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PloS One 2015Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not... (Meta-Analysis)
Meta-Analysis Review
AIM
Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not been investigated systematically. The aim of this article was to review the current state of quantitative research on weight-related stigma by dietitians and nutritionists.
METHOD
A systematic literature review was conducted in 2014 using PubMed, PsycINFO, Web of Science and Cochrane Library.
RESULTS
Eight studies were found that differ in regard to study characteristics, instruments and the origin of the sample. Six out of eight studies reported weight stigma expressed by dietitians and nutritionists. Their believed causes of obesity indicated a defined preference for internal factors rather than genetics or biology.
DISCUSSION
Results of studies were not homogenous. The degree of negative attitudes by dietitians and nutritionists towards people with obesity appeared to be slightly less pronounced compared to the general public and other health care professionals. Stigma and its consequences should be included into educational programs to optimally prepare dietitians and nutritionists.
Topics: Attitude of Health Personnel; Culture; Health Personnel; Humans; Nutritionists; Obesity; Social Stigma
PubMed: 26466329
DOI: 10.1371/journal.pone.0140276 -
Nutrients Apr 2021Chronic diarrhoea affects up to 14% of adults, it impacts on quality of life and its cause can be variable. Patients with chronic diarrhoea are presented with a plethora... (Review)
Review
Chronic diarrhoea affects up to 14% of adults, it impacts on quality of life and its cause can be variable. Patients with chronic diarrhoea are presented with a plethora of dietary recommendations, often sought from the internet or provided by those who are untrained or inexperienced. In this review, we summarise the possible causes of chronic diarrhoea that can be managed by diet, the symptom improvement and quality of life benefits but also the potential risks of such dietary treatments. Clinicians need to consider both the benefits and risks of dietary treatments before making dietary recommendations to manage chronic diarrhoea. The pivotal role that dietitians have in ensuring optimal symptom improvement without jeopardising nutritional and overall health is discussed.
Topics: Chronic Disease; Diarrhea; Diet; Humans; Nutritionists; Patient Acceptance of Health Care
PubMed: 33919083
DOI: 10.3390/nu13051393 -
Public Health Nutrition Oct 2021The objective of this scoping review was to examine the research question: In the adults with or without cardiometabolic risk, what is the availability of literature... (Review)
Review
OBJECTIVE
The objective of this scoping review was to examine the research question: In the adults with or without cardiometabolic risk, what is the availability of literature examining interventions to improve or maintain nutrition and physical activity-related outcomes? Sub-topics included: (1) behaviour counseling or coaching from a dietitian/nutritionist or exercise practitioner, (2) mobile applications to improve nutrition and physical activity and (3) nutritional ergogenic aids.
DESIGN
The current study is a scoping review. A literature search of the Medline Complete, CINAHL Complete, Cochrane Database of Systematic Reviews and other databases was conducted to identify articles published in the English language from January 2005 until May 2020. Data were synthesised using bubble charts and heat maps.
SETTING
Out-patient, community and workplace.
PARTICIPANTS
Adults with or without cardiometabolic risk factors living in economically developed countries.
RESULTS
Searches resulted in 19 474 unique articles and 170 articles were included in this scoping review, including one guideline, thirty systematic reviews (SR), 134 randomised controlled trials and five non-randomised trials. Mobile applications (n 37) as well as ergogenic aids (n 87) have been addressed in several recent studies, including SR. While primary research has examined the effect of individual-level nutrition and physical activity counseling or coaching from a dietitian/nutritionist and/or exercise practitioner (n 48), interventions provided by these practitioners have not been recently synthesised in SR.
CONCLUSION
SR of behaviour counseling or coaching provided by a dietitian/nutritionist and/or exercise practitioner are needed and can inform practice for practitioners working with individuals who are healthy or have cardiometabolic risk.
Topics: Adult; Cardiovascular Diseases; Exercise; Humans; Nutritional Status; Nutritionists; Systematic Reviews as Topic
PubMed: 34030758
DOI: 10.1017/S1368980021002184 -
Canadian Journal of Dietetic Practice... Jun 2015
Topics: Congresses as Topic; Humans; Leadership; Nutritionists; Quebec
PubMed: 26067410
DOI: 10.3148/cjdpr-2015-011 -
Journal of Nutritional Science and... 2015This author (A.I.) has witnessed the introduction of the Nutrition Care Process (NCP) and its subsequent adjustment over 10 y of her career in an acute and critical... (Review)
Review
This author (A.I.) has witnessed the introduction of the Nutrition Care Process (NCP) and its subsequent adjustment over 10 y of her career in an acute and critical setting. A.I. observed that the NCP went through several revisions to better suit the actual clinical practices and the NCP was gradually incorporated into everyday work and accepted in a clinical setting. The NCP helped ensure that all practicing registered dietitians (RDs, RDNs) have up-to-date skill sets. The NCP is a systematic problem-solving tool with four distinct and interrelated steps that help RDs to improve critical thinking and address practice-related problems so that RDs can more effectively intervene and evaluate. In summary, RDs using the NCP are producing consistent and easy-to-read documentation of clinical practices that benefit other healthcare members. The intention to provide diagnosis-oriented assessment and to treat nutrition problems with intervention plans opens up opportunities for communication within healthcare teams and clients. The best practice requires interactive and ongoing communication with healthcare teams and clients. The NCP has resulted in improved productivity as the RDs are writing diagnosis- focused documentation with specific plans for intervention. In addition, analysis of common problems and nutrition diagnoses resolution rates appear to be in process in some facilities and may further promote RD roles in practice settings. In conclusion, the NCP is an effective tool to provide improved nutrition care.
