Position of the academy of nutrition and dietetics: the role of nutrition in health promotion and chronic disease prevention

FROM THE ACADEMY
Position Paper
Position of the Academy of Nutrition and Dietetics:
The Role of Nutrition in Health Promotion and
Chronic Disease Prevention
It is the position of the Academy of Nutrition and Dietetics that primary prevention is the It is the position of the Academy of Nutrition most effective and affordable method to prevent chronic disease, and that dietary inter- and Dietetics that primary prevention is the vention positively impacts health outcomes across the life span. Registered dietitians most effective and affordable method toprevent chronic disease, and that dietary in- and dietetic technicians, registered are critical members of health care teams and are tervention positively impacts health out- essential to delivering nutrition-focused preventive services in clinical and community comes across the life span. Registered dieti- settings, advocating for policy and programmatic initiatives, and leading research in tians and dietetic technicians, registered, are disease prevention and health promotion. Health-promotion and disease-prevention critical members of health care teams andare essential to delivering nutrition-focused strategies are effective at reducing morbidity and mortality and improving quality of life, preventive services in clinical and commu- and have a significant impact on the leading causes of disease. By applying these prin- nity settings, advocating for policy and pro- ciples within a social ecological theoretical framework, positive influence can be applied grammatic initiatives, and leading research across the spectrum of engagement: at intrapersonal, interpersonal, institutional, com- in disease prevention and health promotion.
munity, and public policy levels. Through the application of efficacious and cost-effec-tive interventions, registered dietitians and dietetic technicians, registered, can posi-tively impact public health as well as health outcomes for the individuals that theycounsel. This position paper supports the “Practice Paper of the Academy of Nutritionand Dietetics: The Role of Nutrition in Health Promotion and Chronic Disease Preven-tion” published on the Academy’s website at: J Acad Nutr Diet. 2013;113:972-979.
THISPOSITIONPAPERSUPPORTS careLifestyleinterventionshave counselingprovidedbyanRD,when equipped to provide essential HPDP inter- ling, and warrants action. As risk factors CHRONIC CONDITIONS RELATED
systematic review of the scientific evi- TO DIETARY CONSUMPTION
that foster poor dietary and physical ac- JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
2013 by the Academy of Nutrition and Dietetics.
FROM THE ACADEMY
Overweight and Obesity
Rates of diabetes are considerably higher Cardiovascular and
Cerebrovascular Disease
cers of the breast, endometrium, ovaries, cholesterol, and high triglyceride levels disease, stroke, and heart failure), met- ease), degenerative diseases (eg, arthri- Diabetes Mellitus
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
FROM THE ACADEMY
tivity results in a 30% reduction of colon higher density of fast-food restaurants.
Osteoporosis
tively related to diet quality, and higher borhoods). In addition, social ecological level factors (eg, Dietary Guidelines for agricultural, or federal assistance regula- nature, social ecological models are read- ily applicable to complex and multifacto- rial HPDP efforts. In addition, the ability view of the role of these dietary factors mediated by social support, social capital, and social and physical disorder (ie, anti- social behavior of residents and deterio- ration of built environment) in the neigh- SOCIAL ECOLOGICAL
FEDERAL GUIDELINES FOR
PERSPECTIVE AS A
FRAMEWORK FOR HPDP
Healthy People 2020
For the past 30 years, national priorities that aim to prevent the disease risk fac- bers, these objectives serve as a guiding tion” of health issues or diseases (eg, spond to this multifactorial context.
spective” to effectively address public in turn are likely to influence food in- JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
FROM THE ACADEMY
COST EFFECTIVENESS OF HPDP
INTERVENTIONS
MNT is the legal definition of nutrition as obesity, hyperlipidemia, and other CVD and stroke, cancer, arthritis, and respi- screening all adults for obesity and recom- Preventive Services 2012, the USPSTF dividuals and groups regarding HPDP.
care clinicians or by specialists such as evidence of the cost effectiveness of in- Preventive Services, also from the USP- report focus on the integration of a life- found to be more expensive for the first be less expensive in years 2 and 3 of the depending on patient characteristics.
