Continuing Education

The 2015-2020
Patricia A. Rouen, PhD, FNP-BC,
and Brenna R. Wallace
Overview and Implications for Nursing Practice

72 Volume
Vollume 35 | Number
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Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

its. 2014. 1969. re. functional status.. This article reviews the 2015-2020 Dietary Guidelines for Americans released in 2016. Nursing and Nutrition The high prevalence of Nursing’s interest in nutrition obesity in the United States. or situational factors such as dates back to Florence Night- where 45% of all adults (Fryar food insecurity and disparity ingale who emphasized the et al. The National Health and Nutrition Exami. Ekman et al. tion of the Dietary Guidelines and cancer (Cahill et al. & Morgan. 2016. 132). stronger support to address nutrition issues. Key recommendations are summa- rized and significant changes in the guidelines are highlighted. for Americans: 2015-2020 Centers for Disease Control (HHS & USDA. a growing purpose of this article is to body of evidence has also present an overview of the documented that healthy eat. Inc. 2016b). Medicaid Services.S. Reedy et al. With the implementation of the Patient Pro. intake of nonnutritive foods. 2016a) and approxi. Fitzgerald. 2013. contribute to the nutritional status of the clients etary patterns and chronic disease prevalence they serve. The eighth edi- lar disease (CVD). tions in nutrition may de.S. daily hab- 2014). 2010.org) includes goals to decrease the he has had and how much he ought to have today” numbers of obese adults and children and to in. consider.. your patient’s diet. Nurses conduct assessments of physi- among Americans of all ages and cultures (CDC. Altera. These sources. ment. © sarsmis / shutterstock weight. All rights reserved. Lastly. and dietary patterns to identify nutritional February 2017 Home Healthcare Now 73 Copyright © 2017 Wolters Kluwer Health. “have a rule of thought about mote nutritional health. has prompted Nightingale advised nurses to national initiatives to pro. cardiovascu. remember how much healthypeople. A nutritious diet plays a foundational role in tection and Affordable Care Act (2010) that empha- health promotion and disease prevention.... cal and mental health.. 2011). 68). (HHS) and U. to 19 years are affected (Fryar On the topic of nutrition. Healthy People 2020 (www. 1983. ongoing health maintenance. 2014). 2015) was re- and Prevention [CDC]. reproduction. Implications for nursing practice to promote nutrition health are identified and resources to support implementation are included. (Nightingale. the U. the healthcare system now provides 2013. or of Agriculture (USDA) pub- situational factors such as lish a report every 5 years food insecurity and disparity that provides evidence-based that limit access to food dietary guidelines. sizes preventive care and the Medicare Chronic Adequate nutrition is essential for human Care Management model (Centers for Medicare & growth and development. diabetes. health-promoting care for those with chronic and quality of life (Slawson. Estruch of clinical disease. 2014). interventions. Department take of nonnutritive foods.. guideline recommendations ing patterns support wellness Alterations in nutrition may and their implications for and reduce chronic disease develop as a consequence nursing practice. dietary et al. 2015) which funds monthly covery from illness. leased in January 2016. p. Although robust guidelines inform health data have demonstrated the policy and program develop- relationship between un. With a holistic approach crease the proportion of primary care office visits that emphasizes health promotion and person- that include education related to nutrition and centered care (American Nurses Association. et al. dietary in. nurses are well-positioned to nation Survey (NHANES) annually reports the di. Public Health Reports. sources. that limit access to food importance of food to prevent mately 18% of youths ages 2 illness and promote healing. and provide recom- healthy diets and elevated mendations for nutrition rates of obesity.. Department of velop as a consequence of Health and Human Services © Alina555 / iStock clinical disease. The George et al. p. diseases. 2014. . (Bazzano et al.

