Dietetic Research Research Articles

Human Breast Milk Exosomes: Affecting Factors, Their Possible Health Outcomes, and Future Directions in Dietetics

Background: Human breast milk is a complex biological fluid containing multifaceted biological compounds that boost immune and metabolic system development that support the short- and long-term health of newborns. Recent literature suggests that human breast milk is a substantial source of nutrients, bioactive molecules, and exosomes. Objectives: This review examines the factors influencing exosomes noted in human milk and the impacts of exosomes on infant health. Furthermore, it discusses potential future prospects for exosome research in dietetics. Methods: Through a narrative review of the existing literature, we focused on exosomes in breast milk, exosome components and their potential impact on exosome health. Results: Exosomes are single-membrane extracellular vesicles of endosomal origin, with an approximate radius of 20–200 nm. They are natural messengers that cells secrete to transport a wide range of diverse cargoes, including deoxyribonucleic acid, ribonucleic acid, proteins, and lipids between various cells. Some studies have reported that the components noted in exosomes in human breast milk could be transferred to the infant and cause epigenetic changes. Thus, it can affect gene expression and cellular event regulation in several tissues. Conclusions: In this manner, exosomes are associated with several pathways, including the immune system, oxidative stress, and cell cycle, and they can affect the short- and long-term health of infants. However, there is still much to learn about the functions, effectiveness, and certain impacts on the health of human breast milk exosomes.

What Evidence?: Qualitative Publishing in the Canadian Journal for Dietetic Practice and Research.

Background: Qualitative research involves the analysis of data in various forms (i.e.,written text such as interview transcripts, literature, or a personal diary; visual media such as photographs, maps, or memes; and audio materials such as podcasts, music, or voice notes) to describe and/or interpret phenomena and humans' perceptions and experiences of the world, including of food, health, and well-being. Dietetic-scholars have raised concerns about the dearth and quality of qualitative dietetic research.Objective: To document the availability and quality of qualitative research published in Canadian dietetic literature.Methods: A manifest content analysis of articles published in the Canadian Journal of Dietetic Research and Practice (CJDRP) between 2012 and 2021.Results: In total, 340 articles were published between 2012 and 2021 of which 43 (12.6%) used qualitative methods. Overall, the quality of qualitative articles was poor; articles frequently failed to report the methodological approach or a theoretical framework. Methods of data collection, data analysis, and strategies to ensure rigor were seldom described in detail. Reported limitations were often inappropriate for qualitative research.Discussion: Qualitative research is markedly underrepresented in the CJDPR. Efforts are needed to ensure that high-quality qualitative research evidence and publishing opportunities are available to Canadian dietetic practitioners and researchers. This study provides baseline data to evaluate the impact of future efforts.

Dietetic research involvement is associated with the European region where a dietitian is working and their highest degree qualification.

Research is the foundation of the dietetic profession and of evidence-based guidelines/practice. The present study aimed to examine the level of research involvement among dietitians in Europe. A cross-sectional study was conducted among dietitians across Europe using the validated Research Involvement Questionnaire (RIQ), which assigns participants to four levels of research involvement. The survey link was distributed through various channels; for example, National Dietetic Association (NDA) members of European Federation of the Associations of Dietitians (EFAD), the EFAD eNewsletter, national newsletters, etc. Data were analysed with SPSS, using descriptive statistics, statistical tests and ordinal logistic regression analysis with the level of research involvement as the dependent variable. In total, 257 European dietitians completed the survey (84.6% female). Most participants held a Master's degree (46.1%), followed by a Bachelor's degree (27.3%) or Doctorate (25.7%). One-third of participants were involved at level 3 or 4 (leading research, leadership in research), whereas most were involved at level 1 (evidence-based practice) or 2 (collaboration in research). The multivariate regression analysis showed that dietitians' research involvement was higher in dietitians with a Doctorate and in Northern/Southern Europe compared to Eastern/Western Europe. Dietitians have low levels of research involvement in practice even when highly qualified. Interventions to motivate dietitians to be more involved in research projects are important, as well as interventions to facilitate dietitians' research activities. This would inform the discipline's evidence base, strengthen the professional status of dietitians and increase their reputation within the healthcare sector.

