Journal of Human Nutrition and Dietetics最新文献

{"title":"Complementary Feeding Practices of Former Neonatal Intensive Care Children: A Cohort Study","authors":"Simone Augusta Ribas,&nbsp;José Guilherme de Santana Santos,&nbsp;Michelle Teixeira Teixeira,&nbsp;Vitor Barreto Paravidino,&nbsp;Natalia Gomes Pimenta,&nbsp;Helena Silva do Nascimento","doi":"10.1111/jhn.70308","DOIUrl":"10.1111/jhn.70308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Healthy feeding practices during the first 2 years of life are crucial for ensuring adequate growth and development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate infant and young child feeding (IYCF) practices among high-risk children during the first 2 years of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cohort study including former Neonatal Intensive Care Unit children followed at two University hospitals from birth until 24 months of age. Dietary data were collected using 24-h recalls, and diet quality was assessed based on the World Health Organization's IYCF indicators, including the consumption of ultra-processed foods (UPF). Early weaning was defined as the interruption of exclusive breastfeeding before 6 months of age, according to World Health Organization recommendations. Linear mixed-effects models were used to evaluate changes over time in the proportion of ultra-processed food consumption and dietary diversity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 155 children included in the study, early weaning occurred in 82.9% of participants. Minimum dietary diversity increased with age (58.0%–85.0%; <i>p</i> &lt; 0.001), while consumption of vitamin A–rich foods remained stable (average 63%; <i>p</i> = 0.90) and below recommended levels. Significant increases were observed in the intake of added sugar (26.0%–67.0%; <i>p</i> &lt; 0.001), sugar-sweetened beverages (17.0%–57.0%; <i>p</i> &lt; 0.001), and ultra-processed foods (41.0%–78.0%; <i>p</i> &lt; 0.001) between 6 and 24 months. Full-term children were less likely to achieve dietary diversity compared with preterm infants (OR: 0.27; 95% CI: 0.09–0.80; <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The diet quality of children was suboptimal during the first 2 years of life, marked by early weaning, insufficient intake of vitamin A–rich foods, and high exposure to ultra-processed products. These results highlight the urgent need for targeted interventions to promote healthier feeding practices in this vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392443","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 as Connectors and Brokers in Food Systems Transformation: A Reflexive Perspective From a Regional Circularity Case Study","authors":"Anita Stefoska-Needham,&nbsp;Catherine Lucas,&nbsp;Suzanne Pickles,&nbsp;Spring Zhou,&nbsp;Namal Bandaranayake,&nbsp;Senevi Kiridena,&nbsp;Karen Charlton","doi":"10.1111/jhn.70297","DOIUrl":"10.1111/jhn.70297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dietitians are increasingly called upon to address complex food systems challenges, including the transition to circular economies that support both human and planetary health. This reflexive perspective draws on a structured reflective process undertaken by the research team to explore how dietitians can apply their core competencies, such as critical thinking, evidence-based practice, and communication, to lead and facilitate food systems transformation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Drawing on a case study from the Bega Valley region of Australia, known for its unique focus on circularity, researchers from the University of Wollongong conducted interviews with small-scale agrifood producers to identify barriers and enablers to circular supply chains. Findings from this prior qualitative study subsequently informed a structured reflection process undertaken by the inter-disciplinary research team which included dietitians. Using Borton's Reflective Model (<i>‘What? So What? Now What?’</i> framework), researchers reflected on the role of dietitians in advancing food systems transformation. Reflexive thematic analysis was applied to the written reflections to identify key themes across each stage of the framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 10 original research team members, seven completed the reflection process, comprising three dietitians, two engineers with an interest in circular economy, one supply chain expert, and one food systems doctoral researcher. The collective reflections showed: <i>What?</i> We engaged in research exploring perspectives of small-scale producers towards circularity to understand the barriers and enablers towards implementing more circular supply chains. <i>So What?</i> The reflection highlighted dietitians' capacity to engage diverse stakeholders and navigate complexity, with potential to broaden their scope in transitioning the food system. <i>Now What?