At the end of a long winter, summer brings new growth and inspiration! Issue 29.3 contains a combination of interesting topical articles including 4 that focus on role opportunities for dietitians in research, education, patient care, and community settings. Other new areas are also examined-green tea for weight loss and the possible connection between breast-feeding and autism spectrum disorders as well as that between breast cancer survivors and weight management.
The patient-centered medical home (PCMH) is a new model for delivering preventive care by an interdisciplinary team and one that should include the dietitian. Registered dietitian nutritionists are not routine providers of care in PCMHs. Thus, Gregg and her colleagues have examined the potential for dietitians to contribute to high-quality, cost-effective care in this environment. The authors call for more research to support their involvement in PCMHs, especially in measuring outcomes of nutrition intervention.
Winham and her colleagues assessed the attitudes and perceptions of nutrition professionals on the role of preceptors in dietetic internships. An online survey to Arizona preceptors had 552 respondents. Significant differences were found on the value of being a preceptor, institutional support, and benefits of interns. The findings provide an opportunity to address concerns of preceptors and nonpreceptors and increase participation on this vital role in dietetics education.
There is a long history of research involvement in dietetics, with leaders in the profession encouraging every dietitian and nutritionist to participate in and advance the research agenda. This article explores the research opportunities, use of the Academy of Nutrition and Dietetics' Evidence Analysis Library and ways to facilitate participation. King et al note some opportunities and barriers to the expansion of practice-based research and assert that clinical questions may be best answered in clinical settings.
A community-based study in 2 regions of Honduras examined the food security status of randomly selected households with children aged 6 to 60 months. Chicoine and colleagues used the ELCSA to survey 140 households in Santa Maria and Montana de la Flor regions of Honduras. They found that 10.7% of households were food secure, 13% were food insecure, and 76% were very to severely food insecure, indicating a need for intervention.
The article by Hand et al extends previous work for developing an online algorithm to compare health outcomes for patients with chronic kidney disease on hemodialysis. Contrasting 2 methods (with and without the algorithm) showed little difference in outcomes, although changes in risk factors varied. The analysis of strengths and weaknesses of this second pilot indicate that additional exploration is necessary to refine the algorithm and determine whether practitioners are using it primarily for clinical decision making or as a method of documentation.
Hatch and Davis present a pilot study of breast cancer survivors, using retrospective chart reviews. Posttreatment survivorship care plans with surgery, chemotherapy, and radiation treatments were compared to evaluate weight changes and potential need for expanded services from an oncology dietitian. Differences were seen with weight gain and loss in pre- and postmenopausal women, based on treatment and stage of cancer.
A review article on green tea as a dietary aid for weight loss by Hutcheon and Ziegler presents recent available data on composition, mechanism of action, efficacy, and safety for use in overweight and obese adults. More research is needed to determine the safety of green tea as a dietary supplement, and, for now, caution should be exercised for using green tea for weight loss.
Hong et al examine studies that may affect risk of autism spectrum disorders with breast-feeding and formula-feeding. Several studies were reviewed with contradictory and inconsistent results. They concluded that there is insufficient evidence to link either breast-feeding or formula-feeding to risk of autism spectrum disorders.
Please continue to provide input on this issue and previous articles in Topics in Clinical Nutrition. It is hoped that this issue will entice you to write your own article or to request to become a reviewer for us.
-Judith A. Gilbride, PhD, RDN, FAND
Editor