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IANE members are invited to submit content to be published in the IANE blog! If you would like to write something related to Nutrition, Nutrition Education, Public Health, Healthcare and related areas please contact us to submit your post for review! We will also be selecting some blog posts to publish on NNEdPro website!

* Please note, we can only accept posts related to the subjects mentioned above, we will review your content and only approved material will be published. Not all blog posts will be published on NNEdPro website.

  • 29 May 2021 2:57 PM | Kai Sento Kargbo (Administrator)



    By Kai Sento Kargbo

    Acknowledgements: A sincere thank you to the panel and presenters for their time and insights, and to the Cambridge One Health Society for co-facilitating the production of this webinar session.  

    Webinar Presenters

    Professor Sumantra Ray, James Bradfield, Helena Trigueiro and Dr Kathy Martyn

    Journal Club Presenters and Panel

    Shane McAuliffe, Prof Sumantra Ray, Dr Kathy Martyn, James Bradfield and Helena Trigueiro

    In March, our members got together virtually for the second webinar and linked journal club on "Diet and Climate Change" which explored the synergistic relationship between diet sustainability and climate change. The aim of this blog is to summarise the key themes from the sessions, including main take-home points. However, the recordings of both the webinar and journal club sessions can be found on the IANE portal. 

    Webinar Summary

    Following introductions by Shane McAuliffe, Science Communications Lead at NNEdPro, Professor Sumantra Ray, our first speaker of the evening, presented on “Research-Based Perspectives: from policy to practice”, referencing the award-winning Bhavishya Shakti Mobile Teaching Kitchen initiative, in Kolkata, India. In his presentation, Professor Ray recognises the need for multi-sectoral actions by the public sector, private sector, and government in developing context-specific solutions to the issues surrounding food, sustainability, and climate change.    

    Our next presenter, James Bradfield, discussed his editorial on the effectiveness of global dietary change as a strategy to mitigate climate change and its effects (Bradfield et al. 2020), published last year in BMJ Nutrition, Prevention and Health. The main arguments in this article include;

    • Global greenhouse emissions were at an all-time high in 2020, prior to COVID-19 lockdown measures, with food production accounting for 26% of all emissions.
    • According to the United Nations Food and Agriculture Organisation (FAO), a third of food produced for human consumption is wasted.
    • A multidisciplinary and multifactorial approach is needed to implement changes and address the issues surrounding climate change and diet sustainability.
    • At the individual level, promoting plant-based diets bearing in mind affordability, nutritional adequacy and cultural preferences.    

    This was followed by Helena Trigueiro’s presentation, “Food, Sustainability and Health: what can we do?” on the role of individuals, industry, and government in addressing the “global syndemic” –  a triangle with obesity, climate change, and undernutrition – all of which have effects on human health and the natural systems they depend upon. Lastly, we heard from Dr. Kathy Martyn who advocated for an assessment of food production and food systems at the local/national level. 

    Journal Club Summary 

    The journal club session was kicked off by Professor Sumantra Ray with a summary of the proceedings from the 24-hour Global Digital Marathon by the FAO and Future Food Institute, in celebration of the 54th Earth Day. The online event comprised of 24 multi-sectoral dialogues from leaders and experts around the world on the issues linking food, sustainability and health. Key arguments from the event include;

    • Healthy (and productive) populations are key to socioeconomic development and prosperity, emphasising the link between food systems, population health and development.
    • High costs associated with the double burden of malnutrition, owing partly to the focus on curative rather than preventive health measures.
    • The need for effective communication and implementation strategies, beyond model building, toward achieving impact at the individual and policy level.  
    Our second speaker, Shane McAuliffe, provided an extensive overview of a modelling study, “The healthiness and sustainability of national and global food based dietary guidelines: modelling study” by Springmann et al. 2020. Key findings from this study include:
    • Dietary changes towards national Food Based Dietary Guidelines (FBDGs) are associated with improved health outcomes, especially with regards to diet-related non-communicable diseases.
    • Currently, over 50% of countries do not have national FBDGs.
    • Some FBDGs were associated with moderate reductions in environmental impact, whereas most were incompatible with a set of environmental targets.

    Our third and final speaker of the evening, Dr Kathy Martyn, emphasised the importance of the notion of commensality (“coming together for a meal”) in our understanding of sustainable diets and food consumption patterns across cultures and regions of the world. Further, in her reflections on health professionals and the healthcare setting in the UK, Dr Martyn highlights the central role of food in the provision of care, particularly in acute care settings.

