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Insights from user experience and evaluation of a mobile health nutrition intervention for children with autism: A qualitative study 针对自闭症儿童的移动健康营养干预的用户体验和评估启示:定性研究。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-09-09 DOI: 10.1111/jhn.13365
Courtney N. Slater, Krista Schroeder, Amanda Fultz, Emily S. Kuschner, Lauren O'Malley, Kelsey Johnson, Teresa Benvenuti, Jesse Chittams, Ryan J. Quinn, J. Graham Thomas, Jennifer Pinto-Martin, Susan E. Levy, Tanja V. E. Kral

Background

Children with autism spectrum disorder (ASD) experience high rates of atypical eating behaviours, such as food neophobia. Mobile health (mHealth) interventions have been found to improve communication, behaviour and social skills for children with ASD. However, there is limited evidence examining mHealth nutrition interventions among children with ASD.

Methods

The present study comprised a qualitative descriptive study that used qualitative content analysis to explore parent and child experiences with a novel mHealth nutrition intervention. Ten parent–child dyads provided user feedback and evaluation of the intervention. Data collection tools included a semistructured interview guide and a quantitative questionnaire with open-ended questions. Data analysis of the interview transcripts and open-ended questionnaire responses was an iterative process that continued until saturation was achieved. Descriptive statistics were used to analyse quantitative questionnaire data.

Results

Analysis of the qualitative semistructured interviews led to emergence of three themes: (1) positive intervention outcomes; (2) parent suggestions for improvement; and (3) barriers to engagement. Each theme included subthemes. Questionnaire data revealed the ability to pick rewards and the virtual character that reinforced dietary goals (“Nutrition Ninja”) were the most liked components of the application. Sending messages within the application and the Nutrition Ninja game were the least liked components of the application.

Conclusions

Collectively, findings indicated that the app served as an interactive tool prompting dietary change and conversations within families. Yet, for some families, the intervention design, resistance to change or child disinterest hindered use and implementation of the intervention.

背景:患有自闭症谱系障碍(ASD)的儿童有很高比例的非典型饮食行为,如食物恐惧。研究发现,移动医疗(mHealth)干预措施可改善自闭症谱系障碍儿童的沟通、行为和社交能力。然而,在 ASD 儿童中研究移动医疗营养干预措施的证据却很有限:本研究是一项定性描述性研究,采用定性内容分析法探讨家长和儿童在使用新型移动保健营养干预措施方面的经验。十位家长和孩子组成的二人小组提供了用户反馈和对干预措施的评价。数据收集工具包括半结构式访谈指南和带有开放式问题的定量问卷。对访谈记录和开放式问卷回答的数据分析是一个反复的过程,一直持续到达到饱和为止。描述性统计用于分析定量问卷数据:对半结构式定性访谈的分析产生了三个主题:(1) 积极的干预结果;(2) 家长的改进建议;(3) 参与的障碍。每个主题都包括次主题。调查问卷数据显示,可以选择奖励的功能和强化饮食目标的虚拟角色("营养忍者")是应用程序中最受喜爱的部分。在应用程序中发送信息和 "营养忍者 "游戏是应用程序中最不受欢迎的部分:总之,研究结果表明,该应用程序是一种互动工具,可促使家庭改变饮食习惯和进行对话。然而,对于一些家庭来说,干预设计、对改变的抵触或儿童的不感兴趣阻碍了干预的使用和实施。
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引用次数: 0
Expression of Concern 表达关切。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-08-26 DOI: 10.1111/jhn.13363

Expression of Concern: Karamali M, Kashanian M, Alaeinasab S, Asemi Z. The effect of dietary soy intake on weight loss, glycaemic control, lipid profiles and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomised clinical trial. J Human Nutr Diet. 2018;31(4): 533–43. https://doi.org/10.1111/jhn.12545

This Expression of Concern is for the above article, published online on 22 February 2018 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Lauren Ball, and Wiley Periodicals LLC. The Expression of Concern has been agreed because of concerns raised regarding the integrity of the research and discrepancies in reporting. An investigation has been conducted by the National Committee for Ethics in Biomedical Research, Iran, in coordination with Kashan University of Medical Sciences (KAUMS). However, without the verification of clinical records, there remain sufficient doubts about the feasibility and integrity of the research undertaken. As a result, the journal has decided to issue an Expression of Concern to alert readers.

