Dietetic Research Research Articles

Abstracts from Dietetic Research Event – June 14, 2013

From the west coast of Canada it is with great pleasure that I welcome you to beautiful Victoria, host city of the 2013 Dietitians of Canada Annual Conference Research Event. This year the Canadian Foundation for Dietetic Research received many high quality abstracts that clearly illustrate diverse interests and issues faced by members in everyday dietetic practice. Through the continued support of Dietitians of Canada and Canadian Foundation for Dietetic Research, the 2013 Research Event has shaped up to be an inspiring forum for strengthening the practice of Canadian dietitians from coast to coast to coast.The topics showcased in this year’s abstracts span a broad scope of practice areas that include Public Health Nutrition, Undergraduate Education and Dietetic Internship, Patient Services, and using Technology in Health Education, to name a few. Moreover, the findings help us to better understand the effects of ethnicity, socioeconomic, gender, and age on health and illness.New to this year’s event, each presenter will provide a 10-minute oral presentation followed by a short question period. This lively format replaces the electronic posters and 20-minute presentations used in the past and is sure to ignite plenty of enthusiastic discussion! As you listen to and reflect on the issues that your colleagues passionately share, I urge you to consider how you can become more involved in the research and experience-sharing process. Discuss an idea with a presenter you would like to meet or with colleagues you already know. By engaging our curious minds in critical dialogue, together we will continue to strengthen dietetic knowledge and practice in Canada.A successful Research Event requires dedicated work and commitment from many people. On behalf of Dietitians of Canada and Canadian Foundation for Dietetic Research, I would like to extend a special thank you to the members of the 2013 Abstracts Review Committee who represented community nutrition, private practice, clinical nutrition, food service, and academic areas of expertise and practice and worked collaboratively to ensure an outstanding line-up of research: Colleen McGuire (atthetablenutrition.com), Dani Shahvarani-Renouf (4elementshealth. wordpress.com), Dr. Evelyn Cornelissen (Research, Southern Medical Program, Faculty of Medicine, University of British Columbia), Gerry Kasten (Community Nutritionist, Squamish Community Health Centre, Vancouver Coastal Health), Mahsa Jessri (PhD Candidate, Faculty of Medicine, University of Toronto), and Mohsen Saberi (Food Services Manager, University of British Columbia Hospital). I would also like to express my gratitude to Dr. Daphne Lordly (Associate Professor, Mount St. Vincent University), Dr. Karen Davison (Instructor, Langara College), and Theresa Cividin (Practice Leader, Clinical Nutrition, Vancouver Coastal Health) for graciously moderating research sessions. And finally, a special thank you to Diana Sheh at Dietitians of Canada and Isla Horvath at Canadian Foundation for Dietetic Research for guiding the Committee through the inaugural use of an online abstract review system and in scheduling the research presentations.I look forward to seeing you at the Research Event on June 14th to celebrate an impressive selection of dietetic research that is happening in Canada from resplendent coast to coast to coast.