vitamins. 2015. and preferred. 2014). vege- fats and reduce sodium intake. as one of the most powerful tools to reduce obe. 36). 12). This recommendation emphasizes that “nutritional centrated on individual nutrients and food groups.-style eating pat- tern encourages Americans to eat more fruits and vegetables from all groups and colors. sodium (HHS & USDA. poultry. frozen. The vegetarian pattern increases the in- evaluate patient outcomes to ensure optimal health take of total and whole grains and provides specific for their patients (DiMaria-Ghalili et al. 3). minerals.. Protein options include seafood. In addition eat more fruits and vegetables from to diet. pattern encourages Americans to lean meats. and soy products (HHS & USDA. needs should be met primarily from food” (HHS & but the new recommendations emphasize overall USDA. Nutrient Density. Fruits are best eaten whole and not juiced or 74 Volume 35 | Number 2 www. eggs. legumes. nuts.. all groups and colors. Oils from plant sources and natural oils in foods such as nuts. iron. 2016. Compared to the concerns (DiMaria-Ghalili et al. few refined starches. 15). eggs.S. p. use low-fat or fat-free dairy products and include grains. and Amount sity and chronic disease. Nutrient-dense choices 3) limit calories from added sugars and saturated are available across all food groups. style. use low-fat or Table 1 presents the food group components fat-free dairy products and include of the three healthy eating patterns using a grains. style. dietary intake over time” (HHS & USDA. are similar to the U. 12). p. beverages that constitute an individual’s complete and minerals (e. 2015). seeds.g. ries. and soy products. and little 2) focus on variety. Reed). p. nutrient density. and provide nutrition education. 2016. legumes. seafood. and seafood are The Healthy U. 2) the Healthy-Mediterranean style and 3) the Healthy-Vegetarian style” (Health Policy Brief. and lean meats and poultry are consid- ered nutrient-dense foods (HHS & USDA. the Mediterranean diet permits a half cup In collaboration with healthcare providers. U. 2015. 15). Three eating pat- terns are presented as exemplars: “1) the Healthy- U. All rights reserved. The 2015-2020 Dietary Guidelines The 2015-2020 guidelines emphasize healthy eating Guideline 2: Focus on Variety. and amount. regular physical activity is recommended. Nutrient-dense foods and bev- eating patterns that accommodate personal and erages are those items that provide a lot of nutrients cultural preferences (HHS & USDA. at least half of which should 2. . For all three plans.S. nurses more fruit. Inc. p. p.-style pattern with few differ- ences. products. Both the Mediterranean.and vegetarian-style eating patterns be whole grains.S. reduces the dairy intake by one cup. at least half of which should be whole grains (HHS & USDA.S. legumes. Guideline 1: Follow a Healthy Eating Fruits and vegetables can be fresh. seeds. low-fat and fat-free dairy eating patterns for all (HHS & USDA). seeds. The Healthy U. p.homehealthcarenow. p. sugars or solid fats. All fruits. monitor dietary plans. weekly amounts for proteins such as eggs. Reed. 12). nuts.S.-style eating recommended. mobilize resources to adds an ounce to the protein choices with seafood support food security. 4) shift to healthier tables. whole grains.000-calorie plan (HHS & USDA. or choline). the recommendations for vegetables and oils are the same. or dried in cooked or raw forms. Nutrient-dense choices should have no added low a healthy eating pattern across the lifespan. Fruits An eating pattern is “the combination of foods and and vegetables are rich sources of fiber.org Copyright © 2017 Wolters Kluwer Health. potassium. fiber) with relatively few calo- document addresses five major guidelines: 1) fol. 2015). Previous guidelines con. An eating pattern should include calories to © MKucova / iStock provide adequate nutrition for a healthy body weight and varies by individuals.. The (vitamins. Pattern Across the Lifespan canned. un- food and beverage choices. and 5) support healthy salted nuts and seeds.

canned fruits should have low sugar amounts or and eggs is recommended. 2012). peas) 1½ c-eq/wk 1½ c-eq/wk 1½ c-eq/wk Starchy 5 c-eq/wk 5 c-eq/wk 5 c-eq/wk Other 4 c-eq/wk 4 c-eq/wk 4 c-eq/wk Fruits 2 c-eq/day 2½ c-eq/day 2 c-eq/day Grains 6 oz-eq/day 6 oz-eq/day 6½ oz-eq/day Whole grains ≥ 3 oz-eq/day ≥ 3 oz-eq/day ≥ 3½ oz-eq/day Refined grains ≤ 3 oz-eq/day ≤ 3 oz-eq/day ≤ 3 oz-eq/day Dairy 3 c-eq/day 2 c-eq/day 3 c-eq/day Protein Foods 5½ oz-eq/day 6½ oz-eq/day 3½ oz-eq/day Seafood 8 oz-eq/wk 15 oz-eq/wk N/A Meats.gov/ dietaryguidelines/2015/guidelines/ Office of the Disease Prevention and Health Promotion (ODPHP. eq = equivalents. and 5 (pages 79-88) in the U. g = gram. and cancer risk (McEvoy et al.. poultry. For adults. and seafood provide heme iron. canned products. Yates et al. Eggs are a com. sodium or rinsed before cooking to remove salt. amounts of sodium.000 Calories U. c = cup.S.-Style Mediterranean Vegetarian Food Groups Amounts Amounts Amounts Vegetables 2½ c-eq/day 2½ c-eq/day 2½ c-eq/day Dark green 1½ c-eq/wk 1½ c-eq/wk 1½ c-eq/wk Red & orange 5½ c-eq/wk 5½ c-eq/wk 5½ c-eq/wk Legumes (beans. For exam. The 2015 guidelines rec. wk = week. soy products 5 oz-eq/wk 5 oz-eq/wk Nuts. 4. If be included in diets but require attention to the refined grains are chosen. meats. 26 ounces weekly of meats. Department of Health and Human Services and U. = United States.dried. Eating patterns with less meats and few necessitating smaller servings. 