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The article outlines the intricate process of applying nutrition evidence to personalized care, emphasizing the importance of sound evidence-based dietary advice in maintaining health and managing diseases. It also discusses the challenges faced in integrating research findings into individualized nutrition interventions, including navigating conflicting information sources and tailoring treatments to diverse health and social situations.

An editorial is presented which discusses the Academy of Nutrition Sciences' second Position Paper on the regulation of nutrition and health claims around the world, with a specific focus on Europe. It discusses the regulations for the European Union and Great Britain and emphasizes the learning's gained through the implementation of the European Food Safety Authority's evidence-based process for assessment of proposed claims.

Objective: Obesity is a chronic disease that disproportionately affects individuals from nonmajority racial/ethnic groups in the United States. Research shows that individuals from minority racial/ethnic backgrounds consider it important to have access to providers from diverse backgrounds. Health care providers and scientists from minority racial/ethnic groups are more likely than their non‐Hispanic White counterparts to treat or conduct research on patients from underrepresented groups. The objective of this study was to characterize the racial/ethnic diversity of nutrition‐ and obesity‐focused professional organizations in the United States. Methods: This study assessed race/ethnicity data from several obesity‐focused national organizations including The Obesity Society, the Academy of Nutrition and Dietetics (AND), the American Society for Nutrition, and the American Board of Obesity Medicine (ABOM). Each organization was queried via emailed survey to provide data on racial/ethnic representation among their membership in the past 5 years and among elected presidents from 2010 to 2020. Results: Two of the three professional societies queried did not systematically track race/ethnicity data at the time of query. Limited tracking data available from AND show underrepresentation of Black (2.6%), Asian (3.9%), Latinx (3.1%), Native Hawaiian or Pacific Islander (1.3%), or indigenous (American Indian or Alaskan Native: 0.3%) individuals compared with the US population. Underrepresentation of racial/ethnic minorities was also reported for ABOM diplomates (Black: 6.0%, Latinx: 5.0%, Native American: 0.2%). Only AND reported having racial/ethnic diversity (20%) among the organization's presidents within the previous decade (2010–2020). Conclusions: Findings suggest that (1) standardized tracking of race and ethnicity data is needed to fully assess diversity, equity, and inclusion, and (2) work is needed to increase the diversity of membership and leadership at the presidential level within obesity‐ and nutrition‐focused professional organizations. A diverse cadre of obesity‐ and nutrition‐focused health care professionals is needed to further improve nutrition‐related health outcomes, including obesity, cardiovascular disease, diabetes, and undernutrition, in this country. [ABSTRACT FROM AUTHOR]

Gastrointestinal (GI) toxicities are common in patients receiving radiotherapy (RT) to the pelvis. This systematic review aims to evaluate the effectiveness of nutritional interventions involving dietary counselling (DC) on GI toxicities in patients receiving pelvic RT. The search method entailed two phases to retrieve studies. Articles from a previous Cochrane review by Lawrie et al. 2018 were assessed for inclusion. An updated systematic search was then conducted to retrieve articles published between 2013 and 2020 from five electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL and Scopus). The inclusion criteria entailed randomised controlled trials involving adults ≥18 years, undergoing curative pelvic RT, receiving a nutritional intervention involving DC with or without supplements. DC was defined as written or face‐to‐face dietary advice provided before or during RT. Outcomes included GI toxicities reported by validated assessment tools. The Academy of Nutrition and Dietetics Quality Criteria Checklist was utilised to assess quality and risk of bias. Of 1922 studies retrieved, 12 articles encompassing 11 individual RCTs were included. Seven studies included a supplement in addition to DC. Supplements included probiotics, prebiotics, probiotic + soluble fibre, high protein liquid supplement and fat emulsion. Of the 11 studies, one involved individualised DC, and the remaining studies prescribed consumption or avoidance of fats, fibre, lactose, protein and FODMAP. The most common toxicities reported were diarrhoea (n = 11), pain/cramping (n = 9) and bloating/flatulence (n = 5). Three studies stated an improvement in diarrhoea incidence. Results varied between studies. Further quality studies are required to assess the effectiveness of DC, in particular individualised DC on GI toxicities in patients receiving pelvic RT. [ABSTRACT FROM AUTHOR]

