Nutrition Professionals Research Articles

Bridging the Gap Between Corporate Sustainability Commitments and Consumer Action: Nutrition Communications Help Consumers Contribute to a More Sustainable Food Value Chain

The complexity of finding sustainable solutions to produce more food with less environmental impact to feed more people has been at the forefront of stakeholders across the food value chain over the past decade. The recent pandemic has provided the opportunity to assess and evaluate current practices for optimal sustainable practices. The goal to feed the world in a way that promotes healthy people, healthy planet, and healthy communities is reflected in the missions and actions of suppliers and companies along the food value chain. Progress has been made with continued opportunities for goal attainment. Decision-making by consumers, however, often does not align with where companies are prioritizing their actions and communications. The most important role of nutrition professionals, then, may be to help consumers better understand the nuances around sustainability, including how and where consumers can have the greatest impact in creating a more sustainable food system. It is only when all stakeholders across the food chain continuum gain alignment in understanding sustainability and where they make a difference that we can create our desired future.

Nutrition Professionals’ Knowledge, Consumption and Recommendations of Whole Grains

Nutrition Professionals’ Knowledge, Consumption and Recommendations of Whole Grains

Registered Dietitian Nutritionists’ Experience and Confidence with Gluten-free Diet: A Cross Sectional Study

Bring awareness of roles of RDNs in celiac disease support, as well as the importance of standardized training for RDNs in working with people with celiac disease. Currently the only treatment for celiac disease (CD), an autoimmune disease triggered by ingestion of the protein gluten, is a gluten-free (GF) diet. Registered dietitian nutritionists (RDNs) are a source of information for people with celiac disease (PWCD). This study aimed to examine RDNs’ training and confidence levels in assisting PWCD in maintaining a GF diet. A deidentified REDCap survey was shared with RDNs through the Academy CDR listserv. Another survey was shared with PWCD through social media (Reddit, Facebook, Discord server). Descriptive and qualitative statistics assessed data, and developed response themes. Of the 122 PWCD responses, 13.2% cited RDNs or other nutrition professionals as a primary source of support for managing CD, and 43.0% the Celiac Disease Foundation or National Celiac Association. Of 51 RDNs responses, 62.7% had practiced for ten or more years. When discussing GF dietary options with PWCD, the majority expressed high levels of confidence in the areas of GF diets (66%), eating outside the home (62.3%), checking food labels (71.7%), and cooking GF foods (73.6%). RDN GF training included a combination of on-the-job experience (21.57%), attending conferences about GI disorders (21.57%), or doing their own research (21.57%). Several (13.73%) reported they or a close family member had CD. Two were certified LEAP Therapists and one was certified by AND for Gluten Disorders. This study aims to bring awareness of roles of RDNs in CD support, as well as the importance of standardized training for RDNs in working with PWCD.

Cross-Curricular Mentoring Between First-Year and Upper-Level Dietetics Students Enhances Alignment with the Academy's Standards of Excellence

Describe the benefits of cross-curricular mentoring among undergraduate dietetics students to prepare early-career professionals to uphold the Academy's Standards of Excellence. Mentoring is a tool used in higher education for enriching personal and professional growth. The Academy recognizes the importance of mentoring through its Standards of Excellence. The achievement of these standards requires the development of unique skillsets including communication, leadership, teamwork, use of resources, and application of information. The purpose of this quality improvement project was to assess the effectiveness of formalized peer mentoring between first-year and upper-level undergraduate dietetics students as a tool for preparing early-career professionals to uphold the Academy’s Standards of Excellence. This cross-curricular quality improvement project was conducted in the Fall 2020 semester. Mentors were upper-level dietetics students (n=30) and mentees were first-year dietetics students (n=29). Mentoring activities, both in-person and virtual, included monthly in-class trainings and one-on-one meetings. Data were gathered through student written reflections. Four nutrition professionals (n=2 faculty, 1 graduate student, 1 undergraduate student) analyzed the data using inductive coding and peer consensus during iterative discussion sessions. Common themes among mentors included improved leadership (n=14), communication (n=18), and ability to apply content across the curriculum (n=15). Mentee themes were improved confidence (n=24), organization (n=14), and ability to utilize resources (n=21). The majority of mentors and mentees desired program continuation and expansion. Peer mentoring was perceived as a beneficial tool for both mentees and mentors. Common themes aligned with the Academy’s Standards of Excellence serving to meet the requirements for dietetics education (KRDN 2.8), as well as prepare students for their internship and professional careers (CRDN 2.15).

