Dietitians Of Canada Research Articles

Supporting Dietitians in Practice: Professional Development Activities of Dietitians of Canada in the Past 30 Years

Dietitians of Canada (DC) was established in 1997 from the Canadian Dietetic Association and the provincial associations. This project is part of a larger program of work to document the recent history of Canadian dietetic practice, including the professional development (PD) initiatives DC has provided since its inception. The aims of the present study are to synthesize a timeline of PD events since 1993, understand the context that led to their development, and understand their impact on the profession. 13 key informants were recruited by email, of which 11 semi-structured interviews were conducted, and 8 participants provided written contributions. Interview transcripts and written contributions were analyzed thematically, and a final timeline of events was developed. Six themes were found: 1) the use of technology in PD tools, e.g. online courses, Learning on Demand; 2) conferences and workshops , e.g. national conference, Coast-to-Coast workshops; 3) initiatives that placed DC as a leader in health and nutrition, e.g. Practice-based Evidence in Nutrition (PEN); 4) informal discussion about emerging issues in dietetics, e.g. PEN Current Issues, Practice Blog; 5) DC actively sought member input to inform PD strategy, e.g. members issues forums; and, 6) DC PD events demonstrated their support for research and dietetic education, e.g. relationship with CFDR, public health online course. Key concerns for the future included: declining DC membership and funding, and dietetics not keeping pace with other professions on PD. The successes and failures of initiatives in this time period can inform the development of DC’s PD strategy for the coming decades.

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

COVID-19 Pandemic Effects on Job Search and Employment of Graduates (2015-2020) of Canadian Dietetic Programmes.

Purpose: Self-reported coronavirus 2019 (COVID-19) pandemic effects on dietetic job search, employment, and practice of recent graduates were explored within a national workforce survey.Methods: Graduates (2015-2020) who were registered/licensed dietitians or eligible to write the Canadian Dietetic Registration Exam were recruited through dietetic programmes, Dietitians of Canada's communication channels, and social media. The online survey, available in English and French from August through October 2020, included questions about pandemic experiences. Descriptive statistics and thematic analysis were applied to closed and open-ended responses, respectively.Results: Thirty-four percent of survey respondents (n = 524) indicated pandemic effects on job search and described delayed entry into dietetics, fewer job opportunities, and challenges including restricted work between sites. The pandemic affected employment for 44% of respondents; of these, 45% indicated working from home, 45% provided virtual counselling, 7% were redeployed within dietetics, 14% provided nondietetic COVID-19 support, and 6% were furloughed or laid off. Changed work hours, predominantly reduced, were identified by 29%. Changes in pay, identified by 12%, included loss (e.g.,raises deferred) or gain (e.g.,pandemic pay). Fear of infection and stress about careers and finances were expressed.Conclusion: The COVID-19 pandemic profoundly affected both acquiring positions and employment in 2020 for recent dietetic graduates.

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.

What Practice Issues Over 25 Years Most Interest Registered Dietitians? Survey and Interview Results.

Dietetics has changed substantially; a mixed-methods project was undertaken to: (i) gauge interest in the profession history since 1993, (ii) identify preferred format(s), (iii) identify possible topics, and (iv) identify possible key informants. An online bilingual survey was conducted in 2018, with follow-up phone interviews among interested respondents. Survey content was organised as 12 major topics. Respondents were invited via a Dietitians of Canada (DC) newsletter, Facebook groups, and at the DC national conference. Survey data, including respondent-generated topics of interest and interview content, were descriptively analyzed. The online survey garnered 360 responses; 332 (92%) completed more than 10% of the survey and were interested in history. Detailed responses were analyzed (296 English; 36 French); 51 were interviewed. An online timeline was the most preferred format (79%). Review of the rise in technology and obesity, aging, supermarket registered dietitians (RDs), the local/organic movement, Practice-based Evidence in Nutrition (PEN), the changes in training models and scope of practice, public awareness of the profession, and advocacy and unique career paths were of most interest (≥ 50% of respondents). These results confirm interest in the recent history of the profession among RDs and provide guidance on preferred format and topics for further work.