2015. Seafood is a and Reduce Sodium Intake healthy protein and rich source of polyunsaturated As strong evidence demonstrates diets high in sat- fatty acids that improve cholesterol and reduce in. rent dietary guideline cautions men and teenage both provide complimentary nutrients.gov) February 2017 Home Healthcare Now 75 Copyright © 2017 Wolters Kluwer Health. https://health.. poultry. minerals. 2015). the cur- Protein choices include animal or plant sources. Department of Agriculture. boys to eat less meat. p. Low-fat or fat-free dairy products pro. saturated fats. eggs 26 oz-eq/wk 26 oz-eq/wk Eggs 3 oz-eq/wk Nuts. When selecting processed meats or poultry reduce CVD. less than 10% of calories flammation (Estruch et al.S. Comparison of the Recommended Healthy Eating Patterns Using 2. Saturated yet. the average American weekly fish intake is 5. 2014). teenage boys and men exceeds 26 ounces. urated fat incur CVD risk. 8th Edition. is not necessary (HHS & USDA. December 2015. poultry.S. Accessed from: http://health. Whole grains are preferred. Added Sugars and Saturated Fats plete protein and a source of iron.. seeds. Processed meats may no added sugars. U. they should have lim. Adapted from Appendix 3. kcal = kilocalorie. 25). vegetable choices should be low diabetes. Trans fat is Table 1.. 2015-2020 Dietary Guidelines for Americans. seeds: 7 oz-eq/wk Soy products: 8 oz-eq/wk Legumes: 6 oz-eq/wk Oils 27 g/day 27 g/day 27 g/day Calories for other uses 270 kcal/day 260 kcal/day 290 kcal/day Note. . and added ited sugar and be enriched with vitamins and sugars in these products (HHS & USDA.S. All rights reserved. obesity. 2014). ologic functions and consumption of saturated fat ommend at least eight ounces of seafood per week. 2013. ple. per day should come from saturated fat. whereas plant-based proteins such as nuts Guideline 3: Limit Calories From and legumes have nonheme iron.5 fat is naturally made in humans to support physi- ounces (Jahns et al. as sugar and calorie amounts are higher. As data show the meat consumption of vide calcium and protein. oz = ounce. Inc.

p. 2015). ben- serum values (Fernandez. p. Low-calorie guideline as there is inadequate evidence of a rela.500 recommended level. sweeteners (e. Kanter et al. and gender have greater influence on serum cholesterol values than diet (Alphonse Guideline 4: Shift to Healthier Food & Jones. exceeding recommended intake limits for refined grains. 2012. and (HHS & USDA). teenage boys and men eat more than the recom- tension. 2015). 2013). sugars from concentrated juices (HHS & USDA. and sodium (HHS & those age 14 and older. Substantial nutrient-dense foods that align with personal and data demonstrate reducing sodium intake lowers cultural preferences. 58). all persons with hyper. lactose. whereas added amounts of natural trans fats are formed in animals sugars are sweeteners added during food process- and found in meats and milk. 2015. Suggested shifts to increase fruit intake in- may lead to adverse events.. The recommendation to limit cholesterol in.. 76 Volume 35 | Number 2 www. Natural sugars are found as low as possible (de Souza et al. A new recommendation protein include quinoa.org Copyright © 2017 Wolters Kluwer Health.300 mg/day recommendation for added sugars. or selecting seafood twice a week are strategies to decrease saturated fat intake. clude serving fruits as side dishes or dessert. The guidelines propose “shift” blood pressure. ge. amaranth. efits on long-term weight loss have not been estab- 2012). 2011). . consuming low-fat or ing that increase calories. 12) and are common in beverages. Added sugars include fat-free versions of these products is encouraged high fructose corn syrup..g. age. 2015. breads to whole wheat or from white rice to brown hypertension (Brown et al. Small in foods such as fruits and milk. is advised. Instead. low sodium intake dishes. and Beverage Choices NHANES reports (USDA. considered the worst type of fat because of its as. or barley. the less than 2. or kidney disease. All rights reserved. Further. Inc. 31).. The previous guideline USDA.. can Americans has been removed from the 2015 The 2015-2020 guidelines recommend shifting to guidelines (Health Policy Brief. 2010). revealing diets that are low in 300 mg threshold (HHS & USDA. lished (HHS & USDA. dairy products. but an Insti. strategies such as choosing vegetables as snacks or tute of Medicine (2013) report presented evidence increasing the amounts of vegetables and decreas- that there was no health benefit of the reduced ing the amount of meat or refined grains in mixed goal and in some populations. Anagnostis et al. 31). netic traits. saturated fats. diabetes. but sex group data show mg for those over age 50. p.. and all Afri.© merc67 / iStock Reducing the amount of meat and adding more beans and vegetables to stews. 2015. To Strong evidence shows added sugar intake is improve whole grain intake. CVD and stroke risk. candy. 2016.homehealthcarenow. shifting from white associated with CVD mortality (Yang et al. vegetables. and di. mended amounts. data demonstrate body weight. 2014) show the average Years of data have documented the eating pat- daily cholesterol intake is 270 mg and below the terns of Americans. Protein is the only nutrient at the recommendation limiting sodium intake to 1.440 mg of oils. 2016). whole grains. 2014). malt syrup. and seafood consumption but are above the sodium daily (HHS & USDA. advises that less than 10% of daily calories should sociation with CVD mortality and intake should be come from added sugars. sucralose) are designated safe to tionship between dietary cholesterol intake and consume but while they may reduce calories. Other whole grains high in fiber and abetes (Hu & Malik.. take to 300 mg daily is not included in the 2015 and baked sweets (Huth et al. 2015). Americans consume approximately 3. obesity. p. fruits.

