Journal of Human Nutrition and Dietetics最新文献

Background

Private practice dietetics is a rapidly growing work domain for graduate and experienced dietitians due to a competitive job market, expansion in remuneration options from health insurance systems and a desire for self-employment and flexible working conditions. Private practice dietetics requires core dietetics skills and business acumen, however, tertiary training opportunities for private practice preparation and development are unclear. This qualitative descriptive study aimed to explore the experiences and perceptions of academic educators from accredited Australian dietetics programmes on workforce development in private practice dietetics, with a focus on graduate preparedness, curriculum models, competency development, and placement opportunities.

Methods

Academic educators from accredited tertiary training programmes were purposively sampled for participation in semi-structured interviews on their experiences and perceptions on workforce development aspects for private practice. Data was analysed using qualitative thematic analysis methods.

Results

Nineteen academics participated from 15 universities. Sixteen themes emerged across seven constructs; pathways, the work of private practitioners, preparation, competency development, placements, competency requirement, and workforce challenges. Preparing future private practice dietitians presents notable challenges within the context of tertiary education, particularly due to challenges around private practice placements, curriculum crowding and competing educational priorities. Additionally, significant professional and structural barriers were identified in relation to building capacity within the private practice dietetics workforce.

Conclusions

Addressing the issues raised with tertiary educators will require a collaborative approach, including the development of consensus on key workforce development strategies. Such efforts are essential to support this important career pathway, which plays a critical role in delivering nutrition services to the community.

Background

Paediatric patients undergoing stem cell and gene therapy frequently experience nutritional challenges. Although nutritional status is known to correlate with outcomes, there is no scoring index to quantify the intensity and duration of dietetic interventions in children. We developed a nutritional intensity score that assigns weighted values to different nutritional support strategies that reflects both intervention type and duration over the first 100 days post-transplant.

Methods

We retrospectively analysed 131 paediatric patients after transplant or gene therapy. Nutritional interventions were categorised into five levels: routine dietetic review (1 point), oral nutritional support (2 points), enteral nutritional support (4 points), parenteral nutritional (PN) support (6 points), and bespoke PN support (7 points). The cumulative nutritional intensity score was calculated by multiplying the intervention points by the duration (in days) and summing across all interventions. Subgroup analyses compared median area under the curve (AUC) values in different groups. A further multivariate logistic regression was employed to assess predictors of ≥ PN need at Day 100 within the allogeneic group.

Results

Nutritional intensity varied with different treatment modalities. Chimeric Antigen Receptor T-cell (CAR-T) patients showed notably lower median nutritional intensity score (53.0, 95% CI: 30–117) relative to allogeneic (326.0, 95% CI: 282–404) or stem cell gene therapy (124.5, 95% CI: 56–182, p < 0.05) recipients. Within the allogeneic group (n = 109), patients with malignant diseases had a median nutritional intensity score of 444.0 (95% CI: 350.0–466.0) compared to 261.5 (95% CI: 224.0, 322.0, p < 0.01) in those with nonmalignant conditions. Those receiving total body irradiation (TBI) had higher median nutritional intensity score values (476.0, 95% CI: 317–543) than those without TBI (302.0, 95% CI: 244–386; p < 0.01). In the multivariate analysis, higher nutritional intensity score, malignant disease status, and TBI were significant predictors of ≥ PN requirement at Day 100.

Conclusion

Our nutritional intensity score reflects the cumulative burden of nutritional interventions in paediatric patients, and will inform patient and service planning. Future prospective studies are required to validate its predictive value.

Background

Evidence on the effectiveness of augmented reality (AR)-based tools for portion size estimation as an educational aid remains limited. In this pilot study, we developed a 3D food model using AR and assessed the feasibility of using this application to teach portion size estimation skills.

Methods

This intervention study involved 43 students (including 38 females) from two dietetic education institutions. Participants were randomly assigned into four groups: (1) text only, (2) text and pictures, (3) food model and (4) AR. Learning effectiveness was evaluated using a pretest of 10 different foods, followed by a 10-min instructional session with the assigned tool, and then a post-test. Participants rated each learning tool for enjoyment, usefulness and recommendation to others on an 11-point Likert scale. Outcomes included the change in the number of correct answers within ± 10% or ± 20% of the true food weight.