Communicating Nutrition and Dietetics Research: A Crucial Step to Advancing Evidence-Based Practice

The primary objective of nutrition research is to make discoveries that will improve human health, and this is more likely to happen when researchers collaborate and share research findings with clinicians, program and policy makers, and the public. Nutrition research directly informs evidence-based care provided by registered dietitian nutritionists. However, the current academic model often lacks sufficient incentives and preparation for researchers to effectively disseminate their work. Consequently, research findings can be misrepresented, misinterpreted, distorted from their original context, or fail to reach the intended audience altogether. The aim of this article was to describe the importance and value of communication and disseminating nutrition research with various audiences and discuss what material should be disseminated. The information presented can serve as a guide for nutrition researchers to effectively disseminate their research for maximal impact and relevance.

Crime and Nourishment: A Narrative Review Examining Ultra-Processed Foods, Brain, and Behavior

Recently, there has been increased scientific and clinical interest in the potential harms associated with ultra-processed foods, including poor mental health, aggression, and antisocial behavior. Research spanning epidemiology, mechanistic pre-clinical work, addiction science, microbiome and exposome science, and human intervention trials has underscored that nutrition is of relevance along the criminal justice continuum. As such, the emerging dietetics research is salient to the thousands of international psychologists and allied mental health professionals that are engaged in justice work, including forensics, prevention, and intervention. In addition, relationships between nutrition and behavior relate to “food crime”, an emergent area unifying criminal justice researchers with psychology, public health, and other interdisciplinary sectors. Food crime scrutinizes the vast harms, including non-communicable diseases and adverse behavioral outcomes, as influenced by the distribution of addictive ultra-processed food products. Here, we examine the emergent research, including biophysiological mechanisms, and evidence indicating that dietary patterns/components intersect with psychosocial vulnerabilities linked with risks of antisocial behavior and justice involvement. Viewed through a prevention lens, the study of nutrition and aggressive behavior should be prioritized, especially if the outcomes emerge as externalities of the global consumption of ultra-processed food. In the context of criminal justice and behavior, there is a need for forensic examination of how industry influence and power structures can undermine matters of food justice.

Survey Methodology for Data Collection and Analysis in Nutrition and Dietetics Research

This article is part of a series of articles in the Journal of the Academy of Nutrition and Dietetics exploring the importance of research design, epidemiological methods, and statistical analysis as applied to nutrition and dietetics research. The purpose of this ongoing statistical portfolio is to assist registered dietitian nutritionists and nutrition and dietetic technicians, registered with interpreting nutrition research and applying scientific principles to produce high-quality data analysis. A survey is a systematic method for collecting reportable information on a topic of interest. Developing, adapting, and conducting survey research is a complex process; its aim is to collect accurate and useful data for the intended purpose and context. This article, which accompanies a companion article on electronic survey research, is an overview of survey methodology for data collection and analysis in nutrition and dietetics research. Its purpose is to highlight the general principles and components of survey development and survey administration that would maximize the validity of the data obtained. The goal is to provide a practical guide on the design and implementation of a survey as a method for data collection. Supporting figures are provided for use in direct application by practitioners and students.

Pragmatic patchwork ethnography, a call to action for health, nutrition and dietetic researchers.

Qualitative research methods are increasingly used in nutrition and dietetics research. Ethnography is an underexploited approach which seeks to explore the diversity of people and cultures in a given setting, providing a better understanding of the influences that determine their choices and behaviours. It is argued that traditional ethnography, that is, the methodology of living within participant communities, is a dated practice, with roots in colonialism, accessible to only researchers with the means, connections and status to conduct such research, typically white, privileged males. This paper proposes a formal interpretation of 'patchwork ethnography', whereby research is carried out in situ around existing modern-day commitments of the researcher, thus enabling more researchers within health, nutrition and dietetic practice to benefit from the rich data that can be discovered from communities. This review proposes the concept that pragmatic patchwork ethnography is required, proposing a framework for implementation, providing researchers, particularly within the fields of human nutrition, dietetics and health, the accessibility and means to deploy a meaningful client-centric methodology. We present pragmatic patchwork ethnography as a modern method for use within multiple healthcare settings, thus adding a progressive brick in the wall of qualitative research.

