Physician and dietitian prescribing of a commercially available oral nutritional supplement.
We examined whether a policy change transferring prescribing privileges for oral nutritional supplements to dietitians resulted in fewer inappropriate outpatient prescriptions. This was a pre/post study design using a retrospective review of physician and dietitian prescribing for ambulatory patients during two separate time periods: physician prescribing, October to December, 1994; dietitian prescribing, April to June, 1995. Inappropriate prescriptions during each period were defined as those given to patients with normal nutritional status or with a contraindication to a high-energy, electrolyte-containing solution. The study was conducted in outpatient clinics at a Veterans Affairs teaching hospital. We found that dietitians gave fewer prescriptions to outpatients who were not malnourished or to outpatients who had a contraindication to receiving a supplement (11% vs 34%; P = 0.002). In addition, dietitians more often completed relevant laboratory assessments (75% vs 43%; P = 0.001) and more frequently arranged follow-up dietetic evaluations (84% vs 30%, P < 0.001) for ambulatory patients receiving supplements. We conclude that transferring nutritional supplement prescribing privileges to dietitians led to fewer inappropriate outpatient prescriptions and to more comprehensive nutritional assessments, as measured by relevant laboratory use and dietetic follow-up. Physicians more frequently prescribed supplements to outpatients who were not malnourished or who had contraindications to receiving supplements. Our results suggest that physicians would benefit from assistance with and/or education concerning oral nutritional supplements. (+info)
Mapping the literature of dietetics.
Research on the literature of dietetics, apart from the broader field of nutrition, has not been reported in the literature. The purpose of this bibliometric study was to identify the core journals of dietetics and to determine the extent of indexing coverage for these journals. The study was conducted as part of a larger project, the Project for Mapping the Literature of Allied Health, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association. Citations appearing in three journals between 1995 and 1997 were analyzed by the methodology common to studies in the project. Results revealed that dietetic literature relies heavily on journal literature and on those journals that are from associated health sciences fields. Of the indexing services examined, EMBASE/Excerpta Medica and MEDLINE provided the most complete coverage of the literature. The study's findings have implications for those involved with the literature of dietetics. (+info)
Do we facilitate the scientific process and the development of dietary guidance when findings from single studies are publicized? An American Society for Nutritional Sciences controversy session report.
This American Society for Nutritional Sciences Controversy Session presented at the 1997 Experimental Biology meeting considered whether publicity of findings from single studies facilitates or hampers the scientific process and the development of scientifically sound dietary guidance. In a 1995 survey, 78% of primary household shoppers believed it "very likely" or "somewhat likely" that in the next 5 y experts would have a completely different idea about which foods were healthy and which were not. This skepticism is fueled by the media's emphasis on reporting new and often controversial findings about food and nutrition. Media efforts are reinforced by the fact that some scientific journals regularly publicize newly published research findings. As a consequence, journalists frequently mediate scientific debate in a public forum-debate that previously was conducted among knowledgeable peers. Tight deadlines often make it difficult for reporters to thoroughly investigate findings publicized in press releases. Headlines can make results from single studies appear important, even when results are inconclusive. Finally, scientists and public policymakers have limited opportunity for making timely comments in response to an issue reported in the media. Nevertheless, the public has a right to be informed about health-related research findings to help them make decisions about their diets. The media are a valuable resource for educating the public and maintaining public interest in the importance of diet in overall health status. Nutrition scientists should be more involved in helping the media accurately convey diet and health messages. (+info)
Physician-nutrition-specialist track: if we build it, will they come? Intersociety Professional Nutrition Education Consortium.
The Intersociety Professional Nutrition Education Consortium (IPNEC) has made substantial progress in its first 2 y. With support from 9 participating nutrition societies and certification organizations and with funding from the National Institutes of Health and several nutrition industry partners, a sustained, functioning consortium has been established. The consortium's 2 principal aims are to establish educational standards for fellowship training of physician nutrition specialists (PNSs) and to create a unified mechanism for certifying physicians who are so trained. Its long-term goals are to increase the pool of PNSs to enable every US medical school to have at least one PNS on its faculty and to surmount obstacles that currently impede the incorporation of nutrition education into the curricula of medical schools and residency programs. The consortium formulated and refined a paradigm for PNSs, conducted a national role delineation survey to define the scope of the discipline of clinical nutrition, and developed a preliminary curriculum template for training PNSs that can be completed in a minimum of 6 mo. IPNEC and its sponsoring societies are strategically positioned to play an important long-term role in nutrition education for physicians. We intend to continue soliciting broad input, especially from directors of fellowship training programs in nutrition and closely related subspecialties; to develop the core content for fellowships in nutrition and related subspecialties; and to initiate a unified PNS certification examination. (+info)
Nutrient requirements and optimisation of intakes.
