Food security, defined as having access to sufficient safe and nutritious food to meet dietary requirements, is an aspect of person-centered care that concerns dietitians who support people to manage and improve health using food and nutrition(1). Given the increasing levels of food insecurity (FI) in some countries(2,3) there is a need to outline the roles of the dietitian in supporting people at risk of or experiencing FI, aiming to enhance existing practice.
This study aimed to identify and review the scope of the available evidence on the role and impact of the dietitian, when supporting people experiencing or at risk of FI and identify current training and gaps.
A scoping review was conducted to identify the available published peer-reviewed and grey literature on the topic, in line with the JBI approach. Databases: MEDLINE, CINAHL, Embase, Scopus, Web of Science, and Pubmed were searched using relevant keywords, namely the 4 key terms listed below in July and December 2022. Searches of the grey literature focussed on international and UK dietetic professional bodies (e.g: British Dietetic Association, Academy of Nutrition and Dietetics). Studies were included if they were published after 2008 in English and reported original research of any methodology, from any country, including case studies, strategic position statements, and practice recommendations. Articles were summarised descriptively using tables and thematic synthesis was used to identify initial emerging dietetic roles.
A total of 14 articles were included: position statements (n = 3), practice guidance (n = 3), primary research (n = 6), and case studies/reports (n = 2). These encompassed clinical, community, and household areas of practice in Canada (n = 1), the USA (n = 9), the UK (n = 3), and Europe (n = 1). Two studies reported the role of dietitians working directly with people experiencing FI, including training dietetic interns within a food bank and providing education on food choice. Practice recommendations, including FI screening, were outlined in four articles featuring guidance from the USA. One study highlighted dietitians’ awareness and use of validated screening tools. Dietitians’ roles vary, including identification and screening, community interventions, and policy development. Gaps exist in evidencing the impact of the dietitian and supporting people with FI and formal training and tools.
The limited available global literature at the time of the scoping exercise suggests dietitians hold a range of roles to support people experiencing FI. This synthesis and identification of gaps can underpin future work aimed at better resourcing dietitians and evidencing their impact
Acknowledgments
The authors would like to thank the BDA dietitians for their contribution.
