Canadian Journal of Dietetic Practice and Research最新文献

Purpose: Malnutrition is an underdiagnosed and undertreated medical condition among hospitalized patients. Validated nutritional care algorithms guide dietitians in identifying malnutrition and elaborating appropriate nutritional care plans for malnourished patients. This study describes how malnutrition was managed in a Canadian hospital that implemented the Integrated Nutrition Pathway for Acute Care (INPAC) algorithm. Methods: Retrospective chart audits were conducted using electronic medical records of all malnourished hospitalized patients admitted to nine acute care units in 2017 and 2019 to describe nutritional care plans during their hospitalization and at discharge. Results: A total of 158 and 122 patients were identified as malnourished in 2017 and 2019, respectively. All malnourished patients (100%) in 2017 and 2019 were provided with a nutritional care plan by a dietitian during their hospitalization. Nutritional discharge planning was more frequent in 2019 (n = 53, 43%), compared to 2017 (n = 46, 29%). The use of oral nutritional supplements (ONS) at mealtime remained the most commonly used nutritional intervention during hospitalization in 2017 (n = 106, 67.1%) and 2019 (n = 81, 66.4%). However, the assistance of a dietetic technician had become as frequently used as ONS at mealtime in 2019 (n = 81, 66.4%). Referring patients to an outpatient clinic represented the most frequently used nutritional intervention during discharge planning in both years (n = 20, 43.5% in 2017 and n = 35, 66.0% in 2019). Conclusions: All malnourished patients received a nutritional care plan during their hospitalization, but only half were provided with a nutrition care plan at discharge. Future studies are needed to assess the impact of nutritional interventions on malnourished patients during hospitalization and at discharge and to clarify the optimal number and types of interventions required to treat malnutrition.

Purpose: Dietitians play a key role in diabetes care. Offering mentorship to increase the capacity of dietitians to provide overall diabetes care may improve outcomes and experiences of people living with diabetes (PWD). The objectives of this study are to assess the perceived need of dietitians for mentorship in diabetes and their preferences for mentorship structure and content.Methods: A 28-question online survey was developed, piloted with 7 dietitians through cognitive interviewing, and disseminated to dietitians in Quebec, Canada. Quantitative data were analyzed descriptively, and survey responses were stratified by years of clinical experience.Results: Of 284 respondents (97% women, mean age 41 ± 10 years), 97% (n = 275) identified a need for mentorship in diabetes. Desire to participate as a mentee, mentor, or both was dependent on years of clinical experience. Formal mentorship was preferred by 41% of respondents, informal by 30%, and 29% preferred a combination of both. The type of mentorship was independent of the years of experience. Finally, 94% believed their confidence levels in providing care for PWD would increase if they participated in mentorship.Conclusion: Mentorship in diabetes was perceived favourably and is believed to increase dietitians' confidence level in caring for PWD and for interprofessional collaboration.

Purpose: The growing interest in digital health applications (apps) in dietetic practice prompted the current study aimed to describe app use among Registered Dietitians (RDs) in Alberta. Methods: A cross-sectional web-based survey was developed, drafted in REDCap, and tested with RDs. The College of Dietitians of Alberta distributed it to all registered members via email list. RDs registered with the College were eligible to participate. Responses were analyzed using descriptive statistics and single level structural coding of open-ended responses. Results: Of the 290 RDs who partially or fully completed the survey, 74.5% used and 84.9% recommend apps to patients in their practice. Barriers to use include patient technological self-efficacy and uncertainty about which apps to recommend. RDs desire guidance and support from professional organizations in selecting and using apps, highlighting the need for evidence-based evaluation criteria for apps. RDs emphasized the need for user-friendly, evidence-based, secure apps tailored to specific nutrition management needs. Conclusions: RDs in Alberta are using and recommending apps in their practice despite limited evidence regarding their effectiveness in improving health outcomes. Collaborative efforts among RDs, app developers, and health organizations are essential to address current limitations and advance the use of apps in dietetic practice.

Purpose: Dietitians (RDs) are well-positioned to drive food system transformation by supporting dietary patterns sourced from sustainable food systems (SFS). This research aims to identify how RDs conceptualize sustainability, describe SFS activities, define success, and determine the knowledge and skills required to practice in this area. Methods: A convenience sample of Canadian RDs completed a cross-sectional survey with open- and close-ended questions. Quantitative data were analyzed using descriptive statistics. Qualitative responses were thematically analyzed. Practice activities were mapped using the Socioecological Framework (SEF). Results: A diverse sample (n = 92) reported using common SFS definitions, frameworks, or other documents. Practice activities were reported on all levels of the SEF. Dietitians reported successes; however, the vagueness or responses suggested it may be too early to quantify these. Dietitians reported needing foundational and practice area-specific knowledge and skills and practical examples to support SFS in practice. Conclusions: Canadian RDs in this study demonstrated significant work in SFS using skills they developed to practice in other areas of dietetics. There is an opportunity to expand impact by sharing existing resources, developing new supports that include Indigenous perspectives and systems thinking, evolving RD roles, increasing macro-level strategies, and identifying success indicators to monitor impact.

