Applied Filters
- Review
Journal Title
Publication Date
Author
- Engler-Stringer, Rachel PhD2
- Garcia, Alicia C PhD RD CFE2
- Hanning, Rhona M PhD2
- Lordly, Daphne DEd PDt2
- Ryan-Harshman, Milly PhD RD2
- Aldoori, Walid MB BCh MPA ScD1
- Anderson, Kristin PhD1
- Austin, Zubin PhD1
- Ayliffe, Brenna MScAHN RD1
- Barnard, Neal MD1
- Berenbaum, Shawna PhD PDt1
- Berkow, Susan E PhD CNS1
- Cameron, Jill MSc1
- Castle, David PhD1
- Chan, Kathleen BSc1
- Charbonneau, Kimberly D MScFN C1
- Chaudhary, Neera MHSc RD1
- Chouinard, Laura E BASc RD1
- Cockell, Kevin A PhD1
- Colley, Paige MSc1
- Cooke, Martin PhD1
- Cooper, Marcia J PhD RD1
- Dahl, Wendy J PhD1
- Dalton, Janice E BSc HEc MHS RD1
- Dombrow, Carol RD1
Access Type
1 - 36of36
Save this search
Please login to be able to save your searches and receive alerts for new content matching your search criteria.
Filters
Search Name | Searched On |
---|---|
Paper Type: Review (36) | 8 May 2024 |
You do not have any saved searches
- Exclusive breastfeeding to 6 months with continued breastfeeding up to 2 years and beyond are well-established infant feeding recommendations based on evidence that breastfeeding has unparalleled maternal and infant health benefits as well as environmental and economic benefits. As with many high-income countries, breastfeeding rates remain suboptimal with only a quarter of Canadian and European infants receiving breast milk exclusively for the first 6 months. Breastfeeding promotion efforts have largely targeted caregivers in the prenatal and postnatal period; however, breastfeeding outcomes have been shown to be associated with broader sociocultural factors. Noncaregivers play an influential role in infant feeding at both an individual level (e.g., cues and input from health care practitioners and caregivers’ social networks; as future parents) as well as a broader population level (sociocultural norms and policy decisions). This paper outlines recent research on breastfeeding knowledge and attitudes of noncaregivers by population subgroup. Positive correlations have been identified between breastfeeding attitudes, infant feeding knowledge, breastfeeding exposure, and breastfeeding intention among different subgroups; however, key knowledge gaps, lack of exposure to breastfeeding, and negative public perceptions of breastfeeding persist. Dietitians can advocate for breastfeeding promotion strategies that consider the role of noncaregivers to address sociocultural norms around breastfeeding.
- At least 5% of women have an eating disorder (ED) during pregnancy. These EDs affect prepregnancy body mass index (BMI) and weight gain during pregnancy, factors associated with birth complications and adverse neonatal outcomes. This review contributes to the literature by examining several adverse birth outcomes associated with EDs and differentiates between past and present EDs. Of the 18 articles reviewed, EDs were associated with preterm birth in 5/14 (36%) and small-for-gestational-age in 5/8 (63%) studies. Anorexia Nervosa increases the odds of a low birth weight baby, particularly when women enter pregnancy with a low BMI. Binge Eating Disorder is positively associated with having a large-for-gestational-age infant, and Bulimia Nervosa is associated with miscarriage when symptomatic during pregnancy. Having a current ED increases the risk for adverse birth outcomes more than a past ED. Since the aetiology of adverse birth outcomes is multi-factorial, drawing conclusions about causal relationships between EDs and birth outcomes is problematic given the small number of studies reporting these outcomes. Resources should target preconception interventions that put EDs into remission and help women achieve a healthier BMI prior to pregnancy, as these have been consistently shown to improve birth outcomes.
- The quality of children’s diets has declined over the past few decades, giving rise to a variety of health-related consequences. In response to this trend, school food programs have become an increasingly effective method to support nutrition and lifelong healthy eating habits. This systematic review synthesizes current academic literature pertaining to school nutrition programs in Canada to identify existing interventions and their impacts on children’s nutritional knowledge, dietary behaviour, and food intake. The review was conducted through a search of the following databases: ERIC, Education Source, CINAHL, PubMed, SagePub, SCOPUS, EMBASE, and CBCA. Information extracted from the articles included the program objectives, intervention design and components, research evaluation, and primary outcomes. A total of 11 articles evaluating Canadian school nutrition programs were identified. The programs incorporated a variety of intervention components including policy, education, family and community involvement, and/or food provision. These multi-component interventions were positively associated with children’s development of nutrition knowledge, dietary behaviour changes, and intake of healthy foods; however, barriers associated with intervention duration, intensity, and availability of resources may have influenced the extent to which these programs impacted children’s diets and overall health.
