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Hamel V, Hennessy M, Mialon M, Moubarac JC. Interactions Between Nutrition Professionals and Industry: A Scoping Review. Int J Health Policy Manag 2023; 12:7626. [PMID: 38618820 PMCID: PMC10590255 DOI: 10.34172/ijhpm.2023.7626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 07/31/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND In recent years, interactions between nutrition professionals (NPs) and the food industry, such as sponsorship arrangements, have raised concerns, particularly as these may negatively impact the trustworthiness and credibility of the nutrition profession. This study aimed to map the literature and identify knowledge gaps regarding interactions between NPs and industry. We sought to examine the nature of such interactions and NPs perspectives about these, as well as the risks and solutions. METHODS We conducted a scoping review according to a pre-registered protocol, searching eight electronic databases and grey literature sources in March 2021 to identify documents for inclusion. Two independent reviewers screened citations for inclusion and conducted data extraction. Quantitative and qualitative syntheses were conducted. RESULTS We identified 115 documents for analysis, published between 1980 to 2021, with a majority from the United States (n=59, 51%). Only 32% (n=37) were empirical studies. The food industry was the most frequent industry type discussed (n=91, 79%). We identified 32 types of interactions between NPs and industry, such as continuing education provided by industry and sponsorship of professional bodies and health and nutrition organizations. The financial survival of nutrition organizations and continuing education access for NPs were the most frequently cited advantages of industry-NPs interactions. On the other hand, undermining public trust, NPs credibility and public health nutrition recommendations were pointed out as risks of these interactions. Following a code of ethics, policies, or guidelines was the most frequently proposed solution for managing these interactions. CONCLUSION Despite the increasing attention given to this issue, few empirical papers have been published to date. There is a need for more research to better and systematically document industry interactions with NPs and the impacts associated with these, as well as more research on effective management strategies. Registry Name and Number: Interactions between nutrition professionals and industry actors: A scoping review protocol. doi:10.17605/OSF.IO/Q6PUA.
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Affiliation(s)
- Virginie Hamel
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Centre de recherche en Santé publique, Montreal, QC, Canada
| | - Marita Hennessy
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - Mélissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | - Jean-Claude Moubarac
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Centre de recherche en Santé publique, Montreal, QC, Canada
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Appleton J, Russell CG, Fowler C, Jansen E, Burnett AJ, Rossiter C, Denney-Wilson E. Informing Infant Nutrition: Timing of Infant Formula Advice, Infant Formula Choice and Preparation in the First 6 Months of Life. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:908-915. [PMID: 36216441 DOI: 10.1016/j.jneb.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/22/2022] [Accepted: 06/05/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To examine the sources and timing of advice formula feeding parents receive and how this and other factors influence the choice of formula product and formula preparation. DESIGN Components of a cross-sectional survey. SETTING A child and family health service in New South Wales, Australia. PARTICIPANTS Parents (n = 153) who were fully or partially formula feeding infants aged 0-6 months and who visited the service's facilities or its social media site. VARIABLES MEASURED Type of formula, preparation of formula, and use and sources of formula feeding advice. ANALYSIS Descriptive statistics, Mann-Whitney U or Pearson's chi-square tests, and inductive content analysis. RESULTS The most common source of formula feeding advice was the formula tin/packet (96.6%). Although 79.2% received advice from a health professional, only 18.9% reported receiving this advice before using formula. Approximately half (48.0%) of the parents chose a standard cow's milk-based formula. The most common reason for their choice of formula type/brand was a personal recommendation (53.0%). Parents' responses indicated that nearly half (46.3%) incorrectly prepared the formula. CONCLUSION AND IMPLICATIONS Although health professional advice was widely received, this was rarely before starting formula. Despite the current national infant feeding regulations, parents who were not exclusively breastfeeding their infants did not always receive timely, health professional advice about formula feeding.
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Affiliation(s)
- Jessica Appleton
- Tresillian Family Care Centres, Sydney, New South Wales, Australia; Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, New South Wales, Australia; School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia.