CFDR Research Showcase: Early Bird Abstracts

Given the pandemic challenges we experienced over the last year, the 2021 Dietitians of Canada (DC) National Conference from May–June brought our dietetic community together from all across Canada and the world. This year the Canadian Foundation for Dietetic Research (CFDR) showcased another successful event with novel, relevant, timely research projects via the OnAIR Virtual Event Portal. Twenty-four research abstracts were submitted and reviewed by the Early Bird Abstract Review Committee. It was exciting to have research from different nutrition and dietetic practice areas represented. Thanks for all of the abstract submissions! Eight Early Bird abstracts were presented as Lightning Rounds during the virtual DC National Conference and were very well-received. The remaining 16 abstracts were displayed as posters for the duration of the conference with a live 7-min presentation opportunity from the poster gallery on May 19, 2021. All of the Early Bird abstracts are published in this issue of the Canadian Journal of Dietetic Practice and Research and are also featured on the CFDR website. These abstracts represent a wide variety of practice-based nutrition research projects in Canada. The Early Bird abstract research event would not have been possible without the commitment and dedication of many supportive individuals. On behalf of DC and CFDR, we extend a special thank you to members of our abstract review committee: Susan Campisi (University of Toronto); Pauline Darling (University of Ottawa); Andrea Glenn (St. Francis Xavier University); Mahsa Jessri (University of British Columbia); Grace Lee (University Health Network), Jessica Lieffers (University of Saskatchewan); Shelley Vanderhout (University of Toronto). A sincere thank you to all of the moderators, the DC Conference team and Izabella Bachmanek for their support with the Lightning Round presentations over the course of the DC virtual conference. Please consider submitting an abstract next year for the CFDR Research Showcase at the 2022 DC National Conference in Saskatoon, SK. Wishing all of you a wonderful Fall! Warm regards, Christina Lengyel PhD RD Chair, 2021 Early Bird Committee Professor Director of the Dietetics Program Food and Human Nutritional Sciences University of Manitoba Janis Randall Simpson PhD RD FDC FCNS Executive Director, CFDR Professor Emerita University of Guelph This article was corrected after publication.

Successes and Challenges Implementing a "Fresh from the Farm" Fundraising Program in Schools.

In 2013, 4 partner organizations: Dietitians of Canada (DC); Ontario Fruit and Vegetable Growers Association; Ontario Ministry of Agriculture, Food and Rural Affairs; and Ontario Ministry of Education created "Fresh from the Farm" (FFF), a healthy fundraiser for Ontario Schools. FFF was designed to support the Ontario government's School Food and Beverage Policy and Local Food Act and to provide a feasible alternative for less healthy fundraising options. This paper outlines the program successes and challenges over the 6 years of DC's involvement. After 6 years, over 1700 schools successfully participated in FFF and over $2 million has been paid to Ontario farmers for product and distribution. The average participating school has generated $2040 in sales towards their fundraising efforts, equating to 770kg (1700 lbs) of fresh produce per school. Schools reported high satisfaction with FFF, with over 90% of participating schools enrolling in subsequent years. The main reasons for satisfaction included: easy to implement, profitable, offers a healthy alternative to "traditional" fundraising programs, and provides great value for cost. The main challenges were logistics of sourcing and delivery, higher than anticipated costs that made the financial model less feasible than predicted, and competition from other fundraisers.

The Mediterranean Athlete's Nutrition: Are Protein Supplements Necessary?

(1) Background: It is recommended that an athlete, in order to ensure correct nutrition and performance, should consume between 1.2 and 2.0 g/kg/day of protein, while the daily recommended protein intake for a non-athlete is 0.8and 0.9 mg/kg/day. It is unclear if athletes living in Mediterranean countries are able to meet protein requirements without supplementation, since Mediterranean diet de-emphasizes meat and meat products. (2) Methods: 166 athletes (125 males) enrolled between 2017 and 2019 were required to keep a dietary journal for three consecutive days (2 workdays and 1 weekend day). Athletes had to be >18 years old, train in a particular sport activity more than 3 h a week and compete at least at an amateur level. Journal data were collected and then translated into macro-nutrient content (grams of protein, carbohydrates, and lipids) by a nutritionist. (3) Results: The protein intake reported by this specific population vary slightly from the Academy of Nutrition and Dietetics (AND), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) joint statement recommendation level. Average protein levels without protein supplementation fell within the protein guidelines. Counterintuitively, the intake among those who supplemented their diet with protein was higher compared with those who did not, even when excluding the contribution of supplements. Although the majority of subjects participating in the study were able to meet protein intake recommended for athletes without protein supplementation, 27% of athletes were below the guideline range. (4) Conclusions: these data suggest that athletes’ nutrition should be more often evaluated by a nutritionist and that they will benefit from increasing their nutritional knowledge in order to make better food choices, resorting to protein supplementation only when effectively needed.

