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  • eNews - PEN eNews 10(2) February 2020
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PEN eNews 10(2) February 2020

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.


Heart Health: The PEN® System Has So Much To Share

February is the time of year that gets us thinking about hearts. Wondering about heart health? The PEN System has you covered with the following new and updated practice questions:

  • Does the use of sweeteners (e.g. nonnutritive, artificial, intense, low calorie, sugar substitutes) increase the risk of cardiovascular disease in people with diabetes?
  • What overall dietary and lifestyle strategies are recommended for the treatment of dyslipidemia?
  • Does diet have a role in preventing hypertension?
  • Do individuals with hypertension who consume a nutritionally balanced diet that is low in sodium have lower blood pressure?
  • What nutrition strategies can prevent cardiovascular disease (CVD) in the healthy population (primary prevention)?
  • Are diets higher in total dietary fibre (including whole grains, cereals, vegetable, fruit and legume/pulse fibre) recommended for primary or secondary cardiovascular disease (CVD) prevention?

In addition, there are:

  • 5 Knowledge Pathways dedicated to cardiovascular disease
    • Cardiovascular Disease    
    • Cardiovascular Disease - Hypertension
    • Cardiovascular Disease - Dyslipidemia
    • Cardiovascular Disease - Heart Failure
    • Cardiovascular Disease - Chocolate
  • 123 Practice Questions
  • 90+ Consumer Tools and Resources
  • 80+ Professional Tools and Resources.


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.


What Herbal Beverages/Supplements are Safe to Take During Pregnancy and Lactation? 

The Question

What Herbal Beverages/Supplements are Safe to Take During Pregnancy and Lactation?

There are so many herbal beverages and supplements on the market. It can be challenging for women who are pregnant and/or breastfeeding to sort through them all. Looking for up-to-date information? Check out this updated PEN Practice Question.

Did you know that there are 79 Practice Questions (PQs) on pregnancy and 42 on lactation, including these new or updated PQs?
  • Is any amount of alcohol safe to consume during pregnancy?
  • What non-prescription therapies are effective for the treatment of nausea and vomiting in early pregnancy (first trimester)?
  • What is the effect of increasing omega-3 fatty acid intake during pregnancy?
  • What is the effect of fructose consumption during pregnancy on outcomes for the mother and child?
  • Are there safety concerns for the ingestion of fish in women who are pregnant, planning to become pregnant or breastfeeding related to mercury contamination?
  • What factors put breastfed infants at risk for growth faltering?

Related Content

For an overview of the Pregnancy Knowledge Pathways see:
  • Pregnancy Practice Guidance Toolkit

This toolkit provides an overview of the Pregnancy, Pregnancy - Hyperemesis Gravidarum, Pregnancy - Hypertension and Pregnancy - Multi-fetal Knowledge Pathways that includes a description of the topic, key nutrition issues, nutrition assessment, intervention and nutrition monitoring/evaluation. The Summary of Recommendations and Evidence for each pregnancy knowledge pathway is also included in the toolkit.

  • Breastfeeding, 
  • Herbal Supplement, 
  • Pregnancy 

Allergy - High Risk Infant: The Latest



The Allergy – High Risk Infant Knowledge Pathway has updated answers to the following questions:
  • Does a history of maternal atopy predict a higher risk for the development of allergy in infants and children as compared to a paternal history of atopy?
  • Do infants with a parental history of allergy have a reduced incidence of allergy if their mothers avoid common allergenic foods during pregnancy as compared to infants of mothers who do not restrict their diets during pregnancy?
  • Do infants and children with a parental history of allergy who are exclusively breastfed and whose mothers avoid common allergenic foods during breastfeeding have a reduced incidence of allergy as compared to infants whose mothers do not restrict their diets?
  • Among term infants and children, with a parental history of allergy, does breastfeeding reduce the incidence of allergy?
  • Among infants with parental history of allergy, does delaying the introduction of common allergenic foods until after four months of age decrease the incidence of allergy?
  • What infant feeding formulas contribute to risk reduction for allergic diseases, including food allergy and eczema, among infants at high risk for allergy?
  • Among infants with parental history of allergy, does a combination of maternal avoidance of common allergenic foods during breastfeeding, infant feeding with hydrolysed formula, delayed introduction of common allergenic foods and a house dust mite reduction program decrease the incidence of allergy as compared to infant-mother pairs who do not adhere to these interventions?

