Journal of Human Nutrition and Dietetics最新文献

{"title":"Effects of Walnut (Juglans regia L.) on Blood Pressure and Endothelial Function in Adults: A Systematic Review and Dose-Response Meta-Analysis.","authors":"Ghazal Mashayekhi, Damoon Ashtary-Larky, Mehdi Karimi, Omid Asbaghi, Arvin Porkar Rezaeyeh, Zahra Shouhani, Ali Hosseini, Moslem Naderian","doi":"10.1111/jhn.70335","DOIUrl":"10.1111/jhn.70335","url":null,"abstract":"<p><strong>Background: </strong>Walnuts (Juglans regia L.) are rich in bioactive compounds with anti-inflammatory and antioxidant properties, which may benefit cardiovascular health. However, the evidence regarding their effects on blood pressure (BP) and endothelial function remains inconclusive.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the effects of walnut consumption on systolic and diastolic BP (SBP and DBP), and endothelial function markers, including flow-mediated dilation (FMD), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in adults.</p><p><strong>Methods: </strong>A systematic search of PubMed, Web of Science and Scopus was conducted through February 2026 to identify relevant randomized controlled trials (RCTs). Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were estimated using a random-effects model. Subgroup analyses were conducted based on intervention duration and walnut dosage. Dose-response associations were further examined using both linear and nonlinear modelling approaches.</p><p><strong>Results: </strong>Pooled analysis data from 36 RCTs showed no significant overall effect of walnut consumption on SBP (WMD: -0.65 mmHg; 95% CI: -1.61 to 0.30, p = 0.183) or DBP (WMD: -0.68 mmHg; 95% CI: -1.56 to 0.19, p = 0.125). However, significant reductions in DBP were observed in studies lasting ≥ 12 weeks. Walnut intake significantly increased FMD (WMD: 0.93%; 95% CI: 0.27 to 1.59, p = 0.006), but had no overall significant effect on ICAM-1 (WMD = -0.56 ng/mL; 95% CI: -2.50 to 1.38; p = 0.571) and VCAM-1 (WMD: -8.68 ng/mL, p = 0.663). Subgroup analysis indicated a reduction in ICAM-1 in participants at high cardiovascular risk. The dose-response analysis supported a greater effect on ICAM-1 at higher walnut intakes.</p><p><strong>Conclusion: </strong>Walnut supplementation may improve vascular health by reducing endothelial dysfunction and promoting a dose-dependent reduction in endothelial inflammation.</p><p><strong>Trial registration: </strong>International Prospective Register of Systematic Reviews (PROSPERO): CRD420261461684.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":"e70335"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801817","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":"Nutritional Recovery After Critical Illness: A Qualitative Study of ICU Survivors' Experiences After Hospital Discharge","authors":"Ella Terblanche,&nbsp;Hazreen Abdul Majid,&nbsp;Humaira Khan,&nbsp;Steven Vogel","doi":"10.1111/jhn.70322","DOIUrl":"10.1111/jhn.70322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Substantial and persistent barriers to achieving adequate nutritional intake exist for adult survivors of critical illness in the year following hospital discharge. Despite the clear burden, nutrition rehabilitation remains a largely neglected component of post-ICU recovery. Greater understanding of lived experiences is needed to inform person-centred dietetic interventions. The aim was to explore how survivors of critical illness describe, interpret, and navigate their nutritional recovery after hospital discharge, and the personal, relational, and systemic factors that shape these experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative study adopted a narrative enquiry approach to elicit participants lived experiences and stories using in-depth interviews. The Transtheoretical Model was used as a sensitising concept that emerged during analysis. Participants were recruited through convenience sampling, and sample size determined using information power. Narrative analysis and reflexive thematic analysis was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen participants (11 women, 5 men) took part (median age 53 years; median of 2.4 years since discharge). Four coexisting themes were identified: (1) Eating in the shadow of critical illness, (2) Nutritional care that worked (3) Unmet nutritional needs, and (4) What we wish we'd had. Integration of narrative and thematic analysis revealed two broad nutritional recovery processes, an enabling and a constraining recovery process, shaped by psychological readiness, agency, relational support, and access to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nutritional recovery after critical illness is dynamic and multidimensional shaped not only by physical symptoms, but also by trauma, identity disruption, readiness to change, relational environments and systemic support. These findings provide groundwork for person-centred dietetic interventions following hospital discharge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632804","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":"Generational Influence on Diet Quality: An Analysis Based on Vigitel 2023","authors":"João Paulo Lima de Oliveira,&nbsp;Laudicéia Ferreira Fróis,&nbsp;Bianca Aparecida de Sousa,&nbsp;Hemily Lopes Menezes Silvério,&nbsp;Giovana Oliveira Mendonça,&nbsp;Leticia Ohara de Paiva,&nbsp;Nathalia Luiza Ferreira,&nbsp;Lílian Gonçalves Teixeira","doi":"10.1111/jhn.70320","DOIUrl":"10.1111/jhn.70320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Food consumption is influenced by sociodemographic factors throughout life, including generational affiliation. Different cohorts, such as Traditionalists, Baby Boomers, Generation X, Generation Y and Generation Z, are considered. In this context, the study aimed to examine the association between generational groups and diet quality, specifically the consumption of unprocessed/minimally processed foods and ultra-processed foods (UPF), using data from the 2023 Vigitel survey in Brazil.