English

Introduction Existing guidelines on nutrition support in patients with cancer cachexia state limited evidence for the beneficial effects of n-3 polyunsaturated fatty acids (PUFAs) on clinical outcome. In order to report on the latest evidence for n-3 PUFAs in cancer cachexia, we conducted a systematic literature review of randomized controlled trials (RCTs), comparing the effects on clinical outcome parameters of oral or enteral supplementation of n-3 PUFAs in cancer patients receiving chemotherapy, radiotherapy, surgery or palliative care. Materials and methods In PubMed, EMBASE and the Cochrane Library, search terms on cancer, n-3 PUFAs and clinical outcome parameters (nutritional status, morbidity, mortality and quality of life) were entered on 1 April 2013, using limits for adults, humans and English language. The quality and evidence of the retrieved publications were appraised by an expert team of Australian and Dutch dieticians and nutritionists, using the ADA grading system. Fifteen RCTs were retrieved. Results Nine RCTs were of positive quality, five of neutral quality and one of negative quality and were performed in patients with various types of cancer. Fair evidence shows that supplementation of n-3 PUFAs appears to be safe and may improve the quality of life and physical activity in patients with cancer. However, supplementation of n-3 PUFAs does not improve energy or protein intake, appetite or survival and does not reduce postoperative complications. The evidence for the effect on body weight, fatfree mass and performance status remains inconclusive. Conclusion Supplementation of n-3 PUFAs may have some positive effects in patients with cancer. Introduction Cancer cachexia, a complex metabolic syndrome associated with underlying illness, characterized by an increased inflammatory status and loss of muscle mass with or without loss of fat mass, is highly prevalent among patients with cancer1–7. This syndrome is a result of complex alterations in carbohydrate, lipid and protein metabolism8,9, caused by inflammatory mediators such as cytokines and tumour-derived catabolic drivers10. Proteolysis-inducing factor (PIF) is produced by the tumour and induces protein catabolism11. As a result of the acute-phase response, the liver shows an increased protein turnover for the production of inflammatory mediators, using muscle mass to release amino acids9,10. Changes in lipid metabolism in cancer include a reduction of lipogenesis, with unchanged whole-body lipolysis and mobilization of fatty acids from fat tissue. Alterations in glucose metabolism are reflected by glucose intolerance and insulin resistance8,9,11. Thus far, conventional nutritional support has been limited in its ability to stabilize body weight and maintain fat-free mass in patients with cachexia. Pharmaceutical interventions sometimes improved appetite, body weight and quality of life, but weight gain mostly consisted of fat mass12–15. n-3 Polyunsaturated fatty acids (PUFAs), especially eicosapentaenoic acid (EPA), seem to be promising agents to treat cancer cachexia. A dose of around 2 g of EPA per day (alone or combined with docosahexaenoic acid, DHA) appears to decrease the production of proinflammatory cytokines16,17 and PIF and is associated with stabilization of body weight and probably fat-free mass13,18. This has been shown in animal studies and in nonrandomized human trials in pancreatic cancer patients19,20. However, randomized controlled trials (RCTs) show contradictory results21–26. This may be due to issues related to study limitations, such as the disease severity, confounding factors and nonadherence with n-3 PUFA supplements. Also, study designs and outcome parameters differ in terms of supplementation dosage, * Corresponding author Email: b.vandermeij@vumc.nl 1 Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center Amsterdam, the Netherlands 2 Centre for Dietetics Research, School of Human Movement Studies, University of Queensland, Brisbane, Australia 3 Department of Nutrition and Dietetics, Royal Brisbane & Women’s Hospital, Brisbane, Australia 4 Department of Nutrition and Dietetic Services, Princess Alexandra Hospital, Brisbane, Australia 5 Department of Surgery, VU University Medical Center Amsterdam, the Netherlands

University Students’ Reservations: About Dietetics as a Career Choice

Dietetics students' reservations about their career choice were investigated. In several dietetics programs in various provinces, an in-class or online survey was administered to students in the early or late stages of their education (n=397). Data were coded and analyzed, using descriptive statistics. Chi-square testing for independence was used to establish significant relationships. Forty-three percent (n=149) of those responding to the research question (n=344) indicated they had reservations about a dietetics career, primarily because of internship, salary, and employment concerns. Students enrolled in a coordinated internship/degree program experienced no reservations about internship. Students experienced fewer career reservations when they had made their career decision before grade 12, were influenced by a dietitian, or were in the later stages of their education. Findings have implications for dietetics recruitment, retention, research, and education. An understanding of sources of reservations about career choice will allow policy-makers, researchers, and educators to address issues to ensure that potential professionals are well informed about career components and that educational programs meet students' needs.