CFDR Research Showcase, Early Bird Abstracts

Due to the cancellation of the Dietitians of Canada (DC) conference for 2020 because of the COVID-19 pandemic, the 2020 Research Showcase was not able to be held as planned in Saskatoon in June 2020. Ten of the Early Bird abstracts were presented as Lightning Rounds during the virtual DC conference that was held in June and July, 2020. All 25 Early Bird abstracts are published in this issue of the Canadian Journal of Dietetic Practice and Research and are also posted on the CFDR website . These abstracts represent a wide variety of practice-based nutrition research projects in Canada. The Early Bird abstract research event would not be possible without the commitment and dedication of many people. On behalf of DC and CFDR, we extend a special thank you to members of our abstract review committee: Susan Campisi (University of Toronto); Elaine Cawadias (Retired); Pauline Darling (University of Ottawa); Andrea Glenn (St. Francis Xavier University); Mahsa Jessri (University of British Columbia); Jessica Lieffers (University of Saskatchewan); Shelley Vanderhout (University of Toronto). Thanks also to the moderators for the Lightning Round presentations in the virtual DC conference. Finally, thanks also to the DC Conference team for their support with the Lightning Round presentations over the course of the DC virtual conference. Christina Lengyel PhD RD Chair, 2020 Early Bird Committee Associate Professor Director of the Dietetics Program Human Nutritional Sciences University of Manitoba Janis Randall Simpson PhD RD FDC FCNS Professor Emerita University of Guelph Executive Director, CFDR

The Implementation of Eating Healthy Program in Early Childhood


 
 
 Eating habits develop during the first years of a child's life, children learn what, when, and how much to eat through direct experience with food and by observing the eating habits of others. The aim of this study is to get a clear picture of the Eating program Healthy, starting from the planning, implementation, supervision, and evaluation as a case study of nutrition education; to get information about the advantages, disadvantages and effects of implementing a healthy eating program for children. This research was conducted through a case study with qualitative data analysed using Miles and Huberman techniques. Sample of children in Ananda Islāmic School Kindergarten. The results showed the Healthy Eating program could be implemented well, the diet was quite varied and could be considered a healthy and nutritious food. The visible impact is the emotion of pleasure experienced by children, children become fond of eating vegetables, and make children disciplined and responsible. Inadequate results were found due to the limitations of an adequate kitchen for cooking healthy food, such as cooking activities still carried out by the cook himself at the Foundation's house which is located not far from the school place; use of melamine and plastic cutlery for food; the spoon and fork used already uses aluminium material but still does not match its size; does not involve nutritionists.
 Keywords: Early Childhood, Eating Healthy Program

Knowledge of Sugars Consumption and the WHO Sugars Guideline among Canadian Dietitians and Other Health Professionals.

Purpose: The objective was to assess knowledge related to sugars consumption and World Health Organization (WHO) sugars guideline among Canadian dietitians and other health professionals. Methods: A multiple-choice style survey was administered at Dietitians of Canada and Canadian Diabetes Association conferences in 2014. Results: The study showed that only 12% of the surveyed respondents (n = 335) in 2014 were able to correctly identify the amount of added sugars consumed by Canadians, whereas two-thirds overestimated this amount. About 10% of the respondents knew that the 10% guideline by WHO for free sugars was based on evidence related to dental caries. Registered dietitians had relatively better knowledge of Canadian sugars consumption (P = 0.003), but not of the WHO free sugars guideline compared with other surveyed health professionals such as medical doctors or nurses. Conclusions: Knowledge gaps existed among surveyed Canadian health professionals on topics related to sugars consumption and the WHO sugars guideline. Future research should focus on tools to support better communication of sugars guideline and consistent use of sugars terminology.

Education Matters: Certified health professionals have higher credibility than non health professionals on Instagram

Social media serves as an accessible source of health information and nutrition information. Instagram, an internationally known social media platform with an average of more than 1 billion monthly active users, allows its users to create and share content. However, the credibility of the nutrition content created by users with unknown qualifications may be questionable. The objective of this study is to assess the credibility of content created by nutrition influencers on Instagram by comparing health professionals with non-health professionals.
 For this study, “influencer” is defined as an Instagram user with at least 15,000 followers who promotes products, services, or ideas and who creates nutrition- or health-related content. For each influencer (n=29), two posts were selected every month from August 2018 to July 2019. Using the “Credible Information Factsheet” from the Dietitians of Canada, a credibility score based on four dichotomous criteria was created. Looking at the 24 posts of each influencer holistically, a credibility score out of 4 was calculated, with 0 being the least credible and 4 being the most credible.
 Without exception, a greater proportion of health professionals compared to non-health professionals met each criterion from the “Credible Information Factsheet”. 92% of the health professionals met criteria 1 (Miracle Cure) compared to only 31% of non-health professionals. This demonstrates how the vast majority of health professionals would not promise a miracle cure, while most non-health professionals would readily promise a miracle cure. Additionally, 46% of health professionals met criteria 4 (Research-based) compared to only 19% of non-health professionals, which demonstrates how non-health professionals do not support claims with research. When looking at the total credibility scores for health professionals and non-health professionals, not a single health professional scored a total of 0, while not a single non-health professional scored a total of 4. Most importantly, health professionals had an average credibility score of 2.4, which is twice as high as that of non-health professionals (1.2).
 Overall, health professionals appeared to be more credible than non-health professionals. By viewing nutrition information posted on Instagram by non-health professionals, followers potentially expose themselves to misinformation. Further research should be undertaken to validate the credibility score based on the “Credible Information Factsheet” by determining how adept the factsheet is at differentiating credibility for Instagram content.