Nutrition Graduate Students have Neutral Perceptions, Attitudes, and Self-efficacy Related to Utilizing and Conducting Research

Explore nutrition graduate students’ perceptions, attitudes and self-efficacy related to utilizing and conducting research. Low levels of research utilization and engagement have been reported by nutrition professionals. Numerous studies have investigated dietitians’ perceptions, attitudes and self-efficacy related to utilizing and conducting research but few studies have focused on these factors in nutrition students. Nutrition graduate students from a faith-based university (n=45, 93% female) participated in an online survey that assessed experience, perceptions, attitudes, and self-efficacy related to research. All items were adapted from valid, reliable 5-point scales scored from strongly disagree to strongly agree. Overall students had neither positive nor negative attitudes regarding research being part of a dietitian’s role (3.60±0.72). Students agreed that RDs should apply research in practice (4.51±0.85), but were less likely to believe that RDs should conduct research (3.90±0.95). Students’ rated their research self-efficacy slight above neutral (3.83± 0.71). Students were most confident in their ability to collect data and to develop research questions and were less confident in their ability to consent subjects and analyze data. Students were somewhat confident in their ability to participate in evidence-based practice (3.82, ±0.73) and in their ability to engage in collaborative research (3.98±0.78). Overall students had neutral perceptions, attitudes, and self-efficacy related to utilizing and conducting research as a part of their future career. Future research should examine the potential for additional graduate level research courses or experiences to improve students’ perceptions, attitudes and self-efficacy related to utilizing and conducting research. This may encourage students to utilize and conduct research upon entering the workforce and may in turn improve patient health outcomes.

Can the concept of nutrient density be useful in helping consumers make informed and healthier food choices? A mixed‐method exploratory approach

AbstractPoor dietary patterns are major risk factors for chronic diseases and pose a challenge to public health. Strategies to achieve dietary improvement are likely to be complex and multifactorial, but of interest is whether the concept of nutrient density, paying attention to intakes of multiple essential nutrients within appropriate energy balance, could be a worthwhile approach, and whether this could help in the communication of healthier dietary patterns to consumers. In order to explore the concept further, a mixed‐methods market research approach was undertaken, using in‐depth interviews and surveys with consumers and nutrition professionals. This produced some rich insights into the way consumers perceive the nutrient quality of their diets. There was a notable desire amongst both groups to support a move away from concentrating on single nutrients and calories to a broader, more holistic approach that incorporates some of the positive nutritional aspects of foods. Overall, the concept of nutrient density was recognised as a helpful tool in describing healthier foods and nutritional quality. However, the actual term ‘nutrient density’ is unfamiliar to consumers, and communicating nutrient density to consumers who have different understandings, beliefs and motivations may be challenging. Further research is needed to identify how to best frame the concept in a way that resonates with consumers and facilitates dietary behaviour change.

Bioética en investigación en nutrición clínica

Bioethics is the systematic study of human behavior in the fields of biological sciences and health care. Clinical Nutritions part of health sciences, and nutrition professionals should be considered within the international bioethical framework as part of the scientific community. Scientific research is the only way to solve scientific questions in a rigorous, comprehensive and systematic way. This is why clinical nutrition research must be governed by the principles of bioethics, and clinical nutrition research protocols must follow all the principles of good clinical research practices set out in the Declaration of Helsinki.