Background: Frailty is rampant in candidates of liver transplantation (LT); however, its impact on posttransplant survival is inconclusive. Most studies have used a single measure of frailty; however, a comprehensive frailty severity index (FSI) has not been developed. The objectives of this study were to (1) evaluate frailty utilizing several metrics, (2) develop an FSI for end-stage liver disease (ESLD), and (3) determine its predictive abilities for outcomes after LT.Methods: Frailty metrics included (1) modified nutrition assessment of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition that includes height-adjusted third lumbar vertebra psoas mass index, (2) physical performance assessment combining Karnofsky Performance Status and pressure injury scale, and (3) Controlling Nutritional Status as a measure of severity of liver disease and inflammation.Results: Moderate to severe frailty was reported in 52%-97% of recipients depending on the metric. A statistically significant threshold FSI value was identified for each adverse outcome studied. FSI ≥ 14 was associated with decreased survival (88% vs 97% for FSI < 14).Conclusions: The proposed FSI for ESLD is predictive of poorer outcomes after LT. [ABSTRACT FROM AUTHOR]

Background: Standardized diagnostic criteria for malnutrition were developed by the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN) in 2012. The criteria as a whole has had little validation, and the effect of underlying condition on the impact of malnutrition has not been well studied. We measured the association between severe malnutrition and hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality among critically ill inpatients.Methods: We analyzed hospital records from 5606 patients whose admission included an ICU stay. Associations between severe malnutrition and LOS and mortality were examined by multivariable linear and logistic regression.Results: Thirteen percent were diagnosed with severe malnutrition. These had significantly longer hospital LOS (18 [interquartile range 10-35] days vs 8 [5-14] days), total ICU LOS (7 [3-15] days vs 3 [1-6] days) and in-hospital mortality (odds ratio [OR] 2.78, 95% confidence interval [CI] 2.33-3.31), compared with those without severe malnutrition. After adjusting for demographics, we found significant interactions between severe malnutrition and ICU location. Patients with malnutrition in the cardiothoracic surgery ICU experienced the largest increases in hospital LOS (21.10 days, 95% CI 18.58-23.61), ICU LOS (12.14 days, 95% CI 10.41-13.87), and in-hospital mortality (OR 8.78, 95% CI 5.11-15.07).Conclusion: Critically ill patients diagnosed with severe malnutrition based on the AND/ASPEN diagnostic characteristics experienced longer hospital and ICU LOS and increased mortality. The magnitude of effect of malnutrition was modified by ICU location, underscoring the need to identify the major comorbidities associated with malnutrition. [ABSTRACT FROM AUTHOR]

Aim Three years following a state-wide Nutrition Care Process Terminology ( NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Methods Pre-implementation and three years post-implementation, all Queensland Government hospitals state-wide were invited to repeat a validated NCPT survey. Additionally, a separate survey sought dietetic managers' opinions regarding NCPT's use and acceptance, usefulness for patient care, role in service planning and continued use. Results A total of 238 dietitians completed the survey in 2011 and 82 dietitians in 2014. Use of diagnostic statement in the previous six months improved ( P < 0.001). Perceptions of NCPT's importance ( P < 0.020) and benefits of incorporating NCPT into practice ( P = 0.029) increased. Time to complete NCPT documentation ( P < 0.013) and access to mentors decreased ( P < 0.001). Other areas including enhanced attitudes, familiarity, confidence, views, knowledge and incorporation into practice were sustained ( P > 0.05). Key elements in sustaining NCPT implementation over three years included ongoing management support, workshops/tutorials, discussion and mentor and peer support. The most valued resources were pocket guides, ongoing workshops/tutorials and mentor support. Dietetic managers held many positive NCPT views, however, opinions differed around the usefulness of service planning, safer practice, improving patient care and facilitating communication. Some managers would not support NCPT unless it was recommended for practice. Conclusions Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment. [ABSTRACT FROM AUTHOR]

