FNCE 2023
Session 357. Providing MNT for the Pediatric Type 1 Diabetes Population: What Does the Evidence Show?
Monday, October 9, 8:30 AM - 9:30 AM

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Nutrition and Physical Activity

Nutrition and Physical Activity

Welcome to the Nutrition and Physical Activity Project

The Academy of Nutrition and Dietetics (Academy) and the American Council on Exercise (ACE) have collaborated to develop an evidence-based guideline and systematic review on the topic of nutrition and physical activity interventions for adults in the general population.

Lifestyle behaviors, particularly consuming a nutritious diet and obtaining adequate physical activity, can help prevent cardiometabolic diseases (CMDs) such as type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and obesity. However, many adults do not meet population-based dietary and physical activity recommendations. While most adults desire to achieve and maintain health, each person experiences unique facilitators and barriers to implementing recommended lifestyle behaviors. Nuanced, biased, and evolving information, from both the media and research, may mislead or confuse consumers about which lifestyle behaviors best improve and maintain health. Further, dissonance may exist between evidence available that guides lifestyle behaviors and the unique needs of an individual adult.

Qualified nutrition and exercise practitioners can address challenges to adopting healthy lifestyle behaviors by providing consistent, individualized, and evidence-based education and programming within their professional scopes of practice to improve client outcomes. Evidence-based practice provided by qualified nutrition and exercise practitioners may offer the most practical and sustainable means of providing comprehensive, effective care to diverse adults in a range of environments, because it combines the best available research with clinical expertise and client values.

Guideline

This evidence-based nutrition practice guideline (EBNPG) aims to inform practice decisions for nutrition and exercise practitioners who provide nutrition and physical activity interventions for adults (≥18 years of age) who are healthy or have cardiometabolic risk factors, such as overweight (body mass index ≥25 kg/m2 or as defined for the specific population), pre-diabetes and pre-hypertension. This EBNPG does not focus on adults with a diagnosed disease. 

For tips on implementing the guideline recommendations, download the Nutrition and Physical Activity Interventions Practitioner Guide. This two-page guide is designed with clear and unambiguous language that may help practitioners and their patients/clients to actively participate in shared decision making for their nutrition care.

Systematic Review

The aim of the systematic review was to identify, characterize, and analyze studies examining nutrition and physical activity interventions combined provided by nutrition and exercise practitioners in adults in the general population (those with or without cardiometabolic disease risk factors but without diagnosed disease). 

Systematic Review Key Findings:

  • Nutrition and physical activity interventions provided by dietitians or equivalent, qualified exercise practitioners and/or health coaches may increase physical activity amount and fruit and vegetable intake. 
  • Nutrition and physical activity interventions provided by dietitians or equivalent, qualified exercise practitioners and/or health coaches are likely to improve anthropometric outcomes.
  • Nutrition and physical activity interventions provided by dietitians or equivalent, qualified exercise practitioners and/or health coaches may have no effect on quality of life or anxiety/depression.
  • Interventions provided by a dietitian with or without an exercise practitioner resulted in significant improvements for nearly all outcomes measured, but there was little information available on the efficacy of interventions delivered by health coaches. 

Use the links in the left navigation bar to view the results of the systematic review. Expand the section below titled Project Team and Disclosures for a listing of the individuals who contributed to the development of the project, conflict of interest, and project funding information. Expand the section titled Resources and Articles to access articles published on the project.

3/10/2023

  • Nutrition and Physical Activity: General Population Scoping Review Team and Disclosures (2020)

    The following individuals contributed their valuable time and expertise to the review:

    Project Manager

    • Mary R. Rozga, PhD, RDN
      Nutrition Researcher, Academy of Nutrition and Dietetics, Chicago, IL, USA

    Lead Analyst

    • Amy  M. Yahiro, MS, RD, LDN
      Evidence-Based Medicine Manager, North American Spine Society, Burr Ridge, IL, USA

    Methodologist

    • Deepa Handu, PhD, RDN
      Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA

    Medical Librarian

    • Michelle Fiander, MA, MLIS
      Fiander Consulting, Halifax, NS, Canada

    Content Advisors

    • Kelly R. Jones, MS, RD, CSSD, LDN
      Owner, Kelly Jones Nutrition, LLC, Newtown, PA, USA
    • Janet Peterson, DrPH, RDN, RCEP, WEMT, FACSM
      Professor, Health and Human Performance, Linfield College, McMinnville, OR, USA
    • Justin Robinson, MA, RDN, CSSD, CSCS. TSAC-F- FAFS
      Human Performance Dietitian, Naval Special Warfare Center, Coronado, CA, USA

    Financial Contributors

    • Academy of Nutrition and Dietetics
    • American Council on Exercise

    The views or interests of the funding bodies did not influence the development of this review.


    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members and content advisors have with companies that sell products or services that are relevant to this topic. Workgroup members and content advisors are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have adverse impact on the content, but they are noted here to fully inform readers:

    • Jones K: Received compensation for speaking services from Honey Stinger, The Wonderful Company, Newtown Athletic Club, and various high school and college teams.
    • Peterson J: received travel reimbursement expenses from ACEND for services as an accreditation reviewer.
    • Robinson J: received travel and meeting reimbursement for Hawaii AND annual meeting speaker (2019) and California AND annual meeting speaker (2020)

     

  • Nutrition and Physical Activity: General Population Guideline and Systematic Review Project Team and Disclosures (2020-23)

    The following individuals contributed their valuable time and expertise to this project:

    Expert Panel

    • Justin A. Robinson, MA, RDN, CSSD, CSCS, TSAC-F, FAFS, Chair
      Adjunct Faculty, Point Loma Nazarene University, San Diego, CA, USA
    • Kimberly Gottesman, DCN, RDN, LDN, CNSC
      Assistant Professor, California State University Los Angeles, Los Angeles, CA, USA
    • Peggy L. Hamlett, PhD, MS
      Owner, Peg Hamlett Fitness, Moscow, ID, USA
    • Lama Mattar, PhD, MS
      Associate Professor of Nutrition, Lebanese American University, Beirut, Lebanon
    • Erin M. Nitschke, PhD, MS, NSCA-CPT, NFPT-CPT
      Exercise Science Professor, Laramie County Community College, Cheyenne, WY, USA
    • Ashley P. Tovar, PhD, RDN
      Research Scientist, Gilead Sciences, Foster City, CA, USA

    Project Leaders

    • Mary R. Rozga, PhD, RDN, Project Manager
      Nutrition Researcher, Academy of Nutrition and Dietetics, Chicago, IL, USA
    • Kathryn S. Keim, PhD, RDN,,Lead Analyst (added April 2021)
      Rush University (retired), Chicago, IL, USA
    • Amy Yahiro, MS, RDN, Lead Analyst (resigned July 2021)
      Senior Manager, Evidence-based Medicine, North American Spine Society, Burr Ridge, IL, USA
    • Deepa Handu, PhD, RDN, Methodologist
      Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA
    • Michelle Fiander, MA, MLIS
      Fiander Consulting, Halifax, NS, Canada

    Evidence Analysts

    • Megan Baumler, PhD, RD
      Lino Lakes, MN, USA
    • Lyanne Chin, PhD, RD
      Garden City, CA, USA
    • Amy Huang, MPH, RDN
      Basel, Switzerland
    • Telma Moreira, MS, RD, CSO, CNSC
      Houston, TX, USA
    • Maja Redzic, MS, RD
      Chicago, IL, USA
    • Helen Solomon, MBA, RD
      Wildwood, MO, USA

    Guideline Reviewers

    • Samantha E. Edgar, MS, RD, CDN
      Dietitian, Lexington ARC, Gloversville, NY, USA
    • Donna Giovenco, RDN, LD, CN, ACSM-CPT
      Dietitian/Wellness Coordinator, Concentra, Louisville, KY, USA
    • Madeline Hric, MS, RD, LD
      Dietitian, Cleveland Clinic, Cleveland, OH, USA
    • Samantha L. Hutson, PhD, LDN
      Assistant Professor, Tennessee Tech University, Cookeville, TN, USA
    • Fatimah Adnan Kadi, RDN
      Personal Trainer, Makkah, Saudi Arabia
    • Abigail E. King, RDN
      Consultant, Evidence Based Eaters, Atlanta, GA, USA
    • Jesse D. Shaw, D.O.
      Assistant Professor of Family Medicine and Sports Medicine, USA Weightlifting, Beaverton, OR, USA
    • Virginia E. Uhley, PhD, RDN
      Associate Professor, Oakland University William Beaumont School of Medicine, Orchard Lake, MI, USA

    Financial Contributors

    • Academy of Nutrition and Dietetics
    • American Council on Exercise

    The views or interests of the funding bodies did not influence the development of the systematic review or guideline.

    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.

    • Robinson J: received payment from the American Council on Exercise for the development of educational presentations.
    • Mattar L: received payment from UNICEF Lebanon for consultant work.


    updated: 10/21/2021

  • Resources and Articles
    • Nutrition and Physical Activity Interventions Provided by Nutrition and Exercise Practitioners for the General Population: An Evidence-Based Practice Guideline From the Academy of Nutrition and Dietetics and American Council on Exercise: Evidence from a systematic review was translated to practice recommendations using an evidence-to-decision framework by an interdisciplinary team of nutrition and exercise practitioners and researchers. This evidence-based practice guideline does not provide specific dietary or physical activity recommendations but rather informs nutrition and exercise practitioners how they may utilize existing guidelines for the general population to individualize programming for a range of clients. This evidence-based practice guideline provides widely applicable recommendation statements and a detailed framework to help practitioners implement the recommendations into practice. J Acad Nutr Diet. 2023;Published:April 13, 2023 DOI:https://doi.org/10.1016/j.jand.2023.04.004 
       
    • Impact of Nutrition and Physical Activity Interventions Provided by Nutrition and Exercise Practitioners for the Adult General Population: A Systematic Review and Meta-Analysis: This systematic review and meta-analysis aimed to examine the effect of interventions including both nutrition and physical activity provided by nutrition and exercise practitioners for adults in the general population (those without diagnosed disease). Nitschke E, Gottesman K, et al. Nutrients 2022 Apr 21;14(9):1729 PMID: 35565696 doit: 10.3390/nu14091729
       
    • Nutrition and Physical Activity Interventions for the General Population with and without Cardiometabolic Risk: A Scoping Review: The objective of this scoping review was to examine the research question: In the adults with or without cardiometabolic risk, what is the availability of literature examining interventions to improve or maintain nutrition and physical activity related outcomes? Sub-topics included 1) behavior counseling or coaching from a dietitian/nutritionist or exercise practitioner; 2) mobile applications to improve nutrition and physical activity; and 3) nutritional ergogenic aids. Rozga M, Jones K, Robinson J, et al. Public Health Nutr 2021 May 25;1-49
       
    • Nutrition and Physical Activity: General Population (2023) Guideline Presentation: this 28-slide MS Powerpoint presentation includes the recommendations and ratings of the guideline along with implementation tips and resources. Ideal for meetings, in-service presentations, and classroom lectures (this product is not designed for the consumer). Download for free.