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  1. Article: Authors' Response.

    Rozga, Mary

    Journal of the Academy of Nutrition and Dietetics

    2020  Volume 120, Issue 12, Page(s) 1960–1961

    Language English
    Publishing date 2020-09-18
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2646718-5
    ISSN 2212-2672
    ISSN 2212-2672
    DOI 10.1016/j.jand.2020.07.030
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  2. Article: Authors' Response: Treatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on Systematic Reviews.

    Kirk, Shelley / Rozga, Mary

    Journal of the Academy of Nutrition and Dietetics

    2023  Volume 123, Issue 3, Page(s) 405–406

    MeSH term(s) Child ; Humans ; Dietetics ; Overweight/therapy ; Obesity/therapy ; Nutritional Status ; Academies and Institutes
    Language English
    Publishing date 2023-01-05
    Publishing country United States
    Document type Letter
    ZDB-ID 2646718-5
    ISSN 2212-2672
    ISSN 2212-2672
    DOI 10.1016/j.jand.2023.01.001
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  3. Article ; Online: Nutrition Interventions for Pediatric Obesity Prevention: An Umbrella Review of Systematic Reviews.

    Rozga, Mary / Handu, Deepa

    Nutrients

    2023  Volume 15, Issue 24

    Abstract: Nutrition interventions to prevent pediatric obesity can help to establish healthy habits to improve current and future health. The objective of this umbrella review of systematic reviews (SRs) is to examine the impact of obesity prevention interventions ...

    Abstract Nutrition interventions to prevent pediatric obesity can help to establish healthy habits to improve current and future health. The objective of this umbrella review of systematic reviews (SRs) is to examine the impact of obesity prevention interventions with a nutrition component on body mass index measures, overweight/obesity prevalence, and cost-effectiveness in participants 2-17 years old. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used, and this umbrella review was registered on PROSPERO (CRD42023443033). Included SRs were required to search ≥2 databases and to assess the risk of bias (RoB) of primary studies, and they were published 2017-June 2023. Database searches identified 4776 articles, and 31 SRs were included. In all age groups combined, interventions with both nutrition and physical activity were effective and cost-effective in all settings combined, and in the community setting specifically. In children ≤5 years old, interventions in the home and family, community, and healthcare settings demonstrated some efficacy, whereas in children 6-12 years old, school interventions were most effective. Evidence with individuals 13-17 years was limited. The certainty of evidence was generally low due to RoB in included studies, inconsistency, and imprecision. Pediatric obesity prevention interventions with nutrition should be tailored to the developmental stage to ensure appropriateness and efficacy.
    MeSH term(s) Child ; Humans ; Child, Preschool ; Adolescent ; Pediatric Obesity/epidemiology ; Pediatric Obesity/prevention & control ; Systematic Reviews as Topic ; Body Mass Index ; Overweight ; Exercise
    Language English
    Publishing date 2023-12-13
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu15245097
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  4. Article: Authors' Response.

    Rozga, Mary / Kirk, Shelley

    Journal of the Academy of Nutrition and Dietetics

    2022  Volume 122, Issue 6, Page(s) 1088

    Language English
    Publishing date 2022-05-18
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2646718-5
    ISSN 2212-2672
    ISSN 2212-2672
    DOI 10.1016/j.jand.2022.02.003
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  5. Article: Current Systems-Level Evidence on Nutrition Interventions to Prevent and Treat Cardiometabolic Risk in the Pediatric Population: An Evidence Analysis Center Scoping Review.

    Rozga, Mary / Handu, Deepa

    Journal of the Academy of Nutrition and Dietetics

    2021  Volume 121, Issue 12, Page(s) 2501–2523

    Abstract: Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric ... ...

