Professional development needs in nutrition and dietetics

Background. Continuing education has long played a role in the maintenance of professional competence of nutrition and dietetics professionals. Due to the lack of published continuing education research in nutrition over the last 15 years, very little is known about the adequacy of continuing education resources for today’s nutrition and dietetics professionals. Objective. To examine the continuing education needs of nutrition and dietetics professionals. Design and Methods. A cross-sectional survey study of nutrition and dietetics professionals who graduated from the University of Texas at Austin Didactic Program in Dietetics and/or Coordinated Program in Dietetics. A survey was constructed and content-validated to assess continuing education needs in specific areas of nutrition. Descriptive statistics was used to report the results. Measures. Demographics, areas of focus in continuing education, continuing education activity preferences, targeted levels of competence in continuing education, and learning needs. Results. 54 surveys were returned. Of those 54, 41 were able to be used for analysis. Most of the participants worked in clinical nutrition (64.7%) and/or in nutrition education (38.2%). 75.6% of participants chose continuing education activities based on convenience and accessibility in their areas of interest. 63.4% of participants reported that their continuing education learning needs were not being met in at least one of their areas of focus in continuing education. Conclusion. Despite the emphasis on continuing education in the nutrition field, most of the participants reported unmet learning needs in some capacity. Further investigation into the adequacy of continuing education resources in nutrition is needed.Nutritional Science

Nutrigenomics 2.0: The Need for Ongoing and Independent Evaluation and Synthesis of Commercial Nutrigenomics Tests' Scientific Knowledge Base for Responsible Innovation

Nutrigenomics is an important strand of precision medicine that examines the bidirectional interactions of the genome and nutritional exposures, and attendant health and disease outcomes. This perspectives article presents the new concept of "Nutrigenomics 2.0," so as to cultivate and catalyze the next generation research and funding priorities for responsible and sustainable knowledge-based innovations. We further contextualize our recent study of the 38 genes included in commercially available nutrigenomics tests, and offer additional context in relation to the 2014 American Academy of Nutrition and Dietetics position. Finally, we make a call in the best interest of the nutrigenomics science community, governments, global society, and commercial nutrigenomics test providers that new evidence evaluation and synthesis platforms are created concerning nutrigenomics tests before they become commercially available. The proposed assessment and synthesis of nutrigenomics data should be carried out on an ongoing dynamic basis with periodic intervals and/or when there is a specific demand for evidence synthesis, and importantly, in ways that are transparent where conflict of interests are disclosed fully by the involved parties, be they scientists, industry, governments, citizens, social scientists, or ethicists. We submit that this will cultivate responsible innovation, and business models that are sustainable, robust, and stand the test of time and context

Factors determining the integration of nutritional genomics into clinical practice by registered dietitians

YesPersonalized nutrition has the potential to improve health, prevent disease and reduce healthcare expenditure. Whilst research hints at positive consumer attitudes towards personalized nutrition that draws upon lifestyle, phenotypic and genotypic data, little is known about the degree to which registered dietitians (RD) are engaged in the delivery of such services. This review sought to determine possible factors associated with the integration of the emerging science of Nutritional Genomics (NGx) into the clinical practice setting by practicing registered dietitians. Scope Search of online databases (Pubmed; National Library of Medicine; Cochrane Library; Ovid Medline) was conducted on material published from January 2000 to December 2014. Studies that sampled practicing dietitians and investigated integration or application of NGx and genetics knowledge into practice were eligible. Articles were assessed according to the American Dietetic Association Quality Criteria Checklist. Key findings Application of nutritional genomics in practice has been limited. Reluctance to integrate NGx into practice is associated with low awareness of NGx, a lack of confidence in the science surrounding NGx and skepticism toward Direct to consumer (DTC) products. Successful application to practice was associated with knowledge about NGx, having confidence in the science, a positive attitude toward NGx, access to DTC products, a supportive working environment, working in the clinical setting rather than the public health domain and being in private rather than public practice. Conclusions There is a need to provide RGs with a supportive working environment that provides ongoing training in NGx and which is integrated with clinical practice

Determinants of the application of personalised nutrition and associated technologies in dietetic practice - A mixed methods study of key stakeholders in personalised nutrition

Background: Tech-enabled personalised nutrition is an emerging area that has promise to improve health outcomes, widen access to nutrition expertise and reduce healthcare expenditure, yet uptake by registered dietitians remains low. This research programme aimed to identify levers and barriers that contribute to adoption of personalised nutrition in order to guide practice and policy for registered dietitians, educators and consumers. Methods: A mixed methods study with a sequential exploratory design was adopted to determine what the barriers to adoption of technologies are, and secondly, what needs to be in place to make tech-enabled personalised nutrition a reality. The research programme was conducted online using qualitative (focus groups and interviews) and quantitative measures (survey and secondary analysis). Thematic analysis, statistical and secondary analyses of data were performed respectively. Results: Using diffusion of innovation and entrepreneurial theories, findings indicate that barriers to integration of personalised nutrition technologies include intrinsic and extrinsic factors which relate to a low self-efficacy, high perception of risk, low perceived importance and usefulness of technologies to dietetic practice as well as a lack of an entrepreneurial mindset and regulatory environment. Conclusion: Uptake of tech-enabled personalised nutrition by registered dietitians will require a multi-stakeholder approach. Educational, professional, regulatory and health policies will need to be in place and strategies that open discussion between Registered Dietitians (RD’s) at all levels are needed

Continuing Educational Needs and Preferences for Swiss Registered Dietitians: Lessons Learned.

