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Journal of the Academy of Nutrition and... Mar 2023Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or...
Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline.
Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or international equivalents (dietitians) collaborate with each client and other health care professionals to meet client-centered goals, informed by the best available evidence, and translated through a lens of clinical expertise and client circumstances and preferences. Since the last iteration of the Academy of Nutrition and Dietetics guideline on adult weight management in 2014, considerable research has been conducted and circumstances confronting dietitians have evolved. Thus, updated guidance is needed. The objective of this evidence-based practice guideline is to provide recommendations for dietitians who deliver medical nutrition therapy behavioral interventions for adults (18 years and older) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client. Recommendations in this guideline highlight the importance of considering complex contributors to overweight and obesity and individualizing interventions to client-centered goals based on specific needs and preferences and shared decision making. The described recommendations have the potential to increase access to care and decrease costs through utilization of telehealth and group counseling as effective delivery methods, and to address other barriers to overweight and obesity management interventions. It is essential for dietitians to collaborate with clients and interprofessional health care teams to provide high-quality medical nutrition therapy interventions using the nutrition care process to promote attainment of client-centered outcomes for adults with overweight or obesity.
Topics: Adult; Humans; United States; Dietetics; Overweight; Nutritionists; Quality of Life; Obesity; Nutrition Therapy; Evidence-Based Practice
PubMed: 36462613
DOI: 10.1016/j.jand.2022.11.014 -
Journal of the Academy of Nutrition and... Sep 2019
Topics: Career Choice; Dietetics; Humans; Job Satisfaction; Nutritionists
PubMed: 31446934
DOI: 10.1016/j.jand.2019.07.006 -
Annual Review of Nutrition Sep 2020My career as an accidental nutritionist began with my immersion in cholera control, a cyclone disaster, a smallpox epidemic, and formal training in ophthalmology and...
My career as an accidental nutritionist began with my immersion in cholera control, a cyclone disaster, a smallpox epidemic, and formal training in ophthalmology and epidemiology. Interest in blindness prevention inexplicably led me to (re)pioneer the effects, treatment, and prevention of vitamin A deficiency, while faced with intense criticism by many leading scientists in the nutrition community. The resulting efforts by the World Health Organization and UNICEF in support of programs for the global control of vitamin A deficiency still face vocal opposition by some senior scientists, despite having been estimated to have saved tens of millions of children from unnecessary death and blindness. This entire journey was largely an accident!
Topics: Biomedical Research; Child; Child Nutritional Physiological Phenomena; History, 20th Century; Humans; Indonesia; Nutritional Sciences; Nutritionists; Vitamin A Deficiency; Xerophthalmia
PubMed: 32966182
DOI: 10.1146/annurev-nutr-111919-033415 -
Nutrition & Dietetics: the Journal of... Jul 2023
Topics: Humans; Nutritionists; Australia; Attitude of Health Personnel
PubMed: 37461152
DOI: 10.1111/1747-0080.12827 -
Gastroenterology Clinics of North... Mar 2021There are several online tools, books, and applications available to enhance the application of nutrition interventions for gastroenterologists and patients with... (Review)
Review
There are several online tools, books, and applications available to enhance the application of nutrition interventions for gastroenterologists and patients with gastrointestinal (GI) disorders. Nutritional health may be compromised in GI patients because of the nature of the disease impacting use of nutritional substrates or reducing oral intake. Protein-calorie malnutrition can result from insufficient intake, malabsorption of nutrients, and increased energy expenditure, all of which can occur in certain GI conditions. Eating disorders and disordered eating, and food insecurity, also impact nutritional status. Therapeutic nutrition interventions should be implemented with guidance of a registered dietitian with expertise in their application.
Topics: Gastroenterologists; Humans; Malnutrition; Nutrition Assessment; Nutritional Status; Nutritionists
PubMed: 33518156
DOI: 10.1016/j.gtc.2020.10.011 -
Patient Education and Counseling Jul 2022The aim of this scoping review was to identify and map available evidence concerning counseling strategies that contribute to effective DC. (Review)
Review
OBJECTIVE
The aim of this scoping review was to identify and map available evidence concerning counseling strategies that contribute to effective DC.
METHODS
Following the PRISMA SCR-Scoping Reviews Statement and Checklist, a systematic search in electronic databases was performed in March 2020.
RESULTS
Synthesis of recurring themes in the 28 included studies revealed seven core counseling strategies that effectively contribute to DC: 1) connecting to motivation, 2) tailoring the modality of DC, 3) providing recurring feedback, 4) using integrated dietetic support tools, 5) showing empathy, 6) including clients' preferences, wishes, and expectations during decision-making, and 7) dietitians having high self-efficacy.
CONCLUSIONS
Multiple counseling strategies contributing to effective DC have been identified and mapped. The counseling strategies identified seem to interrelate, and their conceived interrelatedness reveals that strategies can both compliment or contrast each other. Therefore, advancing effective DC requires further development towards an integrated approach to DC that includes combinations of strategies that form a unified whole.