    The panel presentations were then followed by a highly engaging open discussion during which three key themes were explored;

    Mediterranean Diet was discussed extensively as a concept that embraces sustainability, biodiversity, cultural values, and quality and palatability of food. Although the Mediterranean diet has shown success in improving overall health outcomes (in particular diet-related non-communicable disease), however issues surrounding its adaptability in different regions (and/or contexts) across the world were brought up. Some of the limitations ­discussed include local availability, affordability of food types, and cultural traditions and acceptability of food types.

    The culture, values and local food and dietary customs as a key component to dietary patterns and food consumption was also discussed. Shane McAuliffe emphasised the need for food-based dietary guidelines to be in line with the local cultures, food environment, and traditions surrounding diet and food consumption. 

    Economics of health and eating was also a recurring theme. Who is going to pay for what? Can the individual afford the ‘healthier’ food types? The panelists reminded us that a key element of diet sustainability and health outcomes is affordability and access, which brings us to another critical aspect discussed, health and food equity. Two billion people worldwide do not have reliable access to safe and nutritious foods. The issue of food desserts were also discussed as barriers to healthy eating behaviour, especially among marginalised and impoverished communities. Therefore, sustainable food systems should ensure equitable access to safe and nutritious food, whilst also promoting the inclusion of vulnerable groups e.g., women and children, migrant workers etc. 

    Key Take-Home Points

    • There is a need to shift to sustainable food consumption patterns which allow for high efficiency and reduced waste.
    • Inequities in access to sustainable healthy diets persist, with nutrient rich foods being generally less available and less affordable than the energy dense but nutrient poor alternatives. 
    • Increasing awareness of the public, industry, and policy makers on the associations between diet sustainability, food insecurity and climate change is important but bringing health into the conversation is key.
    • The science of nutrition is complex and multidisciplinary in nature, considering cultural factors, family dynamics, ethics, climate change and sustainability, all of which are not nutrition but have a huge impact on nutrition and dietary patterns and food consumption across cultures and regions of the world.


    The next IANE webinar will be held in June 2021, focusing on “Workplace Wellbeing – Diet, Mind, Movement, Sleep”. To register, visit https://iane.nnedpro.org.uk/Events 

    BMJ Nutrition, Prevention and Health Special Collections on diet sustainability and Climate Change is calling for submissions. For more information, visit https://nutrition.bmj.com/pages/bmj-nutrition-prevention-health-collections/


    References

    Bradfield J, Trigueiro H, Ray S. (2020). Is global dietary change an effective strategy to curb climate change? BMJ Nutrition, Prevention & Health. doi: 10.1136/bmjnph-2020-000101

    Gomez-Zavaglia, A., Mejuto, J. C., & Simal-Gandara, J. (2020). Mitigation of emerging implications of climate change on food production systems. Food research international (Ottawa, Ont.)134, 109256. https://doi.org/10.1016/j.foodres.2020.109256

    Medina F. X. (2021). Looking for Commensality: On Culture, Health, Heritage, and the Mediterranean Diet. International journal of environmental research and public health18(5), 2605. https://doi.org/10.3390/ijerph18052605

    Springmann, M., Spajic, L., Clark, M. A., Poore, J., Herforth, A., Webb, P., Rayner, M., & Scarborough, P. (2020). The healthiness and sustainability of national and global food based dietary guidelines: modelling study. BMJ (Clinical research ed.)370, m2322. https://doi.org/10.1136/bmj.m2322

    Swinburn, B. A., Kraak, V. I., Allender, S., Atkins, V. J., Baker, P. I., Bogard, J. R., Brinsden, H., Calvillo, A., De Schutter, O., Devarajan, R., Ezzati, M., Friel, S., Goenka, S., Hammond, R. A., Hastings, G., Hawkes, C., Herrero, M., Hovmand, P. S., Howden, M., Jaacks, L. M., … Dietz, W. H. (2019). The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet (London, England)393(10173), 791–846. https://doi.org/10.1016/S0140-6736(18)32822-8

    SOFI 2020 – Transforming food systems for affordable healthy diets available at https://scalingupnutrition.org/news/transforming-food-systems-for-affordable-healthy-diets/

  • 28 May 2021 7:26 PM | Kai Sento Kargbo (Administrator)

    Author: Kai Sento Kargbo

    Acknowledgements: Prof Sumantra Ray, Sucheta Mitra, Faculty and Mentors Panel and the IANE Steering Committee. A special thank you to Breanna Lepre, Lead Organiser for the Summer School 2021 and the organising team. 