g. Mediterranean.-style. 2015. school. Using liquid instead of solid fats (e. A multifactorial approach that ad. or © iofoto / iStock choosing unsalted nuts and low-sodium soups. Healthy shifts for dairy products include switch- ing to low-fat or fat-free versions of milk and cheese. Department of Health and Human Services and U. work. 2015).and monounsaturated fats such as sunflower or canola. and seeds as protein dresses diet and physical activity in the context of consumption of meat. Caf. lunch programs and cafete- Shift to healthier choices in Eat 8 oz of seafood weekly rias need nutrient-dense food choices and sched. showing it was not associated patterns are recommended diet with chronic disease risk. 64) in daily sodium to 2. Less than 10% of calories Eat less saturated fats. every food group uled time for physical activity is needed. 33). Reducing the amount of meat and adding more beans and vegeta- bles to stews. butter) is a healthy shift. environments. lines for Americans. include modifying recipes to healthier versions 3–5 cups of coffee/day is Limit alcohol consumption and encouraging families to plan and cook meals part of a healthy eating to one drink/day for women pattern and two drinks/day for men together. Department of Agriculture. from: http://health. 1. and community settings is and poultry meat products recommended.300 mg. but was considered in the disease guidelines as it is a component in foods and bever. 2015. At the community level.S. A new statement indicates Eat a variety of nutrient. natural oils found in foods The recommendation of such as nuts and seeds creating and maintaining healthy eating patterns. Accessed ficial trans fats from processed foods and in 2016. and men to reduce protein nuts.S. 2015–2020 Dietary Guide- In 2015. farmer’s mar- kets and community gardens can improve the sup. Inc. activity ply of healthy foods. vegetables dense foods and grains. with 50% a healthy eating pattern can include three to five coming from whole grains 8-ounce cups per day of coffee (HHS & USDA. Nutrition requirements can ages. daily should come from sodium. December 2015.S. the FDA recommended the removal of arti. Moderate alcohol use was recommended What’s New What’s the Same with a limit of one drink daily for women and up to two drinks daily for men (HHS & USDA. or selecting seafood twice a week are strategies to decrease saturated fat intake. eggs. exchanging a cookie for fruit. or choosing low-sugar yogurt or fortified soy prod- ucts (HHS & USDA. p. avoid processed home. or vegetarian healthy eating all be met with a balanced dressed coffee intake. school. oil choices should be high in poly. sources. . All rights reserved. Sugar and sodium intake can improve by switching from soda to water. and serving sizes needed for physical activity (HHS & USDA). All trans fats will be removed Be aware of fats: Type from food over the next matters more than amounts Food and Drug Administration (FDA) 3 years Contributions Adapted from U. 8th Edition. Table 2. U. and safe public spaces are potassium. vending machines with healthier patterns across settings helpful tool to guide portion options and planned times for activity breaks are (home.500 mg/day for specific Strategies to encourage healthy eating in the home groups was removed. Emphasis on a healthy Healthy eating is the most eating pattern powerful to prevent chronic feine is not a nutrient. Successful change requires that For those over age 14. In schools. 49). p. and added sugars Guideline 5: Support Healthy added sugars Eating Patterns for All The recommendation to limit Consume low-fat or fat-free Nutrition is a population health issue that requires cholesterol to 300 mg daily dairy products has been removed attention to the individual and their surrounding Encourage teenage boys Eat lean meats. work.. sizes communities) possibilities. p. Main Messages in the 2015-2020 Dietary Alcohol and caffeine were addressed in the Guidelines guideline. limit Use plant-based oils or “everyone has a role” (HHS & USDA. Vitamin D.gov/dietaryguidelines/2015/guidelines/ February 2017 Home Healthcare Now 77 Copyright © 2017 Wolters Kluwer Health. poultry. Eat more fruits. Most of the evidence regarding caffeine ad. Food label revisions include Engage in regular physical added sugars. For those Support healthy eating The My Plate method is a in work settings.