PRACTICAL IMPLICATIONS
Insights from this scoping review provide a foundation for dietitians to effectively carry out DC and serve as a starting point to further work towards effective DC.
Topics: Counseling; Dietetics; Humans; Nutritionists
PubMed: 34953620
DOI: 10.1016/j.pec.2021.12.011 -
The Lancet. Diabetes & Endocrinology Jul 2021
Review
Topics: Humans; Nutrition Disorders; Nutritionists; Physicians; Social Media; Weight Loss
PubMed: 34146492
DOI: 10.1016/S2213-8587(21)00146-7 -
The Proceedings of the Nutrition Society May 2022Implications of the 'changing world' for nutrition and nutritionists are considered, using the UK within a global context as an illustration. The first section... (Review)
Review
Implications of the 'changing world' for nutrition and nutritionists are considered, using the UK within a global context as an illustration. The first section summarises the slow recognition by policy makers of the significance of the changing world of food and nutrition. The second section 'Food system stress is now at a critical level' considers the present scale of global food system stress and the failure so far sufficiently to narrow the gap between evidence and policy change. The year 2021 was earmarked when three major UN conferences had the opportunity to chart food changes ahead. The third section 'Multi-criteria analysis helps frame 21st century nutrition science' proposes that multi-criteria analysis is an essential methodology for nutrition within this more complex policy world; nutrition studies can no long exclude social and environmental criteria. The penultimate section 'Nutrition science can reconnect its life science, social and environmental nutrition traditions to contribute to new paradigm formation' suggests that nutrition science can now recombine three traditions within its own history to address this complexity: social nutrition, environmental nutrition and life sciences. The final section 'Priorities ahead' concludes that this multi-criteria approach to nutrition offers new routes for science and policy influence. Five priorities are identified: (1) clarification of the features of a good food system; (2) new sustainable dietary guidelines which integrate different determinants of sustainability; (3) helping consumer engagement with change; (4) developing improved policy frameworks and (5) contributing to professional channels in these processes. In the UK, while the challenge of narrowing the gap between evidence, policy and change remains daunting, the risks of not attempting to improve the transition to an ecologically sound public health nutrition are even greater.
Topics: Food Supply; Humans; Nutrition Policy; Nutritionists; Public Health; United Kingdom
PubMed: 35177156
DOI: 10.1017/S0029665122000817 -
Nutrients Sep 2020Dietitian involvement has considerable benefits for hospitalized patients, resulting in better health outcomes and improved quality of life. However, dietitian referral...
Dietitian involvement has considerable benefits for hospitalized patients, resulting in better health outcomes and improved quality of life. However, dietitian referral routines are often inappropriate in hospitals. The aim of this study was to identify predictors for dietitian referrals in hospitalized patients. This study was performed on data collected in an annually conducted cross-sectional study (in the years 2017, 2018, 2019). A standardized questionnaire was used to collect data, and logistic regression and a generalized estimating equation (GEE) model were used to calculate the associations between the patient characteristics and dietitian referrals. In the final GEE model, the following predictors for dietitian referrals remained significant: diabetes diagnosis (OR 1.80), cancer diagnosis (OR 1.76), digestive disease diagnosis (OR 2.03), presence of a pressure injury (OR 1.58), risk of malnutrition based on body mass index (BMI) and weight loss (OR 1.72), risk of malnutrition based on the malnutrition universal screening tool (MUST) (2.55), and the application of any malnutrition screening at admission to hospital (2.20). Total dietitian referral rate was 16.8%. The highest rate of dietitian referrals was found in patients with a risk of malnutrition (37%). This study included a large sample of hospitalized adult patients and revealed a low dietitian referral rate among these patients. These results indicate that dietitian involvement in hospitalized patients with nutrition-related conditions urgently needs to be improved.
Topics: Aged; Female; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Nutritionists; Referral and Consultation
PubMed: 32962105
DOI: 10.3390/nu12092863 -
Nutrition Research (New York, N.Y.) Oct 2019A dietitian has qualifications in nutrition and dietetics and applies the science of food and nutrition to improve the health of individuals, groups, and communities.... (Review)
Review
A dietitian has qualifications in nutrition and dietetics and applies the science of food and nutrition to improve the health of individuals, groups, and communities. The Registered Dietitian (RD) credential has gained recognition over the years for its expertise. The accreditation systems were developed and have been used to ensure quality of this profession. Accreditation systems set standards for academic and professional training in nutrition and dietetics and reflect current research-based information. The purpose of this paper is to review a few countries that have a RD accreditation system including China and several other countries, e.g. the United States, Japan, and the United Kingdom. The aims are to introduce the newly established RD system in China and to compare the differences among the countries' systems.
Topics: Accreditation; China; Dietetics; History, 20th Century; Humans; Japan; Nutritionists; United Kingdom
PubMed: 30077351
DOI: 10.1016/j.nutres.2018.07.002