-
Journal of Neurogastroenterology and... Jul 2022The 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on... (Review)
Review
BACKGROUND/AIMS
The 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on dietitian delivered education. However, access to dietitians can be limited, and challenges exist when applying the diet to a wide range of cultures, such as limited FODMAP analysis of local foods. This review aims to discuss ways to optimally use the FODMAP diet in practice in a wide range of cultures, directed at gastroenterologists from a dietitian's perspective.
METHODS
Recent literature was analysed via search databases including Medline, CINAHL, PubMed and Scopus.
RESULTS
The dietetic process involves detailed assessment and follow-up through the 3 stages of the FODMAP diet (restriction, re-introduction, and long-term maintenance). Emerging evidence suggests the diet can be delivered by other health professionals such as the gastroenterologist or nurse, but training on how to do so successfully would be needed. Self-guided approaches through use of technology or specialised food delivery services may be an alternative when dietitians are not available, but efficacy data is limited. Regardless of delivery mode, nutritional and psychological risks of the diet must be mitigated. Additionally, culturally appropriate education must be provided, with accommodations necessary when the FODMAP content of local foods are unknown.
CONCLUSION
While the diet has shown improved irritable bowel syndrome outcomes across studies, it is important to acknowledge the essential role of dietitians in implementing, tailoring, and managing the diet to achieve the best outcome for each individual.
PubMed: 35799231
DOI: 10.5056/jnm22035 -
Nutrition & Dietetics: the Journal of... Jul 2021Dietitians must be statistically literate to effectively interpret the scientific literature underpinning the discipline. Despite this, no study has been conducted that... (Review)
Review
AIM
Dietitians must be statistically literate to effectively interpret the scientific literature underpinning the discipline. Despite this, no study has been conducted that objectively identifies common statistical methods and packages specific to current nutrition and dietetics literature. This study aimed to identify statistical methods and software frequently used in nutrition and dietetics research.
METHODS
A text mining approach using the bag-of-words method was applied to a random sample of articles obtained from all journals in the 'Nutrition and Dietetics' subject category within the SCImago Journal and Country Rank portal and published in 2018. A list of 229 statistical terms and 19 statistical software packages was developed to define the search terms to be mined. Statistical information from the methods section of included articles was extracted into Microsoft Excel (2016) for data cleaning. Statistical analyses were conducted in R (Version 3.6.0) and Microsoft Excel (2016).
RESULTS
Seven hundred and fifty-seven journal articles were included. Numerical descriptive statistics were the most common statistical method group, appearing in 83.2% of articles (n = 630). This was followed by specific hypothesis tests (68.8%, n = 521), general hypothesis concepts (58.4%, n = 442), regression (44.4%, n = 336), and ANOVA (30.8%, n = 233). IBM SPSS statistics was the most common statistical software package, reported in 41.7% of included articles.
CONCLUSION
These findings provide useful information for educators to evaluate current statistics curricula and develop short courses for continuing education. They may also act as a starting point for dietitians to educate themselves on typical statistical methods they may encounter.
Topics: Curriculum; Data Mining; Dietetics; Humans; Nutritionists; Software
PubMed: 34155748
DOI: 10.1111/1747-0080.12678 -
PloS One 2021Healthcare professionals provide paid care at work and potentially have caregiving responsibilities outside of work; work responsibilities in addition to child and/or...
Healthcare professionals provide paid care at work and potentially have caregiving responsibilities outside of work; work responsibilities in addition to child and/or elder care is considered double- or triple-duty care. Employees may experience conflict and/or enrichment as their work and family responsibilities interface. This study's purpose is to explore the work and family interface of Registered Dietitian Nutritionists (RDNs), determine the prevalence of work-family conflict and enrichment, and identify characteristics associated with higher work-family conflict and enrichment scores. A survey instrument assessing caregiving responsibilities and work-family conflict and enrichment was distributed electronically to 4,900 RDNs throughout the United States. Frequencies, means, correlative relationships, and ANCOVA were calculated using SAS software 9.04. Of 1,233 usable responses, nearly two-thirds of RDNs (65.5%) reported providing either double-duty or triple-duty care. About half of RDNs (47.2%) reported work-family conflict and fewer (14.8%) reported family-work conflict. Additionally, most RDNs (79.4%) reported work-family enrichment and even more (85.2%) reported family-work enrichment. Higher work-family conflict scores had correlative relationships with higher levels of burnout, lower life satisfaction, and higher intent to quit. Higher work-family enrichment scores had correlative relationships with lower burnout, higher job satisfaction, higher career satisfaction, higher life satisfaction, and lower intent to quit. Understanding the unpaid caregiving responsibilities of RDNs and the interface of work/family responsibilities may provide insight into career planning for RDNs and guide managers of RDNs in efforts to amplify the contribution of RDNs.
Topics: Adult; Aged; Burnout, Professional; Caregivers; Delivery of Health Care; Family; Family Conflict; Female; Health Personnel; Humans; Job Satisfaction; Male; Middle Aged; Nutritionists; Surveys and Questionnaires; United States
PubMed: 33690670
DOI: 10.1371/journal.pone.0248109 -
Nutrition & Dietetics: the Journal of... Sep 2020It is the position of Dietitians Australia that clients can receive high-quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via...
It is the position of Dietitians Australia that clients can receive high-quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via telehealth. Outcomes of telehealth-delivered dietetic consultations are comparable to those delivered in-person, without requiring higher levels of additional training nor compromising quality of service provision. Dietitians Australia recommends that policy makers and healthcare funders broaden the recognition for telehealth-delivered dietetic consultations as a responsive and cost-effective alternative or complement to traditional in-person delivery of dietetic services. The successful implementation of telehealth can help to address health and service inequalities, improve access to effective nutrition services, and support people with chronic disease to optimise their diet-related health and well-being, regardless of their location, income or literacy level, thereby addressing current inequities.
