| 1. |
- Coyle, Daisy H, et al.
(författare)
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The Contribution of Major Food Categories and Companies to Household Purchases of Added Sugar in Australia.
- 2022
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier. - 2212-2672 .- 2212-2680. ; 122:2, s. 345-353.e3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Australian Government will soon be releasing a series of sugar reformulation targets for packaged foods.OBJECTIVE: To estimate the amount of added sugar purchased from packaged food and beverages and the relative contribution that food categories and food companies made to these purchases in 2018. The secondary objective was to examine differences in purchases of added sugar across income levels.DESIGN: Cross-sectional study.PARTICIPANTS/SETTING: We used 1 year of grocery purchase data from a nationally representative panel of Australian households (the NielsenIQ Homescan panel), combined with a packaged food and beverage database (FoodSwitch).MAIN OUTCOME MEASURES: Added sugar purchases (grams per day per capita), purchase-weighted added sugar content (grams per 100 g) and total weight of products (with added sugar) purchased (grams per day per capita).STATISTICAL ANALYSES PERFORMED: Food categories and food companies were ranked according to their contribution to added sugar purchases. Differences in added sugar purchases by income levels were assessed by 1-factor analysis of variance.RESULTS: Added sugar information was available from 7188 households and across 26,291 unique foods and beverages. On average, the amount of added sugar acquired from packaged foods and beverages was (mean ± SE) 35.9 ± 0.01 g/d per capita. Low-income households purchased 11.0 g/d (95% CI: 10.9-11.0 g/d, P < .001) more added sugar from packaged products than high-income households per capita. The top 10 food categories accounted for 82.2% of added sugar purchased, largely due to purchases of chocolate and sweets, soft drinks, and ice cream and edible ices. Out of 994 food companies, the top 10 companies contributed to 62.1% of added sugar purchases.CONCLUSIONS: The Australian Government can strengthen their proposed sugar reduction program by adding further category-specific targets, prioritizing engagement with key food companies and considering a broader range of policies to reduce added sugar intakes across the Australian population.
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| 2. |
- Lövestam, Elin, 1983-, et al.
(författare)
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Nutrition Care Process Implementation : Experiences in Various Dietetics Environments in Sweden
- 2017
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier BV. - 2212-2672 .- 2212-2680. ; 117:11, s. 1738-1748
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) are currently being implemented by nutrition and dietetics practitioners all over the world. Several advantages have been related to this implementation, such as consistency and clarity of dietetics-related health care records and the possibility to collect and research patient outcomes. However, little is known about dietitians’ experiences of the implementation process.ObjectiveThe aim of this qualitative study was to explore Swedish dietitians’ experiences of the NCP implementation process in different dietetics environments.MethodThirty-seven Swedish dietitians from 13 different dietetics workplaces participated in seven focus group discussions that were audiotaped and carefully transcribed. A thematic secondary analysis was performed, after which all the discussions were re-read, following the implementation narrative from each workplace. In the analysis, The Promoting Action on Research Implementation in Health Services implementation model was used as a framework.ResultsMain categories identified in the thematic analysis were leadership and implementation strategy, the group and colleagues, the electronic health record, and evaluation. Three typical cases are described to illustrate the diversity of these aspects in dietetics settings: Case A represents a small hospital with an inclusive leadership style and discussion-friendly culture where dietitians had embraced the NCP/NCPT implementation. Case B represents a larger hospital with a more hierarchical structure where dietitians were more ambivalent toward NCP/NCPT implementation. Case C represents the only dietitian working at a small multiprofessional primary care center who received no dietetics-related support from management or colleagues. She had not started NCP/NCPT implementation.ConclusionsThe diversity of dietetics settings and their different prerequisites should be considered in the development of NCP/NCPT implementation strategies. Tailored implementation strategies should be considered in relation to context, such as increased dietetics support and facilitation where management does not lead or support the implementation process.
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| 3. |
- Lövestam, Elin, 1983-, et al.
