TikTok is a global social media platform popular with young people, encouraging viewers to engage with user-generated video content (through likes, shares and comments) and mimic displayed behaviours (by creating similar videos or content). It is therefore a powerful and engaging tool that has potential for the widespread dissemination of information (or misinformation) and to influence behaviours. Social media is saturated with the promotion of ‘diet culture’ and has a strong influence on the eating behaviours of young people (1,2). This is concerning as childhood and adolescence are critical periods of growth requiring optimal nutrition (3). This study aimed to investigate how dieting is portrayed on TikTok and consider the potential implications for public health. A cross-sectional descriptive content analysis was undertaken of 50 videos from each of the five most popular diet-related hashtags (#diet, #whatieatinaday, #wieiad, #dietitian, #diettips). A codebook was developed to analyse the body-related content referenced (weight measurement, calories, body image, body checking, body comparisons over time) and collect the engagement for each video (likes, comments and shares). Overall, the 250 videos contributed to a total of 197.2 million likes (M = 789,051.0, SD = 923,335.0), 126,7251 comments (M = 5,069.0, SD = 9,315.3), and 3.8 million shares (M = 15,423.2, SD = 41,271.3). Most videos featured adults (n = 205, 82%), and only a small number of videos featured identifiable children or adolescents (n = 16, 6.4%). The information and advice regarding diets and eating behaviours came from two types of sources: 'experts’ and regular creators sharing their personal experience. Almost half of the videos were educational or instructional (n = 116, 46.4%), of which 74 (63.8%) were posted by users who claimed expert status. The most common titles by those claiming to be experts were “dietitian” (n = 43, 58.1%), “health and wellness coach” (n = 7, 9.5%), “doctor” (MD; n = 6, 8.1%), “fitness trainer” (n = 6, 8.1%), and “nutritionist” (n = 3, 4.1%). Of the videos that specifically mentioned a certain diet, the most common diets were low calorie (n = 32, 12.8%), vegan (n = 14, 5.6%), self-reported healthy eating (n = 12, 4.8%), and fasting (n = 10, 4.0%). The use of humour was the only feature significantly associated with engagement. Health professionals are presented with a unique opportunity to widely and positively influence the public by utilising the popularity of TikTok amongst young people to disseminate evidence-based information and promote healthy eating behaviours. Our findings suggest that experts using authentic, humorous, and engaging personas would be more likely to be popular on this platform.

Obesity can increase the risk of postoperative complications. Despite increased demand for patients living with obesity to lose weight prior to common surgical procedures, the impact of intentional weight loss on surgical outcomes is largely unknown. We aimed to conduct a pilot study to assess the feasibility of a full-scale randomised controlled trial (RCT) to examine the effect of preoperative dietitian-led Very Low Calorie Diet (VLCD) Clinic on surgical outcomes in gynaecology and general surgeries. Between August 2021 and January 2023, a convenience sample of adults living with obesity (BMI ≥ 30 kg/m2) awaiting gynaecology, laparoscopic cholecystectomy and ventral hernia repair procedures were randomised to dietitian-led VLCD (800–1000 kcal using meal replacements and allowed foods), or control (no dietary intervention), 2–12 weeks preoperatively. Primary outcome was feasibility (recruitment, adherence, safety, attendance, acceptability and quality of life (QoL)). Secondary outcomes were anthropometry and 30-d postoperative outcomes. Outcomes were analysed as intention-to-treat. Fifty-one participants were recruited (n 23 VLCD, n 28 control), mean 48 (sd 13) years, 86 % female, and mean BMI 35·8 (sd 4·6) kg/m2. Recruitment was disrupted by COVID-19, but other thresholds for feasibility were met for VLCD group: high adherence without unfavourable body composition change, high acceptability, improved pre/post QoL (22·1 ± 15 points, < 0·001), with greater reductions in weight (–5·5 kg VLCD v. −0·9 kg control, P < 0·05) waist circumference (–6·6 cm VLCD v. +0·6 control, P < 0·05) and fewer 30-d complications (n 4/21) than controls (n 8/22) (P > 0·05). The RCT study design was deemed feasible in a public hospital setting. The dietitian-led VLCD resulted in significant weight loss and waist circumference reduction compared with a control group, without unfavourable body composition change and improved QoL.

The aim of the present study was to develop and validate a test to evaluate dietitian's clinical competence (CC) about nutritional care in patients with early chronic kidney disease (CKD). The study was conducted through five steps: (1) CC and its dimensions were defined; (2) test items were elaborated, and choice of response format and scoring system was selected; (3) content and face validity were established; (4) test was subjected to a pilot test and those items with inadequate performance were removed; (5) criterion validity and internal consistency for final validation were established. A 120-items test was developed and applied to 207 dietitians for validation. Dietitians with previous CKD training obtained higher scores than those with no training, confirming the test validity criterion. According to item analysis, Cronbach's α was 0⋅85, difficulty index 0⋅61 ± 0⋅22, discrimination index 0⋅26 ± 0⋅15 and inter-item correlation 0⋅19 ± 0⋅11, displaying adequate internal consistency.

Dietary restriction of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is clinically effective and a commonly utilised approach in the management of functional symptoms in irritable bowel syndrome. Despite this, the low FODMAP diet has a number of challenges: it can alter the gut microbiota; impact nutrient intake and diet quality; is complex to understand; requires the patient to be adequately supported to follow the diet accurately and safely; and lastly, not all patients respond to the diet. The current review highlights the evidence for the clinical effectiveness of the low FODMAP diet, but focusses on the challenges associated with the diet to the patient, health professionals and the wider healthcare service. Finally, the review discusses research findings and practical guidance for how these challenges can be minimised and mitigated. The low FODMAP diet is a useful management strategy for irritable bowel syndrome, with data from clinical trials suggesting a 50–80% response rate, and when administered appropriately, the challenges to implementing the diet can be overcome so that these outcomes can be realised effectively and safely in clinical practice.

Diet–gene interactions have become the focus of much research in recent years. However, little is known about UK dietitians' involvement, confidence and knowledge in genetics and diet–gene interactions. A validated postal questionnaire sent to a randomly selected sample of 600 dietitians in the UK resulted in 390 responses (65 %). Most dietitians had no involvement in eleven activities relating to genetics and diet–gene interactions and lacked confidence in undertaking such activities. However, a significant positive association was found between involvement and confidence for all activities tested (P < 0·0001). A mean knowledge score of 41 % (sd 19) indicated generally low levels of knowledge in genetics and diet–gene interactions. Knowledge scores were higher for those who reported discussing the genetic basis of disease or discussing how diet–gene interactions affected risk (P < 0·05). For the majority of activities, dietitians who reported higher confidence had higher knowledge scores. Given the importance of interactions between genetics and nutrition in preventing and managing disease, this study identifies a need to increase the involvement, confidence and knowledge in genetics and diet–gene interactions of dietitians in the UK.

Enteral feeding in primary care has increased markedly over the last decade. It allows patients to be discharged to home or residential care who previously would have remained in hospital. Difficulties do arise for patients, their carers and health professionals, as care of these patients and support for health professionals is often patchy or non-existent. Dietitians are uniquely placed to participate in the management of tube feeding in primary care, provide support and education to patients and their carers, evaluate treatment and promote better outcomes for patients receiving tube feeding.