The Good Food for Learning Population Health Intervention Research Project piloted a universal school lunch program in select Saskatoon elementary schools. Digital photography-assisted weighing (DPAW) was used to conduct plate waste audits to determine student food consumption. DPAW is a novel method, thought to be too labour-intensive to be used in schools. The purpose of the study was to determine the practicalities of using DPAW plate waste audits in elementary schools from research assistants' (RAs') viewpoint. Semi-structured, 30-45-minute virtual interviews were conducted with former RAs and research supervisors involved in data collection during the 2021 and 2023 phases of the Good Food for Learning Project. Ultimately, 11 of 16 prospective participants were interviewed. A hybrid approach of deductive and inductive data coding was used for thematic analysis. We found that although most of the RAs wanted to improve in-person training and coordination with school staff, most reported that they would recommend this method to other researchers carrying out studies under similar settings. This study shows that RAs support the feasibility of DPAW plate waste audits in elementary schools, though some challenges need to be addressed to improve implementation.

Dietitians' lack of knowledge about eating disorders (EDs) can hinder access to nutritional care and present iatrogenic risks for people with EDs. This systematic review described existing trainings and deficiencies in the dietitians' education about EDs. It was carried out following the PRISMA guidelines. A total of 10 databases were systematically searched for quantitative and qualitative literature and 11 studies met the inclusion criteria and were included. The included studies outlined that the current formal education opportunities for dietitians about EDs are insufficient. Education about EDs was associated with better clinical skills and self-efficacy in the field of EDs. A lack of knowledge about EDs was identified as a cause of unwillingness to work with people with EDs. Specific knowledge relative to EDs underlined as deficient included gastro-intestinal disturbances, mental comorbidities and the treatments available. The development of formal education for dietitians about EDs addressing their gastro-intestinal and mental aspects is advised. If effective, it could improve the dietitians' educational opportunities about EDs and increase their willingness to care for this clientele.

LGBTQ+ inclusion in dietetics education is essential to fostering culturally safe and structurally responsive learning environments. Drawing on auto-theory informed by poststructuralism, I reflect on a piece of student feedback that described the LGBTQ+ content in my course as excessive and suggested that such excess denied discussion about other historically excluded groups. This feedback illustrates how cis-heteronormative assumptions shape expectations about what counts as appropriate, balanced, or necessary content in professional education. Using the queer expression "," I explore how power, discourse, and affect emerge in moments of discomfort and curricular critique. I consider how such moments offer opportunities for reflexivity and deeper attention to the norms that shape belonging, visibility, and legitimacy in professional training. This paper contributes to ongoing efforts to embed cultural safety into dietetics curricula in ways that are reflexive, relational, and justice-oriented.

Dietitians (RDs) are well-positioned to drive food system transformation by supporting dietary patterns sourced from sustainable food systems (SFS). This research aims to identify how RDs conceptualize sustainability, describe SFS activities, define success, and determine the knowledge and skills required to practice in this area. A convenience sample of Canadian RDs completed a cross-sectional survey with open- and close-ended questions. Quantitative data were analyzed using descriptive statistics. Qualitative responses were thematically analyzed. Practice activities were mapped using the Socioecological Framework (SEF). A diverse sample ( = 92) reported using common SFS definitions, frameworks, or other documents. Practice activities were reported on all levels of the SEF. Dietitians reported successes; however, the vagueness or responses suggested it may be too early to quantify these. Dietitians reported needing foundational and practice area-specific knowledge and skills and practical examples to support SFS in practice. Canadian RDs in this study demonstrated significant work in SFS using skills they developed to practice in other areas of dietetics. There is an opportunity to expand impact by sharing existing resources, developing new supports that include Indigenous perspectives and systems thinking, evolving RD roles, increasing macro-level strategies, and identifying success indicators to monitor impact.

There have been many changes to both academic and practical aspects of dietetic education in Canada since 1993. This study sought to document and explore major changes. Key informants (n = 22) identified through purposeful sampling completed semi-structured interviews, using a draft timeline based on a literature review. Recordings were transcribed, coded, and analyzed thematically using a social ecologic framework. Five main themes emerged: () challenges with the traditional dietetic education model; () emergence of champions for change; () barriers and facilitators for change; () shift towards integration; and () increasing access for diverse populations. The interviews supported that changes had been driven by a need to increase access to dietitians and to improve the capacity and sustainability of dietetic education. The past thirty years have been marked by changes in the organization and delivery of dietetic education in Canada, mainly through collaborations of university programs with health system and community partners. Overall, dietetic education programs have increased their capacity and sustainability. By doing so, they have improved access and better positioned the profession to meet the needs of diverse populations. These findings provide context for dietitians, educators, and students to prepare for future development of the profession.

