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The current study was conducted to evaluate the dietary habits of the dietitians who had a leading role in this regard during the pandemic and their use of dietary supplements, functional food and herbal medicines. A cross-sectional study. An online questionnaire was used as a data collection tool to identify the participants’ socio-demographic characteristics, health statuses and dietary habits and their use of dietary supplements, functional foods and herbal medicines. Turkey. The study population was 550 dietitians. In the current study, the participants’ average age was 30·6 ± 9·1 years, and most of them (88·2 %) were women. More than half of the participants (88·9 %) thought that adequate and balanced nutrition would positively affect the course of COVID-19. To avoid COVID-19, 94·5 % of the dietitians used dietary supplements, 46·1 % herbal medicines and 34·9 % functional foods during the pandemic. The most commonly used dietary supplement was fish oil (81·9 %), functional food was vegetables and fruits (80·5 %) and the herbal medicine was cinnamon (63·5 %). Women’s consumption of functional foods was approximately twice higher compared with men (95 % Cl: 1·048, 4·165; P < 0·05). The findings showed that the longer the dietitians were in their careers, the more functional foods and herbal medicines they used. During the pandemic, dietitians’ use of foods with protective effects against diseases increased depending on their academic knowledge and experience in nutrition. The findings obtained in the current study suggest that an expert’s opinion should be obtained before using dietary supplements and herbal medicines.

Objectives: In Latin America, clinical dietitian-nutritionists (DNs) play a crucial role in addressing the rising prevalence of chronic disease and malnutrition within hospitals. However, there is a lack of a common tool to evaluate prioritization activities among nutrition professionals. Having a reliable tool could help standardize and enhance the quality clinical nutrition practice in Latin America, as well as enable optimal utilization of the DN skills, ultimately reducing job burnout and improving quality of care. This study aimed to: 1) develop a Professional Weighted Activities Score (PwAS) to assess the professional activities of DNs in hospital settings according to task prioritization; and 2) apply the new scoring system to a previously collected sample of Latin American DNs. The PwAS tool was developed using the criteria of a panel of experts from all participating countries. A multicentric and cross-sectional study was conducted among 1222 clinical DNs from 13 Latin American countries to identify their professional activities in public and private health care facilities. The survey comprised 30 questions related to clinical nutrition tasks, with responses weighted according to the priority assigned by an expert panel. A PwAS was developed encompassing 19 activities performed by clinical DN, each assigned a prioritization score by a panel of experts in clinical nutrition. The scoring spectrum ranged from 0 to 100, reflecting the variability in DN engagement with their professional activities. The analysis revealed significant differences in the professional activities of DNs across various countries. Guatemala, Paraguay, and Colombia achieved the highest scores, while Costa Rica, Peru, and Uruguay recorded the lowest. Factors positively associated with higher PwAS scores included greater years of experience and multiple specializations. In contrast, working in low-complexity facilities and facing barriers to task performance were negatively correlated with the PwAS. The significant variation observed in clinical nutrition practices across countries underscores the need for studies to identify underlying causes and develop standardization. The PwAS tool could serve as a valuable resource for hospital administrators seeking to optimize staffing and enhance the quality of nutritional care within Latin American health care systems. •A panel of 146 expert dietitian-nutritionists from Latin America identified and established a prioritization order for 19 key activities that are fundamental to the professional practice of the clinical dietitian-nutritionist in hospital settings.•The Professional Weighted Activity Score (PwAS) highlights critical determinants for the performance of clinical dietitian-nutritionists in the context of each country. In addition, it addresses the complexity of health care facilities, the number of specialties, and perceived barriers to performance of the activities.•The PwAS represents innovative methodological progress as it integrates the frequency of task execution and the clinical prioritization assigned by the experts.

Obesity is a modifiable risk factor associated with hospital-associated complications. Recent studies show there is a high prevalence of patients with obesity presenting to hospital and evidence indicates that people living with obesity should receive diet advice from a dietitian; however, patients often do not receive this care in acute settings. The primary aim of this study was to explore the experiences of dietitians caring for patients living with obesity in acute hospital settings. A multi-site qualitative study was conducted from October 2021 to November 2023 in Melbourne, Australia. Constructivist grounded theory methodology informed sampling and data collection. Semi-structured interviews were undertaken with dietitians working in acute care. Data were analysed using open coding and constant comparison underpinned by Charmaz's framework. Interviews were conducted with 25 dietitians working across four hospitals. The theory developed from the data describes an enculturated decision-making process whereby acute clinical dietitians are limiting acute nutrition care for people living with obesity in hospital. The theory includes five interdependent categories that influence clinical decision-making and practice: (1) culture of professional practice, (2) science and evidence, (3) acknowledgement of weight bias and stigma, (4) dietitian-led care and (5) hospital systems and environment. The findings from this study provide new insights as to why dietitians may not be providing acute nutrition care for people living with obesity. Strategic leadership from clinical leaders and education providers together with the lived experience perspectives of people with obesity is needed to shift the culture of dietetic professional practice to consider all nutrition care needs of patients living with obesity who are accessing acute hospitals for health care.

