Journal of the Academy of Nutrition and Dietetics
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Consumption of sugary beverages has been identified as a contributor to childhood obesity. Studies have established the importance of specific parenting practices to children's beverage consumption; however, no study has examined multiple operationalizations of parenting to better understand where to focus future interventions. The present study examined the relationship between children's sugary beverage consumption and a parenting model that included household food rules, parent modeling of food rules, parent-mediated behaviors, and parent support. ⋯ Parent support and parent-mediated behaviors, including total screen time and eating at fast-food restaurants at least weekly, were associated with greater consumption of sugary beverages in children. No other parenting variables were significant. Encouraging caregivers to promote healthy dietary behaviors and provide healthy choices, limiting children's television and computer use, and reducing fast-food consumption can contribute to reductions in sugary beverage consumption among children.
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Physical inactivity and being overweight or obese are lifestyle factors that put breast cancer survivors at a higher risk for a cancer recurrence and/or development of other chronic diseases. Despite this, there is limited research that has identified effective lifestyle interventions aimed specifically at weight loss in breast cancer survivors. This pilot study is a single-arm experimental pre-post test design, conducted from November 2009 to July 2010, that tested the efficacy of a 24-week group-based lifestyle intervention modeled on the Diabetes Prevention Program in early stage breast cancer survivors (N=14). ⋯ In exploratory analysis, participants who lost >7% body weight were older and attended a greater percentage of diet and supervised exercise sessions. There were no significant changes in any of the blood biomarkers at 24 and 36 weeks; however, the results provide a measure of expected effect size for future research studies. This pilot study demonstrated the efficacy of a lifestyle intervention based on the Diabetes Prevention Program in early stage breast cancer survivors and represents an innovative clinical intervention for dietetics practitioners to address the unmet need for programs.
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Comparative Study
Beyond malnutrition screening: appropriate methods to guide nutrition care for aged care residents.
Malnutrition is common in older adults and early and appropriate nutrition intervention can lead to positive quality of life and health outcomes. ⋯ MST, MUST, MNA-SF, and the anthropometric screens corrected arm muscle area and calf circumference have acceptable concurrent validity compared with validated nutrition assessment tools and can be used to triage nutrition care in the long-term-care setting.
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Many factors affect the current and future practice of dietetics in the United States. This article provides an overview of the most important population risk factors and trends in health care and public policy that are anticipated to affect the current dietetics workforce and future of dietetics training and practice. It concludes with an overview of the state of the current workforce, highlighting the opportunities and challenges it will face in the future. ⋯ This bifurcation will require the dietetics profession to consider new practice roles and the level of education and training required for these roles in relation to how much the health care delivery system is willing and able to pay for services. There are many challenges and opportunities for the dietetics workforce to address the changing population risk factors and trends in health care and public policy by working toward intervention targets across the social-ecological model to promote health, prevent disease, and eliminate health disparities. Addressing nutrition-related health needs, including controlling costs and improving health outcomes, and the demands of a changing population will require careful research and deliberation about new practice roles, integration in health care teams, workforce supply and demand, and best practices to recruit and retain a diverse workforce.
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Review
Nutrition and health literacy: a systematic review to inform nutrition research and practice.
Health literacy is defined as the degree to which individuals obtain, process, and understand basic health information and services to make informed health decisions. Health literacy is a stronger predictor of health than age, income, employment, education, and race. Although the field has grown during the past decade, most health literacy research does not explicitly focus on food or nutrition, and dietetics practitioners often remain unaware of patients' health literacy level. ⋯ Of the 33 studies reviewed, four focused on measurement development, 16 on readability assessments, and 13 on individual literacy skills assessments. Collective evaluation revealed four noteworthy gaps, including the need to use more comprehensive assessment approaches that move beyond readability and numeracy to address the full spectrum of health literacy factors; the need to apply more robust experimental studies to examine the effectiveness of health literacy interventions among individuals, communities, health care providers, and health care systems; the need to explore the moderating and mediating roles of an individual's health literacy status on nutrition outcomes; and the need to examine long-term effects of health literacy interventions on nutrition outcomes. This article defines health literacy gaps and opportunities in nutrition research and practice, and calls for continued action to elevate the role of dietetics practitioners in addressing health literacy.