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2.
J Acad Nutr Diet ; 122(10S): S55-S66, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36122960

RESUMO

It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.


Assuntos
Dietética , Nutricionistas , Academias e Institutos , Dietética/educação , Insegurança Alimentar , Humanos , Estado Nutricional , Estados Unidos
3.
Nutr Diet ; 79(4): 489-496, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36082525

RESUMO

AIMS: To understand how young adult women use social media, including which nutrition and health-related content they prefer to view and why. Findings are intended to support dietitians to use social media more effectively for health promotion to reach, educate and positively influence young adult women. METHODS: Qualitative research was conducted through semi-structured interviews involving 10 women aged 18-35 years via Zoom videoconferencing. The interviews were recorded, transcribed verbatim and analysed using an interpretative phenomenological approach. RESULTS: Young adult women use social media daily to view a wide variety of content, including nutrition and health-related content. Three themes were identified: authenticity, engaging content, and affecting trust through selling products. CONCLUSION: To effectively use social media for health promotion, dietitians need to share their authentic voice while maintaining professional standards. Recommendations for effective social media engagement include using engaging content, infographics, and videos with closed captions. More research is needed to assess whether health promotion deployed via social media is effective at increasing nutrition knowledge, improving health literacy, and producing behaviour change.


Assuntos
Nutricionistas , Mídias Sociais , Feminino , Promoção da Saúde , Humanos , Estado Nutricional , Pesquisa Qualitativa , Adulto Jovem
5.
J Acad Nutr Diet ; 122(9): 1744-1763.e49, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35988945

RESUMO

Awareness of the social determinants of health has been increasing in recent years. These include equitable access to health care and foods that support healthy eating patterns. A wide range of issues related to these determinants influence practice in the public health and community nutrition field. In response to these evolving needs, the Public Health and Community Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as a tool for Registered Dietitian Nutritionist (RDNs) currently in practice or interested in working in public health and community nutrition, to assess their current skill levels and to identify areas for professional development. The Standards of Practice address the four steps of the Nutrition Care Process for community and public health RDNs: assessment, diagnosis, intervention, and evaluation/monitoring. The Standards of Professional Performance consists of six domains of professional performance for community and public health RDNs: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate the ways in which RDNs can address population nutrition and health. The indicators describe three skill levels (Competent, Proficient, and Expert) for RDNs. These tools highlight the unique scope of expertise that RDNs provide to the field of public health and community nutrition.


Assuntos
Dietética , Nutricionistas , Academias e Institutos , Competência Clínica , Humanos , Saúde Pública
7.
Nutr Diet ; 79(3): 276-278, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35796180
8.
Clin Nutr ESPEN ; 50: 314-317, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35871940

RESUMO

BACKGROUND & AIMS: To improve hospital malnutrition care, assessing actual malnutrition practices and knowledge is essential. Our objectives are to assess malnutrition care practices, evaluate dietitians' malnutrition knowledge, and explore barriers and facilitators to optimal malnutrition care in a LMIC hospitals. METHODS: This is a national cross-sectional study of mixed-method design. Two questionnaires from the Malnutrition Quality Improvement Initiative were used to assess malnutrition care practices and dietitians' malnutrition knowledge. In-depth interviews were used to investigate barriers and facilitators to optimal malnutrition care. RESULTS: Mean average for malnutrition care practices score was 20.96 out of 30 (N = 56). Factors affecting malnutrition practices were: (1) private/public affiliation of the hospital and (2) presence of a documented malnutrition protocol. Dietitians (N = 62) working at academic hospitals scored 57% for malnutrition knowledge which was higher than the score for those working at non-academic hospitals (44%). Gaps in malnutrition knowledge among hospital staff, shortage in hospital staff, and lack of financial coverage for nutrition therapy were the main barriers identified from eight in-depth interviews. CONCLUSION: Efforts should be taken by decision makers to facilitate malnutrition care and increase malnutrition awareness among healthcare professionals.