表达关切:M. Karamali、M. Kashanian、S. Alaeinasab 和 Z. Asemi,"膳食大豆摄入对多囊卵巢综合征妇女体重减轻、血糖控制、血脂概况以及炎症和氧化应激生物标志物的影响:随机临床试验》,《人类营养与饮食学杂志》31,No.4 (2018):533-543, https://doi.org/10.1111/jhn.12545.本《关注声明》针对 2018 年 2 月 22 日在线发表于 Wiley Online Library(wileyonlinelibrary.com)的上述文章,由期刊主编 Lauren Ball 和 Wiley Periodicals LLC 协议发布。之所以同意发布 "关注声明",是因为有人对研究的完整性和报告中的差异表示担忧。伊朗国家生物医学研究伦理委员会(National Committee for Ethics in Biomedical Research Iran)已与卡尚医科大学(KAUMS)合作开展调查。然而,在没有对临床记录进行核实的情况下,对所开展研究的可行性和完整性仍然存在足够的怀疑。因此,本刊决定发布 "关注声明",以提醒读者注意。
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引用次数: 0
Corrigendum to “Exploring the role of dietitians in mental health services and the perceived barriers and enablers to service delivery: A cross-sectional study” 探索营养师在精神健康服务中的角色以及提供服务的障碍和促进因素:横断面研究"。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-08-25 DOI: 10.1111/jhn.13361

Teasdale SB, Tripodi E, Harman A, Plain J, Burrows TL. Exploring the role of dietitians in mental health services and the perceived barriers and enablers to service delivery: a cross-sectional study. J Hum Nutr Diet. 2023 Oct;36(5):1771-1781.

Following the publication of the above article, the authors noted that the author order was incorrect when transferred from the submission system.

The authors have submitted the corrected author order. This correction does not affect the conclusions presented in the study. The authors regret this inadvertent error during proofreading and apologize for this mistake.

The corrected author order is given below:

Tripodi E, Teasdale SB, Harman A, Plain J, Burrows TL. Exploring the role of dietitians in mental health services and the perceived barriers and enablers to service delivery: a cross-sectional study. J Hum Nutr Diet. 2023 Oct;36(5):1771-1781.

Teasdale SB, Tripodi E, Harman A, Plain J, Burrows TL.探索营养师在心理健康服务中的作用以及提供服务的障碍和促进因素:一项横断面研究。J Hum Nutr Diet.2023 Oct;36(5):1771-1781.Following the publication of the above article, the authors noted that the author order was incorrect when transferred from the submission system.The authors have submitted the corrected author order.作者已提交了更正后的作者顺序。这一更正并不影响研究中提出的结论。作者对校对过程中的这一无心之失表示遗憾,并为这一错误道歉。更正后的作者顺序如下:Tripodi E, Teasdale SB, Harman A, Plain J, Burrows TL.探索营养师在心理健康服务中的作用以及提供服务的障碍和促进因素:一项横断面研究。J Hum Nutr Diet.2023 Oct;36(5):1771-1781.
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引用次数: 0
Nice to know 2: The impact of NICE guidelines on ketogenic diet services in the UK and Ireland – An update 很高兴知道 2:NICE 指南对英国和爱尔兰生酮饮食服务的影响 - 最新情况。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-08-19 DOI: 10.1111/jhn.13359
Victoria J. Whiteley, Natasha E. Schoeler, Ketogenic Dietitians Research Network

Background

Ketogenic diet therapy (KDT) has been recommended as a treatment for drug-resistant epilepsy in children and young people since 2012 in the National Institute for Health and Care Excellence Clinical Guidelines for Epilepsies. The Ketogenic Dietitians Research Network completed a survey in 2017 to assess the impact of these guidelines.

Methods

An online survey was circulated to ketogenic dietitians across the UK and Ireland. The results were compared with those of the 2017 survey.

Results

The number of individuals following KDT was 854, comprising an increase of 13% since 2017. Service sizes ranged widely, with 1–74 (median 16) patients on the diet. Of 36 services, 30 had a waiting list, ranging from 2 to 67 (median 9) patients. The classical diet continued to be the most common KDT used (58% of patients). Ten services reported use of a new flexible medium chain triglyceride protocol. Some 48% of patients (n = 427) had been following the KDT for over 2 years, comprising an 18% increase since 2017. Of these, 68 (15.9%) had attempted to wean off KDT but had to re-start as a result of a deterioration in seizures.