    Abstract Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric individuals. This scoping review examines current evidence on interventions and exposures influencing pediatric cardiometabolic health to inform registered dietitian nutritionists working at each systems level, ranging from individual counseling to public policy. A literature search of MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, and other databases was conducted to identify evidence-based practice guidelines, systematic reviews, and position statements published in English from January 2017 until April 2020. Included studies addressed nutrition interventions or longitudinal exposures for participants 2 to 17 years of age who were healthy or had cardiometabolic risk factors. Studies were categorized according level of the social-ecological framework addressed. The databases and hand searches identified 2614 individual articles, and 169 articles were included in this scoping review, including 6 evidence-based practice guidelines, 141 systematic reviews, and 22 organization position statements. The highest density of systematic reviews focused on the effects of dietary intake (n = 58) and interventions with an individual child or family through counseling or education (n = 54). The least frequently examined levels of interventions or exposures were at the policy level (n = 12). Registered dietitian nutritionists can leverage this considerable body of recent systematic reviews to inform a systems-level, collaborative approach to prevention and treatment of pediatric cardiometabolic risk factors.
    MeSH term(s) Adolescent ; Cardiometabolic Risk Factors ; Child ; Counseling/methods ; Dietetics/methods ; Dietetics/standards ; Female ; Humans ; Male ; Metabolic Syndrome/prevention & control ; Nutrition Therapy/methods ; Nutrition Therapy/standards ; Pediatric Obesity/prevention & control ; Pediatrics/methods ; Pediatrics/standards ; Practice Guidelines as Topic ; Systematic Reviews as Topic
    Language English
    Publishing date 2021-01-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2646718-5
    ISSN 2212-2672
    ISSN 2212-2672
    DOI 10.1016/j.jand.2020.12.014
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  6. Article: 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.

    Robinson, Justin / Nitschke, Erin / Tovar, Ashley / Mattar, Lama / Gottesman, Kimberly / Hamlett, Peggy / Rozga, Mary

    Journal of the Academy of Nutrition and Dietetics

    2023  Volume 123, Issue 8, Page(s) 1215–1237.e5

    Abstract: A nutritious diet and adequate physical activity vitally contribute to disease prevention, but most adults do not meet population-based dietary and physical activity recommendations. Qualified nutrition and exercise practitioners can address challenges ... ...

    Abstract A nutritious diet and adequate physical activity vitally contribute to disease prevention, but most adults do not meet population-based dietary and physical activity recommendations. 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. The objective of this evidence-based practice guideline is to inform practice decisions for nutrition and exercise practitioners providing nutrition and physical activity interventions for adults who are healthy or have cardiometabolic risk factors, but no diagnosed disease. 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. Common barriers and facilitators encountered when delivering nutrition and physical activity interventions, such as adherence to professional scopes of practice; methods to support behavior change; and methods to support inclusion, diversity, equity, and access, are discussed. Nutrition and exercise practitioners can consistently provide individualized, practical, and evidence-based interventions by seeking to understand their clients' needs, circumstances, and values and by co-creating interventions with the client and their allied health team.
    MeSH term(s) Adult ; Humans ; Dietetics ; Exercise ; Diet ; Nutritional Status ; Evidence-Based Practice
    Language English
    Publishing date 2023-04-14
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2646718-5
    ISSN 2212-2672
    ISSN 2212-2672
    DOI 10.1016/j.jand.2023.04.004
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  7. Article ; Online: Medical Nutrition Therapy Provided by Dietitians is Effective and Saves Healthcare Costs in the Management of Adults with Dyslipidemia.

    Sikand, Geeta / Handu, Deepa / Rozga, Mary / de Waal, Desiree / Wong, Nathan D

    Current atherosclerosis reports

    2023  Volume 25, Issue 6, Page(s) 331–342

    Abstract: Purpose of review: Referral to nutrition care providers in the USA such as registered dietitian nutritionists (RDNs) for medical nutrition therapy (MNT) remains low. We summarize research on the effectiveness of MNT provided by dietitians versus usual ... ...

