Hello, Ladies and Gentlemen, Nice meeting you.
I am Shigeru Yamamoto

What should we do to make dietitians
respected by society?

The importance ofresearch publication for dietitians

Shigeru Yamamoto, Professor, Ph.D., RD International Nutrition, Department of Food andNutritional Sciences、Graduate School of Human Life Sciences, Jumonji University, 2-128 Sugasawa, Niiza-City, Saitama 352-8510, JapanTel+81-48-260-7613

e-mails: yamamotoshigeru426@gmail.com, office: shigeruy@jumonji-u.ac.jp

Forward•The importance of research publication for dietitians
Dietitians in hospitals are the most important professionals inmeals and health. They are not only responsible for making tasty
meals, but also for what kind of meals patients need. However, inhospitals, can dietitians guide doctors and nurses on the mostappropriate meals for patients ? Without adequate knowledge offoods and health, we may not be able to win the trust of doctors andother medical staff. Research publications are essential to obtaining
such trust and respect.

• For example, do dietitians have greater knowledge than doctors
about whether patients need protein or amino acids, carbohydratesor lipids?

• How much did dietitians contribute to the creation of parenteral andenteral formulas?

• How involved are dietitians in developing dietary reference intakes(DRIs)? Given the therapeutic foods being developed by doctors,
pharmacists, and food companies, could dietitians simply become
technicians who administer these products?

• Are dietitians educating students to present their on-site experience
as researches and in publications?

••

Research publications will be essential for dietitians to becomesocially respected.

• Without researches and the resulting publications, we would not beable to secure a higher status.

• In order to write a good research papers, good research plans andwriting skills are indispensable. Recent scientific papers are required
to provide evidence.

• It may be relatively easy, if the work is within a specific, narrowly
defined area.

• However, the works of a dietitian include a wide variety of complex
fields such as medicine, food science, psychology, economics andsociology etc, which makes it difficult for dietitians to write articles.
Nevertheless, without publications specifically on the works ofdietitians, the social status of dietitians will not rise.

• My lecture today is with the hope that it will help dietitians write
scientific publications as often as possible. I myself find it difficult towrite articles, and I am not at all confident. I hope that my lecture
will stimulate and encourage dietitians to publish their articles.

• I will illustrate using published articles and PowerPoints.

Some more questions

1. Does rice cause T2DM and obesity?
2. Are Asians easy to be T2DM?

3. Who do the national nutrition survey? I hope they are
dietiaitns.
4. Why is obesity definition different between Asians andAmericans? Obesity for Asians BMI 25, but for
Americans 30.
5. How was fiber RDA determined?
6. Is protein supplementation meaningful for athletes?
7. Is it proper to express protein requirement by energy %?
8. Do you have your country standards for child height andweight?

Contents
1. Evaluation of the research in article No.1 (See article No. 1) (Home work forparticipants before the conference).
• Please read and write your comments on the following and send them to theconference office. Please do not work on English because it will be checked byexperts but the content is written by the authors.
• 1) title, 2) abstract, 3) introduction, 4) methods, 5) results, and 6) discussion.
•2. Evaluation of the research in article No. 2 (See article No.2). An example ofan intervention study (Effect on body weight; High protein diet vs Highcarbohydrate diet). I will explain the research and the article on the intervention
research which was published by a journal in the States.
•3. Evaluation of the research in article No.3 (see article No. 3). A decrease inNaCl for patients decreased food intake. The idea is simple but important. it isreally a good example of research by a dietitian.
•4. Evaluation of the research in articles No.4. What can we learn from thepublications in the Journal of the Academy of Nutrition and Dietetics 2021
(official journal of the USA and Canada Dietetic Association, impact factor 4.9). I
think that the purpose of studies is not so different from what we think. Perhaps
the writing is excellent. If we learn how to do this, we can also publish ourarticles in such high-quality journals.

Home work before the conference:
Please read the Article No. 1 (See article No. 1) )and write yourcomments on the following and send them to the conference
office. Please do not work on English because it will be checkedby experts but the content is written by the authors.
1. title.
2. abstract.
3. introduction
4. methods

5. results
6. discussion.

