Journal of Human Nutrition and Dietetics最新文献

{"title":"Feasibility and Accuracy of Caregiver-Led Child Growth Measurements for Remote Healthcare","authors":"Sarah L. Trace,&nbsp;Sam D. Leary,&nbsp;Kara Y. Richards,&nbsp;Julian P. H. Shield","doi":"10.1111/jhn.70364","DOIUrl":"10.1111/jhn.70364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Remote healthcare is expanding, with accurate growth data essential for nutritional care. Guidance for routine caregiver-led measurements is limited and largely untested. This study evaluated the feasibility and accuracy of caregiver-led child growth measurements at home, compared to ‘gold-standard’ measurements in the hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Caregivers of children attending outpatient appointments completed a survey on their access to weighing scales and tape measures at home. Those with suitable equipment were consented to participate in a home measurement study. Using provided instructions, caregivers measured their child twice within 48 h of a hospital appointment, where two healthcare professionals (HCPs) repeated measurements. Caregiver experiences were explored through short interviews. Agreement between methods was assessed using Bland–Altman analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 677 survey respondents (49% response), 61% owned both scales and tape measure, with ownership more likely in relatively affluent postcodes. One hundred and forty participants consented to the home measurement study but due to low recruitment in the 0–2-age group (<i>n</i> = 18), analysis was restricted to 122 2–15-year-olds with median age 8.5 [IQR 5,12]. Participants were predominantly white British (88%) from relatively affluent areas (78% IMD 5–10). LOA between caregivers and HCP were −3.46% to 3.79% (height) and −4.91% to 4.36% (weight), demonstrating reasonable caregiver accuracy. LOA between the two caregiver measurements were −0.97% to 0.99% (weight) and −1.04% to 0.80% (height), demonstrating consistency, and LOA between two HCPs were −0.48% to 0.53% (weight) and −0.61% to 0.55% (height), demonstrating good inter-observer agreement. The majority found the process straightforward, with greater confidence in weighing than in measuring, despite achieving lower accuracy. Most were willing to routinely provide measurements before remote appointments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Caregiver-led measurements appear feasible and reasonably accurate for children aged 2–15 years, although they may be more suitable to monitor trends, rather than in situations needing precision. Equipment access may be limited in less affluent areas, but generally, caregivers are willing to monitor weight and height at home.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Low-FODMAP Diet on Symptoms and Quality of Life in Women With Endometriosis: A Systematic Review and Meta-Analysis","authors":"Amanda Alves Rabelo,&nbsp;Júlia Fraga Castro e Oliveira,&nbsp;Janete Rabelo Rios,&nbsp;Yasmim de Souza Nunes,&nbsp;Gabriel Bernardes Yacoub,&nbsp;Carolina Alves Corrêa,&nbsp;Guilherme Santos da Silva,&nbsp;Alessandra Bedin-Pochini","doi":"10.1111/jhn.70353","DOIUrl":"10.1111/jhn.70353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Endometriosis is a chronic inflammatory gynaecological disease that significantly impairs quality of life. Dietary strategies such as low-FODMAP diet have been proposed as adjunctive non-pharmacological approaches to symptom management. This systematic review and meta-analysis aim to evaluate the association of a low-FODMAP diet on quality-of-life outcomes in women with endometriosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, and Cochrane were searched for randomised and observational studies assessing low-FODMAP dietary interventions in women with endometriosis. Outcomes were evaluated using the Endometriosis Health Profile-30 (EHP-30). Pooled analysis was performed using a random-effects model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included three studies comprising 90 women with a mean age of 34 years. The mean follow-up duration was 3.5 months. The pooled post-intervention mean score was 28.45 for pain (95% CI: 20.88 to 36.02; <i>I</i>² = 61.8%) and 39.33 for control/helplessness (95% CI: 24.92 to 53.73; <i>I</i>² = 81.7%). The corresponding post-intervention mean scores were 31.87 for emotional well-being (95% CI: 27.15 to 36.59; <i>I</i>² = 0%), 38.94 for social support (95% CI: 33.69 to 44.20; <i>I</i>² = 0%), and 43.22 for self-image (95% CI: 35.94 to 50.49; <i>I</i>² = 21.