- The high prevalence of constipation in long-term care (LTC) residents has been a long-standing issue for caregivers, attending health professionals, and the residents themselves. The traditional medical response has been to utilize pharmaceutical laxatives, enemas, and suppositories for treatment. The purpose of this review was to determine if fibre supplementation (including fibre added to foods) is effective in increasing stool frequency, improving stool consistency, and decreasing laxative use in LTC residents. A systematic search was conducted using PubMed and CINAHL databases, inclusive to March 2017. Search terms included: “long-term care” or “nursing home” AND “fiber (fibre),” “bran,” “psyllium,” “inulin,” or “prebiotic.” Intervention trials of fibre supplementation with ≥5 LTC residents were included. The search generated 456 articles following removal of duplicates; 8 studies met the inclusion criteria. Three additional trials were identified through a hand search of references of pertinent articles. Current evidence suggests that added fibre may be effective in increasing stool frequency and/or decreasing laxative use in LTC residents and, thus, may lessen the burden of constipation. However, randomized controlled trials are needed to clearly demonstrate the effects of adding fibre to foods, particularly insoluble and less fermentable sources, on constipation in LTC residents.
- Raphaëlle Jacob M. Sc.,
- Angelo Tremblay Ph. D.,
- Vicky Drapeau Ph. D.,
- Véronique Provencher Ph. D., and
- Louis Pérusse Ph. D.
En présence d’un environnement favorisant la sédentarité et l’accessibilité aux aliments, certains individus sont plus susceptibles au gain de poids. Cette différence individuelle peut s’expliquer par des interactions gène-environnement. En effet, il a été démontré que certains individus présentent une prédisposition génétique à l’obésité. De plus, une composante génétique a également été associée aux comportements alimentaires, tels que la restriction cognitive, la désinhibition et la susceptibilité à la faim, ces derniers étant également liés à l’obésité. L’objectif de cet article de revue est de présenter l’état des connaissances en ce qui a trait à l’héritabilité de certains comportements alimentaires, puis d’identifier les gènes associés à ces comportements. Les résultats démontrent que la désinhibition et la susceptibilité à la faim sont deux comportements alimentaires particulièrement héritables et que plusieurs gènes candidats sont maintenant associés aux comportements alimentaires. Ces résultats indiquent que l’on est loin d’être tous égaux face aux aliments et peuvent aider les professionnels à mieux comprendre la variabilité observée en contexte d’intervention. L’identification des gènes associés aux comportements alimentaires s’avère primordiale afin de mieux identifier les individus plus à risque de gain de poids et de mieux intervenir auprès de ces derniers.- The impact on student development associated with being part of a competitive program is an emerging finding in dietetics research. As such, a narrative review of relevant literature was conducted pertaining to competition in post-secondary programs and the educational experience of students with respect to developing a career in dietetics. The review was guided by 2 questions: How is competition experienced by students? What strategies can reduce competition among dietetics students within the educational experience? A refined literature screening process justified including 32 articles in the review. The overall review findings suggested that, across dietetics programs, the outcomes of competition negatively impacted students’ personal identity, motivation in the learning process, and involvement behaviours, including collaboration among students, participation in academic opportunities, and student relationships with faculty. The implementation of strategies conducive to addressing the effects of excessive competition and building a supportive academic environment, for example increasing collegiality and engaging students in intrinsic learning, are important for continued growth of the dietetics profession. Educators can reflect on the complex nature of competition and how the effects of excessive competition may be in opposition with the competencies that students are expected to develop as professionals.
