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Focus Area References


To accelerate progress toward achieving the Academy's Strategic Plan, the President’s Strategic Advancement Groups developed official statements and rationales, supported by a summary of the scientific evidence for each of the focus areas, emphasizing the impact of the nutrition and dietetics profession on each area. Read the report.
  1. Health Resources and Services Administration, National Center for Health Workforce Analysis. Sex, Race and Ethnic Diversity of U.S, Health Occupations (2011-2015). U.S. Department of Health and Human Services, 2017.

  2. Academy of Nutrition and Dietetics. Compensation & Benefits Survey of the Dietetics Profession 2021. Exhibit 7.08 Heritage/Race, pg 170.

  3. Academy of Nutrition and Dietetics. Advancing Equity: The Academy’s Commitment to Supporting Inclusion, Diversity, Equity and Access. J Acad Nutr Diet. 2021;122(1),159-165.

  4. U.S. Census Bureau. 2020 American Community Survey, DP05 ACS Demographic and Housing Estimates. Accessed December 5, 2022.

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  6. Snyder CR, Frogner BK, Skillman SM. Facilitating racial and ethnic diversity in the health workforce. Journal of Allied Health. 2018;47(1), 58-69.

  7. White House National Strategy on Hunger, Nutrition and Health. Published September 2022. Accessed January 23, 2023.

  8. Robinson S. Doubling Down on Diversity: The Journey to a More Diverse Field. Food & Nutrition Magazine. Accessed December 5, 2022.

  9. Thornton H, Melton T, Johnson C, Belleny Lewis D. Evolving Beyond the World Foods Course: Creating Racially and Ethnically Inclusive Educational Spaces for Dietetics Students. J Acad Nutr Diet. 2022;122(11):1993-2000.

  10. Baxter SD, Landry M, Rodriguez J, Cochran N, Sweat S, Dotimas L. Improved demographic data are needed for more accurate assessment of race/ethnic and gender diversity in the nutrition and dietetics profession. J Critical Dietetics. 2022;6(2):28-44.

  11. Baxter SD, Gordon B, Cochran N. Enhancing diversity and the role of individuals with disabilities in the dietetics profession. J Acad Nutr Diet. 2020;120(5):749-757.

  12. Academy of Nutrition and Dietetics. Strategic Plan. April 2021. Accessed January 23, 2023.

  13. Academy of Nutrition and Dietetics Inclusion, Diversity, Equity and Access (IDEA) Action Plan. Accessed January 23, 2023.

  14. Academy of Nutrition and Dietetics Inclusion, Diversity, Equity and Access (IDEA) Promotion Grant. Accessed January 23, 2023.

  15. Hurtado S, Alvarado AR. Discrimination and Bias, Underrepresentation and Sense of Belonging on Campus. Higher Education Research Institute. 2015. Los Angeles, CA: Higher Education Research Institute.

  16. Dutta N, Maini A, Afolabi F, Forrest D, Golding B, Salami RK, Kumar S. Promoting cultural diversity and inclusion in undergraduate primary care education. Education for Primary Care. 2021;32(4), 192-197.

  17. Vespa J, Medina L, Armstrong DM. Demographic Turning Points for the United States: Population Projections for 2020 to 2060, Current Population Reports, P25-1144, U.S. Census Bureau, Washington, DC, 2020. Accessed December 6, 2022.

  18. Jones JM. LGBT identification in U.S. ticks up to 7.1%. Washington, DC. Published February, 2022. Accessed January 23, 2023.

  19. Burt KG, Losak R, He H. Nutrition professionals feel underprepared to serve persons with marginalized identities. Pedagogy in Health Promotion. 2022;8(3):192-8.

  20. McCabe CF, O’Brien-Combs A, Anderson OS. Cultural competency training and evaluation methods across dietetics education: a narrative review. J Acad Nutr Diet. 2020;1;120(7):1198-209.

  21. Fergusson P, Greenspan N, Maitland L, Huberdeau R. Towards providing culturally aware nutritional care for transgender people: key issues and considerations. Canadian Journal of Dietetic Practice and Research. 2018;79(2):74-9.

  22. Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press (US); 2003.

  23. Awosogba T, Betancourt JR, Conyers FG, Estapé ES, Francois F, Gard SJ, Kaufman A, Lunn MR, Nivet MA, Oppenheim JD, Pomeroy C, Yeung, H. Prioritizing health disparities in medical education to improve care. Annals of the New York Academy of Sciences. 2013;1287(1), 17-30.

