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Recent world events have shone a spotlight on the social and structural injustices that impact the lives, health, and well-being of individuals and communities under threat. Dietitians should be well positioned to play a role in redressing injustice through their individual and collective “response abilities”, that is, the combination of responsibility for and ability to be responsive to such injustices due to the varying privilege and power that dietitians have. However, recent research shows that dietitians report a lack of knowledge, skill, and confidence to take on such roles, and that dietetic education includes little knowledge- or skill-based learning that might prepare dietitians to do so. This primer aims to introduce readers to concepts that are fundamental to socially just dietetics practice, including privilege, structural competence, critical reflexivity, critical humility, and critical praxis. We assert that when implemented into practice and used to inform advocacy and activism these concepts enhance dietitians’ individual and collective response ability to redress injustice.

Purpose: The study aimed to determine current practice, barriers, and enablers of foodservices in Canadian hospitals relative to guiding principles for best practice to prevent malnutrition.Methods: Foodservice managers completed a 55-item cross-sectional, online survey (closed- and open-ended questions).Results: Survey responses (n = 286) were from diverse hospitals in all Canadian regions; 56% acute care; 13% had foodservices contracted out; and 60% had a reporting structure combined with clinical nutrition. Predominantly, foodservice systems were 43% in-house versus 41% pre-prepared, 46% cook–serve food production, 64% meals assembled centrally (on-site), and 40% non-selective menus with limited opportunities for patient choice in advance or at meals. The “regular menu” (44%) was most commonly served as 3 meals, no snacks at specific times. Energy and protein-dense menus were available, but not widespread (9%). Daily energy targets ranged from 1200 to 2400 kcal and 32% of respondents viewed protein targets as important. The number of therapeutic diets varied from 2 to 150.Conclusions: Although hospital foodservice practices vary across Canada, the survey results demonstrate gaps in national evidence-based practices and an opportunity to formalize guiding principles. This work highlights the need for standards to improve practice through patient-centered, foodservice practices focused on addressing malnutrition.

This qualitative study explored the impressions of pregnant Canadian women toward Canada’s Food Guide (CFG) snapshot released in January 2019. Semi-structured interviews were conducted with 8 physically active pregnant women. Interviews were digitally recorded, transcribed verbatim, and analyzed using thematic analysis. Three themes emerged: (i) pregnancy changes what I eat; (ii) what is healthy to me? and (iii) a connection with people and food. Pregnancy was the primary factor influencing dietary changes, and messages in the snapshot reinforced some dietary behaviours that participants had already incorporated. Participants wanted information specific to pregnancy but were not aware of available resources pertaining to nutrition on existing websites. Dietitians and other health care professionals should take steps to raise awareness of and ensure wider dissemination of reliable resources on healthy eating during pregnancy including Canada’s Food Guide website.

A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified: (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.