- Katelyn M. Godin BSc,
- Sharon I. Kirkpatrick PhD,
- Rhona M. Hanning PhD,
- Jackie Stapleton MLS, and
- Scott T. Leatherdale PhD
School breakfast programs are widespread and serve varying objectives regarding youth health promotion. Evidence-based guidelines for breakfast programs may be important in maximizing their effectiveness related to student outcomes, yet it is unclear what is available in Canada. A systematic review was conducted to identify and compare Canadian guidelines related to breakfast programs. Data sources included grey literature databases, customized search engines, targeted websites, and content expert consultations. Eligible guidelines met the following criteria: government and nongovernment sources at the federal and provincial/territorial levels, current version, and intended for program coordinators. Recommendations for program delivery were extracted, categorized, and mapped onto the 4 environments outlined in the ANGELO framework, and they were classified as “common” or “inconsistent” across guidelines. Fifteen sets of guidelines were included. No guidelines were available from federal or territorial governments and 4 provincial governments. There were few references to peer-reviewed literature within the guidelines and despite many common recommendations for program delivery, conflicting recommendations were also identified. Potential barriers to program participation, including a lack of consideration of allergies and other dietary restrictions, were identified. Future research should identify how guidelines are implemented and evaluate what effect their implementation has on program delivery and student outcomes.- In Canada 95% of dietitians are female despite serving a sex-diverse population. Literature examining why there are so few male dietitians is limited. However, nursing, like dietetics, is female dominated but has a large body of literature examining sex diversity within the profession. Therefore, a narrative literature review was conducted to find articles that examined the following questions: (i) What are the barriers and motivating factors for prospective male nursing students? and (ii) What are the perceived sex-based challenges that male nursing students encounter during their education? A total of 38 articles were included in the final review and the results are presented under the following headings: barriers, motivators, and educational experiences both in the classroom and during clinical rotations. The review outlines the current state of knowledge regarding sex as it relates to nursing and how this information compares with the current dietetics literature. Conclusions and recommendations are drawn about what changes could be made in dietetic education immediately and how further research could provide insight towards reducing the barriers and facilitating easier access to dietetics education for males.
- The diet industry and media have a powerful influence over women, leading many to believe that they must modify their appearance for societal acceptance. Dietetics, as one of many predominantly female professions, may be particularly vulnerable to these pressures. An integrative review process was used to examine eating disorders and disordered eating within the dietetics profession with the aim to both synthesize existing data and develop questions for future research. Seventeen articles were reviewed using broad search terms and dates because of the dearth of available literature. Given nutrition programs and dietetic practice often involve significant exposure to food, ideas and opinions about food, weight, and its place in health and dietetic practice researchers were compelled to ask “why”. Findings were organized under 3 categories including thinness ideology, implications of food and body associated with nutrition or dietetic education, and establishment of a continuum. This review serves as a platform to inspire future research in an understudied but important topic related to dietetic education and practice. Minimally as a profession, baseline data need to be collected to understand the prevalence of disordered eating and eating disorders along the continuum of practice in Canada.
- There is evidence that Aboriginal children and youth in Canada and elsewhere are at higher risk of obesity and overweight than other children. However, there has been no review of healthy weights interventions specifically aimed at Aboriginal children. A structured search for peer-reviewed articles presenting and evaluating healthy weights interventions for Aboriginal children and youth was conducted. Seventeen articles, representing seven interventions, were reviewed to identify their main characteristics, evaluation design, and evaluation outcomes. Interventions included several large community-based programs as well as several more focused programs that all targeted First Nations or American Indians, rather than Métis or Inuit. Only 1 program served an urban Aboriginal population. None of the published evaluations reported significant reductions in obesity or overweight or sustained increases in physical activity, although some evaluations presented evidence of positive effects on children's diets or on nutrition knowledge or intentions. We conclude that broader structural factors affecting the health of Aboriginal children may limit the effectiveness of these interventions, and that more evidence is required regarding interventions for Aboriginal children in various geographic and cultural contexts in Canada including Inuit and Métis communities.
- Katrin Müller MSc,
- Lars Libuda PhD,
- Anna Maria Terschlüsen Dipl-Oecotroph, and
- Mathilde Kersting PhD
Because of widespread irregular lunch consumption by both children and adults, information on the effects of lunch on short-term cognitive functioning is relevant to public health. In September 2012, a MEDLINE search was conducted for studies in which the effects of lunch on cognitive performance were examined. Eleven experimental studies published from 1981 to 1996 were found and evaluated; all involved adults. In three studies, the effects of lunch and lunch skipping were compared; the remaining studies involved a determination of the effects of lunch size and lunch composition. Results of studies in which lunch was compared with no lunch indicate that lunch leads to potential impairment of some aspects of cognitive functioning in the early afternoon. Lunch size may influence cognitive functioning, with impairment more likely to occur after a large lunch than a small lunch. Furthermore, in comparison with low-fat lunches, high-fat lunches seem to result in slower but more accurate responses to some cognitive tasks. However, these suggestions must be viewed with caution, as they are based on only a few studies and are not thoroughly supported by high-quality evidence. In addition, results obtained with adults are not applicable to children. Thus, the potential effects of lunch need further examination in children and adults.- Registered dietitians (RDs) are regulated health professionals in short supply in Ontario and throughout Canada. Projected workforce studies indicate the situation will likely worsen. Accessing these nutrition specialists is an even greater concern for residents living in rural or remote regions of the province. Smaller communities are increasingly using telehealth as a way to deliver health care services and to improve access to health care professionals. The adoption of interactive videoconferencing as a telehealth application is examined as an alternative approach for accessing RDs in rural communities. While valid reasons exist for implementing videoconferencing, other issues must be considered. These include costs, technological requirements, organizational readiness, and legal and ethical concerns. Future research must fully address the concept of videoconferencing in relation to the Canadian dietetic workforce and practice requirements.
