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Aim The aim of this study was to provide an introduction to nutrition informatics, including a brief history and a rationale of its importance for Australian dietetics. Methods The study method used was a narrative review informed by a literature review and expert consultation with the Academy of Nutrition and Dietetics. Results Nutrition informatics has demonstrated potential to improve efficiencies, reduce costs, support research and ultimately enhance patient care. Governments and organisations have identified this as an emerging priority area. The Dietitians Association of Australia has launched initiatives to advocate and provide strategic advice on dietetic involvement in biomedical informatics and specifically nutrition informatics. Conclusions If nutrition standards and processes are not integrated into information systems, dietitians may inherit technologies that do not support dietetic work practices, and opportunities to enhance nutrition services may be missed. It is recommended that dietitians be aware of the opportunities and potential benefits of nutrition informatics, become familiar and involved in technology initiatives, and take the lead in guiding the development and implementation of technologies that may impact patient nutritional care. [ABSTRACT FROM AUTHOR]

Dietitian and general practitioner collaboration in the nutrition care of a patient is important to assist patients to achieve their nutrition goals. This paper aims to review the published literature on dietitians' correspondence practices with recipient general practitioners regarding nutrition interventions recommended to patients. A literature search was conducted of publications from 1995 to December 2009. Key words were used to search the electronic databases Medline, CINAHL Plus, ProQuest, PsycINFO and Google Scholar. Twenty papers that addressed this topic were selected by two authors for inclusion in the review. There is evidence that dietitians often fail to provide general practitioners with formalised correspondence that describes dietitians' nutrition interventions with patients. Doctors report they lack patient information via dietitians' correspondence. Information about nutrition care of hospital patients often remains within hospital records. Doctors prefer standardised letter formats with content presented succinctly. The letter should include a nutrition diagnosis, agreed goals, a plan for ongoing dietetic visits and instructions for a general practitioner's supportive actions. Dietitians need skill in drafting reports or letters useful for general practitioners by selecting content of value to doctors and using a suitable style. Implementation of shared electronic records in Australia will facilitate information transfer to help realise collaborative patient care. Further investigations of dietitian-general practitioner correspondence are warranted to determine best practice. [ABSTRACT FROM AUTHOR]