Water and sodium intake habits and status of ultra-endurance runners during a multi-stage ultra-marathon conducted in a hot ambient environment: an observational field based study

BackgroundAnecdotal evidence suggests ultra-runners may not be consuming sufficient water through foods and fluids to maintenance euhydration, and present sub-optimal sodium intakes, throughout multi-stage ultra-marathon (MSUM) competitions in the heat. Subsequently, the aims were primarily to assess water and sodium intake habits of recreational ultra-runners during a five stage 225 km semi self-sufficient MSUM conducted in a hot ambient environment (Tmax range: 32°C to 40°C); simultaneously to monitor serum sodium concentration, and hydration status using multiple hydration assessment techniques.MethodsTotal daily, pre-stage, during running, and post-stage water and sodium ingestion of ultra-endurance runners (UER, n = 74) and control (CON, n = 12) through foods and fluids were recorded on Stages 1 to 4 by trained dietetic researchers using dietary recall interview technique, and analysed through dietary analysis software. Body mass (BM), hydration status, and serum sodium concentration were determined pre- and post-Stages 1 to 5.ResultsWater (overall mean (SD): total daily 7.7 (1.5) L/day, during running 732 (183) ml/h) and sodium (total daily 3.9 (1.3) g/day, during running 270 (151) mg/L) ingestion did not differ between stages in UER (p < 0.001 vs. CON). Exercise-induced BM loss was 2.4 (1.2)% (p < 0.001). Pre- to post-stage BM gains were observed in 26% of UER along competition. Pre- and post-stage plasma osmolality remained within normal clinical reference range (280 to 303 mOsmol/kg) in the majority of UER (p > 0.05 vs. CON pre-stage). Asymptomatic hyponatraemia (<135 mmol/L) was evident pre- and post-stage in n = 8 UER, corresponding to 42% of sampled participants. Pre- and post-stage urine colour, urine osmolality and urine/plasma osmolality ratio increased (p < 0.001) as competition progressed in UER, with no change in CON. Plasma volume and extra-cellular water increased (p < 0.001) 22.8% and 9.2%, respectively, from pre-Stage 1 to 5 in UER, with no change in CON.ConclusionWater intake habits of ultra-runners during MSUM conducted in hot ambient conditions appear to be sufficient to maintain baseline euhydration levels. However, fluid over-consumption behaviours were evident along competition, irrespective of running speed and gender. Normonatraemia was observed in the majority of ultra-runners throughout MSUM, despite sodium ingestion under benchmark recommendations.

Dietetic research impact and influence: the power of strong coalitions

Dietetic research impact and influence: the power of strong coalitions

Abstracts from Dietetic Research Event – June 14-15, 2012

Welcome to Toronto! On behalf of the Canadian Foundation for Dietetic Research, it is my great pleasure to welcome you to the 2012 Dietitians of Canada Annual Conference Research Event. This preeminent event represents the breadth and depth of dietetic research in Canada. This year we had a record-breaking number of almost 100 abstract submissions! This exemplifies the strong and significant role dietitians are playing in the research community to support all areas of dietetic practice. To date, we already have over 950 delegates attending the conference with 36 oral presentations and over 50 research posters. The abstracts cover topics including clinical nutrition, communitybased nutritional care, nutrition needs of vulnerable groups, wellness and public health, dietetic practice and education, and food safety and policy. The broad spectrum of topics is one of the exciting aspects of our profession. This will surely be a great opportunity to reacquaint yourself with old friends and to meet new colleagues through your common research interests and practice. I wish to acknowledge and congratulate all the presenters and co-authors for all their hard work and for sharing their research. New to this year’s event will be the electronic poster sessions, which is based on the popular Poster Tours from previous years. Each presenter will speak about the highlights of his/her research while the presenter’s poster is projected on to a large LCD screen. On behalf of the membership of Dietitians of Canada, I would like to thank the Abstracts Review Committee members who took time out of their busy schedules to volunteer their expertise in reviewing the abstracts. Our Abstracts Review Committee represented a broad spectrum of dietetic expertise and professional practice. I wish to thank them for their tremendous effort and contribution. Thank you to: Beth Armour from PEN of Dietitians of Canada, Dr. Pauline Darling from St. Michael’s Hospital and the University of Toronto, Dr. Alison Duncan from the University of Guelph, Mahsa Jessri from the University of Alberta, Christine Mehling from EatRight Ontario, and Dawna Royall from the Canadian Journal of Dietetic Practice and Research. I would also like to acknowledge the following individuals who will assist with moderating the oral and poster sessions in conjunction with the Committee members. Thank you to: Barb Anderson, Isla Horvath, Jane Thirsk, and Pat Vanderkooy. A special thank you also goes to Isla Horvath from the Canadian Foundation for Dietetic Research and Diana Sheh from Dietitians of Canada in supporting the Committee in the abstracts review process. Finally, I would like to acknowledge the Canadian Foundation for Dietetic Research and Dietitians of Canada for their ongoing support of research in dietetics and nutrition in Canada and for their mission to foster and support new researchers and dietetic interns in this important area of practice. Please join me in celebrating this exciting event and the research of your fellow colleagues.