Conclusions

The number of individuals following medical KDT remains stable. Referral numbers and waiting lists remain high, highlighting that KDT is still a well-recognised treatment option for drug-resistant epilepsy. The types of KDT used are similar to previous years, although increasingly flexible protocols are being adopted. Longer-term use of KDT is increasing, with a proportion of patients requiring long-term use to maintain seizure control.

背景:自2012年以来,美国国家健康与护理卓越研究所癫痫临床指南一直推荐生酮饮食疗法(KDT)作为治疗儿童和青少年耐药性癫痫的方法。生酮饮食研究网络于2017年完成了一项调查,以评估这些指南的影响:向英国和爱尔兰的生酮营养师分发了一份在线调查。调查结果与 2017 年的调查结果进行了比较:接受生酮饮食治疗的人数为 854 人,比 2017 年增加了 13%。服务规模差别很大,有 1-74 名(中位数为 16 名)患者在接受饮食治疗。在 36 家服务机构中,有 30 家设有候诊名单,患者人数从 2 人到 67 人(中位数为 9 人)不等。传统饮食仍然是最常用的 KDT(58% 的患者)。有 10 家服务机构报告使用了新的灵活中链甘油三酯方案。约 48% 的患者(n = 427)已采用 KDT 超过 2 年,自 2017 年以来增加了 18%。其中,68 名患者(15.9%)曾尝试脱离 KDT,但由于癫痫发作恶化而不得不重新开始:结论:接受医源性 KDT 的人数保持稳定。转诊人数和候诊人数仍然居高不下,这表明KDT仍然是公认的治疗耐药性癫痫的一种方法。尽管采用的方案越来越灵活,但所使用的KDT类型与往年类似。长期使用KDT的患者越来越多,有一部分患者需要长期使用KDT来维持癫痫发作控制。
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引用次数: 0
Patients' experiences of dietary changes during a structured dietary intervention for irritable bowel syndrome 在针对肠易激综合征的结构化饮食干预过程中,患者对饮食变化的体验。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-08-13 DOI: 10.1111/jhn.13349
Cecilia Weznaver, Sanna Nybacka, Magnus Simren, Hans Törnblom, Sofie Jakobsson, Stine Störsrud

Background

Diet plays an important role in management of gastrointestinal (GI) symptoms in patients with irritable bowel syndrome (IBS). Restrictive diets have gained popularity as treatment for IBS, but no studies have examined the patients' experiences of implementing such diets. Thus, the present study aimed to explore the experience of patients with IBS undergoing a structured dietary intervention.

Methods

Using inductive content analysis, semi-structured interviews were conducted in 19 patients with IBS, who were recruited from a randomised controlled trial evaluating two different restrictive diets for 4 weeks: a diet low in total carbohydrates; and a diet low in fermentable oligo-, di- and monosaccharides and polyols (i.e., FODMAP) combined with traditional IBS dietary advice.

Results

Three main themes developed from the qualitative analysis and together they describe the dietary intervention as supportive, as well as the dietary changes as challenging and contributing to reflection. Patients found the dietary support effective in both initiating and adhering to their dietary changes. Despite the support, the implementation of the diet was perceived as challenging when it interfered with other important aspects of their lives. However, going through the dietary change process, the patients began to reflect on their eating behaviours, which enabled individual dietary adjustments. The adjustments that patients maintained were not only a result of alleviation of GI symptoms, but also based on personal preferences.

Conclusions

Patients with IBS undergoing restrictive diets appear to benefit from structured support. However, considering the individual patient's life situation and personal preferences, individualised dietary options should be encouraged to achieve long-term dietary changes.

