Dietitians’ involvement, confidence and perceptions around processed foods and health: Preliminary Survey Results

Abstract

Food processing, defined as a range of processes which convert fresh food into safe products, is of interest to nutrition professionals including dietitians given associations between consumption of highly processed products and health⁽¹⁾. Given such products contribute between 51-68% to UK diets⁽²⁾, dietetic practice is now likely to encompass this topic. This study aimed to explore dietitians’ involvement in professional practice around the topic of processed foods and health, and their perceptions of individual products displaying label information (nutrition and ingredients).

An online survey was developed using (5-point likert scale) items adapted from other surveys^(3,4) to evaluate levels of professional involvement (1 = never, 5 = daily) and confidence (1 = not confident, 5 = very high) around this topic. For three products displaying label information (tinned tomatoes, Quorn Mince, wholemeal bread), respondents’ perceptions of; level of processing (i.e. ranging from

“minimally processed” to “highly/ultra-processed”) and recommended frequency of consumption (FoC) (1 = should be avoided, 5 = several times a day) were evaluated. Ethical approval was granted before survey invites were sent via email to over 10,000 members of the British Dietetic Association between November 2023 and January 2024. Data analysis quantified percentages of all responses (%) and Kruskal-Wallis and Wilcox Pairwise tests were performed to explore differences in respondents’ overall responses across, and between pairs of products.

A total of 366 dietitians completed the survey. Most (96%) were female with an average of 13 ±9.8 years in practice across specialisms including diabetes, paediatrics, and gastroenterology. In practice, around half of respondents were regularly (weekly or daily) engaged in discussion of processed foods and health (51%) and provided guidance on this topic (46%). Most reported high confidence in discussing (61%) and providing guidance (59%) on processed foods and health. Most strongly agreed/agreed that healthy balanced diets can include some processed (94%) and “highly/ultra” processed (71%) foods, and that nutritional content is more important than level of processing (61%). Most respondents reported high/very high confidence (range: 60%-62%) in their classifications of processing levels for each product. Respondents’ most popular classification of products were: tomatoes “minimally processed” (54%), Quorn mince “highly/ultra-processed” (57%), and bread “processed” (46%), which were significantly different across products (p = <0.01). Perceptions of recommended FoC were also significantly different across products; tomatoes and bread “several times a week” (69%, 58%, respectively), and Mince “several times a month” (40%) (p = <0.01).

Surveyed dietitians reported high involvement and confidence in discussing and providing guidance around processed food and health. Perceptions of individual product’s level of processing varied across three processed products which displayed label information. This is the first insight into dietitians and the topic of processed foods, and further work is warranted to support dietetic practice and training.