In 1991, dietary reference values were published in the UK. These refer to nutrients and provide the basis for dietary advice. To complement this, practical food-based guidance on how to plan a healthy and balanced diet has been developed. Interest continues in how best to establish guidance which helps individuals modify their diets so as to better match the dietary targets established as a means of promoting health and avoiding disease. Furthermore, in recent years, interest has grown in the potential to optimise nutrition and so promote health and well-being, rather than just avoiding deficiency. This has been accompanied by an awareness that many foods, particularly plant foods, contain substances that may have health promoting properties but are not, as yet, regarded as conventional nutrients. (+info)
Special diets in hospitals: discrepancy between what is prescribed and what is eaten.
An assessment has been made in four hospitals of the food eaten by 40 patients on special diets restricted in energy, carbohydrate, fat, protein, or sodium. The diets eaten by most patients were significantly different from those prescribed, partly because of patients' unrestricted access to food they possessed or could buy in the ward, but mainly because of the extra or alternative foods provided by ward staff. Not only may the patients, progress be prevented or hindered by excessive consumption but also the lack of progress may be interpreted as indicating that the dietary treatment has failed rather than that it has not been followed. (+info)
Dietetics in ancient Greek philosophy: Plato's concepts of healthy diet.
Plato (5th-4th century BC), one of the most important philosophers of Greek antiquity, left a valuable spiritual heritage, compiled in his famous dialogues. His teachings extend to almost every single field of human knowledge. Among other philosophical concepts, Plato's works are imbued with the fundamental principle of moderation. This spirit is characteristically evident in his references to human diet. According to the philosopher, a moderate and thus a healthy diet, consists of cereals, legumes, fruits, milk, honey and fish. However, meat, confectionery and wine should be consumed only in moderate quantities. Excesses in food lead to ailments and therefore should be avoided. Plato considers physicians responsible for the regulation of human diet, for medicine is a science and not merely an art as in the case of cookery. The dietary pattern presented in Platonic dialogues shares many common components with the highly-reputed Mediterranean diet. As a whole, Plato's writings represent a valuable source for the study of the nutritional customs during the classical period of ancient Greece. (+info)
Relative validity of a semi-quantitative food frequency questionnaire versus 28 day weighed diet records in Japanese female dietitians.
OBJECTIVE: To assess the relative validity of a semi-quantitative food frequency questionnaire (SQFFQ) against 28 day weighed diet records (WDRs). SUBJECTS AND METHODS: The SQFFQ was administered to 106 (21 male and 85 female) Japanese dietitians in Aichi Prefecture in autumn, 1996 and four-season consecutive 7 day WDRs were carried out during 1996-1997. We evaluated validity of intakes of 15 foods and 31 macro- and micro-nutrients based on the SQFFQ against those according to 28 day WDRs among 79 Japanese female dietitians. RESULTS: Mean daily intakes of selected foods and nutrients determined by the SQFFQ were generally equivalent to those measured by 28 day WDRs. Pearson's de-attenuated correlation coefficients (CCs) with log-transformation and energy-adjustment between intakes of selected foods and nutrients quantified by the SQFFQ and 28 day WDRs (minimum-median-maximum) ranged from 0.17 (beverages)-0.52 to 0.74 (rice), and Spearman's rank CCs with energy-adjustment ranged from 0.28 (confectionery)-0.42 to 0.68 (rice). Respective Pearson's CCs for intakes of nutrients were 0.28 (PUFAs)-0.51 to 0.73 (magnesium), and Spearman's rank CCs ranged from 0.23 (n-3 PUFAs)-0.45 to 0.71 (magnesium). Favorably higher agreement for intakes of foods/nutrients was achieved along with lower disagreement. CONCLUSIONS: Satisfactorily higher relative validity was attained in Japanese female dietitians with the SQFFQ. This calibrated questionnaire seems therefore appropriate for administration to Japanese dietitians to clarify associations between diet and health/disease. SPONSORSHIP: A grant-in-aid from the Ministry of Education, Science, Sports and Culture (06454242). (+info)