Aim: The aim of this scoping review was to provide an overview of the development of practice nurses, and the learnings that could be applied to improve the profile of dietetics practice in primary care. Methods: A scoping review synthesising peer‐reviewed and other literature relevant to the development of Australian practice nurses was conducted. Structured searches using keywords 'general practice', 'nurse' and 'Australia' were conducted in PubMed and Google Scholar in June 2021. Key government websites, Department of Health and Services Australia, were searched to identify grey literature. One reviewer screened the titles and abstracts against inclusion criteria; two reviewers conducted full‐text screening independently. Data on the evolution of practice nursing were extracted based on its interest and transferability to the dietetics workforce. Results: A total of 102 results (82 peer‐reviewed and 20 other literature) were included in the review. Key drivers for practice nurse role development in Australia were government funding, practice nurse practice standards, cost–benefit analyses of practice nurses, career and education opportunities, general practitioner and patient perspectives of practice nurses and, individual, community and local needs. Conclusions: The practice nurse role has grown and strengthened and there are three key learnings that could be translated to strengthen the dietetics workforce in primary care. (1) Use and expansion of government funding, (2) furthering post‐tertiary education and career opportunities, including dietetic primary care practice standards and (3) targeting underserviced areas such as those that are rural and remote and building positive relationships with other stakeholders including practice nurses, general practitioners, patients and the broader primary care team. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide a critical review of the most recent literature from 2005 onwards, on the effect of alcohol intake during lactation on the hormonal control of lactogenesis; breastmilk alcohol concentration; the breastfeeding infant, and on the breastfeeding outcomes of the mother and infant dyad. An update on public policy guiding alcohol consumption during lactation nationally and internationally is explored. The databases PubMed, CINAHL, Proquest Health and Medical Complete, ScienceDirect, Medline and ISI Web of Knowledge were searched from 2005 onwards. Alcohol inhibits the role of oxytocin in breastfeeding women, resulting in an increased time to milk ejection and a decrease in total breastmilk yield. Breastfeeding women are less likely to consume alcohol at high-risk levels, and drinking at these levels is associated with the early cessation of breastfeeding. A higher level of education and a higher income level are the characteristics of the maternal drinker during lactation. Available public health policy in Australia provides direction for breastfeeding mothers who choose to drink alcohol during this important stage of infant development. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to explore what is known about food literacy programmes targeting adolescents, including identification of the constituents of food literacy addressed, assessment of programme effectiveness, and description of programme design or delivery specific to adolescents. Methods A review of the peer-reviewed literature surrounding adolescent food literacy was conducted using scholarly electronic databases. Programme reports were identified in the grey literature using online searching and cross-referencing to support the research aim. Programmes from 2000 to 2012 targeting adolescents aged 13-17 years were included. Results A total of 19 peer-reviewed papers and four grey literature programmes met the search criteria. Interventions focused on practical cooking and/or food preparation skills and targeted younger adolescent age groups. Programmes were most commonly held in schools and community settings. The majority of programmes (n = 16/23) did not use a theoretical basis for their development. Programme evaluation encompassed the use of pre- and post-intervention questionnaires and focus groups. Only nine studies included a dietary behaviour-based outcome measure. Although 19 of the 23 studies reviewed reported positive changes related to the intervention, these did not include significant changes in diet quality or cooking frequency at home. Conclusions Few existing adolescent food literacy programmes have demonstrated a positive impact on dietary behaviours to date. Adolescent target groups present unique challenges in programme development and delivery. However, the physical, social and emotional health needs of this age group and potential to influence lifelong behaviours highlight the need to design effective and age-appropriate adolescent food literacy programmes. [ABSTRACT FROM AUTHOR]

Aim: Competency standards support a range of professional activities, including the accreditation of university courses educating health professionals. Reviewing these standards is essential to ensure universities continue to produce well-equipped graduates, who are able to meet the challenge of changing workforce requirements. This paper has two aims: (a) to provide an overview of the methodological approaches used for compilation and review of the Competency Standards for Dietitians and (b) to evaluate the Dietitians Association of Australia's Competency Standards and capture emerging and contemporary dietetic practice. Methods: A literature review of the methods used to develop competency standards for dietitians in Australia, including entry-level, Advanced level and Dieticians Association of Australia Fellow competencies and other specific areas of competency, such as public health nutrition and nutrition education, is outlined and compared with other allied health professions. The mixed methods methodology used in the most recent review is described in more detail. Results: The history of Dietetic Competency Standards development and review in Australia is compared with Dietetic Competency Standards internationally and within other health professions in Australia. The political context in which these standards have been developed in Australia and which has determined their format is also discussed. The results of the most recent competency standards review are reported to highlight emerging practice in Australia. Conclusion: The mixed methods approach used in this review provides rich data about contemporary dietetic practice. Our view supports a planned review of all competency standards to ensure practice informs education and credentialing, and we recommend the Dietitians Association of Australia consider this in the future. [ABSTRACT FROM AUTHOR]

Although the adverse health consequences of zinc deficiency are becoming increasingly well known internationally, few studies have investigated zinc status in Australia and New Zealand. The aim of this review was to identify which population groups, if any, in Australia and New Zealand are likely to be at risk of zinc deficiency. A literature review was conducted to identify papers on zinc status in Australasia using electronic databases (MEDLINE, BIOSIS Previews, CINAHL, EMBASE, Web of Knowledge, ProQuest and Cochrane Library). Government databases and reference lists from peer-reviewed journal articles were also accessed. Thirty-one Australasian studies that measured dietary zinc intake and/or serum zinc were identified. Many were based on a small number of self-selected subjects, and did not use the recommended procedures for evaluating the prevalence of inadequate zinc intakes and low serum zinc concentrations. Existing data suggest that at-risk groups in Australasia are toddlers, adolescents (especially those of Pacific and Aboriginal ethnicities), institutionalised elderly and possibly people with diabetes. Data on the zinc status of selected population groups in Australasia are limited. Randomised controlled zinc supplementation trials that include the recommended indicators and other clinical outcomes are needed to confirm the existence of zinc-related health outcomes among the at-risk groups identified. [ABSTRACT FROM AUTHOR]