  24. DallaPiazza M, Ayyala MS, Soto-Greene ML. Empowering future physicians to advocate for health equity: a blueprint for a longitudinal thread in undergraduate medical education. Medical Teacher. 2020;42(7), 806-812

  25. Lekas HM, Pahl K, Fuller Lewis C. Rethinking Cultural Competence: Shifting to Cultural Humility. Health Serv Insights. 2020;13. doi: 10.1177/1178632920970580.

  26. Baxter SD, Cochran N. Ensuring Success for RDNs and Interns with Disabilities: Clinical managers can make it work. Future Dimensions in Clinical Nutrition Practice (Newsletter of Clinical Managers DPG) Spring, 2021 Special Edition, pgs 2-14.

  27. Lezzoni LI, Rao SR, Ressalam J, Bolcic-Jankovic D, Agaronnik ND, Donelan K, Lagu T, Campbell EG. G. Physicians' perceptions of people with disability and their health care: study reports the results of a survey of physicians’ perceptions of people with disability. Health Aff. 2021;40(2), 297-306.

  28. Kuzma E K, Pardee M, Darling-Fisher CS. Lesbian, gay, bisexual and transgender health: Creating safe spaces and caring for patients with cultural humility. Journal of the American Association of Nurse Practitioners. 2019;31(3), 167-174.

  29. Morris M, Cooper RL, Ramesh A, Tabatabai M, Arcury TA, Shinn M, Im W, Juarez P, Matthews-Juarez P. Training to reduce LGBTQ-related bias among medical, nursing and dental students and providers: a systematic review. BMC Medical Education. 2019;19(1), 1-13.

  30. National LGBT Health Education Center. (n.d). Providing inclusive services and care for LGBT people: A guide for health care staff. Boston, MA. Accessed January 23, 2023.

  31. Mateo CM, Williams DR. Addressing bias and reducing discrimination: The professional responsibility of health care providers. Academic Medicine. 2020; 95(12S), S5-S10.

  32. Van Dyne L, Ang S, Tan ML. Cultural Intelligence. Oxford Bibliographies. Oxford, Oxford University Press. 2017. doi:10.1093/OBO/9780199846740-0115

  33. Lund A, Yoder Latortue K, Rodriguez J. Dietetic Training: Understanding Racial Inequity in Power and Privilege. J Acad Nutr Diet; 2020;121(8);1437-1440. doi: 10.1016/j.jand.2020.09.041

  34. ACEND 2022 Standards and Templates. Accessed January 23, 2023.

  35. Boersma P, Black L, Ward B. Prevalence of multiple chronic conditions among US adults. Prev Chronic Dis. 2020;17:200130. doi:http://dx.doi.org/10.5888/pcd17.200130

  36. Andes L J, Cheng Y J, Rolka DB, Gregg EW, Imperatore G. Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016. JAMA Pediatr. 2020;174(2):e194498-e194498.

  37. Imperatore G, Boyle JP, Thompson TJ, Case D, Dabelea D, Hamman RF, Lawrence JM, Liese AD, Liu LL, Mayer-Davis EJ, Rodriguez BL, Standiford D, SEARCH for Diabetes in Youth Study Group. Projections of Type 1 and Type 2 diabetes burden in the US population aged< 20 years through 2050: dynamic modeling of incidence, mortality and population growth. Diabetes care. 2020;35(12):2515-2520.

  38. Center for Medicare & Medicaid Services. National health expenditure data: historical; 2021. Retrieved August 3, 2022.

  39. Buttorff C, Ruder T, Bauman M. Multiple chronic conditions in the United States. Santa Monica: RAND Corporation; 2017. doi:https://doi.org/10.7249/TL221

  40. Centers for Disease Control and Prevention. National diabetes statistics report. Retrieved August 3, 2022.

  41. Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States; 2021. Retrieved August 3, 2022.

  42. Centers for Disease Control and Prevention. Childhood obesity facts: Prevalence of childhood obesity in the United States; 2022. Retrieved September 1, 2022.

  43. Warren M, Beck S, Delgado D. The state of obesity: better policies for a healthier America 2020. Trust for America's Health. 2022. Retrieved August 3, 2022.