Article No. 1•
The efficacy of Using OKR to Improve the Quality of Meal for Diabetes
Patients in a Japanese Hospital•• ABSTRACT: Diabetes Mellitus (DM) has been increasing rapidly in Vietnam, we hypothesizedthat the main reason that Vietnamese people using fiber and vegetable less than the amount offiber rather than the recommendation of WHO, at about 10-12g/1000 kcal/d. In this crosssectional study we tried to use OKR to improve the amount of fiber in daily meal for diabetes
patient and access the acceptability of patient with dishes which contain OKR. 20 patientsdiagnosed with DM were divide all participant into 2 groups, using 3 consecutive days of OKR
meal and 3 days of Hospital meal (not using OKR) and take the sensory test in all patient. At thebaseline and final period, anthropometric measurement, there was a significant higher in theamount of fiber of patient who using OKR, from 10.8 to 13.8 (p <0.05). About sensory test, points
for Okara meal sample were higher than from hospital diet sample on color, shape evenly,
juiciness, tenderness, and overall. And the differences have the mean points (p<0.05). Point for
OKR diet was higher than hospital diet in taste 7.7 ± 0.6 points and 7.0 ± 0.7 points, respectively(p<0.05).

Article No. 2
Effects of high protein and high carbohydrate
diets on body weight were similar in healthy
young Vietnamese women with normal bodyweightSample size サンプル数の計算• The sample size for testing the differences of two mean valuesn > (Zα+Zβ)2 x 2 x σ2 / d2

• In which:• n: Study sample size of HP group and HC group• d: The difference in mean of changes in body weight between twogroups after intervention, d=1.5• σ: Standard deviation is estimated from previous study, σ =1.0
• Zα is 1.96 for a confidence level of 95% and Zβ is 0.84 for a power of80%• => n > (1.96+0.84) 2 x 2 x 1.052 / 1.52 = 6.9 => n=7• The dropout rate was estimated at 15%. Finally, we selected 10
subjects in each group.

Note: The smaller the sample size, the easier it is to carry out
tresearch. However, if sample size is too small, the statistical result
is not often shown, even if there is.

Study Design
HP group (n=10)
Nutrition
survey7 consecutive
days
Dietary intake,Physical activitylevel

Matched pairs
by energy
intake, physicalactivity level,height, weightRandomlyassigned toHP or HCgroup

Intervention duration: 28 days
3-day cycle menu

HC group (n=10)
The intervention began on the 10th day
after the menstrual cycle. This is because
the energy intake varies depending on thecycle.

BodyｗeightPhysical activity: Pedometer

Body
ｗeightEnergy and Macronutrients Composition in Intervention Diets

Energy (kcal/day)

2500

2000

1500

Protein-rich food
Ad libitum
自由摂取

0

Carbohydrate-richfood
Ad libitum

自由摂取

1000

500

自由食

Carbohydrate
糖質: 120g

基礎食 （両群で同じ食事） Carbohydrate: 120g
E: 900-1000 kcal

Lipid脂質: 40g

Lipid: 40g

Proteinたん白質：50ｇ

Protein: 50g

HP DietHC DietIntervention study

Cycle menu - No. 1
HP DietBreakfast

Dinner

HC DietLunch

BreakfastLunch

SnackDinner

SnackSubject characteristics at baseline 開始時の値
HP group (n=10)

HC group (n=10)

P-value

Age(y)

20.8±0.9

20.7±0.9

0.81

Height (cm)156.3±5.5

155.5±5.6

0.37

Weight (kg)47.8±3.345.8±4.1

0.92

BMI (kg/m2)

19.5±1.518.9±1.4

0.32

Energy (kcal/day)

1686±159

1654±1460.66

Protein (%)

16.1±1.6

16.7±1.00.28

Lipid (%)

28.8±7.3

28.1± 3.8

0.81

Carbohydrate (%)

55.1±8.455.3±4.10.95

Physical activity(step/day)

7847±1696

8185±3558

0.79

Values are means ± SD
P-value using a Mann-Whitney U-test. All the data were similar between the groups.

