New issue out now


The January/February issue of the Journal of Human Nutrition and Dietetics is now available online


This editorial accompanies our virtual issue on vitamin D and is published jointly with Nutrition Bulletin.

Vitamin D – has the new dawn for dietary recommendations arrived? (pages 3–6) S. A. Lanham-New and L. R. Wilson


Body composition and morphological assessment of nutritional status in adults: a review of anthropometric variables (pages 7–25) A. M. Madden and S. Smith

Indices of adiposity as predictors of cardiometabolic risk and inflammation in young adults (pages 26–37) L. K. Pourshahidi, J. M. W. Wallace, M. S. Mulhern, G. Horigan, J. J. Strain, E. M. McSorley, P. J. Magee, M. P. Bonham and M. B. E. Livingstone


Predictors of protein-energy wasting in haemodialysis patients: a cross-sectional study (pages 38–47) M. Ruperto, F. J. Sánchez-Muniz and G. Barril

Pinch grip strength as an alternative assessment to hand grip strength for assessing muscle strength in patients with chronic kidney disease treated by haemodialysis: a prospective audit (pages 48–51) S. El-Katab, Y. Omichi, M. Srivareerat and A. Davenport

Exploring associations between anthropometric indices and graft function in patients receiving renal transplant (pages 52–58) L. Tsirigoti, M. D. Kontogianni, M. Darema, V. Iatridi, N. Altanis, K. A. Poulia, G. Zavos and J. Boletis

Comparison of energy estimates in chronic kidney disease using doubly-labelled water (pages 59–66) S. Sridharan, J. Wong, E. Vilar and K. Farrington


Dietary intake in infants with complex congenital heart disease: a case–control study on macro- and micronutrient intake, meal frequency and growth (pages 67–74) L. Hansson, I. Öhlund, T. Lind, C. Stecksén-Blicks and A. Rydberg


Building bridges in dietary counselling: an exploratory study examining the usefulness of wellness and wellbeing concepts (pages 75–85) A.-T. McMahon, P. C. Tay, L. Tapsell and P. Williams

Lessons learnt from a feasibility study on price incentivised healthy eating promotions in workplace catering establishments (pages 86–94) D. Mackison, J. Mooney, M. Macleod and A. S. Anderson Editor’s Pick (Free to access for 2 months)


Effect of a high-fat meal containing conventional or high-oleic peanuts on post-prandial lipopolysaccharide concentrations in overweight/obese men (pages 95–104)

A. P. B. Moreira, T. F. S. Teixeira, R. D. M. Alves, M. C. G. Peluzio, N. M. B. Costa, J. Bressan, R. Mattes and R. C. G. Alfenas

The effect of marjoram (Origanum majorana) tea on the hormonal profile of women with polycystic ovary syndrome: a randomised controlled pilot study (pages 105–111) I. Haj-Husein, S. Tukan and F. Alkazaleh


Polymorphism G1359A of the cannabinoid receptor gene (CNR1): allelic frequencies and influence on cardiovascular risk factors in a multicentre study of Castilla-Leon (pages 112–117) D. A. de Luis, M. Ballesteros, A. Lopez Guzman, E. Ruiz, C. Muñoz, M. A. Penacho, P. Iglesias, A. Maldonado, L. San Martin, O. Izaola and M. Delgado

Association of G1359A polymorphism of the cannabinoid receptor gene (CNR1) with macronutrient intakes in obese females (pages 118–123) D. A. de Luis, O. Izaola, R. Aller, J. J. Lopez, B. Torres, G. Diaz, E. Gomez and E. Romero

Open communication facilitates behaviour change in diabetes

The nutrition care needs of patients newly diagnosed with type 2 diabetes: informing dietetic practice

Ball et al., JHND Early View


Understanding patients’ experiences and preferences for health care is important with respect to informing how to provide best-practice, patient-centred care. The present study aimed to explore the perceptions of patients who have been recently diagnosed with type 2 diabetes regarding nutrition care received from dietitians.


Ten individuals recently diagnosed with type 2 diabetes participated in three individual semi-structured qualitative telephone interviews: at baseline, then at 3 and 6 months after recruitment. Data were analysed using content analysis at each time point and meta-synthesis of findings over time.


Participants’ initial interactions with dietitians were challenging and overwhelming as a result of the instructional nature of consultations. Many participants questioned the use of dietary guidelines to inform nutrition care because this was not adapted to the individual. Some participants valued receiving education on topics such as label reading and serving sizes; however, others considered that the nutrition care was rushed and overly directive. Very few participants perceived that an ongoing relationship with a dietitian would be useful, and limited interaction was planned beyond 6 months after diagnosis.


These findings suggest that there is considerable opportunity for dietitians to enhance the nutrition care provided to patients with type 2 diabetes. Tailoring of dietary guidelines to individuals, utilising supportive counselling styles, and focusing on open communication in consultations that facilitate ongoing, useful care for patients, may help patients with type 2 diabetes achieve and maintain healthy dietary behaviours.


Micronutrient deficiency is a risk in children with inborn errors of metabolism

The challenges of vitamin and mineral supplementation in children with inherited metabolic disorders: a prospective trial

Daly et al., JHND Early View


In order to achieve metabolic stability, dietary treatment of inborn errors of metabolism may require restriction of protein, fat or carbohydrate. Manipulation of dietary intake potentially reduces micronutrient status, and provision of a comprehensive vitamin and mineral supplement becomes an essential adjunct to dietary treatment.


To review the efficacy of a new complete vitamin and mineral supplement [Fruitivits, Vitaflo Ltd] in 14 subjects in an open prospective 26-week study.