  44. Hughes HK, Matsui EC, Tschudy MM, Pollack CE, Keet CA. Pediatric Asthma Health Disparities: Race, Hardship, Housing and Asthma in a National Survey. Acad Pediatr; 2017,17(2):127-134. doi:10.1016/j.acap.2016.11.011

  45. Sentell T, Choi SY, Ching L, Quensell M, Keliikoa LB, Corriveau É, Pirkle C. Prevalence of selected chronic conditions among children, adolescents and young adults in acute care settings in Hawai‘i. Prev Chronic Dis. 2020,17:190448. http://dx.doi.org/10.5888/pcd17.190448external icon

  46. Academy of Nutrition and Dietetics. Racial and Ethnic Health Disparities and Chronic Disease Issue Brief; 2021. Retrieved September 1, 2022.

  47. Bodenheimer T, Sinsky C. From trip to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573-576. doi:10.1370/afm.1713

  48. Academy of Nutrition and Dietetics Evidence Analysis Library. Medical Nutrition Therapy Effectiveness Systematic Review, 2013-2015. 2015. Retrieved September 1, 2022, from http://www.andeal.org/mnt

  49. Academy of Nutrition and Dietetics Evidence Analysis Library. MNT: Weight Management. 2015. Retrieved September 1, 2022.

  50. Early KB, Stanley K. Position of the Academy of Nutrition and Dietetics: The role of medical nutrition therapy and registered dietitian nutritionists in the prevention and treatment of prediabetes and Type 2 diabetes. J Acad Nutr Diet. 2018;118, 343-353. doi:https://doi.org/10.1016/j.jand.2017.11.021

  51. Dobrow L, Estrada I, Burkholder-Cooley N, Miklavcic J. Potential effectiveness of registered dietitian nutritionists in health behavior interventions for managing Type 2 diabetes in older adults: a systematic review. Front Nutr. 2022;8(737410). doi: 10.3389/fnut.2021.737410

  52. Johansson K, Malmberg Hård af Segerstad E., Mårtensson H., Agardh D. Dietitian visits were a safe and cost‐effective form of follow‐up care for children with celiac disease. Acta Paediatr. 2019, 108(4):676-680. doi:10.1111/apa.14411

  53. Singhato A, Khongkhon S, Rueangsri N, Booranasuksakul U. Effectiveness of medical nutrition therapy to improve dietary habits for promoting bone health in people living with chronic HIV. Ann Nutr Metab. 2021;76(5):313-321. doi:10.1159/000510367

  54. Rozga M, Burrowes J, Byham-Gray L, Handu D. Effects of sodium-specific medical nutrition therapy from a registered dietitian nutritionist in individuals with chronic kidney disease. J Acad Nutr Diet. 2022;122(2):445-460. doi:doi:10.1016/j.jand.2021.03.016

  55. Greenlee H, Santiago-Torres M, McMillen KK, Ueland K, Haase AM. Helping patients eat better during and beyond cancer treatment: continued nutrition management throughout care to address diet, malnutrition and obesity in cancer. Cancer J. 2019;25(5):320-328. doi:10.1097/PPO.0000000000000405

  56. Badaracco C, Bruno M, Mitchell K, McCauley S. Advancing Health Equity through Malnutrition Quality Measurement Roundtable: Practice Applications. J Acad Nutr Diet. 2022 Oct;122(10S):S21-S27. doi: 10.1016/j.jand.2022.06.016. PMID: 36122955.

  57. Yang Y, Conti J, McMaster CM, Hay P. Beyond refeeding: the effect of including a dietitian in eating disorder treatment, a systematic review. Nutr. 2021;13(12):4490. doi:10.3390/nu13124490

  58. Toulson Davisson Correia MI, Castro M, de Oliveira Toledo D, Farah D, Sansone D, de Morais Andrade TR, Tannus Branco de Araújo G, Fonseca MCM. Nutrition therapy cost‐effectiveness model indicating how nutrition may contribute to the efficiency and financial sustainability of the health systems. JPEN. 2021;45(7):1542-1550. doi:10.1002/jpen.2052

  59. Martin H, Kushner S, Iles K, Montgomery H. Advocating for expanded access to medical nutrition therapy in medicare. J Acad Nutr Diet. 2022;122(1):175-181. doi:doi:10.1016/j.jand.2021.02.024

  60. Sikand G, Cole RE, Handu D, deWaal D, Christaldi J, Johnson E, Aprino LM, Ekvall SM. Clinical and cost benefits of medical nutrition therapy by registered dietitian nutritionists for management of dyslipidemia: a systematic review and metaanalysis. J Clin Lipidol. 2018;12(5):1113-1122. doi:https://doi.org/10.1016/j.jacl.2018.06.016

  61. Van Baal PH, van den Berg M, Hoogenveen RT, Vijgen SM, Engelfriet PM. Cost-effectiveness of a low-calorie diet and Orlistat for obese persons: modeling long-term health gains through prevention of obesity-related chronic disease. Value Health. 2018;11(7):1033-1040.