Dietary Intervention Targeting Increased Fiber Consumption for Metabolic Syndrome

Metabolic syndrome is highly prevalent in the U.S. and is a harbinger of diabetes and cardiovascular disease (CVD). With the staggering rise of diet-related chronic diseases such as diabetes and CVD, simple and effective dietary intervention strategies are needed. National dietary recommendations are ever-changing and complex, which can be overwhelming and confusing for individuals who are trying to prevent or manage a chronic condition. Some evidence suggests that healthy changes in one area of diet are associated with healthy changes in other untargeted areas of diet (1, 2). There is an opportunity to bridge a dietetics research gap by testing a simple dietary message focusing on fiber intake to improve risk factors of the metabolic syndrome.

Publishing Nutrition Research: A Review of Multivariate Techniques—Part 2: Analysis of Variance

This article is the eighth in a series exploring the importance of research design, statistical analysis, and epidemiology in nutrition and dietetics research, and the second in a series focused on multivariate statistical analytical techniques. The purpose of this review is to examine the statistical technique, analysis of variance (ANOVA), from its simplest to multivariate applications. Many dietetics practitioners are familiar with basic ANOVA, but less informed of the multivariate applications such as multiway ANOVA, repeated-measures ANOVA, analysis of covariance, multiple ANOVA, and multiple analysis of covariance. The article addresses all these applications and includes hypothetical and real examples from the field of dietetics.

Abstracts from Dietetic Research Event – June 16-17, 2011

I wish to welcome everyone to Edmonton and the 2011 Dietitians of Canada Annual Conference Research Event. This year we have over 600 participants attending the conference with over 80 research posters and oral presentations that span topics from clinical nutrition to food policy to research methodology to community nutrition and dietetic practice and education. This year the breadth of research was very strong indicating the strong role that dietitians play in conducting evidenced based nutrition research that supports dietetic practice in all areas of professional practice. I wish to congratulate each and every presenter for sharing their research and for all their hard work. This year we will continue with the Poster Tours. These tours allow each presenter to discuss the highlights of his/her research under the guidance of one of the abstract review committee members and/or graduate students. These sessions are very interactive and also provide those attending the tours the opportunity to network with other dietetic researchers in Canada. We hope that you will enjoy these tours once again. On behalf of the membership of Dietitians of Canada, I would like to thank the Abstracts Review Committee members who took the time from their busy schedules to provide their expertise to review these abstracts. Our abstract committee represented a broad spectrum of dietetic expertise from professional practice sectors across Canada. I wish to thank them for their hard work. Thanks go to: Dr(s) Kate Storey, Laura Forbes, Justine Turner, Anna Farmer, Michelle MacKenzie, Vera Mazurak and Heidi Bates from the University of Alberta, Lyn Zuberbuhler and Tanis Fenton from Alberta Health Services, Alice Lee from Covenant Health, Roula Tzianetas from Mount Sinai Hospital, Roseann Nasser from Regina Qu'Appelle Health Region, Dr Christine Lengyel from the University of Manitoba and Dr. Frances Rioux from the University of Ottawa. I would also like to acknowledge the Canadian Foundation for Dietetic Research and Dietitians of Canada for their ongoing support of practice based research in Canada and for their vision of supporting dietetic training and research in this important area of practice. Please join me in celebrating Canadian Dietetic Research by attending the poster presentations on Thursday and Friday (June 16 and 17) and the oral presentations on Friday, June 17 in the afternoon.