Advancing Nutrition and Dietetics Research in Global Food and Nutrition Security: A Roundtable Meeting Report

Food and nutrition security remains a relevant issue globally, impacting nutritional status and other health outcomes. This is further complicated by various environmental factors that impact stable access to, availability of, and utilization of nutritious foods. Nutrition and dietetics practitioners play an important role in the identification and treatment of food and nutrition security and are also well positioned to advance research that can support food and nutrition security solutions. To address this important issue, the Academy of Nutrition and Dietetics’ Council on Research convened a Global Food and Nutrition Security Research Task Force (Task Force). To leverage existing information and expertise in this area and identify the need for future evidence, the Task Force hosted a virtual roundtable with key internal and external stakeholders. This 2-day event included discussions on research gaps, potential entry points for nutrition and dietetics practitioners, and important equity considerations in the area of food and nutrition security research. The identified research gaps included the need for standardized terminology for consistent data collection, the need for validated screening and assessment tools that can be used across settings and also assess diet quality, additional translational and implementation science research, multi-sectoral and multi-pronged approaches, interdisciplinary collaboration with community partners, incorporation of research into policy development, and additional evidence on food systems approaches to target food and nutrition security. To more clearly identify the entry points for practitioners, five examples from various countries were included to identify food and nutrition security issues and how nutrition and dietetics practitioners can be involved in research to address food and nutrition security. The Task Force would like this information to inform a research agenda and be leveraged by the larger scientific community to drive future funding and research opportunities for food and nutrition professionals on this topic.

Confronting Colonialism in Canadian Dietetics Curricula.

Many Canadian universities have committed to becoming more accountable to Indigenous Peoples by confronting the systemic, historical, and ongoing colonialism and anti-Indigenous racism that shape their campuses. In this Perspective in Practice piece, we invite the field of dietetics to consider how colonialism has shaped dietetics research, teaching, and practice. We also consider how we might transform the field of dietetics in ways that accept settler responsibility for interrupting racism and colonial harm; support the resurgence of Indigenous food and health practices; and recognise the connections between struggles to ensure that Indigenous Peoples can access culturally appropriate food and health care, and struggles for Indigenous sovereignty and self-determination. We do this by reviewing the history of the dietetics field, examining critical responses to existing Indigenisation and decolonisation efforts, and reflecting on recent changes to required dietetics competencies. We argue that curricula in dietetics programmes must teach the history of the colonial food system and equip students to identify and interrupt the individual and institutional colonial dynamics that contribute to the ongoing dispossession of Indigenous Peoples' lands and food sources and negatively impact Indigenous patients.

Rural nutrition and dietetics research-Future directions.

The aim of this study was to summarise key evidence from recent Australian rural nutrition research and provide recommendations for future nutrition and dietetics research with rural communities. Clear evidence demonstrates that diet plays a role in the health gap between rural and metropolitan Australia. Despite the opportunity to address the health of rural Australians through better nutrition, alarmingly low investment in nutrition and dietetics research has occurred historically, and over the past decade. A review of the evidence was undertaken by rural nutrition and dietetics leaders to provide a commentary piece to inform future rural nutrition research efforts. Establishing strong, collaborative place-based nutrition and dietetics research teams are necessary to combat the significant gaps in the scientific knowledge of solutions to improve nutrition in rural Australia. Further, dieticians and nutritionists who live in and understand the rural contexts are yet to be fully harnessed in research, and better engaging with these professionals will have the best chance of successfully addressing the nutrition-related disease disparity between rural and metropolitan Australia.

Research Showcase Early Bird Abstracts

The 2023 Dietitians of Canada (DC) National Conference held on 25–26 May 2023 was our first in-person conference since June 2019 and celebrated our unity and resiliency as a profession. It was amazing! The Canadian Foundation for Dietetic Research (CFDR) showcased a diverse array of experience sharing and research abstracts through oral and poster presentations, and virtual sessions. There were 23 Early Bird (EB) research abstracts, in which 10 were selected for in-person presentations during the conference, and 19 Late Breaking research abstracts which were posters. Thank you to all who submitted abstracts! Thanks to the dedication and commitment of the Abstract Review Committee members. Early Bird Abstract Review Committee: Susan Campisi (University of Toronto); Andrea Glenn (University of Toronto); Mahsa Jessri (University of British Columbia); Louise St-Denis (University of Montreal). Late Breaking Abstract Review Committee: Lesley Andrade (University of Waterloo); Carla D’Andreamatteo (Consultant, Winnipeg); Laura Forbes (University of Guelph); Billie Jane Hermosura (University of Ottawa); Christine Nash (University Health Network); Louise St-Denis (University of Montreal). Thanks to the CFDR Board, DC Conference team, digital partners, all of the moderators, and conference attendees for supporting the research presentations. Warm regards, Christina Lengyel, PhD, RD Chair, 2023 EB/LB Abstract Committees Professor Food and Human Nutritional Sciences University of Manitoba Ravi Sidhu Managing Director Development & Operations CFDR