Assuntos
Desnutrição , Nutricionistas , Estudos Transversais , Hospitais , Humanos , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/terapia , Apoio Nutricional
9.
Br J Community Nurs ; 27(7): 336-340, 2022 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-35776564

RESUMO

This article focuses on the main areas in which dietitians can impact patient care, particularly within a community setting, as well as discussing the contribution from dietitians in extended roles and working at advanced practice. A range of research papers and national guidance on dietetic practice are discussed to develop a summative article on the scope of their practice. This article aims to provide insight into the work of dietitians in the community - strengthening the understanding of the roles and to demonstrate how dietetic practice can influence patient care as part of a community multidisciplinary team.


Assuntos
Dietética , Nutricionistas , Humanos , Assistência ao Paciente
10.
Nutrients ; 14(14)2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35889820

RESUMO

The aim of this retrospective cohort study was to evaluate the effect of 5-year follow-up of dietitian-led medical nutrition therapy (eating vegetables before carbohydrates) on glycemic control in outpatients with type 2 diabetes (T2DM) at a primary care clinic. A total of 138 patients with dietitian-led medical nutrition therapy (intervention group) and 104 patients without dietitian-led nutrition therapy (control group) were compared for glycemic control, serum lipid, blood pressure, and diabetic complications for 5 years. Each patient in the intervention group received dietary education focused on food order (eating vegetables before carbohydrates) by dietitians. A significant improvement in HbA1c after 5 years in the intervention group [8.5 ± 1.7% (69 mmol/mol) to 7.6 ± 1.1% (59 mmol/mol), p < 0.001] was observed, whereas no change was observed in the control group [7.9 ± 1.2% (62 mmol/mol) to 8.0 ± 1.2% (63 mmol/mol)]. Dietary intake of protein, fat, carbohydrates, cholesterol, and salt in the intervention group demonstrated significant reduction, while the intake of dietary fiber significantly increased after the dietary education. Simple dietary education of 'eating vegetables before carbohydrates' presented by dietitians achieved good glycemic control after a 5-year period in outpatients with T2DM at primary care clinic.


Assuntos
Diabetes Mellitus Tipo 2 , Terapia Nutricional , Nutricionistas , Glicemia/metabolismo , Hemoglobina A Glicada/metabolismo , Controle Glicêmico , Humanos , Pacientes Ambulatoriais , Atenção Primária à Saúde , Estudos Retrospectivos
11.
Nutrients ; 14(15)2022 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-35893880

RESUMO

NOVA is a food-classification system based on four levels of processing, from minimally processed to ultra-processed foods (UPFs). Whole-grain-containing commercial breads and ready-to-eat breakfast cereals are considered ultra-processed within NOVA, despite being considered core foods in the Australian Dietary Guidelines. These food categories contribute the greatest quantities of whole grain in the Australian diet, although consumption is less than half of the 48 g/day daily target intake. Dietitians are key to disseminating messages about nutrition and health; therefore, an accurate understanding of whole grains and the effects of processing is critical to avoid the unnecessary exclusion of nutritionally beneficial foods. The aim was to utilise an online structured questionnaire to investigate dietitians' attitudes to the promotion of grains and whole grains and understand their level of knowledge about and attitudes towards NOVA and the classification of specific whole-grain foods. Whole-grain foods were perceived positively and are regularly promoted in dietetic practice (n = 150). The dietitians tended not to consider whole-grain breads and ready-to-eat breakfast cereals as excessively processed, although most generally agreed with the classification system based on the extent of processing. If dietitians intend to incorporate NOVA and concepts of UPFs in their counselling advice, the anomalies regarding the categorisation of whole-grain choices and optimum intakes should be addressed.


