Nutrition & Dietetics最新文献

{"title":"Protein intake in aged care residents before and after the Royal Commission into Aged Care Quality and Safety: A review of historical data compared to contemporary intakes.","authors":"Emily Adams, Annalise Macriyiannis, Shannon Turnbull, Sandra Iuliano","doi":"10.1111/1747-0080.70075","DOIUrl":"10.1111/1747-0080.70075","url":null,"abstract":"<p><strong>Aim: </strong>Malnutrition is prevalent among aged care residents and is exacerbated by inadequate provision and intake of protein. High rates of malnutrition and inadequate provision of protein were two issues raised by the Royal Commission into Aged Care Quality and Safety that prompted the Federal government to provide financial support to the sector to improve nutrition in residents. We aimed to determine if protein provision to, and intake in, residents has improved and meets requirements following the Royal Commission.</p><p><strong>Methods: </strong>Protein intakes from 12 Pre-Royal Commission studies were identified from a literature search (n = 2378 residents, 85.9 years, 72.3% female). Post-Royal Commission intakes of 78 residents (84.3 years, 84.6% female) were documented. Protein intakes were measured using weighed intake or visual plate waste assessment over 1-3 days. Intakes (±95% confidence interval) for protein (g), relative protein (g/kg body weight), high-protein foods and energy (kJ/kg body weight) were calculated. Differences occurred if the 95% confidence interval between Pre- and Post-Royal Commission intakes did not overlap.</p><p><strong>Results: </strong>Mean relative protein (0.9 g/kg body weight; 95% confidence interval: 0.8-0.9) and energy (98 kJ/kg body weight; 95% confidence interval: 97-100) intakes of residents pre-Royal Commission did not differ to post-Royal Commission residents (protein: 0.9 g/kg body weight; 95% confidence interval: 0.8-1.0, energy: 96 kJ/kg body weight; 95% confidence interval: 88-104). Provision and intakes of high-protein foods remained below recommended levels.</p><p><strong>Conclusions: </strong>Protein intake of residents and provision of high-protein foods were inadequate prior to and remain below recommendations since the Royal Commission. Regulatory changes such as minimal national nutritional standards for food provision are required to ensure nutritional adequacy of aged care residents.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"387-398"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent malnutrition in a remote Australian hospital-Insights from a 10-year cross-sectional study.","authors":"Rachael Smalley, Elisabeth Nichols, Lauren Caruana, Megan Scott, Elise Jochinke, Tiffany Tregea, Natasha Franklin","doi":"10.1111/1747-0080.70073","DOIUrl":"10.1111/1747-0080.70073","url":null,"abstract":"<p><strong>Aim: </strong>To describe the burden of malnutrition in an at-risk population and validate a screening tool.</p><p><strong>Methods: </strong>A 10-year cross-sectional study was conducted in a remote hospital. Dietitians screened participants using the Malnutrition Screening Tool or the Adult Nutrition Tool. Participants scoring ≥2 utilising the Malnutrition Screening Tool or ≥4 utilising the Adult Nutrition Tool, or already under the care of a dietitian, were assessed for malnutrition using a Subjective Global Assessment. The validity of the Adult Nutrition Tool was compared to the Malnutrition Screening Tool in participants undergoing a Subjective Global Assessment.</p><p><strong>Results: </strong>Of 980 study participants, 70.1% identified as Aboriginal Australian and 42.6% were at risk of malnutrition. Three-hundred and seventy-four (58.8%) participants were malnourished. The Adult Nutrition Tool showed superior area under the curve (0.74, 95% confidence interval [0.67, 0.81], p < 0.001) than the Malnutrition Screening Tool (0.64, 95% confidence interval [0.56-0.73], p 0.001). An Adult Nutrition Tool score ≥2 demonstrated superior sensitivity (98.2%) and specificity (16.7%) compared to a Malnutrition Screening Tool score ≥2 (sensitivity 97.2% and specificity 14.3%). An Adult Nutrition Tool score of ≥3 demonstrated reduced sensitivity (92.0%) but superior specificity (20.2%) than screening scores ≥2 for both tools.</p><p><strong>Conclusion: </strong>Malnutrition risk is high in a remote Australian hospital. This study confirms the Adult Nutrition Tool and the Malnutrition Screening Tool are valid tools to predict malnutrition in a unique remote hospital, recommending an 'at-risk' threshold of ≥2 for the Adult Nutrition Tool to aid in the early detection of malnutrition.