Abstract
Background: Low professional confidence and perceived competence create tangible barriers to integrating sustainable food systems (SFS) and diets into dietetic practice. One opportunity to facilitate more systemic integration into dietetic education and training is to include these concepts in professional standards. To better understand the barrier of low professional confidence and perceived competence for engagement with SFS-related practice, the purpose of this research was to investigate dietetic training standards for SFS content and to highlight opportunities for growth within the profession. Questions posed by this research are: (1) how, if at all, are SFS and diets articulated in dietetic training standards, and (2) to what level of cognitive complexity? Methods: A content analysis of dietetic training standards documents was conducted between 15 April and 15 September 2021. Search terms included 'sustain*' or 'sustainable', 'food systems' and/or 'diets'. Extracted data with applicable SFS content were analysed for level of cognitive complexity requirements. Results: Of 47 National Dietetics Associations, researchers obtained 23 dietetic training standards documents, of which 16 included SFS-related content. The majority of documents used broad descriptors of the concepts, with little granularity and at a lower level of cognitive complexity.
Abstract from Higgins M, Strother H, Burkhart S, et al.: Sustainable food systems and diets in dietetic training standards: an international content analysis. J Hum Nutr Diet. 2023;36(3):957–966.
Knowledge Transfer of Fiona McCullough (Nottingham)
Key Points
This research examined how countries are training dietitians for sustainable food systems (SFS) competence.
Of 23 dietetic training standards reviewed, 16 included SFS-related content.
More than 50% used broad/general language with little granularity; 59% require shallow depth of knowledge.
More robust frameworks adaptable to regional contexts would strengthen the training and ability to contribute to SFS.
Commentary
The paper, published in 2023, highlights the need to embed sustainability principles within all aspects of dietetic practice. In 2015, the 2030 Agenda for Sustainable Development was adopted by the United Nations member states. Since then, the United Nations Educational, Scientific and Cultural Organization has prioritised raising awareness regarding sustainability [1]. The research examined the international landscape of dietetics education – specifically, are SFS and sustainable diets articulated in dietetics curricula and to what level of cognitive complexity? A sustainable diet considers not only the nutritional needs of individuals but also the environmental and social impact of food production; however, this is over-simplistic. Helpfully, the paper defines both sustainable diets and food system sustainability and notes that these are inseparable from one another.
The authors carried out a content analysis of dietetic training standards in spring 2021 and collected information from 47 National Dietetics Associations, which yielded 23 dietetic training standard documents. Extracted data were analysed using open coding. The level of cognitive complexity varied in the training standards from a more shallow depth of knowledge to Understand through to Apply, and some required deeper levels such as to Analyse and to Create.
There was a lack of specific reference in 30% of the documents examined. The paper tabulated (Table 3 in [4]) the common language used for SFS-related content in the standards for dietetics education. The guidance from the European Federation of the Associations of Dietitians (EFADs) Competences (2016) was mentioned [2].
Dietetic educators have the responsibility to ensure curricula are up to date and incorporate emerging relevant areas. Universities serve as knowledge hubs, equipping students with the tools to apply their knowledge. Students are often passionate about this topic and expect to advocate for SFS, influencing policies and practices within their work. Existing practice areas well-reflected in a recent review of dietetics education in Canada by Everitt et al. [3] included Food and Nutrition Expertise, Management and Leadership, Food Provision, and Population Health Promotion.
The paper does not provide ideas for content, but from the perspective of the EFAD Education and Lifelong Learning Committee (ELLLC) this could include:
1. Principles of Sustainable Nutrition: the environmental, social, and economic dimensions of food production and consumption.
2. Food Systems and Supply Chain: how food is produced, processed, distributed, and consumed; the impact of agriculture, transportation, and food waste.
3. Climate Change and Agriculture: the connection between diet and climate change; the environmental footprint of different types of diets and the role of agriculture in contributing to greenhouse gas emissions.
4. Ethics and Social Responsibility: the ethical considerations related to food choices, promoting awareness of fair trade, social justice, the well-being of agricultural workers.
5. Policy and Advocacy: exploring ways to advocate for policies that support sustainable practices and address public health concerns.
6. Alternative Protein Sources: such as plant-based diets, insect protein, and lab-grown meat, considering their nutritional value and environmental impact.
7. Nutrition Education and Behaviour Change: how to promote behaviour change towards more sustainable food choices.
8. Waste Reduction and Circular Economy: understanding how in the food industry these are essential components.
9. Local and Seasonal Eating: the benefits of consuming locally and seasonally available foods.
Embedding such topics, through real-world case studies and practical experiences, will allow the development of problem-solving skills and ultimately produce graduates who are equipped to address the complex challenges and opportunities presented.
Interestingly, the dietetic workforce can feel less knowledgeable about this topic than young people. Hence EFAD has been actively involved in promoting sustainable diets and integrating sustainability into dietetic practice, considering nutritional needs of individuals and the broader ecological and social implications of food production and consumption. In 2022, EFAD Learning produced a freely available lifelong learning module on Sustainable Diets. The content includes a position paper, recipes, and learning aimed to support dietitians with promoting plant-based diets, reducing food waste, advocating for SFS, and considering the environmental impact of dietary recommendations. The aim is to build the professional confidence and perceived competence around sustainability that the paper refers to.
Supporting higher education institutions (HEIs) to showcase sustainability effectively remains a priority. At the EFAD Congress in 2023, a parallel session on Sustainability, predominantly for HEI teachers, was held. Currently, a project working group is being set up to continue to map practice and enhanced consistency of provision. The ELLLC members will be approaching HEIs about this project over the next 12 months.
In conclusion, sustainability is a topical issue and within dietetics curricula needs space to be embedded and developed to an applied level within food service, public health and clinical dietetic processes, as well as the dietary advice provided. This learning should be captured appropriately within programme documentation.
Disclosure Statement
I hereby declare that there are no conflicts of interest with regards to this commentary.