Nutrient intakes（Energy％）%

HP group

HC group

70

***

60
50

***

40
30
20100Protein

LipidValues are means ± SD.
P-value using Mann-Whitney U-test between the groups.
*** P<0.001

CarbohydrateEnergy and Nutrient intakes
HP group(n=10)

HC group(n=10)

P-value

Energy (kcal)

1558±991551±242

0.94

Protein (g)116.2±4.6

57.1±2.3<0.001

Lipid (g)49.4±3.749.5±6.2

0.98

160.8±12.8

219.9±44.9

0.002

8.9±0.1

8.9±0.1

0.61

Carbohydrate(g)Fiber (g)Values are means ± SD
P-value using a Mann-Whitney U-test between groups.

Changes in body weight
HP群 (n=10)

InitialBody weight (kg)
Change (kg)Final

HC群 (n=10)

InitialFinal

47.8 ± 3.3 47.8 ± 3.2 45.8 ± 4.1 45.8 ± 4.4
0.0 ± 3.4

0.0 ± 0.7

Values are means ± SD. Comparison were made between baseline and final
values within a group by Wilcoxon signed-rank test and no differences werefound (P>0.05). There was not statistical difference between changes in thetwo groups by a Mann-Whitney U-test (P>0.05)

Article No. 2

Title: Write so that readers can understand the study .
Better to avoid, XEffects …., Study on…. , because we
Ti well.
can not know the results until we read

Background:

What is the problem?
What is known andwhat is not known,

Therefore,
what are you
going to do?
Methods

Methods

Results
Conclusion

Article No. ３
Simple but dietitian’s observation can be a good article

Article No. ３
Simple but dietitian’s observation can be a good article

No. 4 Research articles in
Journal of Academiyof Nutrition and Dietetics 2021
by the USA and Canada Dietetic Association(Details are shown in the last part of this PPts)• What can we learn from this journal to be
accepted by good journals?