Background In the general population, a higher Alternate Healthy Eating Index ( AHEI)-2010 score is related to decreased cardiovascular disease ( CVD) risk. Few studies have described the dietary patterns that reduce the risk of CVD or coronary heart disease ( CHD) in type 2 diabetes mellitus (T2 DM) patients. In the present study, the association between the American Diabetes Association ( ADA)-recommended dietary pattern, AHEI-2010 , and CVD risk factors and the CVD incidence over 52 months in T2 DM patients was evaluated. Methods The ADA score was developed from the ADA dietary recommendations. In this prospective study, the 24-h dietary recall of 124 adult T2 DM patients without nephropathy or chronic kidney disease was collected. The CVD risk factors were collected at baseline and at 6-month follow-up. Results Compared with lower ADA and AHEI-2010 score participants, the higher score participants exhibited a significantly lower waist circumference, serum low-density lipoprotein cholesterol level and 10-year risk of CHD. Participants with higher ADA dietary scores had a significantly reduced risk of central obesity and systolic blood pressure >140 mmHg. Higher AHEI-2010 scores were significantly related to a reduced risk of serum low-density lipoprotein cholesterol > 100 mg dL-1. Seven participants had their first-ever CVD during the follow-up period, although neither ADA score, nor AHEI-2010 score could predict CVD incidence. Conclusions The ADA-recommended dietary pattern and a higher AHEI-2010 score might both exhibit reduced risk factors of CVD in T2 DM patients. [ABSTRACT FROM AUTHOR]

Background Obesity prevalence continues to increase worldwide, with significant associated chronic disease and health cost implications. Among more recent innovations in health service provision is the use of text messaging for health behaviour change interventions including weight management. This review investigates the efficacy of weight management programmes incorporating text messaging. Methods Medical and scientific databases were searched from January 1993 to October 2013. Eligibility criteria included randomised controlled trials ( RCTs), pseudo RCTs and before and after studies of weight management, among healthy children and adults, that used text messaging and included a nutrition component. Data extraction and quality assessment followed guidelines from PRISMA ( Preferred Reporting Items for Systematic reviews and Meta-Analyses) and the Evidence Analysis Manual of the American Academy of Nutrition and Dietetics. Results From 512 manuscripts retrieved, 14 met the inclusion criteria (five manuscripts in children and nine in adults). Duration of interventions ranged from 1 to 24 months. Frequency of text messaging was from daily to fortnightly. Six studies in adults were included in a meta-analysis with mean body weight change as the primary outcome. The weighted mean change in body weight in intervention participants was −2.56 kg (95% confidence interval = −3.46 to −1.65) and in controls −0.37 kg (95% confidence interval = −1.22 to 0.48). Conclusions The small body of evidence indicates that text messaging interventions can promote weight loss. However, lack of long-term results indicate that further efficacy studies are required. Future investigations should elucidate the determinants, such as intervention duration, text message frequency and level of interactivity that maximise the success and cost effectiveness of the delivery medium. [ABSTRACT FROM AUTHOR]

Background This review examines knowledge and confidence of nutrition and dietetics professionals in nutritional genomics and evaluates the teaching strategies in this field within nutrition and dietetics university programmes and professional development courses internationally. Methods A systematic search of 10 literature databases was conducted from January 2000 to December 2012 to identify original research. Any studies of either nutrition and/or dietetics students or dietitians/nutritionists investigating current levels of knowledge or confidence in nutritional genomics, or strategies to improve learning and/or confidence in this area, were eligible. Results Eighteen articles (15 separate studies) met the inclusion criteria. Three articles were assessed as negative, eight as neutral and seven as positive according to the American Dietetics Association Quality Criteria Checklist. The overall ranking of evidence was low. Dietitians have low involvement, knowledge and confidence in nutritional genomics, and evidence for educational strategies is limited and methodologically weak. Conclusions There is a need to develop training pathways and material to up-skill nutrition and/or dietetics students and nutrition and/or dietetics professionals in nutritional genomics through multidisciplinary collaboration with content area experts. There is a paucity of high quality evidence on optimum teaching strategies; however, methods promoting repetitive exposure to nutritional genomics material, problem-solving, collaborative and case-based learning are most promising for university and professional development programmes. [ABSTRACT FROM AUTHOR]