Aim: This scoping review aimed to explore the extent of the evidence of experimental studies evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Methods: Five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Scopus) were searched to October 2020 for cost‐analysis studies of interventions aiming to improve dietary intake in people with mental disorders. No restriction was placed on participant age, mental disorder type or intervention design. Results are presented narratively. Results: Of 2753 articles identified, 13 articles reporting on eight studies were included. Studies were RCTs (n = 5), cluster RCT (n = 1), cluster preference RCT (n = 1), and pre‐post test (n = 1). Seven studies were in community settings (eg, outpatient clinics), and one study in the community housing setting. All studies were in adults, seven included male and female participants, and one included only females. Defined mental disorder diagnoses included serious/severe mental disorders (n = 3), major depression (n = 2), schizophrenia, schizoaffective disorder or first‐episode psychosis (n = 1), any mental disorder (n = 1), and bulimia nervosa (n = 1). Five interventions were multi‐behaviour, two were diet only and one was eating disorder treatment. Cost analyses included cost‐utility (n = 3), cost‐effectiveness (n = 1), cost‐utility and cost‐effectiveness (n = 3), and a costing study (n = 1). Two studies (25%) reported positive results in favour of cost effectiveness, and four studies reported a mix of positive and neutral results. Conclusions: There is limited evidence evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Additional studies in various settings are needed to confirm cost effectiveness of different interventions. [ABSTRACT FROM AUTHOR]

Aim: The COVID‐19 pandemic has disrupted the Australian food supply with potential ramifications on food security. This scoping review aimed to synthesise current evidence on the prevalence of food insecurity and changes to factors related to food insecurity during the COVID‐19 pandemic in Australia. Methods: A comprehensive search strategy was used to search seven databases (MEDLINE, CINAHL, Embase, Global Health, Cochrane Database of Systematic Reviews, PsycINFO, Informit Online) and Google Scholar. Included studies were written in English, published in 2020–2021 and examined food security status in Australia during the COVID‐19 pandemic and/or factors associated with food insecurity in free‐living Australian residents. Articles with participants residing in institutional settings, where meals were supplied, were excluded. Results: A total of 700 records were identified from database, grey literature and hand searching, and nine articles were included. All studies indicated that the prevalence of food insecurity had increased due to negative changes to food availability, accessibility, usability and stability. The downturn in employment and economic circumstances following the onset of the COVID‐19 pandemic appeared to create a new group of food‐insecure Australians consisting of newly unemployed, and international students. Conclusion: COVID‐19 has exacerbated vulnerabilities in the Australian food supply and food security. Suggested actions include ongoing data collection on the long‐term impact of COVID‐19 on food supply and security in addition to coordinated national and community responses that improve the stability of the local food supply and address underlying determinants of food insecurity. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to synthesise the evidence on the effectiveness of dietary interventions targeting adolescents (>13 years) and adults living in rural or remote Australia. Methods: Six electronic databases were searched to identify dietary interventions undertaken in rural or remote communities. Studies were included if they utilised intervention and control comparisons or pre and post assessment of diet‐related outcomes. If studies included metropolitan populations, dietary outcome measures had to be provided separately for rural data. Results: In total, 14 articles from 12 unique studies met the criteria for inclusion and together provided incomplete coverage across all states of Australia, included intervention studies targeted diet to address obesity, cardiovascular disease, and high blood pressure or diabetes. No studies were focussed on reducing community malnutrition. All studies, with one exception, focussed specifically on rural adults, no interventions specifically targeted adolescents in rural areas. Only two studies documented the involvement of a dietitian in intervention development or delivery. All studies produced a significant outcome for either dietary intake, body mass index, waist circumference, or diet related biomedical risk factors for individuals located in rural or remote areas of Australia. Conclusion: Dietary interventions in rural Australia are under‐studied, especially among the adolescent population. This is despite the high level of preventable diet‐related disease burden in rural and remote Australia. Existing evidence shows promise in improving dietary intakes, but further, large scale intervention research, with the involvement of dietitians, is urgently needed to improve the health of rural communities. [ABSTRACT FROM AUTHOR]

