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Purpose: How Canadian dietitians define and use non-dieting and size acceptance approaches (SAAs) in the context of weight management was explored. Methods: Fifteen focus groups with 104 dietitians were conducted in seven Canadian cities. Questions were designed to explore participants’ understanding and use of non-dieting and SAAs, including counselling goals, techniques, and outcome measures. Sessions were tape-recorded, transcribed verbatim, coded, and analyzed using qualitative methods. Results: Participants generally agreed that non-dieting involves promoting healthy lifestyles and avoiding restrictive diets. Participants also agreed that size acceptance means accepting all body shapes and sizes and promoting comfort with one's body. Many dietitians said they use size acceptance only with appropriate clients, most often with those who are lighter or without other health risks. Others said that size acceptance, by definition, is appropriate for everyone. Opinions varied about the appropriateness of teaching portion sizes or using meal plans, and whether weight loss could be a goal of non-dieting and SAAs. Conclusions: Views on the usefulness of non-dieting and size acceptance strategies in weight management counselling were related, at least partially, to the different understanding that dietitians had of these approaches. Terminology needs to be clarified when we speak about non-dieting and SAAs. The varied understanding about these concepts should help dietitians reflect on their own perspectives and practice.

The Hamilton Health Service Organization Nutrition Program integrates nine registered dietitians (RDs) into the offices of 80 family physicians (FPs) at 50 sites in Hamilton, Ontario. The program is based on a shared care model, in which FPs and RDs work collaboratively to provide nutrition services aimed at prevention, treatment, and management of nutrition-related problems. In addition to their clinical role, dietitians in the program are involved in health promotion, disease prevention and early intervention strategies, interdisciplinary collaboration, building links with community services, and research. The RDs’ specialized knowledge, skills, and experience allow them to provide a wide range of services that complement and augment those of the FP. This model is consistent with Canadian health care reform recommendations and offers significant benefits for both health care providers and consumers.

Purpose: Texture-modified diets offered in long-term care (LTC) facilities are often prepared from the regular menu, planned using Canada's Food Guide to Healthy Eating. The appropriateness of protein levels of puréed diets in LTC facilities was determined. Methods: Protein content was measured in 29 duplicate diets, collected from 20 urban LTC facilities in Saskatchewan (SK) and Ontario (ON). Mealtime puréed food intakes of 20 LTC residents were assessed. The target protein levels were calculated as estimated average requirements plus one or two standard deviations of intake, thus allowing for moderate (16%) or low (2.5%) risk of inadequacy, respectively. Results: The duplicate diets provided 57.9 ± 7.9 and 85.4 ± 31.1 g/day of protein in SK and ON, respectively. Protein intake of SK LTC residents consuming puréed food averaged 54 ± 19 g/day. Only 43% of the SK puréed diets provided more than 59 g/day of protein and none provided more than 78 g/day; in contrast, 87% and 40% of ON puréed diets provided more than 59 and 78 g/day of protein, respectively. Conclusions: In-house prepared puréed diets do not consistently provide sufficient protein levels to ensure a low risk of inadequacy for the LTC residents consuming these diets.