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A low-FODMAP diet was associated with improvements across multiple quality-of-life domains in women with endometriosis. However, these findings should be interpreted with caution and considered hypothesis-generating, requiring confirmation by larger, well-designed randomised controlled trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet Quality and Physical Activity at 3–4 Years Following a Hypertensive Pregnancy: A Blood Pressure Postpartum Cross-Sectional Sub-Study","authors":"Yining Chen,&nbsp;Megan Gow,&nbsp;Katie Harris,&nbsp;Lynne Roberts,&nbsp;Amanda Henry","doi":"10.1111/jhn.70356","DOIUrl":"10.1111/jhn.70356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hypertensive disorders of pregnancy (HDP), as well as being a leading global cause of maternal mortality, confer lifelong increased maternal cardiovascular disease (CVD) risk. Although lifestyle interventions may mitigate these risks, robust evidence remains scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This cross-sectional sub-study of the three-armed, multicenter BP² randomised controlled trial primarily assessed diet quality, physical activity, and their association with CVD risk markers in women 3–4 years after HDP, following different BP² postpartum care/lifestyle intervention strategies implemented between six and 12 months post-HDP. Diet quality was evaluated using the Australian Recommended Food Score (ARFS) derived from the Australian Eating Survey. Duration of moderate-vigorous physical activity (MVPA) was estimated using the International Physical activity Questionnaire. Associations between key lifestyle outcomes and clinical cardiovascular markers were examined using linear regression models. Secondary lifestyle outcomes include estimated daily energy intake, food consumption, nutrients, estimated duration and engagement of specific physical activity types, and sedentary behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 180 participants, the mean ARFS was 33.8 ± 10.5 (SD), with 61% scoring &lt; 38 indicating suboptimal diet quality. Median MVPA was 515 (IQR 690) minutes/week with 87% meeting physical activity recommendations of at least 150 min/week. No significant differences were observed across BP² lifestyle intervention strategies, HDP subtypes (chronic hypertension, gestational hypertension, preeclampsia, and superimposed preeclampsia), or baseline body mass index (BMI) categories (&lt; 30 vs. ≥ 30 kg/m²). Neither ARFS nor MVPA showed significant associations with blood pressure, BMI, or waist circumference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Suboptimal diet was observed 3–4 years after HDP despite prior lifestyle interventions, highlighting the need for postpartum support and long-term lifestyle interventions to reduce CVD risks post-HDP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Adaptation and Psychometric Evaluation of the Turkish DESTEK (D-SCOPE) Questionnaire: A Multidimensional Assessment of Dietitians' Knowledge, Attitudes and Preparedness Regarding Dietary Supplements in Türkiye","authors":"Ayşe Betül Bilen,&nbsp;Ayşenur Çalık,&nbsp;Pınar Ece Demiray,&nbsp;Kardelen Kandemir,&nbsp;Gülen Ecem Kalkan,&nbsp;Ömer Turan,&nbsp;Müveddet Emel Alphan","doi":"10.1111/jhn.70341","DOIUrl":"10.1111/jhn.70341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objectives</h3>\u0000 \u0000 <p>The increasing use of dietary supplements in Türkiye underscores the need for validated instruments to assess dietitians' knowledge, attitudes and self-efficacy regarding supplements. However, no validated Turkish tool is currently available. This study aimed to culturally adapt the Dietitians' Survey of Comfort, Opinions and Preparedness in Education in Supplements (-SCOPE) Questionnaire into Turkish (Diyetisyenlerin Eğitim, Supleman Tercihleri ve Konforu Anketi; DESTEK) and evaluate its psychometric properties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This methodological study included 223 dietitians. Exploratory factor analysis (Principal Axis Factoring with Direct Oblimin rotation) was conducted to identify the underlying structure, followed by confirmatory factor analysis to test model fit. Internal consistency was assessed using Cronbach's alpha. Convergent validity was examined through composite reliability and average variance extracted, and discriminant validity was evaluated using the Fornell–Larcker criterion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A four-factor structure explaining 38.3% of total variance was identified. Sampling adequacy was acceptable (KMO = 0.78; Bartlett's test: χ²(153) = 1023.27, <i>p</i> &lt; 0.001). Confirmatory factor analysis demonstrated acceptable model fit (CFI = 0.915; TLI = 0.893; RMSEA = 0.062; SRMR = 0.057). The total scale showed acceptable internal consistency (α = 0.795), with subscale α values ranging from 0.531 to 0.824. Composite reliability values ranged from 0.60 to 0.83. Test–retest analysis demonstrated acceptable temporal stability (overall ICC = 0.772). Discriminant validity was supported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings provide preliminary evidence supporting the validity and reliability of the DESTEK scale for assessing Turkish dietitians' knowledge, attitudes and perceived preparedness regarding dietary supplements. Given its multidimensional