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- Seabrook, Jamie A PhD3
- Twynstra, Jasna PhD3
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- Grant, Shannan PDt MSc PhD2
- Harvey, Antonia PDt MScAHN2
- MA, David W L PhD2
- Mannette, Jessica MA2
- Steel, Cindy MSc RD2
- Vohl, Marie-Claude PhD2
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- Ann, Fox PhD RD1
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- Arsenault, Judy Fraser PDt MAHE1
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- Bailey, Erin MSc RD1
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- Berenbaum, Shawna PhD RD1
- Bhattacharjee, Aritra1
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- OPEN ACCESSOropharyngeal dysphagia (OD), or dysphagia, is associated with malnutrition, pneumonia, and hospital admissions, and affects up to 35% of older adults in the community. This study aimed to understand dysphagia assessment and management practices among registered dietitians (RDs), speech-language pathologists (SLPs), and occupational therapists (OTs) working with adults in Canadian primary care and to help identify gaps and opportunities to optimize dysphagia patient care.A 22-question online practice survey was administered to RDs, SLPs, and OTs recruited through professional associations and practice groups.A total of 126 respondents partially or fully completed the survey. Clinical swallowing evaluations/mealtime observations were the primary assessment method used by RDs (92%), SLPs (83%), and OTs (50%). Patient education, oral care, and diet modifications were indicated as the top three management strategies. Challenges identified in dysphagia care included patient adherence to management strategies and limited personnel for assessing and managing dysphagia. Inter-professional clinical care pathways, patient/caregiver resources, and professional training for dysphagia assessment were identified to be the most valued resources for providing care.Timely assessment and management are crucial for community-living individuals with dysphagia. Finding unique and sustainable ways to overcome challenges in managing dysphagia in primary care will help improve care for this vulnerable population.
- OPEN ACCESSPurpose: To assess dietetic students’ anxiety levels before and after a series of simulations and to document students’ perceived sources of anxiety while completing simulation-based learning activities.Methods: A mixed-method convergent pilot study was conducted. Students enrolled in a Nutrition Assessment course that included a series of four simulations were invited to participate. Students completed an online pre-post simulation survey and engaged in individual interviews and a focus group discussion. The questionnaires included demographic questions and the French State-Trait Anxiety Inventory. Nonparametric tests and thematic analysis were used to examine data.Results: Fourteen students participated in the study’s quantitative component and seven in the qualitative component. There was a significant decrease in trait (44.5 ± 13.8 vs 32.0 ± 14.0, P = 0.01) and state (47.0 ± 11.2 vs 33.0 ± 18.0, P = 0.05) anxiety from pre- to post-simulations. Individual factors influencing students’ anxiety levels were stress and self-confidence. External factors influencing students’ anxiety levels were unknown situations, observers, patient profiles, observers’ feedback, preparation level, and academic setting.Conclusions: Our findings suggest that ensuring the educator is not present during simulations, advance preparation, and reassurance that simulations are a learning and not an evaluation activity may be effective pedagogical strategies for dietetic educators to reduce learners’ anxiety and facilitate competency development.
- OPEN ACCESS
- Paulina Morelli BASc,
- Véronique Garneau MSc, RD,
- Laurie Miville-Deschênes BSc, RD,
- Josiane Morin-Bernier BSc, RD,
- Marie-Claude Vohl PhD,
- Sophie Desroches PhD, RD, and
- Justine Keathley PhD, RD
Purpose: To investigate why Canadian nutrition care providers choose, or not, to integrate nutritional genomics into practice, and to evaluate the nutritional genomics training/education experiences and needs of nutrition providers in Canada, while comparing those of dietitians to non-dietitians.Methods: A cross-sectional online survey was distributed across Canada from June 2021 to April 2022.Results: In total, 457 healthcare providers (HCPs) [n = 371 dietitians (81.2%)] met the inclusion criteria. The majority (n = 372; 82.1%) reported having no experience offering nutritional genomics to clients (n = 4 did not respond). Of the 81 respondents with experience (17.9%), the most common reason to integrate nutrigenetic testing into practice was the perception that clients would be more motivated to change their eating habits (70.4%), while the most common reason for not integrating such tests was the perception that the nutrigenetic testing process is too complicated (n = 313; 84.1%). Dietitians were more likely than non-dietitians to view existing scientific evidence as an important educational topic (p = 0.002). The most selected useful educational resource by all HCPs was clinical practice guidelines (n = 364; 85.4%).Conclusions: Both dietitians and non-dietitians express a desire for greater nutritional genomics training/education; specific educational needs differ by type of HCP. Low implementation of nutrigenetic testing may be partly attributed to other identified barriers. - OPEN ACCESS
