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  • eNews - PEN eNews 9(2) September 2019
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PEN eNews 9(2) September 2019

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.


Wondering about Hemp? 

The PEN Knowledge Pathway: Functional Foods/Nutraceuticals – Hemp was recently updated.
This knowledge pathway provides information on:
  • the health benefits of hemp
  • the impact of hemp seed product ingestion on cannabis drug use testing
  • the differences between hemp and cannabis
  • THC content of hemp
  • the industrial uses of hemp
  • hemp safety
  • nutrient content
  • regulatory issues.


Check out the following practice questions:

  • Can a person who has consumed hemp seed products test positive for cannabis drug use?
  • Are there any health benefits associated with the use of hemp seed?

You can also review the Summary of Recommendations and Evidence, Background and Related Tools and Resources.

To see what else is new or updated in the PEN System, click here.

PEN TIP

Are you a new PEN User?

Welcome! You will need to set up your account. Watch this video clip to see how. Find out about the PEN System with this Storyboard, tours and video tutorials. Learn more about handout customization, content alerts and building your personal library.


Juice and Excess Weight Gain in Children and Adolescents 

The Question

Is 100% fruit juice intake associated with excess weight gain in children and adolescents?

The Evidence

A 2018 umbrella review found a statistically but not clinically significant association between fruit juice intake and BMI z score in children aged one to six years, although this association did not hold in older children (aged seven to 18 years). In younger children, this BMI change translated to <1% body weight increase for each daily fruit juice serving (240 mL) over one year, which is below the amount of weight gain thought to be associated with cardiometabolic risk in this population.

A 2019 systematic review found inconsistent results regarding the relationship between fruit juice intake and weight-related outcomes in children younger than one year.

The Recommendation

Consuming 100% fruit juice (240 mL/day) for one year may lead to modest weight gain in children aged one to six years, although this weight gain may not be clinically significant.
 
 There was no relationship between fruit juice intake and weight gain in older children and adolescents (aged seven to 18 years).
 
 The relationship between fruit juice intake and weight-related outcomes (BMI, body weight, weight status) in children younger than one year is unclear.

For country-specific recommendations regarding juice, see Healthy Eating Guidelines.

To see the entire Practice Question, including Remarks, Evidence Statements, Comments and References, click here.

My Favourites

Is this a practice question that you want to keep an eye on? If so, add it to My Favourites.

  • Weight Management, 
  • Children 

Type 2 Diabetes and the Ketogenic Diet 

Check out this new GRADE practice question, Should a Ketogenic diet (< 50 g / day carbohydrate) be recommended for adults with type 2 diabetes?

In the PEN Ketogenic Diet Pathway, you’ll find background info, a summary of recommendations and evidence, related tools and resources, along with these timely practice questions:

  • What is the clinical evidence describing the safety of a very low carbohydrate (20-50 g/day) ketogenic diet during pregnancy?
  • What is the clinical effectiveness of the ketogenic diet on weight loss and cardiovascular risk factors in adults with overweight/obesity? 


Just Published!

New/Updated Summaries of Recommendations and Evidence
Infant Nutrition – Complementary Feeding
Ketogenic Diet
Cardiovascular Disease - Dyslipidemia
Mediterranean Diet
Gastrointestinal System - Probiotics
Pregnancy
Traumatic Brain Injury


Coming Soon - New and Updated Content

  • School Health
  • Immune System
  • Pediatric Obesity

PEN TIP

The PEN System allows you to access evidence-based answers to practice-based questions. These questions reflect everyday situations that dietitians face.

They are organized into Knowledge Pathways, a bit like chapters in a book.

Watch this short video tutorial where we show you how to find knowledge pathways and how to locate key features within them.


  • Diabetes, 
  • Ketogenic Diet 

Mental Health and Dietary Supplements 

Seeking answers about mental health and dietary supplements? Mental Health is one of the newest knowledge pathways in the PEN System. Read this knowledge pathway to learn more about the evidence to support specific dietary supplements for the prevention and treatment of the following conditions:
  • Disruptive, impulse-control and conduct disorders
  • Schizophrenia spectrum and other psychotic disorders
  • Bipolar and related disorders
  • Personality disorders or personality pathologies
  • Tardive dyskinesia (TD)
  • Suicide and the treatment of suicide ideation and attempts

You can also read the Mental Health Summary of Recommendations and Evidence for an overview of all the key points.

In addition to this knowledge pathway, there are seven more mental health-related knowledge pathways in the PEN System and more than 60 practice questions on a variety of topics.
 

