School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada; Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.
Can J Diabetes. 2023 Aug;47(6):482-489. doi: 10.1016/j.jcjd.2023.04.007. Epub 2023 Apr 14.
Our aim in this work was to ascertain Canadian registered dietitians' (RDs) use of the 2018 Diabetes Canada nutrition therapy (NT) recommendations and to identify the degree of agreement with facilitator-to-use statements.
A national 28-item anonymous cross-sectional survey of RDs who counsel people with diabetes was conducted.
Three hundred sixty RDs responded to the survey, but some questions had fewer responses. Mean age of respondents was 36.8±10.1 years and 51.3% were certified diabetes educators (CDEs). Energy/macronutrient recommendations used most were regular timing/spacing of meals (85%), 30 to 50 g/day dietary fibre intake (71%), and maintaining a low glycemic index (65%). Mediterranean and Dietary Approaches to Stop Hypertension (DASH) dietary patterns had similar utilization rates as macronutrient distribution ranges, at 50% to 60%. Specific food recommendations were used most often, with the emphasis on fruits/vegetables and whole grains at 92% and 86%, respectively. Of the special considerations for people on insulin, regular meals/meal spacing was the recommendation used most often (88%). The statements "I trust the content …" and "I understand the scientific basis …" of the NT chapter were the internal facilitators most agreed with, at 86% each. The least agreed upon external facilitators were "my workplace encourages me to use the NT chapter," at 54%, and "I learned about the NT chapter in my formal education," at 44%. CDEs had significantly higher agreement on 12 of the 21 facilitator statements compared with non-CDEs.
Canadian RDs are utilizing the NT guidelines, including the new dietary patterns. Simple, easy-to-implement recommendations, such as specific foods and timing/spacing of meals, were used most frequently. Opportunities for increased use could include encouraging dietetic training programs and worksites to promote utilization of CPGs in practice.
本研究旨在确定加拿大注册营养师（RDs）对 2018 年加拿大糖尿病学会（Diabetes Canada）营养治疗（NT）建议的使用情况，并确定其对便于使用的陈述的认同程度。
对为糖尿病患者提供咨询的 RD 进行了一项全国性的、匿名的、28 项的横断面调查。
共有 36 名 RD 对该调查做出了回应，但有些问题的回应较少。受访者的平均年龄为 36.8±10.1 岁，其中 51.3%为认证糖尿病教育者（CDE）。最常使用的能量/宏量营养素建议包括规律的进餐时间和间隔（85%）、每天 30 至 50 克膳食纤维摄入（71%）以及保持低升糖指数（65%）。地中海和 DASH 饮食模式与宏量营养素分配范围的利用率相似，为 50%至 60%。最常使用的具体食物建议，分别强调水果/蔬菜和全谷物，使用率分别为 92%和 86%。对于使用胰岛素的人群，最常使用的特殊考虑因素是规律的进餐/餐间间隔（88%）。NT 章节的陈述“我信任内容……”和“我理解科学依据……”是最被认同的内部促进因素，认同率均为 86%。最不被认同的外部促进因素是“我的工作场所鼓励我使用 NT 章节”，认同率为 54%，以及“我在正规教育中学习了 NT 章节”，认同率为 44%。与非 CDE 相比，CDE 对 21 个促进因素陈述中的 12 个的认同度显著更高。
加拿大 RD 正在使用 NT 指南，包括新的饮食模式。最常使用的是简单、易于实施的建议，如特定的食物和进餐时间/间隔。增加使用的机会可能包括鼓励饮食培训计划和工作场所促进实践中 CPG 的使用。