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"334-344"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivering equitable care experience to hospitalised people with higher weight: A service-wide survey of inpatients and staff.","authors":"Thea Moloney, Alison Lunt, Mikaela Foy, Stephanie Gleeson, Michelle Shannon, David A Snowdon, Laura Jolliffe","doi":"10.1111/1747-0080.70058","DOIUrl":"10.1111/1747-0080.70058","url":null,"abstract":"<p><strong>Aim: </strong>Caring for people with higher weight and complex health needs is increasingly common in hospitals. This study aimed to explore and compare inpatient and staff perspectives on the care of people with higher weight.</p><p><strong>Methods: </strong>Cross-sectional study using purpose-designed surveys within Metropolitan Victoria, Australia. Inpatients (who weighed over 100 kg) and hospital staff who provide care across four hospitals were invited to complete an inpatient-specific or staff-specific survey, respectively. Surveys contained questions related to clinical care, environment and dignity/respect. Data was analysed using descriptive statistics of scale-based items, and textual synthesis of free-text responses.</p><p><strong>Results: </strong>Thirty inpatients and 59 staff participated. Most inpatients reported their clinical care needs were met (73%-83%) and described appropriate equipment and staff support. However, 25% felt judged or emotionally unsupported, with some experiencing delays in care due to staffing or equipment availability. Staff were less positive, with 73% reporting difficulty accessing equipment, 71% citing inadequate staffing and only 39% agreeing that non-stigmatising care was provided. Differences in weight-related terminology preferences emerged: inpatients favoured the terms 'higher weight' (27%) or 'obese/overweight' (34%), while staff preferred 'bariatric' (71%). Three themes were identified: (1) Inappropriate equipment, delays to equipment-access can negatively impact on inpatient experience of care; (2) Processes of care and communication influence inpatient experience of care; and (3) Weight-related stigma.</p><p><strong>Conclusions: </strong>Addressing gaps in care requires improved training, better resource access and alignment of language with consumer preferences to reduce stigma and deliver person-centred care.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"291-301"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating enablers and barriers to home enteral nutrition care and blended tube feeding use in adult clients: A mixed methods study.","authors":"Lina Breik, Janet Golder, Lisa A Barker, Judy Bauer, Zoe E Davidson","doi":"10.1111/1747-0080.70048","DOIUrl":"10.1111/1747-0080.70048","url":null,"abstract":"<p><strong>Aim: </strong>To investigate enablers and barriers to providing home enteral nutrition care and the use of blended tube feeding for adult clients.</p><p><strong>Methods: </strong>An explanatory sequential mixed-methods study mapped to the Theoretical Domains Framework, comprising a national cross-sectional web-based survey, descriptive qualitative analysis of focus groups, and triangulation of quantitative and qualitative data. The target population was dietitians operating in all work environments with adult clients in patient-facing roles.</p><p><strong>Results: </strong>23 enablers and 24 barriers were identified for the provision of home enteral nutrition and blended tube feeding. Home enteral nutrition enablers: clinical guideline familiarity, confidence in troubleshooting, capacity for home visits, and access to peer support. Barriers centered on time constraints, complex funding arrangements, and an unclear scope of practice, particularly in relation to advanced procedures and community-based roles. Blended tube feeding enablers: patient and caregiver enthusiasm, alignment with person-centred care, peer encouragement, and the availability of written resources. Barriers included limited clinician training, inconsistent messaging between hospital and community sectors, and restrictive or absent organizational policy. Awareness of best practice guidelines emerged as a shared enabler between home enteral nutrition care and blended tube feeding use, while the lack of targeted university education and post-graduate clinical support was the only common barrier across both.</p><p><strong>Conclusions: </strong>This novel study offers insights into dietitians' experiences in home enteral nutrition care and blended tube feeding use. Tailored strategies must address the unique barriers in home enteral nutrition and blended tube feeding to improve the quality and consistency of care for tube-fed adults.