     

    The International Academy of Nutrition Educators (IANE) would like to extend a warm welcome to our incoming members – class of 2021 of the NNEdPro-IANE Summer School in Applied Human Nutrition as well as our new members on the Faculty and Mentors Panel (FMP) – to our global and life-long learning network.

    Member Benefits. IANE offers a range of benefits including bespoke mentoring, training, and career development opportunities for professionals and organisations interested in developing and delivering quality nutrition education and evaluating its impact, particularly on healthcare practices.  

    Summer School in Applied Human Nutrition. The NNEdPro-IANE Summer School is a foundational certificate in applied human nutrition, covering basic nutritional concepts, through current research and methods, to prevention, healthcare and policy applications. At this year's Summer School we had the pleasure of hosting 34 candidates representing 18 nations

    Class of 2021

    Ako Carole-Shennelle Mbeng, Cameroon

    Alan Stewart, United Kingdom

    Ally Jaffee, United Kingdom

    Andreia Matos Ribeiro, Portugal

    Anne-Marie O’Brien, United Kingdom

    Asimkumar Manna, India

    Barbara Santos, Brazil

    Berta Valente, Portugal

    Christine Delon, United Kingdom

    Clare Van Dorssen, Australia

    Edgard Leandro de Oliveira, Brazil

    Eleonara Comini, Italy

    Esther Sulkers, the Netherlands

    Iain Broadley, United Kingdom

    Jaydeep Chakraborty, India

    Jordy Van Buiten, the Netherlands

    Julia Cerqeira Maranhao, Brazil

    Margherita Camodeca, Italy

    Marta Silva, Portugal

    Matheus Duarte Brito, Brazil

    Niky Raja, United Kingdom

    Praosiri Charusalaipong, Thailand

    Rafaela Barros Romano Fontes, Brazil

    Rahila Zakir, United Kingdom

    Ramin Shafii, Thailand

    Roisin McCarron, United Kingdom

    Sally Ayyad, United Kingdom

    Sarah Armes, United Kingdom

    Suzana Mantovani Cerqueira, Switzerland

    Thais de Vries, Brazil

    Vince Kelly, United Kingdom

    Wanja Nyaga, United Kingdom

    Xunhan Li, China

    Zana Shabani, Kosovo


    Faculty and Mentors Panel (FMP). We are delighted to announce our new additions to the IANE faculty and mentors panel, who span the globe and multiple areas of nutrition related expertise. 

    Alan Flanagan 


    Holds an MSc. in Nutritional Sciences and current PhD candidate. Former practising Lawyer (Barrister) from Dublin, Ireland. Founder of "Alinea Nutrition", an online education hub, dedicated to empowering others with clear, impartial evidence-based knowledge and understanding about the science of nutrition. 

    Dr. Beatrice Biasini


    Postdoctoral Research Fellow at the Department of Food and Drug of the University of Parma, Italy. Her research interests pertain to both individuals and population approaches, as part of her research aims to assess good practices in improving food quality schemes and public governance and efficiency in school canteens. 

    Dr. Dora Pereira 


    Former Research Group Leader at the University of Cambridge where she led Phase II clinical trials with a novel oral iron supplement ("IHAT") in collaboration with the MRC Unit the Gambia at London School of Hygiene and Tropical Medicine. Now works in Medical Affairs where she maintains a strong focus on providing safe and efficacious treatments for iron deficiency and anaemia across different patient groups.  

    Dr. Francesca Ghelfi


    Completed a PhD in Food Science and Human Nutrition at the  University  of  Parma, focussed on nutrition  science  education and communication in two different settings: catering schools and oncology centres. Also a nutritionist in the "SmartFood Project" which aims to fill the existing knowledge gap between health institutions and general public, in particular students and patients, about health and nutrition.  

    A/Prof Francesca Scazzina 


    Assistant Professor at the Department of Food and Drug, University of Parma. Her research focusses on complex carbohydrate, dietary fibre, prebiotics and antioxidants in foods, and their effects on metabolism and intestinal functions. Since 2009, Francesca has been involved in food educational projects implemented in primary schools of the Parma area, where she acquired extensive experience in educational health learning programs and children population surveys.

