Journal of Human Nutrition and Dietetics最新文献

{"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}

{"title":"Intervention Using Video and Comic Books Targeting Nutritional Outcomes in Children and Adolescents: A Systematic Review","authors":"Ira Dwijayanti,&nbsp;Marian Abrafi Osei,&nbsp;Farah Nuriannisa,&nbsp;Luthfia Dewi,&nbsp;Arif Sabta Aji,&nbsp;Adi Lukas Kurniawan","doi":"10.1111/jhn.70362","DOIUrl":"10.1111/jhn.70362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Unhealthy eating behaviours and rising rates of undernutrition and obesity remain widespread among children and adolescents. Traditional education often fails to engage this population. In contrast, video and comic book formats offer accessible, engaging tools for nutrition education, but evidence on their effectiveness is inconsistent. This systematic review synthesises and critically appraises the evidence on video- and comic-based interventions for improving nutritional outcomes in children and adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In accordance with PRISMA guidelines a protocol was registered in PROSPERO (CRD420251138451). We systematically searched PubMed, Embase, and CENTRAL from January 2000 to October 2025 for randomised, cluster-randomised, and non-randomised intervention studies in participants aged ≤ 18 years using video- or comic-based formats. Outcomes included nutritional status, dietary intake, food consumption, dietary patterns, and nutrition literacy. The risk of bias quality of the included studies were independently assessed by two reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 498 records, 18 studies met inclusion criteria—14 video-based and 4 comic-based interventions across school, digital, and clinical settings in Asia, Africa, Europe, North America, and Australia (sample sizes ranged from 57 to 6,640). Interventions consistently improved nutrition-related knowledge, attitudes, and self-efficacy. Effects on dietary behaviours, including fruit and vegetable consumption, were favourable, but rarely sustained at follow-up. The effects of anthropometric factors on BMI and body composition were limited and inconsistent. Risk of bias ranged from some concerns to high or serious.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Video- and comic-based interventions effectively improve nutrition literacy among children and adolescents but show limited and inconsistent effects on dietary behaviours and anthropometric outcomes. Future interventions should move beyond information delivery and embed multimedia within multilevel strategies addressing behavioural, environmental, and parental determinants of diet.</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://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129507","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":"Functional Nutrition Literacy and Healthy and Sustainable Eating Efforts Across Diverse Populations.","authors":"Alejandra Jáuregui, Edna Jacqueline Ramírez-Contreras, Kathia Larissa Quevedo Torres, Alejandra Contreras-Manzano, Christine M White, Laura Patricia Arellano-Gómez, Simón Barquera, David Hammond, Rachel E Davis, James F Thrasher","doi":"10.1111/jhn.70355","DOIUrl":"10.1111/jhn.70355","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding how nutrition literacy influences individuals' efforts to adopt healthier and more sustainable dietary patterns is essential for informing effective public health strategies. Mexico and the United States have recently implemented several nutrition policies to promote healthier food choices within distinct social and food environments. We aimed to examine the association between functional nutrition literacy and healthy and sustainable eating efforts among Mexican Americans, non-Latino Whites in the US, and Mexicans.</p><p><strong>Methods: </strong>Online surveys were conducted among adults in Mexico (n = 5779) and the US (Mexican Americans = 3343; non-Latino Whites = 3674) as part of the International Food Policy Study 2021. Nutrition literacy was assessed using six questions based on country-specific nutrition facts labels. Efforts to modify diet across food categories were used to construct indicators of healthy and sustainable eating aligned with international guidance. Logistic regression models estimated associations between functional nutrition literacy and dietary efforts, stratified by population group.</p><p><strong>Results: </strong>Healthy and sustainable eating efforts were similar between Mexican Americans and Mexicans (≈50%-80%), but lower for non-Latino Whites (≈37%-65%), despite lower literacy levels in the former groups. Higher nutrition literacy was associated with greater likelihood of engaging in most dietary efforts across all populations, including increasing fruit, vegetable, and whole grain intake, and reducing consumption of processed foods, sugary drinks, and nutrients of concern (AORs = 1.07-2.73). Some associations were stronger among Mexican Americans and Mexicans (p < 0.008).</p><p><strong>Conclusions: </strong>Functional nutrition literacy is positively associated with healthy and sustainable eating efforts, supporting its role as a target for public health strategies alongside population-level interventions.