- Nutrition applications for mobile devices (e.g., personal digital assistants, smartphones) are becoming increasingly accessible and can assist with the difficult task of intake recording for dietary assessment and self-monitoring. This review is a compilation and discussion of research on this tool for dietary intake documentation in healthy populations and those trying to lose weight. The purpose is to compare this tool with conventional methods (e.g., 24-hour recall interviews, paperbased food records). Research databases were searched from January 2000 to April 2011, with the following criteria: healthy or weight loss populations, use of a mobile device nutrition application, and inclusion of at least one of three measures, which were the ability to capture dietary intake in comparison with conventional methods, dietary self-monitoring adherence, and changes in anthropometrics and/or dietary intake. Eighteen studies are discussed. Two application categories were identified: those with which users select food and portion size from databases and those with which users photograph their food. Overall, positive feedback was reported with applications. Both application types had moderate to good correlations for assessing energy and nutrient intakes in comparison with conventional methods. For self-monitoring, applications versus conventional techniques (often paper records) frequently resulted in better self-monitoring adherence, and changes in dietary intake and/or anthropometrics. Nutrition applications for mobile devices have an exciting potential for use in dietetic practice.
- With the growing pervasiveness of mass media, individuals of all ages and both sexes are bombarded with images that glorify youthfulness, messages that tie self-worth to thinness, and products that promise youth and beauty forever. Aging women are vulnerable to these societal messages and experience strong pressures to maintain their youth and thinness. As the physiological changes that accompany normal aging move these women farther from the “ideal” image, body dissatisfaction may increase. These women are confronted with the impossible task of trying to defy the natural process of aging through a variety of means, including fashion, cosmetics, selective surgeries, and personal food choices. The resulting body image issues, weight preoccupation, and eating disturbances can lead to voluntary food restriction, depression, social withdrawal, lower self-esteem, and disordered eating, all of which can have a negative impact on quality of life and nutritional status. In this review we explore existing research on body dissatisfaction among middle-aged (30 to 60) and older (over 60) women, discuss the prevalence of body dissatisfaction, its predisposing risk factors, and the resulting eating and body maintenance behaviours, and examine implications for dietetic practice.
- The process of professionalization has been widely studied in nursing, but little is known about it in dietetics. We explored the process of professionalization using an integrative review of nursing literature. Three research questions were addressed: 1. What are the stages of professional socialization? 2. Who are the participants in the socialization process? 3. What challenges are associated with the socialization process? From an initial list of 322 articles compiled from a search of relevant databases, 49 English-language primary research papers were selected for review. A form of constant comparative analysis was conducted to extract relevant data into categories based on the research questions. Findings suggest that the process of professional socialization is a complex and stressful process, which occurs in three phases and begins before entry into the formal education system. Within the formal education system, faculty and preceptors can have a positive or negative impact on an individual's professional growth and development. Much work is needed to develop an understanding of this process in dietetics, but the findings will have immediate relevance to dietitians’ educational and practice contexts.
- Sustainability and the environment are issues influencing individual and organizational choices on purchasing, waste management, and energy-saving practices. The food service industry and related stakeholders have reported active pursuit of initiatives to reduce environmental impacts. We examine reported environmentally friendly practices being implemented in the food service industry and consider ways in which health care or hospital food services can adopt some of these programs. Building and equipment, waste management, food, and non-food supplies and procurement are considered. Suggestions are made for small changes to start the green initiative in each of these areas. A health care food service department is a large consumer of resources, and therefore food service workers, managers, dietitians, and administrators can make a significant difference by supporting and adopting environmentally friendly practices. Further studies are needed to determine which practices are currently being implemented in health care facilities in Canada, as well as perceived facilitators and barriers to these practices in the food service area.
- North American family physicians and dietitians commonly recommend psyllium fibre supplementation for treating symptoms of irritable bowel syndrome (IBS). In this review, evidence on the effectiveness of psyllium supplementation for diagnosed IBS symptoms was evaluated and summarized. A systematic search of MEDLINE, CINAHL, and Web of Science was conducted. Included were full-length, peer-reviewed, English language articles in which psyllium ingestion was tested for its effect on IBS symptoms. Quality of these articles also was assessed. Twelve met the criteria for complete data abstraction. Seventy-five percent of the studies examined were of weak quality. Study designs and methods were heterogeneous. Patient-perceived global symptoms improved significantly in six of the nine studies measuring a global symptom outcome. In one study, significant improvements occurred in reported abdominal pain; in three, improvement did not occur. Quality of life and flatulence did not improve significantly in any studies in which these outcomes were examined. The results of this systematic review indicate limited and conflicting evidence to support the recommendation of psyllium supplementation for symptomatic IBS treatment.
