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TABLE OF CONTENTS
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| 1 | Clinical Nutrition Research in Pediatrics
Kendrin Sonneville, ScD, RD, LDN
Have you ever wondered what impact your nutrition intervention has on the
short- and long-term health outcomes of your patients? Have you ever questioned
whether a nutrition intervention you use is superior to the standard clinic
practice? If so, you are thinking like a researcher.
Research is the cornerstone of nutrition and dietetics (1). Clinical dietitians are
surrounded by unanswered research questions and opportunities for research.
Good research is often the product of clinical experience and curiosity. As such,
clinical research typically evolves from a clinician's desire to improve patient
health or to increase effectiveness of services (1).
Although clinicians usually acquire a vast amount of anecdotal evidence
through clinical practice, it is the empirical evidence obtained by conducting clinical
research that is most often shared with others and used to improve care and
advance our field. Clinical nutrition research informs our practice, expands our |
| 6 | Pediatric Clinical Nutrition Research: Applications for the CTSA
Nicolle L. Quinn MS, RD, LDN
The National Center for Research
Resources (NCRR), a division of National
Institutes of Health (NIH), initiated the
Clinical and Translational Science Award
(CTSA) in 2006. There are currently 55
medical research institutions in 28
states and the District of Columbia who
have been awarded the CTSA. The
award was developed with the goal of
bringing together researchers to
improve the translation of research into
clinical practice for the patient (1).
Within each CTSA-funded research center
the infrastructure is made up of multiple
core departments which vary by
institution, one of which may be
Nutrition or sometimes referred to as
Bionutrition. The nutrition services
offered within a nutrition core vary from
site to site and may include nutrition
assessment techniques such as indirect
calorimetry, anthropometrics, dual energy
x-ray absorptiometry (DEXA), and
bioelectrical impedance analysis (BIA),
as well as nutrient intake analysis,
dietary counseling, and controlled feeding
studies. The research dietitian may
also assist principal investigators with
protocol development, study design,
data analysis, and manuscript preparation.
The objective of this article is to
review the role of the registered dietitian
within a pediatric-focused CTSAfunded
research center and to describe
a few of the nutrition research techniques
available and commonly practiced.
Some of these methods entail
measuring energy expenditure, energy
intake, body composition, bone density,
and other measures of growth. These
will be described in further detail. |
| 10 | International Pediatric Nutrition
Research: Experiences from
West Africa
Shelby E. Wilson, MPH, RD
The research process in developing
countries is fundamentally the same as
anywhere else: hypothesis formation,
data collection and analysis, and interpretation
of results. The differences are
the types of problems (undernutrition
and related health issues) and their causes,
and the resources available (human,
institutional, financial, infrastructure) to
conduct research. International nutrition
encompasses aspects of human nutrition
important to low-income populations
around the world, recognizing that these
populations are especially vulnerable to
undernutrition and related diseases (1).
The principal direct causes of childhood
undernutrition are lack of access to nutritious
foods, poor feeding practices, and
infection; although poverty, natural disasters,
political instability, and environmental
factors (such as lack of safe drinking
water and sanitation facilities, which
allow the spread of disease) are important
underlying factors (1). This paper
will provide an overview of the major
nutrition concerns among young children
of developing countries, a description
of the project I am helping to coordinate
in rural Burkina Faso, and some
personal reflections on the challenges
and rewards of this type of research. |
| 14 | Qualitative vs. Quantitative Methods: Two Opposites That Make a Perfect Match
Rayane AbuSabha, PhD, RD, Mary Lou Woelfel, MA, RD
Researchers in sociology, psychology,
nutrition, public health, and many other
related fields have been engaged in a
long-standing debate about the use of
qualitative vs. quantitative approaches to
research (1-4). The two philosophies are
as opposite as day and night. One, qualitative
research, rests on the principle of
subjectivity; it is often labeled soft and
unscientific (5,6). The other, quantitative
research, rests on the principle of objectivity;
it is faulted for forcing individuals
and human behavior into rigid categories
(2,6). Qualitative researchers argue that in
the absence of close connections with
the object of study, results will be distorted.
They seethe about the quantification
or categorization of any qualitative findings.
On the opposite end, quantitative
researchers argue that in the absence of
distance between the researcher and the
object of study, results will be distorted.
Quantitative researchers let their data
speak for itself, with no self-involvement
or judgment other than what the numbers
reveal. Researchers quickly joined
camps and considered any mixing of the
two methodologies as misguided and,
most of all, not pure (7-12). Yet being pure
often means being inflexible. How can we
study human nature, as infinitely varied
and in constant motion as it is, when we
are locked into rigid ways of thinking? |
| 19 | From the Editor
Lori J. Bechard, MEd, RD, LDN
As the fall season settles in with the return to
academia, many of us may be considering new
projects and ways to influence future pediatric
nutrition practice. In this first issue of the 2010-
2011 year of Building Block for Life, enthusiasm for
clinical research in the pediatric setting shines
through the words of the authors. |
Copyright 2010 Pediatric Nutrition Practice Group, ADA.
The BUILDING BLOCK FOR LIFE is published quarterly by
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FOR THIS ISSUE:EDITORLori J. Bechard, MEd, RD, LDN
Clinical Nutrition Specialist III
Children's Hospital Boston
300 Longwood Avenue
Boston, MA 02115
Co-EDITORMichelle S. Trumpy,A, MPH, RD, CSP, LD
The Emily Programy,A, RD
2265 Como Avenue
St. Paul, Minnesota LOOKING AHEADVolume 34, No. 1: The Ketogenic diet, classical and modified
Atkins approach; Motivational Interviewing for families of
children with special health care needs.
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