FONDAMENTI METODOLOGICIDELLA DIETETICA CIVICA

Giorgio Bedogni

Domande

• Qual 6 il ruolo del dietista nella promozione dellasostenibilità alimentare?

• Perché questo ruolo deve essere affrontato conmetodo?

Domande

• Qual è il ruolo del dietista nella promozione dellasostenibilità alimentare?

• Perché questo ruolo deve essere affrontato conmetodo?

Posizione ADA

Position of the American Dietetic Association:Food and Nutrition Professionals Can Implement

Practices to Conserve Natural Resources and SupportEcological Sustainability

J Am Diet Assoc. 2007;107:1033-1043.

Academy of Nutrition and Dietetics

.eato Academy of Nutritionright. and DieteticsThe world's largest organization of food and nutrition professionals.Formerly the American Dietetic Association.

Sostenibilità alimentare

"Sobal and colleagues describe the food and nutritionsystem as the transformation of raw materials intofoods and then nutrients into health outcomes, withinbiophysical and sociocultural contexts"

JADA 2007;107:1033

Journal of Ihinger Environmental Nutrition, 5:2-12, 2010Copyright C Taylor & Francis Group. LLCISSN: 1932-0248 punt/1932-0256 online1)01: 10,1080/193202.10903573983

Taylor fy, Francis1•14.0 kfvoros Grow

Beyond Eating Right: The Emergence of CivicDietetics to Foster Health and Sustainability

Through Food System Change

JENNIFER L. WILKINS,' JULIA LAPP,2 ANGIE TAGTOW,3 andSUSAN ROBERTS4

'cornea olitrrsity, Ithaca. New York, USA'Ithaca College, Ithaca_ New Yoriz, USA

5Etuironmental Nutrition Solutions, Elkhart, Iowa, USA'Susan Roberts Health Concepts, Ankeny, Iowa, USA

8

Per una dietetica "civica"

"Dietetics, as a profession, has remained strikinglyunengaged with the food system — agriculturalproduction, processing and packaging, distribution andstorage, marketing— and its impact on consumers'abilities to 'eat r ight'

JHEN 2010;5-2

Per una dietetica "civica"

"Because the entire food system determines whatfoods are available, it plays a fundamental role inpublic health and nutrition"

JHEN 2010;5-2

Per una dietetica "civica"

"Making food system issues integral to dietetic practicerepresents a transition for the professional, calling fornew applications of skills and expertise"

JHEN 2010;5-2

Sogno o necessità?

"Today, increasing global prevalence of obesity, diet-related diseases, and pervasive hunger and foodinsecurity are among the most visible indicators of foodsystem failure"

JFIEN 2010;5-2

Sogno o necessità?

"Documentation of negative impacts on communitiesand natural resources attributable to the dominantagriculture and food system is fast accumulating andincludes failure of small businesses, school closings inrural communities, greenhouse gas accumulation, soilerosion, water contamination and depletion, anddeclining biodiversity"

JHEN 2010;5-2

Ma pin) funzionare?

"Tangible physical and organizational manifestations ofcivic agriculture— including community-supportedagriculture farms, community gardens, organicagriculture, farmers markets, farmer and foodcooperatives, community kitchens, and specialty nicheproducers a r e on the rise"

JFIEN 2010;5-2

Inputs and Resources

Ecologic andcommunity health

11 modello di Sobal

111 - 111 .Producer

Distributor

Comumer

thiman Health

Outputs and Waste

Ecologic and,:ommunity heahh

FIGI'Rli I Mudd of the food production and nutritioin system.

Table adapted from Saul, J., khan. LK • lipaigns. CA. A cm-emu-II nukki of the food ;Ind nutritionsystem SoctI Science and Medicirk. 1990-0171.7)-463-63 and Ling. T., and M I leasnun, 2004_ Food tr'ars:11,t• Okatle for milaihN. minds dim: markets. London: Lirthf.L.ui it, KAN.JHEN 2010;5-2

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Compiti del dietista secondo HEN/ADA

• providing leadership in the development of "attribute labeling."• engaging stakehoklers in the identification of community food and nutri-

tion needs and in developing food system strategies for addressing thoseneeds.

• drawing upon expertise in nutrients, food and diet to critically analyzedevelopments in agriculture technology.

• using expertise to evaluate the "goodness- of a food based On both healthand sustainability criteria.

• promoting an awareness of environmental. social, and economic external-ities associated with dieta iv advice that go beyond the health and Nvell-being of the clients that dietitians serve.

