PEN® eNews 14(12) December 2024 - New and Updated Content!
PEN
® eNews is a monthly e-newsletter shared with the global PEN Community and created to help dietitians position themselves as leaders in evidence-based nutrition practice. In addition, users of the PEN System will find articles on the new evidence, resources and features available and how to maximize one's use of PEN.
We've made the companion document to our PEN Webinar, "What is the safe upper limit of drinking alcohol?", open access all month.
Check it out here!
Chocolate and Your Heart
The Question
An important question for this holiday season: is chocolate good for your heart? Specifically, we asked whether commercially available chocolate and cocoa products should be recommended for the prevention of cardiovascular disease.
The Recommendation
Consuming small amounts of commercially available chocolate (e.g. 5 g/day) may be associated with a slight reduction in CVD events and mortality.
Dark chocolate intake (no dose specified), in particular, has been associated with lower risk of essential hypertension but not other CVD conditions.
Consuming chocolate in a variety of forms (e.g. bars, beverages, snacks, cocoa extract) probably has no effect on CVD risk factors (e.g. blood pressure, blood lipids, blood glucose, BMI or waist circumference).
Grade of Evidence B
To see the full practice question, including the Evidence Statements, Remarks and References, click here.
Sugar and Your Heart
The Question
SMust we limit sugar and sugar-sweetened beverages to prevent cardiovascular disease? Specifically, we asked whether diets lower in added sugars should be recommended for the primary or secondary prevention of cardiovascular disease (CVD) or secondary prevention of CVD.
The Recommendation
Diets lower in total sugars and fructose (but not added sugars or sucrose) may be associated with a slight decreased risk of death from any cause and death from CVD in generally healthy individuals (primary prevention) and those with a history of CVD or with CVD risk factors (secondary prevention).
Diets lower in added sugar consumption may have a small effect in reducing total cholesterol and triglyceride levels and reducing systolic and diastolic blood pressure but may not affect LDL-C or HDL-C levels in generally healthy individuals.
To see the full practice question, including the Evidence Statements, Remarks and References, click here.
Sweeteners and Your Health
Now that we know about sugar’s effect on our heart, what can we learn about sweeteners? PEN has comprehensive content examining different sweeteners, their safety, and their effect on health conditions such as cardiovascular disease, diabetes, pregnancy and lactation. We even have content examining the effect of sweeteners in children.
For example, did you know that acesulfame, cyclamate, saccharin and sucralose have been measured in human milk as early as two hours after consumption? Or that nonnutritive sweetener intake likely has a negligible effect on markers of type 2 diabetes? Learn more in ourSummary of Recommendations and Evidence.
Background on Cannabis
As holiday parties rage, you may find your patients/ clients asking you about cannabis. Statistics from 2015 to 2017 indicate that 15% of Canadians, 18% of Americans, 10% of Australians and 7% of those from the United Kingdom reported using cannabis, either recreationally or medicinally, at some point within the past year of when the studies took place.
Understanding a dietitian’s scope of practice is essential in providing safe, ethical and client-centered nutritional care. Canadian provincial regulatory bodies have released position statements or question and answer documents on cannabis and dietetics' scope of practice, with the following themes:
Understand the evidence and literature of both the health benefits and dangers of consuming cannabis, including the quality of the studies and acknowledging that there is limited published literature.
Use your professional judgement to determine if a client’s question about cannabis pertains to their nutritional health and whether you have the knowledge, skills and judgement to provide safe, ethical and competent advice. If not, consider referring this client to another health professional.
Generally, dietitians are not allowed to prescribe or recommend cannabis (including suggesting cannabis recipes) to clients to manage health conditions (e.g. changes to appetite). It may be appropriate for dietitians to discuss the impact of cannabis on a clients’ nutritional health (e.g. body weight, appetite), although the dietitian must use their professional judgement to determine if this is within the scope of practice of dietetics.
In Canada, the Cannabis Act prohibits the advertising, promoting or selling of cannabis to minors (age varies by province). Because of the presence of minors on social media, dietitians are advised not to advertise cannabis products or services on social media platforms.
The above recommendations are not a complete summary of the rules and regulations for safe and ethical practice of cannabis. It is recommended that each practitioner review their governing body’s statement (if provided) and contact them if there are questions about the scope of practice with cannabis.
Familiarize yourself with the basics in our Background document:
Cannabis and Health.
In Case You Missed It: PEN System Webinar about Alcohol
With December being a traditional party season, it may be a time that your patients/ clients are asking you more about alcohol. If you missed last year's webinar about the safe upper limit for drinking alcohol, we've recorded it for you to watch anytime.
This webinar is a deep dive into the safe drinking guidelines from our PEN partner countries (Canada, the UK and Australia). We discuss how the guidelines differ, how different countries interpret the same evidence differently, and how you might interpret the evidence yourself. Find this open access webinar here
Become a PEN Topic Advisor!
Our goal is to have all PEN content reviewed by dietetic practitioners who practice across different practice areas. Topic Advisors provide input on what PEN Practice Questions we should include in our Knowledge Pathways that reflect everyday practice situations dietitians face working in these practice areas.
Currently, we’re looking for Topic Advisors in the following areas:
COPD
Mental Health
Eating Disorders
If you think you’d like to contribute, let us know by emailing coordinator@pennutrition.com!
PEN eNews
December 2024 Volume
14 (12)
A Publication of the PEN® System Global Partners,
a collaborative partnership between International Dietetic Associations.
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