2011 ADA Member Benefits Update

2011 ADA Member Benefits Update

To reform or be reformed: Can clinical dietitians survive without research as part of their everyday practice?

To reform or be reformed: Can clinical dietitians survive without research as part of their everyday practice?

Ethical requirements for nutrition and dietetic research

Ethical requirements for nutrition and dietetic research

Qualitative research in nutrition and dietetics: data collection issues

The wide scope of qualitative enquiry presents the researcher with a number of choices regarding data collection and sampling. Selecting data collection and sampling techniques can therefore be somewhat daunting, particularly because, often, there is no single, universally accepted 'correct' option. Appropriate research methods are, however, crucial to ensure high-quality research. This review, the second in the series, provides an overview of the principal techniques of data collection and sampling that may be used for qualitative research in nutrition and dietetics. In addition, it describes a process for choosing appropriate data collection and sampling methods that considers the extent to which they provide data that answers the research question(s) and are compatible with the philosophical assumptions about ontology, epistemology and methodology that underpin the overall design of a study. Finally, it discusses the central role that the researcher plays in qualitative data collection and encourages researchers to acknowledge and reflect upon their impact on the data. Other reviews in this series provide a model for embarking on a qualitative research project in nutrition and dietetics, an overview of the principal techniques of data analysis and quality assessment of this kind of research, and some practical advice relevant to nutrition and dietetics, along with glossaries of key terms.

Qualitative research in nutrition and dietetics: assessing quality

In recent years, qualitative research has become much more widely used in healthcare settings and undoubtedly has much to offer nutrition and dietetics. Its value is, however, still sometimes called into question and, for those unfamiliar with qualitative approaches, it can be difficult to grasp what distinguishes 'good' qualitative research from that which has been less rigorously conceived and conducted. This review, the fourth in the series, aims to highlight some of the key scientific debates around the quality criteria that can be applied to qualitative research, and offers some flexible guidelines that may be used both in producing and assessing qualitative health research, including studies in nutrition and dietetics. Other reviews in this series provide a model for embarking on a qualitative research project in nutrition and dietetics, an overview of the principal techniques of data collection, sampling and analysis and some practical advice relevant to nutrition and dietetics, along with glossaries of key terms.

Qualitative research in nutrition and dietetics: data analysis issues

Although much of the analysis conducted in qualitative research falls within the broad church of thematic analysis, the wide scope of qualitative enquiry presents the researcher with a number of choices regarding data analysis techniques. This review, the third in the series, provides an overview of a number of techniques and practical steps that can be taken to provide some structure and focus to the intellectual work of thematic analysis in nutrition and dietetics. Because appropriate research methods are crucial to ensure high-quality research, it also describes a process for choosing appropriate analytical methods that considers the extent to which they help answer the research question(s) and are compatible with the philosophical assumptions about ontology, epistemology and methodology that underpin the overall design of a study. Other reviews in this series provide a model for embarking on a qualitative research project in nutrition and dietetics, an overview of the principal techniques of data collection, sampling and quality assessment of this kind of research and some practical advice relevant to nutrition and dietetics, along with glossaries of key terms.