Nutrition Bulletin recognised with Impact Factor™

<i>Nutrition Bulletin</i> recognised with Impact Factor™

Effects of a multiprofessional approach on anthropometric variables, body composition and food profile of overweight or obese adolescents

Introduction: To investigate the effects of a multiprofessional approach on anthropometric parameters and body composition and the level of food processing in adolescents. Methods: Twelve overweight/obese male adolescents between 13-17 years old participated in a series of 12-week multiprofessional interventioms led by physical education, nutrition and psychology professionals. The participants were assessed before the intervention as well as at 6 and 12 weeks into it. Anthropometric assessments were performed, including body weight, stature and body mass index; body composition, with fat mass (FM), body fat (%BF), skeletal muscle mass (SMM) and resting metabolic rate (RMR) and by filling in a three-day food record, in order to calculate the ingested foods, by the level of processing of the food: fresh, minimally processed, processed and ultra-processed. Results: No differences were observed for the anthropometric parameters performed at different stages (p&gt;0.05). Reductions for FM and %BF and increases in SMM and RMR (p&lt;0.05) were identified, all after 12-week of the intervention. There was an increase in the consumption of natural foods/g, and an increase in the caloric consumption of processed foods/kcal, after 12-week of interventions (p&lt;0.05). Conclusion: The model resulted in decreases in FM and %BF, an increase in SMM, RMR, natural foods/g and processed foods/kcal.

Public health nutrition in Afghanistan-policies, strategies and capacity-building: current scenario and initiatives.

Afghanistan is grappling with high burden of malnutrition in women and children and a rising burden of noncommunicable diseases. A narrative review was conducted with the aim of mapping current nutrition policies and capacity development initiatives to assess policy and the institutional environment and identify gaps and opportunities. A comprehensive, broad based search was conducted, including databases and websites and policy and programme documents. The policy focuses on multisectoral efforts to address nutrition challenges; however; implementation of nutrition-specific and nutrition-sensitive interventions is not delivered uniformly at the community level due to continued conflic situations and geographic inaccessibility, lack of availability of trained human resources and weak institutions. There is limited evidence on the effectiveness of nutrition programmes in Afghanistan. Limited policy provisions are available to address nutrition issues due to the rising burden of noncommunicable diseases, urbanization and changing dietary patterns. The shortage of skilled nutritional professionals is a critical issue. Lack of institutional capacity, educational standards and accreditation mechanism poses major challenges. Ongoing training programmes are fragmented and fail to meet the requirements of a professional nutrition workforce. The findings highlight that well-structured policies and strategies focusing on maternal and child nutrition provide an enabling policy environment to scale up nutrition interventions. Evidence on the implementation of programmes is needed to aid policy recommendations. The lack of an institutional mechanism for professional nutrition education highlights the great need for action in Afghanistan for public health nutrition and education.

Obesity and food away from home: What drives the socioeconomic gradient in excess body weight?

Rising obesity rates are one of the most challenging public health issues in many emerging economies. To what extent food away from home (FAFH) and its nutritional components are behind this rise is not yet well understood. To address the issue, this paper combines a representative restaurant survey that includes detailed information on the diet quality of the most widely consumed meals and their nutritional components from 1605 restaurants and a representative household survey with anthropometric measures of adult women living in 40 neighborhoods in the Lima Metropolitan Area. One important advantage of the dataset is the fact that nutrition professionals observed the preparation of the meals and that they were subject to a detailed laboratory analysis. Exploiting this data, we examine the differences in nutritional quality of FAFH among 40 neighborhoods of various socioeconomic groups and explore whether these differences can explain part of the observed socioeconomic gradient in excess body weight. The findings indicate that less healthy food in restaurants located in the food environment of the households is significantly associated with higher rates of obesity and overweight. In particular, the high supply and intake of sodium potentially drives higher excess body weight. The study also finds that up to 15 percent of the socioeconomic gradient in obesity is attributable to the restaurant food quality in the food environment of the households.