_MEN 2010;5-2

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Accreditamento (ADA)

"The ADA's Commission on Accreditation for DieteticsEducation (CADE) is the organization's accreditingagency for dietetic training programs"

"To ensure that accreditation requirements andstandards are met, CADE establishes core knowledgeand skill competency sets that graduates of accreditededucational programs must demonstrate"

JFIEN 2010;5-2

CADE - Scientific and Evidence Base

Skills and knouledge OUICOPlit'S

1. CADE 031•C Competency- -Scientific and-Select appropriate indicators and measure

achievement of clink al. programmatic*quality, productivity, economic or otheroutcomes.-

'Justify programs, proclucts, services and careusing appropriate evidence or data:,

-Evaluate emerging research for application indietetics practice-

Rationale for cit•ic dietetics

Evidence Base of Practice"The sustainability and healthfulness of the

food system is determined through theuse of such indicators. In todaysenvironment of concern with resourcedepletion, programs, products andservices will require a greater foundationof supportive evidence. The gk)bal trendtoward sustainability requires assessmentskills for appropriate, evidence-basedapplication to practice. Training in thisrealm should integrate a food systemsperspective.

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Domande

• Qual 6 il ruolo del dietista nella promozione dellasostenibilità alimentare?

• Perché questo ruolo deve essere affrontato conmetodo?

Perché il metodo è essenziale?

Il Dietista e la praticaprofessionale:

Posizioni dell'ANDID.1ssociazione Nazionale

Medicina basata sun' evidenza: il metodo al servizio del paziente

di Giorgio Redogni Uni t i Fegato e Nutrizione. Centro Studi Fegato. AREA Science Park.Rasm izza. Trieste: Socio onorario A NDID

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Perché è il metodo è essenziale?

• Perché consente di aumentare la mia conoscenza a serviziodel paziente/collettività

• ( I l metodo è uno strumento e non un fine)

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Impact of Garden-Based Youth NutritionIntervention Programs: A ReviewRAMONA ROBINSON-O'BRIEN. PhD, AD: MARY STORY. PhD, AD: STEPHANIE HEIM, MPH

ABSTRACTclarden-bastNI nutrition-education programs for youthare gaining in popularity and are viewed by many as apromising strategy for increasing preferences and im-proving dietary intake of fruits and vegetables. This re-view examines the scientific literature on garden-basedyouth nutrition intervention programs and the impact onnutrition-related outcomes. Studies published between1990 and 2007 were identified through a library search ofdatabases and an examination of reference lists of rele-vant publications. Studies were included i f they involvedchildren and adolescents in the United States and exam-ined the impact of garden-based nutrition education onfruit and/or vegetable intake, willingness to taste fruitsand vegetables, preferences for fruits and vegetables, orother nutrition-related outcomes. Only articles publishedin peer-reviewed journals in English were included in the

Quale evidenza?

review. Eleven studies were reviewed. Five studies tookplace on school grounds and were integrated into theschool curriculum, three studies were conducted as partof an afterschool program, and three studies were con-ducted within the community. Studies included youthranging in age from 5 to 15 years. Findings from thisreview suggest that garden-based nutrition interventionprograms may have the potential to promote increasedfruit and vegetable intake among youth and increasedwiltingness to taste fruits and vegetables among youngerchildren; however, empirical evidence in this area is rel-atively scant. Therefore, there is a need for well-designed,evidenced-based, peer-reviewed studies to determine pro-gram effectiveness and impact. Suggestions for futureresearch directions, including intervention planning.study design, evaluation, and sustainability are provided,

An7t Dirq Assoc. 2009309:2 73-280.

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Review of the Nutritional Implications ofFarmers' Markets and Community Gardens:A Call for Evaluation and Research EffortsLACEY AFNESON IlkCORVP0( MI41. I l i t E l a A NELSON LASKA PhD. RD. NICOLE L LARSON, PhD NPR V A R Y srow, PhD RD

ABSTRACTThe development and procnotion of farmers markets andcommunity gardens is growing in popularity ag a 5trateo-to incrraxe mmmunity-wide fruit anti vegetable con-sumption. Despite large numbers of farmers' marketsand community gardens in the United States. as well aswidespread enthusiasm for their uwe as a health promo-lion tool, huh- is known about Owir influcence on dietaryintake. This review examines the current scientific liter-ature on the implications of farmers' market programsand community gardens on nutrition-nil it tea outcome* inadults. Studies pubhshed between -linuary 19S0 andJanuary 2009 were identified via PubMed and Agricoladatabase searehee and by examining reference Iona fromrelevant studies Studio* were included in this review ifthey took place in the United States and qualitatively orquantitatively examined nutrition-re6ted outrocnes. in-cluding dietnry intake, attitudt-s and beliefs nlardingbuying prepanng• or eating fruits and vegetables: and

