021. The remote nutrition care lasted approximately 6 months, and dietitians prescribed the nutrition care based on medical records and daily telephone contact with nurses who were in direct contact with patients. Data were retrospectively collected, patients were grouped according to the nutrition care delivered (remote or in person), and we compared the time to start NT and achieve the nutrition goals. RESULTS: One hundred fifty-eight patients (61.5 ± 14.8 years, 57% male) were evaluated, and 54.4% received remote nutrition care. The median time to start NT was 1 (1-3) day and to achieve the nutrition goals was 4 (3-6) days for both groups. The percentage of energy and protein prescribed on day 7 of the ICU stay concerning the requirements did not differ between patients with remote and patients with in-person nutrition care [95.5% ± 20.4% × 92.1% ± 26.4% (energy) and 92.9% ± 21.9% × 86.9% ± 29.2% (protein); P > 0.05 for both analyses]. CONCLUSION: Remote nutrition care in patients critically ill with COVID-19 did not impact the time to start and achieve the NT goals.

Prevalence and Determinants of Predialysis Dietitian Follow-Up: Results From the Brazilian Dialysis Registry.

OBJECTIVE: We aimed to evaluate the prevalence and sociodemographic determinants of predialysis dietitian follow-up in a large cohort of Brazilian dialysis patients. METHODS: We retrospectively evaluated data from all incident adult dialysis patients included in the Brazilian Dialysis Registry from January 2011 to September 2021. Predialysis dietitian follow-up was classified as present when a period more than 6 months of dietitian care was reported. Gender, age, skin color, education, body mass index, chronic kidney disease etiology, first chronic dialysis program, healthcare provider, and geographic regions were tested in logistic regression models. RESULTS: Ten thousand three hundred and eighty two patients met the inclusion criteria and 1,254 (12.1%) reported predialysis dietitian follow-up, most of them referred by a nephrologist (94.2%). The independent determinants of dietitian follow-up were older age, white skin color, higher education level, not having diabetes, living in North/Northeast and South (compared to Southeast), and having a nonpublic healthcare provider. When considered only patients under a predialysis care of a nephrologist, higher education, hemodialysis as the first dialysis modality, and living in the North/Northeast and South regions (compared with Southeast) were associated with dietitian follow-up. CONCLUSION: Predialysis dietitian follow-up for more than 6 months in a country where the public health system is the main dialysis provider is still very low. The nephrologist is pivotal for referral to dietitians but socioeconomic factors also seem to play a role in this regard.

Under the 'weight' of norms: Social representations of overweight and obesity among Brazilian, French and Spanish dietitians and laywomen.

Most contemporary Western cultures are characterized by fatphobia. The fat body is seen as morally incorrect, a sign of disease, loss of control and weakness. People with obesity and overweight, especially women, are discriminated against and stigmatized for their body size, including by health professionals like dietitians. This study sought to understand and compare social representations of obesity and overweight among dietitians and laywomen from three nationalities: Brazilian, French and Spanish. A qualitative and comparative methodology was established based on 131 semi-structured individual interviews. The analysis revealed that the categories of overweight and obesity were negatively perceived by laywomen and dietitians from all three nationalities. Moral discourses linking these conditions with lack of discipline and a lack of emotional control were frequently used. Fatness was associated with irrationality, putting individuals who were overweight and obese in a position of social and moral inferiority. In the case of obesity, these ideas were more discriminatory and stigmatizing. Although environmental, genetic, hereditary or metabolic causes were mentioned as factors causing obesity, behavioural aspects occupied a central place in the discourses. Differences were also observed among the three nationalities. Cultural factors related to the relationship with body and food seemed to influence the interviewees' social representations. Brazilian laywomen and dietitians put more emphasis on moral and individual aspects. Spanish, French and informants who were overweight were more likely to cite physiological and environmental determinants. French informants also mentioned the role of food education given by parents. In conclusion, the discourses of professionals and laywomen had more similarities than differences, were based on moral and normative judgements and influenced by sociocultural norms. Fatphobic attitudes may impact dietitians' perception of patients with obesity and the eating education process.

Use of Social Networks in the Context of the Dietitian's Practice in Brazil and Changes During the COVID-19 Pandemic: Exploratory Study.