    Abstract Purpose of review: Referral to nutrition care providers in the USA such as registered dietitian nutritionists (RDNs) for medical nutrition therapy (MNT) remains low. We summarize research on the effectiveness of MNT provided by dietitians versus usual care in the management of adults with dyslipidemia. Improvements in lipids/lipoproteins were examined. If reported, blood pressure (BP), fasting blood glucose (FBG) glycated hemoglobin (A1c), body mass index (BMI), and cost outcomes were also examined.
    Recent findings: The synthesis of three systematic reviews included thirty randomized controlled trials. Multiple MNT visits (3-6) provided by dietitians, compared with usual care, resulted in significant improvements in total cholesterol (mean range: - 4.64 to - 20.84 mg/dl), low-density lipoprotein cholesterol (mean range: - 1.55 to - 11.56 mg/dl), triglycerides (mean range: - 15.9 to - 32.55 mg/dl), SBP (mean range: - 4.7 to - 8.76 mm Hg), BMI (mean: - 0.4 kg/m2), and A1c (- 0.38%). Cost savings from MNT were attributed to a decrease in medication costs and improved quality of life years (QALY). Multiple MNT visits provided by dietitians compared with usual care improved lipids/lipoproteins, BP, A1c, weight status, and QALY with significant cost savings in adults with dyslipidemia and justify a universal nutrition policy for equitable access to MNT.
    MeSH term(s) Humans ; Adult ; Nutritionists ; Glycated Hemoglobin ; Quality of Life ; Nutrition Therapy/methods ; Dyslipidemias/therapy ; Triglycerides ; Cholesterol, LDL ; Health Care Costs
    Chemical Substances Glycated Hemoglobin ; Triglycerides ; Cholesterol, LDL
    Language English
    Publishing date 2023-05-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057369-8
    ISSN 1534-6242 ; 1523-3804
    ISSN (online) 1534-6242
    ISSN 1523-3804
    DOI 10.1007/s11883-023-01096-0
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    Zs.A 5534: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
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  8. Article ; Online: Medical Nutrition Therapy Provided by a Dietitian Improves Outcomes in Adults with Pre-Hypertension or Hypertension: A Systematic Review and Meta-Analysis.

    Senkus, Katelyn E / Dudzik, Josephine M / Lennon, Shannon L / DellaValle, Diane M / Moloney, Lisa M / Handu, Deepa / Rozga, Mary

    The American journal of clinical nutrition

    2024  

    Abstract: Background: Hypertension is an important risk factor for cardiovascular disease. Interventions with dietitians can help modify dietary intake and reduce hypertension risk.: Objective: To examine the research question: In adults with pre-hypertension ... ...

    Abstract Background: Hypertension is an important risk factor for cardiovascular disease. Interventions with dietitians can help modify dietary intake and reduce hypertension risk.
    Objective: To examine the research question: In adults with pre-hypertension or hypertension, what is the effect of medical nutrition therapy (MNT) provided by a dietitian on blood pressure (BP), cardiovascular risk and events and anthropometrics compared to standard care or no intervention?
    Methods: MEDLINE, CINAHL and Cochrane Central databases were searched for randomized controlled trials (RCTs) published in peer-reviewed journals from 1985-2022. Risk of bias (RoB) was assessed using the version 2 of the Cochrane tool for RCTs. Meta-analyses were conducted using the DerSimonian-Laird random-effects model. Certainty of evidence (COE) was assessed for each outcome using the Grading of Recommendations, Assessment, and Evaluation (GRADE) method.
    Results: Forty articles representing 31 RCTs were included and analyzed. MNT provided by a dietitian likely reduces systolic [Mean Difference (MD): -3.63 mmHg (95% confidence interval (CI): -4.35, -2.91)] and diastolic [-2.02 mmHg (-2.56, -1.49)] BP (p<0.001) and body weight [-1.84 kg (-2.72, -0.96), p<0.001], and improves anti-hypertensive medication usage, relative risk of stroke [0.34 (0.14, 0.81), p=0.02] and CVD risk score [standardized mean difference (SMD): -0.20 (-0.30, -0.09), p<0.001] compared to control participants, and COE was moderate. Additionally, MNT may reduce arterial stiffness [SMD: -0.45 (-0.71, -0.19), p=0.008] and waist circumference [-1.18 cm (-2.00, -0.36), p=0.04], and COE was low. There was no significant difference in risk for myocardial infarction between groups. Dietitian interventions reduced BP and related cardiovascular outcomes for adults with pre-hypertension or hypertension.
    Conclusion: Dietitians play a critical role in improving cardiometabolic risk factors for adults with elevated BP; thus, improved payment for and access to MNT services has the potential to significantly impact public health.
    Registration id and url: This systematic review was registered in the International Prospective Register of Systematic Reviews: PROSPERO# CRD42022351693 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351693).
    Language English
    Publishing date 2024-04-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    DOI 10.1016/j.ajcnut.2024.04.012
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    Ue I Zs.208: Show issues Location:
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  9. Article: Treatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews.