Foods and the nutrients they contain can interact with drugs and thereby interfere with their therapeutic safety and efficacy. Adequate knowledge of healthcare professionals (HCPs) about drug-food interactions can help in preventing potential drug-food interactions among patients. This study aimed to assess the knowledge of HCPs about common drug-food interactions. A cross-sectional study was carried out among 459 HCPs from three public hospitals in eThekwini district, KwaZulu-Natal between November 2018, and January 2019. Informed consent was obtained from the HCPs, and a structured questionnaire was thereafter administered. Data were analysed using SPSS® version 25. Factors associated with knowledge of the HCPs were determined using logistic regression analysis. Of the 459 participants, 22.2% (n = 102) were doctors, 11.3% (n = 52) pharmacists, 63.8% (n = 293) nurses and 2.6% (n = 12) dietitians. Most of the HCPs were females 79.7% (n = 366), the mean age of the HCPs was 38.61±0.48. The knowledge score of the HCPs was 22.66±0.25 out of an overall score of 46. The HCPs poorly identified food types that interact with drugs and correct administration time of drugs relative to meals. Being a pharmacist (OR: 14.212, CI: 4.941-40.879, p<0.001), doctor (OR: 5.223, CI: 2.146-12.711, p<0.001), or a dietitian (OR: 5.476, CI: 1.103-27.191, p = 0.038) was associated with higher knowledge of drug-food interactions. The HCPs in this survey had low drug-food interaction knowledge. These findings suggest the need for additional training and educational courses for the HCPs on drug-food interactions.

Background/Objectives: Registered dietitian nutritionists (RDNs) are allied healthcare professionals who can help people with multiple sclerosis (MS) incorporate healthy eating, but little is known about their involvement in MS care. Thus, the objective of this survey was to investigate the perceptions and utilization of RDNs in MS care among multidisciplinary MS providers in the United States and Canada. Methods: An online survey was disseminated via the Consortium of MS Centers email listserv and MS-specific scientific conferences. The survey queried practitioner type, RDN referrals, the perceived benefits of RDNs in MS care, and the proportion of their patients who follow ‘MS diets’ or have nutrition-related issues. Reasons for or against RDN referral and beneficial resources were also queried. Results: Of the 60 completed surveys, respondents were primarily neurologists (n = 27, 45.0%). Most (n = 43, 71.7%) indicated that half or more of their patients inquire about diet, but n = 32 (53.3%) indicated that very few follow an ‘MS diet’ and n = 47 (78.3%) indicated that very few decline disease-modifying therapies to follow an ‘MS diet’. Most (n = 45, 77.6%) respondents indicated referring their patients to a RDN with lack of nutrition knowledge/general healthy eating advice (n = 34, 73.9%) and overweight/obesity (n = 31, 67.4%) as being the most common reasons for referral. RDNs were reported as being helpful or extremely helpful by n = 38 (84.4%) of respondents who reported referring to RDNs. Most (n = 46, 79.3%) indicated that their patients would benefit from having an RDN with MS-specialized training as a member of staff. Conclusions: MS care providers support the need for RDNs with specialized training in MS care.

Introduction: Recent guidelines developed by the European Association for the Study of Obesity (EASO) and the European Federation of the Associations of Dietitians (EFAD) focused on the dietetic management of obesity in adults. The present study aimed to explore the perspectives of healthcare professionals regarding these guidelines. Methods: In total, 85 registered dietitians/nutritionists from Greece, the Netherlands, the Republic of Ireland, and the United Kingdom completed an online survey, and 10 were interviewed, in February–March 2023. Demographic data were also collected. Results: Awareness of the EASO-EFAD guidelines among registered dietitians/nutritionists was moderate (57.6%), but only 20% had read them in full. Dietitians with higher education and relevant experience were more likely to have read the guidelines. Less than half reported that key evidence-based recommendations, such as individualized medical nutrition therapy and intensive behavioral interventions, are already included in national guidance. Recommendations like portfolio or DASH diets, partial meal replacements, and calorie restriction were less commonly part of national guidance/usual practice. A small percentage of participants described their adoption of several nutritional approaches novel to them. These included the portfolio dietary pattern, partial meal replacements, and intermittent fasting or continuous calorie restriction. For some Irish dietitians, prioritizing weight as the main outcome conflicted with their emphasis on overall health and individualized nutrition therapy. Other barriers of recommendation implementation included exclusive availability in English, rapid changes in obesity management, staffing shortages, limited multidisciplinary collaboration, and inconsistent knowledge among healthcare providers. Conclusions: The present study identified gaps in the adoption of the EASO-EFAD guidelines into dietetic/clinical practice. EFAD will develop strategies to disseminate these guidelines at different levels of stakeholders (national/local authorities, dietitians/nutritionists, and patients).