CFDR Research Showcase, Early Bird Abstracts: June 6, 2019

Through the support of Dietitians of Canada (DC) and the Canadian Foundation for Dietetic Research (CFDR), the 2019 Research Showcase at the DC conference represented a wide variety of practice-based nutrition research projects in Canada. The 2019 Research Showcase consisted of several new elements this year. Early Bird abstracts were considered for either oral or oral ePoster sessions. New this year was the presentation of 11 Early Bird abstracts as oral presentations within the regular conference sessions: we called these “Lightning Rounds”. The remaining 27 Early Bird abstracts were presented as oral ePosters on June 6, 2019; authors presented their research in 2–3 minutes plus 2 minutes for questions, using their ePosters. For 2019, there were 3 concurrent oral ePoster sessions. All accepted, and presented, abstracts from the Early Bird submission are published in the Journal. This research event would not be possible without the commitment and dedication of many people. On behalf of DC and CFDR, we extend a special thank you to members of our abstract review committee: Susan Campisi (University of Toronto); Elaine Cawadias (Retired); Andrea Glenn (St. Francis Xavier University); Brenda Hartman (Brescia College, Western University) Mahsa Jessri (University of Ottawa); and Jessica Lieffers (University of Alberta). Thanks also to our moderators for the Oral ePosters: Barb Anderson (Acadian University); Jane Bellman (Dietitians of Canada); Brenda Hartman (Brescia College, Western University); Jessica Lieffers (University of Alberta); Dawna Royall (Dietitians of Canada); and Lee Rysdale (Northern Ontario School of Medicine). We enjoyed interacting with many of you at the oral research presentations as we highlighted the findings from our dietetic colleagues across our country! Finally, a special thank you to Gareth Willows Tribe and Michelle Naraine at CFDR for their assistance and support throughout the review process. Christina Lengyel, PhD, RD Chair, 2019 Early Bird Committee Associate Professor Director of the Dietetics Program Human Nutritional Sciences University of Manitoba Janis Randall Simpson, PhD, RD, FDC Chair, 2019 Late Breaking Committee Professor Emerita University of Guelph Executive Director, CFDR

Teaching Future Dietitians Leadership: A General Needs Assessment

The needs of the patient population are characterized by more chronic or complex health problems and the health care delivery system is constantly undergoing transformation. While discussions among stakeholders about changing the health system are essential, there is a concurrent need to focus on health professions education. There is a need to understand how entry-to-practice standards are used to develop health professions curricula. Based on recent stakeholder consultations and workforce assessments conducted by Dietitians of Canada and provincial interest groups, an emerging area of dietetic competency appears to be leadership. The purpose of this research project was to gain a better understanding around how competency standards are utilized to develop health professions curriculum, with a focus on dietetic curriculum related to management and leadership. To meet this objective, a general needs assessment was conducted using five databases: CINAHL, PubMed, FSTA, Scopus, and ERIC. The ancestry method was incorporated with purposive sampled articles to find additional research articles. The following key terms were included in the search: health professions, dietetics, nutrition, management, leadership, education, curriculum, competency, entry-level. A review of the literature indicates that developing professional competencies in leadership can strengthen some health professionals’ capacity to take on certain roles through competency-based education. In addition, the long-term training effects result in an increase in specific competencies relevant for effective interprofessional collaboration. There is opportunity for pedagogical and practice-based activities to strengthen leadership abilities of future dietetic professionals.