(författare)
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The International Nutrition Care Process and Terminology Implementation Survey : Towards a Global Evaluation Tool to Assess Individual Practitioner Implementation in Multiple Countries and Languages
- 2019
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier BV. - 2212-2672 .- 2212-2680. ; :2, s. 242-260
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Nutrition Care Process (NCP) and NCP Terminology (NCPT) is a systematic framework for critical thinking, decision making, and communication for dietetics practitioners worldwide, aiming to improve quality and patient safety in nutrition care. Although dietetics practitioners in several countries have implemented the NCP/NCPT during recent years, to date there is no globally validated instrument for the evaluation of NCP/NCPT implementation that is available in different languages and applicable across cultures and countries.Objective: The aim of this study was to develop and test a survey instrument in several languages to capture information at different stages of NCP/NCPT implementation across countries and cultures.Setting: In this collaboration between dietetics practitioners and researchers from 10 countries, an International NCP/NCPT Implementation Survey tool was developed and tested in a multistep process, building on the experiences from previous surveys. The tool was translated from English into six other languages. It includes four modules and describes demographic information, NCP/NCPT implementation, and related attitudes and knowledge.Methods: The survey was reviewed by 42 experts across 10 countries to assess content validity and clarity. After this, 30 dietetics practitioners participated in cognitive interviews while completing the survey. A pilot study was performed with 210 participants, of whom 40 completed the survey twice within a 2- to 3-week interval.Results: Scale content validity index average was 0.98 and question clarity index was 0.8 to 1.0. Cognitive interviews and comments from experts led to further clarifications of the survey. The repeated pilot test resulted in Krippendorff’s α=.75. Subsequently, refinements of the survey were made based on comments submitted by the pilot survey participants.Conclusions: The International NCP/NCPT Implementation Survey tool demonstrated excellent content validity and high test–retest reliability in seven different languages and across an international context. This tool will be valuable in future research and evaluation of implementation strategies.
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| 4. |
- Lövestam, Elin, 1983-, et al.
(författare)
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Use of the Nutrition Care Process and Nutrition Care Process Terminology in an International Cohort Reported by an Online Survey Tool
- 2019
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier BV. - 2212-2672 .- 2212-2680. ; 119:2, s. 225-241
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dietitians in countries across the world have been implementing the Nutrition Care Process (NCP) and Terminology (NCPT) during the past decade. The implementation process has been evaluated in specific countries and in smaller international studies; however, no large international study comparing implementation between countries has been completed.Objective: The aim of this study was to describe and compare the level of NCP/NCPT implementation across 10 countries.Methods: A previously tested web-based survey was completed in 2017 by 6,719 dietitians across 10 countries. Participants were recruited through e-mail lists, e-newsletters, and social media groups for dietitians. Nondietitians were excluded through screening questions and targeted dissemination channels.Main outcome measures and statistical analysis: The main outcome of interest was the level of implementation of each of the four NCP steps. Differences in implementation between the NCP (process) and NCPT (terminology) were also measured. Differences between groups were assessed using Kruskal-Wallis test and Mann-Whitney U test. Multiple linear regression was used to assess relationships between the main outcomes and respondent demographic information.Results: Australia, New Zealand, and the United States had higher implementation rates compared with other countries surveyed. Awareness of the NCP was high in most countries (>90%) but lower in Greece (50%). All countries had a higher implementation level of the NCP (process) compared with the NCPT (terminology). Dietitians working with inpatients reported the highest implementation levels while those working in public health reported the lowest.Conclusions: Dietitians in countries with more experience in NCP/NCPT implementation and a clear implementation strategy had higher levels of implementation. To achieve a successful NCP/NCPT implementation among dietitians, there is a need to promote the value of a standardized dietetic language together with the more easily implemented process. There is also a need to promote NCP/NCPT for all areas of practice, and develop strategic plans for implementation of the NCP and NCPT.
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| 5. |
- Murtas, Rossella, et al.
(författare)
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Does Providing Assistance to Children and Adolescents Increase Repeatability and Plausibility of Self-Reporting Using a Web-Based Dietary Recall Instrument?
- 2018
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier. - 2212-2672 .- 2212-2680. ; 118:12, s. 2324-2330
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Tidskriftsartikel (refereegranskat)abstract
- Background It is important to find ways to minimize errors when children self-report food consumption. Objective The objective of this study was to investigate whether assistance given to children completing a self-administered 24-hour dietary recall instrument called SACANA (Self-Administered Child, Adolescent and Adult Nutrition Assessment) increased the repeatability and plausibility of energy intake (EI) estimates. Participants/setting The study was conducted between October 2013 and March 2016 in a convenience sample of 395 children, aged 8 to 17 years, from eight European countries participating in the I.Family study. Design SACANA was used to recall the previous day's food intake, twice in a day, once with and once without assistance. Main outcome measures The difference in EI between the first and second recalls was the main repeatability measure; the ratio of EI to basal metabolic rate was the plausibility measure. Statistical methods Generalized linear mixed models, adjusted for sex, age, and body mass index z-score, were used to assess whether assistance during the first vs second recall influenced repeatability and plausibility. Results The difference in estimated EI (EI from second recall minus EI from first recall) was significantly lower (P<0.001) in those assisted at first (median=-76 kcal) than those assisted at second recall (median=282 kcal). Modeling showed that EI at assisted first recall was 19% higher (95% CI 1.13 to 1.24) than in assisted second recall. Overall, 60% of recalls had a plausible EI. Modeling to estimate the simultaneous effects of second vs first recall and assistance vs no assistance on plausibility showed that those assisted at first recall had significantly higher odds of a plausible recall than those unassisted (odds ratio 3.64, 95% CI 2.20 to 6.01), with no significant difference in plausibility of second recall compared to the first (odds ratio 1.48, 95% CI 0.92 to 2.35). Conclusions When children are assisted at first recall, the plausibility and repeatability of the later unassisted recall improve. This improvement was evident for all ages. A future, adequately powered study is required to investigate the age range for which assistance is advisable.