An exploratory longitudinal cohort study to assess scientific literacy (SL) skill development (both practical and self-perceived capabilities) in the Master of Applied Nutrition program. Students ( = 22) completed an optional online survey at the start and end of the combined coursework and practicum training portion of the program. Practical SL skills were assessed using the validated Test of Scientific Literacy Skills. Both practical and perceived SL capabilities increased during the program with the largest increases in the ability to draw conclusions based on quantitative data and to read and interpret graphical data. Critical assessment of scientific literature validity was an identified training gap. SL skills are necessary for evidence-based dietetic practice and are critical skills that are acquired in the program; however, targeted approaches to minimize training gaps are required.

To investigate the knowledge, attitudes, practices, and perceptions of Canadian dietitians regarding supporting individuals with intellectual and developmental disabilities (IDDs) in their practice. A 25-question cross-sectional online survey was developed by the research team, reviewed by experts, mounted on Research Electronic Data Capture (REDCap), and advertised to dietitians across Canada. Recruitment took place via email, social media, and e-newsletters. The survey was open in January-February 2024. Closed-ended responses were analyzed using descriptive statistics, and open-ended responses were analyzed using conventional content analysis. In total, 136 respondents met inclusion criteria; 80% reported they have supported patients/clients with IDD in their role as a dietitian, and 96% agreed dietitians can positively influence the health outcomes of people with IDD. Over 50% of respondents did not feel they had access to appropriate client/caregiver resources, nearly 75% of respondents denied receiving dietetic training in the nutrition care of patients/clients with IDD. Most respondents (∼70%) were interested in learning more about supporting people with IDD as dietitians. Many respondents reported a gap in education, skills, and resources in this area. These findings can be used to improve dietetic training and inform future strategies to help reduce the shortcomings in health care experienced by people with IDD.

A rapid assessment was conducted, including a literature review and key informant interviews, to explore optimal staffing levels and factors influencing staffing decisions across public health jurisdictions in Canada, including strategic plans and priorities. The literature review found no current guidance to plan for future public health dietitian workforce needs. An outdated staffing benchmark (1 full-time equivalent [FTE] per 50,000 population) is still referenced in some sources. Twenty-nine individuals from 25 jurisdictions across nine provinces participated via interviews or email. Eleven jurisdictions had public health nutrition-related strategic plans, with common priorities. Staffing numbers from 21 jurisdictions ranged from 1 FTE per 32,000 to 1 FTE per 316,000. Additional staffing challenges that surfaced included lost positions due to attrition or transitions to other roles, insufficient staff for programme needs, increased complexity and inconsistencies in public health dietitian roles and responsibilities across jurisdictions. There is an urgent need for updated workforce planning approaches for public health nutrition practice in Canada. Public health dietitians, leaders, and academics must collaborate to recognize and address this need.

The growing interest in digital health applications (apps) in dietetic practice prompted the current study aimed to describe app use among Registered Dietitians (RDs) in Alberta. A cross-sectional web-based survey was developed, drafted in REDCap, and tested with RDs. The College of Dietitians of Alberta distributed it to all registered members via email list. RDs registered with the College were eligible to participate. Responses were analyzed using descriptive statistics and single level structural coding of open-ended responses. Of the 290 RDs who partially or fully completed the survey, 74.5% used and 84.9% recommend apps to patients in their practice. Barriers to use include patient technological self-efficacy and uncertainty about which apps to recommend. RDs desire guidance and support from professional organizations in selecting and using apps, highlighting the need for evidence-based evaluation criteria for apps. RDs emphasized the need for user-friendly, evidence-based, secure apps tailored to specific nutrition management needs. RDs in Alberta are using and recommending apps in their practice despite limited evidence regarding their effectiveness in improving health outcomes. Collaborative efforts among RDs, app developers, and health organizations are essential to address current limitations and advance the use of apps in dietetic practice.

Dysphagia, common among adult patients in acute care settings, is associated with various complications. This study aimed to identify significant predictors of adverse health outcomes in hospitalized patients with dysphagia. A consulting committee meeting preceded a retrospective chart review involving 420 adult patients (mean age 72 years, 55% male) hospitalized at who underwent an interdisciplinary dysphagia assessment. Multivariate logistic and linear regression analyses were conducted to examine relationships between potential predictors and outcomes (in-hospital mortality and pneumonia), with age and sex as covariates. The consulting committee agreed that most predictors of adverse health outcomes, identified through the research team's clinical experience and existing literature, were both important and applicable to clinical practice. Stroke, head and neck cancer, all types of malnutrition, and unauthorized food intake were the most significant predictors of mortality ( < 0.04, for all). Intellectual disability, chronic obstructive pulmonary disease, gastroesophageal reflux, and severe malnutrition were the most significant predictors of pneumonia ( ≤ 0.02, for all). This study highlights the importance of addressing malnutrition as a significant modifiable risk factor for mortality and pneumonia among hospitalized patients with dysphagia. These findings underscore the need to manage high-risk patients with dysphagia effectively.