</i> Researchers proposed actionable pathways to increase dietitians' competencies in systems transformation. Professional advocacy is required to position dietitians for future food system and policy roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reflections from this study suggest that dietitians are well-positioned to act as connectors and brokers within food systems when equipped with systems thinking tools and opportunities for cross-sector engagement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378076","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":"Behavioural Determinants of Dietary Self-Management in Chronic Kidney Disease: A Theory-Informed Analysis to Inform Dietetic Interventions","authors":"Andrew Morris,&nbsp;Deborah Lycett,&nbsp;Riya Patel","doi":"10.1111/jhn.70295","DOIUrl":"10.1111/jhn.70295","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To identify the key behavioural determinants that influence dietary self-management among adults with CKD, using the Theoretical Domains Framework and Behaviour Change Wheel to guide development of practical dietary interventions for clinical practice and research trials.&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 theory-informed secondary analysis of a published qualitative meta-synthesis that included 92 studies and 2924 adults with CKD from 23 countries. Themes from the meta-synthesis were mapped to Theoretical Domains Framework (v2) and linked to Behaviour Change Wheel intervention functions and behaviour change techniques. Potential behaviour change intervention strategies were then evaluated using the APEASE criteria (Affordability, Practicability, Effectiveness/Cost-effectiveness, Acceptability, Side-effects/Safety, Equity).&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;Twelve of the 14 Theoretical Domains Framework (v2) domains were identified, indicating that dietary self-management in CKD is influenced by a broad range of cognitive, emotional, social, and environmental factors. Key barriers included inconsistent or conflicting dietary advice (Knowledge; Environmental Context and Resources), limited practical guidance (Skills; Behavioural Regulation), and emotional distress and social disruption associated with dietary change (Emotion; Social Influences). Trust in healthcare professionals and experiential learning also shaped adherence (Beliefs about Capabilities and Consequences). Optimism and Intentions domains were not evident. Mapping to the Behaviour Change Wheel identified Education, Enablement, Environmental Restructuring, Training, Persuasion, Incentivisation, and Modelling as relevant intervention functions. APEASE assessment suggested that Education and Enablement were the most feasible, acceptable, and scalable approaches for clinical implementation, while more complex components requiring additional resources or coordination (e.g., training and system-level changes) were comparatively less practical.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Dietary self-management in CKD is influenced by multiple behavioural determinants beyond knowledge alone. Interventions should therefore integrate education with skills training, confidence building, social support, and environmental adaptation. Embedding these multi-component strategies within clinical nutrition practice and research may enhance self-management and improve patient engagement across the CKD care pathway.&lt;/p&gt;\u0000 ","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378072","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":"Pilot Test of a Diet Cost Calculation Process for Use in Economic Evaluations of Dietary Interventions","authors":"Monique Aucoin,&nbsp;Hainan Yu,&nbsp;Melissa Murphy,&nbsp;Nicole Yoannou,&nbsp;Laura LaChance,&nbsp;Kieran Cooley,&nbsp;Patricia M. Herman","doi":"10.1111/jhn.70302","DOIUrl":"10.1111/jhn.70302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nutrition is a significant modifiable risk factor for many illnesses. One often-cited barrier to diet change is the perceived cost of healthy food. While many diet diary templates exist, none have been developed to capture the data needed for calculating the cost of a diet consumed during a diet intervention study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The objective of the present project was to develop and pilot test (1) a tailored diet diary template with instructions, and (2) alternative approaches for calculating diet cost. We created a draft diet diary and instructions which were used by participants. We used those data to test the feasibility of calculating weekly diet cost. Two methods were used: calculation of the cost of the actual price of the items purchased, and standardised prices. Acceptability was assessed by conducting participant interviews and the feedback that was provided was used to revise them. The methods to calculate costs were compared in terms of feasibility and researcher time needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 15 participants enrolled, 14 completed the interview. All participants reported that the process was acceptable or highly acceptable. Participant feedback was used to guide changes to the diet diary and instructions. Costs were calculated for 85.3% to 96.3% of food items. The researcher time needed to complete each method per participant, per week was 5 to 6.5 h. Participants who gave feedback confirmed that the edits addressed their previous concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, the diet diary and instructions were acceptable to participants who are women and feasible for the collection and costing of diet data in Canada.