- Melissa D. Rossiter PhD,
- Margaret Young MSc,
- Elizabeth Dickson MHSc,
- Julie E. Campbell MSc,
- Sarah Caldwell MSc, and
- Jessie-Lee Mcisaac PhD
Early learning and child care (ELCC) settings in Canada follow nutrition standards that outline food provisions, with many also encouraging responsive feeding practices that help to create a supportive environment for children. Caregivers who lack confidence in children’s ability to regulate their own intake, or those who feel stressed about mealtime, may unknowingly engage in less responsive feeding practices. The CELEBRATE Feeding Approach is a flexible framework, driven by behaviour change theory, that builds on previous definitions and concepts of responsive feeding in ELCC environments. Through this approach, there is an intentional focus on supporting early childhood educators to implement feeding practices that are more responsive. The approach incorporates 13 target educator behaviours related to the three overlapping categories of CELEBRATE language, CELEBRATE Mealtime, and CELEBRATE Play. These practices recognize and support the development of a child’s sense of autonomy, confidence, and self-regulation not only at mealtimes but also through play-based exploration and language that is used throughout the day around food and feeding. The goal is that children will be open to a wide variety of food, develop their self-regulation skills, and build the foundation for a positive relationship with food throughout their lifetime. - OPEN ACCESSThe purpose of this literature review is to evaluate the extant research addressing food insecurity and mental health among street-involved 2S/LGBTQI+ youth in Canada. Searches were undertaken in academic databases, Google, and Google Scholar for relevant research articles, reports, and grey literature. Our team found nil research specifically addressing food insecurity and the mental health of street-involved 2S/LGBTQI+ youth in Canada. Given that, contextual and contributory factors affecting the mental health and food security of this population are discussed. The available research demonstrates a significant misalignment between the existing support mechanisms and the requirements of this specific population. This underscores the urgent necessity for the establishment of structurally competent, safe, and easily accessible resources. Moreover, there is a clear imperative for additional research endeavors aimed at addressing knowledge deficiencies. These efforts are crucial in empowering dietitians to facilitate enhanced interdisciplinary collaboration, thereby fostering the creation of sustainable, accessible, and appropriate food systems tailored to the needs of this vulnerable demographic.
- OPEN ACCESS
- Anisha Mahajan PhD, RD,
- Alison M. Duncan PhD, RD,
- Gerarda Darlington PhD,
- Jess Haines PhD, RD,
- David W.L. MA PhD,
- Andrea C. Buchholz PhD, RD, and
- On behalf of the Guelph Family Health Study
Purpose: Our understanding of the influence of sugar intake on anthropometrics among young children is limited. Most existing research is cross-sectional and has focused on sugar-sweetened beverages. The study objective was to investigate longitudinal associations between young children’s total, free, and added sugar intake from all food sources at baseline with anthropometric measures at baseline and 18 months.Methods: The Guelph Family Health Study (GFHS) is an ongoing randomized controlled trial and a family-based health promotion study. Food records and anthropometric data were collected at baseline (n = 109, 55 males; 3.7 ± 1.1 y, mean ± SD) and 18 months (n = 109, 55 males; 5.1 ± 1.1 y) of the GFHS pilots. Associations between sugar intakes and anthropometrics were estimated using linear regression models with generalized estimating equations adjusted for age, sex, household income, and intervention status.Results: Total sugar intake was inversely associated with body weight at 18 months (P = 0.01). There was no effect of time on any other associations between total, free, and added sugar intakes and anthropometrics.Conclusions: Early life dietary sugar intakes may not relate to anthropometric measures in the short term. Further investigation into potential associations between dietary sugar intakes and anthropometric variables over longer time periods is warranted. - OPEN ACCESS
- Antonia Harvey PDt, MScAHN,
- Jessica Mannette MA,
- Rotem Sigall-Boneh RD, MSc,
- Brad Macintyre BScH,
- Matthew Parrott PhD,
- Leah Cahill RD/PDt, PhD,
- Jessica Connors PhD,
- Anthony Otley MD, MSc,
- Jennifer Haskett PDt, BSNH,
- Johan van Limbergen MD, PhD, and
- Shannan Grant PDt, MSc, PhD