Conventional food systems lead to environmental degradation and nutrient deficiencies, contributing to poor health. Conceptualizing dietetic practice by practice areas limits how dietitians (RDs) see the relevance of food systems to practice and potential actions to contribute to more healthy, sustainable food systems. RDs are well-positioned to promote sustainable food systems (SFS) because they work across the food system landscape: Food Production, Economic, Political, Consumer Demand, and Health Systems. In this article, we invite RDs to view SFS activities through a systems lens, bringing more awareness to their impact. This includes identifying leverage points - actions that have a larger impact than their immediate outcome - and unintended negative consequences of recommendations. We discuss findings from a scoping review that included 11 peer-reviewed and 16 grey literature articles and chart practice activities, tools and recommendations according to practice area and the food system landscape. Findings demonstrate there are several existing activities and areas for further growth. Framing practice activities across the food system landscape, facilitates understanding of the interconnected nature of the food system to get to the root cause of problems. As a self-determining profession, dietitians determine the degree of influence they have in supporting the transition to sustainable dietary patterns.

The negative experiences of Indigenous children who attended Indian residential school are well documented. A scoping review of the peer-reviewed and grey literature was conducted, following the methodological framework of Arksey and O'Malley (2005). Most documents focused on the impacts of residential schooling among First Nations, but some included Métis and Inuit. Sixty-eight articles were selected for inclusion, analyzed and categorized by theme. Themes identified stemming from Indian residential schools' food policies and practices included disruption in traditional food ways; underfeeding, child labour; and increased rates of obesity and diabetes later in life. Future strengths-based research utilizing Indigenous methodologies is needed to examine how allies and Indigenous communities are involved in actions to restore traditional food systems.

Purpose: To examine the associations between dairy-derived saturated fat from fluid cow's milk, cheese, and yogurt, and body composition [body mass index z-scores (BMIz), fat mass index (FMI), and waist-to-height ratio (WHtR)] in children aged 1.5-5 years. Methods: This cross-sectional study used baseline data from 267 children (3.5 ± 1.2 years) from the Guelph Family Health Study. Dairy-derived saturated fat intake (g/1000 kcal) was assessed via one 24-hour dietary recall completed by parents using the web-based Automated Self-Administered 24-Hour Dietary Assessment Tool 2016 - Canadian version. Linear regression using generalized estimating equations explored associations between dairy-derived saturated fat intake and BMIz and FMI, adjusted for physical activity, household income, parent education, and child ethnicity; WHtR was additionally adjusted for age and sex. Results: Total dairy- and milk-derived saturated fat were not associated with any body composition outcomes. Cheese-derived saturated fat intake was positively, but marginally associated with BMIz (B̂ = 0.03, 95% CI: 0.01 to 0.06, p = 0.013), while yogurt-derived saturated fat was inversely associated with FMI (B̂ = -0.19, 95% CI: -0.34 to -0.04, p = 0.015). Conclusions: These cross-sectional findings may inform dietary guidelines to recognize the neutral or potentially beneficial effects of saturated fat from dairy products on body composition in young children. Longitudinal studies are warranted.

LGBTQ+ inclusion in dietetics education is essential to fostering culturally safe and structurally responsive learning environments. Drawing on auto-theory informed by poststructuralism, I reflect on a piece of student feedback that described the LGBTQ+ content in my course as excessive and suggested that such excess denied discussion about other historically excluded groups. This feedback illustrates how cis-heteronormative assumptions shape expectations about what counts as appropriate, balanced, or necessary content in professional education. Using the queer expression "No T, no shade, no pink lemonade," I explore how power, discourse, and affect emerge in moments of discomfort and curricular critique. I consider how such moments offer opportunities for reflexivity and deeper attention to the norms that shape belonging, visibility, and legitimacy in professional training. This paper contributes to ongoing efforts to embed cultural safety into dietetics curricula in ways that are reflexive, relational, and justice-oriented.

The Good Food for Learning Population Health Intervention Research Project piloted a universal school lunch program in select Saskatoon elementary schools. Digital photography-assisted weighing (DPAW) was used to conduct plate waste audits to determine student food consumption. DPAW is a novel method, thought to be too labour-intensive to be used in schools. The purpose of the study was to determine the practicalities of using DPAW plate waste audits in elementary schools from research assistants' (RAs') viewpoint. Semi-structured, 30-45-minute virtual interviews were conducted with former RAs and research supervisors involved in data collection during the 2021 and 2023 phases of the Good Food for Learning Project. Ultimately, 11 of 16 prospective participants were interviewed. A hybrid approach of deductive and inductive data coding was used for thematic analysis. We found that although most of the RAs wanted to improve in-person training and coordination with school staff, most reported that they would recommend this method to other researchers carrying out studies under similar settings. This study shows that RAs support the feasibility of DPAW plate waste audits in elementary schools, though some challenges need to be addressed to improve implementation.