    Kirk, Shelley / Ogata, Beth / Wichert, Elizabeth / Handu, Deepa / Rozga, Mary

    Journal of the Academy of Nutrition and Dietetics

    2022  Volume 122, Issue 4, Page(s) 848–861

    Abstract: This Academy of Nutrition and Dietetics Position Paper describes current evidence on multi-component interventions with nutrition to treat pediatric overweight and obesity and discusses implications for RDNs. An umbrella review of eight systematic ... ...

    Abstract This Academy of Nutrition and Dietetics Position Paper describes current evidence on multi-component interventions with nutrition to treat pediatric overweight and obesity and discusses implications for RDNs. An umbrella review of eight systematic reviews provides evidence that multi-component interventions that include nutrition improve body mass index z-scores in all ages and in a variety of settings. More evidence is needed regarding appropriate body mass index measures to track weight and health status changes in children and adolescents with overweight and obesity. Current evidence indicates that multi-component interventions that include nutrition do not negatively impact psychosocial outcomes, but research on long-term outcomes is needed. Evolving technology and societal circumstances have created opportunities to provide innovative, collaborative, and engaging interventions through telehealth. RDNs specializing in pediatric overweight and obesity treatment play a crucial role in providing a wide range of evidence-based interventions in a variety of settings. These skills are important for tailoring treatment to each child or adolescent while accounting for community and societal factors, which can lead to improved health across the lifespan.
    MeSH term(s) Adolescent ; Body Mass Index ; Child ; Dietetics ; Humans ; Obesity/therapy ; Overweight/psychology ; Overweight/therapy ; Pediatric Obesity/psychology ; Pediatric Obesity/therapy ; Systematic Reviews as Topic
    Language English
    Publishing date 2022-01-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2646718-5
    ISSN 2212-2672
    ISSN 2212-2672
    DOI 10.1016/j.jand.2022.01.008
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  10. Article ; Online: Nutrition and physical activity interventions for the general population with and without cardiometabolic risk: a scoping review.

    Rozga, Mary / Jones, Kelly / Robinson, Justin / Yahiro, Amy

    Public health nutrition

    2021  Volume 24, Issue 14, Page(s) 4718–4736

    Abstract: Objective: 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 ... ...

    Abstract Objective: 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) behaviour counseling or coaching from a dietitian/nutritionist or exercise practitioner, (2) mobile applications to improve nutrition and physical activity and (3) nutritional ergogenic aids.
    Design: The current study is a scoping review. A literature search of the Medline Complete, CINAHL Complete, Cochrane Database of Systematic Reviews and other databases was conducted to identify articles published in the English language from January 2005 until May 2020. Data were synthesised using bubble charts and heat maps.
    Setting: Out-patient, community and workplace.
    Participants: Adults with or without cardiometabolic risk factors living in economically developed countries.
    Results: Searches resulted in 19 474 unique articles and 170 articles were included in this scoping review, including one guideline, thirty systematic reviews (SR), 134 randomised controlled trials and five non-randomised trials. Mobile applications (n 37) as well as ergogenic aids (n 87) have been addressed in several recent studies, including SR. While primary research has examined the effect of individual-level nutrition and physical activity counseling or coaching from a dietitian/nutritionist and/or exercise practitioner (n 48), interventions provided by these practitioners have not been recently synthesised in SR.
    Conclusion: SR of behaviour counseling or coaching provided by a dietitian/nutritionist and/or exercise practitioner are needed and can inform practice for practitioners working with individuals who are healthy or have cardiometabolic risk.
    MeSH term(s) Adult ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Exercise ; Humans ; Nutritional Status ; Nutritionists ; Systematic Reviews as Topic
    Language English
    Publishing date 2021-05-25
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1436024-x
    ISSN 1475-2727 ; 1368-9800
    ISSN (online) 1475-2727
    ISSN 1368-9800
    DOI 10.1017/S1368980021002184
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