Nutrition Education in Psychiatry Residency Programs: A Call to Action.

The burden of disease attributable to mental health is expected to rise in the coming decades. Poor nutritional status is considered a modifiable risk factor for general mental health. In fact, nutrition interventions are now accepted as a core strategy in mental healthcare to combat physical health inequalities and life-expectancy gap in people with certain psychiatric disorders. However, most psychiatrists are not familiar with evidence for the potential therapeutic benefits of diet in psychiatric illness, and this may be related to sparse nutrition education for physicians. Thus, there is a need to integrate nutritional management in psychiatric practice, but there is a gap in medical education that would support this practice. Here, we discuss evidence for and challenges in 1) assessing diet quality in psychiatric illness, 2) recommending improvements in diet quality and specific dietary patterns in psychiatric illness, and 3) recommending dietary supplements in psychiatric illness. This discussion serves as a call to develop nutrition curricula within psychiatry residency programs.

Nature of the evidence base and approaches to guide nutrition interventions for individuals: a position paper from the Academy of Nutrition Sciences.

This Position Paper from the Academy of Nutrition Sciences is the third in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This paper focuses on evidence which guides the application of dietary recommendations for individuals. In some situations, modified nutrient intake becomes essential to prevent deficiency, optimise development and health, or manage symptoms and disease progression. Disease and its treatment can also affect taste, appetite and ability to access and prepare foods, with associated financial impacts. Therefore, the practice of nutrition and dietetics must integrate and apply the sciences of food, nutrition, biology, physiology, behaviour, management, communication and society to achieve and maintain human health. Thus, there is huge complexity in delivering evidence-based nutrition interventions to individuals. This paper examines available frameworks for appraising the quality and certainty of nutrition research evidence, the development nutrition practice guidelines to support evidence implementation in practice and the influence of other sources of nutrition information and misinformation. The paper also considers major challenges in applying research evidence to an individual and suggests consensus recommendations to begin to address these challenges in the future. Our recommendations target three groups; those who deliver nutrition interventions to individuals, those funding, commissioning or undertaking research aimed at delivering evidence-based nutrition practice, and those disseminating nutritional information to individuals.

Brief instruments for measuring nutrition literacy - the Nutrition Health Literacy Scale and the Self-Perceived Food Literacy Scale Short Form.

BACKGROUND: A healthy diet is a critical factor in maintaining long-term health. In addition to a health-promoting food environment, the nutrition health literacy (NHL) and food literacy (FL) of the population are important in this context. This paper describes the development and validation of two short instruments to measure the nutrition literacy of the population, used in the Austrian Nutrition Literacy Survey 2021. METHODS: An instrument to measure NHL (Nutrition Health Literacy Scale; NHLS) has been adapted and further developed. To measure FL, the Self-perceived Food Literacy Scale by Poelman et al. has been modified and shortened (SPFL-SF). Validation of the instruments was based on data from a web survey conducted in Austria in 2021 with almost 3,000 participants aged 18 years and older. Exploratory and confirmatory factor analyses were performed to assess the factorial validity/dimensionality of the instruments. Additionally, internal consistency was assessed using Cronbach's alpha, ordinal alpha, and McDonald's omega. RESULTS: Both instruments demonstrate excellent data-model fit. The NHLS also shows excellent internal consistency (α = 0.91), while the SPFL-SF displays a sufficient internal consistency for all (α between 0.70 and 0.89) but one sub-dimension (resisting temptation α = 0.61). Furthermore, the distribution of the items indicates that the measures are understandable and suitable, as evidenced by the absence of missing values in the sample. In addition, the items of both instruments differ in their level of difficulty or agreement. CONCLUSIONS: The NHLS and SPFL-SF are reliable and valid instruments for measuring NHL and FL in the general adult population. The brief instruments measuring the different aspects of nutrition literacy can be easily used in nutritional or evaluation studies. Further work is required to investigate other aspects of validity.

Cross-cultural adaptation and validation of the short nutritional literacy scale for young adults (18-35years) and analysis of the influencing factors.

