Practice Papers

A practice paper is a critical analysis of the current research literature that addresses a practice topic to translate science to practice. It provides registered dietitian nutritionists (RDNs) and dietetic technicians, registered (DTRs) with information to enhance critical reasoning and quality improvement in dietetics practice.

As of July 2015, practice papers are published in the Journal of the Academy of Nutrition and Dietetics. In addition, all practice papers continue to be available on the Academy's website. From August 2011 to July 2015 only practice paper abstracts were published in the Journal and the entire practice paper was published online.


Management of Food and Nutrition Systems

  • Principles of Productivity in Food and Nutrition Services (July 2015)
    Food and nutrition services, along with the health care organizations they serve, are becoming increasingly complex. As health care continues to change and new models of care are introduced, food and nutrition services managers will need to consider innovative approaches to improve productivity that are consistent with their individual health care organization’s vision and mission. Use of process improvement tools such as Lean and Six Sigma as strategies for evaluating and improving food and nutrition services efficiency should be considered.

    *This paper offers a free CPE opportunity for Academy members.

Health Promotion/Disease Prevention

  • Role of the Registered Dietitian Nutritionist in the Diagnosis and Management of Food Allergies (October 2016)
    The Role of the Registered Dietitian Nutritionist in the Diagnosis and Management of Food Allergies Practice Paper is published in the October 2016 Journal of the Academy of Nutrition and Dietetics. Incidence of food allergy has increased significantly over the past decade and represents an important health issue for millions of Americans. Accurate diagnosis is crucial to avoid unnecessary dietary restriction, especially in children. The purpose of this paper is to provide guidance to the RDN and NDTR on appropriate and evidence-based nutrition counseling for diagnosis and management of food allergies.

    *This paper offers a free CPE opportunity for Academy members.

  • Nutrient Density: Selecting Nutrient-Dense Foods for Good Health (September 2016)
    The 2015 Dietary Guidelines for Americans encourage selection of nutrient-dense foods for health promotion and disease prevention and management. The purpose of this Academy of Nutrition and Dietetics practice paper is to provide an update regarding the science and practice of nutrient-dense food identification and selection. Characterization of tools used to identify nutrient density of foods is provided and recommendations for how registered dietitian nutritionists and nutrition and dietetics technicians, registered might use available profiling tools to help consumers select nutrient-dense foods is discussed.

    *This paper offers a free CPE opportunity for Academy members.

  • Oral Health and Nutrition (June 2014)
    This paper supports the "Position of the Academy of Nutrition and Dietetics: Oral Health and Nutrition" published in the May 2013 Journal of the Academy of Nutrition and Dietetics. There is a synergistic multi-directional association between diet, nutrition and oral health. Given that the mouth is the portal of entry into the body, it is essential that RDNs and DTRs include the oral cavity in their assessment for nutritional risk factors and deficiencies. Nutrition assessment is vital to identifying dietary intake and nutritional factors impacting oral health. The provision of medical nutrition therapy that incorporates total health, including oral health, is a component of the Standards of Practice for RDNs and DTRs. Inclusion of didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in education programs for both professional groups. The multifaceted interactions between diet, nutrition and oral health in practice, education and research, in both dietetics and dentistry, merit the need for collaborative efforts to ensure comprehensive patient care.

  • The Role of Nutrition in Health Promotion and Chronic Disease Prevention (July 2013)
    Food intake, lifestyle behaviors, and obesity are linked to the development of chronic diseases such as type 2 diabetes, certain cancers, and cardiovascular diseases. Certain life cycle phases appear to be especially important for health promotion and disease prevention as the development of chronic diseases can take several decades. This practice paper supports the position paper of the Academy of Nutrition and Dietetics: The Role of Nutrition in Health Promotion and Disease Prevention. In concordance with the Academy's position, this practice paper provides an overview of practice examples, effective program components, and a comprehensive range of health promotion and chronic disease prevention strategies for RDs and DTRs.

    *This paper offers a free CPE opportunity for Academy members.

Medical Nutrition Therapy

  • Critical Thinking Skills in Nutrition Assessment (November 2013)
    Nutrition assessment is an essential component of the Nutrition Care Process and Model (NCPM), as it is the initial step in developing a comprehensive evaluation of the client's nutrition history. A comprehensive nutrition assessment requires the ability to observe, interpret, analyze and infer data to diagnose nutrition problems. This practice paper provides insight into the process by which critical thinking skills are utilized by both registered dietitian nutritionists (RDNs) and dietetic technicians, registered (DTRs).

  • Ethical and Legal Issues in Feeding and Hydration (June 2013)
    Registered dietitians should work collaboratively as part of an interprofessional team to make recommendations of providing, withdrawing or withholding nutrition and hydration in individual cases and serve as active members of institutional ethics committees. This paper provides a proactive, integrated, systematic process to implement the Academy's position. This practice paper supports the Academy position paper on the same topic published in the June 2013 Journal of the Academy of Nutrition and Dietetics.

  • Nutrition and Women's Health (November 2013)
    Currently, cardiovascular disease (CVD) is the leading cause of death in women, followed by cancer and stroke. Breast cancer, while associated with lower mortality than most other cancers, is the leading cause of cancer-related morbidity in women. Osteoporosis also threatens women, particularly after menopause. Importantly, each of these diagnoses in aging women share a commonality in that lifestyle choices, including diet, play a primary role in prevention and treatment of these diseases.This practice paper provides a synopsis of current dietary recommendations for CVD, osteoporosis and breast cancer in women. Registered dietitians (RDs) and dietetic technicians, registered, play important roles in risk reduction for these diagnoses and RDs are uniquely qualified to provide medical nutrition therapy.