Assuntos
Nutricionistas , Grãos Integrais , Austrália , Dieta , Grão Comestível , Fast Foods , Humanos
12.
J Diabetes Res ; 2022: 3542375, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35782628

RESUMO

This study explores the knowledge and practice of diabetes educators and dietitians on diet and lifestyle management in women with gestational diabetes mellitus (GDM). Diabetes educators and dietitians were recruited from three maternity hospitals in Adelaide (Australia), through snowball and purposive sampling. Thirteen semistructured interviews were conducted, audio recorded, transcribed verbatim, and analysed for codes and themes. Four themes emerged: guidelines and resources, dietary intervention, management delivery, and communication. Diabetes educators and dietitians demonstrated consistent knowledge of nutritional management for GDM and uniform delivery methods. However, a lack of culturally diverse resources was highlighted, along with a lack of continuity of care across the multidisciplinary team. Barriers towards uptake of dietary intervention were reflected by diabetes educators and dietitians as women showing signs of guilt and stress and disengaging from the service. Further exploration on the knowledge and practice of diabetes educators and dietitians for GDM to best inform implementation strategies for knowledge translation of nutritional management is needed. The indication of language and cultural barriers and resources highlight an ongoing key priority area to support the care of women of ethnic minorities.


Assuntos
Diabetes Gestacional , Nutricionistas , Diabetes Gestacional/diagnóstico , Dieta , Feminino , Humanos , Estilo de Vida , Gravidez , Pesquisa Qualitativa
13.
Cien Saude Colet ; 27(8): 3053-3061, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35894318

RESUMO

COVID-19 has challenged health professionals in widely divergent areas, including innovation of practice, communication, multidisciplinary activities, broader use of technology, and adaptability. The role of the dietitian and other health professionals in dealing with the evolving crisis might be considered essential in treating patients. Given the limited access to various food options, nutrition screening and assessment deserves a high priority to complete a comprehensive nutrition evaluation, identify nutrition risks, prioritize care, and provide early nutrition intervention and support to all patients with or who have had, COVID-19 and are experiencing ongoing symptoms. Such an intervention would benefit the patients and the health system by reducing the length of hospital stay, ameliorating further complications, limiting hospital readmission, enhancing recovery, and assisting in the management of comorbidities and their metabolic alterations. This brief overview outlines the essential role of nutrition intervention and support as part of an integrated, multidisciplinary treatment program for the care of COVID-19 patients during the pandemic. Restrictive movements have changed consultative approaches, and the importance of Telenutrition for the effective communication of health status and recommendations.


Assuntos
COVID-19 , Nutricionistas , Pessoal de Saúde , Humanos , Avaliação Nutricional , Pandemias/prevenção & controle
14.
Proc Nutr Soc ; 81(1): 41-48, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35760590

RESUMO

Malnutrition is common among older adults and is associated with a progressive decline in overall health and increased mortality. With a rapidly ageing population, the detection, prevention and management of malnutrition require urgent attention within health service planning and delivery. Routine screening for malnutrition among older adults in community settings, which addresses aetiological as well as phenotypic factors, is considered an important step for prevention and early intervention. The aim of this review is to summarise current malnutrition screening literature and highlight research that seeks to understand and address community-based approaches to malnutrition screening and management. Key healthcare professionals (HCPs) that encounter community-dwelling older adults include general practitioners (GPs), community-based nurses, community pharmacists and a range of other health and social care professionals including dietitians, physiotherapists, speech and language therapists, and occupational therapists. The key barriers to implementing screening in primary care include lack of knowledge about malnutrition among non-dietetic HCPs, lack of resources allocated to managing malnutrition, lack of access to dietetic services, and poor GP knowledge about oral nutritional supplement prescribing. In addition, older adults have poor insight into the clinical condition and the associated negative health implications. Investment in education among HCPs and public awareness is required, as well as accompanying resources to successfully implement malnutrition screening programmes for community-dwelling older adults.


Assuntos
Desnutrição , Nutricionistas , Idoso , Humanos , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/prevenção & controle , Programas de Rastreamento/efeitos adversos , Inquéritos e Questionários
15.
Nutr Diet ; 79(4): 469-480, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35692187