OBJECTIVES: This study translated the short nutrition literacy scale for young adults (18-35 years) into Chinese, examined its reliability and validity, and analyzed its influencing factors. METHODS: The scale was translated using a modified Brislin translation model. A convenience sample of 508 cases was selected for the survey. Content validity, structural validity, Cronbach's alpha coefficient, and test-retest reliability were used to evaluate the scale's reliability and validity. To screen the factors influencing nutrition literacy in young people. RESULTS: The Chinese version of the Item-Level Content Validity Index (I-CVI) was 0.833 ~ 1, and the Scale-Level Content Validity Index/Average (S-CVI/Ave) was 0.908. The cumulative variance contribution of the scale was 51.029%, and the model was generally well-fitted. The Cronbach's alpha coefficient and retest reliability of the scale were 0.826 and 0.818. The results showed that the level of education, mother's education, nutrition-related courses, and frequency of attention to nutritional health information were the factors influencing the nutritional literacy of young people. CONCLUSION: The Chinese version of the S-NutLit Scale can effectively assess the nutrients of young Chinese people. Low levels of education, low levels of education of mothers, lack of exposure to nutrition-related courses, and low frequency of attention to nutritional health information can lead to lower levels of nutritional literacy among young people.

An investigation of employer perceptions of Irish nutrition graduate competencies.

BACKGROUND: Undergraduate nutrition programmes prepare students and graduates for a wide range of employment opportunities. However, little is known about how employers perceive current nutrition education practices in Ireland and how well graduates are prepared for the realities of today's workforce. The present study aimed to explore employers' perspectives of nutrition placement students and graduates' competencies for the workforce. METHODS: Interviews were conducted with 12 nutrition employers across Ireland and the UK who currently or have recently employed Irish nutrition graduates or supervised placement students. Interviews were transcribed verbatim and thematically analysed. RESULTS: Three themes were identified including: "adapting to modern workforce needs", "professional competency expectations" and "valuing competency-based educational and professional systems". Employers reported an overall positive experience with Irish nutrition placement students and graduates. They are perceived as adaptable, willing to learn and professional. Many felt nutrition students and graduates had received quality education with knowledge, skills and attitudes meeting expectations of nutrition education being provided but felt that students and graduates often lacked confidence in their abilities. Employers remarked that graduates who had undergone placements were better prepared for the professional work environment. However, gaps were identified because employers felt nutrition curricula lack training on business skills and digital competencies. CONCLUSIONS: Employers had a positive experience with Irish nutrition graduates and students and felt they were competent for the workforce. Addressing the gaps identified by employers to adapt curricula to modern workforce needs would further enhance graduate employability.

Nutrition employability and graduate readiness: The Australian Working in Nutrition study.

BACKGROUND: Nutrition science graduates contribute to the nutrition workforce by bringing specialist knowledge and skills needed to address future food challenges. This study aims to provide a snapshot of the current employment landscape for nutrition science graduates in Australia and how well their degrees prepare them for employment. METHOD: A cross-sectional survey of Australian tertiary nutrition graduates was conducted to explore tertiary training, employment pathways and their perceived preparedness for practice. RESULTS: This study included a final sample of 119 graduates from 17 Australian tertiary institutions. Almost two-thirds of respondents had completed further training. Most graduates (77%, n = 91) had worked in a food, nutrition science or health-related role after their degree; the most frequently cited employment settings were government or public health organisations; research, not-for-profit or nongovernment organisations; and the food industry. Work-integrated learning was identified as a key predictor of graduates working in a role that differed from their expectations as a student. The skill categories developed during nutrition training that were most valued in the workplace included nutrition and scientific knowledge, and professional and communication skills. CONCLUSIONS: This study offers first insights into the current employment landscape for nutrition graduates across Australia. Findings show that current nutrition science professionals are highly qualified and prepared to navigate the evolving demands of nutrition practice. Regular review of graduate employment will inform nutrition science curriculum to enable graduates to be well equipped in the face of dynamic practice settings.

Increasing Trainee Comfort with Nutrition.

OBJECTIVES: Nutrition counseling is necessary for the prevention and treatment of many chronic diseases. US survey data demonstrate that 61% of Internal Medicine (IM) residents receive little to no nutrition training. The objective of our study was to develop a curriculum to increase IM resident comfort and ability in conducting a nutritional assessment. METHODS: Categorical IM residents at a large academic medical center participated in a curriculum that included a lecture, a small-group discussion, and a skills exercise. Residents completed pre- and posttest surveys that evaluated their attitudes and comfort level with nutritional assessment. RESULTS: Eighty percent (84/105) of the residents participated in the curriculum and 48% (40/84) of them completed both pre- and postsession surveys. Residents who considered themselves moderately to extremely comfortable completing a nutritional assessment increased after the program (27.5% to 87.5%, P < 0.0001). The proportion of those who agreed or strongly agreed with the statement, "Nutritional counseling should be included in any routine appointment, just like diagnosis and treatment," increased from 62.50% to 80.00% (P = 0.012). The proportion of residents who considered lack of individual knowledge to be a barrier for nutrition counseling decreased from 65.79% to 42.11% (P = 0.0126). CONCLUSIONS: This curriculum was successful in increasing IM resident comfort with conducting a nutritional assessment.