Looking for information on probiotics and allergy in infants? Check out the Food Allergies - Probiotics and Prebiotics (Infants) Knowledge Pathway.

  • Allergens, 
  • Infants 

PEN® Summary of Recommendations and Evidence:  Where Evidence and Practice Guidance Meet


Short on time, but need a quick and comprehensive overview of the evidence on a topic area? The Summary of Recommendations and Evidence (SRE) is your new favourite tool. The SRE organizes all of the questions in a knowledge pathway by topic. It is your one-stop shop to find the key practice points (including recommendations and graded evidence) for the topics covered in the knowledge pathway. The SRE replaces the Evidence Summary, which was a synthesis of just the evidence part of the key practice points, organized by evidence grade level. The SRE is a stand-alone tool and is mirrored in the Practice Guidance Toolkit, replacing the Key Findings and Recommendations section.  

There are now more than 200 Knowledge Pathways in the PEN System, which means that we have many SREs to create! So far, we have created more than 80! The remainder of SREs will be in the former Evidence Summary format until content in those KPs are updated or new content is added.

Here are the latest new or updated Summaries of Recommendations and Evidence:
  • Pregnancy Summary of Recommendations and Evidence
  • Gerontology Summary of Recommendations and Evidence
  • Cardiovascular Disease - Hypertension Summary of Recommendations and Evidence
  • Cardiovascular Disease - Dyslipidemia Summary of Recommendations and Evidence
  • Weight/Obesity- Dietary Approaches Summary of Recommendations and Evidence
  • School Health Summary of Recommendations and Evidence
  • Healthy Lifestyle - Eating Together Summary of Recommendations and Evidence
  • Chronic Obstructive Pulmonary Disease (COPD) Summary of Recommendations and Evidence
  • Systemic Lupus Erythematosus Summary of Recommendations and Evidence

Note: PEN-specific terms used in this article are defined at this link: https://www.pennutrition.com/terminologyfeatures.aspx  
 
Adapted from a December 2018 PEN eNews article.

  • PEN Features 

The PEN Team's Surprise Findings - Back by Popular Demand! 


We publish our surprising findings through out the year now but in the past we released all our findings in one issue. Check out our Surprising Findings for 2018. 

Below are the PEN Team's findings:
  • Dating Profile: Must Love Gluten-free Diets? (Or at least the dieter)
  • Mediterranean Diet Retraction  
  • Are you ready to print your food?
  • When is a diet not a diet?
  • Omega-3’s and Cardiovascular disease
  • Surprising findings about vitamin D and fish oil – maybe you don’t need supplements?
  • PEN System is definitely “making the GRADE”
  • Time Flies
  • Calcium Supplementation and PMS
  • Using levies to improve eating behaviours
  • Primary and Secondary CVD Prevention and Daily Fish Intake – Wow!
  • Surprising findings about Fluoride
  • Nutritional considerations for transgender people  

Adapted from a December 2018 PEN eNews article.

  • PEN Features 

PEN® International Guideline Collections


Many knowledge pathways include a tool called the International Guideline Collection. These collections gather all of the clinical practice guidelines on a specific topic from our global partners and around the world.

There are over 20 International Guideline Collections. Here are the latest ones that are new or have been updated:
  • International Nephrology Guidelines Collection
  • International Chronic Obstructive Pulmonary Disease (COPD) Guideline Collection
  • International Parkinson’s Disease Guideline Collection
  • International Weight/Obesity Guideline Collection (Children and Adults) 
  • International Caffeine Guidelines Collection

Looking for the entire list of International Guidelines Collections, look no further than here.


  • PEN Features, 
  • PEN Uses 
PEN eNews
PEN: The Global Resource for Nutrition Practice  
February 2020  Volume 10 (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
  • Heart Health: The PEN System Has So Much To Share
  • What Herbal Beverages/Supplements are Safe to Take During Pregnancy and Lactation?
  • Allergy - High Risk Infants
  • PEN® Summary of Recommendations and Evidence: Where Evidence and Practice Guidance Meet
  • The PEN Team's Surprise Findings 2018 - Back by Popular Demand
  • PEN® International Guideline Collections
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