Knowledge and attitudes of registered dietitians concerning vegetarian diets

Registered Dietitians' (RD) knowledge and attitudes about the safety, adequacy and health benefits of vegetarian diets were estimated. A questionnaire was developed with demographic, knowledge, and attitude questions and was completed by 182 RDs from Washington, Nebraska and Vermont. The results showed that RDs in Vermont had significantly higher attitude scores regarding vegetarian diets than RDs in Nebraska (63% vs. 52% of questions answered correctly, respectively) and that RDs in Washington had significantly higher knowledge scores concerning vegetarian diets than RDs in Nebraska (73% vs. 67% of questions answered correctly, respectively). A significantly higher percentage of the RDs from Vermont, 52%, reported having followed some type of vegetarian diet compared to only 28% of the RDs from Washington or 12% of the RDs from Nebraska. Results also showed that RDs who had followed vegetarian diets at the time of the study or at some time in the past had significantly higher overall knowledge and attitude scores when compared with those RDs who had never followed vegetarian diets. There was a significant positive correlation between overall knowledge and overall attitude score for individual subjects. This suggests that increasing the knowledge base of RDs concerning vegetarian diets may lead them to consider meatless diets in a more positive light. In addition, average overall knowledge and attitude scores suggested that RDs are not up to date with current research in the field of vegetarian nutrition.     

青壮年单纯性肥胖的饮食分析

目的讨论青壮年单纯性肥胖与饮食结构的关系。方法356位住户中,根据WHO提出的年龄划分,筛选100位符合年龄、性别条件的社区居民完成初选。临床上一般采用的衡量肥胖度、体质量指数（BMI）、腰围测量和腰臀比计算方法筛选出两组进行膳食结构、饮食数量、食物类型的比较。最后运用中国营养学会推荐的“中国居民平衡膳食宝塔”作为衡量饮食是否合理的标尺,对研究组的饮食情况和运动情况进行类别性的分析并发现问题提出建议再给出具体的膳食宝塔推荐值。结果单纯性肥胖与饮食有较强关联。避免膳食失衡、树立正确运动意识、培养良好运动和饮食习惯、能很好控制单纯性肥胖。结论在合理补充人体必需物质的同时,建立合理营养膳食结构,消除饮食过量等不均衡现象;树立正确运动意识、培养良好运动习惯,都能有效控制肥胖症发病率及纠正肥胖状况。     

A primary care based healthy-eating and active living education session for weight reduction in the pre-diabetic population

AimsMany studies have demonstrated the effectiveness of primary prevention strategies in type 2 diabetes, however, questions remain around the feasibility of high resource, intensive interventions within a healthcare setting. We report the results of a dietitian-led pre-diabetes education session targeting healthy eating and active living as strategies for weight reduction.MethodsParticipants were asked to complete a baseline questionnaire prior to completing the pre-diabetes education session and were sent follow-up questionnaires at 3 and 6 months. Differences between participants at baseline, 3 and 6 months were determined using χ², t-tests and ANOVA.ResultsOf the 211 participants asked to fill out baseline questionnaires, 45 participants completed questionnaires at baseline, 3 months and 6 months. Although we observed general trends towards improvements in diet, physical activity and weight related behaviours among the 45 completers, no significant changes were observed among participants between questionnaire periods.ConclusionA “one-off”, theory-guided group education session may be insufficient to support lifestyle modifications in the context of weight management in a pre-diabetic population. Further evaluation of the efficacy and feasibility of the PCN as a setting for lifestyle intervention is required.     

The Use of Behavior Change Theories in Dietetics Practice in Primary Health Care: A Systematic Review of Randomized Controlled Trials

BackgroundBehavior change theories frameworks provide the theoretical underpinning for effective health care. The extent to which they are applied in contemporary dietetics interventions has not been explored.ObjectiveTo systematically review the evidence of behavior change theory-based interventions delivered by credentialed nutrition and dietetics practitioners in primary health care settings.MethodsMedline, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Embase, and Cochrane databases were searched for English language, randomized controlled trials before August 2019. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Eligible interventions included adults (aged ≥18 years) receiving face-to-face dietetics care underpinned by behavior change theories in primary health care settings with outcome measures targeting changes in health behaviors or health outcomes. Screening was conducted independently in duplicate and data were extracted using predefined categories. The quality of each study was assessed using the Cochrane Risk of Bias tool. The body of evidence was assessed using the Academy of Nutrition and Dietetics Evidence Analysis Manual Conclusion Grading Table.ResultsThirty articles reporting on 19 randomized controlled trials met the eligibility criteria, representing 5,172 adults. Thirteen studies (68%) showed significant improvements for the primary outcome measured. Social cognitive theory was the behavior change theory most commonly applied in interventions (n=15) with 11 finding significant intervention effects. Goal setting, problem solving, social support, and self-monitoring were the most commonly reported techniques (n=15, n=14, n=11, and n=11, respectively). Most studies had a high (n=11) or unclear (n=8) risk of bias. There was fair evidence (Grade II) supporting the use of behavior change theories to inform development of dietetics interventions.ConclusionsInterventions delivered by credentialed nutrition and dietetics practitioners that were underpinned by behavior change theories and utilizing various behavior change techniques were found to have potential to be more effective at improving patient health outcomes than dietary interventions without theoretical underpinnings. Findings from this review should inform future primary health care research in the area of dietary behavior change. In addition, findings from this review highlight the need for stronger documentation of use of behavior change theory and techniques that map on to the theory within dietetics practice.