Teaching critical thinking in nutritional sciences: a model course and assignments.

Critical thinking is a common and important learning outcome in college curricula. Case-based and problem-based learning can be used to assess and foster critical thinking skills. HNF 250-Contemporary Issues in Human Nutrition is a critical thinking course developed during the redesign of a nutritional sciences major program. Course assignments were designed to assess the course and nutritional sciences major learning outcomes. The nutrition and health claim assignment is scaffolded across the academic semester as three assignments: 1) bibliography assignment; 2) poster presentation; and 3) paper. Course lectures and materials have been designed to prepare students for completion of each assignment. The assignments have been modified over time based on classroom observations and student performance. In 2021, the course learning outcomes were examined by assessing several assignments including the nutrition and health claim poster and paper. Course learning outcome benchmarks using these assessments generally included 80% of students achieving an 80% for each criterion. Results revealed that students were not meeting most of these assessment benchmarks during the 2021 iteration, although benchmark data from other course assessments were more satisfactory. It is possible that the transition from a virtual to an in-person format negatively influenced student performance on these course learning outcomes. This course and the nutrition and health claim assignment example can provide a course design and learning outcome assessment framework for other higher education critical thinking courses.NEW & NOTEWORTHY This paper describes how a scaffolded nutrition and health claim assignment is used to teach critical thinking skills among nutritional sciences students and examine the program's learning outcomes. Further, this course example is to serve as an model for STEM majors on how to incorporate case-based and problem-based learning strategies into an undergraduate course.

An innovative educational approach to teach high school students the physiological mechanisms and nutrition concepts associated with the development of obesity.

An interdisciplinary team-teaching session was introduced to high school students who participated in the Oakland University William Beaumont Future Physician Summer Enrichment Program. The rising prevalence of adolescent obesity necessitates innovative educational strategies that effectively engage high school students in understanding the complex physiologic mechanisms and nutrition concepts underlying its development. This submission presents a session that is designed to integrate the physiological concepts and nutrition that are associated with the development of obesity. Foundational information about the different food ingredients and physiology of the gastrointestinal organ system followed by concepts associated with the development of obesity and its complications were introduced. The session was delivered using combined educational approaches such as a dialogical-narrative approach and hands-on application activities by two discipline experts, physiology and nutrition. This innovative approach was well received, as evidenced by high satisfaction rates among participants. While direct measures of critical thinking and practical skills development were not captured, the positive feedback suggests that students appreciated the engaging, hands-on application of theoretical concepts. The sessions fostered an awareness of personal health responsibilities, with students actively participating and connecting learned material with practical scenarios. We believe that using combined educational approaches in interdisciplinary team-teaching sessions promotes inclusiveness and interactive engagement and enhances long-life learning.NEW & NOTEWORTHY An interdisciplinary team-teaching session was introduced to high school students who participated in the Oakland University William Beaumont Future Physician Summer Enrichment Program. The session aimed to integrate physiological concepts and nutrition that are associated with the development of obesity. The session was delivered using combined educational approaches including a dialogical-narrative approach and hands-on application activity that are guided by combined learning theories such as dialogism, narrative, theories of engagement, and multimedia active learning.

Linking Immigrants with Nutrition Knowledge (Project LINK): An Innovative Approach to Improve Cultural Competence in Dietetic Education.

Linking Immigrants with Nutrition Knowledge (Project LINK) was a service-learning cultural competence training programme completed by undergraduate dietetic students enrolled in the University of Saskatchewan's (USASK) nutrition and dietetic programme.This paper evaluates the impact of participation in the programme on students' cultural competence. We conducted a cross-sectional survey and qualitative analysis of reflective essays of 107 participants of Project LINK from 2011 to 2014. Cumulative logistic regression models assessed the impact of the intervention on students' cultural competencies. The Akaike information criterion compared models and Spearman correlation coefficient identified possible correlation among pre- and post-intervention data points. Student reflective essays were analyzed by inductive thematic analysis.All cultural competencies improved comparing pre- and post-participation in Project LINK. Odds of increasing one level of student knowledge were 110 times of that prior to Project LINK. Comparing student competencies before and after Project LINK, the odds of increasing one level of students' skills were six times greater, five times greater for increasing one level of students' ability to interact or encounter, and 2.8 times greater for increasing one level of students' attitude.The results of this study indicate Project LINK has successfully increased cultural competence and underscores the importance of combining opportunities for practical experience in addition to classroom-based training on cultural competence.