- Contemporary Western society emphasizes thinness for women, and the ideal female body size has become progressively smaller over the past half century. Meanwhile, the actual female body size has increased steadily, and rates of aberrant attitudes and behaviours surrounding food and weight have risen and tend to be much more common in overweight individuals. Thus disordered eating and excess body weight may perpetuate each other's development. We have synthesized the literature concerning female body size and disordered eating within a sociocultural context. Eight cognitions and behaviours that occur in women were examined: media exposure, weight stereotypes, body dissatisfaction, dieting, “fat talk,” emotional eating, perfectionism, and the “superwoman” ideal. The research literature suggests that these factors may play a role in both disordered eating and obesity. Furthermore, these factors may induce triggers, exacerbated by perfectionism and excess weight, that increase the risk of binge eating. These triggers include interpersonal discrepancies, low interpersonal esteem, depressive affect, and dietary restraint. Comprehensive interventions targeting the indicated sociocultural cognitions and behaviours, combined with healthy living education, may be the most effective strategy for reducing the prevalence of disordered eating and obesity among females.
- Many health conditions are treated, at least in part, by therapeutic diets. Although the success of any intervention depends on its acceptability to the patient, the acceptability of therapeutic diets and factors that influence it have been largely neglected in nutrition research. A working definition of acceptability is proposed and an examination and summary are provided of available data on the acceptability of common diet regimens used for medical conditions. The goal is to suggest ways to improve the success of therapeutic diets. The proposed working definition of “acceptability” refers to the user's judgment of the advantages and disadvantages of a therapeutic diet—in relation to palatability, costs, and effects on eating behaviour and health—that influence the likelihood of adherence. Very low-calorie, reduced-fat omnivorous, vegetarian and vegan, and low-carbohydrate diets all achieve acceptability among the majority of users in studies of up to one year, in terms of attrition and adherence rates and results of questionnaires assessing eating behaviours. Longer studies are fewer, but they suggest that vegetarian, vegan, and reduced-fat diets are acceptable, as indicated by sustained changes in nutrient intake. Few studies of this length have been published for very low-calorie or low-carbohydrate diets. Long-term studies of adherence and acceptability of these and other therapeutic diets are warranted.
- An evidence-based review of research on obesity prevention and treatment in youth was conducted to identify successful elements of community nutrition interventions. Guidelines for dietetic practice appropriate to this age group were synthesized. Following a systematic review of English-language research papers published from 1996 to 2009, 63 interventions met inclusion criteria and were graded according to methodological quality, quantity, consistency, and reproducibility. They also were analyzed for common themes and used to develop guideline statements and a practice algorithm. A national panel of experts in community nutrition, public health, adolescent health, academia, and endocrinology assessed the guidelines and the practice algorithm for validity, acceptability, and applicability. Successful prevention strategies are comprehensive, address social and environmental influences, include nutrition education and physical activity, and use schools as a health promotion delivery venue. Computer- or technologybased and peer-modelling strategies are promising, developmentally appropriate approaches. Effective obesity treatment strategies utilize diet plans and behaviour modification techniques, and involve families in intensive, multidisciplinary interventions. Given the distinct needs of this age group, healthy body weight must be promoted through a comprehensive school-based approach. In summary, obesity prevention and treatment interventions should be comprehensive, multidisciplinary, and developmentally appropriate.
- Il est reconnu que les personnes âgées vivant en hébergement constituent une population à risque de souffrir de déshydratation. Un apport insuffisant en eau contribue au maintien d'un état d'hydratation sous-optimal, affectant la qualité de vie et l’état de santé. Selon les résultats des études recensées, entre 32 et 96 % des résidents des centres d'hébergement avaient des apports insuffisants en eau, et plus de 50 % consommaient moins de 1,5 l de boissons et d'eau par jour. Les facteurs de risque contribuant à limiter l'apport en eau des résidents se divisent en deux catégories, selon qu'ils touchent l'individu ou l'environnement social et institutionnel. L'apport en eau des résidents est associé aux repas et à l'administration des médicaments. La diminution de la perception de la soif, le refus volontaire de boire, la dysphagie et la dépendance fonctionnelle sont les facteurs individuels identifiés contribuant le plus à la diminution des apports hydriques. Le manque de soutien familial et de ressources humaines est également un facteur important puisqu'il réduit l'assistance offerte. Les diététistes jouent un rôle capital dans le maintien d'un bon état d'hydratation des résidents en identifiant les facteurs de risque pouvant compromettre les apports hydriques et en assurant l'implantation de mesures correctives appropriées.