背景:饮食在治疗肠易激综合征(IBS)患者的胃肠道(GI)症状方面发挥着重要作用。限制性饮食作为肠易激综合征的治疗方法已越来越受欢迎,但还没有研究对患者实施此类饮食的经历进行调查。因此,本研究旨在探讨肠易激综合征患者接受结构化饮食干预的经验:采用归纳内容分析法,对 19 名肠易激综合征患者进行了半结构化访谈,这些患者是从一项随机对照试验中招募的,该试验评估了为期 4 周的两种不同限制性饮食:一种是低碳水化合物总量饮食;另一种是结合传统肠易激综合征饮食建议的低可发酵寡糖、双糖、单糖和多元醇(即 FODMAP)饮食:定性分析得出三大主题,它们共同描述了饮食干预的支持作用,以及饮食改变的挑战性和反思作用。患者认为饮食支持对开始和坚持饮食改变都很有效。尽管得到了支持,但当饮食影响到他们生活的其他重要方面时,他们还是认为实施饮食具有挑战性。然而,在改变饮食习惯的过程中,患者开始反思自己的饮食行为,从而对个人饮食习惯进行调整。患者所坚持的调整不仅是消化道症状缓解的结果,也是基于个人喜好:结论:接受限制性饮食的肠易激综合征患者似乎能从有组织的支持中获益。然而,考虑到患者的生活状况和个人偏好,应鼓励患者选择个性化饮食,以实现长期饮食改变。
{"title":"Patients' experiences of dietary changes during a structured dietary intervention for irritable bowel syndrome","authors":"Cecilia Weznaver,&nbsp;Sanna Nybacka,&nbsp;Magnus Simren,&nbsp;Hans Törnblom,&nbsp;Sofie Jakobsson,&nbsp;Stine Störsrud","doi":"10.1111/jhn.13349","DOIUrl":"10.1111/jhn.13349","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diet plays an important role in management of gastrointestinal (GI) symptoms in patients with irritable bowel syndrome (IBS). Restrictive diets have gained popularity as treatment for IBS, but no studies have examined the patients' experiences of implementing such diets. Thus, the present study aimed to explore the experience of patients with IBS undergoing a structured dietary intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using inductive content analysis, semi-structured interviews were conducted in 19 patients with IBS, who were recruited from a randomised controlled trial evaluating two different restrictive diets for 4 weeks: a diet low in total carbohydrates; and a diet low in fermentable oligo-, di- and monosaccharides and polyols (i.e., FODMAP) combined with traditional IBS dietary advice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three main themes developed from the qualitative analysis and together they describe the dietary intervention as supportive, as well as the dietary changes as challenging and contributing to reflection. Patients found the dietary support effective in both initiating and adhering to their dietary changes. Despite the support, the implementation of the diet was perceived as challenging when it interfered with other important aspects of their lives. However, going through the dietary change process, the patients began to reflect on their eating behaviours, which enabled individual dietary adjustments. The adjustments that patients maintained were not only a result of alleviation of GI symptoms, but also based on personal preferences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with IBS undergoing restrictive diets appear to benefit from structured support. However, considering the individual patient's life situation and personal preferences, individualised dietary options should be encouraged to achieve long-term dietary changes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 5","pages":"1336-1348"},"PeriodicalIF":2.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing metabolic flexibility response to a multifibre diet: a randomised-controlled trial 评估代谢灵活性对多纤维饮食的反应:随机对照试验。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-08-13 DOI: 10.1111/jhn.13350
Adrien Aubin, Hugo Hornero-Ramirez, Harimalala Ranaivo, Chantal Simon, Laurie Van Den Berghe, Nathalie Feugier Favier, Isabelle Dussous, Loïc Roger, Martine Laville, Christel Béra-Maillet, Joël Doré, Cyrielle Caussy, Julie-Anne Nazare

Introduction

Metabolic flexibility (MetF), defined as the ability to switch between fat and glucose oxidation, is increasingly recognised as a critical marker for assessing responses to dietary interventions. Previously, we showed that the consumption of multifibre bread improved insulin sensitivity and reduced low-density lipoprotein cholesterol (LDLc) levels in overweight and obese individuals. As a secondary objective, we aimed to explore whether our intervention could also improve MetF.

Methods

In this study, 39 subjects at cardiometabolic risk participated in a double-blind, randomised, crossover trial lasting 8 weeks, repeated twice. During each phase, participants consumed either 150 g of standard bread daily or bread enriched with a mixture of seven dietary fibres. MetF response was assessed using a mixed-meal tolerance test (MMTT), analysing changes in respiratory quotient (∆RQ) measured using indirect calorimetry.

Results

Although there were no significant differences in ∆RQ changes induced by dietary fibre between the two diets, these changes were positively correlated with postprandial triglyceride excursion (∆TG) at baseline. Subgroup analysis of baseline fasting and postprandial plasma metabolites was conducted to characterise MetF responders. These responders exhibited higher baseline fasting LDLc levels and greater post-MMTT ∆TG.

Conclusion

In conclusion, although dietary fibres did not directly impact MetF in this study, our findings highlight potential determinants of MetF response, warranting further investigation in dedicated future interventions.