Topics: Dietetics; Humans; Nutritional Status; Nutritionists
PubMed: 26598881
DOI: 10.3177/jnsv.61.S41 -
Critical Care (London, England) Jul 2023The optimal feeding strategy in critically ill patients is a matter of debate, with current guidelines recommending different strategies regarding energy and protein... (Review)
Review
The optimal feeding strategy in critically ill patients is a matter of debate, with current guidelines recommending different strategies regarding energy and protein targets. Several recent trials have added to the debate and question our previous understanding of the provision of nutrition during critical illness. This narrative review aims to provide a summary of interpretation of recent evidence from the view of basic scientist, critical care dietitian and intensivist, resulting in joined suggestions for both clinical practice and future research. In the most recent randomised controlled trial (RCT), patients receiving 6 versus 25 kcal/kg/day by any route achieved readiness for ICU discharge earlier and had fewer GI complications. A second showed that high protein dosage may be harmful in patients with baseline acute kidney injury and more severe illness. Lastly, a prospective observational study using propensity score matched analysis suggested that early full feeding, especially enteral, compared to delayed feeding is associated with a higher 28-day mortality. Viewpoints from all three professionals point to the agreement that early full feeding is likely harmful, whereas important questions regarding the mechanisms of harm as well as on timing and optimal dose of nutrition for individual patients remain unanswered and warrant future studies. For now, we suggest giving low dose of energy and protein during the first few days in the ICU and apply individualised approach based on assumed metabolic state according to the trajectory of illness thereafter. At the same time, we encourage research to develop better tools to monitor metabolism and the nutritional needs for the individual patient accurately and continuously.
Topics: Humans; Critical Illness; Nutritionists; Nutritional Status; Acute Kidney Injury; Body Fluids; Observational Studies as Topic
PubMed: 37393289
DOI: 10.1186/s13054-023-04543-1 -
Journal of Nutrition Education and... Aug 2022To understand if a culinary medicine training program increases food literacy, culinary skills, and knowledge among practicing registered dietitian nutritionists (RDN).
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.
Topics: Clinical Competence; Curriculum; Dietetics; Humans; Literacy; Nutritional Status; Nutritionists
PubMed: 35644786
DOI: 10.1016/j.jneb.2022.04.001 -
Canadian Journal of Dietetic Practice... Jun 2015
Topics: Canada; Food Services; Humans; Long-Term Care; Malnutrition; Menu Planning; Nutrition Assessment; Nutritional Status; Nutritionists
PubMed: 26067411
DOI: 10.3148/cjdpr-2015-012 -
PloS One 2023This study compares documentation and reimbursement rates before and after provider education in nutritional status documentation. Our study aimed to evaluate accurate...
This study compares documentation and reimbursement rates before and after provider education in nutritional status documentation. Our study aimed to evaluate accurate documentation of nutrition status between registered dietitian nutritionists and licensed independent practitioners before and after the implementation of a dietitian-led Nutrition-Focused Physical Exam intervention at an academic medical center in the southeastern US. ICD-10 codes identified patients from 10/1/2016-1/31/2018 with malnutrition. The percentage of patients with an appropriate diagnosis of malnutrition and reimbursement outcomes attributed to malnutrition documentation were calculated up to 24 months post-intervention. 528 patients were analyzed. Pre-intervention, 8.64% of patients had accurate documentation compared to 46.3% post-intervention. Post-intervention, 68 encounters coded for malnutrition resulted in an estimated $571,281 of additional reimbursement, sustained at 6, 12, 18, and 24 months. A multidisciplinary intervention improved physician documentation accuracy of malnutrition status and increased reimbursement rates.
Topics: Humans; Quality Improvement; Malnutrition; Nutritional Status; Physicians; Documentation; Nutritionists
PubMed: 37561733
DOI: 10.1371/journal.pone.0287124 -
Canadian Journal of Dietetic Practice... Sep 2014
Topics: Achievement; Canada; Dietetics; Evidence-Based Medicine; Goals; Humans; Leadership; Nutrition Policy; Nutritionists; Societies, Scientific; Workforce
PubMed: 26066812
DOI: 10.3148/cjdpr-2014-015