Re-imagining the ‘social’ in the nutrition sciences

Objective: To explore public health nutritionists' perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition. Design: Qualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation. Setting: Queensland, Australia. Subjects: Public health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience. Results: Opportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners' perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes. Conclusions: Public health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are 'for the good' of mothers and infants.

Section: Discussionmentioning

confidence: 99%

Community pharmacy as a setting for public health nutrition action: Australian nutritionists’ perspectives

Maher

Lowe

Hughes

2014

“…Relevant competencies: CC3c, CC3e, CC3f The participants (2)(3)(4)(5)(6)(7)(8) suggested that organising and structuring their lives was important to ensure adherence (nine references) and that when that structure was challenged, adherence became difficult. A lack of structure, organisation and time management led to previous failures for some:…”

Section: Self-managementmentioning

confidence: 99%

“…Some participants revealed that stressful life events led to binge eating in the absence of sufficient coping mechanisms and comfort eating was problem for some. Social situations were revealed unanimously to threaten consistency (1)(2)(3)(4)(5)(6)(7)(8) and the following examples were described as coping mechanisms for such occasions: driving instead of drinking, limiting food choices, flexible restraint and increasing exercise:…”

Section: Relevant Competencies: Cc3c Cc3fmentioning

confidence: 99%

“…'Professional Conduct' (the fifth) contains seven sub-competencies (CC5a-CC5g) that demonstrate professional conduct and the nutritionist's code of ethics (6) . While the competency criteria appear to be comprehensive, nutrition has been criticised by some authors who suggest that nutrition knowledge has been biased towards positivistic science (7,8) , that many diet-related issues are underscored by social and behavioural issues (7,8) , that dietary problems are only partially understood by nutritionists and that nutritionists might not be best equipped to deal with them (7,8) . A growing body of evidence indicates that overweight and weight management are multidimensional conditions that have physical, social and behavioural dimensions (9,10) .…”

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confidence: 99%

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Undergraduate UK nutrition education might not adequately address weight management

Rogerson

Soltani²,

Copeland³

2015

Objective: Weight management appears to be multidimensional and complex, and registered nutritionists might work to educate, promote and provide weightmanagement services to communities, groups and individuals. However, nutrition education might not adequately reflect the weight-management requirements of individuals and groups. The aim of the present study was to investigate if the Association for Nutrition's undergraduate core competency framework for accredited Nutrition degrees sufficiently reflects the weight-management needs and experiences of individuals. Design: A qualitative investigation, conducted within critical realist ontology, was performed to understand the weight-management experiences of dieters and compare these with the Association for Nutrition's accreditation criteria for undergraduate Nutrition degrees. Setting: Framework analysis was used to identify and explain participants' experiences thematically and to compare these with the Association for Nutrition's core competency criteria. Subjects: Participants (n 8) with weight-loss (n 4) and weight-maintenance experiences (n 4) were interviewed using semi-structured interviews to understand weight management at the agential level. Results: Participants described knowledge, exercise, planning, psychological constructs and behaviour-change techniques, determinants of eating and social support as features of weight management. The competency criteria provided clear guidance on all aspects discussed by the group, apart from psychological constructs and behaviour-change techniques and social support. Conclusions: Accredited Nutrition courses might not fully reflect the weightmanagement needs and experiences of individuals. Nutritionists might require greater knowledge of psychology and behaviour change to better understand and accommodate their clients' weight-management needs. Keywords Weight managementWeight loss Weight maintenance Nutrition education QualitativeNutritionists work in diverse roles with groups, communities, individuals and within industry to educate about and promote good health (1) . Depending on their specialism, nutritionists might work with dietitians and other health professionals in hospitals and clinics, within public health and policy development, or provide consultancy services within private practice (2) . To become registered in the UK, nutritionists must register with the UK Voluntary Register of Nutritionists, which is regulated by the Association for Nutrition (AfN) (3) . The AfN also accredits undergraduate Nutrition degrees, which must adhere to strict professional and ethical standards, and provide evidence that the AfN's score competency criteria for undergraduate degree courses have been embedded into the curriculum (3,4) .These competencies were established to define the areas of knowledge and expertise of UK nutritionists (2) ; reflect an international drive to develop standards for practice and workforce development (5) ; and were developed from research highlighting the breadth of knowledge required...

“…In a final article to highlight in this issue, Schubert et al (9) remind us of what Leitzmann and Cannon (10) declared in this journal six years ago, as part of the New Nutrition Science: 'the main solutions to nutritional problems lie less in unlocking biological pathways, and more in creating healthy societies and also environments'. Schubert et al's objectives are to promote a central role for a 'social' dimension in the nutrition sciences and to encourage greater social engagement by nutrition r The Authors 2012 researchers.…”

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confidence: 99%

Public health nutrition and the environment

Yngve

Haapala²,

Hodge³

et al. 2012

This issue of Public Health Nutrition includes a variety of articles relating to environment and sustainability. Last month, in an editorial for this journal, Barrie Margetts posed these questions, among others, in preparation for the World Nutrition Rio2012 Congress in April: 'Can we feed the world in an environmentally sustainable way?' and 'Can we assume that the current dominant model of global food production is environmentally sustainable?' (1). In this issue, O'Kane (2) asks a related question: 'What is the real cost of our food?' The real cost, in terms of social, environmental and health costs, is of course high, and O'Kane makes a strong case for supporting local food systems in order to encourage more sustainable food production methods, development of local economies and stronger ties between farmers and consumers. Her article goes further to challenge public health nutritionists to explore the potential of local food systems for reducing inequities, improving access and promoting health, to encourage people to become 'food citizens' and to advocate for sustainable food systems. School gardens are one facet of a local food system, but without financial support success in school gardening programmes is difficult to achieve. The California Instructional School Garden Program, authorizing the distribution of $US 15 million worth of grants towards school gardens, is one such well-intentioned effort. But as Hazzard et al. (3) show, in less than half of the schools receiving grants were the funds sufficient to accomplish their garden goals; over a third of schools responded that the severe budget deficit in California had a negative impact on their garden programme. School garden programmes might enjoy greater success if they are integrated into existing curricula, with active involvement by (often undervalued) home economics teachers as well as school food service personnel. If not integrated into the school curriculum, such garden programmes will continue to be viewed as external to schools' objectives and needs, and as competition for limited funding. Clearly, for local food systems to survive, they must have ongoing support and commitment from all corners: government, educators, 'food citizens' and public health practitioners. We often think of sustainable food systems and good health as going hand in hand. Clonan et al. (4) directly address one instance in which they are at odds-the recommendation of eating fish as an alternative to red meats-and the risk of depleting already overburdened fish stocks. They find that, in the UK, health is the primary motivation for people to eat fish, and only one out of four people think about whether the fish they buy comes from