Literature on dietary behaviours of the pediatric Crohn’s Disease (CD) population and the relationship between dietary intake and CD activity is limited. Three dietary indices were developed and tested to conduct dietary pattern analysis in pediatric patients with CD consuming a free diet following remission induction via exclusive enteral nutrition (n = 11). Index scores underwent descriptive and inferential analysis. The mean adjusted scores (out of 100) for the Pediatric Western Diet Index, Pediatric Prudent Diet Index, and Pediatric-Adapted 2010 Alternate Healthy Eating Index (PA2010-AHEI) were 29.82 ± 15.22, 34.25 ± 15.18, and 51.50 ± 11.69, respectively. The mean Western-to-Prudent ratio was 0.94 ± 0.55. A significant correlation (r = −0.71) and relationship (F[1, 9] = 9.04, P < 0.05, R2 = 0.501) between the Western-to-Prudent ratio and PA2010-AHEI was found. The results suggest participants were not following a Western or Prudent diet, and were consuming foods not captured by the indices. More research is needed to describe dietary intake of individuals with CD, validate dietary indices in diverse samples, and explore the utility of these indices in CD assessment and treatment. The co-authors hope this work will stimulate/inspire subsequent interprofessional, dietitian-led research on this topic. - OPEN ACCESSLand2Lab is an evolving community-based intergenerational program that brings together Elders and youth on the land and in the kitchen and lab to share and celebrate Mi’kmaw foodways. Rooted in an Etuaptmumk-Two Eyed Seeing (E-TES) perspective, which acknowledges both Indigenous and Western ways of knowing, the project to date has featured seasonal food workshops, involvement in a children’s summer math camp, a food safety training workshop for teens, and the development of an online toolkit. The project was guided by the Mi’kmaw principle of Netukulimk, which reinforces respect for Mother Earth and stewardship of the land, water, and air for subsequent generations. Involvement of community leaders has been key to successful planning and implementation. While technology plays an important role, lessons learned on the land are critical and will inform efforts to include language and ceremony in future programming. Dietitians are encouraged to support Indigenous-led land-based learning in support of the profession’s commitment to reconciliation.
- OPEN ACCESS
- Hassan Vatanparast PhD, MD,
- Carol Henry PhD,
- Mehdi Rostami PhD, MSc,
- Sarah Finch PhD, RD,
- Allison Cammer RD,
- Emily Johnson,
- Zoe Longworth MPH, and
- Cindy Wang PhD
Linking Immigrants with Nutrition Knowledge (Project LINK) was a service-learning cultural competence training programme completed by undergraduate dietetic students enrolled in the University of Saskatchewan’s (USASK) nutrition and dietetic programme.This paper evaluates the impact of participation in the programme on students’ cultural competence. We conducted a cross-sectional survey and qualitative analysis of reflective essays of 107 participants of Project LINK from 2011 to 2014. Cumulative logistic regression models assessed the impact of the intervention on students’ cultural competencies. The Akaike information criterion compared models and Spearman correlation coefficient identified possible correlation among pre- and post-intervention data points. Student reflective essays were analyzed by inductive thematic analysis.All cultural competencies improved comparing pre- and post-participation in Project LINK. Odds of increasing one level of student knowledge were 110 times of that prior to Project LINK. Comparing student competencies before and after Project LINK, the odds of increasing one level of students’ skills were six times greater, five times greater for increasing one level of students’ ability to interact or encounter, and 2.8 times greater for increasing one level of students’ attitude.The results of this study indicate Project LINK has successfully increased cultural competence and underscores the importance of combining opportunities for practical experience in addition to classroom-based training on cultural competence. - OPEN ACCESS
- Liza Boyar RD MHSc,
- Ellis Lakhani BPH,
- Ivan Ho RD MScFN,
- Bridget King RD MHSc,
- Lauren Kennedy RD MScFN,
- Mary Ellen Prange RD MHSc,
- Daniel Harrington PhD, and
- Rachel Prowse RD PhD
Purpose: This study aimed to assess the reliability and validity of an online approach to monitoring food affordability in Ontario using the updated Ontario Nutritious Food Basket (ONFB).Methods: The ONFB was priced online in 12 large multi-chain grocery stores to test intra-/inter-rater reliability using percent agreement and intra-class correlations (ICCs). Then, the ONFB was priced in-store and online in 28 stores to estimate food price differences using paired t-tests and Pearson’s correlation for all (n =1708) and matched items (same product/brand and purchase unit) (n = 1134).Results: Intra-/inter-rater agreement was high (95.4%/81.6%; ICC = 0.972, F = 69.9, p < 0.001). On average, in-store prices were less than $0.02 lower than online prices. There were no significant differences between mean in-store and online prices for all items (t = 0.504 p = 0.614). The mean price was almost perfectly correlated between in-store and online (fully matched: R = 0.993 p < 0.001; all items: R = 0.967 p < 0.001). Online monthly ONFB estimates for a family of four were strongly correlated (R = 0.937 p < 0.001) with estimates calculated using in-store data.Conclusions: Online pricing is a reliable and valid approach to food costing in Ontario that contributes to modernizing the monitoring of food affordability in Canada and abroad. - OPEN ACCESS