BACKGROUND: Social networks have been pointed out as 1 of the greatest means of spreading information. A large part of the population is already present on these platforms, looking up subjects such as health, nutrition, and food. To reach this audience, it may be important for dietitians to explore social networks. However, there is a gap in scientific studies on exploring the ways in which these platforms are used by dietitians in Brazil, and the roles they play in the profession have not been well defined. OBJECTIVE: This study aims to describe the roles that social networks play in dietitians' practice in Brazil and their mode of use of social networks. This study also aims to identify professionals' perceptions and opinions regarding the use of these tools, as well as changes in behavior on social network usage caused by the COVID-19 pandemic. METHODS: We carried out a quantitative cross-sectional study, collecting data through an online questionnaire, submitted between October 2020 and January 2021 to dietitians registered on the Federal Council of Dietitians. All participants included in the study answered questions about the use of social networks in their professional context. RESULTS: In total, 264 (91.7%) of the 288 participants reported using social networks for professional practice. Instagram was the social network most often used by professionals (224/264, 84.8%). Dietitians (N=288) related to the use of social networks (always to almost always) for sharing information about their services (n=114-72 [39.6%-25%], respectively), following the work of other dietitians (n=172-64 [59.7%-22.2%], respectively), and writing about topics related to food and nutrition (n=166-53 [57.6%-18.4%], respectively). The roles played by social networks in the professional context of dietitians were attracting more clients (210/289, 72.7%) and keeping in touch with them (195/289, 67.5%). Furthermore, 227 (78.5%) of the 289 dietitians strongly agreed that social networks are good tools to promote their services. During the COVID-19 pandemic, 216 (74.7%) of the 289 participants noticed changes in their behavior, feelings, or beliefs on the use of social networks related to professional practice, and 149 (51.6%) have increased the frequency of sharing information about nutrition and health in general on social networks. CONCLUSIONS: The main roles of social networks in the professional context of dietitians are to attract clients and to facilitate the contact between professional and client. The modes of use reported by the professionals included sharing information about their services, following the work of professional colleagues, and writing about topics related to nutrition. Most of them reported believing that social networks are an effective way to disseminate their services. Moreover, most professionals claimed to have noticed changes in their behaviors or beliefs on social media during the COVID-19 pandemic.

Nutrition Counseling in an Academic Medical Center According to Socioeconomic Status and Grocery Shopping Consumer Behavior Decreased Relative Fat Mass in Breast Cancer Survivors

ABSTRACT Background: Body composition assessment in breast cancer survivors (BCSs) is essential to plan feasible dietary strategies for sarcopenic obesity prevention. Objective: Studying the effect of an individualized nutrition intervention according to socioeconomic status and grocery shopping behavior on BCSs relative fat mass (RFM). Methods: BCSs attending an academic medical center were studied; participants saved all 1-week supermarket tickets and answered a grocery shopping consumer preference survey. RFM was assessed at baseline and after the 3-month nutrition intervention. Nutrition plans were based on the dynamic macronutrient meal-equivalent menu method (MEM) and dietary guidelines for BCSs. Results: Thirty-three BCSs completed the study and 91% of them presented obesity or overweight at baseline. After the intervention, BCSs lost 1.6 kg (p < 0.01) of body weight, 1.8 kg (p < 0.01) of RFM, 3 cm (p < 0.01) of waist circumference, and 2.4 cm (p < 0.01) of hip circumference, while no changes were observed in fat-free mass (p = 0.6) and arm bone-free muscle area (p = 0.7). Conclusions: RFM and body weight in breast cancer survivors decreased after an individualized nutrition intervention according to socioeconomic status and grocery shopping consumer behavior. Based on the participants’ food preferences and consumer behavior, plant-based protein diet plans cost less than the animal-based protein diet plans.

Quality of Life Prior and in the Course of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study with Brazilian Dietitians.

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians' perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians' quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.

Anthropometric and blood pressure changes in patients with or without nutritional counselling during cardiac rehabilitation: a retrospective study.