Qualitative research in nutrition and dietetics: getting started

Qualitative research is well placed to answer complex questions about food-related behaviour because it investigates how and why individuals act in certain ways. The field of qualitative health research is undoubtedly gaining momentum and, increasingly, there is a recognition that it should be a vital part of the decision-making processes that direct the development of health policy and practice. Much of the guidance available, however, is difficult to navigate for those new to 'qualitative research', and there is little discussion of qualitative research issues specifically in relation to nutrition and dietetics. This review, the first in a series, outlines the field of qualitative enquiry, its potential usefulness in nutrition and dietetics, and how to embark upon this type of research. Furthermore, it describes a process to guide high-quality qualitative research in this area that proceeds from the research question(s) and considers the key philosophical assumptions about ontology, epistemology and methodology that underpin the overall design of a study. Other reviews in this series provide an overview of the principal techniques of data collection and sampling, data analysis, and quality assessment of qualitative work, and provide some practical advice relevant to nutrition and dietetics, along with glossaries of key terms.

Abstracts from Dietetic Research Event – May 27-28, 2010

Welcome to Montreal and the 2010 Dietitians of Canada Annual Conference Research Event. This year will be quite exciting with nearly 70 high quality research and practice presentations. Topics are varied and include: public health nutrition, food service management, food production, nutrition friendly environments, clinical and applied nutrition, and dietetic practice in various settings, such as schools, community centres, hospitals, health centres, etc. The innovation this year will be the Poster Tour that will allow each presenter to discuss the highlights of his/her research under the guidance of one of the abstract review committee members or a dedicated nutritionist or graduate student. Judging abstracts was a difficult task considering the variety of topics and the large number and high quality abstracts received this year. Members of the Committee had a wide spectrum of expertise and collaborated to share their knowledge and set strict criteria for abstract selection. They also assisted in finalizing the oral and poster presentations schedules. On behalf of the membership of Dietitians of Canada, I would like to thank the Abstracts Review Committee members who took time from their busy schedules to provide their expertise to review these abstracts: Drs. Katherine Gray-Donald and Hugues Plourde from McGill University; Drs. Irene Strychar and Marie Marquis from the Université de Montréal and Dr. Maria Kalergis from the Dairy Farmers of Canada. Join me in celebrating Canadian Dietetic Research by attending the poster sessions on Thursday and Friday (May 27 and 28) and the oral presentations on Friday May 28 in the afternoon.

Photovoice and Its Potential Use In Nutrition and Dietetic Research

Photovoice is an innovative qualitative method of participatory action research based on health promotion principles; however, it has not been used to its full potential in health care, particularly in nutrition and dietetics. Photovoice is also based upon the theoretical literature on education for critical consciousness, feminist theory, and community-based approaches to documentary photography. Participants take photographs representing their views on a specific topic and discuss them in a group process of critical reflection. Originally designed for research with rural women, Photovoice has been used with a variety of population groups throughout the lifespan, such as adolescents, nurses and nursing students, professional groups, Aboriginal women, the elderly, immigrant and low-income groups, and patients with a variety of diseases. The use of Photovoice as a research method is not restricted by health conditions, financial situation, employment status, or literacy level. It is used in community settings, professional practice, or institutional learning environments to explore participants' views and opinions. We review studies in which Photovoice has been used, as well as the impacts, advantages, limitations, and ethics of its use. Gaps in knowledge and its potential use in nutrition and dietetic research are identified.

2010 ADA Member Benefits Update

2010 ADA Member Benefits Update

Publishing Nutrition Research: A Review of Epidemiologic Methods

The use of epidemiologic research designs and analytical methods is common in dietetics research. Food and nutrition professionals who seek to perform evidence-based practice or participate in research design, analysis, and communication need skills in the essentials of epidemiology. This is one of a series of monographs on research methodology that addresses these needs and supports the goals of the Board of Editors of the Journal of the American Dietetic Association to further enhance competency and skills. This monograph focuses on statistical approaches for univariate analyses used with the primary observational study designs associated with epidemiology. Tables illustrating the presentation and interpretation of these results are included.