Gleaning in the 21st Century: Urban food recovery and community food security in Ontario, Canada

Historic gleaning activities in Europe took place in farmers’ fields where gleaners could collect the leftovers of the harvest. One of the primary motivations for modern gleaning in Canadian cities is to donate fresh food to local organizations such as food banks. As there is currently little research in this area, this study aims to explore how gleaning initiatives contribute to community food security. The study is based on interviews and surveys with volunteers from several gleaning organizations in Ontario, combined with the Dietitians of Canada’s Food Security Continuum (FSC) as a framework for analysis. Findings include that gleaning contributes to all three stages of the FCS: initial food systems change, food systems in transition, and food systems redesign for sustainability. Respondents felt that while the amount of food harvested could be scaled up, there were benefits that augmented community food security, such as increased food literacy, food awareness, community cohesiveness, and a fresh food supply. Overall, this study improves our understanding of how gleaning initiatives can contribute to community food security. With better ongoing support from the community and on the policy agenda, such projects could further enhance their impacts.

Dietetic Research Event: June 7 and 8, 2018.

Vancouver, British Columbia was the host city of the 2018 Dietitians of Canada Annual Conference. Through the support of Dietitians of Canada (DC) and Canadian Foundation for Dietetic Research (CFDR), the 2018 Research Showcase was an informative exchange of research and experience-sharing efforts. The submissions for this year's CFDR event represented the diversity of dietetic research conducted within Canada. The 2018 Research Showcase highlighted the Early Bird abstracts in 2 formats; some as 10 minutes oral sessions and others as ePosters with a short oral component. The Late Breaking abstracts were displayed as ePosters. This research event would not be possible without the commitment and dedication of many people. On behalf of DC and CFDR, we would like to extend a special thank you to members of our Early Bird abstract review committee: Susan Campisi (University of Toronto); Elaine Cawadias (Retired); Andrea Glenn (St. Francis Xavier University); Mahsa Jessri (University of Ottawa); Jessica Lieffers (University of Saskatchewan). Members of the Late Breaking abstract review committee included: Laurie Drozdowski (University of Alberta); Laura Forbes (Co-chair)(University of Guelph); Joann Herridge (Hospital for Sick Children); Grace Lee (Toronto General Hospital); Lee Rysdale (Northern Ontario School of Medicine); Jessica Wegener (Ryerson University); Sarah Woodruff Atkinson (University of Windsor). We would also like to thank all of our moderators, Pierrette Buklis (CFDR Board), Marcia Cooper (Health Canada), Jenny Gusba (CFDR Board), Brenda Hartman (Brescia College), Paula Brauer (University of Guelph), Dawna Royall (DC), and MaryAnne Smith (DC), who kept our research presentation sessions on time during the conference. Finally, a special thank you to France Bertrand and Michelle Naraine at CFDR for their assistance and support throughout the review process. We enjoyed interacting with many of you at the oral research presentations as we highlighted the research findings from our dietetic colleagues across our country! Christina Lengyel, PhD, RD Chair, 2018 Early Bird Abstracts Review Committee Associate Professor Director of the Dietetics Program Food and Human Nutritional Sciences University of Manitoba Janis Randall Simpson, PhD, RD, FDC Chair, 2018 Late Breaking Abstracts Review Committee Professor Emerita University of Guelph Executive Director, CFDR.

Social Support and Exclusive Breast feeding among Canadian Women.

The World Health Organization recommendation for exclusive breast feeding for 6 months has been endorsed by Health Canada, the Canadian Pediatric Society, Dietitians of Canada, and the Breastfeeding Committee for Canada as of 2012. This study examines whether social support is associated with exclusive breast feeding up to 6 months among Canadian mothers. We utilised data from the Canadian Community Health Survey and limited our sample to mothers who gave birth in the 5 years prior to the 2009-2010 survey (n = 2133). Multivariable logistic regression was used to examine the relationship between exclusive breast feeding and four dimensions of social support: (i) tangible, (ii) affectionate, (iii) positive social interaction, and (iv) emotional and informational, based on the Medical Outcomes Study Social Support Scale. Absolute and relative differences in the probability of breast feeding exclusively and their 95% confidence intervals were calculated. In adjusted models, differences in the probability of exclusive breast feeding for 6 months were not different among women with high vs. low social support. The association between social support and breastfeeding exclusively was modified by education level, with significantly higher probability of breast feeding exclusively among women with lower education and high vs. low levels of tangible and affectionate support. Among women with education below a high school level, high tangible and affectionate support significantly increased probability of exclusive breast feeding for 6 months in this study. Efforts to encourage exclusive breast feeding need to address social support for mothers, especially those with lower education.

Female Athlete Triad or Relative Energy Deficiency in Sports (RED-S): Is There a Difference?

Female Athlete Triad or Relative Energy Deficiency in Sports (RED-S): Is There a Difference?

Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance.

It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.

American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance.

It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.