Results

Mean acceptability ratings for the text only, text and picture, food model and AR groups were enjoyment (4.1, 5.6, 7.0 and 7.9), usefulness (5.5, 7.4, 8.4 and 8.3) and recommendation to others (3.6, 6.3, 6.3 and 7.1), respectively. The mean changes in correct answers for text only, text and picture, food model and AR groups were 0.7, −1.1, 1.5 and 0.1, respectively, within a 10% error margin, and 1.2, −1.9, 2.0 and 0.8, respectively, within a 20% error margin.

Conclusions

This pilot study suggests that AR-based tools have potential as educational aids for portion size estimation among future dietitians, with acceptability ratings comparable to conventional methods, such as text only, text and pictures, and food models.

Trial Registration: The study was registered with the University Hospital Medical Information Network; UMIN000054307.

Background

Evidence suggests that women should eat a healthy diet during pre-conception and pregnancy as this benefits their own health as well as reducing the risk of non-communicable diseases in offspring (such as obesity, diabetes, hypertension, cardiovascular and mental health problems); however, previous work indicates that the recommendations are not being followed. This study aimed to understand: the facilitators and barriers to healthy food and diet practices during pre-conception and pregnancy; how these barriers could be addressed, and the changes required to facilitate good food practices.

Methods

The research used a qualitative approach; five online focus groups were undertaken with 19 women living across the UK who were trying to conceive, pregnant or had babies under 6-months old. Data were thematically analysed.

Results

The findings revealed three main themes (Challenges of trying to eat healthily; Facilitators to eating healthily; Changes required) and six subthemes (Mothers' load; Body sabotage; Food environment; Information not individualised; Planning skills; Family support; Co-creation and investment for the future; Access to professional advice). Participants spoke of internal factors (such as tiredness and nausea) and external influences (e.g., their financial situation) that impacted on their ability to eat healthily. They identified the need to access more effective professional advice.

Conclusions

This unique study demonstrated a need for clear, consistent, engaging and culturally appropriate dietary information, as well as access to professionals (such as nutritionists and dietitians) who can give both generic and tailored advice to those trying to conceive and those who are already pregnant.

Background

The growing use of social media has created new avenues through which food choices and eating behaviours may be influenced. This study aimed to investigate whether addiction to Instagram, a highly visual and food-focused social media platform, is linked to picky eating behaviours and fat and cholesterol intake patterns that may affect cardiovascular health in young adults.

Methods

This cross-sectional study was conducted among 388 adults (80.9% female) aged 18–29 years in Türkiye between November 2024 and April 2025. Participants completed self-reported questionnaires, including the Instagram Addiction Scale (IAS), Social Media Addiction Scale (SMAS), Adult Picky Eating Questionnaire (APEQ), and the MEDFICTS dietary assessment questionnaire. Data were analysed using SPSS 24.0.

Results

Significant differences in IAS, SMAS, and APEQ scores were found across MEDFICTS diet quality categories (p = 0.026, p = 0.006, and p < 0.001, respectively). Correlation analyses showed a weak positive association between IAS and MEDFICTS scores (r = 0.150, p < 0.001), and a moderate negative correlation between APEQ and MEDFICTS scores (r = –0.490, p < 0.001). In multiple regression, BMI (β = –0.148, p = 0.004), IAS (β = 0.184, p = 0.004), and MEDFICTS scores (β = –0.187, p < 0.001) were significant predictors of picky eating, explaining for 9.0% of the variance (R² = 0.090).

Conclusion

This study indicates a modest link between Instagram addiction, picky eating, and dietary fat intake in young adults. Picky eating was associated with lower intake of saturated fat and cholesterol, highlighting a complex connection between digital media use and diet quality.

Background

Inflammatory bowel disease is complex, heterogeneous and chronic, necessitating individualized and holistic long-term care and self-management. While dietary therapy can induce remission in some cases, no dietary guidelines currently exist for maintaining remission. Despite remission, gastrointestinal symptoms can persist. This, together with perceived lack of guidance from healthcare providers are sources of frustration. To bridge the dietary information gap, many individuals may turn to social media, where extensive discussions occur. This study aimed to quantify, explore and describe the nutrition-related information needs and experiences of this cohort by analysing comments on social media.