Challenging deficit discourse in Aboriginal and Torres Strait Islander nutrition and dietetics research: A critical discourse analysis

Prior to colonisation, Aboriginal and Torres Strait Islander peoples used detailed knowledges on food and nutrition to develop sustainable practices which supported strong and healthy ways of life. Despite this, there is often a focus in the nutrition and dietetics literature on the deficits relating to food and nutrition for Aboriginal and Torres Strait Islander peoples, rather than the strengths. This study used a critical discourse analysis to investigate how Aboriginal and Torres Strait Islander peoples are portrayed in the discourse of peer-reviewed research relating to Aboriginal and Torres Strait Islander nutrition and dietetics. In doing so, this study explored the extent to which these portrayals perpetuate deficit discourse and the implications of this for Aboriginal and Torres Strait Islander peoples’ health, and nutrition and dietetics research. Four prominent themes were identified: problem describing, comparison, acknowledgment of colonisation and inclusion of Aboriginal and Torres Strait Islander perspectives. The results indicate that deficit discourse dominates nutrition and dietetics literature, and a lack of strengths-based discourse is evident. This study brings awareness to, and emphasises the importance of, challenging and changing these discourses to ones that are more strengths-based.

Editorial introductions.

Editorial introductions.

Dietitians as change agents for promoting healthy and sustainable food systems

Dietitians as change agents for promoting healthy and sustainable food systems

The United Nations Sustainable Development Goals: Aspirational or obtainable?

The <scp>United Nations</scp> Sustainable Development Goals: Aspirational or obtainable?

Research Showcase Abstracts.

The 2022 Dietitians of Canada (DC) National Conference brought together our nutrition and dietetics community for a successful virtual event on September 15 & 16, 2022. We have had three virtual conferences due to the COVID-19 pandemic, but that has not prevented us from sharing our experiences and research. This year the Canadian Foundation for Dietetic Research (CFDR) showcased a wide variety of experience sharing and research abstracts through the online conference platform. There were 33 Early Bird (EB) research abstracts, in which five were selected for live presentations during the conference, and ten Late Breaking research abstracts. Thirty-one posters were presented virtually at the conference. Thank you for all of the abstract submissions! A sincere thank you to the Abstract Review Committee members for their support, dedication and commitment. Early Bird Abstract Review Committee: Susan Campisi (University of Toronto); Pauline Darling (University of Ottawa); Andrea Glenn (University of Toronto); Mahsa Jessri (University of British Columbia); Shelley Vanderhout (University of Toronto). Late Breaking Abstract Review Committee: Lesley Andrade (University of Waterloo); Carla D'Andreamatteo (Consultant, Winnipeg); Pauline Darling (University of Ottawa); Laura Forbes (University of Guelph); Billie Jane Hermosura (University of Ottawa); Christine Nash (University Health Network). Thanks to the DC Conference team, all of the moderators and conference attendees for supporting the virtual and poster research presentations. Please consider submitting an abstract for the 2023 CFDR Research Showcase. Looking forward to seeing all of you at the 2023 Dietitians of Canada Conference in Montreal, QC, from May 24-26, 2023. Warm regards, Christina Lengyel, PhD, RD Chair, 2022 EB/LB Abstract Committees Professor Food and Human Nutritional Sciences University of Manitoba Ravi Sidhu Managing Director Development & Operations CFDR.

Survey tools for measuring research or evidence-based practice constructs in dietetics: A narrative review.

Exact quantification of research conducted by dietitians and tracking the effectiveness of interventions or training programs to increase either evidence-based practice (EBP) or research behaviours have been hampered by the variety of tools used to measure these constructs. In this narrative review, we identified and classified the various tools previously used to measure constructs related to research and/or EBP in the dietetics profession, and to summarise estimates of the constructs measured. We identified and classified 15 scored tools that had been used at least once in the dietetics profession and extracted tool parameter estimates from 22 resulting papers. We also identified six unscored tools and three qualitative studies. The most frequent constructs measured were attitudes and behaviours. Very few tools measured objective knowledge (skills). No objective measures of research outputs were identified. Several tools were closely related to one another. Even when tools were used across multiple papers, reporting method varied making comparisons difficult. This review should encourage future researchers to utilise existing tools when possible, and encourage the development or adaptation and testing of tools that fill identified gaps. The constructs measured by the tools identified may also provide a starting point for the development of educational interventions aiming to increase research or EBP skills among dietitians. Only by using consistent tools will the dietetics profession be able to track the progress in increasing research conduct and EBP implementation over time.