All subjects had dietary restrictions: low protein diets (57%, n = 8), regular daytime cornstarch and overnight glucose polymer tube feeds (29%, n = 4), low fat diet (7%, n = 1) and modified Atkins diet (7%, n = 1). Plasma nutritional biochemistry, anthropometry and food frequency questionnaires were collected at week 0, 12 and 26 weeks respectively.


Five nutritional parameters showed a significant improvement from baseline (week 0) to study end (week 26): folate (P = 0.01), vitamin E (P= 0.04), plasma selenium (P = 0.002), whole blood selenium (P = 0.04) and total vitamin D (P = 0.008). All the other nutritional markers did not significantly change. Even with regular monitoring, 37% of the product remained unused.


Despite improvements in some nutritional markers, overall use of the vitamin and mineral supplement was less than prescribed. New methods are needed to guarantee delivery of micronutrients in children at risk of deficiencies as a result of an essential manipulation of diet in inborn disorders of metabolism.

Dietetic education: Assessing competence in public health nutrition

A cross-sectional study exploring the different roles of individual and group assessment methods in assessing public health nutrition competence

Palermo et al., JHND Early View


Competency in the practice of public health is essential for dietitians, yet little is known about credible and dependable assessment in this field. The present study aimed to investigate the role of individual and group assessment tasks as elements of a public health nutrition competency-based assessment system.


Assessment performance data from 158 dietetics students (three group tasks and one individual task) who had completed a practical placement learning experience in a public health nutrition setting were examined using nonparametric techniques. All 158 students were deemed individually ‘competent’ on completion of the placement.


The median mark was significantly lower for the individual compared to the group task, with a greater range of marks achieved in the individual assessment. There was a weak relationship between individual and group marks for the whole cohort (n = 158) (Spearman’s rho correlation coefficient = 0.193, P = 0.015). Bland–Altman analysis showed that the mean (SD) agreement between the two assessment tasks was −5.9 (17.7) marks. Systematic bias between the two tasks was also demonstrated, indicating that students with the lowest average mark of the two assessments scored lower on the individual assessment task compared to their group task and those who had a higher average mark scored higher on the individual group assessment compared to their group task.


Student performance in public health differs between individual and group assessment. Individual assessment appears to differentiate between students, yet group work is essential for the development of teamwork skills. Both should be considered in the judgement of public health nutrition competency.

Measurement of vitamin D intake

Development, validation and implementation of a quantitative food frequency questionnaire to assess habitual vitamin D intake

Kiely et al., JHND Early View


A well-designed, validated quantitative food frequency questionnaire (FFQ) could offer an efficient and cost-effective method for assessing habitual vitamin D intake. The present study aimed to describe the development, validation and implementation of a vitamin D FFQ.


National food consumption survey data obtained from Irish adults (18–64 years) were used to identify foods that contribute 95% of vitamin D intake. A winter-based validation study was carried out for the resulting FFQ in 120 females, including 98 women [mean (SD) 65.0 (7.3) years] and 22 girls [12.2 (0.8) years], using a 14-day diet history (DH) as a comparator. Serum 25(OH)D concentrations were analysed. Validity coefficients were calculated using the method of triads. Cross-classification and Bland–Altman analysis were also performed.


Median (interquartile range) vitamin D intakes (including the contribution from nutritional supplements) were 5.4 (3.7) and 3.7 (5.9) μg day−1 from the FFQ and DH, respectively and intakes of vitamin D from food sources were 3.6 (3.1) and 2.4 (2.2) μg day−1. The FFQ and DH classified 86% and 87% of individuals into the same and adjacent thirds of wintertime serum 25(OH)D status, respectively. There was a strong association (r = 0.71, P < 0.0001) and no significant systematic or proportional bias observed for the difference between estimates from the FFQ and DH. The validity coefficient for the FFQ was 0.92 (95% confidence interval = 0.80–0.97). Repeatability analysis (n = 56) performed 6–12 months later showed no significant difference in estimates of vitamin D between administrations.


The data obtained in the present study indicate high validity and good reproducibility of a short, interviewer-administered FFQ for vitamin D.


Perceptions of seafood during pregnancy

Erring on the side of caution: pregnant women’s perceptions of consuming fish in a risk averse society

Lucas et al., JHND Early View


Fish and seafood are good sources of several nutrients that are important for foetal growth and development. Despite guidelines encouraging the eating of fish during pregnancy, research indicates that pregnant women may be limiting or avoiding these foods. Possible factors contributing to this include concerns regarding levels of mercury and other contaminants and pregnant women’s purported heightened risk consciousness. The present study aimed to explore pregnant women’s perceptions of consuming fish and seafood during pregnancy.


Semi-structured telephone interviews were conducted with 15 pregnant women across all three trimesters in New South Wales, Australia. Questions focussed on exploring nutrition information received during pregnancy, dietary changes made during pregnancy and, more specifically, perceptions of fish and seafood, as well as views on information of fish and seafood commonly provided to pregnant women. Data were collected, then transcribed and analysed using an inductive coding process, guided by the qualitative theory grounded approach.


Multiple inter-related themes were found to shape pregnant women’s perceptions related to fish and seafood consumption during pregnancy; namely, the understanding of fish and seafood as part of a healthy diet, external factors such as cost, individual preferences such as taste, and confidence in choosing and preparing fish. The context of a risk adverse society permeated these themes.


The present study provides insight into the inter-related factors that influence pregnant women’s consumption or avoidance of fish and seafood.