Assessment of knowledge and nutritional status of students before and after nutritional education.

INTRODUCTION: There are many educational and health programs implemented on a smaller or larger scale in Poland. Many of them address the problem of overweight and obesity in different age groups. Each such activity is considered valuable and important, since the problem of excessive body fat is growing and, in addition, poses a health risk due to the development of other diseases, including diabetes and hypertension. The aim of the study was to test the effectiveness of nutrition education implemented over a 7-week period and to assess the nutritional status of 32 students aged 20-21 from Wroclaw. MATERIAL AND METHODS: The study group of students participated in a Human Nutrition course that included 30 hours of lectures and 30 hours of exercises. In the study group, the level of knowledge was assessed twice (before and after education) using a questionnaire with 13 closed questions, and body composition analysis was performed twice (before and after education) using an InBody270 analyser. RESULTS: The study group showed a statistically significant increase in the number of correct answers on the nutrition knowledge questionnaire after the nutrition education (average 9.7 points vs. 11.4 points; p<0.05). No statistically significant differences were noted in the studied anthropometric parameters performed before and after nutrition education. CONCLUSIONS: The knowledge gained during nutrition education allowed the surveyed students to give more correct answers in the questionnaire after the Human Nutrition course. The nutritional status of the surveyed students did not change statistically significantly, but two students achieved a weight reduction of 1.5-2 kg during the study period.

Conversation with Eric Ciappio, PhD, RD, Strategic Development Manager Nutrition Science Team Balchem.

No Abstract Available.

Advancing the decadal plan for the science of nutrition: Progressing a framework for implementation.

AIMS: In 2019, the Australian Academy of Science in collaboration with the nutrition community published the decadal plan for the science of nutrition. This article aims to review progress towards each of its pillar goals (societal determinants, nutrition mechanisms, precision and personalised nutrition, and education and training) and two enabling platforms (a national data capability and a trusted voice for nutrition science), prioritise actions, and conceptualise program logic implementation models. This process also brought together public health nutrition researchers to reflect on societal determinants of health, and advise how the next 5 years of the decadal plan could reflect contemporary issues. METHODS: Two engagement events, in 2023, brought together experienced and mid- and early-career nutrition professionals for co-creation of implementation logic models. RESULTS: One hundred and nine early and mid-career professionals were involved. A revised model for the decadal plan pillars emerged from synthesis of all logic models. This new model integrated the precision and personalised nutrition pillar with nutrition mechanisms pillar. These combined pillars build towards the national data capability enabling platform and created new cross-cutting themes for education and training. The need arose for greater focus on respectful engagement with Aboriginal and Torres Strait Islander communities and sustained effort to build cross-disciplinary collaboration to realise the plan's societal determinants goals. A new alliance for nutrition science is proposed to become a unified advocacy voice and build trust in nutrition professionals. CONCLUSIONS: A programmatic approach provides a road map for implementing the decadal plan for the final 5 years.

There and Back Again: A Forty-Year Perspective on Physician Nutrition Education.

Medical education faces an urgent need for evidence-based physician nutrition education. Since the publication of the 1985 National Academies report "Nutrition Education in the United States Medical Schools," little has changed. Although several key efforts sought to increase nutrition content in undergraduate medical education over the past 40 y, most medical schools still fail to include the recommended minimum of 25 h of nutrition training. Without foundational concepts of nutrition in undergraduate medical education, graduate medical education unsurprisingly falls short of meeting patient needs for nutritional guidance in clinical practice. Meanwhile, diet-sensitive chronic diseases continue to escalate, although largely preventable and treatable by nutritional therapies and dietary lifestyle changes. Fortunately, recent recognition and adoption of Food is Medicine programs across the country increasingly connect patients with healthy food resources and nutrition education as core to their medical care, and physicians must be equipped to lead these efforts alongside their dietitian colleagues. Filling the gap in nutrition training will require an innovative and interprofessional approach that pairs nutrition with personal wellness, interprofessional practice, and community service learning. The intersectional benefits of connecting these domains will help prepare future physicians to address the social, behavioral, and lifestyle determinants of health in a way that recognizes nourishing food access as a core part of clinical practice. There are numerous strategies to integrate nutrition into education pathways, including didactic and experiential learning. Culinary medicine, an evidence-based field combining the culinary arts with nutritional science and medicine, is 1 promising educational framework with a hands-on, interprofessional approach that emphasizes community engagement. Advancing the critical need for widespread adoption of nutrition education for physicians will require support and engagement across societal stakeholders, including co-leadership from registered dietitian nutritionists, health system and payor reform, and opportunities for clinical innovation that bring this essential field to frontline patient care.