- We examined the research literature to determine the skills and attributes that dietetic interns desire in clinical preceptors. A search of three databases produced little information specific to dietetics. Literature on preceptors in other health disciplines identified preceptor attributes that students in clinical placements value. We were able to cluster the data from these studies into four themes: knowledge and experience, personal characteristics, teaching skills and attitudes, and interpersonal relationships. This review suggests a need for further development of dietitian preceptor training, as well as for further research specific to dietetic interns’ needs.
- Over the past century, a major shift in North American food practices has been taking place. However, the literature on this topic is lacking in several areas. Some available research on food and cooking practices in the current context is presented, with a focus on how these are affecting health and how they might be contributing to health inequalities within the population. First, cooking and cooking skills are examined, along with the ambiguities related to terms associated with cooking in the research literature. Food choice, cooking, and health are described, particularly in relation to economic factors that may lead to health inequalities within the population. The importance of developing an understanding of factors within the wider food system as part of food choice and cooking skills is presented, and gaps in the research literature are examined and areas for future research are presented. Cooking practices are not well studied but are important to an understanding of human nutritional health as it relates to cultural, environmental, and economic factors.
- Noelle Martin BSc (HEc) Honors FN, MScFN (candidate),
- Alicia C. Garcia PhD, RD, CFE, and
- Beverly Leipert RN, PhD
Photovoice is an innovative qualitative method of participatory action research based on health promotion principles; however, it has not been used to its full potential in health care, particularly in nutrition and dietetics. Photovoice is also based upon the theoretical literature on education for critical consciousness, feminist theory, and community-based approaches to documentary photography. Participants take photographs representing their views on a specific topic and discuss them in a group process of critical reflection. Originally designed for research with rural women, Photovoice has been used with a variety of population groups throughout the lifespan, such as adolescents, nurses and nursing students, professional groups, Aboriginal women, the elderly, immigrant and low-income groups, and patients with a variety of diseases. The use of Photovoice as a research method is not restricted by health conditions, financial situation, employment status, or literacy level. It is used in community settings, professional practice, or institutional learning environments to explore participants’ views and opinions. We review studies in which Photovoice has been used, as well as the impacts, advantages, limitations, and ethics of its use. Gaps in knowledge and its potential use in nutrition and dietetic research are identified.- Milly Ryan-Harshman PhD, RD,
- Ellen Vogel PhD, RD, FDC,
- Holly Jones-Taggart PhD,
- Julia Green-Johnson PhD,
- David Castle PhD,
- Zubin Austin PhD, and
- Kristin Anderson PhD
Nutrigenomics is concerned with the role of nutrients in gene expression, and nutrigenetics is the study of how genetic variants or polymorphisms (mutations) can affect responses to nutrients; nutritional genomics is the umbrella term. Nutritional genomics can be expected to revolutionize the way dietitians and other health professionals identify people with chronic diseases and treat those diseases. Understanding the science of nutritional genomics is important to dietitians and other health professionals because major scientific advancements such as this usually have a significant impact on ethics, policy, and practice. Blood lipid profiles are one area in which nutritional genomics has quickly advanced knowledge. New knowledge is available on blood lipid profiles and associated conditions, such as obesity and type 2 diabetes. New technology has also had an impact on policy and practice issues, and ethics is an important issue to consider.- Telediabetes is a form of telemedicine used to provide education and clinical care to persons living with diabetes. Web-based delivery modes using cellular telephones and/or computers are of particular interest as they are becoming increasingly available. A review of current research on the practice of web-based telediabetes to adults with type 2 diabetes was conducted to determine the potential impact of this delivery mode on professional dietetics practice. Nine articles meeting the inclusion criteria were identified, critiqued, and summarized. Studies varied greatly in breadth and scope; consequently, few general conclusions could be drawn about telediabetes programs. Telediabetes programs were discussed in the context of soundness, effectiveness, cost-effectiveness, and practical characteristics. Trends indicated a promising future for telediabetes. Dietitians should view telemedicine as a viable tool for service delivery and increase their knowledge, competency, advocacy, and research efforts in this area.