Evaluation of labeling, nutritional composition, ingredients and food additives in greek yogurtes marketed in supermarkets in the city of João Pessoa

To analyze the labeling adequacy of Greek Yogurts with the current Brazilian legislation for packaged products, which includes the list of ingredients, the content of proteins, carbohydrates and sugars, the amount of saturated fat and the presence of additives. This research was done in products of this kind available in João Pessoa - Paraíba supermarkets. The data collected was about the list of ingredients, nutritional facts and the information contained on the labels. The collected data were tabulated on the Excel ® spreadsheet and analyzed statistically by Principal Component Analysis (PCA). 107 yogurts from 10 different brands were evaluated, in which all yogurts were in compliance with current legislation. As of nutritional composition, the products had high amounts of added sugars, saturated fat and additives, which differs from the original composition of the original Greek yogurt recipe; however, the G brand had the lowest content of added substances and the best nutritional quality. The results show that consumers need to pay attention to product labels to make better choices, nutrition professionals are expected to better understand the composition of these yogurts to effectively guide their consumption.

Association between energy intake under‐reporting and previous professional nutritional counselling in low‐income women with obesity: A cross‐sectional study

AbstractIt is unclear if individuals who have previously been counselled by nutrition professionals are more prone to subsequently under‐report their energy intake. This study aimed to determine whether there is an association between energy intake under‐reporting and previous professional nutritional counselling for weight control in low‐income women with obesity. This is a cross‐sectional study. Adult women (19–44 years old in Brazil) with obesity, living in a household classified as the lowest economic strata, were included. Energy intake (EI) was identified using 24‐h food records (for three non‐consecutive days, including a weekend day. Total energy expenditure (TEE) was assessed using indirect calorimetry and triaxial accelerometers. Individuals with EI:TEE ratio below 0.65 were considered as under‐reporters. Participants were also asked if they had been previously counselled by a nutrition professional for their obesity treatment. Association was calculated using a multivariable model, adjusted for age, bodyweight, height, education and body fat. The sample consisted of 58 women, with a mean age of 33 years and a body mass index of 32.51 kg/m2. Among total participants, 20 (34.5%) women had undergone previous professional nutritional counselling, and 21 (36.2%) under‐reported their EI. Women who had already had some counselling with a nutrition professional had a higher adjusted prevalence of under‐reporting their EI [adjusted prevalence ratio: 2.58; 95% CI (1.27; 5.25), p = 0.008]. Low‐income women with obesity who had undergone previous professional nutritional counselling for weight loss showed a higher prevalence of under‐reporting their EI.

Physico‐chemical and functional properties of legume protein, starch, and dietary fiber—A review

AbstractLegumes have gained increased dietary importance in recent years due to their recognized health benefits. Recent plant protein revolution has elevated legumes to the forefront from consumers' and food industry's perspective. Unlike cereal proteins and starches, there is a scarcity of information on the structural properties of legume starches. Consumption of legume‐derived dietary fibers have a positive impact on the human health, in particular, gut health, which is a current research focus for nutrition and health professionals. Knowledge of legume ingredients properties (e.g., protein denaturation, starch gelatinization, pasting, and thermal properties) could aid in understanding functionality and potential uses of these materials. The physicochemical, thermal, and the functional properties of legume proteins, starches, and dietary fibers are elucidated. Both the food ingredient manufacturers and research and development professionals in the food industry can benefit from the information provided in this review article.

What MFTs should know about nutrition, psychosocial health, and collaborative care with nutrition professionals.

Despite sufficient evidence on the role of nutrition in psychosocial health, Marriage and Family Therapists lack the knowledge for sufficient assessment and referrals in treatment. The purpose of this article is to orient MFTs to human metabolism and the effects of various nutrients, or lack thereof, on the psychosocial health in their clients. The roles of several micronutrients and macronutrients will be described as well as the effects of eating patterns and overall metabolic health on mental health. Finally, implications for MFTs as sole practitioners, domains for assessment and psychoeducation, and recommendations for collaborating with nutrition professionals will be discussed.

Saliency-Aware Class-Agnostic Food Image Segmentation

Advances in image-based dietary assessment methods have allowed nutrition professionals and researchers to improve the accuracy of dietary assessment, where images of food consumed are captured using smartphones or wearable devices. These images are then analyzed using computer vision methods to estimate energy and nutrition content of the foods. Food image segmentation, which determines the regions in an image where foods are located, plays an important role in this process. Current methods are data dependent and thus cannot generalize well for different food types. To address this problem, we propose a class-agnostic food image segmentation method. Our method uses a pair of eating scene images, one before starting eating and one after eating is completed. Using information from both the before and after eating images, we can segment food images by finding the salient missing objects without any prior information about the food class. We model a paradigm of top-down saliency that guides the attention of the human visual system based on a task to find the salient missing objects in a pair of images. Our method is validated on food images collected from a dietary study that showed promising results.