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378132","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":"Alignment of Australian Hospital Nutrition Standards With National and International Evidence-Based Guidelines: A Scoping Review","authors":"Elizabeth Edwards,&nbsp;Tsun Lok Morris Tsang,&nbsp;Priya Iyer","doi":"10.1111/jhn.70301","DOIUrl":"https://doi.org/10.1111/jhn.70301","url":null,"abstract":"<p>Hospital malnutrition remains highly prevalent in Australia and contributes to poorer clinical outcomes and increased healthcare costs. Hospital nutrition standards play a critical role in ensuring nutritionally adequate menus and supporting patient intake. While Australian jurisdictions have developed hospital nutrition standards, the extent of their consistency and alignment with national and international evidence-based guidelines has not been systematically examined. This scoping review aimed to identify and compare existing hospital nutrition standards across Australia and assess their alignment with the Australian Dietary Guidelines (ADG) and European Society for Clinical Nutrition and Metabolism (ESPEN) hospital nutrition guidelines. Guided by JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guidelines, grey literature searches were conducted across government websites, national repositories, and targeted Google searches. Twelve documents met inclusion criteria, including six nutrition standards and six supporting documents. Directed content analysis guided by ADG and ESPEN deductive frameworks was used to extract and compare data across jurisdictions. Findings showed strong alignment with the ADG, particularly in five food group provision and macronutrient targets. Alignment with ESPEN guidelines was more variable. All jurisdictions met minimum energy and protein targets and offered patient menu choices; however, inconsistencies were observed in therapeutic diet provisions, macronutrient distribution, food service considerations, adaptations for diverse patient groups and monitoring practices. Hospital nutrition standards in Australia are fragmented. Developing a unified evidence-based standard integrating ADG principles with ESPEN hospital nutrition recommendations could enhance consistency, quality, and equity in hospital nutrition care.</p>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343387","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":"Exploring Eating Patterns and Cooking Habits Among Emerging Adult College Students to Inform a Pilot Meal Kit Program","authors":"Emma Watras,&nbsp;Noereem Z. Mena,&nbsp;Kelley Strout,&nbsp;Kayla Gayer,&nbsp;Kathryn Yerxa,&nbsp;Jade McNamara","doi":"10.1111/jhn.70299","DOIUrl":"https://doi.org/10.1111/jhn.70299","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Emerging adult college students often experience poor diet quality (DQ) and rely heavily on ultra-processed foods (UPFs), such as sugary beverages, salty snacks, sweet snacks, and other calorie-dense, convenience foods. Meal kits, which provide pre-portioned ingredients and simple recipes, may offer a practical strategy to support healthier eating among emerging adults, yet their relevance and feasibility in college settings remain poorly understood. This study aims to assess the health behaviors, needs, and preferences of the target college student population to inform the development and feasibility of a pilot meal kit program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This exploratory, community-informed research used a multi-method approach implemented in two phases: (1) an electronic survey of undergraduate students assessing sociodemographics, eating patterns, and meal preparation habits, and (2) virtual focus groups exploring protein intake, cooking behaviors, and desired meal-kit features. Quantitative data were analyzed using descriptive statistics, Pearson correlations, and logistic regression models. Qualitative data were coded using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Students (<i>N</i> = 501) demonstrated low DQ (sHEI = 47.7 ± 10.0/100), and 33.7% reported low or very low food security. Higher UPF intake (OR = 1.14, 95% CI [1.02, 1.25], <i>p</i> = 0.015), more frequent cooking (OR = 1.31, 95% CI [1.02, 1.70], <i>p</i> = 0.037), and greater food insecurity (OR = 1.08, 95% CI [1.003, 1.16], <i>p</i> = 0.042) significantly predicted interest in meal kits, although effect sizes were small (Nagelkerke <i>R</i>² = 0.015–0.023). Qualitative findings identified key barriers to healthy meal preparation, including limited time, inadequate kitchen access and equipment, financial constraints, and dissatisfaction with campus dining protein options. Students perceived meal kits as convenient and customizable but expressed concerns about affordability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Emerging adult college students face numerous barriers to healthy eating. Many view meal kits as a practical way to access convenient, nutritious meals. Affordable, culturally and economically tailored programs may help improve DQ and reduce reliance on UPFs. Findings support pilot testing a campus-based meal-kit program.