- Recent concerns about adolescent nutrition and unhealthy weights have prompted an examination of the myriad influences on dietary intake during adolescence. Included here are a summary of the literature on family influence on dietary intake, specifically during adolescence and within the family context, a summary of family meal patterns, and a systematic review of the known influences of family meals on dietary intake. Because of the complexity of families in today’s society, models were developed to depict the broad context of familial influences on adolescent nutritional behaviours and attitudes and to describe what is known and not known about family meal influences on adolescent dietary intake and quality. A systematic review of the literature revealed seven articles specifically related to adolescents, family meals, and dietary intake, which were analyzed for strength of evidence and plausibility. In spite of data collection methods relying on self-report, results suggested that family meals were associated with improved dietary intakes. Families in today’s societies are complex. Nevertheless, parents have the potential to influence positively, through family meals, what food is provided, where it is provided (e.g., home, restaurant), and within what type of atmosphere it is provided.
- A systematic review was conducted of community-based nutrition and physical activity strategies for chronic disease prevention targeting low-income populations. A computer search of the relevant published literature from 1996 to 2004 was done using Medline, EMBASE, ERIC, CINAHL, PubMed, and HealthSTAR databases. The primary objective was to develop an inventory of intervention strategies. The interventions ranged in approach from traditional group sessions taught by allied health professionals, peer-led workshops, one-on-one counselling print material, and home-based telephone and mail interventions to multimedia strategies and experiential activities such as food demonstrations and group exercise. The results suggest that nutrition and physical activity interventions aimed at low-income audiences tend to be delivered in an interactive visual format, to be culturally appropriate, to be administered in accessible primary care settings, and to provide incentives.
- John L. Sievenpiper BASc, MSc,
- Alexandra L. Jenkins BSc, RD, CDE,
- Dana L. Whitham BSc, RD, CDE, and
- Vladimir Vuksan PhD
Insulin resistance is a prevalent condition, in which insulin loses its normal physiological action. Since people were first classified as insulin resistant over 60 years ago, one of the main discoveries has been that insulin resistance clusters with other risk factors such as obesity, elevated triglycerides, and low high-density lipoprotein cholesterol, increasing cardiovascular disease risk. Although insulin resistance appears to manifest first in the periphery and then in the liver, other sites, such as the brain and the pancreatic β-cell, may play pathogenic roles. Factors contributing to insulin resistance at these sites include perturbations in free fatty acids, glucose, and hormone-signalling, some of which may be linked to various genetic polymorphisms. Appropriate nutritional treatment for insulin resistance is controversial. Two main approaches are drawn from diabetes recommendations: i) a high-carbohydrate, low-fat, highfibre diet emphasizing low glycemic-index foods and ii) sharing calories between monounsaturated fat and complex carbohydrate at the expense of saturated fat. Recent interest in insulin resistance has prompted the development of new guidelines. Promising data have also emerged, showing that a high-carbohydrate, high-fibre, low-fat diet plus exercise programs maintained through intensive counselling can decrease diabetes risk by over 40%. Additional research is required to confirm the sustainability of this approach and sort out the determinants of insulin resistance so that more effective nutritional interventions will result.- This paper summarizes existing evidence on the impact of food information programs. Published and unpublished literature produced within the past decade was searched and reviewed. Relevant data were tabulated and key findings summarized. Food information programs are becoming increasingly popular as tools to help consumers select a healthy diet. The key feature of a food information program is a package logo on foods meeting nutrition criteria set by the program's administering body. The logo acts as a health message. Several countries, including Canada, have adopted food information programs. Critics believe that these programs oversimplify the concept of healthy eating, that consumers misinterpret the logo's meaning, that licensing fees prohibit small companies from participating, and that the programs are limited to purchase behaviour and do not necessarily have an impact on dietary intake. Consumers report support for the programs and are able to interpret a logo's meaning accurately. In addition, evidence shows the programs have had a positive impact on the nutrient composition of foods. Research is still needed, however, to establish the impact of such programs on food purchases and dietary intake, and the overall and long-term effectiveness of the programs as a nutrition intervention.
- Ilene Hyman PhD, BSc (PT),
- Sepali Guruge BScN, MSc, PhD Student,
- Mary-Jo Makarchuk MHSc, MSc, RD,
- Jill Cameron MSc, and
- Vaska Micevski MScN, RN
Little attention has been given to the dietary patterns of new immigrant women in Canada. Research suggests that before migration, many immigrants, especially those from non-Western countries, consume a healthy diet, but this changes on migration. This paper presents information from a recently completed literature review conducted for the Women's Health Council of the Ontario Ministry of Health and Long-Term Care. The paper includes a review of the major determinants of food choice and health promotion strategies appropriate to new immigrant women. Our findings suggest that nutrition intervention for new immigrant women must consider the social context of these women's lives, address cultural, linguistic, economic and informational barriers and consider how these change over time. Recommendations are also made on how to best promote healthy eating in this group.- Energy requirements of children and adolescents with cerebral palsy appear to be disease-specific and different from the current recommendations for healthy children, varying depending upon functional capacity, degree of mobility, severity of disease, and level of altered metabolism. Feeding problems are prevalent in many of these children, and can result in inadequate energy intake. Wasting of voluntary muscles, a common symptom of cerebral palsy, contributes to reduced resting energy needs; nevertheless, the location of the central nervous system lesion may also influence energy requirements. To guarantee individualized, accurate, and optimal energy recommendations for this population, resting energy expenditure should preferentially be measured by indirect calorimetry. Equations and formulae to predict healthy people's resting energy expenditure are available, but tend to overestimate these children's energy needs. Future studies should address the role of the central nervous system in regulating energy metabolism in this population. When adequately nourished, children and adolescents with cerebral palsy appear more tranquil and require decreased feeding time, which gives caregivers time to develop the child's functional independence and character. Understanding energy requirements of this population will provide caregivers and health professionals with guidelines for providing optimal nutritional status.