Food Choice Decisions of Collegiate Division I Athletes: A Qualitative Exploratory Study.

Limited research has examined athletes’ food and health beliefs and decisions and the congruence of these decisions with recommendations from nutrition professionals. This study aimed to improve understanding of athletes’ food-related beliefs and practices to enable nutrition professionals to more effectively enhance performance while protecting athletes’ health. Division I college athletes (n = 14, 64% female) from a variety of sports were recruited to participate in 20-min semi-structured phone interviews about food and nutrition-related behaviors and cognitions. Data were content analyzed to identify themes and trends. Prominent factors influencing athletes’ food choices were potential benefits to health and performance, availability of foods, and recommendations from sports dietitians. Foods commonly consumed by athletes, including fruits, vegetables, and lean protein, were generally healthy and aligned with sports nutrition recommendations. Athletes avoided energy-dense nutrient-poor foods, such as fast food and fried foods, with the goal of improving performance. Some athletes took supplements (i.e., multivitamin, iron, protein) on the premise that they would improve health and enhance performance or recovery. While athletes’ nutrition behaviors are generally congruent with current recommendations, findings highlighted misconceptions held by athletes related to the benefits of some supplements and the belief that packaged/processed foods were inherently less healthy than other options. Nutrition misconceptions held by athletes and incongruities between athletes’ nutrition knowledge and behaviors suggest that dietitians should aim to dispel misconceptions held by athletes and provide additional guidance and information to support athletes’ current healthful behaviors to ensure these behaviors extend beyond their college athletic career.

O15 Montana Offers Innovative Virtual School Nutrition Leadership Institute During COVID-19

<h3>Objective</h3> Evaluate the Montana Cook Fresh Leadership Institute (MCF) for K-12 school nutrition staff, offered virtually due to COVID-19 restrictions. <h3>Use of Theory or Research</h3> The MCF curriculum was developed using a participatory approach from Montana Team Nutrition staff, school nutrition professionals, and state-level administration to include evidence-based materials and learning strategies. <h3>Target Audience</h3> Twenty-two nutrition professionals from 9 Montana school districts in July 2020. <h3>Program Description</h3> MCF was developed as a 30-hour, 5-day in-person training during 2018 and 2019. In 2020, the format of MCF was adjusted to a 10 day, 30-hour, 3-hour a day virtual workshop. MCF utilized live video conferencing and independent work completed via an online learning management platform. Topics addressed USDA regulations, procurement, food production, culinary skills, and emergency preparedness. <h3>Evaluation Methods</h3> A pre and post self-reported survey tool and a post MCF evaluation tool were applied. Descriptive statistics and ANOVA was applied to determine significant changes from pre to post (<i>P</i> < 0.05). <h3>Results</h3> Pre (n = 22) and post surveys (n = 21) determined an average 9.96% percent change in mean comfort level, confidence, and likelihood of future behavior (<i>P</i> < 0.05). The emergency preparedness plan demonstrated the greatest increase in comfort level (+26.50%; <i>P</i> < 0.05). Although not significant, comfort levels with farm to school (+16.98%) and USDA foods (14.06%) increased, while scratch cooking (-4.40%) decreased. Using herbs and spices in recipes (+20.48%) and completing a daily production record (+23.31%) demonstrated the greatest increases in reported comfort level (<i>P</i> < 0.05). Participants were most likely to participate in future remote professional development activities (+16.40%) and use a new recipe that includes fresh and dried legumes (+13.71%), although not significant. Seventy-five percent of knowledge questions demonstrated increases in correct answers. <h3>Conclusion</h3> The pre to post evaluation results indicate that a virtual MCF can achieve positive learning outcomes. Future training efforts should be focused on exploring ways to improve participants comfort with scratch cooking and batch cooking in a virtual format.