  • Nutrition Intervention in the Treatment of Eating Disorders (August 2011)
    This paper provides concrete ideas about the role of the RD working with people diagnosed with eating disorders (EDs) as well as updates on current research and controversies within the eating disorders field, which serve to inform RDs about their role with this unique population. This paper supports the position of the Academy of Nutrition and Dietetics "Nutrition Intervention in the Treatment of Eating Disorders" published in the August 2011 Journal of the American Dietetic Association.

Nutrition Through the Lifecycle

  • Individualized Nutrition Approaches for Older Adults in Health Care Communities (October 2010)
    This practice paper supports the Position of the American Dietetic Association "Individualized Nutrition Approaches for Older Adults in Health Care Communities" (October 2010) Journal of the American Dietetic Association. The Academy advocates the use of qualified food and nutrition practitioners to assess and evaluate the need for nutrition care according to each person's individual medical condition, needs, desires and rights, and that the quality of life and nutritional status of older adults residing in health care communities can be enhanced by individualization to less-restrictive diets. The expansion of health care communities creates a multitude of options for RDs and dietetic technicians, registered, to promote the role of good food and nutrition in the overall quality of life for the older adults they serve.

  • Nutrition and Lifestyle for a Health Pregnancy Outcome (July 2014)
    This new practice paper was published on the Academy website July 2014 and the abstract is published in the Journal of the Academy of Nutrition and Dietetics July 2014. This paper supports the Academy's position paper with the same title, published in the Journal of the Academy of Nutrition and Dietetics July 2014. Components leading to healthy pregnancy outcome include healthy pre-pregnancy weight, appropriate weight gain and physical activity during pregnancy, consumption of a wide variety of foods, appropriate vitamin and mineral supplementation, avoidance of alcohol and other harmful substances, and safe food handling. Using the 2010 Dietary Guidelines for Americans, registered dietitian nutritionists and dietetics technicians, registered, can help pregnant women select a food plan based on age, physical activity, trimester, weight gain and other considerations.

  • Promoting and Supporting Breastfeeding (March 2015)
    This paper supports the Academy's position paper with the same title, published in the Journal of the Academy of Nutrition and Dietetics March 2015. Breastfeeding is an important public health strategy for improving infant and child morbidity and mortality, improving maternal morbidity, and helping to control health care costs. This practice paper was created to provide registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs) with guidelines and resources to promote and support breastfeeding. The position and practice papers should be used together to address the important contribution breastfeeding makes to the health of women, children, and infants and the future of our nation.

    *This paper offers a free CPE opportunity for Academy members.

Management of Sustainable, Resilient and Healthy Food and Water Systems

  • Promoting Ecological Sustainability within the Food System (March 2013)
    Registered dietitians (RDs) and dietetic technicians, registered, (DTRs) can implement environmentally-responsible practices in their workplace and personal lives. RDs and DTRs who conserve natural resources while minimizing environmental degradation will help maintain sustainability of the food system, which requires knowledge of the external costs of operational and personal decisions. In an effort to promote ecologically-sustainable diets, it is important to consider natural resources as they relate to food production, transformation, distribution, access and consumption.

Professionalism and Practice

  • Addressing Racial and Ethnic Health Disparities (March 2011)
    This article provides an in-depth look at the recommendations put forth by the IOM, offers discipline specific recommendations consistent with those outlined in the IOM model and introduces other models that may be of use as food and nutrition practitioners move forward with developing strategies to eliminate racial and ethnic health disparities.

  • Communicating Accurate Food and Nutrition Information (May 2012)
    Consumers are increasingly interested in food and nutrition information and the channels for receiving information are expanding at a fast pace. New opportunities are available for registered dietitians (RDs) to reach diverse audiences with credible nutrition messages. RDs must actively take steps to position themselves as reliable sources of science-based food and nutrition information and communicate through a variety of new media and traditional channels. This paper provides information to help RDs evaluate nutrition research, stay abreast of the latest food and nutrition information and effectively communicate science-based information in a variety of formats.

  • Home Care - Opportunities for Food and Nutrition Professionals (June 2009)
    Home care continues to expand. With this growth are opportunities for registered dietitians to demonstrate the vital role that they play not only in providing optimal nutrition care, but also in contributing to each patient's quality of life.

  • Nutrition Informatics (November 2012)
    In today's world, practice takes place in a wide variety of settings from corporate wellness to the intensive care unit. All settings require that dietetics practitioners have immediate access to accurate information. The term informatics describes the science of managing, storing and communicating information. Health informatics focuses on the application of information science within the health care arena. The field of health informatics includes medical, nursing, pharmacy, dental, public health and now nutrition informatics. Registered dietitians and dietetic technicians, registered, are now creating nutrition informatics as a new area of dietetics practice.

  • Social Media and the Dietetics Practitioner: Opportunities, Challenges and Best Practices (November 2016)

    The potential role of social media in the profession is far reaching, yet there are important guidelines to follow related to ethics and professionalism. When using social media, nutrition and dietetics practitioners must remember that they are governed by the same Code of Ethics that guides all other aspects of practice. In today's digital age, it is essential for nutrition and dietetics practitioners to recognize the professional opportunities and challenges of social media. This Academy of Nutrition and Dietetics practice paper is to provide guidance on social media's relevance, potential applications, best practices, benefits and risks.

    *This paper offers a free CPE opportunity for Academy members.

  • Using the Dietary Reference Intakes (May 2011)
    The Dietary Reference Intakes, a set of nutrient reference standards developed for the United States and Canada by the Institute of Medicine, provide tools for dietary assessment and planning for individuals and groups. This paper offers practical guidelines for appropriate application of the DRIs, and to better recognize both the benefits and challenges associated with their use. Ultimately, utilization of more comprehensive methods of assessing and planning nutrient intakes has the potential to further enhance recognition of registered dietitians' essential roles in nutrition care.