  62. Academy of Nutrition and Dietetics. MNT: comparative effectiveness of MNT services. 2009. Retrieved July 21, 2022.

  63. Academy of Nutrition and Dietetics Quality Management Committee. Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Registered Dietitian Nutritionist. J Acad Nutr Diet. 2018;118(1):141-165

  64. Academy of Nutrition and Dietetics Quality Management Committee. Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitian Nutritionists. J Acad Nutr Diet. 2018;118(1):132-140.

  65. Andersen, D., Baird, S., Bates, T., Chapel, D.L., Cline, A.D., Ganesh, S.N., Garner, M., Grant, B.L., Hamilton, K.K., Jablonski, K. and Jones, S.L., 2018. Academy of nutrition and dietetics: revised 2017 scope of practice for the nutrition and dietetics technician, registered. Journal of the Academy of Nutrition and Dietetics, 118(2), pp.327-342.

  66. Academy of Nutrition and Dietetics. Licensure and professional regulation of dietitians. 2021. Retrieved September 1, 2022.

  67. Centers for Disease Control and Prevention. Chronic Diseases in America. . National Center for Chronic Disease Prevention and Health Promotion. Published 2022. Updated December 2022. Accessed April 13, 2023.

  68. Boersma P, Black LI, Ward BW. Prevalence of Multiple Chronic Conditions Among US Adults, 2018. Prev Chronic Dis. 2020;17:E106.

  69. Center for Medicare & Medicaid Services. National health expenditure data: Historical. Published 2021. Accessed April 13, 2023.

  70. Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Santa Monica, CA: RAND Corporation; 2017.

  71. Academy of Nutrition and Dietetics. Racial and Ethnic Health Disparities and Chronic Disease Issue Brief. Published 2021. Accessed April 13, 2023.

  72. National Academies of Sciences E, Medicine, Health, et al. In: Baciu A, Negussie Y, Geller A, Weinstein JN, eds. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press (US).Copyright 2017 by the National Academy of Sciences. All rights reserved.; 2017.

  73. Brownson RC, Baker EA, Housemann RA, Brennan LK, Bacak SJ. Environmental and policy determinants of physical activity in the United States. Am J Public Health. 2001;91(12):1995-2003.

  74. Leung CW, Tester JM. The Association between Food Insecurity and Diet Quality Varies by Race/Ethnicity: An Analysis of National Health and Nutrition Examination Survey 2011-2014 Results. J Acad Nutr Diet. 2019;119(10):1676-1686.

  75. Centers for Disease Control and Prevention. Reducing Chronic Disease Through Physical Activity and Nutrition. Published 2022. Updated February
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  76. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025.9th Edition. 2020.

  77. World Health Organization. Physical Activity. Published 2022. Updated October 5, 2022. Accessed April 12, 2023.

  78. Centers for Disease Control and Prevention. Poor Nutrition. Published 2022. Updated September 8, 2022. Accessed April 12, 2023.

  79. Adams ML, Grandpre J, Katz DL, Shenson D. The impact of key modifiable risk factors on leading chronic conditions. Prev Med. 2019;120:113-118.

  80. Rock CL, Thomson C, Gansler T, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin. 2020;70(4):245-271.

  81. Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Top 4 Tips to Prevent Chronic Diseases. Published 2022.
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  82. Atanasova P, Kusuma D, Pineda E, Frost G, Sassi F, Miraldo M. The impact of the consumer and neighbourhood food environment on dietary intake and obesity-related outcomes: A systematic review of causal impact studies. Soc Sci Med. 2022;299:114879.

  83. Fang Zhang F, Liu J, Rehm CD, Wilde P, Mande JR, Mozaffarian D. Trends and Disparities in Diet Quality Among US Adults by Supplemental Nutrition Assistance Program Participation Status. JAMA Netw Open. 2018;1(2):e180237.

  84. Centers for Disease Control and Prevention. Social Determinants of Health at CDC. Updated December 2022. Accessed April 13, 2023.

  85. U.S. Department of Health and Human Services. (n.d.). Published Social Determinants of Health. Accessed April 13, 2023.