org Copyright © 2017 Wolters Kluwer Health. refined grains foods. 2014). As patient-centered providers and the largest tion of these changes is expected by July 2018. Strategies to support to food ingestion. added sugars. dairy products. Lower amounts of meats. and agnoses commonly address imbalanced nutrition: sugar-sweetened drinks or foods are advised. whole grains. 2014. body weight.. RNs are well-positioned to im- emphasize healthy eating patterns that are custom. and rein- Nutrition interventions can prevent disease. social A and C content is not required as these deficien. high chronic disease reduction strategies. Nursing nutrition di- cially processed forms. prove the dietary health of patients.. range for nutritious home-based meals. . Implementa. Dietary counseling is a consis- 78 Volume 35 | Number 2 www. 2014) and may be related healthy eating pattern.. Vitamin cians. with the epidemic of obesity (Fryar et al. revisions to nutrient food labels were announced. 2014). package will be labeled as one serving. and increased prevalence. or hydration status healthy eating and physical activity transcend issues (DiMaria-Ghalili et al. work. healthcare occupation in the United States (DiMaria- In summary. food adjusted to reflect the amounts people are consum. families. eating habits. im. Serving sizes are being tions (e. and seafood consumption but are above the recommended intake limits for refined © gilaxia / iStock grains. including CVD and ment. and ized to individuals and families and include nutri. fruits and whole grains. oils. force nutrition education (Reed. saturated fats. 2016) and for- dairy products. registered dietitian nutritionists. less than or more than body requirements intake erate alcohol and caffeine intake is acceptable in a (Herdman & Kamitsuru. 2014). and plant-based proteins mulate clinical judgments about patients that are is recommended. functional chronic disease risk (Table 2). If items are between one and two servings. communities. fruits. in vegetables. with low-fat and appetite (DiMaria-Ghalili et al. the 2015-2020 Dietary Guidelines Ghalili et al.. In the United patient stressors that negatively affect dietary in- States. physi- (Hoy & Goldman. 2011). revealing diets that are low in vegetables.. Reed asserts that nurses also identify (de van der Schueren et al. and community environments. school. Looker et al. RNs coach patients toward health. espe. RNs assess clinical indicators of ent-dense foods to improve health and reduce nutritional health including cognitive. Nurses sup- home. workers. home-delivered meal programs.. take and body composition and encourage stress- 2016a). All rights reserved. A diet that is higher and hydration status. metabolism. A multi- Added sugars will be required on the labels. health promotion. and reduce healthcare costs et al.). nutrition issues abound. amenable to nursing action..g.. and resources from community organiza- cies are no longer common. and acute and chronic diabetes. Mod. an aging population. ar- disease management (DiMaria-Ghalili et al. Schueren et al. adequate sleep. the goals (HHS & USDA. and data showing 33% to 50% of hos. Years of data have documented the eating patterns of Americans. 2015). 2014). 2015). intake for chronic conditions. Inc. and sodium. faceted interprofessional team approach to potassium and Vitamin D will also be included as improve nutritional health requires registered data consistently show low levels of these nutrients nurses (RNs). seafood.homehealthcarenow. banks) to achieve the 2015-2020 Dietary Guideline ing.. nurse practitioners (NPs). intake of antioxidant-rich foods to attenuate these pitalized patients are malnourished (de van der adverse changes. 2012. Smolowitz prove quality of life. port nutrition interventions during transitions from hospitals to homes that may involve tube Nursing Implications feedings or parenteral nutrition as well as diet Optimal nutrition plays an important role in many management plans to control carbohydrate or fat aspects of health including growth and develop.