BACKGROUND: Whether a patient's outcomes are better when receiving nutritional counselling during cardiac rehabilitation (CR) has been scarcely described. We compared changes in weight, waist circumference (WC) and blood pressure (BP) in patients attending CR with and without nutritional counselling. METHODS: A retrospective analytical study was conducted in which two groups of patients who completed a phase II CR (36 sessions) were compared: CONTROL [n = 144, mean (SD) age = 59 (12) years, 17% females], comprising patients without nutritional counselling (attended between 2003 and 2009), and NUT [n = 128, mean (SD) age = 60 (13) years, 27% females], comprising patients with dietitian-delivered nutritional counselling (attended between 2010 and 2019). Repeated-measures analysis of variance was used to compare changes in weight, WC, and BP during CR between groups. Logistic regression models determined the probability of reducing weight and systolic BP (SBP). RESULTS: NUT group decreased weight [-1.3 (3.1) kg; P < 0.0001] and WC [-3.0 (3.8) cm; P < 0.0001] to a greater extent than CONTROL [weight: -0.4 (3.1) kg; P = 0.51; WC: -1.4 (4.5) cm; P = 0.02]. In CONTROL, 7% reduced ≥ 5% weight and 31% reduced ≥ 10 mmHg SBP, whereas, in the NUT group, 18% reduced ≥ 5% weight and 47% reduced ≥ 10 mmHg SBP. Patients in NUT (versus CONTROL) were more likely to lose ≥ 5% of weight (odds ratio = 4.27, 95% confidence interval = 1.69-10.80; P < 0.01) and reduce SBP ≥ 10 mmHg (odds ratio = 3.15, 95% confidence interval = 1.58-6.27; P < 0.01). CONCLUSIONS: Patients who received nutritional counselling during CR improved anthropometric measures and were more likely to lose weight and reduce SBP than patients without nutritional counselling.

How would you define healthy food? Social representations of Brazilian, French and Spanish dietitians and young laywomen.

The perception that food affects our health has increased over the past fifty years in industrialised Western countries. The notion of "healthy food" has become ubiquitous in medical, political, and media discourse as well as in the discourses of the lay population. This study seeks to understand the social representations of "healthy food" of Brazilian, Spanish and French dietitians and young laywomen. A qualitative and comparative methodology based on 131 individual semi-structured interviews was set up. According to the analysis of the discourses, the notion of "healthy food" is ambivalent and polysemic. Scientific-nutritional rationality is not the only way to think about "healthy food". Two main ways of categorising "healthy foods" are observed in the three countries. They are based on eating analysis criteria that referred to diverse value systems and different scientific, symbolic and moral rationalities: on the one hand, a physiological, nutritional and functional conception, and on the other, an "eco-ideological" conception that took into account production, culture and distribution methods. Though dietitians have a greater technical knowledge of nutrients and metabolic processes than laywomen, professionals and young laywomen, mainly within the same nationality, shared similar discourses concerning the notion of "healthy food", revealing patterns that differentiate each nationality. Taking together, the results reveal that although medical-nutritional discourses are disseminated internationally, discourses on "healthy food" are constructed taking into account social, cultural, symbolic and moral dimensions. These discourses are linked to a historical and sociocultural context.

Evaluación del nivel de participación del nutricionista en la prescripción dietética en hospitales públicos y privados de Chile / Evaluation of Clinical Dietitian Participation in Adequate Prescription of Dietary Indications in Public and Private Hospitals in Chile

Antecedentes: actualmente, Chile tiene un déficit de dietistas clínicos y se desconoce si este déficit está afectando la prescripción de indicaciones dietéticas adecuadas para pacientes hospitalizados. Objetivo: evaluar el nivel de participación del nutricionista clínico en la prescripción dietética en los hospitales públicos y privados del territorio nacional, entre los meses de agosto y octubre del año 2016. Materiales y métodos: estudio exploratorio, descriptivo; se invitaron a participar a 360 nutricionistas, contestaron 110 nutricionistas clínicos. Se aplicó un cuestionario de 21 preguntas, enviado vía correo electrónico. Resultados: las horas diarias dedicadas al servicio clínico presentaron una mediana de 6 horas, el 41,8 % de los encuestados tenía entre 26 y 50 pacientes a su cargo. El 99 % de los nutricionistas puede sugerir cambios en la prescripción dietética; sin embargo, un 45 % de las sugerencias realizadas al médico para modificar regímenes son registradas siempre en la ficha clínica. La participación en la prescripción dietética al inicio del tratamiento corresponde a un 9,1 %, en la evolución es de un 32,7 % y en la prescripción realizada al alta es de un 56,4 %. A más años de experiencia y más horas dedicadas al servicio se presenta un significativo mejor puntaje en la prescripción dietética (p<0,05). Conclusiones: el nivel de participación del nutricionista clínico es medio, los nutricionistas con más años de experiencia y mayor número de horas dedicadas a los pacientes presentan mayor prescripción dietética.