Development of a Culinary Medicine Curriculum to Support Nutrition Knowledge for Gastroenterology Fellows and Faculty.

Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine course for a GI fellowship training program. The objective of this study is to describe the development, implementation, and acceptability of the course. A registered dietitian, a chef instructor, and a gastroenterology clinical professor trained in culinary medicine developed the four-class tailored curriculum and delivered the classes remotely. Each class had a theme related to commonly encountered GI disorders and included hands-on meal preparation, a nutrition lecture, and a patient case study discussion. Post-course feedback surveys were disseminated. Twenty-three GI physicians enrolled in the course and the attendance rates in classes 1-4 were 83%, 65%, 61%, and 48%, respectively. Among 15 completed feedback surveys, 80% reported that the class contents were either moderately or extremely useful and all endorsed the curriculum for other gastroenterologists. Future studies of culinary medicine programs tailored to medical specialties should identify strategies to maintain engagement and assess the impact on nutrition knowledge, competencies, and translation of these new skills to clinical practice.

Looking to the future: Agendas, directions, and resources for nutrition research.

The development and progression of nutrition as a scientific field is ever evolving and complex. Although the history of nutrition research began by exploring specific food components, it has evolved to encompass a more holistic view that considers the impact of dietary patterns over time, interactions with the environment, nutrition's role in disease processes, and public policy related to nutrition health. To guide the future direction of nutrition science, both federal and other professional organizations have established agendas and goals. The Strategic Plan for National Institutes of Health Nutrition Research outlines four goals and five cross-cutting research areas that are priorities to explore between 2020 and 2030. Similarly, the American Society for Parenteral and Enteral Nutrition and other governmental and professional organizations have identified priority areas in their research agendas. Rigorous research studies are needed to explore these areas of interest while also considering practical implementation strategies for translating research into practice. Nutrition clinicians are uniquely positioned to lend expertise in the areas of research design, implementation, advocacy and evidence-based practice; there are numerous resources to support practitioners in these endeavors.

Regulation of glycose and lipid metabolism and application based on the colloidal nutrition science properties of konjac glucomannan: A comprehensive review.

The physicochemical properties of dietary fiber in the gastrointestinal tract, such as hydration properties, adsorption properties, rheological properties, have an important influence on the physiological process of host digestion and absorption, leading to the differences in satiety and glucose and lipid metabolisms. Based on the diversified physicochemical properties of konjac glucomannan (KGM), it is meaningful to review the relationship of structural characteristics, physicochemical properties and glycose and lipid metabolism. Firstly, this paper bypassed the category of intestinal microbes, and explained the potential of dietary fiber in regulating glucose and lipid metabolism during nutrient digestion and absorption from the perspective of colloidal nutrition. Secondly, the modification methods of KGM to regulate its physicochemical properties were discussed and the relationship between KGM's molecular structure types and glycose and lipid metabolism were summarized. Finally, based on the characteristics of KGM, the application of KGM in the main material and ingredients of fat reduction food was reviewed. We hope this work could provide theoretical basis for the study of dietary fiber colloid nutrition science.

Research priorities and considerations for nutrition research: methods of sex and gender analysis for biomedical and nutrition research.

For some 20 years, science funding bodies have been asking for the integration of sex- and gender-related factors into the content of research and innovation. The rationale for those requirements has been the accumulated evidence that sex and gender are important determinants of health and disease. The European Commission (EC) has been the first, since 2002, to seriously ask for the integration of sex and gender into research and innovation in the context of their multi-annual framework programmes. When introduced, this condition was not immediately applauded by the research community, who perhaps lacked training in methods for the integration of sex- and gender-related factors. The EC Expert Group on Gendered Innovations sought to fill this gap. This review describes the work of this international collaborative project which has resulted in the development of general and field-specific methods for sex and gender analysis and 38 case studies for various research domains (science, health and medicine, environment, engineering) to illustrate how, by applying methods of sex and gender analysis, new knowledge could be created. Since 2010, science funding bodies in Canada, the USA and several EU member states have followed the example of the EC issuing similar conditions. Although the effects of nutritional patterns on a range of (physiological and health) outcomes may differ for men and women, sex and gender analyses are rarely conducted in nutrition research. In this review, we provide examples of how gender is connected to dietary intake, and how advancing gender analysis may inform gender-sensitive policies and dietary recommendations.