edu/academics/public-health/centers/ community-health-promotion/research-tools-and-resources.org dwelling elders demonstrated improved outcomes This site has resources for nutrition assessment and education.. patient handouts. February 2017 Home Healthcare Now 79 Copyright © 2017 Wolters Kluwer Health. Nutrition assessment guides nursing interven. 2012). tent was not sufficient (DiMaria-Ghalili et al. In Patient Protection and Affordable Care Act 2010 http://www. Reed. but did not Rapid Eating and Activity Assessment for Patients (REAP) always include biochemistry courses or clinical https://www. In hospitals. anthropometric measures (e.pdf taught nutrition assessment.com/ et al. A review of telehealth visits for community- http://www. tions. . body mass index). Inc.choosemyplate. tion education in training and practice settings. for diet adherence (van den Berg et al. A survey of My Fitness Pal interprofessional healthcare practitioners (Han- www.. and to guide wellness promotion strategies for a healthy phone applications (Henning.com/getinvolved/hospitalnutritiontoolkit celiac disease (Kris-Etherton et al. specific nutrition issues necessi- ment (Cereda. Nurses also implement dietary inter- This multidisciplinary organization supports nutrition practices for patients and was founded by the Academy ventions that have been shown to reduce the of Medical-Surgical Nurses. Standardized population (HHS & USDA. DiMaria-Ghalili Mini Nutrition Assessment for elders et al. but nurses consistently report the con- counseling. diet counseling. recipes.brown. mental and functional health inventories. 2014). 2012). https://www. suggesting there is a need to improve nutri- of the new labels. and graphics adolescents featuring text messaging have been Choose My Plate successful (Militello et al.com/forms/MNA_english. and Weight Activity Variety and Excess (WAVE) enteral and parenteral nutrition.mna-elderly. 2012.usda.gov/dietaryguidelines/2015/resources. nutrition content can be taught preventive-services-covered-under-aca/ in a single course or embedded within several Link to the preventive services coverage including dietary classes. policy updates. A resource toolkit is available at http://malnutrition. For those with instruments such as the Mini Nutritional Assess. severity. 2012). 2009).myfitnesspal..eatright...gov/ compared with physicians. rendered (Jones et al. Data show that healthcare professionals pro- FDA—Food Label Changes http://www. and clinical laboratory testing.. 2014). mended.gov/Food/GuidanceRegulation/ vide nutrition counseling on a daily-to-weekly GuidanceDocumentsRegulatoryInformation/ basis. nutrition learning experiences. American Academy of Nutrition and Dietetics 2016).. All rights reserved. elders).g.fda. (2014) documented that almost all programs http://www. the Academy of Nutrition prevalence. for Patients. or morbidity related to spe- and Dietetics. cancer. population subgroups https://health. 2014. computer programs. and the Wave Activity Variety and pitalizations.supertracker. diabetes.asp (e. physician assistants. and Excess screen are useful (Gans et al. Nurse-driven evidence-based interven- 2015-2020 Dietary Guidelines for Americans tions tailored to individuals. the Society of Hospital Medicine and cific diseases such as CVD.g.gov/ improved meal appearance increased patient’s in- This site provides healthcare professional and age and culturally relevant patient resources take and decreased readmissions (Navarro et al.. For example. 2012) and including dietary guidelines. diet interventions for powerpoint presentation. chronic disease..htm abilities to manage these issues (Hanson et al. school-based programs to improve diet patterns. implying a need to Instructions on the site require an email to secure use for bolster nutrition content and provide continuing both tools... education in practice organizations. tion assessments also include physical examina- 2012) and accounts for 14% of home care services tions. the Rapid Eating Assessment tate different strategies and a variety of nursing actions are needed to optimize nutrition and Table 3. 2015). discharge education plans. The Alliance to Advance Patient Nutrition demonstrated improvements in fruit intake (Evans http://malnutrition.) documented that NPs had the highest USDA Supertracker prevalence of daily nutrition-related encounters https://www.. but do not report high confidence in their LabelingNutrition/ucm385663.hhs. Nutrition Assessment Tools Ilmonen et al.gov/healthcare/facts-and-features/fact-sheets/ nursing schools. 2012). This site includes the proposed revisions and infographics 2016). or communities are recom- This site includes the guideline.com son et al. Nutri- primary care clinic encounters (Ilmonen et al..tent key nursing activity implemented during hos. or Abbott Nutrition Nurse. children. Tools (Table 3) for evaluating dietary intake The 2015-2020 Dietary Guidelines are intended include food diaries. Nutrition Resources health. 2003). a professional’s toolkit.