Background: Currently Chile has a deficit of clinical dietitians and it is unknown if this deficit is affecting the prescription of adequate dietary indications to hospital patients. Objective: Evaluate the participation level of clinical dietitians in the adequate prescription of dietary indications in public and private hospitals nationally, between August and November 2016. Materials and Methods: Exploratory descriptive study. 360 dietitians were invited to participate, and 110 accepted. A 21-question self-response questionnaire was sent to participants via email. Results: Daily hours dedicated to clinical services was a median of 6 hours among participants, 41.8% of whom had between 26 and 50 patients in their care. 99% of the dietitians are able to suggest changes to the dietary prescriptions; however only 45% of the modifications that are suggested to the doctors are ever recorded in the clinical records. Participation in dietary prescription at the beginning of patient treatment is 9.1 %, throughout the hospital stay is 32.7 %, and prescriptions made at discharge correspond to 56.4 %. More years of experience and more hours dedicated to clinical service correspond to a significantly better percentage in dietary prescriptions administered (p<0.05). Conclusions: The level of dietitian participation is average; the dietitians with more years of experience and higher number of hours dedicated to patient care present better dietary prescription to hospital patients.

Efficacy of nutritional recommendations given by registered dietitians compared to other healthcare providers in reducing arterial blood pressure: Systematic review and meta-analysis.

INTRODUCTION: The multidisciplinary health practitioners can facilitate adherence to treatment of hypertension. Nutritional recommendations delivered by an expert in nutrition might increase the blood pressure control through a better comprehension about how nutrition plays a role on hypertension. OBJECTIVE: To evaluate the effect of nutritional intervention performed by a multidisciplinary team with and without registered dietitians compared to usual care in blood pressure control of hypertensive patients. METHODOLOGY: Systematic review including randomized clinical trials that assessed participants >18 years, both sexes, with blood pressure ≥140/90 mmHg or use of antihypertensive, ≥8 weeks duration and at least one nutritional planned intervention versus usual care. The search was conducted in July 2015 in MEDLINE, EMBASE, BIREME, Web of Science and LILACS without limitation to language. Outcome was defined as deltas of systolic (SBP) and diastolic blood pressure (DBP). Sub-group analysis was conducted according to the presence or not of the registered dietitians in the staff. The analyses were performed in RevMan 5.3 software, using random effects model with heterogeneity assessed by statistical I2. RESULTS: From 7280 identified titles, 62 studies were selected for data extraction, and 13 were included in the meta-analysis, with a total of 2050 participants. There was a greater reduction in ΔSBP -2.82 mmHg (95% CI: 4.03 to -1.62) and ΔDBP -1.37 mmHg (95% CI: -2.11 to -0.62) when diet recommendations have been delivered by multi-professional team versus usual care. In stratified analyses only the subgroup of studies with registered dietitians showed statistical significant reduction in blood pressure ΔSBP -3.21 mmHg (95% CI: -4.14 to -2.27); ΔDBP -1.46 mmHg (95% CI: -2.06 to -0.86). There were significant differences between the deltas of blood pressure according to sodium restriction (ΔSBP -3.5 mmHg (95% CI: -4.52 to -2.48), ΔDBP -1.69 mmHg (95% CI: -2.36 to -1, 02)) and caloric restriction (ΔSBP -2.83 mmHg (95% CI: -5.11 to -0.54); ΔDBP -0.92 mmHg (95% CI: -2.21 to 0.37)) only when there was a registered dietitians in the multidisciplinary team. CONCLUSION: Nutritional recommendation made by multidisciplinary team has a statistical significant effect on blood pressure control in hypertensive patients, mainly when a registered dietitian is present in the team.

Atitudes de nutricionistas em relação a indivíduos obesos - um estudo exploratório / Attitudes of dietitians in relation to obese individuals - an exploratory study

O objetivo foi identificar atitudes de nutricionistas em relação à obesidade; envolvendo crenças sobre características atribuídas às pessoas obesas, fatores de desenvolvimento e a obesidade em si. Os participantes (N = 344; 97,1% mulheres) foram contatados via conselho profissional e responderam a pesquisa online. As questões do estudo foram adaptadas de trabalhos internacionais com as respostas analisadas por frequência de concordância. As respostas indicaram forte estigmatização da obesidade e preconceito contra o obeso, atribuindo características como: guloso (67,4%), não atraente (52,0%), desajeitado (55,1%), sem determinação (43,6%) e preguiçoso (42,3%). E considerando entre os mais importantes fatores causais: alterações emocionais e de humor, vício ou dependência de comida e baixa autoestima. Esta temática deve ser mais pesquisada uma vez que tais atitudes podem impactar a eficácia do tratamento; também para discussão e formação ampla sobre os significados da obesidade, e tratamento mais individualizado e humanizado para pacientes obesos.