Aim: Food insecurity (FI) is a critical public health issue in Australia. Population‐based interventions aiming to address the socio‐ecological determinants of FI are critical for relieving and preventing it. This review aimed to map and summarise the characteristics of population‐based interventions addressing household and/or community FI in Australia. Methods: A systematic scoping review was undertaken. Five databases, selected for range and relevance to FI in Australia ("CINAHL plus", "Ovid MEDLINE", "Sociological Abstracts", "Australian Public Affairs Information Service", and "Rural and Remote Health") were searched in May 2018 using the terms and relevant synonyms "FI" and "interventions". In addition a systematic grey literature search using multiple Google searches was undertaken. Data synthesis included categorisation and counting intervention type. Interventions were defined and charted by influence of at least one dimension of food security and impact on the socioeconomic, cultural and environmental conditions. Results: A total of 3565 published and grey literature records were identified, with the final 60 records describing 98 interventions. Few national interventions were identified, with approaches predominantly in Victoria, Northern Territory and Tasmania. Determinants related to living and working environments, food availability and food utilisation were most frequently addressed. Interventions addressing the key determinant of FI economic access were limited. A number of interventions did not appear to be associated with rigorous evaluation. Conclusions: While there is evidence of population responses to FI in Australia, the effectiveness of these remains limited. Importantly there is a lack of coordinated and coherent national responses that address the range of FI determinants. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to systematically map and summarise existing research regarding dietetics workforce preparation and preparedness that has been conducted in Australia. The secondary aim was to then identify gaps in the literature to inform future priority areas in Australian dietetics education research. Methods: The databases MEDLINE, CINAHL, Embase, ERIC, Informit and PsycINFO were systematically searched from inception until July 2017 using key search terms to identify eligible studies. Extracted data were independently reviewed, and study quality was appraised by multiple researchers. Results were categorised by setting and primary focus/foci and then narratively summarised. Results: Sixty‐eight studies were included from 3779 records identified. Dietetics education research in Australia has spanned almost 30 years with more than half of studies (51%; 35/68) published in the last five years. The greatest proportion of research was conducted in the university setting (43%; 29/68), with students as participants (48%; 43/90) and was focused on the medical nutrition therapy area of dietetics practice (43%; 29/68). Published studies involving graduates (14%; 13/90); conducted in the workplace (12%; 8/68); and regarding emerging areas of dietetics practice (0%; 0/90) are lacking. Employment outcomes of dietetics graduates across Australia were last published over 25 years ago. Conclusions: This review provides a map for dietetics educators and researchers in Australia to guide future research regarding the preparation and preparedness of dietitians. Advancing the Australian dietetics workforce of the future will require a strategic, coordinated and collaborative approach to address the research gaps identified in this review. [ABSTRACT FROM AUTHOR]