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a population-based cross-sectional study conducted using data from VIGITEL 2023, including adults (≥ 18 years) residing in Brazilian state capitals. Dietary intake, the outcome variable, was assessed using questions based on the VIGITEL questionnaire, followed by the construction of a score considering consumption frequency and the level of food processing. Generational status was defined based on the difference between participants' reported age and the year of data collection, with individuals classified into the following cohorts. Traditionalists, Baby Boomers, Generation X, Generation Y and Generation Z. Univariate and multivariable logistic regression models were used to assess associations, adjusting for educational level, marital status, and geographic region, with statistical significance set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final sample comprised 21,690 Brazilian adults. Individuals from Generation X (OR: 1.78; 95% CI: 1.33–2.38), Generation Y (OR: 3.24; 95% CI: 2.42–4.34), and Generation Z (OR: 3.45; 95% CI: 2.46–4.83) exhibited significantly higher odds of consuming a lower-quality diet compared to Traditionalists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Younger generations demonstrated a greater propensity toward diets high in ultra-processed foods, characterised by elevated energy density, added sugars, and saturated fats, underscoring the need for targeted public health strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610123","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":"Registered Dietitians' Knowledge, Attitudes and Use of Simulation-Based Education in Ireland: A Mixed-Methods Study","authors":"Aoibheann Power,&nbsp;Clodagh Lee,&nbsp;Clare Corish,&nbsp;Annelie Shaw","doi":"10.1111/jhn.70326","DOIUrl":"10.1111/jhn.70326","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Simulation-based education (SBE) is increasingly used in healthcare training to support the development of communication, clinical reasoning and professional competence. Despite its growing use in medicine and nursing, little is known about how SBE is understood and used within dietetics in Ireland. This study investigated dietitians' knowledge, attitudes and use of SBE, and explored factors influencing its implementation in pre-registration dietetic education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A convergent mixed-methods design was used. An online questionnaire was distributed to CORU-registered dietitians in Ireland, assessing familiarity with SBE, attitudes, use, and perceived barriers and facilitators. Data were analysed using descriptive and inferential statistics. Semi-structured interviews were conducted with a sample of respondents and analysed using thematic analysis informed by the Capability, Opportunity, Motivation-Behaviour (COM-B) model. Quantitative and qualitative findings were integrated at interpretation using the COM-B framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 114 dietitians, of whom 15 participated in the qualitative component. Although 78% had been exposed to simulation activities and 85% expressed interest in further training, only 14% of respondents reported using SBE. Greater familiarity with SBE was associated with more positive attitudes, stronger motivation, and fewer perceived resource and cost barriers (<i>p</i> &lt; 0.001). Years of professional experience was the only significant predictor of SBE use. Qualitative findings revealed uncertainty about what constitutes SBE, with many dietitians using role-play or case-based activities without identifying them as simulation. Participants viewed SBE as a supportive tool, but not a replacement for real patient contact. Key barriers included limited time, educator training, resource constraints and limited institutional support. Enablers included shared resources, interdisciplinary collaboration and clearer guidance from higher education institutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dietitians in Ireland support SBE, but its use remains inconsistent due to gaps in understanding. Coordinated educator training, clearer definitions and stronger institutional support may enable more effective integration of SBE into dietetic education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622669","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":"Dietary and Lifestyle Changes Before and After Diagnosis of Cardiovascular Disease","authors":"Aoi Suzuki,&nbsp;Yuri Ishii,&nbsp;Ribeka Takachi,&nbsp;Junko Ishihara,&nbsp;Kazumasa Yamagishi,&nbsp;Yoshihiro Kokubo,&nbsp;Isao Saito,&nbsp;Hiroshi Yatsuya,&nbsp;Isao