| | - Catherine G Russell
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Cathrine Fowler
- Tresillian Family Care Centres, Sydney, New South Wales, Australia; School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Elena Jansen
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia; Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alissa J Burnett
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Christine Rossiter
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, New South Wales, Australia; School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, New South Wales, Australia; Sydney Local Health District, Camperdown, New South Wales, Australia
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Kassie B, Wube T, Jara D, Teshome M, Shiferaw A, Getaneh S, Desta M. A prospective follow-up study on how long newborns are fasting in Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2020. PLoS One 2022; 17:e0268558. [PMID: 35972926 PMCID: PMC9380941 DOI: 10.1371/journal.pone.0268558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 05/03/2022] [Indexed: 11/26/2022] Open
Abstract
Background At birth, continuous flow of nutrients to the fetus in utero interrupted due to cut of the route /umbilical cord/. Instead of the cord, breast-mouth connection will be the next route in the extra uterine life. Nevertheless, limited data in our locality show the duration for how long immediate newborns are fasting. Objective This study aimed to assess time to initiation of breastfeeding and its predictors among postnatal mothers within 12 hours of birth in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2020. Methods A Facility based prospective follow-up study was conducted among 475 participants who were selected using systematic random sampling techniques. To collect the data, techniques including interview, chart review and observation were used. Data was entered to Epi-data version 3.1 and analyzed by STATA 14 software. A cox proportional hazards regression model was fitted to identify predictors for survival time. Results of the final model were expressed in terms of adjusted hazard ratio (AHR) with 95% confidence interval, statistical significance was declared with P-value is less than 0.05. Results Newborns were fasting breast-milk for the median time of 2 hours. In this study, 25% of participants initiated breastfeeding within 1 hour, pre-lacteal while 75% initiated within 3 hours. Gave birth to multiple babies (AHR 0.37, 95% CI (0.19, 0.69)), operative delivery (AHR 0.77, 95% CI (0.62, 0.96)), got advice on timely initiation of breastfeeding immediately after delivery (AHR 0.79, 95% CI (0.63, 0.97)), pre-lacteal feeding initiation (AHR 10.41, 95% CI (2.82, 38.47)) and neonatal sickness (AHR 0.08, 95% CI (0.03–0.19)) were statistically significant predictors for time to initiation of breastfeeding. Conclusion Fifty percent of mothers initiated breastfeeding within 2 hours. Most of them didn’t initiate breastfeeding based on world health organization’s recommendation, within one hour after delivery. Multiple birth, operative delivery, getting advice on timely initiation of breastfeeding immediately after delivery, giving pre-lacteal feeding and neonatal sickness were found to be predictors of time to initiation of breastfeeding.
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Affiliation(s)
- Bekalu Kassie
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Tejitu Wube
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Dube Jara
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Muluken Teshome
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aster Shiferaw
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Sefinew Getaneh
- Department of Public Health Specialist in Epidemiology, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Shaker‐Berbari L, Ghattas H, Symon AG, Anderson AS. Infant and young child feeding in emergencies: Organisational policies and activities during the refugee crisis in Lebanon. MATERNAL & CHILD NUTRITION 2018; 14:e12576. [PMID: 29316209 PMCID: PMC6055656 DOI: 10.1111/mcn.12576] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 11/29/2022]
Abstract
Appropriate infant and young child feeding (IYCF) is key to reducing mortality amongst children aged under 2. Facilitating adherence to recommended IYCF practices during emergencies includes having relevant policies to support breastfeeding and complementary feeding as well as regulating the distribution of breast milk substitutes. In the current crisis, more than 1.2 million Syrian refugees are in Lebanon and it is timely to examine organisational IYCF policies and programmes. One hundred and thirty-five non-governmental organisations providing humanitarian aid in Lebanon were invited to participate in an online survey about organisational policies and programmatic activities on IYCF. Responses were obtained from 54 organisations: 29 International Non-Governmental Organisations (INGOs) and 25 Local Non-Governmental Organisations (LNGOs). In total, 8 (15%) reported having a written policy on IYCF, but only 1 policy (in draft format) was available for inspection. Twelve (8 INGOs and 4 LNGOs) indicated endorsing an external IYCF policy, but only 6 listed a valid policy. Four organisations (3 INGOs and 1 LNGO) had programme objectives that indicate protection, promotion, and support of IYCF. Three LNGOs reported receiving infant formula donations and 5 organisations (2 INGOs and 3 LNGOs) indicated distributing infant formula; 2 (1 INGO and 1 LNGO) did so in accordance with international and national policies. Few organisations violated IYCF guidance but organisational policies and activities on IYCF are not well established. In order to improve response in the current refugee crisis in Lebanon, there is a need to ensure policies are in place and implemented so that interventions support, promote, and protect IYCF.
