The Domains of Human Nutrition: The Importance of Nutrition Education in Academia and Medical Schools

open28noHuman nutrition encompasses an extremely broad range of medical, social, commercial, and ethical domains and thus represents a wide, interdisciplinary scientific and cultural discipline. The high prevalence of both disease-related malnutrition and overweight/obesity represents an important risk factor for disease burden and mortality worldwide. It is the opinion of Federation of the Italian Nutrition Societies (FeSIN) that these two sides of the same coin, with their sociocultural background, are related to a low "nutritional culture" secondary, at least in part, to an insufficient academic training for health-care professionals (HCPs). Therefore, FeSIN created a study group, composed of delegates of all the federated societies and representing the different HCPs involved in human nutrition, with the aim of identifying and defining the domains of human nutrition in the attempt to more clearly define the cultural identity of human nutrition in an academically and professionally oriented perspective and to report the conclusions in a position paper. Three main domains of human nutrition, namely, basic nutrition, applied nutrition, and clinical nutrition, were identified. FeSIN has examined the areas of knowledge pertinent to human nutrition. Thirty-two items were identified, attributed to one or more of the three domains and ranked considering their diverse importance for academic training in the different domains of human nutrition. Finally, the study group proposed the attribution of the different areas of knowledge to the degree courses where training in human nutrition is deemed necessary (e.g., schools of medicine, biology, nursing, etc.). It is conceivable that, in the near future, a better integration of the professionals involved in the field of human nutrition will eventually occur based on the progressive consolidation of knowledge, competence, and skills in the different areas and domains of this discipline.openDonini, Lorenzo M; Leonardi, Francesco; Rondanelli, Mariangela; Banderali, Giuseppe; Battino, Maurizio; Bertoli, Enrico; Bordoni, Alessandra; Brighenti, Furio; Caccialanza, Riccardo; Cairella, Giulia; Caretto, Antonio; Cena, Hellas; Gambarara, Manuela; Gentile, Maria Gabriella; Giovannini, Marcello; Lucchin, Lucio; Migliaccio, Pietro; Nicastro, Francesco; Pasanisi, Fabrizio; Piretta, Luca; Radrizzani, Danilo; Roggi, Carla; Rotilio, Giuseppe; Scalfi, Luca; Vettor, Roberto; Vignati, Federico; Battistini, Nino C; Muscaritoli, MaurizioDonini, Lorenzo M; Leonardi, Francesco; Rondanelli, Mariangela; Banderali, Giuseppe; Battino, Maurizio; Bertoli, Enrico; Bordoni, Alessandra; Brighenti, Furio; Caccialanza, Riccardo; Cairella, Giulia; Caretto, Antonio; Cena, Hellas; Gambarara, Manuela; Gentile, Maria Gabriella; Giovannini, Marcello; Lucchin, Lucio; Migliaccio, Pietro; Nicastro, Francesco; Pasanisi, Fabrizio; Piretta, Luca; Radrizzani, Danilo; Roggi, Carla; Rotilio, Giuseppe; Scalfi, Luca; Vettor, Roberto; Vignati, Federico; Battistini, Nino C; Muscaritoli, Maurizi

The Domains of Human Nutrition: The Importance of Nutrition Education in Academia and Medical Schools

Human nutrition is a broad, interdisciplinary cultural and scientific field, involving a wide range of chemical, molecular, genetic, biochemical, physiological, psychological, cognitive-behavioral, statistical-epidemiological, clinical, technological, educational, economic, political and social aspects. The high levels of over- and under-nutrition represent an important risk factor for mortality and burden of disease worldwide. It is the opinion of Federation of the Italian Nutrition Societies (FeSIN) that these two sides of the same coin, with their socio-cultural background, are related to a low ‘nutritional culture’ secondary, at least in part, to an insufficient academic training for healthcare professionals. Therefore FeSIN created a study group, composed of delegates of all the federated societies and representing the different healthcare professionals involved in human nutrition, with the aim of identifying and defining the domains of human nutrition in the attempt to more clearly define the cultural identity of human nutrition in an academically- and professionally-oriented perspective and to report the conclusions in position paper. Three main domains of human nutrition, namely Basic Nutrition, Applied Nutrition and Clinical Nutrition, were identified. FeSIN has examined the areas of knowledge pertinent to human nutrition. Thirty-two items were identified, attributed to one or more of the three domains and ranked considering their diverse importance for academic training in the different domains of human nutrition. Finally, the study group proposed the attribution of the different areas of knowledge to the degree courses where training in human nutrition is deemed necessary (e.g. schools of medicine, biology, nursing, etc). It is conceivable that, based on the implementation of knowledge-competences-skills trajectories in the different areas and domains of human nutrition, a better, pro-active, cost-effective integration of the professionals involved in this field will eventually occur

GLUTAMITALY 2003: Consensus Paper SINPE sull'impiego della glutamina nella nutrizione artificiale dell'adulto

From among the several nutrients believed to exert pharmacological actions, the amino acid Glutamine (GLN) is by far the most extensively studied during the last fifteen years. As an example, more than 970 papers appeared in Medline® between 1990 and 2003, matching the terms glutamine and nutrition, more than 300 of which in the form of review articles. The interest for this 'conditionallly essential' amino acid stems from the observation that it fulfills a number of biochemical needs. It operates as a nitrogen shuttle, may contribute to the formation of other amino acids, glucose, nucleotides, protein and glutathione, and represents the primary energy fuel for rapidly dividing cells, such as enterocytes, lymphocytes, macrophages and fibroblasts. In situations where a certain tissue is in greater need of GLN, inter-organ transfer of GLN usually fulfills site-specific requirements. Under certain conditions, however, endogenous GLN synthesis is not adequate to satisfy tissue needs and exogenous supplementation becomes necessary. Although exogenous parenteral and enteral GLN administation has been proven safe in the clinical setting, precise guidelines and recommendations for its use in clinical practice are still lacking, due to the non univocal interpretation of the clinical trials so far performed. The present article represents the Consensus Paper based on the results of the Glutamitaly 2003 SINPE Consensus Meeting on GLN in adult artificial nutrition. Rationale of use, indications, results of available clinical trials on GLN supplementation have been critically reviewed by a board of experts in the field of clinical nutrition with the aim to develop the methodology for possible future clinical trials evaluating the efficacy of parenteral or entreral GLN supplementation in surgery, ICU, gastroenterology, oncology and haematology patients