Muraki,&nbsp;Hiroyasu Iso,&nbsp;Shoichiro Tsugane,&nbsp;Norie Sawada","doi":"10.1111/jhn.70317","DOIUrl":"10.1111/jhn.70317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although the presence or absence of cardiovascular disease (CVD) recurrence is related to lifestyle habits, including diet, evidence for the maintenance of dietary improvement among participants with incident CVD after acute treatment is scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine changes in diet and other lifestyle factors in participants with incident CVD in the Japan Public Health Center-based Prospective Study (JPHC study) over a 5-year period before and after diagnosis by comparing changes with those in participants without a diagnosis of CVD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 68733 subjects aged 45–76 years at the baseline survey. Intakes of seven nutrients and 16 food groups were estimated using Food Frequency Questionnaires at the baseline survey and 5-year follow-up survey, and the amount of change was determined. Those diagnosed with CVD during the 5-year follow-up period were defined as participants with incident CVD (800 cases) and those not diagnosed were considered the non-CVD controls. Differences in the change between the two groups over the 5-year period were examined using the Mann-Whitney U test and multivariate linear regression analysis. Changes in smoking status, body mass index (BMI), and physical activity were compared by logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CVD participants appeared to restrict sodium intake after diagnosis, and even after energy adjustment were more likely to avoid eating sodium, miso soup and pickles. In addition, they were less likely to eat beef and pork than controls. Significantly more CVD participants than controls stopped smoking and had decreased BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participants with incident CVD showed modification in selective lifestyle factors, characterised by reduced sodium intake and smoking cessation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610125","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":"Environmental Performance Indicators Used in Healthcare Foodservices: A Scoping Review","authors":"Sharon Ong,&nbsp;Mark Lawrence,&nbsp;Mike Forrester,&nbsp;Judi Porter","doi":"10.1111/jhn.70316","DOIUrl":"10.1111/jhn.70316","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Healthcare foodservices are increasingly recognised as a key contributor to advancing the United Nations Sustainable Development Goals, particularly through reducing greenhouse gas emissions, waste minimisation, and promotion of sustainable diets. This scoping review aimed to identify existing international evidence on environmental sustainability indicators used in healthcare foodservices and examine their alignment with relevant Australian standards and policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following Joanna Briggs Institute methodology and reported against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, systematic searches of Ovid Medline All, EBSCO Environmental Complete, and EBSCO Global Health were conducted. Environmental sustainability indicators were extracted and synthesised into the Foodservice Systems Model and Sustainable Development Goals. The extent to which indicators are reflected in existing Australian standards and policies for food, nutrition and sustainable procurement was assessed through a policy scan and content mapping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty studies met eligibility criteria. In total, 51 indicators were identified across procurement, facilities, workforce, menu design, production, delivery, waste management, and quality systems. Key gaps included scope 3 emissions reporting, inconsistent waste measurement methods, and limited integration into quality audits. Cross mapping revealed most indicators were absent or only partially embedded in current policy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight the challenges in assessing and benchmarking environmental sustainability in Australian hospitals. In the absence of an agreed set of important and feasible indicators, evaluation of the current state (cross sectional) and change (longitudinal) of progress towards the Sustainable Development Goals in this setting remains challenging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610205","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 Sustainability Consciousness to Sustainable Dietary Behaviours: The Mediating Roles of Food Waste and Food Preference","authors":"Ayşe Nur Songür Bozdağ,&nbsp;Simay Yeşildağ,&nbsp;Ruken Zeynep Aydın","doi":"10.1111/jhn.70319","DOIUrl":"10.1111/jhn.70319","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;In shaping sustainable dietary habits, the structural dynamics of the food system may play a role as significant as the individual's cognitive processes. This study aims to examine how sustainability awareness among Turkish adults relates to their dietary behaviours and to identify the mediating mechanisms involved in this relationship. In doing so, it seeks to contribute to the identification of potential leverage points within the food system.