    Gabriele Mocciaro 


    Research Assistant in the Department of Biochemistry, University of Cambridge. Main research interest lies in the field of nutrition anmetabolism. Specifically, he plans to investigate the role of diet and nutrients on the prevention and treatment of metabolic disease and its complications (coronary heart disease, type 2 diabetes, fatty liver, Alzheimer’s disease, and cancer).  

    Guiseppe Di Pede


    Holds a BSc in Gastronomic Sciences and completed his studies for an MSc in Food Science and Technology at the University of Parma. His Master’s thesis in human nutrition focussed on the effect of different starch sources and the addition of fat on starch digestion and glycaemic index in rice and pasta. Currently, he is a Ph.D. student in Food Science at the Human Nutrition Unit of the University of Parma.

    Justyna Godos 


    Currently a PhD candidate at the Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Italy. Her primary research interests focus on how nutritional factors are associated with human health, and her key disciplinary areas are nutritional biochemistry and nutritional epidemiology.

    Dr Letizia Bresciani 


    Post-Doctoral Research Fellow at The Laboratory of Phytochemicals in Physiology, Human Nutrition unit, University of Parma, Italy. She has a Master's degree in Food Science and Technology and a PhD in Food Science at the University of Parma. Her  expertise includes purification and characterisation of phenolic compounds from  vegetables and investigation of pharmacokinetics, absorption, metabolism, bioavailability and bioactivity of human and microbial phenolic metabolites, using principally in vivo models, both animal and human. 

    Dr. Lisa Sharkey 


    Qualified from the University of Cambridge and completed her Gastroenterology training within the East of England. Lisa is involved in undergraduate and postgraduate education in nutrition and is the nutrition representative for the national Gastroenterology Training Committee. Her research interests include Intestinal Failure Associated Liver Disease, nutritional outcomes after intestinal transplant and biomarkers of graft rejection.

    Dr. Simon Poole


    Cambridge based medical doctor, broadcaster and commentator and is an internationally renowned authority on the science and application of the Mediterranean diet and lifestyle. He is author of the award winning Olive Oil Diet and speaks regularly on the subject of communication and change management in population and individual nutritional health. Simon is an international senior collaborator with the NNedPro Global Center for Nutrition and Health, and has previously been involved in teaching at Cambridge University primary care department.


    For more detailed information on IANE, including events, fellowship, and how to become a member, visit our webpage


  • 28 May 2021 1:47 PM | Kai Sento Kargbo (Administrator)


    At the 7th International Summit on Nutrition and Health, we will be launching the IANE Awards Scheme recognising faculty, professional, and student members for their excellence and continued engagement with the IANE community and member platform in the following categories:


    Outstanding Achievement Award

    Self-nominated or nominated by the IANE faculty and mentors panel; awarded for outstanding contribution and impact on nutrition education of health professionals and/or community members.

    Eligibility Criteria

    Does not need to be an existing IANE or NNEdPro member. Contribution can include the development of curricula and/or policy for the nutrition education of health professionals.

    Documents needed to apply

    • Two letters of recommendation (from individuals of significant standing in the discipline or related field)
    • CV or resume
    • Cover letter
    • List of publications and/or portfolio of external impacts; showing evidence of reach and impact is desirable 



    Associate Member of the Year

    Self-nominated or nominated by the IANE faculty and mentors panel; awarded to a member of the Academy who has demonstrated commitment to nutrition education and education of health professionals.

    Eligibility Criteria

    Has been an IANE member for 1 year or more. Maintained active participation in IANE e.g., attended all journal clubs, contributed to a journal club or newsletter. 

    Documents needed to apply

    • Letter of recommendation (from an individual of significant standing in the discipline or related field)
    • CV or resume
    • Cover letter


    Professional Member of the Year 

    Self-nominated or nominated by the IANE faculty and mentors panel; awarded to a member of the Academy  who has demonstrated commitment and contribution to nutrition education and/or education of health professionals. 

    Eligibility Criteria

    Has been a member of IANE for 1 year or more. Has actively participated as a mentor as part of the IANE Faculty and Mentors Panel. Maintained active participation in IANE (e.g., attended all journal clubs, contributed to a journal club or newsletter). Significant involvement in activities helping IANE to achieve its strategic goals. 