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":"e70355"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221101","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":"A Systematic Review of Nutrition Interventions for Shift Workers, With Subgroup Analysis of First Responder Populations","authors":"Alison Jayne Booker,&nbsp;Steven Powell,&nbsp;Joanne Louise Fallowfield,&nbsp;Rachel Gibson","doi":"10.1111/jhn.70340","DOIUrl":"10.1111/jhn.70340","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Shift work is an increasingly prevalent feature of the modern workforce, with first responders constituting a critical occupational group required to sustain 24-h operations. Modifiable health behaviour interventions, such as improving diet quality, may be effective in preventing or mitigating the non-communicable disease onset linked to shift work. This review evaluated evidence supporting nutritional interventions in shift workers with first responder populations considered as a pre-specified subgroup of interest.&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 systematic review (PROSPERO CRD42023421400) evaluated intervention and observational studies informing dietary guidance for shift workers. Four databases (Embase, Cochrane Library, Web of Science, PubMed) were searched from inception to August 2023, with no date restrictions, and searches were updated in July 2025. Searches were supplemented by grey literature searches specifically targeting first responder populations. Studies were screened by two researchers. Studies of a randomised controlled trial (RCT), crossover-RCT or observational study design, conducted in free-living shiftwork populations or a laboratory-controlled shiftwork setting, the intervention included a dietary component, and health-related outcomes were reported. A narrative synthesis of results grouped by intervention type was conducted, with a pre-specified subgroup analysis of studies in first responder populations. Quality assessment was measured using the Cochrane Risk of Bias Tools. Observational studies were evaluated using the Newcastle–Ottawa Scale.&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;From the 6909 articles retrieved, 43 met the inclusion criteria. Most articles reported using a crossover (49%) or observational (33%) study design. Where specified, most studies involved free-living participants (67%) in nursing and healthcare professionals (40%), with a few studies (9%) involving first responder subgroups (e.g., firefighters and police officers). Frequently reported intervention components included macronutrient adjustments (23%), time-restricted eating (TRE) (21%), and meal timing and quantity (19%). Frequently reported outcomes were cardiometabolic health (40%), cognitive performance (30%), and sleep quality (12%). Methodological heterogeneity and prevalent risk of bias limited the evidence strength for determining shift worker nutritional guidelines.&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 current evidence-base is insufficient to formulate eviden","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118817","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":"Nutrition Support in Patients With Delirium: A Retrospective Case Series.","authors":"Jolie Baird, Angela Tremayne, Esti Adithama, Kate Desneves, Brooke Chapman, Roger Hughes, Caroline Tuck","doi":"10.1111/jhn.70358","DOIUrl":"10.1111/jhn.70358","url":null,"abstract":"<p><strong>Aim: </strong>Malnutrition and delirium are highly prevalent and closely linked, with poor nutritional status increasing delirium risk, and delirium worsening nutritional intake. This study aimed to characterise the nutritional journey for patients with delirium in an acute tertiary hospital.</p><p><strong>Methods: </strong>A retrospective case series was conducted across six general medical units at Austin Hospital, Victoria, between January and July 2024. Of the 157 patients with a positive Confusion Assessment Method score for ≥ 5 days, 100 were randomly selected. Data were extracted from medical records, including demographics, admission details, delirium characteristics, nutrition screening and assessment, and nutrition interventions. Patient-journey timelines were constructed to illustrate key events from hospital admission to discharge. Referral and assessment timelines and length-of-stay data were analysed using Mann-Whittney U test.</p><p><strong>Results: </strong>Sixteen percent of patients with delirium were malnourished. 44% were automatically referred to a dietitian via the malnutrition screening tool, while 56% did not meet referral thresholds. 50% (19/38) of assessments completed in malnourished patients recorded that patients were unable to answer the weight loss question. 15.8% (6/38) of patients responded 'no' to the weight loss question despite documented evidence of weight loss. Malnourished patients with delirium had a longer length of stay than patients with delirium who were not malnourished (median 22.0 days, IQR 15.9-33.8 vs median 11.8 days, IQR 8.6-17.0; p < 0.001).