简介代谢灵活性(MetF)被定义为在脂肪和葡萄糖氧化之间切换的能力,它越来越被认为是评估饮食干预反应的一个重要标志。此前,我们的研究表明,食用多纤维面包可提高超重和肥胖者的胰岛素敏感性,降低低密度脂蛋白胆固醇(LDLc)水平。作为次要目标,我们旨在探索我们的干预措施是否也能改善 MetF:在这项研究中,39 名有心脏代谢风险的受试者参加了一项为期 8 周的双盲、随机、交叉试验,重复两次。在每个阶段,参与者每天食用 150 克标准面包或富含七种膳食纤维混合物的面包。采用混合餐耐受试验(MMTT)评估 MetF 反应,分析间接热量计测量的呼吸商数(∆RQ)的变化:结果:虽然两种膳食纤维引起的 ∆RQ 变化没有明显差异,但这些变化与基线餐后甘油三酯偏移量(∆TG)呈正相关。对基线空腹和餐后血浆代谢物进行了分组分析,以确定 MetF 反应者的特征。这些应答者表现出较高的基线空腹低密度脂蛋白胆固醇水平和较高的餐后膳食纤维代谢物∆TG:总之,尽管在本研究中膳食纤维并未直接影响 MetF,但我们的研究结果强调了 MetF 反应的潜在决定因素,值得在未来的专门干预措施中进一步研究。
{"title":"Assessing metabolic flexibility response to a multifibre diet: a randomised-controlled trial","authors":"Adrien Aubin,&nbsp;Hugo Hornero-Ramirez,&nbsp;Harimalala Ranaivo,&nbsp;Chantal Simon,&nbsp;Laurie Van Den Berghe,&nbsp;Nathalie Feugier Favier,&nbsp;Isabelle Dussous,&nbsp;Loïc Roger,&nbsp;Martine Laville,&nbsp;Christel Béra-Maillet,&nbsp;Joël Doré,&nbsp;Cyrielle Caussy,&nbsp;Julie-Anne Nazare","doi":"10.1111/jhn.13350","DOIUrl":"10.1111/jhn.13350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Metabolic flexibility (MetF), defined as the ability to switch between fat and glucose oxidation, is increasingly recognised as a critical marker for assessing responses to dietary interventions. Previously, we showed that the consumption of multifibre bread improved insulin sensitivity and reduced low-density lipoprotein cholesterol (LDLc) levels in overweight and obese individuals. As a secondary objective, we aimed to explore whether our intervention could also improve MetF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, 39 subjects at cardiometabolic risk participated in a double-blind, randomised, crossover trial lasting 8 weeks, repeated twice. During each phase, participants consumed either 150 g of standard bread daily or bread enriched with a mixture of seven dietary fibres. MetF response was assessed using a mixed-meal tolerance test (MMTT), analysing changes in respiratory quotient (∆RQ) measured using indirect calorimetry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although there were no significant differences in ∆RQ changes induced by dietary fibre between the two diets, these changes were positively correlated with postprandial triglyceride excursion (∆TG) at baseline. Subgroup analysis of baseline fasting and postprandial plasma metabolites was conducted to characterise MetF responders. These responders exhibited higher baseline fasting LDLc levels and greater post-MMTT ∆TG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, although dietary fibres did not directly impact MetF in this study, our findings highlight potential determinants of MetF response, warranting further investigation in dedicated future interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 5","pages":"1186-1196"},"PeriodicalIF":2.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
‘My words would have more weight’: exploring weight stigma in UK dietetic practice and dietitian's lived experiences of weight stigma 我的话会更有分量":探究英国营养学实践中的体重污名化问题以及营养师的体重污名化生活经历。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-08-07 DOI: 10.1111/jhn.13337
Adrian Brown, Stuart W. Flint

Background

Weight stigma is pervasive within healthcare and negatively impacts both access to care and the patient-practitioner relationship. There is limited evidence on weight stigma among registered dietitians, particularly in the United Kingdom, though data show weight-related prejudice towards people living with obesity. The aim of this study was to examine both explicit and implicit weight stigma in practicing dietitians in the United Kingdom, as well as the lived experience of weight stigma among dietitians, both towards themselves and towards others.

Methods

An online cross-sectional survey was disseminated between February and May 2022 using snowball sampling. Inclusion criteria were that participants were UK registered dietitians aged 20–70 years.

Results

Four hundred and two dietitians responded to the survey (female [94.1%], mean age 40.2 years [standard deviation (SD) 10.7]; White ethnicity [90%]; median 12 years [interquartile range (IQR) 6, 22] within dietetic practice). Mean self-reported body mass index was 25.1 kg/m² (SD 8.7). Most dietitians reported experiencing weight stigma prior to (51%) and postregistration (59.7%), whereas nearly a quarter (21.1%) felt that weight influenced their ability as a dietitian. Weight stigma was experienced across the weight spectrum. Overall participants reported explicit weight bias attitudes, moderate beliefs that obesity is controllable and implicit antifat bias. Within open-ended responses, dietitians reported three key themes related to their personal experiences of weight stigma: (1) experiences of stigma in dietetic practice, (2) impact of weight stigma and (3) perception of weight, appearance and job.