    Documents needed to apply 

    • Letter of recommendation (from an individual of significant standing in the discipline or related field)
    • CV or resume
    • Cover letter



    Faculty Member of the Year

    Self-nominated or nominated by the IANE members; awarded to a faculty member of the Academy that has contributed to the NNEdPro-IANE Summer Schools in Applied Human Nutrition and/or IANE webinars, journal clubs, and mentoring. 

    Eligibility Criteria 

    Sustained excellence and impact in duties and deliverables. Has promoted IANE and/or NNEdPro Education, Training and Skills and/or mentoring objectives. 

    Documents needed to apply 

    • Evidence of contributions with evaluation of impact
    • Cover letter



    Student Member of the Year 

    Self-nominated or nominated by the IANE faculty and mentors panel; awarded to a student member of the academy that has demonstrated commitment to nutrition research and/or education of health professionals. 

    Eligibility Criteria

    Has been a member of IANE for 1 year or more. Maintained active participation in IANE e.g., attended all journal clubs, contributed to a journal club or newsletter.

    Documents needed to apply

    • Letter of recommendation (from an individual of significant standing in the discipline or related field)
    • CV or resume
    • Cover letter



    Paper of the Year

    Self-nominated or nominated by the IANE faculty and mentors panel; awarded to a published journal article of significance to the research, practice or policy community. 

    Eligibility Criteria 

    Has been published in the previous 12 months with multiple citations. Shows originality and innovation. Evidence of reach (i.e., social reach e.g. mass media communication and social media metrics) and/or impact (i.e., contributes toward policy e.g., referenced in a public policy or policymaking forum). 

    Documents needed to apply 

    • Submitted paper
    • Cover letter


    Applications close on 2nd July 2021

    Please note that to apply, all required documents should be sent to Sucheta Mitra at s.mitra@nnedpro.org.uk  with the subject line "IANE Awards  2021_Applicant". 

    For queries, you can send us an email at info@nnedpro.org.uk with the subject line “IANE Awards Scheme 2021”.


    ---

    Key Contributors

    Kai Sento Kargbo, Prof Sumantra Ray and Melissa Adamski 

    Acknowledgements 

    Matheus Abrantes, Faculty and Mentors Panel (FMP) and IANE Steering Committee

  • 19 Mar 2021 3:28 PM | Matheus Abrantes (Administrator)

    Authors

    Jodie Webber, ANutr, Kai Sento Kargbo, BA, and Shane McAuliffe, RD

    Acknowledgments

    Thank you to the panel and presenters for sharing their time, insights, and experiences.

    Webinar Presenters

    Dr Michele Vacca, Dr David Unwin, Dr Kathy Martyn, and James Bradfield (RD)

    Journal Club Presenters/Panel

    Prof Sumantra Ray, Shane McAuliffe (RD), Dr Rajna Golubic, Elaine Macaninch (RD), and James Bradfield (RD)


    In January 2021, IANE held the first webinar of the year: Macronutrient Modulated Diets - Focus on Carbohydrates, Type-2 Diabetes, and Non-Alcoholic Fatty Liver. In February, the accompanying Journal Club session was held, where the topic was discussed further, with reference to the recent position statement published by Diabetes Canada (2020). Here, the main ideas from the webinar and the journal club sessions will be summarised, but please remember the full recordings of both sessions can be accessed on the IANE webpage here.


    Webinar Summary

    Our first speaker, Dr. David Unwin discussed a recent audit conducted with colleagues at his GP surgery in the UK on a low carbohydrate diet (LCD) in patients with Type 2 diabetes mellitus (T2DM) and prediabetes (Unwin et al. 2020). This audit involved 127 patients with T2DM and 71 with prediabetes, which accounted for 27% of the total T2DM population for the practice. Patients were advised on the LCD approach and were informed on how their dietary choices impact their glycaemic control. Further, progress graphs and/or reports were shared with patients throughout. Key findings from this audit include:

    • Reductions in overall weight and HbA1c levels in patients with T2DM, and HbA1c reduction in patients with pre-diabetes.

    • Drug-free remission in 46% of patients with T2DM.

    • 93% of the pre-diabetic group achieved normal HbA1c levels.

    • An overall reduction in total cholesterol, increased HDL cholesterol, reduced triglycerides, reduced weight, improved blood pressure, and improved liver function.

    • The LCD approach was successful with both older patients and young adult patients.