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343388","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":"Seeing Beyond GLP-1: A Systems View of Sustainable Obesity Care","authors":"Yeeli Mui,&nbsp;Megan R. Winkler,&nbsp;Becky Ramsing,&nbsp;Anne Palmer,&nbsp;Daphene Altema-Johnson","doi":"10.1111/jhn.70300","DOIUrl":"https://doi.org/10.1111/jhn.70300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 (GLP-1) receptor agonists represent a major therapeutic advancement, producing substantial weight loss and rapidly reshaping clinical practice, commercial markets, and policy discussions. Their accelerating adoption, however, is unfolding alongside decades of public health progress to address the complex drivers of obesity. Without integration into a broader systems-based approach, growing reliance on GLP-1 therapies risks reinforcing a reactive, treatment-driven model of obesity management that is costly, difficult to sustain, insufficient for addressing root causes, and likely perpetuating existing health inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Drawing on a synthesis of existing literature and emerging clinical evidence, we apply <i>Habits of a Systems Thinker</i> to examine: (1) the promises and pitfalls of growing dependence on GLP-1 therapies; (2) how a systems thinking lens can illuminate unintended consequences and reveal overlooked leverage points; and (3) how dietitians and other healthcare providers can strengthen systems-based dietetic practice to promote health equity, enhance obesity care delivery, and support lasting health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified dominant mental models, gaps in system connections, and feedback loops that shape both obesity management and the integration of GLP-1 therapies. We also highlight potential unintended consequences and outline opportunities to adapt and act strategically within the obesity care system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dietitians hold a critical yet underutilized role, constrained by structural barriers. Fully leveraging their expertise will require system-level changes, including integrating training on a systems approach to GLP-1 therapies; strengthening connections to local and regional food resources to improve access to healthy foods; advocating for reimbursement reforms that support dietitians' contributions to comprehensive, systems-oriented obesity care; and elevating dietitians' roles as citizens to advance equitable obesity care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324436","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":"Evaluating the Impact of a Health Literacy Intervention on the Quality of Dietetic Communication in Outpatient Kidney Care","authors":"Jenna Mazabow,&nbsp;Denelle Cosier,&nbsp;Kelly Lambert","doi":"10.1111/jhn.70296","DOIUrl":"https://doi.org/10.1111/jhn.70296","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;Effective communication between patients and health professionals is essential in chronic disease management. In the context of conditions like chronic kidney disease this is especially critical given the complexity of dietary advice that may be required. The technical quality of dietetic communication in nephrology settings remains underexplored. This study evaluated the technical quality of dietetic communication in renal outpatient clinics and assessed changes in communication following implementation of a health literacy intervention.&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 secondary analysis utilised audio recordings from a quasi-experimental pre-post study conducted in three outpatient kidney clinics. The health literacy sensitive intervention included teachback, use of a renal diet-specific question prompt sheet (QPS), and plain English dietary education resources. Paired consultations (initial and review) were assessed using the validated DIET-COMMS tool with scores converted to percentages and classified as poor (&lt; 40%), average (41%–75%), or good (&gt; 75%).&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;Fifty-four appointments from 27 participants were analysed. The mean DIET-COMMS score was 80.9% (SD 10.2), with 81.5% of consultations demonstrating high-quality communication. No significant changes in DIET-COMMS scores were observed between pre- and post-intervention groups, appointment types, or dietitian experience levels. However, appointments using both teachback and QPS achieved the highest mean scores (86.0%). Notably, active listening and interview structure scores declined post-intervention, while provision of condition-specific dietary information improved.