The PEN® Team’s Surprising Findings of 2013
The field of nutrition and dietetics is vibrant and ever-changing. At the end of each calendar year, it is helpful to pause and reflect on how the nutrition 
and dietetics field has evolved. The PEN® team reflected back on the evidence analyses completed in 2013, and share a few surprising findings:
Tanis Fenton: MHSc PhD RD, PEN® Evidence Analyst, Dietitians of Canada “I was surprised as I delved into the literature to read about the science regarding fasting, cleansing, and detox trends. The more I read, the more I found that a few facts, mostly from rodent studies, have been taken out of context. The human studies either are non-existent, leaving us without information about whether the effects apply to humans, or the human studies show that the rodent effects do not apply to humans. I found these problems particularly true among the commercial claims made by the companies that are selling products and promoting these practices.”
Dawna Royall MSc, RD, PEN® Evidence Analyst “In terms of reflecting on surprising / interesting content, ironically these reflections bring me back to the roots of dietetics: My impressions of the benefits of dietary patterns were reinforced, rather than focusing on specific nutrients. This is especially true and somewhat surprising as we observe that a North American version of the Mediterranean diet pattern has moved to the forefront in response to the controversy surrounding the effects of dietary fats and carbohydrates on health.”
“While I hold true to the 'diet first' philosophy of dietetics, I am impressed that it is gaining momentum as recent evidence fails to support any benefit of vitamin and mineral supplementation for disease prevention (including darling vitamin D) except in individuals at risk for deficiency. I do look forward to continued advances in nutritional genomics to provide a more individualized approach to promoting health and preventing and managing disease.“
Jane Bellman MEd, RD PEN® Resource Manager: “For me this year, most surprising, and disappointing, are the results that are coming out of the
Canadian Malnutrition Task Force. While dietitians have been screening for at risk patients for a number of years, the preliminary results point to the need for enriched nutrition education, enhanced inter-professional collaboration and increased numbers of dietitians within the work force.”
Heather Alaverdy, MA, RD, Editor, Practice-based Evidence in Nutrition®, Dietitians of Canada “My surprising moment was watching the video,
Debunking the Paleo Diet, a new resource that was added to PEN this year. I had always thought of evidence-based research as involving living participants (or at least those who lived in the last century) and found the analysis of our prehistoric ancestors in relation to the Paleolithic diet to be fascinating.”
Heather Petrie, MSc, RD, Evidence Analyst, Practice-based Evidence in Nutrition®, Dietitians of Canada “One thing I found fascinating over the past year was the research from Ontario, Canada that used DNA barcode technology to test for the presence of labelled and un-labelled ingredients in herbal supplements on both the Canadian and American marketplaces. While this was a small sampling of a very large industry, there were a number of cases of the herbal ingredient not being found in the product and other plant species being found in it instead. Additionally, some of fillers detected in the supplements had not been on the label. Such contamination and variability can occur due to plant growing and harvesting conditions but also due to fraudulent activities. Various groups have criticized Canada’s regulations as too strict, yet contamination and product inconsistency still occurs even here. It will be exciting to see DNA barcode databases grow so that DNA technology has the opportunity to become standard practice in the herbal supplement industry. Less health risk to consumers, improved efficacy of commercial herbal products and greater consumer confidence are very important.”
How did the PEN® database help to make a dietitian’s job easier?
Kate Paul, APD AN, Senior Professional Services Dietitian, Dietitians Association of Australia:
‘It has been an exciting year! Our partnership with PEN has allowed DAA to provide our members with synthesized available evidence, practical information and resources – it is a real time saver. Members value this credible and dynamic resource. Accredited Practising Dietitians (APDs) are logging continuing professional development (CPD) hours against reading PEN content to keep themselves up to date and meet the requirements of the APD program. And groups of member dietitians are now joining international teams to ‘give back’, i.e. developing new PEN content. I look forward to supporting PEN content development in 2014.”
Gabrielle Ryan APD, AN, Professional Services Cadet Dietitian, Dietitians Association of Australia:
“PEN has been my first point-of-call as a reliable source for nutrition evidence when updating DAA’s Smart Eating for You (SEFY) Nutrition A-Z Fact sheets throughout 2013. Aimed at the general public, it is important that SEFY fact sheets contain up-to-date nutrition information in order to maintain our Association’s credibility as the leaders in Australia for nutritional advice.
PEN is also a helpful reference tool when answering questions posed to DAA from consumers. Recently a consumer questioned DAA on the benefits of breastfeeding, using the
Infant Nutrition Breastfeeding Toolkit I was able to specify the latest information on the health benefits linked to breast milk. I can trust that PEN is current with the literature on practice recommendations. It is so easy and efficient to use – it’s a real time saver! I look forward to the development of new PEN topics in 2014!”
Celeste Hankins APD, AN, Communications Dietitian, Dietitians Association of Australia:
“As members of DAA’s Communications and Marketing team, we have a deep appreciation for the diversity, quality and applicability of information presented through PEN. Much of our job is to bring nutrition evidence into the consumer arena and develop accurate, practical messages for the public. PEN covers topics from
preschool nutrition to
caffeine in pregnancy or
fluids for hydration to
flavonoids in chocolate. This global resource never ceases to amaze!”
In addition to reflecting on surprising research findings, the PEN® team also notes areas in the field of nutrition to watch:
Jayne Thirsk PhD, RD, FDC, PEN® Director “The concept of the microbiome and the potential effects it may have on health and how nutrition might influence that was a new area for me but one that increasingly came up in conversation with my dietitian colleagues. Click
here for a bit of background. There were almost 200 articles published this year that explored the relationship of the microbiome to numerous gastrointestinal diseases and cancers. We are likely a long way away from specific diet/nutrition recommendations but it might be an area for dietitians to watch and perhaps play a role in providing the research evidence to guide practice.”
“Diet and inflammation and disease is another area of intense discussion. The hypothesis being that chronic low level inflammation underlies numerous chronic diseases such as diabetes, heart disease and cancer. A lot of the literature describes
associations between dietary patterns or nutrients and various markers of inflammation and "anti inflammatory diets and supplements are being marketed with increasing frequency despite a lack of good evidence on their efficacy. I agree with Dr Bauer's comments in the
Mayo clinic Health Letter: It is an area to watch but at the moment we don't have causal data to show that a particular diet, nutrient or supplement will directly impact chronic inflammation.”
Kristyn Hall MSc, RD PEN® Social Media Lead “Something that I see happening is the growing interest and movement in agricultural health and food systems and how that is being tied into nutrition. Food systems, agriculture, healthy public policy, sustainability, food skills – this is an area that provides great opportunity for dietitians. Dietitians have skills in seeing the big picture, as well as skills in critical thinking. As the area of food sustainability continues to evolve, new and emerging roles are afforded for dietetic leadership.”
So there you have it! As we look ahead to 2014, we take inspiration from the following quote: “Take a look at how far you have come, have faith in how far you will go. But don’t forget to enjoy the journey.” M Josephson
Compiled by Kristyn Hall MSc, RD
PEN® Social Media Lead
Dietitians of Canada