    The practice calculated that they made a saving of £50,885 over the year. Dr. Unwin reiterated the importance of feedback to behaviour change, however, there was a range of possible confounding factors that could not be controlled for and no control group for comparison. It is also important to acknowledge that more than two-thirds of the practice T2DM population did not follow the LCD advice, meaning a large proportion remains to be considered and catered for, requiring a focus on alternative dietary approaches to meet their needs. The need for more robust studies that account for these factors was reiterated, as well as the importance of evidence-based medicine that includes the best scientific evidence, clinical experience, and places patient values at the core.

    Dr. Michele Vacca then joined us to provide a ‘deep dive’ into the science of carbohydrates and metabolic syndrome. Dr. Vacca explored the role of glycaemic index and the timing of eating (chrononutrition) as important factors, alongside carbohydrate quantity. Drawing upon a paper with colleagues (Salvia et al. 2017), his study of a calorically unrestricted but carbohydrate-moderated Mediterranean diet was discussed. Dr. Vacca and colleagues found that reductions in glycaemic index and carbohydrate intake, particularly in the evening, resulted in weight reductions and improved glycaemia and dyslipidemia in patients with metabolic syndrome.

    Our third speaker, James Bradfield (RD), shared his experiences from academic research and his work as an NHS dietitian. He discussed the popularity of LCDs in the context of increasing levels of overweight, obesity, and T2DM, and the overlap between them. In summing up the evidence, many important points were addressed:

    • There is no universally accepted definition of an LCD; the term is relative.

    • LCDs often do not emphasise what a person is eating, only what they are not eating.

    • Healthcare practitioners must consider the cultural appropriateness and affordability of LCDs when making recommendations, whilst also being conscious of the language used to share nutrition information, particularly on social media.

    • Some investigation should be made into the environmental impact of LCDs, and how they can be shaped to be more environmentally friendly.

    • There is no ‘one size fits all' approach with diet; whilst LCDs work for some patients, they won’t work for others, and patients must be involved in the decision-making.

    Lastly, we heard from Dr. Kathy Martyn who spoke on ‘Balancing Science and Practice’ and provided us with a summary of the webinar. Dr. Martyn shared a fascinating history of diabetes and the developments in approaches to treatment, from starvation diets, carbohydrate counting, to medications and LCDs. She concluded by reiterating the importance of a continuous cycle of science and evidence-based practice, and the role of scientists and practitioners in implementing, evaluating, and improving their approaches.

    This webinar session reminded us of the importance of considering all macronutrients, not just one, as well as the central role of science in providing an understanding of the metabolic pathways involved with diabetes and metabolic syndrome. Reechoing Dr. Unwin’s mention of ‘hope’; we must focus on patient-centred practice that allows the spread of hope and autonomy.


    Journal Club Presentation

    Professor Sumantra Ray introduced the journal club and reminded us of the key points raised in the webinar. We then heard from Shane McAuliffe (RD) who presented a critical appraisal of the position statement published by Diabetes Canada (2020). The statement makes it clear that an individualised approach is important, and that an LCD approach can be subjective, depending on an individual’s baseline carbohydrate intake, meaning what is defined as ‘low’ for one person may be very different for another. Some of the key research findings in both Type 1 Diabetes (T1DM), and T2DM were discussed, and we learned that there is very limited long-term evidence for both. When considering LCDs and T1DM, the research often lacks depth, whereas in studies of T2DM, there are promising findings regarding reductions of medications, but methodological concerns are present. Our attention was drawn to some of the questions and uncertainties surrounding this research, including the longer-term sustainability of LCDs and many confounding factors, such as caloric intake and weight loss. As a result, whilst LCDs may present a real therapeutic option to healthcare providers and patients, further research is essential, and patients must be at the centre of any decision-making.

    Finally, before the open discussion, we heard from Dr. Rajna Golubic who presented a medical perspective with her presentation ‘Questions in Low Carbohydrate Diet yet to be Answered in Clinical Practice. Dr. Golubic discussed the current evidence around low carbohydrate diets in clinical practice. Some of the main points raised were that the short-term use of LCDs may be considered as a management approach for T2DM, but that ‘active monitoring’ is essential, along with consideration of the necessary adjustments to patients’ diabetes medication. Dr. Golubic also shared thoughts on the many unanswered questions that remain, such as the interactions with physical activity and medications, the effects on disease endpoints, effects on the microbiome and metabolome, and the possibilities of genetic variants which may lead to some individuals having differential responses to such diets. Again, the overarching conclusion was that well-designed trials are the necessary next step in answering these questions.