structure, DESTEK may be useful for evaluating specific domains of supplement-related competence; however, further validation in larger and more diverse samples is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, Pilot Testing, and Preliminary Validation of a Parenteral Nutrition Macronutrient Assessment Tool","authors":"Andrew E. Adorno,&nbsp;Carol Ireton-Jones,&nbsp;Mindy A. Patterson","doi":"10.1111/jhn.70365","DOIUrl":"10.1111/jhn.70365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Parenteral nutrition is an intravenous form of nutrition support for patients unable to meet nutritional needs through the gastrointestinal tract. While guidelines exist for parenteral nutrition macronutrient prescription, variability in clinical practices highlights the need for an assessment tool to evaluate clinician decision-making. This study aimed to develop, pilot test, and perform preliminary validation of a parenteral nutrition macronutrient assessment tool in a sample of clinicians to evaluate prescribing practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight clinical scenario-based questions were developed and refined through expert testing and feedback. Reliability and validity were assessed with experienced clinicians (<i>n</i> = 7, mean 18.3 years of experience) and early-career clinicians (<i>n</i> = 4, mean 2.8 years of experience) involved in parenteral nutrition prescribing. Test-retest reliability and paired samples <i>t</i>-tests were used for statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Test-retest reliability was strong (<i>R</i> or <i>r_s</i> &gt; 0.7), with dextrose prescribing showing the highest consistency. Questions with lower reliability were refined based on participant feedback, and refinements were assessed descriptively through pilot tester evaluation. Tool favorability ratings improved from 4.3/5 (86%) to 4.9/5 (98%) following revisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The parenteral nutrition macronutrient assessment tool demonstrated preliminary evidence of reliability and content validity in assessing prescribing practices. Refinements enhanced favorability, clarity, and perceived clinical relevance. The survey tool may be useful for identifying practice variability and informing educational interventions to improve parenteral nutrition prescribing. Further evaluation in larger and more diverse clinician populations is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Dietitians Into Primary Dental Care for Paediatric Populations: Developing a Conceptual Service Pathway Through a Professional Stakeholder Workshop","authors":"Lauren Hallewell,&nbsp;Raul Bescos,&nbsp;Zoe Brookes,&nbsp;Robert Witton,&nbsp;Patricia Casas-Agustench","doi":"10.1111/jhn.70361","DOIUrl":"10.1111/jhn.70361","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Diet is a common risk factor influencing both oral and systemic health, yet dietary support within dental care is often limited to brief advice focused on sugar intake. Integrating dietitians into primary dental care for the paediatric population may support earlier identification of dietary concerns and provide the opportunity for dietetic care. However, no established integrated dietetic-dental service pathway for paediatric populations has been identified within primary dental care settings in the United Kingdom.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To explore how selected full-consensus agreement statements could be configured into a conceptual dietetic-dental service pathway for paediatric populations attending primary dental care services and to identify the organisational and contextual factors that may influence its future delivery in practice.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A single 70-min online workshop was conducted via video conferencing in April 2026 and facilitated using a structured discussion guide. Workshop activities focused on collaborative service pathway mapping informed by previous Delphi consensus findings. Data sources included a workshop transcript, digital sticky-note outputs, pathway mapping artefacts, facilitator notes and analysed using framework analysis. Subsequent member checking was undertaken to verify the accuracy and completeness of the developed care pathway.