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"355-368"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145391499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celebrating 50 years of Dietitians Australia: Reflections on the journal, Nutrition & Dietetics.","authors":"Linda Tapsell","doi":"10.1111/1747-0080.70079","DOIUrl":"10.1111/1747-0080.70079","url":null,"abstract":"","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"288-290"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of Indigenous foods in Australian hospitals, a cross-sectional study.","authors":"Aimee Dow, Yi-Chin Tsai, Paris Ierino, Lani Wilson, Bridget Agius, Casey L Peiris","doi":"10.1111/1747-0080.70040","DOIUrl":"10.1111/1747-0080.70040","url":null,"abstract":"<p><strong>Aims: </strong>The primary aim of this project was to investigate the provision of Indigenous food items on hospital menus to improve Aboriginal and/or Torres Strait Islander patient meal experiences within Australian public and private hospitals. The secondary aim was to explore other inclusion initiatives at the hospitals.</p><p><strong>Methods: </strong>A cross-sectional study was completed by surveying food service dietitians from inpatient hospitals around Australia to collect data regarding the provision of Indigenous menu items and cultural practices. A convenience sample of dietitians was used, followed by snowball sampling to increase responses. Closed survey question data was analysed using simple descriptive statistics and free text comments via inductive content analysis.</p><p><strong>Results: </strong>67 surveys were completed covering all Australian states and territories. 19% (n = 13) of hospitals provided specific food items for Aboriginal and/or Torres Strait Islander patients while 72% (n = 48) provided Halal and 52% (n = 35) provided Kosher meals. The majority (45%) of responses were from Victoria (n = 30); yet only one Victorian hospital included Indigenous offerings. 72% of hospitals (n = 48) reported they had not considered the needs of Aboriginal and/or Torres Strait Islander patients when it came to food provision.</p><p><strong>Conclusions: </strong>This study was the first to explore current trends in food provision for Aboriginal and/or Torres Strait Islander patients and highlights the gap in hospital food provision that meets these cultural considerations.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"369-376"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implementation and evaluation of a flexible, mixed-model food service system for a greenfield hospital.","authors":"Jennifer Ellick, Hannah Olufson, Adrienne Young, Merrilyn Banks","doi":"10.1111/1747-0080.70072","DOIUrl":"10.1111/1747-0080.70072","url":null,"abstract":"<p><strong>Aims: </strong>The opening of a new digital metropolitan hospital with surgical and subacute cohorts required a flexible food service model to meet diverse patient needs. This project aimed to design, implement and evaluate such a system, optimising service efficiencies and patient experience.</p><p><strong>Methods: </strong>A flexible, mixed-model food service was designed by reviewing research, consulting experts, and gathering consumer feedback. The Knowledge-To-Action framework guided the model's development and implementation. Key features included an on-demand meal ordering system on the surgical ward; efficient and safe communal dining and snack services for long-stay patients; routine patient food intake hospital-wide to proactively identify at-risk patients; innovative waste and cost recovery strategies. Evaluation was based on the quadruple aims of healthcare measuring patient satisfaction, malnutrition prevalence, mealtime assistance, food waste and cost, and staff satisfaction. The success of targeted implementation strategies was also monitored.</p><p><strong>Results: </strong>Patients were highly satisfied with the food service model (4.6/5, n = 1284). High rates of mealtime assistance (>90% over 3 years) were achieved, and malnutrition prevalence was 21% (82/369) over the 3 years. Low plate waste (3-year average 16.5%) and an average food cost per meal of $4.73 were reported. Staff satisfaction was high, with a culture of success noted.</p><p><strong>Conclusions: </strong>This flexible, mixed model food service met the needs of different patient cohorts across surgical, subacute and outpatient services, optimising service efficiencies, patient outcomes and staff satisfaction. This project serves as a guide for creating food service models that address diverse patient needs in hospital settings, translating contemporary evidence into practice.