clinics.02. …. I. (2014. (2016). 51(5). (2011). and communities to implement dards of Practice (2nd ed.gov/nchs/nhanes/about_nhanes. http://dx. regulators. Hu. Fried-food consumption and risk of type 2 diabetes and coronary artery disease: A prospective study healthcare professionals to provide nutrition edu.cms. and physical therapists. biochemistry. physicians. L. Pan. Coordinated strate- The registered dietitian nutritionist gies are required for successful implementation of (RDN) is a certified professional the guideline goals and should include positive with education and practice practical messages tailored to the unique needs of individuals and population groups along with expertise in food and nutrition access to information and resources regarding nu- science. sugar instruction in food safety.. Rouen.. P. Q. . Copyright © 2017 Wolters Kluwer Health.cdc. and physical therapists. (2016). MD: Author.084129. families. is an Associate Professor at als is essential to support the implementation of McAuley School of Nursing. Chronic healthy eating patterns for the patients.. and their blood pressure: International study of macro/micronutrients and blood pressure.1097/NHH.full. J. Annals of Internal Medicine..110. I. pharma. J. The registered University. 2016). Detroit.. Stevenson. Collaboration with other healthcare profession. FNP-BC. K. A. C. Lui. food and nutrition science. 100(2). FNP-BC. McNichols Road. C. pharmacists.. J. and health- and the behavioral-social sciences. National health and nutrition examination survey. They Alphonse. ernment agencies must ensure a safe and equitable but also reported the nutrition education content food supply to create a culture of health that will in their advanced practice nursing program was achieve the 2015-2020 Dietary Guideline goals. deficiencies with older or complex clients. DOI:10. ing plans in those with eating disorders. McAuley School of Nursing. and develop healthy intake of individuals. Willet. Bunol..3945/ajcn. care organizations (Ivens et al. REFERENCES Academy of Nutrition and Dietetics. trol in insulin-dependent patients. A. Beyond the collaborative efforts of nurses. 519-536. Retrieved from http://ajcn. All rights reserved. as valued 695-701. L.cdc. February). E. R. J. Effects of menopause. C.. Elliott. J. E. (2015). Detroit.114. laborate and consult with nursing and other B.. E. RDNs. gov/chronicdisease/ professionals must work together to promote Centers for Medicare & Medicaid Services. 2016). Effects of low-carbohydrate and low-fat diets: A carbohydrate counting to facilitate glycemic con. clinics.org/ Kolasa. cific nutrient issues such as vitamin or mineral 81(1). P. Cahill.gov/ 80 Volume 35 | Number 2 www..7326/M14-0180 Brown. Nursing: Scope and Stan- tients. Inc. & Rimm.. 161(5). (2010).htm to guide interventions to support the health of Centers for Disease Control and Prevention. randomized trial. and the behavioral-social sciences (Ameri- can Academy of Nutrition and Dietetics. RDNs interact with RNs.). L.114. University of Detroit Mercy. D. P. T. Anagnostis. G. PhD. and other healthcare prevention and health promotion.pdf The 2015-2020 Dietary Guidelines provide evi. & Jones.. 2015).org/content/early/2014/06/18/ capacity to address nutrition-related issues. families. Sun.homehealthcarenow. care management services.edu). PhD. doi:10. May). and organizations. Patricia A.1016/j. F. Hu..org Copyright © 2017 Wolters Kluwer Health. The American Journal of cation content that supports these practitioners’ Clinical Nutrition. What is a registered tings. dietitian nutritionist (RDN) is a certified profes. or community health organizations (Eliot & dietitian nutritionist? Retrieved from http://www. …. institute refeed. pharmacology.maturitas. Silver Spring. resources/about-us/what-is-an-rdn-and-dtr/what-is-a-registered- dietitian-nutritionist NPs. 4001 W.doi.2015. E. Johnston. Revisiting human cholesterol conduct nutritional assessments. East Lansing.1007/s11745-015-4096-7 American Nurses Association. trition in communities. Q. Nurses. The authors declare no conflicts of interest. Wallace is a Senior Dietetics student at Michigan State communities.eatrightpro.. evaluate clinical synthesis and absorption: The reciprocity paradigm and its key data to establish diagnoses. L. C. doi:10. Chronic disease Americans. Inc. Centers for Disease Control and Prevention. dietitians and other healthcare professionals.165456 members of the interprofessional team. Stamler. Van Horn. ajcn. Chan. RDNs col.org/10. Yao. plans of care (Academy of Nutrition and Dietetics. home care set.. doi:10. (2014). A. Robertson.. Lipids. provide Dyer.. W. schools. dentists. gender and age on lipids 2013). Chiuve. organizations and gov- pharmacists.0000000000000503 sional team who address nutrition issues across the lifespan in hospitals. in 2 cohorts of US women and men. P. Hypertension. (2016). Sugar-sweetened beverage. 309-318. Retrieved from http://www. Maturitas. recipes to support wellness. doi:10. D. 667-675. RDNs are uniquely qualified to manage spe. and engage with pa. F. All rights reserved. Reynolds. Michigan. the 2015-2020 Dietary Guidelines for patients.. Lastly.nutrition. RDNs are pivotal members of the interprofes. Retrieved from dence-based recommendations and a framework http://www. Y.1161/HYPERTENSIONAHA. 62-68.... 2013-2014. MI 48221 (rouenpa@udmercy. A. Rouen. Retrieved from https://www.. sional with education and practice expertise in Address for correspondence: Patricia A.262 Bazzano. and communities they serve. & God- sland. 57(4).. Crook. Michigan. Brenna R. teach He.. S. cology. (2015.084129. biochemistry. (2014). University of Detroit Mercy. not adequate for their professional role. and high-density lipoprotein cholesterol subfractions. B.