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Eight professional participants (four dietitians and four dental professionals) contributed to the development of a conceptual service pathway. The pathway centred on dietitian-led triage as a central coordinating mechanism, supporting referral management, communication and continuity across services. Workshop outputs highlighted a range of contextual factors that may influence future delivery, including patient engagement, professional roles and system readiness. Key uncertainties related to workforce configuration, escalation pathways and the capacity of external services to accommodate potential referrals generated through preventive dietary care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The findings represent an early stage conceptual dietetic-dental service pathway for paediatric populations, requiring future piloting and evaluation. Contextual factors suggest that delivering the care pathway may require adaptive approaches that are ","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Provision of Plant-Based, Vegetarian and Omnivorous Meals in UK Care Homes for Older People","authors":"Saffron Whyton,&nbsp;Lisa Methven,&nbsp;Kathrin Cohen Kadosh,&nbsp;Victoria Tischler","doi":"10.1111/jhn.70345","DOIUrl":"10.1111/jhn.70345","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>With concerns growing around the impact of western diets on human and planetary health, a global transition is required towards primarily plant-based diets. Although this subject has been the focus of increased research, the potential for meat and dairy reductions in care home settings has not been explored. This study assessed the provision of omnivorous, vegetarian and plant-based meals in UK care homes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 52 menus representing 136 care homes for older people were analysed against a scoring system that reflects the degree to which a menu is plant-forward. Menus were scored out of 80 based on the number of plant-based, vegetarian, red meat-free and processed-meat free meals provided across 1 week. A higher score indicates a greater proportion of plant-based and vegetarian meals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Menus scored on average 28, with a range of 19–41. The low score was primarily driven by a lack of entirely plant-based meals and a reliance on red and processed meat-based meals. Only two menus in the data set excluded processed meats, with all menus containing red meat at least once per week. Processed meats most commonly used in menus included sausages, cured meats and bacon. The most common plant-based proteins included baked beans, lentils and mycoprotein.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Even though the National Health Service recommends reductions in consumption of red and processed meats with increased consumption of plant-based proteins, this transition is yet to be implemented in care homes. This study suggests that there is potential to improve the health and sustainability of meals provided in care home by increasing the availability of plant-based options, especially those rich in plant-based proteins.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Nurse-Led to Clinical Dietitian-Led Nutritional Care in Hospital Practice: Changes in Nutritional Risk Screening Rates, Patient Nutritional Intake and Professional Perspectives","authors":"Marianne Boll Kristensen,&nbsp;Ingeborg Krarup Rask,&nbsp;Lene Nissen Møller Schmidt,&nbsp;Kirstine Guld Frederiksen,&nbsp;Alexander Erichsen,&nbsp;Lone Viggers","doi":"10.1111/jhn.70363","DOIUrl":"10.1111/jhn.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Daily nutritional care is often nurse-led, with clinical dietitians involved only upon referral. This study explored the effects of integrating clinical dietitians into daily nutritional care through reallocation of nutritional care tasks at a medical pulmonary ward, focusing on nutritional risk screening practices, patient nutritional intake, and professional perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multimethod study included three substudies: (1) a retrospective cohort analysis of nutritional risk screening practices, (2) a quasi-experimental comparison of nutritional intake between a historical control group and the intervention group, and (3) qualitative interviews with nurses and clinical dietitians following completion of the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In substudy 1, 1678 admissions were analysed. During clinical dietitian-led nutritional care, 55% of patients were screened within 24 h of admission and 76% overall, compared to 29% and 43% during nurse-led care. In substudy 2, a greater proportion of patients in the intervention group achieved ≥ 75% of their energy requirements than in the control group (79% vs. 57%, <i>p</i> = 0.023), whereas differences in protein intake were not statistically significant (50% vs. 35%). In substudy 3, both professions reported improved nutritional care and collaboration. Nurses described relief but reduced awareness of patients' nutrition, while clinical dietitians found the new tasks meaningful but challenging. Coordination and dialogue were important in adapting to changed routines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reallocating nutritional care tasks from nurses to clinical dietitians was associated with improved nutritional risk screening, higher energy coverage, and stronger interdisciplinary collaboration, particularly when supported by close coordination and dialogue between clinical dietitians and nursing staff.