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"377-386"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening, characterising and assessing malnutrition in the hospital setting: A large-scale point prevalence survey.","authors":"Kate Connell, Andrea Elliott, Emma McShane, Andrea Bramley, Lauren Hanna, Kate Furness","doi":"10.1111/1747-0080.70045","DOIUrl":"10.1111/1747-0080.70045","url":null,"abstract":"<p><strong>Aim: </strong>To assess the prevalence of undernutrition, overnutrition, and simultaneous malnutrition in a hospital setting, as well as undernutrition risk and dietetic intervention rates.</p><p><strong>Methods: </strong>A point prevalence survey was conducted annually from 2016 to 2024 (excluding 2020-2021 due to Coronavirus Disease 2019) across three metropolitan health service hospital sites. Eligible multiday inpatients underwent bedside assessments and medical record reviews to determine Body Mass Index, Malnutrition Universal Screening Tool scores, and undernutrition status based on either the International Classification of Diseases, 10th Revision, or the Global Leadership Initiative on Malnutrition. Data were analysed descriptively.</p><p><strong>Results: </strong>Of 5186 patients surveyed, 21.2% were undernourished, 39.5% were overnourished, and 4.8% were simultaneously under- and overnourished. Just over one-third (37.4%) of all participants were at risk of undernutrition. Dietitian intervention rates were highest among the simultaneously malnourished (70.6%) and undernourished (69.6%), and low among the overnourished (3.6%).</p><p><strong>Conclusion: </strong>The findings underscore the need for improved detection of simultaneous malnutrition and increased rates (towards 100%) of dietary intervention among patients with either under- or simultaneous malnutrition during a patient's hospital stay.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"326-333"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing micronutrients in metabolic and bariatric surgery: A mixed methods study of Australian dietitians' practice and perspectives.","authors":"Xueying Tang, Skye Marshall, Alexandra R Davidson, Lillian Craggs-Dino, Flavia Fayet-Moore, Dianne P Reidlinger","doi":"10.1111/1747-0080.70056","DOIUrl":"10.1111/1747-0080.70056","url":null,"abstract":"<p><strong>Aims: </strong>Dietitians play key roles in the care of patients undergoing metabolic and bariatric surgery, including micronutrient management. This study aimed to explore Australian dietitians' practices and perspectives on managing micronutrients in bariatric surgery.</p><p><strong>Methods: </strong>A mixed methods study of sequential explanatory design was conducted including a cross-sectional survey and semi-structured interviews. Eligible participants were Accredited Practising Dietitians caring for patients undergoing bariatric surgery. A 20-item study-specific practice survey was distributed electronically, and results were analysed descriptively. Interviewees were recruited via the survey and professional networks. Interviews were conducted, audio-recorded, transcribed and analysed using inductive thematic analysis. Findings were integrated following separate analysis.</p><p><strong>Results: </strong>Forty-five eligible dietitians responded to the survey and eight dietitians were interviewed. Practice findings showed pathology tests were most frequently ordered at the 6- and 12-month postoperative timepoints, and oral multivitamins were recommended postoperatively. Divergence across dietitians was seen in repletion practice and the clinical resources used, particularly in private versus public services. Interview findings were mostly consistent with survey results, and two themes identified were individualising supplementation and anticipating future needs.</p><p><strong>Conclusion: </strong>Dietitians' practice on monitoring micronutrient status and postoperative supplementation was broadly consistent. Inconsistent practice in repletion of deficiencies was related to differing models of care. Despite perceiving that patients have a high prevalence of micronutrient deficiency preoperatively, dietitians did not prioritise managing micronutrients until after surgery, largely for practical reasons. More research is needed to improve the evidence-based practice in this area.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"312-325"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable healthy diets need a new paradigm.","authors":"Bradley Ridoutt","doi":"10.1111/1747-0080.70080","DOIUrl":"10.1111/1747-0080.70080","url":null,"abstract":"","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"399-400"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}