- Joyce Slater PhD, RD,
- Alan Katz MBChB, MSc, CCFP,
- Bhanu Pilli Msc,
- Aynslie Hinds PhD,
- Marcelo L Urquia PhD,
- Julianne Sanguins PhD,
- Chris Green PhD,
- Jaime Cidro PhD,
- Dan Chateau PhD, and
- Nathan Nickel PhD
Purpose: The Food and Nutrition for Manitoba Youth (FANS) study examined dietary intakes, food behaviours, food security status, health indicators, and body mass index of a cohort of grade 9 students. This paper describes regional differences and similarities in dietary intake (food and nutrients) and quality of youth participants in the FANS study.Methods: Grade 9 students completed a web-based survey on dietary intakes (24-hour recall), food behaviours, self-reported health indicators, and sociodemographic variables. Nutrient intakes were compared with national guidelines and diet quality was assessed using a modified Healthy Eating Index.Results: A total of 1587 students participated from northern, rural, and urban regions in Manitoba. Northern and rural students had higher intakes of sugar, sodium, and saturated fat compared with urban. Northern students consumed fewer grain products compared to urban, and more servings of “other” foods compared with rural and urban. While most participants were classified into the “needs improvement” or “poor” Healthy Eating Index categories, significantly more northern participants were in the “poor” category.Conclusions: Most adolescents in the study are at nutritional risk; however, there are additional vulnerabilities for those in rural and northern communities. Dietitians can use results to advocate for and plan interventions to improve adolescent nutrition. - OPEN ACCESS
- Jamieson Jennifer A PhD, MSc,
- Erik Vandenboer MScAHN, RD,
- Barbara Anderson MAdEd, RD,
- Daphne Lordly DEd, MAHE, FDC, RD,
- Brenda Macdonald MAdEd, BSc, RD, and
- Fox Ann PhD, RD
Purpose: To explore the impact of the COVID-19 pandemic on Nova Scotian dietitian’s roles, responsibilities, and professional development needs.Methods: We conducted a province-wide, online, exploratory survey with registered dietitians during the initial waves of the COVID-19 pandemic. Differences were explored with descriptive statistics by work sector (hospital/acute care; primary health/community or public health (PH); long-term care [LTC]; other [e.g., private practice, retail]).Results: Dietitians (n = 122) reported being most frequently challenged by stress and anxiety, changing work expectations, and rapidly evolving safety protocols during the pandemic. Those working in PH, primary health, and LTC reported experiencing more work responsibilities, more change, and perceived less employer support than dietitians in other sectors. Despite the identified challenges, most participants (70.7%) felt their education and training were sufficient to take on these new work roles. Primary and PH dietitians, however, more frequently perceived their skill sets to be under-utilized than other sectors. Key learnings from practice identified as being important for dietetic education included qualities such as resilience, problem-solving, flexibility, and self-care.Conclusion: These findings will be of interest to health administrators, professional bodies, and academic institutions to inform strategies for strengthening dietetic practice, building resilience, and preparing for future emergencies. - OPEN ACCESS
- Sharon Stein PhD,
- Tabitha Robin PhD,
- Michael Wesley BSc, RD,
- Will Valley PhD,
- Daniel J. Clegg PhD,
- Cash Ahenakew PhD, and
- Tamara R. Cohen PhD, RD
Many Canadian universities have committed to becoming more accountable to Indigenous Peoples by confronting the systemic, historical, and ongoing colonialism and anti-Indigenous racism that shape their campuses. In this Perspective in Practice piece, we invite the field of dietetics to consider how colonialism has shaped dietetics research, teaching, and practice. We also consider how we might transform the field of dietetics in ways that accept settler responsibility for interrupting racism and colonial harm; support the resurgence of Indigenous food and health practices; and recognise the connections between struggles to ensure that Indigenous Peoples can access culturally appropriate food and health care, and struggles for Indigenous sovereignty and self-determination. We do this by reviewing the history of the dietetics field, examining critical responses to existing Indigenisation and decolonisation efforts, and reflecting on recent changes to required dietetics competencies. We argue that curricula in dietetics programmes must teach the history of the colonial food system and equip students to identify and interrupt the individual and institutional colonial dynamics that contribute to the ongoing dispossession of Indigenous Peoples’ lands and food sources and negatively impact Indigenous patients. - OPEN ACCESS