- The mass media, including broadcast, electronic, and print media, have become entrenched in Canadians’ daily lives. Spending the majority of their leisure time with mass media puts Canadians at increased health risk. Our review of the research literature shows that television (TV) viewing and content are linked to potential consumer health risks due to developed health attitudes, beliefs, and behaviours. The associated health risks of children and youth are of particular concern. Excessive TV viewing has been associated with obesity development, increased energy consumption, reduced energy expenditure, negative body image development, and reduced concern with the concept of self-care. Media literacy, the ability to view critically and understand mediated messages, is a possible technique to mitigate these adverse effects. The enhanced inclusion of media literacy concepts in health education activities of dietetic practice is advocated. Dietitians could increase their understanding of research findings on the health-related effects of mass media use and the implications of including media literacy in daily practice. Such awareness would further augment available health promotion strategies.
- Selenium is an essential trace element involved in several key metabolic activities via selenoproteins, enzymes that are essential to protect against oxidative damage and to regulate immune function. Selenium also may have other health benefits unrelated to its enzymatic functions. It may provide important health benefits to people whose oxidative stress loads are high, such as those with inflammatory or infectious diseases like rheumatoid arthritis or human immunodeficiency virus/acquired immunodeficiency syndrome, or who are at high risk for cancers, particularly prostate cancer. Some studies have generated compelling evidence that selenium is beneficial, either alone or in conjunction with other micronutrients. Additional data from large clinical trials that provide the highest level of evidence will be key to determining the benefits accrued at various selenium intake levels. When the strength of the evidence becomes sufficient, clinical health professionals will need to use dietary and clinical assessment methods to ensure that people at increased risk for cancer or inflammatory and infectious diseases can be appropriately advised about selenium intake.
- Purpose: Collective kitchens are community-based cooking programs in which small groups of people cook large quantities of food. They have developed over the past 20 years, and hundreds of groups have been formed across the country. However, collective kitchens described in the literature vary considerably in structure, purpose, and format. The purpose of this review is to synthesize research on this topic. Methods: Articles and theses were collected through searches of major databases, and synthesized to improve understanding of current information, and of continuing gaps in the knowledge of collective kitchens in Canada. Results: The limited published research on collective kitchens suggests that social and learning benefits are associated with participation. Some indication exists that participants also find the food cooked to be high quality, culturally acceptable, and acquired in a manner that maintains personal dignity. Whether collective kitchens have an impact on food resources as a whole is unclear, as research has been limited in scale. Conclusions: The role of collective kitchens in community building and empowering participants often is noted, and bears further investigation. Dietitians and nutritionists have a unique opportunity to facilitate the health promotion and food security benefits of collective kitchens.
- Overview: Iron is an essential nutrient, playing a central role in oxygen transport and cellular energy metabolism. The importance of ensuring adequate bioavailable dietary iron stems from the severe consequences associated with iron deficiency (ID) and anemia, including reduced immune function and resistance to infection, developmental delays and irreversible cognitive deficits in young children, impaired physical work performance, and adverse pregnancy outcomes. Specific populations: Poor dietary iron intake and ID exist in Canada, particularly in women of reproductive age. Data from the provincial nutrition surveys suggest that the prevalence of inadequate iron intakes (and low intakes of absorbable iron) among women under 50 years of age is over 10%, which may reflect poor iron status. Teenage girls are at risk for low iron stores because of the adolescent growth spurt and the onset of menstruation; those who are vegetarian are at even greater risk. Conclusions: The Canadian diet has changed so that grain products are now the main source of dietary iron for all age groups. The public must be educated to ensure the consumption of adequate quantities of bioavailable iron and enhancing factors such as vitamin C. Industry, government, and health professionals must work together to promote healthy eating patterns and the selection of appropriate foods.