PEN TIP

New and Updated Content
Wondering what else is new? Bookmark these pages to see check what is new and updated:
New Knowledge Pathway Content 
(Practice Questions, Summary of Recommendations and Evidence, Practice Guidance Toolkits, Backgrounds)
Tools and Resources.



There are No Passengers on Spaceship Earth. We Are All Crew1 

As we get ready to relaunch PEN® eNews in a new format and with six more issues per year (!), I took a moment to reflect on some of our first eNews issues in 2011. Although they all provided updates on the latest nutrition evidence and new features in the PEN System, one article in particular “spoke to me”. Sharing it again, is a fitting way to acknowledge the remarkable international partnership that continues to power the PEN System, including our new PEN® eNews.

Globalization – love it or hate it, it impacts dietitians around the globe in small and big ways every day. Whether it be:

  • staying abreast of new science and technology
  • incorporating new nutrition knowledge or new food products into our practices
  • respecting and understanding the health beliefs or food habits of new immigrants
  • responding to global health threats such as HIV/AIDS, SARS, BSE and foodborne E. coli outbreaks
  • contributing to or advocating for policies designed to ensure food security for all in an environmentally sustainable manner.

Recognizing it’s a big job and we are a relatively small profession, three dietetic professional associations from Canada, the United Kingdom and Australia set about creating a global nutrition resource for dietitians that would enable dietitians across the world to collaborate to advance knowledge, to share their resources and to lead the development of practice within their own countries and globally.

The PEN System remains the foundation for this exciting vision as the knowledge base and practice support tool for dietitians and nutrition professionals, providing accessible, affordable and sustainable products to support evidence-based practice.

This global collaboration remains strong and committed to:
Using our limited resources efficiently to create a shared and unique database that we continue to grow “faster, broader and deeper” with contributions from all three partners and users around the world.
Using the PEN System to promote evidence-based practice as outlined in the International Code of Ethics and Code of Good Practice.
Building capacity for evidence literacy and generation within National Dietetic Association partner organizations.
Challenging entrenched thinking to find innovative solutions.
Fostering international networking amongst dietitians.
Using those networks and the wisdom of crowds to solve many problems.  
Enhancing the profile of the profession around the world.


Our PEN Global Partnership principles ensure an equitable partnership that builds on the strengths of all participants for the benefit of everyone. The partnership is built upon open communication with shared responsibility, accountability and decision-making. We are learning about and respecting the processes and legal systems within which we each have to work and recognizing that we may have different drivers or priorities.

The beneficiaries of the PEN global partnership are members of the dietetic association partners, their stakeholders and the dietetic profession as a whole.

As a global team we have developed many new skills and are learning all the time. This encompasses issues like how to effectively horizon scan across three continents, appreciating the many different ways we choose to describe a healthy diet and how to incorporate different Dietary Reference Values. We are also learning to overcome more everyday concerns such as the use of technology to meet across time zones, spelling and terminology differences and discovering a shared sense of humour/humor. These wonderful unexpected consequences of the partnership are ones which everyone who joins us can benefit from.  

Our small, but mighty crew of PEN Team members (Staff, Contractors, Volunteers) continues to scan the evidence, appraise and synthesize it so you can use it in your practice wherever you are in the world. Just like Spaceship Earth, there are no passengers on the Evidence-Based Dietetic Practice Journey. We are all crew. Join us!

Adapted from an article originally published in PEN eNews:
Megan Alsford, Dietitians Association of Australia and Dietitians New Zealand
Sue Kellie, The British Dietetic Association
Jayne Thirsk, Dietitians of Canada
 
1Marshall McLuhan


Key Concepts to Foster Critical Thinking 

 

Twenty-four researchers from a variety of fields came together to establish a set of principles to help us assess the trustworthiness of information/claims in order to make better informed decisions/choices: https://www.nature.com/articles/d41586-019-02407-9


  • Critical Appraisal 
PEN eNews
PEN: The Global Resource for Nutrition Practice  
September 2019  Volume 9 (2)


A Publication of the PEN® System Global Partners,
a collaborative partnership between International Dietetic Associations.
Learn more about PEN.
Copyright Dietitians of Canada . All Rights Reserved.
Articles in this issue
  • Wondering about Hemp?
  • Juice and Excess Weight Gain in Children and Adolescents
  • Type 2 Diabetes and the Ketogenic Diet
  • Mental Health and Dietary Supplements
  • There are No Passengers on Spaceship Earth. We Are All Crew
  • Key Concepts to Foster Critical Thinking
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