RESUMO

AIMS: Effective quality improvement strategies are essential to enhancing outcomes of dietetic care. Interventions informed by complex adaptive systems theory have demonstrated effectiveness in other healthcare settings. This study aimed to explore primary care dietetics practice using complex adaptive systems theory and to identify factors that individuals across the healthcare system can examine and address to improve the quality of dietetic care. METHODS: Qualitative analysis of semi-structured interviews of healthcare consumers and professionals involved in the provision of dietetic care. Data collection and analysis was guided by a complexity-informed conceptual framework. The Framework Method was used to code transcripts and identify themes describing primary care dietetics. RESULTS: Twenty-three consumers and 26 primary care professionals participated. Participants described dietetic care as being delivered by individuals organised into formal and informal systems that were influenced by the wider environment, including legal, economic, and socio-cultural systems. Dietitians described interactions with consumers as a learning opportunity and sought education, mentoring, or supervision to address knowledge and skill gaps. Relationships underpinned transfer of information between individuals. CONCLUSION: Complex adaptive systems theory proved to be a useful conceptual framework for primary care dietetics. Factors identified at the macro (e.g., funding), meso (e.g., professional networks), and micro (e.g., consumer education) levels should be examined and addressed to improve the quality of dietetic care.


Assuntos
Dietética , Nutricionistas , Austrália , Humanos , Atenção Primária à Saúde/métodos , Teoria de Sistemas
16.
J Nutr Educ Behav ; 54(8): 784-793, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35644786

RESUMO

OBJECTIVE: To understand if a culinary medicine training program increases food literacy, culinary skills, and knowledge among practicing registered dietitian nutritionists (RDN). METHODS: Prepost study design evaluating pilot test of RDN train-the-trainer curriculum from September, 2019 to January, 2020. RESULTS: On average, results indicate an increase in culinary nutrition skills (mean difference, 6.7 ± 4.4; P < 0.001; range, 10-30) and a significant increase in 5 of the 8 food literacy factors. Through process evaluation, RDNs rated the training as extremely useful to their practice (mean, 4.4 ± 0.3). CONCLUSIONS AND IMPLICATIONS: Registered dietitian nutritionist participants increased culinary nutrition skills with statistically significant scores across all individual measures. This study describes an RDN training curriculum in culinary medicine across a diverse group of practicing RDNs from a large county health care system. Culinary medicine shows a promising impact on promoting nutrition skills and confidence; however, it warrants further assessment.


Assuntos
Dietética , Nutricionistas , Competência Clínica , Currículo , Dietética/educação , Humanos , Alfabetização , Estado Nutricional
20.
Clin Transplant ; 36(8): e14763, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35761751

RESUMO

INTRODUCTION: Unintentional weight gain, overweight and obesity following solid organ transplantation (SOT) are well-established and linked to morbidity and mortality risk factors. No interventional studies aimed at prevention have been undertaken among lung transplant (LTx) recipients. The combination of group education and telephone coaching is effective in the general population but is untested among SOT cohorts. METHODS: A non-randomized, interventional pilot study was conducted among new LTx recipients. The control group received standard care. In addition to standard care, the intervention involved four group education and four individual, telephone coaching sessions over 12-months. Data collection occurred at 2 weeks, 3- and 12 months post-LTx. Measurements included weight, BMI, fat mass (FM), fat mass index (FMI), fat-free mass (FFM), fat-free mass index (FFMI), waist circumference (WC), visceral adipose tissue (VAT), nutrition knowledge, diet, physical activity, lipid profile, HbA1C , FEV1 , six-minute walk distance and patient satisfaction. RESULTS: Fifteen LTx recipients were recruited into each group. One control participant died 120 days post-LTx, unrelated to the study. There were trends towards lower increases in weight (6.7±7.2 kg vs. 9.8±11.3 kg), BMI (9.6% of baseline vs. 13%), FM (19.7% vs. 40%), FMI, VAT (7.1% vs. 30.8%) and WC (5.5% vs. 9.5%), and greater increases in FFM and FFMI (all P > .05), among the intervention group by 12 months. The intervention was well-accepted by participants. CONCLUSION: This feasible intervention demonstrated non-significant, but clinically meaningful, favorable weight and body composition trends among LTx recipients over 12 months compared to standard care.


Assuntos
Transplante de Pulmão , Nutricionistas , Composição Corporal , Índice de Massa Corporal , Humanos , Transplante de Pulmão/efeitos adversos , Obesidade/epidemiologia , Obesidade/cirurgia , Modalidades de Fisioterapia , Projetos Piloto
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