&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;This cross-sectional study was conducted with the participation of 784 healthy adults living in Izmir. The study examined the relationships between the sub-dimensions of sustainability awareness and sustainable dietary behaviours, and two different mediating pathways were tested. The Sustainability Consciousness Questionnaire and the Behaviours Scale Towards Sustainable Nutrition were utilised during the data collection process.&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;Of the participants, 58.5% were women, and the mean age was 32.50 ± 12.91. It was found that 55% of the participants were unfamiliar with the concept of sustainable nutrition. In the Spearman correlation analysis, a positive and statistically significant association of small to moderate magnitude was found between sustainability consciousness and sustainable dietary behaviours (&lt;i&gt;r &lt;/i&gt;= 0.292, &lt;i&gt;p&lt;/i&gt;&lt; 0.01). This association was strongest in the environmental attitude (&lt;i&gt;r &lt;/i&gt;= 0.310) and environmental behaviour (&lt;i&gt;r &lt;/i&gt;= 0.307) sub-dimensions. Mediational analyses showed that the association between environmental attitude and sustainable dietary behaviour was statistically accounted for by food waste reduction behaviour (indirect effect &lt;i&gt;B &lt;/i&gt;= 10.126; standardised effect = 0.303). Economic attitude was associated with sustainable dietary behaviour both directly (&lt;i&gt;B&lt;/i&gt; = 1.999, &lt;i&gt;p&lt;/i&gt; = 0.009) and indirectly through food preference behaviour (B = 3.921, standardised effect = 0.091), although this indirect association was small in magnitude. These findings indicate that the different subdimensions of sustainability awareness are linked to sustainable dietary behaviours through distinct pathways.&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;These findings suggest that food waste reduction may serve as a practical link between environmental attitudes and everyday dietary practices and may therefore represent a promising point of intervention within the food system, although the observed associations were small to moderate in size and the cross-sectional design precludes causal inference. When considered within a ","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610114","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":"Dietitians' Perceptions of the Obesity Care Pathway: Qualitative Insights on Access, Follow-Up, and Referral of Patients Living With Obesity","authors":"Lucas Schreurs,&nbsp;Valérie Baes,&nbsp;Eva Kimpe,&nbsp;Hilde Marinus,&nbsp;Bart Van der Schueren,&nbsp;Diederik De Cock","doi":"10.1111/jhn.70318","DOIUrl":"10.1111/jhn.70318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>With obesity management medications being used more widely, it is important to understand the role of the dietitian in the obesity care pathway. This study examined primary-care dietitians' perspectives on the various phases of the obesity care pathway, from patients living with obesity (PwO) accessing nutritional services through monitoring and referral.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this qualitative study, first-line dietitians in Flanders, Belgium, between March, 2025 and June, 2025, were invited to participate. Participants were interviewed, and data were transcribed and analysed using thematic analysis. The first section of the semi-structured interview guide focused on how PwO typically access nutrition therapy, how dietitians monitor and follow up with PwO, and the criteria they use for referral. Lastly, dietitians were asked about their collaboration with other healthcare professionals involved in the care of PwO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve dietitians were interviewed before data saturation was reached. PwO accessed dietetic care mainly through self-initiative or medical referral, though referrals from general practitioners (GPs) were reported as limited. Monitoring and follow-up varied widely in duration and evaluation tools, while barriers such as limited patient motivation, time constraints, and limited reimbursement for dietetic care hindered continuity of care. Dietitians highlighted the need for referral guidelines, digital tools to support interprofessional communication, educational initiatives on interprofessional collaboration, and a central care coordinator to improve obesity care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This qualitative study examined primary-care dietitians' experiences across the obesity care pathway, from patient access to monitoring and referral. Dietitians highlighted limited referrals from GPs as well as variability in the duration and monitoring practices of nutritional therapy. Clear treat-to-target and referral guidelines could reduce reliance on individual clinical judgement, promote coordinated care and prevent delays in effective multidisciplinary care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594642","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":"Nutritional Risk Screening Recommendations for Critically Ill Patients: A Meta-Research Study and Quality Appraisal of Clinical Guidelines","authors":"Audrey Machado dos Reis,&nbsp;Millena Dorneles Pinheiro,&nbsp;Daniela Barbieri Hauschild,&nbsp;Diogo da Rosa Viana,&nbsp;Luana Pucci De Lima,&nbsp;Erasmo Benício Santos Moraes Trindade,&nbsp;Yara Maria