To investigate the extent, quality and challenges of dietetic counselling during the pandemic. A cross-sectional online thirty-six-item Google Survey. The survey queried demographics and information on usage and perceived telemedicine quality. The survey was distributed to Israeli Dietetic Association (ATID) mailing list between 31 March and 5 May 2020. Clinical dietitians, members of ATID, who consented to participated in the survey. Three hundred dietitians (12 % of ATID members; 95 % women; mean age 4·41 (sd 10·2) years) replied to the survey. Most dietitians reported a significant ∼30 % decrease in work hours due to the pandemic. The most prevalent form of alternative nutrition counselling (ANC) was over the phone (72 %); 53·5 % used online platforms. Nearly 45 % had no former ANC experience. Both ANC formats were reported inferior to face-to-face nutritional consultation (consultation quality median scores 8 and 7, on a 1-10 scale, for online and phone, respectively). ANC difficulties on either phone or online platforms were technical (56 and 47 %, respectively), lack of anthropometric measurements (28 and 25 %, respectively) and interpersonal communication (19 and 14·6 %, respectively). Older age and former phone counselling experience were associated with higher quality scores, respectively (OR = 1·046, 95 % CI 1·01, 1·08, P = 0·005), (95 % CI 1·38, 4·52, P = 0·02). Those who continued to work full time had five-time greater odds for a higher quality score using online platforms (OR = 5·33, 95 % CI 1·091, 14·89, P = 0·001). Our findings suggest telemedicine holds considerable promise for dietary consultation; however, additional tools and training are needed to optimise remote ANC, especially in light of potential crisis-induced lockdown.

Background: Celiac disease (CD) is a type of systemic autoimmune condition triggered by gluten consumption among genetically predisposed individuals. Aim: To assess the knowledge, awareness, and practices pertaining to CD and associated conditions among dietitians in Jordan. Method: A cross-sectional web-based survey was carried out between April and October 2023. The survey was an internet-based questionnaire with closed-ended questions. Results: The majority of dietitians answered correctly that CD is caused due to an immunological reaction to gluten, gliadin, and protamine (91.7%); it is an autoimmune disease (71.2%); and the risk of developing an autoimmune disease is higher among CD patients (78.8). The majority of respondents (93.6%) correctly identified that a strict gluten-free diet is the treatment approach for CD patients. However, only (18.9%) of dietitians correctly identified the FDA guidelines for “Gluten Free” food labeling. Approximately 53.4% of respondents identified immunoglobulin (IgA) antibody testing as the most reliable way to diagnose patients with CD. Conclusions: The dietitians have a good understanding of CD topics. The development of credentials in CD would ensure that dietitians practicing in CD are skilled.

Background and objectives Despite anecdotal evidence pointing to the high prevalence of job stress and burnout among dietitians and nutritionists, few studies have been conducted on this topic. Moreover, most studies are from Western countries. The objective of the current study, based on systematic review, meta-analysis, and meta-regression, is aimed to provide systematically graded evidence to assess the prevalence of emotional burnout among dietitians and nutritionists across age, sex, and cultural backgrounds. Methods Two reviewers independently conducted a systematic search from 1 January 2000, to 1 April 2024 and was later updated to 15 November 2024, across seven databases: EBSCOhost Research Platform, EMBASE, PubMed/MEDLINE, ProQuest, ScienceDirect, Scopus, and Web of Science. The DerSimonian-Laird method was utilized to pool the data in this meta-analysis. Data from a total of 12,166 dietitians and nutritionists were extracted from 16 datasets (published in twelve research reports) covering a period of approximately 25 years. We measured the pooled prevalence of global burnout syndrome and its individual symptoms among dietitians and nutritionists. Subgroup meta-analyses were also conducted to identify a comprehensive set of moderators, including participants’ age and sex. Results The prevalence of global burnout syndrome in dietitians and nutritionists (K = 10, N  = 10,081) showed an overall prevalence rate of 40.43% [23.69; 59.74], I² = 99.3%, τ [95% CI] = 1.18 [0.84; 1.97], τ² [95% CI] = 1.38 [0.71; 3.89], H [95% CI] = 12.68 [11.70; 13.74]. The prevalence of burnout dimensions/individual symptoms in dietitians and nutritionists (K = 2, N  = 695) is summarized as follows: emotional exhaustion (EE) at 26.11% [15.14; 41.17], I² = 84.0%, τ = 0.21, τ² = 0.46, Q = 6.25, p  < 0.001; depersonalization (DP) at 6.59% [1.08; 31.22], I² = 95.0%, τ = 1.72, τ² = 1.31, Q = 20.18, p  < 0.001; and personal accomplishment (PA) at 59.29% [39.81; 76.23], I² = 89.3%, τ = 0.29, τ² = 0.54, Q = 9.36, p  < 0.001. Meta-regression showed no difference by age or sex, p  = 0.80, and p  = 0.20, respectively. Conclusion This meta-analysis revealed that the prevalence of burnout among dietitians and nutritionists is as high as in other medical professionals. Furthermore, age and sex were not significantly associated with emotional burnout among dietitians and nutritionists. This study provides the impetus for policy changes to improve dietitians’ and nutritionists’ working conditions, as well as the overall quality of nutrition care.

Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.