Quale evidenza?

behaviors and perceptions related to obtammg producefrom a fanners- market or conummity garden- Studiesfocusing on garden-based youth programs were excluded.In total. 16 studies were identified for inclusion in thisreview. Seven studies focused on the impact of farmers-market nutrition programs for Special Supplemental Nu-tritinn Program for Women. Infants. and Children partic-ipants_ five focused on the influence of Carmen!: marketprograms for *onions, and four focused on community

Lrdesai Findings from this review reveal that few well.recworrit studies • eg. throw. incorporating controlgroupai utilising valid and reitahLe dietary astonernenttoothed' to evaluate the influence of farmers' marketsand community gardens on nutntion•rtilated outcomeshave been completed. Recommendations for future re-seareh on the dietary ineuerwee of farmers' markets andcommunity gardens are provided.J Alm Mer Asilcr 2010310:399-40S

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Examining Associations among Obesityand Per Capita Farmers' Markets, GroceryStores/Supermarkets, and Supercentersin US CountiesSTEPHANIE B. JILCOTT. PhD; THOMAS KEYSERLING, MD, MPH THOMAS CRAV,TORD, PhD, JARED T. McGOIRT, MPH,ALICE S. AMMERMAN, OrPH, RD

ABSTRACTFruit zind vegetable consumption is an important compo-nent of a healthful diet, yet fruits and vegetables areunderconsumed, especially among low-income groupswith high prevalence rates of obesity. This study useddata from the US Department of Agriculture EconomicResearch Service Food Environment Atlas to examinecounty-level associations among obesity prevalence andper capita farmers' markets, grocery stores/supermar-kets, and supercenters, adjusted for natural amenities,percent black. percent Hispanic, median age, and medianhousehold income, stratified by county metropolitan sta-tus. In models that included all three of the food venues.supercenters and grocery stores per capita were inverselyassociated with obesity in the combined 1 metro and non-metro) and metro counties. Farmers* markets were notsignificant in the model for combined (metro and non-

metro) or for metro counties alone, but were significantlyinversely related to obesity rates in the model for non-metro counties. I n this ecologic study, density of foodvenues '‘Vfis inversely associated with county-level obesityprevalence. Thus, future research should examine similarassociations at the individual-level.J Ain Diet Assoc, 2011;111:567.572.

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Cabinet Office

Aria di cambiamento?

About the National Security C o n s t h u t i o r t a lCabinet Office R e f o r m

GovernmentEfSciency

Transparency Big Society Government:How it work*

Behaviour Change and Energy useThe Brihnviourel Insights Teem has publiShied a report setting outhow we can use behavioural insights to help people save energyend money. The report, Behawour Change end Energy Use,launchea a senea or tliala and changes lo government poi cy wNchovI matte it °ester or lr.dIvidu l o green their homes and use lessenergy,

DownloadsBehaviour Change end Energy the in PDF Format

lie type mt. POP - Poristle Document tomtit F la site 300

Embed downloads4113•.11•NO wor • - i i i i p . . ',MACON:4,6913MA, gov 1.1011010111MPINOMNIMMIDADIMINPIIVIOW 41111190 I n a l i t t i rgy 4slitt 9111,0130,b1MOW LAIIINPS IWO t n e a p UNIOn Poe

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Aria di cambiamento?

"Four field trials based on behavioural insights will testwhether different interventions increase the likelihoodof people installing green products in their homes"

http://www.cabinetoffice.gov.ukisites/default/filesiresourcesibehaviour-change-and-energy-use.pdt

Conclusione

• Credere in un'impresa è necessario ma non èsufficiente

• Darsi attivamente da fare (compatibilmente coipropri valori e le proprie possibilità) è necessario manon è sufficiente

• Occorre darsi da fare con metodo

Conclusione

• I l metodo sarà anche solo uno strumento, ma senzametodo non abbiano alcuna possibilità di realizzare ivalori in cui crediamo e poca possibilità di farliaccettare ad altri, specialmente se sono quelli che"tengono le redini" del gioco...

Grazie