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| 6. |
- Tyrovolas, Stefanos, et al.
(författare)
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Weight Perception, Satisfaction, Control, and Low Energy Dietary Reporting in the US Adult Population : Results from the National Health and Nutrition Examination Survey 2007-2012
- 2016
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier BV. - 2212-2672 .- 2212-2680. ; 116:4, s. 579-589
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Tidskriftsartikel (refereegranskat)abstract
- Background Prior research has indicated that several factors are associated with low energy dietary reporting; however, there is comparatively little information on the association between body image, weight control, and low energy reporting. Objective Our aim was to evaluate the association between low energy reporting and aspects of weight perception, satisfaction, and control in a nationally representative US adult sample. Design This was a cross-sectional study. Participants/setting Data were analyzed from 13,581 adults aged 20 years and older who participated in the 2007-2012 National Health and Nutrition Examination Survey. Data on sociodemographic, clinical, and lifestyle characteristics, and weight perception, satisfaction, and control were collected. The ratio of reported energy intake to estimated basal metabolic rate (EI/BMR) was calculated and used for the assessment of low energy reporting. Main outcome measures The relationship of low energy reporting with various aspects of weight perception, satisfaction, and control was evaluated. Statistical analyses performed Multivariable logistic regression was used to assess the association between the variables. Results Low energy reporters were significantly more likely to consider themselves overweight (perception), want to weigh less (satisfaction), and to have tried to lose weight in the past 12 months (control). Compared with having no desire for weight change, wanting to weigh less was associated with 1.28 (95% CI 1.07 to 1.53) times higher odds for low energy reporting. Trying to lose weight was also associated with low energy reporting (odds ratio = 1.56; 95% CI 1.38 to 1.76). Effect modification by obesity status was observed for the weight perception, satisfaction, and control variables where the odds ratios of these factors for low energy reporting were higher among those who were not obese. Conclusion Weight perception, satisfaction, and control are related to low energy reporting, and should be taken into account in nutritional assessments. In addition, the effect of these factors can differ by obesity status.
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| 7. |
- Vinci, Gioia, et al.
(författare)
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Implementation of the Nutrition Care Process and the Nutrition Care Process Terminology Among German- and French-Speaking Dietitians in Switzerland : A Secondary Analysis of the Swiss International Nutrition Care Process and Terminology Implementation Survey Data
- 2023
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier BV. - 2212-2672 .- 2212-2680. ; 123:7, s. 1053-1060
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Tidskriftsartikel (refereegranskat)abstract
- Background: Successful implementation of the Nutrition Care Process (NCP) and the Nutrition Care Process Terminology (NCPT) depends on many factors, one of which is the spoken language of the users. Exploring implementation barriers and enablers in a multilingual country such as Switzerland, with a specific focus on dietitians speaking German and French, may provide valuable insights for successful implementation in other multilingual countries.Objective: The aim of this study was to compare the enablers and barriers encountered by Swiss German-and French-speaking dietitians in the implementation of NCP and NCPT in their daily work.Design: The multinational observational INIS study was conducted between February April 2017 using an online survey. Swiss data from the study were analyzed in a secondary analysis in August 2021.Participants: In Switzerland, 237 registered dietitians participated in the INIS study. In this secondary analysis, a total of 228 (German-speaking n = 144, French-speaking n = 84) questionnaires were included. Nine participants were excluded because either they had incomplete surveys or had not completed dietetics training.Main outcome measurements: Primary variables were barriers and enablers to the use of NCP and NCPT in their daily work. Furthermore, characteristics, familiarity with NCP and NCPT, and the extent of implementation of standardized nutrition diagnoses according to NCPT were analyzed.Statistical analyses performed: Descriptive statistics, including summary statistics with percentages, were used. Differences between the two groups were analyzed using the Fisher exact test.Results: The most common barrier was lack of time; no significant differences were found between the two groups regarding implementation barriers. Some statistically significant differences were found in the frequency of mentioning enablers, such as "recommendation by the association to use NCP and NCPT" (German-speaking 89%, French-speaking 77%; P < 0.05), "requirement by the workplace" (German-speaking 75%, French-speaking 53%; P < 0.01), "allocated time to practice" (German-speaking 63%, French-speaking 43%; P < 0.05), and "electronic healthcare records" (Germanspeaking 81%, French-speaking 44%; P < 0.001).Conclusions: Some differences in enablers were found between German-and Frenchspeaking dietitians, although the two groups were similar for all barriers and many enablers. In multilingual countries such as Switzerland, implementation strategies may need to be adapted to the language and the dietitians' specific experiences of using NCP and NCPT to ensure optimal use throughout the country.