Aim: Food security is defined by four dimensions: food availability, access, utilisation and stability. Resettled refugees face unique struggles securing these dimensions and, thus, food security when moving to a new country. This systematic review aimed to identify the challenges Australian refugees experience in achieving the four dimensions of food security. Methods: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed; the SPIDER tool was used to determine eligibility criteria. Three databases were searched using terms relating to food in/security and refugees from 2000 to 20 May 2017. Results: Seven articles were retained for analysis. Studies were categorised against the four dimensions, with four studies identifying challenges against all dimensions. Challenges contributing to high levels of food insecurity in each dimension included: availability and cost of traditional foods, difficulty in accessing preferred food outlets, limited food knowledge and preparation skills and food stability due to low income and social support. Conclusions: Food insecurity adversely impacts refugee health and integration. Methodical research framed by the four dimensions of food security is imperative to address challenges to securing food security in refugee groups and assisting in the development of sustainable interventions. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to identify current research related to the use of school canteens in Australia, with a focus on their food and drink policy. In Australia, approximately 25% of 5–17‐year olds are considered overweight and obese. Up to 41% of energy intake for children aged between 4 and 18 years is found to come from discretionary foods. The structured nature of the school environment provides an ideal environment to address childhood obesity and encourage a culture of healthy eating. Methods: A systematic review of three key nutrition databases: ‘CINAHL’, ‘Academic search complete’ and ‘Medline’ (inception to 2015) was conducted. Inclusion criteria were: Australian, peer‐reviewed studies; studies regarding the purchase of food from school canteens; canteen studies involving students aged 5–18 years, school principals, parents, canteen managers, Parent and Citizen Association members and teachers. Results: The search identified 2741 studies with 12 meeting the inclusion criteria. In the main, studies were descriptive in nature with data summarised into four categories: (i) characteristics of canteens; (ii) canteen use and food availability; (iii) stakeholder perceptions and the role of school canteens; and (iv) compliance with policies and the barriers to healthy food implementation. Overall, compliance with healthy canteen policies was low, guidelines were rarely adhered to in terms of product provision and children had preferences for non‐healthy foods. Conclusions: Strategies to improve compliance, overcome the challenges and encourage stakeholder buy‐in are necessary if food habits are to be changed and healthy cultures developed within the school environment. [ABSTRACT FROM AUTHOR]

Aim: The availability of high-quality, validated food frequency questionnaires is useful for the conduct of robust population dietary iron-related research. This review aimed to evaluate the validation quality of recently validated food frequency questionnaires that measure iron intakes in Australian or New Zealand adults. Methods: Articles validating food frequency questionnaires that measured iron intakes in Australian or New Zealand adults, published from 1995, were sourced from a range of databases using standard search terms. Eligible validation studies were assessed for validation quality using recommendations from international reviews of food frequency questionnaire validation studies, and a quality score was calculated. Results: Nine studies validating food frequency questionnaires were located. Seven of the nine studies had achieved at least an acceptable quality validation score. More than half of the international validation recommendations were met in at least half of the eligible studies. Studies generally did not report or consider nutrient supplementation, did not validate the food frequency questionnaire against a biomarker, nor measured survey repeatability. Conclusions: The majority of food frequency questionnaire validation studies had achieved at least an acceptable quality validation score; however, some food frequency questionnaires had undergone a higher quality validation process than others. Applying the international validation recommendations to future validation studies may improve the quality of the food frequency questionnaire validation process and, potentially, population dietary iron-related research. [ABSTRACT FROM AUTHOR]

Aim: To undertake a systematic literature review to examine the effect of food cost on diet quality and risk factors for chronic disease, specifically focusing on diet-related lifestyle diseases affecting the Australian population. Methods: A search of six databases resulted in the inclusion of one systematic review, three cohort studies, 41 cross-sectional studies and four modelling studies in this review. Results: Between 2000 and 2006, the price of healthy foods has increased more than the price of less healthy foods. Healthy Food Access Basket surveys show that a healthy diet may often be unaffordable for low- and average-income households. Diets of higher energy density were associated with lower diet cost, whereas diets of higher nutrient density and nutritional quality were associated with higher diet cost. Recent studies report an inverse association between food price and food consumption. Consequently, an increase in food cost was associated with a significant reduction in weight, waist circumference, body mass index, obesity and insulin resistance. Conclusions: Manipulation of food cost may alter food consumption and therefore risk factors for chronic disease. Further longitudinal studies investigating the impact of pricing strategies on diet quality and disease risk are needed. [ABSTRACT FROM AUTHOR]