Table of Contents

Purpose: We explored Registered Dietitians’ (RDs’) perceptions about expressive touch (ET) as a means to provide client-centred care, a practice unreported to date. For this study, ET is defined as relatively spontaneous, responsive, and affective contact by dietitians.Methods: This exploratory study used an explanatory sequential mixed-methods approach. RDs in Northern Ontario were surveyed (54% response, n = 135) and these results were further explored in interviews with a subset of participants (n = 17). Analysis included descriptive and association statistics and qualitative description.Results: Most RDs considered ET a useful tool for effective client communication (66%–77%), yet they were hesitant to enact the practice (81%). Analysis of interviews revealed ET to be “situationally beneficial” with uptake influenced by an interplay of factors, described as: perceived client openness to touch, the environment, and RD comfort with touch. Greater uptake was reported among RDs working with distressed clients and clients in ambulatory clinics and long-term care. ET practice was limited by personal safety concerns, unknown client customs, and client misinterpretation.Conclusion: ET was valued by many RDs as an enhancement to client-centred care. Selective use of ET is influenced by the context of dietetic practice and by perceived client and RD comfort with the use of ET.

Purpose: To explore dietetic practitioners’ perceptions of their education and training in the knowledge, skills, and confidence to understand social justice issues and to engage in socially just dietetic practice and social justice advocacy.Methods: An online semi-qualitative survey sent to Canadian dietitians.Results: Most respondents (n = 264; 81.5%) felt that knowledge- and skill-based learning about social justice and social justice advocacy should be a part of dietetic education and training. Reasons given by respondents for the importance of social justice learning include: client-centred care and reflexive practice, effecting change to the social and structural determinants of health, preventing dietitian burnout, and relevance of the profession. Yet, over half of respondents either strongly disagreed or disagreed that they were adequately prepared with the knowledge (n = 186; 57.4%), skills (n = 195; 60.2%), or confidence (n = 196; 60.5%) to engage in advocacy related to social justice concerns. Some questioned the practicality of adding social justice learning via additional courses to already full programs, while others proposed infusing a social justice lens across dietetic education and practice areas.Conclusions: Dietetic education and training must do more to prepare dietitians to answer calls for dietitians to engage in social justice issues through practice and advocacy.

Food processing has a unique impact on patients living with chronic kidney disease who may need to restrict dietary sodium, potassium, and phosphorus intake. Canada is the second largest consumer of processed food in the world. Highly processed foods tend to be more nutrient dense, contain less fibre, and are higher in sodium than unprocessed foods. To reduce the amount of sodium in processed food, Health Canada has encouraged food producers to reduce the sodium in their food. Potassium additives have been identified as an attractive alternative to sodium and their use in food processing is expected to increase. Phosphorus additives have been reported to be present in about 44% of processed foods. Given the changes in the nutrient profiles of processed foods, dietary advice on ways to reduce sodium, potassium, and phosphorus intake may be best achieved by recommending minimally processed food and encouraging unprocessed foods more often.

Body changes concerns and body image dissatisfaction are common during pregnancy. We aimed to examine whether health care professionals (HCPs): (i) believe that women are concerned about body image during pregnancy; (ii) consider it important to question, support, and intervene when pregnant women express body image concerns; (iii) feel comfortable enough in their abilities to question pregnant women with concerns; and (iv) have sufficient knowledge and skills to provide adequate support. A 36-item e-survey, developed by ÉquiLibre in collaboration with an expert committee, was sent to HCPs via email. HCPs believe that some situations are associated with body image concerns: postpregnancy weight loss (74.0%), perceived changes in their appearance (65.9%), excessive weight gain (65.3%), and feeling less in control of their body (36.8%). Among 321 responders, 60% considered it important to question pregnant women’s concerns. One in four (25.4%) considered themselves “totally comfortable” asking about weight and body image concerns. Our study showed that HCPs need to be better supported in developing their abilities to help weight-preoccupied pregnant women. There is an urgent need to clarify HCPs’ roles and to delineate the referral process as well as to ensure staff availability, in terms of time and personnel.

Purpose: To better understand which plant-derived products contribute to the usual daily total polyphenol content (TPC) intake of Canadian adolescents.Methods: A convenience sample from 2 southwestern Ontario high schools was obtained (n = 108). Students of all gender and ethnicity were invited to participate if they were enrolled in grades 9–12 and were between the ages of 13 and 18 years. To measure the usual intake of TPC found in fruits, vegetables, fruit juices, nuts and legumes, tea, and coffee and coffee-based beverages, participants completed a food frequency questionnaire. TPC of the tea, coffee and coffee-based beverages, and fruit juices were determined spectrophotometrically, and the TPC of all other food items were calculated using the Phenol-Explorer Database.Results: Participants’ median consumption of TPC was 974 mg/day (25th, 75th percentile; 559, 2161, respectively). Fruit contributed 69% to TPC intake with 24% from vegetables; 3% from juice; 2% from tea, coffee, and coffee-based beverages; and 0% from nuts and pulses. No sex differences were found.Conclusion: The results of this exploratory study suggest that fruit is the major contributor to the daily TPC intake of adolescents in Ontario, Canada; however, a larger-scale study is warranted to confirm these findings.

Purpose: To investigate experiences with, and perceptions of, simulation in learning and using the Nutrition Care Process/Terminology (NCP/T) of dietitians in Canada.Methods: In February–March 2017, a convenience sample of 382 dietitians in Canada (71.8% in clinical practice) completed an online survey regarding the type(s), setting(s), and perceptions of the simulations in which they engaged in learning and using the NCP/T.Results: A majority (76.7%) of respondents had engaged in NCP/T-related simulation, most commonly case studies (85.3%) and role-play (42.0%), as part of workplace/volunteer training (51.4%) and undergraduate internship/stage/practicum (34.2%). Nearly half (49.5%) of respondents learned all 4 NCP components via simulation, with Nutrition Diagnosis being the most common individual component (57%). Over three-quarters of respondents agreed/strongly agreed that simulation helped them better understand/use the NCP/T and that NCP/T-related knowledge/skills gained through simulation are transferable to the clinical setting/dietetic practice.Conclusions: Dietitians in Canada perceive simulation to have helped them learn and use the NCP/T. Resources should be directed at further developing simulation for teaching the NCP/T in dietetics education and training. Research investigating characteristics, barriers, and facilitators of effective NCP/T-simulation, using objective (vs. perceived) learning outcome measures is needed.