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| 8. |
- Bertz, Fredrik, et al.
(författare)
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Sustainable Weight Loss among Overweight and Obese Lactating Women Is Achieved with an Energy-Reduced Diet in Line with Dietary Recommendations: Results from the LEVA Randomized Controlled Trial.
- 2015
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier BV. - 2212-2672. ; 115:1, s. 78-86
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate dietary changes during and after a dietary treatment shown to result in significant and sustained weight loss among lactating overweight and obese women. This is crucial before clinical implementation. Data were collected from the LEVA (in Swedish: Livsstil för Effektiv Viktminskning under Amning [Lifestyle for Effective Weight Loss During Lactation]) randomized controlled factorial trial with a 12-week intervention and a 1-year follow up. At 10 to 14 weeks postpartum, 68 lactating Swedish women with a prepregnancy body mass index (calculated as kg/m(2)) of 25 to 35 were randomized to structured dietary treatment, physical exercise treatment, combined treatment, or usual care (controls) for a 12-week intervention, with a 1-year follow-up. Dietary intake was assessed with 4-day weighed dietary records. Recruitment took place between 2007 and 2010. The main outcome measures were changes in macro- and micronutrient intake from baseline to 12 weeks and 1 year. Main and interaction effects of the treatments were analyzed by a 2×2 factorial approach using a General Linear Model adjusted for relevant covariates (baseline intake and estimated underreporting). It was found that at baseline, the women had an intake of fat and sucrose above, and an intake of total carbohydrates and fiber below, recommended levels. At 12 weeks and 1 year, the dietary treatment led to reduced intake of energy (P<0.001 and P=0.005, respectively), fat (both P values <0.001), and sucrose (P<0.001 and P=0.050). At 12 weeks, total carbohydrates were reduced (P<0.001). Amajority of women in all groups reported low intakes of vitamin D, folate, and/or iron. In conclusion, a novel dietary treatment led to reduced intake of fat and carbohydrates. Diet composition changed to decreased proportions of fat and sucrose, and increased proportions of complex carbohydrates, protein and fiber. Weight loss through dietary treatment was achieved with a diet in line with macronutrient recommendations.
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| 9. |
- Davis, Nichola J., et al.
(författare)
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Predictors of Sustained Reduction in Energy and Fat Intake in the Diabetes Prevention Program Outcomes Study Intensive Lifestyle Intervention
- 2013
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Ingår i: Journal of the American Dietetic Association. - : Elsevier BV. - 0002-8223. ; 113:11, s. 1455-1464
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Tidskriftsartikel (refereegranskat)abstract
- Background Few lifestyle intervention studies examine long-term sustainability of dietary changes. Objective To describe sustainability of dietary changes over 9 years in the Diabetes Prevention Program and its outcomes study, the Diabetes Prevention Program Outcomes Study, among participants receiving the intensive lifestyle intervention. Design One thousand seventy-nine participants were enrolled in the intensive lifeStyle intervention arm of the Diabetes Prevention Program; 910 continued participation in the Diabetes Prevention Program Outcomes Study. Fat and energy intake derived from food frequency questionnaires at baseline and post-randomization Years 1 and 9 were examined. Parsimonious models determined whether baseline characteristics and intensive lifestyle intervention session participation predicted sustainability. Results Self-reported energy intake was reduced from a median of 1,876 kcal/day (interquartile range [IQR]=1,452 to 2,549 kcal/day) at baseline to 1,520 kcal/day (IQR=1,192 to 1,986 kcal/day) at Year 1, and 1,560 kcal/day (IQR=1,223 to 2,026 kcal/ day) at Year 9. Dietary fat was reduced from a median of 70.4 g (IQR=49.3 to 102.5 g) to 45 g (IQR=32.2 to 63.8 g) at Year 1 and increased to 61.0 g (IQR=44.6 to 82.7 g) at Year 9. Percent energy from fat was reduced from a median of 34.4% (IQR=29.6% to 38.5%) to 27.1% (IQR=23.1% to 31.5%) at Year 1 but increased to 35.3% (IQR=29.7% to 40.2%) at Year 9. Lower baseline energy intake and Year 1 dietary reduction predicted lower energy and fat gram intake at Year 9. Higher leisure physical activity predicted lower fat gram intake but not energy intake. Conclusions Intensive lifestyle intervention can result in reductions in total energy intake for up to 9 years. Initial success in achieving reductions in fat and energy intake and success in attaining activity goals appear to predict long-term success at maintaining changes.
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| 10. |
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