The scope of this study was to assess attitudes of dietitians in relation to obesity; involving beliefs about the characteristics attributed to obese people, the reasons that lead to obesity and obesity itself. Dietitians (N = 344; 97.1% women) were contacted via their professional council and filled out the online survey. The survey questions were translated and adapted from international studies on this subject and the responses were analyzed for concordance rate. The results pointed to strong stigmatization of obesity and prejudice against the obese, attributing characteristics such as greed (67.4%), unattractiveness (52.0%), ungainliness (55.1%), lack of willpower (43.6%) and laziness (42.3%). The most important causal factors were considered to be emotional and mood changes, food addiction and low self-esteem. Research on this topic should be enhanced since these attitudes can affect the efficacy of treatment and also to foster broad discussion and training regarding the significance of obesity and to ensure more individualized and humanized treatment for obese patients.

Formação do nutricionista atuante no Programa Nacional de Alimentação Escolar / Dietitians' training in the National School Feeding Program

The purpose of this research was to investigate the educational demands of dietitians engaged in the National School Feeding Program (NSFP) and to characterize the profile, career trajectory and improvement demands of these professionals, as well as the daily facilities and difficulties of the program. Data collection was carried out through a semi-structured questionnaire. Descriptive statistics and analysis of open questions were performed. The research comprised 246 dietitians - 98.4% of whom were female. Most participants (76.3%) concluded the course 10 years ago, that is, subsequent to the National Curriculum Guidelines (NCG). Contents related to NSFP were part of the undergraduate program of these dietitians, but insufficient for most of them. Thus, 31% of the nutritionists surveyed underwent further training courses to work in the NSFP. The most cited characteristics required to engage the program were technical knowledge, creativity, teamwork and dynamism. The facilities to work in the program were related to administrative aspects, while the difficulties included technical aspects. Training demands included the elaboration of nutritionally adequate menus and costs, greater participation in the nutrition educational processes, bidding, and improvement for all the professionals involved in school feeding, promoting exchanges of experiences, professional value, and raising managers' awareness regarding the importance of the Program. The divergence of content and pedagogical models during training may limit the expansion of the professional integration desired for dietitians, requiring curricular re-equalization concerning the current policies.

Este trabajo tuvo por objetivos investigar las demandas de formación profesional del nutricionista que actúa en el Programa de Alimentación Escolar (PAE), caracterizar su perfil profesional, su trayectoria y las facilidades y dificultades del Programa. La recolección de datos se realizó por medio de cuestionario semi-estructurado. Se realizó tratamiento estadístico descriptivo de los datos y análisis de las preguntas abiertas. La investigación contó con la participación de 246 nutricionistas, siendo 98,4% de sexo femenino. La mayoría (76,3%) había terminado su carrera hacía 10 años, es decir, posteriormente a las Directrices Curriculares Nacionales (DCN). Para la mayoría de los nutricionistas, los contenidos relacionados al PAE constaron en el currículo de grado de forma insuficiente. Por lo tanto, 31% tuvieron que realizar cursos específicos en esa área. Las características más citadas como necesarias para actuación en el programa fueron: conocimiento técnico, creatividad, trabajo en equipo y dinamismo. Las facilidades de los nutricionistas para actuar en el Programa se refirieron a aspectos administrativos, mientras que las dificultades incluyeron aspectos técnicos. Las demandas de formación contemplaron la elaboración de menús adecuados tanto nutricionalmente como en costo, una mayor participación en los procesos de educación nutricional y licitatorios, y la capacitación de todos los profesionales involucrados en el proceso de alimentación escolar, promoviendo intercambio de experiencias, valorización del nutricionista y sensibilización de los gestores con relación a la importancia del Programa. La brecha entre los contenidos y los modelos pedagógicos durante la formación puede limitar la ampliación de la inserción profesional deseada por el nutricionista requiriendo readecuaciones curriculares en función de las actuales políticas.