- Jessie L. Burns PhD,
- Aritra Bhattacharjee,
- Gerarda Darlington PhD,
- Jess Haines PhD,
- David W.L. MA PhD, and
- The Guelph Family Health Study
Purpose: Fish and seafood consumption by North American children is low. This is concerning, given the critical role of n-3 polyunsaturated fatty acids (eicosapentaenoic acid and docosahexaenoic acid), found in fish and seafood, in early development. This study aimed to determine whether parental factors related to fish and seafood consumption are associated with frequency of fish and seafood consumption in Canadian children.Methods: A subgroup of parents (n = 28) participating in the Guelph Family Health Study Pilot reported their perceptions and history of fish and seafood consumption, confidence in preparing fish and seafood dishes, and the frequency of intake for their children (n = 40).Results: This study found that 20% of children consumed one serving of saltwater fish, freshwater fish, or shellfish weekly and 63% consumed at least one type of fish or seafood monthly. Parental cooking confidence preparing fish and seafood was positively associated with at least monthly fish and seafood intake in children.Conclusions: These findings suggest that some children may have low intakes of fish and seafood due to a lack of parental cooking confidence when preparing fish and seafood dishes. Therefore, future research and interventions focused on addressing this barrier may aid in improving fish and seafood intake. - OPEN ACCESSMaternal diet during pregnancy can have a significant impact on maternal and offspring health. As nutrition counselling is an important component of prenatal care, registered dietitians (RDs) are uniquely trained professionals who can provide personalized nutrition counselling customized to an individual’s sociocultural needs. The objective of this systematic review was to determine if RD involvement during pregnancy is associated with a lower prevalence of adverse birth outcomes in the United States and Canada. The review was conducted through a search of four databases: PubMed, CINAHL, Embase, and Web of Science. A total of 14 studies were identified. Women had a lower prevalence of low birth weight and preterm infants when RDs were involved during prenatal care. While RD involvement during pregnancy was not associated with macrosomia, more research is needed to assess its relationship with small for gestational age, large for gestational age, and infant mortality. Future research should also investigate the specific dietary advice provided by RDs and the extent and timing of their involvement throughout pregnancy to better understand the mechanisms surrounding nutrition counselling, in utero development, and health outcomes.
- OPEN ACCESS
- Abigail Clarke,
- Jessica Mannette MA,
- Barb Hamilton-Hinch PhD,
- Mary Lynch MD, FRCPC,
- Patricia Williams PhD, PDt,
- Shannan Grant PhD, PDt, and
- Phillip Joy PhD, PDt
Purpose: FoodNOW (Food to eNhance Our Wellness) engaged in assessment of simulated households that include a person living with HIV/AIDS (PLWHA) in Nova Scotia to determine if a basic nutritious diet is affordable.Methods: We used supermarket websites to cost food and beverage items listed in the National Nutritious Food Basket (NNFB) for simulated households, each with a PLWHA. Food costing methodologies were co-developed and adapted with community members in response to barriers presented by the COVID-19 pandemic.Results: We found that simulated households, each with one PLWHA, that had a potential deficit after monthly expenses were a household of four on Income Assistance (−$1,058.70), a lone mother with two children on Income Assistance (−$973.65), a lone man on Income Assistance (−$677.40), and a household of four with one minimum-wage earner (−$383.45).Conclusions: Nova Scotia households with a PLWHA living on Income Assistance or with a minimum-wage earner cannot reasonably afford a nutritious diet in addition to basic household expenses. Using these food costing data can allow dietitians to efficiently inform government action and policy change to improve the health and wellness of individuals and families. - OPEN ACCESS
- Antonia Harvey PDt, MScAHN,
- Gillian Chu RD, MScAHN,
- Daphne Lordly PDt, DEd,
- Judy Fraser Arsenault PDt, MAHE,
- Sue Conlan PDt, MAHN,
- Tess Laidlaw PhD,
- Laurie A. Wadsworth PDt, PhD, and
- Shannan Grant PDt, MSc, PhD