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Affiliation(s)
| | - Hala Ghattas
- Faculty of Heath SciencesAmerican University of BeirutBeirutLebanon
| | - Andrew G. Symon
- School of Nursing and Health SciencesUniversity of DundeeDundeeScotlandUK
| | - Annie S. Anderson
- Centre for Public Health Nutrition ResearchUniversity of DundeeDundeeUK
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Binns C, Lee MK, Kagawa M. Ethical Challenges in Infant Feeding Research. Nutrients 2017; 9:E59. [PMID: 28085057 PMCID: PMC5295103 DOI: 10.3390/nu9010059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 12/23/2016] [Accepted: 01/09/2017] [Indexed: 01/14/2023] Open
Abstract
Infants have a complex set of nutrient requirements to meet the demands of their high metabolic rate, growth, and immunological and cognitive development. Infant nutrition lays the foundation for health throughout life. While infant feeding research is essential, it must be conducted to the highest ethical standards. The objective of this paper is to discuss the implications of developments in infant nutrition for the ethics of infant feeding research and the implications for obtaining informed consent. A search was undertaken of the papers in the medical literature using the PubMed, Science Direct, Web of Knowledge, Proquest, and CINAHL databases. From a total of 9303 papers identified, the full text of 87 articles that contained discussion of issues in consent in infant feeding trials were obtained and read and after further screening 42 papers were included in the results and discussion. Recent developments in infant nutrition of significance to ethics assessment include the improved survival of low birth weight infants, increasing evidence of the value of breastfeeding and evidence of the lifelong importance of infant feeding and development in the first 1000 days of life in chronic disease epidemiology. Informed consent is a difficult issue, but should always include information on the value of preserving breastfeeding options. Project monitoring should be cognisant of the long term implications of growth rates and early life nutrition.
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Affiliation(s)
- Colin Binns
- John Curtin Distinguished Emeritus Professor of Public Health, Curtin University, Perth 6845, Australia.
| | - Mi Kyung Lee
- Department, School of Health Professions, Murdoch University, Perth 6150, Australia.
| | - Masaharu Kagawa
- Institute of Nutrition Sciences, Kagawa Nutrition University, Saitama 350-0214, Japan.
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Bermejo RM, Parra-Hidalgo P, Oliver-Roig A, Hidalgo MD, Arellano-Morata C, García-de-León-González R. Development and Assessment of a Questionnaire to Study Protection, Promotion, and Support of Breastfeeding. J Obstet Gynecol Neonatal Nurs 2016; 45:166-79. [DOI: 10.1016/j.jogn.2015.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 11/26/2022] Open
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Grundy Q, Bero L, Malone R. Interactions between non-physician clinicians and industry: a systematic review. PLoS Med 2013; 10:e1001561. [PMID: 24302892 PMCID: PMC3841103 DOI: 10.1371/journal.pmed.1001561] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 10/16/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND With increasing restrictions placed on physician-industry interactions, industry marketing may target other health professionals. Recent health policy developments confer even greater importance on the decision making of non-physician clinicians. The purpose of this systematic review is to examine the types and implications of non-physician clinician-industry interactions in clinical practice. METHODS AND FINDINGS We searched MEDLINE and Web of Science from January 1, 1946, through June 24, 2013, according to PRISMA guidelines. Non-physician clinicians eligible for inclusion were: Registered Nurses, nurse prescribers, Physician Assistants, pharmacists, dieticians, and physical or occupational therapists; trainee samples were excluded. Fifteen studies met inclusion criteria. Data were synthesized qualitatively into eight outcome domains: nature and frequency of industry interactions; attitudes toward industry; perceived ethical acceptability of interactions; perceived marketing influence; perceived reliability of industry information; preparation for industry interactions; reactions to industry relations policy; and management of industry interactions. Non-physician clinicians reported interacting with the pharmaceutical and infant formula industries. Clinicians across disciplines met with pharmaceutical representatives regularly and relied on them for practice information. Clinicians frequently received industry "information," attended sponsored "education," and acted as distributors for similar materials targeted at patients. Clinicians generally regarded this as an ethical use of industry resources, and felt they could detect "promotion" while benefiting from industry "information." Free samples were among the most approved and common ways that clinicians interacted with industry. Included studies were observational and of varying methodological rigor; thus, these findings may not be generalizable. This review is, however, the first to our knowledge to provide a descriptive analysis of this literature. CONCLUSIONS Non-physician clinicians' generally positive attitudes toward industry interactions, despite their recognition of issues related to bias, suggest that industry interactions are normalized in clinical practice across non-physician disciplines. Industry relations policy should address all disciplines and be implemented consistently in order to mitigate conflicts of interest and address such interactions' potential to affect patient care. Please see later in the article for the Editors' Summary.
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Affiliation(s)
- Quinn Grundy
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Lisa Bero
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, San Francisco, California, United States of America
- Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Ruth Malone
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, California, United States of America
- Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
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What stops healthy choices? Public Health Nutr 2007. [DOI: 10.1017/s1368980007764601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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