Collaborative Opportunities of Exercise and Nutrition Professionals with Levels of Disease Prevention

Apply It! After reading this article, health and fitness professionals will be able to: • define the five levels of disease prevention • explain how health and fitness professionals fit within each level of prevention • highlight how to collaborate with a registered dietitian nutritionist to meet clients’ health and wellness goals

P30 Interface of Neighborhood Residence on Obesity Prevention Behaviors and Self-Efficacy in Chinese Americans

BackgroundThe obesity epidemic is a prominent health issue affecting Chinese Americans in the United States. An individual's living environment affects dietary choices and consumption patterns, impacting weight-related outcomes. The important construct of self-efficacy provides a foundation for nutrition educators in understanding mediators of health behaviors.ObjectiveTo identify if self-reported neighborhood of residence (‘high income’ vs ‘middle-low income’) elucidate differences in obesity prevention behaviors and self-efficacy in Chinese Americans residing in Los Angeles county and the New York metropolitan area.Study Design, Settings, ParticipantsA cross-sectional survey design was used where a convenience sample of 650 participants (18-60 years old) completed a validated, self-administered questionnaire. Participants were recruited from universities, cultural institutions, and churches, representing a wide range of backgrounds.Measurable Outcome and AnalysisNineteen behaviors related to obesity risk reduction were measured with 9 items measuring self-efficacy for these behaviors. Participants indicated adoption of behaviors over the month reflecting food practices, portion size control, and consumption of plant-based foods. Descriptive statistics were conducted for the entire sample while t tests were applied for categorized neighborhoods (‘high income’ vs ‘middle-low income’).ResultsThe mean age of the study participants (67% female) was 36.3 (SD = 14.5) years. Higher frequency of adoption of 6 health behaviors within the ‘high income group’ as compared to counterparts was indicated by t tests. Notable mean differences in behavior included choosing steamed over fried foods (P < 0.01), using small amounts of oils (P < 0.05), eating healthful snacks (P < 0.05), and following traditional healthful Chinese food patterns (P < 0.01). Stronger self-efficacy levels in the ‘high income group’ for 7 out of 9 items reflecting the performance of dietary behaviors were also indicated by t tests.ConclusionNutrition professionals must assess client's living environments in the adoption of obesity prevention behaviors. In fostering behavioral confidence, investigating the impact of individuals’ neighborhood in various residential areas are warranted. The obesity epidemic is a prominent health issue affecting Chinese Americans in the United States. An individual's living environment affects dietary choices and consumption patterns, impacting weight-related outcomes. The important construct of self-efficacy provides a foundation for nutrition educators in understanding mediators of health behaviors. To identify if self-reported neighborhood of residence (‘high income’ vs ‘middle-low income’) elucidate differences in obesity prevention behaviors and self-efficacy in Chinese Americans residing in Los Angeles county and the New York metropolitan area. A cross-sectional survey design was used where a convenience sample of 650 participants (18-60 years old) completed a validated, self-administered questionnaire. Participants were recruited from universities, cultural institutions, and churches, representing a wide range of backgrounds. Nineteen behaviors related to obesity risk reduction were measured with 9 items measuring self-efficacy for these behaviors. Participants indicated adoption of behaviors over the month reflecting food practices, portion size control, and consumption of plant-based foods. Descriptive statistics were conducted for the entire sample while t tests were applied for categorized neighborhoods (‘high income’ vs ‘middle-low income’). The mean age of the study participants (67% female) was 36.3 (SD = 14.5) years. Higher frequency of adoption of 6 health behaviors within the ‘high income group’ as compared to counterparts was indicated by t tests. Notable mean differences in behavior included choosing steamed over fried foods (P < 0.01), using small amounts of oils (P < 0.05), eating healthful snacks (P < 0.05), and following traditional healthful Chinese food patterns (P < 0.01). Stronger self-efficacy levels in the ‘high income group’ for 7 out of 9 items reflecting the performance of dietary behaviors were also indicated by t tests. Nutrition professionals must assess client's living environments in the adoption of obesity prevention behaviors. In fostering behavioral confidence, investigating the impact of individuals’ neighborhood in various residential areas are warranted.