Gaps in communication training have been identified in Canadian and international academic and practicum dietetics programs. A workshop was developed to pilot supplementary media training to nutrition students/trainees studying in Nova Scotia. Students, interns, and faculty from two universities participated in the workshop. Data on perceived learning, media knowledge/skill use, and workshop feedback were collected immediately post-workshop using a mixed-form questionnaire. A modified questionnaire was administered eight months post-workshop to obtain information on utility of the perceived acquired knowledge/skills. Closed-ended responses underwent descriptive analysis, while open-ended responses underwent thematic analysis. Twenty-eight participants completed the questionnaire post-workshop, and six completed it at follow-up. All participants rated the workshop positively (7-point Likert scale) and reported learning something new (perceived). Perceived learning emphasized general media knowledge/skills and communication skills. Follow-up data suggested participants had applied perceived media knowledge/skills in message development and media and job interviews. These data suggest that nutrition students/trainees may benefit from supplementary communications and media training and provide a stimulus for ongoing curriculum review and discussion. - OPEN ACCESS
- Daiva E. Nielsen PhD,
- Irem Karamanoglu RD, MScA,
- Hannah Yang Han MSc,
- Katherine Labonté PhD, and
- Catherine Paquet PhD
Purpose: This investigation evaluated food values, food purchasing, and other food and eating-related outcomes during the COVID-19 pandemic in Quebec, Canada. The role of stress in eating outcomes was also examined.Methods: An online household survey was conducted among Quebec adults aged ≥18 years (n = 658). Changes in outcomes during, as compared to before, the pandemic were evaluated using descriptive statistics and thematic analysis of free text responses. Eating outcomes by daily stress level (low, some, high) were assessed using Cochran–Armitage test for trend.Results: Most respondents reported increased importance and purchasing of local food products (77% and 68%, respectively) and 60% reported increased grocery spending (mean ± standard deviation: 28% ± 23%). Respondents with a higher daily stress level had a higher frequency of reporting eating more than usual compared to before the pandemic (low stress 21%, some stress 34%, high stress 39%, p-trend <0.0001). Free text responses described more time spent at home as a reason for eating more than usual.Conclusions: To support healthy eating during and post-pandemic, dietitians should consider patients’ mental/emotional well-being and time spent at home. Moreover, support of local food products may provide opportunities to promote healthy eating, sustainability, and post-pandemic resiliency of food systems. - OPEN ACCESSCurrent food systems drive environmental damage, social injustices, and undermine health, and these challenges are complex and seemingly intractable. Collaboration is required to transition to more sustainable food systems (SFS). Registered Dietitians and Nutritionists (RDs) are an under-leveraged and well-positioned group to contribute to addressing food systems challenges because of their locations in the system and their existing skillsets. Drawing on research with dietitians, this perspective paper presents both a theoretical proposal as well as collective expertise in supporting sustainable development of the global food system. It highlights where RDs work in food systems with the aim to reveal multiple points of entry where RDs can and do contribute to SFS across food systems, approaches to apply, as well as opportunities for collaboration within and beyond the profession. Educational and societal barriers exist that prevent systematic RD engagement; however, examples of established work provide models to follow.
- OPEN ACCESSVarious definitions have been proposed to describe Medical Nutrition Therapy (MNT). Broadly, MNT encompasses the provision of nutrition information and advice aimed to prevent, treat, and/or manage health conditions. In Canada, the provision of such information and advice is unregulated, thus allowing anyone to provide MNT services regardless of their education and training. This inevitably poses risks of harm such as the provision of unsafe and/or ineffective nutrition advice as well as delayed evidence-based treatment. Canadian research has further demonstrated that the general public is unable to properly differentiate between regulated, evidence-based nutrition providers (registered dietitians) and those who are unregulated. Therefore, the public is at risk. To reduce nutrition misinformation and ultimately improve the health and well-being of the public, the objective of this paper is, first, to propose a standardized definition of MNT for use across Canada and, second, to propose province- and territory-specific legislative amendments for the regulation of MNT throughout the country. We also present an opposing perspective to the proposed viewpoint. Ultimately, health care regulation across the country requires an overhaul before we expect that nutrition information and advice communicated to the public may be consistently evidence based.