Franco Moreno","doi":"10.1111/jhn.70321","DOIUrl":"10.1111/jhn.70321","url":null,"abstract":"<div>\u0000 \u0000 <p>Clinical practice guidelines (CPGs) are essential tools to support evidence-based nutritional care in critically ill patients; however, the methodological quality and credibility of recommendations for nutritional risk screening remain unclear. This study aimed to evaluate the methodological quality of CPGs addressing nutritional risk screening in critically ill adults and to critically appraise the evidence supporting these recommendations. A systematic search was conducted between January and April 2026 in Embase, PubMed, SciELO, Scopus, LILACS, Google Scholar, and guideline repositories. CPGs, consensus statements, and position papers, including nutritional risk screening recommendations for critically ill adults were eligible. Guideline quality was assessed using the AGREE II and AGREE-REX instruments. Original studies and systematic reviews supporting nutritional risk screening recommendations were critically appraised using ROBINS-E and AMSTAR 2, respectively. Four CPGs were included. AGREE II assessment demonstrated satisfactory methodological quality overall, particularly in Scope and Purpose (84.4%) and Clarity of Presentation (92.0%), whereas Applicability showed the lowest performance (50.0%). AGREE-REX evaluation demonstrated moderate overall recommendation quality (64.8%), with the Chinese Society of Critical Care Medicine guideline presenting the highest score (77.8%). Most original studies supporting recommendations were classified as having high or very high risk of bias, and one systematic review was classified as critically low confidence. Although the included guidelines demonstrated satisfactory methodological quality, important limitations were identified regarding recommendation credibility, applicability, and evidence quality. These findings highlight the need for higher-quality evidence synthesis, transparent risk-of-bias assessment, and improved implementation strategies in future guideline development.</p></div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581298","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":"Developing Systems Thinking Competencies in Emerging Nutrition Professionals: A Case Study Across Academic, Community, and Industry Contexts","authors":"Keagan M. Ringling,&nbsp;Melissa Jansma,&nbsp;Kristina Cibuzar,&nbsp;Therese Liffrig,&nbsp;Mindy Hermann,&nbsp;Len F. Marquart","doi":"10.1111/jhn.70313","DOIUrl":"10.1111/jhn.70313","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;Preparing nutrition and dietetics professionals for the complexity of modern food, health, and environmental systems requires educational models that move beyond reductionist training. Systems thinking and transformational learning offer frameworks that support integrative, adaptive, and equity-oriented professional development. This case study describes a systems-based experiential learning pathway designed to cultivate systems literacy, leadership, and cross-sector collaboration among nutrition students.&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 multi-year experiential learning model was implemented within the University of [Minnesota]'s Department of [Food Science &amp; Nutrition]. This case study design included nine sequential activities were co-designed by a student and faculty mentor using systems thinking and transformational learning principles. Activities engaged the student across community, non-profit, regulatory, agricultural, industry, teaching, and leadership contexts. Mentorship meetings, reflective journaling, and iterative feedback loops were used to assess competency development related to systems thinking, ethical decision-making, interdisciplinary collaboration, and adaptive problem-solving.&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;Experiential learning produced outcomes at personal, institutional, and systems levels. Personally, the student developed transdisciplinary collaboration skills, systems thinking competency, reflective practice, and adaptive leadership capacity. Institutionally, the case contributed to new systems-oriented curricular components, student-led organizations, and expanded mentoring structures that embedded systems thinking into departmental culture. At the systems level, partnerships across industry, government, and non-profit organizations strengthened knowledge exchange and demonstrated how systems-trained students can facilitate cross-sector alignment, support community-engaged problem-solving, and contribute to food system innovation.&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;This systems-based experiential learning model demonstrates how intentional mentorship, reflective practice, and cross-sector engagement can cultivate the competencies required for nutrition and dietetics professionals to navigate 21st-century food system challenges. Embedding systems thinking into both curricular and co-curricular structures fosters a workforce capable of leading collaborative, evidence-informed, and equity-focused change. The case provides a replicable model for integrating systems thinking into nutrition education to prepare graduat","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581211","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}