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Validity of Systematic Nutritional Clinical Assessment in Hospitalized Adults: Comparative Analysis of Patients With and Without Excess Body Weight","authors":"Marina da Silva Guedes,&nbsp;Larissa Farinha Maffini,&nbsp;Isabela Faller Prade,&nbsp;Teodoro Baptista da Silva Veronese,&nbsp;Ana Clara Vital Batista,&nbsp;Monalisa Reis Arruda,&nbsp;Paulo Cesar Tanuri Bento Junior,&nbsp;Adriana Cruz Rios Behrens,&nbsp;André Castro Lyra,&nbsp;Gabriela Corrêa Souza,&nbsp;Lucivalda Pereira Magalhães de Oliveira,&nbsp;Rosangela Passos de Jesus,&nbsp;Valesca Dall'Alba","doi":"10.1111/jhn.70342","DOIUrl":"10.1111/jhn.70342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Excess body weight can underestimate undernutrition in hospitalized patients. Performing standardised Nutrition-Focused Physical Examination may reduce subjectivity. This study aimed to assess the concurrent validity of the Systematic Nutritional Clinical Assessment tool and its ability to identify nutritional depletion in patients with excess body weight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included adult patients hospitalized in two Brazilian regions. Within 48 hours of admission, patients underwent anthropometric assessment, handgrip strength, Subjective Global Assessment or Patient-Generated Subjective Global Assessment, and Systematic Nutritional Clinical Assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 412 patients were included (57.6 ± 14.3 years; 58.7% male), from oncology (29.1%), hepatology (28.6%), cardiology (24.0%), and nephrology (18.2%). Undernutrition frequency was 51.4% by Subjective Global Assessment/Patient-Generated Subjective Global Assessment and 35.7% by Systematic Nutritional Clinical Assessment. The Systematic Nutritional Clinical Assessment showed moderate agreement with the Subjective Global Assessment (<i>k</i> = 0.572; <i>p</i> &lt; 0.001), high diagnostic accuracy (AUROC 0.886), 63.7% sensitivity, and 94% specificity. In the subgroup of patients with excess body weight, the post-test probability for positive results increased from 31.7% to 93.1%. The biceps and triceps compartment stood out for high sensitivity (83.0%), while the dorsum of hands and interosseous muscles stood out for high specificity (87.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Systematic Nutritional Clinical Assessment is shown to be a reliable instrument for confirming nutritional depletion in patients with and without excess body weight. When a simplified physical examination is required during nutritional assessment, the evaluation of the dorsum of hands and interosseous muscles showed the highest specificity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening School-Based Food and Nutrition Education in Ghana: Gaps, Opportunities, and a Roadmap for Action","authors":"Jevaise Aballo,&nbsp;Porbilla Ofosu-Apea,&nbsp;Catherine Adu-Asare,&nbsp;Olivia Adzoa Mawunyo Timpo,&nbsp;Hikmatu Abdulai,&nbsp;Cristina Alvarez Sanchez,&nbsp;Melissa Vargas,&nbsp;Annette Imohe,&nbsp;Cynthia Obbu,&nbsp;Gifty Ampah,&nbsp;Josephine Asante,&nbsp;Mutala Abdulai,&nbsp;Veronica Quartey,&nbsp;Theresa Oppong Mensah,&nbsp;Patrick Banafo,&nbsp;Bright Yammaha Amoore,&nbsp;Victor Mogre","doi":"10.1111/jhn.70366","DOIUrl":"10.1111/jhn.70366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malnutrition among school-age children and adolescents in Ghana is driven by poor diet quality and weakly regulated school food environments (SFEs). School-based Food and Nutrition Education (SFNE) is a key strategy, but its effectiveness depends on coordinated capacity across sectors. This study assessed the enabling factors, and priority actions for institutionalising SFNE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The FAO SFNE capacity needs assessment tool was used, with a multi-phase qualitative study design. Document review and stakeholder mapping were conducted, followed by a two-day consultative workshop. Capacities were assessed across system levels and prioritised through ranking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ghana has supportive SNFE policies; however, implementation is fragmented, lacks unified legal framework, and constrained by inadequate data. Integration into curricula, teacher training, and SFEs is weak, with reliance on short-term funding. Priority actions included strengthening coordination, developing standards; improving data systems, aligning curricula, enhancing SFEs, and sustainable financing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implication for School Health Policy, Practice, and Equity</h3>\u0000 \u0000 <p>Institutionalising SFNE will ensure learners receive high-quality equitable nutrition education and access to supportive school food environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ghana is well-positioned to institutionalise SFNE and may serve as a model for low- and middle-income countries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}