Topics: Australia; Dietary Services; Dietetics; Humans; Nutritionists; Telemedicine
PubMed: 32596950
DOI: 10.1111/1747-0080.12619 -
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 -
Implementation Science : IS Apr 2021Behavioural medicine is characterised by findings for the effectiveness and efficacy of complex behaviour change interventions. Comparatively, scant attention has been... (Randomized Controlled Trial)
Randomized Controlled Trial
Is fidelity to a complex behaviour change intervention associated with patient outcomes? Exploring the relationship between dietitian adherence and competence and the nutritional status of intervention patients in a successful stepped-wedge randomised clinical trial of eating as treatment (EAT).
BACKGROUND
Behavioural medicine is characterised by findings for the effectiveness and efficacy of complex behaviour change interventions. Comparatively, scant attention has been paid to key intervention components or mechanisms of action. Evaluating relationships between process variables (fidelity) and intervention effects is central to addressing this imbalance. Accordingly, in the current study, we sought to explore the magnitude and direction of effect between fidelity predictors (dietitian adherence and competence) and intervention effects (patient nutritional status) during the intervention phase of a real-world, stepped-wedge evaluation of 'EAT: Eating As Treatment'.
METHODS
The EAT clinical trial was conducted within five major Australian hospitals located in Queensland, Western Australia, Victoria and South Australia between 2013 and 2016. EAT is a dietitian-delivered health behaviour change intervention designed to reduce malnutrition in head and neck cancer (HNC) patients undergoing radiotherapy. Dietitian adherence and competence ratings were derived from a 20% random sample of audio-recorded dietetic consultations (n=194) conducted after dietitians (n=18) were trained in EAT. Sessions were coded by trained, independent, coders using a study checklist, the Behaviour Change Counselling Index (BECCI) and items from the Cognitive Therapy Scale-Revised (CTS-R). Patient nutritional status was measured using the Patient-Generated Subjective Global Assessment (PGSGA).
RESULTS
Dietitian adherence to a written nutrition plan (β=7.62, 95% CI=0.65 to 14.58, p=0.032), dietitian adherence to behaviour change counselling (β=0.69, 95% CI =0.02 to 1.38, p=0.045) and competence in delivering behaviour change counselling (β=3.50, 95% CI =0.47 to 6.53, p=0.024) were significant predictors of patient nutritional status. Dietitian adherence and competence ratings were higher during consultations with intervention patients at greater risk of malnutrition.
CONCLUSIONS
This study contributes new insights into the relationship between fidelity and treatment outcome by demonstrating that dietitian adherence and competence is greater when working with more challenging patients. This is likely central to the demonstrated success of the EAT intervention in reducing malnutrition and highlights the importance of ensuring that providers are adequately equipped to flexibly integrate intervention elements according to patient need.
TRIAL REGISTRATION
This study is a process analysis of a stepped-wedge randomised controlled trial prospectively registered on the Australian New Zealand Clinical Trials Registry ( ACTRN12613000320752 ; Date of registration 21/03/2013).
Topics: Cognitive Behavioral Therapy; Humans; Malnutrition; Nutritional Status; Nutritionists; Victoria
PubMed: 33902652
DOI: 10.1186/s13012-021-01118-y -
Canadian Journal of Dietetic Practice... 2014
Topics: Attitude of Health Personnel; Humans; Interprofessional Relations; Mentors; Nutritionists
PubMed: 24749183
DOI: 10.3148/75.1.2014.2 -
Osteoarthritis and Cartilage Apr 2021Explore patient and dietitian experiences with a multi-component dietary weight loss program for knee osteoarthritis to understand enablers and challenges to success at...
"It's the single best thing I've done in the last 10 years": a qualitative study exploring patient and dietitian experiences with, and perceptions of, a multi-component dietary weight loss program for knee osteoarthritis.
OBJECTIVE
Explore patient and dietitian experiences with a multi-component dietary weight loss program for knee osteoarthritis to understand enablers and challenges to success at 6-months.
DESIGN
Qualitative study embedded within a randomised controlled trial. Semi-structured individual interviews with 24 patients with knee osteoarthritis who undertook, and five dietitians who supervised, a weight management program (involving a ketogenic very low calorie diet (VLCD), video consultations, educational resources) over 6 months. Data were thematically analysed.
RESULTS
Five themes were developed: (1) ease and convenience of program facilitated adherence (structure and simplicity of the meal replacements; not feeling hungry on diet; convenience of consulting via video) (2) social and professional support crucial for success (encouragement from partner, family, and friends; guidance from, and accountability to, dietitian; anxiety around going at it alone) (3) program was engaging and motivating (determination to stick to program; rapid weight loss helped motivation) (4) holistic nature of program was important (suite of high-quality educational resources; exercise important to compliment weight loss) (5) rewarding experience and lifelong impact (improved knee pain and function; positive lifestyle change).
CONCLUSIONS
Patients and dietitians described positive experiences with the weight management program, valuing its simplicity, effectiveness, and convenience. Support from dietitians and a comprehensive suite of educational resources, incorporated with an exercise program, were considered crucial for success. Findings suggest this multi-component dietary program is an acceptable weight loss method in people with knee osteoarthritis that may benefit symptoms. Strategies for supporting long-term independent weight management should be a focus of future research.
Topics: Aged; Attitude of Health Personnel; Attitude to Health; Diet, Ketogenic; Diet, Reducing; Female; Humans; Male; Middle Aged; Nutritionists; Obesity; Osteoarthritis, Knee; Qualitative Research; Weight Reduction Programs
PubMed: 33434629
DOI: 10.1016/j.joca.2021.01.001 -
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