Original articles in the Journal of Academy of Nutrition 2021
• Relationships Among the Physical and Social Home Food
Environments, Dietary Intake, and Diet Quality in Mothers andChildren• A Mixed-Methods Evaluation of a School Wellness Initiative:
An Examination of Longer Lunch Periods and More Physical ActivityOpportunities• Associations of Dairy Intake with Circulating Biomarkers ofInflammation, Insulin Response, and Dyslipidemia among
Postmenopausal Women• Examining Associations Between Dietary Inflammatory Index inPregnancy, Pro-inflammatory Cytokine and Chemokine Levels atBirth, and Offspring Asthma and/or Wheeze by Age 4 Years• Relationships Among the Physical and Social Home Food
Environments, Dietary Intake, and Diet Quality in Mothers andChildren• A Qualitative Study Unpacking Factors That Influence
Infant Feeding at Hospital Discharge Among Urban,
Socioeconomically Disadvantaged Women• Associations between ultraprocessed food consumption
and total water intake in the US population• Moving Beyond Breastfeeding Initiation: A Qualitative
Study Unpacking Factors That Influence Infant Feeding atHospital Discharge Among Urban, Socioeconomically
Disadvantaged Women• The Value of Programmatic Assessment in Supporting
Educators and Students to Succeed: A QualitativeEvaluation• Association Between Frequency of Eating Away-FromHome Meals and Risk of All-Cause and Cause-Specific
Mortality• Revising the Academy’s Research Priorities: Methods of the ResearchPriorities and Strategies Development Task Force, 2017-2019• Diet Quality Indices in the SUN Cohort: Observed Changes and Predictorsof Changes in Scores Over a 10-Year Period• A Mixed-Methods Evaluation of a School Wellness Initiative: An
Examination of Longer Lunch Periods and More Physical Activity
Opportunities• Associations of Dairy Intake with Circulating Biomarkers of Inflammation,Insulin Response, and Dyslipidemia among Postmenopausal Women• Examining Associations Between Dietary Inflammatory Index in Pregnancy,
Pro-inflammatory Cytokine and Chemokine Levels at Birth, and Offspring
Asthma and/or Wheeze by Age 4 Years• Association Between Diet Quality and Cardiometabolic Risk Factor
Clustering Stratified by Socioeconomic Status Among Chinese Children• Relationships Among the Physical and Social Home Food Environments,
Dietary Intake, and Diet Quality in Mothers and Children• Diet Quality and Cardiometabolic Risk Factor Clustering Stratified by
Socioeconomic Status Among Chinese Children• Pilot Study of a Farm-to-Special Supplemental Nutrition Program forWomen, Infants, and Children (WIC) Intervention Promoting VegetableConsumption• Relationships Among the Physical and Social Home Food Environments,
Dietary Intake, and Diet Quality in Mothers and ChildrenOriginal articles in the Journal of Academy of Nutrition 2021
• Food Insecurity, Dietary Quality, and Health Care Utilization in LowerIncome Adults: A Cross-Sectional Study• The Cost of Diets According to Nutritional Quality and Sociodemographic
Characteristics: A Population-Based Assessment in Belgium• Favorable Commercial and Health Behavior Impacts of a Healthy Vending
Policy at an Australian University• Infant and Early Child Appetite Traits and Child Weight and Obesity Risk inLow-Income Hispanic Families• Coffee Consumption and the Risk of All-Cause and Cause-Specific Mortality
in the Korean Population• Healthy Eating Index-2015 Scores Among Adults Based on Observed vsRecalled Dietary Intake• Applying the Healthy Eating Index-2015 in a Sample of Choice-Based
Minnesota Food Pantries to Test Associations Between Food Pantry
Inventory, Client Food Selection, and Client Diet
• Associations Between Diet Quality and Dental Caries in Low-Income Women• Limited Association between the Total Healthy Eating Index-2015 Score andCardiovascular Risk Factors in Individuals with Long-Standing Spinal Cord
Injury: An Exploratory Study• Food Insecurity and Dietary Intake among College Students with Unlimited
Meal Plans at a Large, Midwestern University• Subtypes and Severity of Irritable Bowel Syndrome Are Not Related toPatients’ Self-Reported Dietary Triggers: Results From an Online Survey inDutch Adults• Opportunities to Promote Healthy Weight Through Child Care Licensing
Regulations: Trends in the United States, 2016-2020• Protein Intake During Infancy and Subsequent Body Mass Index in Early
Childhood: Results from the Melbourne InFANT Program• Stress and Depressive Symptoms Are Not Associated with Overall Diet
Quality, But Are Associated with Aspects of Diet Quality in Pregnant
Women in South Carolina• Identification and Critical Appraisal of Food Service Satisfaction
Questionnaires for Use in Nursing Homes: A Systematic Review• Disaster Management and School Nutrition: A Qualitative Study ofEmergency Feeding During the COVID-19 Pandemic• A Qualitative Exploration of Predominantly White Non-Hispanic Tennessee
WIC Participants’ Food Retail and WIC Clinic Experiences During COVID-19• Strategies to Reduce Consumption of Unhealthy Foods and Beverages:
Scenario Modeling to Estimate the Impact on the Australian Population’s
Energy and Nutrient Intakes• Differences in Dietary Patterns Identified by the Gaussian Graphical Modelin Korean Adults With and Without a Self-Reported Cancer Diagnosis• Qualitative Study on Participant Perceptions of a Supermarket Fruit andVegetable Incentive Program• Skin Carotenoid Scores Assessed with Reflection Spectroscopy Are
Associated with Self-Reported Fruit and Vegetable Intake Among Latino
Early Adolescents• Examining Parent Preferences for the Use of Behavioral EconomicStrategies on Children’s Menus in Restaurants• Examining Parent Preferences for the Use of Behavioral Economic
Strategies on Children’s Menus in Restaurants• Development and Qualitative Pretesting of Child Feeding and Obesity
Prevention Messages for Parents of Infants and Toddlers• Initial Development and Evaluation of the Food Processing Knowledge(FoodProK) Score: A Functional Test of Nutrition Knowledge Based on Levelof Processing• The Effect of Meal Replacement on Weight Loss According to CalorieRestriction Type and Proportion of Energy Intake: A Systematic Review andMeta-Analysis of Randomized Controlled Trials• Updates to the Definition of Evidence-Based (Dietetics) Practice: ProvidingClarity for Practice• Disaster Management and School Nutrition: A Qualitative Study ofEmergency Feeding During the COVID-19 Pandemic• A Qualitative Exploration of Predominantly White Non-Hispanic Tennessee
WIC Participants’ Food Retail and WIC Clinic Experiences During COVID-19• Strategies to Reduce Consumption of Unhealthy Foods and Beverages:
Scenario Modeling to Estimate the Impact on the Australian Population’s
Energy and Nutrient Intakes

Thanks a lot foryour patience