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The intervention did not result in further increases in overall communication scores from baseline but influenced specific communication behaviours. The decline in active listening may reflect increased cognitive load or altered consultation flow due to prompt sheet use. Combined use of teachback and the QPS shows promise for enhancing communication quality.&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;Dietitians in nephrology outpatient settings generally demonstrate high-quality communication. Targeted interventions can influence specific communication behaviours, highlighting the need for ongoing training and structured tools to support effective, patient-centred ca","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324616","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":"Patient Nutritional Intake and Experiences With Two Models of Texture Modified Food Preparation in Hospital: A Pilot Study","authors":"Kaitlin Brennan,&nbsp;Jennifer Utter,&nbsp;Ruby-Rose Carnes,&nbsp;Chantal Luxton,&nbsp;Sally McCray","doi":"10.1111/jhn.70298","DOIUrl":"10.1111/jhn.70298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Texture modified foods are recommended for people with dysphagia but the visual appeal and nutritional quality of the foods may be reduced through modification. Moulding pureed foods back into their original shape rather than serving as a scoop in a ramekin may improve the visual appeal of texture modified foods, and their intake. The current study describes the cost, nutritional composition, intakes and satisfaction of two methods for preparing and serving texture modified meals in hospital, one cooked-fresh and scooped in ramekins and one commercially prepared and moulded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on patient nutritional intakes and adequacy of energy and protein were collected retrospectively from two cohorts of patients receiving texture modified foods in hospital using data recorded in the electronic menu management system and compared to theoretical nutrition requirements calculated based on height and weight. The first cohort (<i>n</i> = 120) were served texture modified meals made on-site, served in ramekins. The second cohort (<i>n</i> = 152) were served externally sourced commercially prepared, moulded food items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, we found the externally sourced commercially-prepared, moulded meals to be more nutrient dense and approximately 10% more expensive than cooked-fresh, scooped meals, but there were no differences in nutritional intakes between the two cohorts (with patients meeting 43%–47% of energy requirements and 55%–59% of protein requirements). Patient satisfaction reports appeared to favour the commercially-prepared meals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that for a 10% increase in cost, an externally sourced commercially prepared, moulded texture modified meal can deliver a more energy dense product though significant improvements in intakes of energy and protein were not achieved.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320925","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":"Accuracy of Visual Inspection of Thickened Liquids: Implications for Multidisciplinary Dysphagia Management and Clinical Nutrition","authors":"Raymond Fong,&nbsp;Connie C. Y. Kwan","doi":"10.1111/jhn.70294","DOIUrl":"10.1111/jhn.70294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To evaluate the accuracy of visually estimating thickened liquid volume via video-observed conditions and to determine whether clinical experience or thickener composition influences judgement reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey was administered to 57 practising speech-language pathologists (SLPs) and 50 postgraduate SLP students. Participants viewed four 12-s videos of fluids prepared to explicit International Dysphagia Diet Standardisation Initiative consistencies (Levels 1, 2 and 4) using starch and xanthan gum thickeners. Participants estimated the volumetric amount of thickener (in product-specific scoops) added to each sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall accuracy was low, with no significant difference between students (49.5%) and practitioners (47.4%) (<i>p</i> = 0.60). Combined cohort analysis showed that years of clinical practice alone were not associated with improved fluid estimation accuracy (<i>p</i> = 0.38). Students significantly outperformed practitioners in identifying Level 4 starch-based liquids (88.0% vs. 68.4%, <i>p</i> = 0.028) but were inaccurate in identifying Level 4 xanthan gum-based liquids (2.0% vs. 29.8%, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Visual fluid estimation via video is highly variable, and clinical experience alone was not associated with improved accuracy in this cohort. To optimise patient safety and prevent secondary complications like dehydration from over-thickening, multidisciplinary teams should supplement subjective clinical judgement with objective ways to ensure patients are receiving the appropriate level of thickened liquids.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"39 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279950","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}