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J.gov/ Reed. 272-282. you the California Board of Registered Nursing. Role of the registered nurse in pri- Navarro. Liese. Retrieved from ment of Agriculture. practice and research. Accessed July 19.1111/j..1016/j. NHANES 2011-2012.. N. September-October). A. P.doi.. M. doi:10. 130-136. Nightingale.2014. Krause. Position of doi:10.. . Merritt. 2019 and Florida CE Broker #50-1223.. you can print your certificate of earned This activity is also provider approved by contact hours and the answer key. mary health care: Meeting health care needs in the 21st century. (2014). (2014).clnu. Kraft. D.06. Retrieved from https://www. G.com/ce.1016/j. Your certificate Disclosure Statement: is valid in all states..2013. Journal of the therapeutics of omega-3 polyunsaturated fatty acids in chronic in- Academy of Nutrition and Dietetics..pdf Public Health Reports.. Calder. and cancer Yang. D. Worldviews on Evidence-Based Nursing.1016/j.. 1153-1158. & Rainger. M.3945/jn.. Telemedicine and telecare for older patients—a systematic Reedy. intake and decreases readmission rates in hospitalized patients.S. consumed per individual. Depart- tion: Improved nutrition.13563 the Academy of Nutrition and Dietetics: The role of nutrition in Yates. L.. J. B.ars. W..1016/j.homehealthcarenow. 73(2).010 decreased risk of all-cause. 66-77. (2010). 516-524. usda. in Nursing. I. Nutrient intakes from food and beverages: Mean amounts Not. doi:http://dx. Giabra. Ulrich.pharmthera. W.. M.nih.1001/jamainternmed.1741-6787. D. Lippincott Williams & Wilkins is also • For questions.5 contact additional cost. L. Commission on Accreditation. 94-114.95. 82 Volume 35 | Number 2 www. Online Journal of Issues van den Berg. Flanders. 144(6). the American Nurses Credentialing Center’s A passing score for this test is 14 correct answers. E.. Singer. Health promo. Q. doi:10. R. C. (1969). Notes on Nursing: What It Is and What It Is (2014). Zhang. Your planner will keep track of all your Lippincott Lippincott Williams & Wilkins is accredited as Williams & Wilkins online CE activities for you. of Home Healthcare Now.5 • You will need to create a free login to your personal contact hours for this continuing nursing CE Planner account before taking online tests. P. The authors and planners have disclosed no poten.S. All rights reserved. E.2011. D.doi. (2014). Fitzgerald. 174(4). cardiovascular disease. (2015). N. contact Lippincott Williams & Wilkins: an approved provider of continuing nursing 1-800-787-8985.nlm. Retrieved from https://www. If you pass. K.004 Clinical Nutrition. Pharmacology & Therapeutics.S. mortality among older adults.. Pharmacology and health promotion and chronic disease prevention. Speakman. doi:10.1016/j.2013. by gender and age. L.com/ce/HHN. K. F. (2016).113.org/10.005 doi:10. December). go to nursingcenter. 2015-2020 Dietary Guide- http://www.09. S. 7. E. E. & Subar. hours. jand. 63(2). Boaz. Supplement 132-155. C. • The registration fee for this test is $17. § 18001 America. E. 9(2). (2014)... outlook. doi:10. Elis. A. 8th Edition.3912/OJIN. Miller. education activity. F. 972-979.C..maturitas. Department of Agriculture. If you fail. & Hu. Department of Health and Human Services and U. Payment: tial conflicts of interest.hhs.010 For 80 additional continuing nursing education activities on nutrition. D. 42 U. will award 1. The Journal of Nutrition. Higher diet quality is associated with org/10..org Copyright © 2017 Wolters Kluwer Health. publisher Tests can no longer be mailed or faxed.gov/SP2UserFiles/Place/80400530/pdf/1112/Table_1_NIN_ gov/healthcare/ GEN_11. Kahle. & Wood. K. (1983.ncbi. NY: Dover. Park. L. Maturitas. The test for this CE activity can be Provider Accreditation: taken online at www. 35(5).10.x Hayes. Instructions for Taking the CE Test Online The 2015-2020 Dietary Guidelines: Overview and Implications for Nursing Practice • Read the article.. D. Wojnar. A. have the option of taking the test again at no Provider Number CEP 11749 for 1. M. financial or otherwise. What We Eat in Patient Protection and Affordable Care Act. Lippincott Williams & Wilkins.. 141.012 U. 19(3). 113(7).nursingcenter.. Retrieved from http://health. Y. Inc.05. Whelan. & Hoffmann. Krebs-Smith. Improved meal presentation increases food Nursing Outlook. a provider of continuing nursing education by • There is only one correct answer for each question. 2016. education by the District of Columbia.. Schumann. Added sugar intake and cardiovascular diseases mor- 889.2012.2015. Retrieved from http://dx. 881. Z. Chernov. M. U. New York.189407 tality among US adults. JAMA Internal Medicine. Georgia. S.2013. flammatory disease. Smolowitz.. Slawson. (2013). T. …..Vol19No03Man07 (2012). M. doi:10.. Healthy eating for healthy nurses: Nutrition basics dietaryguidelines/2015/guidelines to promote health for nurses and patients. Agricultural Research Service. Gregg..00239. A. review.. (2015.gov/pmc/articles/PMC2047163/ lines for Americans. & Morgan. P.S. W.. F. Registration Deadline: February 28..08.