Este trabalho objetivou investigar as demandas de formação do nutricionista atuante no Programa de Alimentação Escolar (PNAE), caracterizar seu perfil profissional, trajetória de formação, demandas de aprimoramento e facilidades e dificuldades do cotidiano do Programa. Realizou-se a coleta de dados por meio de questionário semiestruturado. Utilizou-se tratamento estatístico descritivo dos dados e análise das questões abertas. A pesquisa contou com a participação de 246 nutricionistas, sendo 98,4% do sexo feminino. A maioria (76,3%) concluiu o curso há 10 anos, ou seja, posteriormente às Diretrizes Curriculares Nacionais (DCN). Conteúdos referentes ao PNAE fizeram parte da graduação dos nutricionistas, porém, de forma insuficiente para a maioria deles. Com isso, 31% deles realizaram cursos de aperfeiçoamento para atuar no PNAE. As características necessárias, mais citadas, para atuação no programa foram: conhecimento técnico, criatividade, trabalho em equipe e dinamicidade. As facilidades dos nutricionistas para atuar no Programa referiam-se a aspectos administrativos, enquanto as dificuldades incluíam aspectos técnicos. As demandas de formação abrangeram a elaboração de cardápios adequados nutricionalmente e ao custo, maior participação nos processos de educação nutricional, licitatórios e em aprimoramentos com todos os profissionais envolvidos no processo da alimentação escolar, promovendo trocas de experiências, valorização do nutricionista e sensibilização dos gestores para a importância do Programa. O descompasso dos conteúdos e modelos pedagógicos durante a formação pode limitar a ampliação da inserção profissional almejada para o nutricionista, requerendo readequações curriculares em função das atuais políticas.

Dimensionamento de recursos humanos em serviços de alimentação e nutrição de hospitais públicos e privados / Human resources dimensioning in food and nutrition hospital services in public and private hospitals

O objetivo deste trabalho foi caracterizar e comparar o dimensionamento de recursos humanos dos Serviços de Alimentação e Nutrição Hospitalar (SANH) e a qualificação do corpo técnico de nutricionistas da rede hospitalar pública e privada. Foram estudados 27 hospitais, 17 de Campinas e 10 de Ribeirão Preto, por meio de um questionário estruturado aplicado aos coordenadores do SANH, que abordou: condições de trabalho, pela relação entre número de leitos por nutricionista e por profissionais do SANH, e pelo número de refeições produzidas por leito, por nutricionistas e por funcionários do SANH; a formação acadêmica; e a experiência profissional dos nutricionistas. Foram encontradas diferenças significativas na relação número de leitos/nutricionista entre hospitais públicos (38,2 dp 11,4) e privados (94,6 dp 46,4) e de funcionários do SANH/nutricionista (11,4 dp 4,9 e 23,8 dp 13,3). A produção de refeições por leitos foi maior nos hospitais públicos (p=0,04). No setor público concentram-se nutricionistas com capacitação stricto sensu, mesmo que ainda em um número reduzido em relação ao encontrado no país; e, no privado, há mais profissionais com formação lato sensu. Uma ampla heterogeneidade no dimensionamento de recursos humanos do SANH em hospitais públicos e privados foi encontrada; contudo, o setor público apresentou condição mais favorável em alguns indicadores, mesmo estando aquém das necessidades, principalmente na área de atenção nutricional ao paciente hospitalizado. Os resultados apontam para a necessidade de se constituirem indicadores específicos de recursos humanos nos SANHs, para o desempenho de ações na área de produção de refeições e de cuidado nutricional ao paciente hospitalizado. Criar mecanismos de capacitação do nutricionista para as áreas de competência da nutrição hospitalar poderia contribuir com o aprimoramento do setor.

The objective of this paper was to characterize and compare the human resources dimensioning in food and nutrition hospital services (FNHS) and the qualification of the dietitian technical personnel in public and private hospitals. We studied 27 hospitals, 17 from Campinas and 10 from Ribeirão Preto, through a structured questionnaire applied to coordinators of the FNHS. The questionnaires addressed working conditions, by the number of beds per dietitian and per FNHS workers and number of meals per beds, per dietitian and per FNHS workers; academic background; and professional experience of dietitians. We found significant differences in the number of beds per dietitian between public (38.2 SD 11.4) and private (94.6 SD 46.4) hospitals, and of FNHS workers per dietitian (11.4 SD 4.9 and 23.8 SD 13.3 for public and private hospitals respectively). The number of meals per bed was greater in public hospitals (p = 0.04). Dietitians with stricto sensu post-graduation degrees are concentrated in public hospitals whereas the ones with lato sensu post-graduation degrees are present in larger numbers in private hospitals. The wide heterogeneity in the dimension of human resources of FNHS in public and private hospitals has been found yet. The public setor showed more favorable conditions hospitals had in some indicators, although short of the needs in the area mainly for nutritional care for hospitalized patients. The results point to the need to provide specific indicators of human resources in FNHS, for the performance of shares in the production of food and nutritional care to hospitalized patients. Build mechanisms for training of nutritionists for areas of competence of hospital food could contribute to improvement of the sector.