Conclusion

This study shows that UK dietitians exhibit both explicit and implicit weight bias towards people living with obesity. Dietitians reported experiencing weight stigma, which impacted their career-related decisions and their perception of their own ability to perform as dietitians. The study highlights the need to address weight stigma and its implications within the dietetic profession.

背景:体重烙印在医疗保健领域普遍存在,对获得医疗服务以及患者与医生之间的关系都产生了负面影响。尽管有数据显示人们对肥胖患者存在与体重相关的偏见,但有关注册营养师体重鄙视的证据有限,尤其是在英国。本研究旨在调查英国执业营养师中显性和隐性的体重污名,以及营养师对自己和他人的体重污名的生活体验:在 2022 年 2 月至 5 月期间,采用滚雪球抽样法进行了在线横截面调查。纳入标准为英国注册营养师,年龄在 20-70 岁之间:42 名营养师对调查做出了回应(女性[94.1%],平均年龄 40.2 岁[标准差(SD)10.7];白人[90%];从事营养师工作的时间中位数为 12 年[四分位距(IQR)6,22])。自我报告的平均体重指数为 25.1 kg/m²(标准差为 8.7)。大多数营养师在注册前(51%)和注册后(59.7%)都曾遭遇过体重羞辱,而近四分之一(21.1%)的营养师认为体重影响了他们作为营养师的能力。体重成见在不同的体重范围内都存在。总体而言,参与者报告了明确的体重偏见态度、认为肥胖可控的适度信念和隐性的反胖偏见。在开放式回答中,营养师报告了与体重鄙视的个人经历有关的三个关键主题:(1)营养学实践中的鄙视经历;(2)体重鄙视的影响;(3)对体重、外貌和工作的看法:本研究表明,英国营养师对肥胖症患者表现出显性和隐性体重偏见。营养师报告称,他们经历了体重鄙视,这影响了他们与职业相关的决定,以及他们对自己作为营养师的能力的看法。这项研究强调了解决体重成见及其对营养师行业影响的必要性。
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引用次数: 0
A qualitative exploration of barriers, facilitators and best practices for implementing environmental sustainability standards and reducing food waste in veterans affairs hospitals 对退伍军人事务医院实施环境可持续性标准和减少食物浪费的障碍、促进因素和最佳实践进行定性探索。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-08-04 DOI: 10.1111/jhn.13357
Bethany D. Williams, Stephanie Jilcott Pitts, Stephen J. Onufrak, Emma Sirois, Anne Utech, Michelle Wood, Jessi Silverman, Funke Ajenikoko, Meghan Murphy, Amy Lowry Warnock

Background

To improve the healthfulness of foods offered while accelerating the use of environmental sustainability practices, it is important to engage hospital food service operators in the adoption of such practices. The purpose of this study was to explore barriers, facilitators and best practices for implementing environmental sustainability standards in food service among veterans affairs (VA) hospitals in the United States.

Methods

We conducted an online survey with 14 VA hospital food service directors and then 11 qualitative interviews. The survey assessed motivations for initiating sustainability standards and included a self-rating of implementation for each of five standards: increasing plant-forward dishes, procuring and serving sustainable foods that meet organic/fair trade and other certifications, procuring and serving locally produced foods, reducing food waste and reducing energy consumption. Interviews were transcribed verbatim. Qualitative analysis, including coding of themes and subthemes, was conducted by two coders to determine barriers, facilitators and best practices for each of these five standards. Quantitative methods (counts and frequencies) were used to analyse the survey data.

Results

Participants had an average of 5 years of experience implementing sustainability standards. The top three motivators cited were reducing food waste, serving healthier foods and increasing efficiency or cost savings. Barriers revolved around patient preferences, contractual difficulties and costs related to reducing waste. Facilitators included taste testing new recipes that include more sustainable food options and easy access to sustainable products from the prime vendor. Best practices included making familiar dishes plant-forward and plate waste studies to prevent overproduction.

Conclusions

Although there were many barriers to implementation, food service directors had solutions for overcoming challenges and implementing food service sustainability standards, which can be tested in future sustainability initiatives.