Conventional food systems lead to environmental degradation and nutrient deficiencies, contributing to poor health. Conceptualizing dietetic practice by practice areas limits how dietitians (RDs) see the relevance of food systems to practice and potential actions to contribute to more healthy, sustainable food systems. RDs are well-positioned to promote sustainable food systems (SFS) because they work across the food system landscape: Food Production, Economic, Political, Consumer Demand, and Health Systems. In this article, we invite RDs to view SFS activities through a systems lens, bringing more awareness to their impact. This includes identifying leverage points - actions that have a larger impact than their immediate outcome - and unintended negative consequences of recommendations. We discuss findings from a scoping review that included 11 peer-reviewed and 16 grey literature articles and chart practice activities, tools and recommendations according to practice area and the food system landscape. Findings demonstrate there are several existing activities and areas for further growth. Framing practice activities across the food system landscape, facilitates understanding of the interconnected nature of the food system to get to the root cause of problems. As a self-determining profession, dietitians determine the degree of influence they have in supporting the transition to sustainable dietary patterns.

To assess nutritional quality of foods promoted in Canadian grocery flyers including level of processing, and whether adherence to dietary guidance varied by year, region, store type (regular or discount), or location in the flyer. Observational study; national sample of weekly digitized flyers (n = 53 flyers; n = 8,790 promoted foods and beverages) were collected from Canada's largest market-share national grocer, from 2014, 2017, and 2021. Flyer food items were extracted and coded manually into food groups and categories. Nutritional quality of promoted items was analyzed by three nutrient profiling systems including NOVA level of processing and Canada's Food Guide (CFG). Logistic regression models were used to examine odds of flyer foods aligning with dietary guidance. Mean food items per flyer were 106 (SD = 66.4) in 2014; 174 (SD = 106.2) in 2017; and 215 (SD = 49.8) in 2021. Baked products (11%), non-alcoholic beverages (10.7%) and milk/dairy (10.2%) comprised the largest proportions of flyers. Least healthy/ultra-processed foods were most frequently advertised (CFG: 58.5%; NOVA: 51.2%); but followed by the most healthy/un/minimally processed (CFG: 33.6%: NOVA: 27.8%). Across geographic regions, odds of CFG alignment were similar, and no different in discount versus regular banners. Food items on the flyer cover page had consistently higher odds of CFG alignment. Consistent with past research, flyer foods frequently did not align with dietary guidance.

The negative experiences of Indigenous children who attended Indian residential school are well documented. A scoping review of the peer-reviewed and grey literature was conducted, following the methodological framework of Arksey and O'Malley (2005). Most documents focused on the impacts of residential schooling among First Nations, but some included Métis and Inuit. Sixty-eight articles were selected for inclusion, analyzed and categorized by theme. Themes identified stemming from Indian residential schools' food policies and practices included disruption in traditional food ways; underfeeding, child labour; and increased rates of obesity and diabetes later in life. Future strengths-based research utilizing Indigenous methodologies is needed to examine how allies and Indigenous communities are involved in actions to restore traditional food systems.

A common consequence of Parkinson's disease (PD) is constipation. Beyond its deleterious effect on the quality of life in affected persons, constipation is associated with gut microbiota dysbiosis and microbial-generated inflammatory metabolites, which may further disease progression. Management strategies are needed, and diet, specifically higher fiber dietary patterns or fiber supplements, may be recommended. However, therapeutic effectiveness and potential health benefits have been underexplored, and risks may be unappreciated. This perspective addresses whether high-fiber diets and fiber supplements to support laxation are efficacious, safe, and generally feasible for people with PD. Diverse sources of fiber from plant-based dietary patterns may be particularly critical for balancing microbiota and the microbial production of beneficial vs. inflammatory metabolites, although adherence to such dietary patterns may be challenging. Supplemental fiber may be needed to manage constipation symptoms. However, the potential safety issues related to fiber supplementation, such as appetite suppression, unintentional weight loss, and risk of malnutrition in the context of neurodegeneration, must also be considered. Slow colonic transit time and defecatory disorders of PD may be best managed with high intakes of bran or hull fibers resistant to microbial fermentation, which will significantly increase stool bulking. However, clinical trials are needed to confirm efficacy and dose-response.