</p><p><strong>Conclusion: </strong>This study highlights issues of suboptimal screening, delayed intervention, and poorer outcomes in those with delirium. Hospitals should improve nutrition screening and referral pathways to facilitate proactive nutrition intervention in patients with delirium.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":"e70358"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221070","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":"Determining Dietitian Staffing Ratios Through a Consensus Building Process in a Large Canadian Health Authority","authors":"Rebekah Sandhu,&nbsp;Delara Saran,&nbsp;Treeva Elliott","doi":"10.1111/jhn.70348","DOIUrl":"10.1111/jhn.70348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dietitian managers are routinely asked to provide recommendations for dietitian staffing ratios (i.e., the number of patients a dietitian 1.0 full-time equivalent (FTE) position can adequately serve). These recommendations are used as a benchmark when advocating for improving dietitian service levels, future hospital planning, and ultimately guide the FTE for which the department is budgeted. To date, there is limited empirically based evidence supporting dietitian staffing ratios for multiple care areas. The purpose of this quality improvement project is to develop consensus on the dietitian staffing ratios for inpatient, ambulatory, and long-term care areas within a large Canadian health authority.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A modified RAND/UCLA method of consensus was used. A draft document of dietitian staffing ratios was informed by a literature review. Next, iterative rounds of anonymous surveys and virtual meetings were conducted until consensus on the dietitian staffing ratios for each care area was achieved. Consensus was defined as &gt; 70% of respondents indicating they rated an item at least slightly agree on a 7-point Likert scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty percent (12/15) dietitian leaders participated in the consensus process. The leaders had an average of 5.8 ± 6.3 years experience supervising a median of 8.0 FTE [1–42] of dietitian positions. Consensus was achieved after 3 rounds of surveys and meetings. The final document provides dietitian staffing ratios for 35 different practice areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This quality improvement project is the first to provide a comprehensive list of dietitian staffing ratios for inpatient, outpatient, and long-term care areas. It provides dietitian managers in other locations with insight into a process by which they could produce their own locally relevant dietitian staffing ratios.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070657","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":"A Mixed-Methods Evaluation of a Dietetic Outcome Measure Tool Pilot in a Community Eating Disorder Service","authors":"Steph Sloan,&nbsp;Jane Sadler,&nbsp;Sharleen Woods","doi":"10.1111/jhn.70346","DOIUrl":"10.1111/jhn.70346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Eating disorders (EDs) are associated with significant physical, psychological, and social impairments. Dietitians play a vital role in ED treatment, yet their impact is underreported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the pilot implementation of a novel dietetic outcome measure tool within a community ED service, with a focus on feasibility and acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods evaluation was conducted over six months in 2024. Quantitative data were collected using a novel dietetic outcome measure tool being piloted within the service and analysed descriptively. Qualitative data were collected through semi-structured interviews with dietitians piloting the tool and analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Quantitative outcome data from 102 patients were analysed to describe service level referral patterns, intervention focus, proposed outcomes, and perceived outcome achievement. Restrictive dietary patterns and malnutrition were identified as common dietetic concerns. Improving nutritional status and eating patterns were the most frequently identified dietetic outcomes. Outcome status was recorded for 54% of patients. Of those, twenty-six (47%) had a recorded outcome as ‘met,’ 21 (38%) as ‘partially met,’ and 8 (15%) as “not met.” Qualitative findings are presented across 3 themes: (1) demonstrating professional value through outcome monitoring, (2) practical and organisational barriers to embedding outcome monitoring, and (3) balancing meaningful data collection with clinician burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participants were supportive of routine outcome monitoring in principle. However, the absence of clearly defined outcome indicators and associated data limited the tool's ability to meaningfully evaluate the intervention's effectiveness. Improved integration within existing electronic systems, combined with clearer outcome indicators and complementary qualitative approaches, may reduce clinician burden while enhancing the feasibility, acceptability, and value of routine outcome monitoring within ED dietetic services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070663","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}