背景:为了提高所提供食品的健康水平,同时加快环境可持续发展实践的使用,让医院餐饮服务经营者参与采用此类实践非常重要。本研究旨在探讨美国退伍军人事务(VA)医院在餐饮服务中实施环境可持续性标准的障碍、促进因素和最佳实践:我们对 14 家退伍军人医院的餐饮服务主管进行了在线调查,然后进行了 11 次定性访谈。调查评估了启动可持续发展标准的动机,并对以下五项标准的执行情况进行了自我评分:增加植物性菜肴、采购和供应符合有机/公平贸易和其他认证的可持续发展食品、采购和供应本地生产的食品、减少食物浪费和降低能耗。访谈内容逐字记录。由两名编码员进行定性分析,包括对主题和次主题进行编码,以确定这五个标准中每个标准的障碍、促进因素和最佳实践。定量方法(计数和频率)用于分析调查数据:结果:参与者平均有 5 年实施可持续发展标准的经验。他们提到的前三大动力是减少食物浪费、提供更健康的食物以及提高效率或节约成本。障碍主要是病人的喜好、合同困难以及与减少浪费有关的成本。促进因素包括对包含更多可持续食品选择的新食谱进行试吃,以及从主要供应商处轻松获得可持续产品。最佳做法包括将熟悉的菜肴改成植物性菜肴,并进行餐盘浪费研究,以防止生产过剩:尽管在实施过程中会遇到很多障碍,但餐饮服务总监们有办法克服挑战,实施餐饮服务可持续发展标准,这些办法可以在未来的可持续发展倡议中进行测试。
{"title":"A qualitative exploration of barriers, facilitators and best practices for implementing environmental sustainability standards and reducing food waste in veterans affairs hospitals","authors":"Bethany D. Williams,&nbsp;Stephanie Jilcott Pitts,&nbsp;Stephen J. Onufrak,&nbsp;Emma Sirois,&nbsp;Anne Utech,&nbsp;Michelle Wood,&nbsp;Jessi Silverman,&nbsp;Funke Ajenikoko,&nbsp;Meghan Murphy,&nbsp;Amy Lowry Warnock","doi":"10.1111/jhn.13357","DOIUrl":"10.1111/jhn.13357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To improve the healthfulness of foods offered while accelerating the use of environmental sustainability practices, it is important to engage hospital food service operators in the adoption of such practices. The purpose of this study was to explore barriers, facilitators and best practices for implementing environmental sustainability standards in food service among veterans affairs (VA) hospitals in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an online survey with 14 VA hospital food service directors and then 11 qualitative interviews. The survey assessed motivations for initiating sustainability standards and included a self-rating of implementation for each of five standards: increasing plant-forward dishes, procuring and serving sustainable foods that meet organic/fair trade and other certifications, procuring and serving locally produced foods, reducing food waste and reducing energy consumption. Interviews were transcribed verbatim. Qualitative analysis, including coding of themes and subthemes, was conducted by two coders to determine barriers, facilitators and best practices for each of these five standards. Quantitative methods (counts and frequencies) were used to analyse the survey data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants had an average of 5 years of experience implementing sustainability standards. The top three motivators cited were reducing food waste, serving healthier foods and increasing efficiency or cost savings. Barriers revolved around patient preferences, contractual difficulties and costs related to reducing waste. Facilitators included taste testing new recipes that include more sustainable food options and easy access to sustainable products from the prime vendor. Best practices included making familiar dishes plant-forward and plate waste studies to prevent overproduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although there were many barriers to implementation, food service directors had solutions for overcoming challenges and implementing food service sustainability standards, which can be tested in future sustainability initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 6","pages":"1420-1431"},"PeriodicalIF":2.9,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypomagnesaemia, an independent risk factor for the development of post-transplant diabetes mellitus in liver and renal transplant recipients? A systematic review 低镁血症是肝移植和肾移植受者发生移植后糖尿病的独立风险因素?系统综述。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-07-29 DOI: 10.1111/jhn.13354
Shujie Chen, David Geoffrey Bowen, Ken Liu, Helen Vidot

Background

Post-transplantation diabetes mellitus (PTDM) is common after solid organ transplantation. In the past decade, there has been increasing interest in the association between hypomagnesaemia and the development of PTDM. This systematic review aimed to investigate the current knowledge regarding the association between hypomagnesaemia and PTDM in adult liver and renal transplant recipients.