    The open discussion stimulated a range of questions and comments, and some of the contributions from the panel are noted here.

    Accessibility was a recurring theme. Elaine Macaninch (RD) shared her experiences of working with patients with gestational diabetes and emphasised the importance of rethinking the process to allow consideration of where nutrition can fit in, in order to give patients, the opportunity to try dietary change approaches before medication. Central to this conversation was the importance of being understanding and compassionate towards individuals’ personal circumstances, beliefs, and motivations. This aligns with points raised about affordability and the fact that shifting dietary patterns requires shifts in purchasing patterns. Additionally, healthcare providers must work with their patients in order to ensure that dietary change recommendations are feasible, sustainable, and appropriate. We were left with the important reminder that dietary choice, and in particular, choosing to omit certain foods from our diets, comes from an inherent place of privilege.

    The question of 'Whether a more drastic reduction is better? was raised with regards to the perception of LCDs. The panel discussed whether knowledge that LCDs could offer positive therapeutic effects could lead to the belief that very low carbohydrate diets, or ketogenic diets, are more beneficial. The notion of an individualised approach was revisited, and there was agreement that it is important to focus on what is right for the individual patient, their knowledge, and their motivations. For instance, for those patients where adherence to an LCD is particularly challenging, the ketogenic diet would likely be unsustainable. This linked to discussions on social media platforms and press coverage. Although these platforms offer an environment for sharing tips, meals, and experiences, they can also be used to misrepresent the reality of these diets. Individuals may find a dietary ‘label’ attractive because it provides the opportunity to be a part of something, but it is important that patients make these decisions with a focus on changing habits and understanding the full story.


    Key Take-Home Points

    • LCDs present a valid therapeutic option for some patients, but further research is essential to explore the many unanswered questions that remain.

    • Patients must be supported by their healthcare providers to fully understand their options, and they should be at the centre of decision-making about their own health.

    • Healthcare providers should focus on how to communicate options effectively, including sharing information about the physiology of disease in an understandable and accessible manner. This will equip patients to make the best decisions for their personal circumstances.

    • Accessibility, affordability, and cultural context play central roles in dietary choice and change; the context must be considered.

    • The perception of LCDs amongst patients should be considered, alongside patients’ personal motivations and beliefs around their health, nutrition, and therapeutic options.


    The next IANE webinar will be held on 24th March 2021, focusing on ‘Diet and Climate Change’. See https://iane.nnedpro.org.uk/Events for further information.


    References

    Diabetes Canada (2020). Diabetes Canada Position Statement on Low-Carbohydrate Diets for Adults With Diabetes: A Rapid Review. Canadian Journal of Diabetes, 44, 295-299.

    Salvia R, D'Amore S, Graziano G, Capobianco C, Sangineto M, Paparella D, de Bonfils P, Palasciano G, Vacca M. (2017). Short-term benefits of an unrestricted-calorie traditional Mediterranean diet, modified with reduced consumption of carbohydrates at evening, in overweight-obese patients. International Journal of Food Sciences and Nutrition, 68(2), 234-248.

    Unwin, D., Khalid, A., Unwin, J., Crocombe, D., Delon, C., Martyn, K., Golubic, R., Ray, S. (2020). Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: a secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years. BMJ Nutrition, Prevention & Health, 3, 285-294.


  • 11 Feb 2021 11:12 AM | Matheus Abrantes (Administrator)


    Within the context of the collaboration between iKANN and the FAO elearning Academy, over 350 multilingual elearning courses, are offered free of charge, as a global public good. The thematic areas covered are Nutrition sensitive food systems, Nutrition situation analysis, gender empowerment, sustainable food value chains, food waste and food losses management, responsible management of natural resources among others. Please check out all the courses available here.

  • 18 May 2020 3:44 PM | Matheus Abrantes (Administrator)

    IANE members are invited to submit content to be published in the IANE blog! If you would like to write something related to Nutrition, Nutrition Education, Public Health, Healthcare and related areas please contact us to submit your post for review! We will also be selecting some blog posts to publish on NNEdPro website!

    * Please note, we can only accept posts related to the subjects mentioned above, we will review your content and only approved material will be published. Not all blog posts will be published on NNEdPro website.


© 2021 by NNEdPro Global Centre for Nutrition and Health.