Research at the Academy of Nutrition and Dietetics: What, How, and Why?

Research is essential to further advance our understanding of the role of nutrition and dietetics in maintenance and improvement of health. Research is also essential for nutrition and dietetics practitioners to create and provide evidence-based interventions, including medical nutrition therapy provided by registered dietitian nutritionists. Given this critical role of research, the Academy of Nutrition and Dietetics (Academy) has a variety of resources to assist its members in accessing, understanding, participating in, conducting, and disseminating nutrition research. These resources are comprehensive and include opportunities to participate in research (eg, Nutrition Research Network and Data Science Center), tools to aggregate practice data (Nutrition Care Process and Terminology and the Academy of Nutrition and Dietetics Informatics Infrastructure), funding opportunities to support primary research (eg, Academy Foundation), resources to understand the latest research informing evidence-based practice (eg, Evidence Analysis Center), and avenues for sharing research findings (eg, Food &amp; Nutrition Conference &amp; Expo™). The aim of this article is to encourage Academy members to get involved in research by describing Academy-based research resources and opportunities to contribute to nutrition and dietetics research, as well as describe specific examples of research conducted at the Academy. The information presented can serve as a framework to guide members in engaging in research through the Academy.

Beauty and the Bran: Kellogg’s Campaign to “Correct Faulty Elimination” and Conquer the Cereal Industry

ABSTRACT Brothers John Harvey Kellogg and William Keith Kellogg understood the importance of public health concerns, particularly those relating to constipation, and of home economics and dietetics research. The Kellogg’s Corn Flake Company’s investment into home economics became integral to the brand itself and helped establish Kellogg’s as a leader in addressing the growing dietary health concerns of the early twentieth century and in the breakfast food industry. The Kellogg’s Corn Flake Company used “reason why” advertising appeals for its bran cereals to teach consumers about the connections between eating bran and health. While the campaigns changed over time, the main focus of eating bran to prevent constipation remained consistent. The company’s success today can clearly be traced back to its original efforts to address health concerns through advertisements that taught women how to use bran cereal as both a curative and preventative food for constipation and related symptoms. Perhaps more significantly, the Kellogg’s Company’s Home Economics Department influenced early dietary standards established by the government for both the American public and military.

Validity and Reliability of the Smart Food Diary Keenoa Against Recovery Biomarkers: A Study Protocol

ObjectivesDietary assessment provides essential data for nutrition research, but current methods have limitations impeding the accuracy of reported intakes. Keenoa is a new mobile food diary that integrates artificial intelligence food recognition. Participants take pictures of their meals, specify foods and beverages consumed and estimate portion sizes with the help of visual pictograms. Data are analyzed from the Canadian Nutrient File v2015 and other national databases. Objectives are 1) To assess Keenoa's validity and reliability for energy, protein, potassium and sodium intakes against recovery biomarkers; 2) to determine the optimal number of tracking days for maximal validity; 3) to assess the appreciation and usability from participants.MethodsAdult participants (18–70 y, n = 120) will be recruited for this 3-month study. They will track their food intake using a weighted written food diary (WFD) and Keenoa, in a randomized order, at month 1 (4 consecutive days), 2 (7 days) and 3 (4 days). At month 2, urinary nitrogen, sodium and potassium excretion will be measured from 24-h urine collections on day 3 of each tracking tool. A subsample of n = 30 will undergo measurement of total energy expenditure using the gold-standard doubly labeled water method. Intakes in other key nutrients will be compared to those reported by WFD, as a relative comparator considered the most accurate among conventional methods. Proportions of under/over-reporters will be analyzed by gender and BMI category. Perceived usability of the Keenoa application will be assessed using the validated System Usability Scale (SUS). The validity of Keenoa will be tested by comparing reported intakes of multiple days against measured recovery biomarkers with paired t-tests and Wilcoxon Signed rank test, as applicable, and Bland Altman's test for bias. Reliability will be tested by comparing repeated measures over time with intraclass correlations. P-values < 0.05 will be considered significant.ResultsN/AConclusionsIf proven accurate, reliable, and appreciated by users, this innovative tool could be used by researchers in a cost-effective manner. It could contribute to expanding nutrition knowledge and support research on the role of nutrition in health.Funding SourcesCanadian Foundation for Dietetics Research.