Methods

A literature search of five databases, Medline, Embase, ProQuest, Scopus and Google Scholar, as well as article reference lists, was performed. Eligible studies that focused on adult liver and renal transplant recipients without pretransplantation hyperglycaemia or diabetes were included. Other eligibility criteria included quantitative studies which reported magnesium concentrations, studies with at least 6 months of follow-up, and studies published in English. The Newcastle–Ottawa Assessment Tool was used for the quality assessment.

Results

In total, 12 studies were included in the final analysis. Eleven focused on renal transplantation and one on liver transplantation. All studies were medium to high quality with eight out of 12 achieving the highest rating of nine. Eight studies found a negative association between either pretransplant or early post-transplant serum magnesium concentration and the risk of PTDM, three studies found no association between these two variables, and one study found a positive association between the magnesium concentration at 8 weeks after transplantation and glycosylated haemoglobin A1C.

Conclusions

Further large-scale prospective studies with at least 6 months of follow-up are needed to confirm these findings, particularly in liver transplantation, to further clarify and explore the relationship between hypomagnesaemia and PTDM.

背景:移植后糖尿病(PTDM)是实体器官移植后的常见病。在过去十年中,人们越来越关注低镁血症与 PTDM 发生之间的关系。本系统性综述旨在调查有关成人肝移植和肾移植受者低镁血症与 PTDM 之间关系的现有知识:方法:对 Medline、Embase、ProQuest、Scopus 和 Google Scholar 五个数据库以及文章参考文献目录进行了文献检索。符合条件的研究主要针对没有移植前高血糖或糖尿病的成年肝脏和肾脏移植受者。其他合格标准包括报告镁浓度的定量研究、随访至少 6 个月的研究以及以英语发表的研究。质量评估采用纽卡斯尔-渥太华评估工具:最终分析共纳入了 12 项研究。其中 11 项侧重于肾移植,1 项侧重于肝移植。所有研究的质量均为中等至高等,12 项研究中有 8 项达到最高的 9 分。八项研究发现移植前或移植后早期血清镁浓度与 PTDM 风险之间存在负相关,三项研究发现这两个变量之间没有关联,一项研究发现移植后 8 周的镁浓度与糖化血红蛋白 A1C 之间存在正相关:结论:需要进一步开展至少随访 6 个月的大规模前瞻性研究来证实这些发现,尤其是在肝移植中,以进一步澄清和探讨低镁血症与 PTDM 之间的关系。
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引用次数: 0
The evolution of nutritional care in preterm infants with a focus on the extreme preterm infant 早产儿营养护理的演变,重点关注极早产儿。
IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Pub Date : 2024-07-25 DOI: 10.1111/jhn.13353
Moriam Mustapha, Hester Blair, Nadia Leake, Vanessa Johnson, Chris H. P. van den Akker, Nicholas D. Embleton

The evolution of nutritional care in preterm infants, particularly those classified as extremely preterm, has undergone significant advancements in recent years. These infants, born at less than 28 weeks of gestation, face unique challenges related to their elevated nutrient requirements, underdeveloped organ systems and minimal reserves, posing a need for timely and specialised nutritional strategies. Historically, the nutritional management of preterm infants focussed on short-term goals to promote survival. In recent years, the focus has shifted to the quality of nutrient provision to optimise neurodevelopment and longer-term health outcomes. This review highlights the shift from a generalised nutritional approach to a robust, evidence-based approach for preterm infants, acknowledging the intricate interplay between nutrition, holistic care and developmental outcomes. As neonatal care continues to evolve, ongoing research will refine nutritional interventions, optimise growth and enhance the long-term health outcomes of these vulnerable infants.

早产儿,尤其是被归类为极早产儿的早产儿的营养护理近年来取得了长足的进步。这些出生时妊娠不足 28 周的婴儿面临着独特的挑战,他们对营养物质的需求量大、器官系统发育不完善且储备极少,因此需要及时采取专门的营养策略。从历史上看,早产儿的营养管理侧重于促进存活的短期目标。近年来,重点已转移到营养供给的质量上,以优化神经发育和长期健康结果。本综述强调了早产儿营养管理方法从笼统的营养管理方法向稳健的循证管理方法的转变,承认营养、整体护理和发育结果之间错综复杂的相互作用。随着新生儿护理的不断发展,正在进行的研究将完善营养干预措施,优化生长发育,提高这些脆弱婴儿的长期健康状况。
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引用次数: 0
期刊
Journal of Human Nutrition and Dietetics
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