Bern University of Applied Sciences (BFH) in Switzerland offers continuing educational programs for registered dietitians. In order to initialize effective changes to maximize attendance, the promotors and barriers influencing the participation of Swiss registered dietitians to continuing education classes were identified. A survey was conducted from December 2013 to January 2014 and sent to 630 registered members of the Swiss Association of Registered Dietitians (SVDE). The questionnaire was developed on the web-based software Survey Monkey® and included 37 open- and closed-ended questions. Evaluation questions were based on a four-point Likert scale and space for individual comments was ensured. Data analysis included descriptive statistics and chi-squared tests. The final sample included 202 dietitians, the majority being female (96%), between 25 and 54 years old (90%) and 45% worked in clinical settings. Almost 70% had participated in a BFH continuing education course. Respondents were overall very satisfied with parameters including course registration, organisation, content, professional competence of teachers, and practical relevance. Preferred course format were short courses (1-2 days). The lecturer’s limited practical experience, no interest to the subject matter, and no cost coverage by employer were mentioned as the main barriers for attending courses. Based on lessons learned from this evaluation, the following aspects should be considered in order to secure the attractiveness of such programs: Favouring shorter more intensive courses and having them taught by lecturers with a strong practical experience, and hence with more insightful approach. Topics should be established based on the audience’s expectations and needs, possibly through an inquiry among professional societies. In addition, overlapping fields as for example nutritional psychology, gerontology, and transdisciplinary approaches could be further included to broaden the dietitians’ perspectives and encourage a more holistic approach. Finally, the registration process and quality of teaching environment should be seamless, in order to avoid negative influences on the course. Keywords Continuing education; Dietetics; Nutritionists; Needs assessmen

Integrative and Functional Nutrition Practices and use of the Integrative and Functional Medical Nutrition Therapy Radial Among Registered Dietitians

Background: The important role nutrition plays in Integrative and Functional Medicine, along with increased enrollment rates in the Dietitians in Integrative and Functional Medicine (DIFM) dietetics practice group points to the fact that dietitians are in need of effective tools to use to guide their integrative and functional nutrition practice. The Integrative and Functional Medical Nutrition Therapy Radial was created as a conceptual framework to assist dietitians in providing personalized nutrition care. We do not know, however, what integrative dietitians are currently doing in their practice or if they are utilizing this conceptual framework. The objective of this research is to investigate the Integrative and Functional Medicine practices of Registered Dietitians as well as assess their use and perceived effectiveness of the Integrative and Functional Medical Nutrition Therapy Radial. Methods : This is a cross-sectional study utilizing a self-administered web-based survey. Participants included Registered Dietitians belonging to the Dietitians in Integrative and Functional Medicine dietetic practice group. Statistical analysis utilized SPSS software. Analysis included descriptive statistics and X2 analysis for independence. Qualitative responses were coded and analyzed for similarity in responses. Main outcome measures included reported functional nutrition related assessment and treatment practices, as well as familiarity with, use, and perceived effectiveness of the Integrative and Functional Medical Nutrition Therapy Radial. Results: Two-hundred and eleven surveys were completed and analyzed. The most frequently assessed client history items included physical activity, use of supplements, and digestive wellness. Eighty-four percent of respondents (n = 178) reported they assess client biochemical status, while only 70 participants reported providing nutrition focused physical exams for their clients. One-hundred and three participants reported having previous exposure to the IFMNT radial, of those participants, 49 had utilized it in their professional practice. The most frequently utilized areas of the radial include Lifestyle and Systems Signs and Symptoms. Participant feedback regarding the IFMNT radial indicates additional education and training is necessary. Conclusions: Reported integrative medicine practices appear similar to those provided on the IFMNT Radial. The IFMNT Radial may provide guidance to Registered Dietitians practicing Integrative and Functional Medicine, however, education and training regarding this tool is needed

EFAD 2022 Supplementary document to the current International Code of Ethics: Recommendations of the PPC on areas of practice not specifically addressed in the International Code of Ethics

Code of Ethics A code of ethics is a written set of principles and rules with the purpose of: • Helping professionals conduct their actions in accordance with primary values, principles and ethical standards. • Assuring the public that members of regulated professions are acting in a socially and professionally acceptable manner. • Assisting individuals to govern their decision making. • Helping professionals practice honestly and with integrity. • Guarding against malicious or self-serving practices and actions

Protective Role of S-Adenosylmethionine Against Fructose-Induced Oxidative Damage in Obesity

Introduction. It has been shown that S-adenosylmethionine (S-AMe) stimulates glutathione synthesis and increases cell resistance to the cytotoxic action of free radicals and pro-inflammatory cytokines. The aim of this study was to determine the effect of S-adenosylmethionine on the oxidative stress in adipose tissue in a model of fructose-induced obesity. Methods. The study was performed on male Wistar rats divided into 3 groups: control, fructose fed (HFD) (35%, 16 weeks), and HFD + S-AMe (20 mg/kg). We examined the changes in the ratio of retroperitoneal adipose tissue weight / body weight; levels of reduced glutathione (GSH) and malondialdehyde (MDA) in the retroperitoneal adipose tissue, and serum levels of GSH and TNF-α. Results. Significant increases in the retroperitoneal adipose tissue, MDA, and serum TNF-α were identified, as well as decreased tissue and serum levels of GSH in rats fed with a high-fructose diet as compared with the control group. In the group fed with HFD and S-AMe, we found significant reduction in the retroperitoneal adipose tissue and decreased levels of MDA and serum TNF-α, as well as increased tissue and serum levels of GSH as compared with the group only on HFD. In conclusion, our results show that fructose-induced obesity causes oxidative stress in hypertrophic visceral adipose tissue. The administration of S-AMe improves the antioxidative protection of adipocytes, and reduces oxidative damage and excessive accumulation of lipids and inflammation

Personalised nutrition and health

This article is one of a series commissioned by The BMJ. Open access fees for the series were funded by SwissRe, which had no input into the commissioning or peer review of the articles.S