Methods

This study used social listening to examine online comments from select Facebook groups. Content and inductive thematic analysis were used to quantify, explore and describe deidentified comments. Chat Generative Pre-Trained Transformer aided content analysis. Topics of interest were represented as percentages.

Results

Moderate agreement (75%) existed between manual and automated content analysis. Of the 11,945 comments, 37.5% were diet-related. Thematic analysis identified five interrelated themes: (1) desire for support and connection, (2) exasperation and desire for information, (3) open to considering advice from non-experts, (4) a desire for food to be thy medicine and (5) Inflammatory Bowel Disease holds me back.

Conclusion

Facebook groups provide access to information and connection, compensating for the perceived lack of timely and ongoing access to a knowledgeable and empathetic multidisciplinary care team. Dietitians caring for individuals with IBD should ensure the advice provided is practical and that barriers to implementation of advice are addressed to facilitate uptake.

Introduction

Patients with beta-thalassemia major (BTM) are vulnerable to imbalanced diets due to treatment-related complications and dietary restrictions. Despite the high prevalence of BTM in Vietnam, no studies to date have examined dietary patterns in this population. This study aims to explore the dietary patterns of adult patients with BTM in Vietnam.

Methods

This secondary data analysis included 317 adult patients with BTM receiving treatment at the largest haematology institute in Vietnam. Dietary patterns were assessed using the validated Vietnamese version of a 24-h recall diet quality questionnaire. Additional variables included diet quality indices, underweight status, malnutrition risk, and sociodemographic characteristics. Exploratory factor analysis was used to derive dietary patterns from 12 food groups. Comparisons of diet quality, nutritional status, and other covariates were made across identified dietary patterns.

Results

Four dietary patterns were identified: ready-to-eat (36.0%), plant-based convenience (29.3%), red meat-based (21.5%), and seafood-based (13.2%). Participants following ready-to-eat and red meat-based patterns had significantly higher non-communicable diseases (NCD)-risk score than participants of other patterns. The global dietary recommendation score was significantly highest among those in the plant-based convenience and seafood-based groups, and lowest in the red meat-based group. The prevalence of underweight and risk of malnutrition was high across all patients, regardless of their dietary patterns.

Conclusion

The predominance of ready-to-eat and red meat-based dietary patterns among patients with BTM is concerning, as these patterns had significantly higher NCD risk and lower adherence to global dietary guidelines. These issues are exacerbated by high rates of underweight and malnutrition risk. We recommend integrating routine nutrition screening and counselling into BTM care and developing evidence-based dietary guidelines to support healthier eating practices in this population.

Ensuring food safety and infection control in large-scale foodservice operations is critical to protecting health in mass feeding environments, including athletes' dining halls and institutional dining settings. Athletes at major competitions are at risk of illness in overcrowded dining areas, especially where foodservice safety standards are inconsistent.

Objectives

This study aimed to (1) develop and pilot-test a Foodservice Provision Audit Tool for Sport (FPAT-S) at two major sport competitions to evaluate compliance with infection control and food safety measures, and (2) determine its inter-rater reliability.

Methods

The FPAT-S was tested by health professionals during the 2022 Canada Summer (n = 12) and 2023 Winter Games (n = 9). The tool included 19 questions with binary, multiple-choice, and Likert scale responses. Compliance trends over time and inter-rater reliability were analyzed.

Results

Hand sanitizer availability exceeded 75% compliance and improved over time, whereas staff sanitation compliance declined by the end of both events. Physical distancing compliance remained below 50% throughout. Binary response questions showed moderate agreement (κ = 0.471, p = 0.028) between auditors compared to scale and multiple-choice questions during the Summer phase, while agreement was lower and non-significant for scale and multiple-choice responses in both phases. Auditor variability was attributed to subjectivity and audit timing.

Conclusion

The FPAT-S provides a structured approach to assessing food safety and infection control in mass foodservice settings. With refinement, it can support dietitians and foodservice managers in maintaining compliance across a range of institutional and commercial operations, beyond sporting events, and inform future public health infection control strategies.