  86. Peregrin T. Social Determinants of Health: Enhancing Health Equity. J Acad Nutr Diet. 2021;121(6):1175-1178.

  87. Nitschke E, Gottesman K, Hamlett P, et al. Impact of Nutrition and Physical Activity Interventions Provided by Nutrition and Exercise Practitioners for the Adult General Population: A Systematic Review and Meta-Analysis. Nutrients. 2022;14(9).

  88. Cradock AL, Barrett JL, Kenney EL, et al. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Prev Med. 2017;95 Suppl:S17-s27.

  89. Kenney EL, Cradock AL, Long MW, et al. Cost-Effectiveness of Water Promotion Strategies in Schools for Preventing Childhood Obesity and Increasing Water Intake. Obesity (Silver Spring). 2019;27(12):2037-2045.

  90. Hoelscher DM, Brann LS, O’Brien S, Handu D, Rozga M. Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews. J Acad Nutr Diet. 2022;122(2):410-423.e416.

  91. Centers for Disease Control and Prevention. The Social-Ecological Model: A Framework for Prevention. Published 2022. Updated January 18, 2022. Accessed April 12, , 2023.

  92. U.S. Department of Agriculture FaNS. Program Data Overview. Published 2023. Updated March 2023. Accessed April 13, 2023.

  93. U.S. Department of Agriculture Food and Nutrition Service nd. FNS Nutrition Programs. Accessed April 13, 2023.

  94. Roy PG, Stretch T. Position of the Academy of Nutrition and Dietetics: Child and Adolescent Federally Funded Nutrition Assistance Programs. J Acad Nutr Diet. 2018;118(8):1490-1497.

  95. Hayes D, Contento IR, Weekly C. Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior and School Nutrition Association: Comprehensive Nutrition Programs and Services in Schools. J Acad Nutr Diet. 2018;118(5):913-919.

  96. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. Washington D.C.,: U.S. Department of Health and Human Services; 2018.

  97. Mangione CM, Barry MJ, Nicholson WK, et al. Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Disease Risk Factors: US Preventive Services Task Force Recommendation Statement. Jama. 2022;328(4):367-374.

  98. Academy of Nutrition and Dietetics. The Academy of Nutrition and Dietetics’ Priorities for the White House Conference on Hunger, Nutrition and Health. Published 2022. Updated September 2022. Accessed April 13, 2023.

  99. White House National Strategy on Hunger, Nutrition and Health. Published 2022. Updated September 2022. Accessed April 13, 2023.

  100. Academy of Nutrition and Dietetics Evidence Analysis Library. Nutrition and Physical Activity Interventions for the General Population Evidence-Based Practice Guideline. www.andeal.org/npa. Published 2023. Updated March 2023. Accessed April 12, 2023.

  101. Bruening M, Perkins S, Udarbe A. Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient and Expert) in Public Health and Community Nutrition. J Acad Nutr Diet. 2022;122(9):1744-1763.e1749.

  102. Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Registered Dietitian Nutritionist. J Acad Nutr Diet. 2018;118(1):141-165.

  103. Dorner B, Friedrich EK. Position of the Academy of Nutrition and Dietetics: Individualized Nutrition Approaches for Older Adults: Long-Term Care, Post-Acute Care and Other Settings. J Acad Nutr Diet. 2018;118(4):724-735.

  104. U.S. Department of Agriculture, Food and Nutrition Service. Food and Nutrition Security. Accessed September 19, 2022.

  105. U.S. Department of Agriculture, Economic Research Service. Definitions of Food Security. Updated September 7, 2022.
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  106. Holben DH, Berger M. Position of the Academy of Nutrition and Dietetics: Food insecurity in the United States. J Acad Nutr Diet. 2017; 1117:1991-2002.

  107. Spiker M, Reinhardt S, Bruening M. Academy of Nutrition and Dietetics: Revised 2020 standards of professional performance for registered dietitian nutritionists (competent, proficient and expert) in sustainable, resilient and healthy food and water systems. J Acad Nutr Diet. 2020; 2212-2676.

  108. Spiker, ML, Knoblock-Hahn, A, Brown, K, Giddens, J, Hege AS, Sauer K, Enos DM, Steiber A. Cultivating sustainable, resilient and healthy food and water systems: a nutrition-focused framework for action. J Acad Nutr Diet. 2020; 120:1057-1067.

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  120. Levy B. Increasing risks for armed conflict: climate change, food and water insecurity and forced displacement. Int. J. Health Serv. 2019; 49(33).

  121. Academy of Nutrition and Dietetics. Heroes Act includes Academy priorities to help keep healthy food on Americans' tables. Published May 13, 2022. Accessed September 19, 2022.

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