LIFE-CYCLE PHASES AND
POPULATION SUBGROUPS
Racial/Ethnic Minorities and
Immigrants
National Prevention Strategy
The National Prevention Strategy: Amer- ica’s Plan for Better Health and Wellness Affordable Care Act. This report reflects The USPSTF
strategies to support preventive services provides insights into best practices.
In The Guide to Clinical Preventive Ser- life span, and to eliminate health dispar- vices 2012, the USPSTF summarizes the JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
FROM THE ACADEMY
Maternal and Infant Health
weight or obesity and physical inactivity, less healthy dietary intake patterns have consume at least 3 cups of milk a day.
ence of acculturation must be noted.
tivity of at least 60 minutes per day dur- others (eg, breast, prostate, lung, colon) Adult Health
risk factors by BMI level, the prevalence These disease risk profiles can be nega- weight, and not having a diagnosis of di- tions will take on increased significanceas the US population ages. Central to Early and Middle Childhood
Persons with Low SES
that the population lives long lives that tors such as total cholesterol, triglycer- ence to needed lifestyle modifications.
recently released its “Position the Acad- and a higher rate of hospitalizations are quality of life, health, and wellness into PHYSICAL ACTIVITY AND ITS
pletely explain the disparities in diabe- ROLE IN HEALTH PROMOTION
Adolescent Health
facilities, rather than of individuals, ap- stage of life that defines this transition engage in 1 hour of physical activity ev- from childhood to adulthood is crucial.
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
FROM THE ACADEMY
CONCLUSIONS
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Academy of Nutrition and Dietetics position adopted by the House of Delegates Leadership Team on October 26, 1997 and reaffirmed on June22, 2000; May 24, 2004; and November 4, 2010. This position is in effect until December 31, 2017. The Academy authorizes republication of theposition, in its entirety, provided full and proper credit is given. Readers may copy and distribute this paper, providing such distribution is notused to indicate an endorsement of product or service. Commercial distribution is not permitted without the permission of the Academy.
Requests to use portions of the position must be directed to the Academy headquarters at 800/877-1600, ext. 4835, or Authors: Deborah Leachman Slawson, PhD, RD, LDN, East Tennessee State University, Johnson City, TN; Nurgul Fitzgerald, PhD, MS, RD,Rutgers-The State University of New Jersey, New Brunswick, NJ; Kathleen T. Morgan, DrMH, DTR, Rutgers-The State University of New Jersey,New Brunswick, NJ.
Reviewers: Sports, Cardiovascular, and Nutrition dietetic practice group (DPG) (Jenna A. Bell, PhD, RD, Consultant, New York, NY); PublicHealth/Clinical Nutrition DPG (Aurora Buffington, MS, RD, Southern Nevada Health District, Office of Chronic Disease Prevention and HealthPromotion, Las Vegas, NV); Sharon Denny, MS, RD (Academy Knowledge Center, Chicago, IL); Nutrition Education for the Public DPG (VivianHaley-Zitlin, PhD, RD, LD, Clemson University, Clemson, SC); Jane E. Heetderks-Cox, MS, RD, Consultant, Austin, TX; Mary Pat Raimondi, MS, RD(Academy Policy Initiatives & Advocacy, Washington, DC); Brenda Richardson, MA, RD, LD, CD, Dietary Consultants, Inc, Richmond, KY; NutritionEducation of Health Professionals DPG (Lona Sandon, MEd, RD, LD, UT Southwestern Medical Center, Dallas, TX); Marsha Schofield, MS, RD, LD(Academy Nutrition Services Coverage); Patricia L. Simmons, MS, RD (Missouri Department of Health and Senior Services, Jefferson City, MO);Alison Steiber, PhD, RD (Academy Research & Strategic Business Development, Chicago, IL); Academy Quality Management Committee (ValareeWilliams, MS, RD, LDN, University of Pennsylvania Health System Philadelphia, PA).
Academy Positions Committee Workgroup: Christine A. Rosenbloom, PhD, RD, LD, CSSD (chair); Karen P. Lacey, MS, RD, CD; Jamie Stang, PhD,MPH, RD (content advisor).
We thank the reviewers for their many constructive comments and suggestions. The reviewers were not asked to endorse this position or thesupporting paper.
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS

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