Conceptualising sustainability in Canadian dietetic practice: A scoping review

BackgroundDietitians (RDs) are well-positioned to promote sustainable food systems and diets. This research aims to review the literature for how RDs in Canada define sustainability and determine the types of relevant activities that exist in practice as described in published literature.MethodsUsing standardised scoping review methods, researchers searched CINAHL, ACASP, PubMed and ENVCOM databases to identify peer-reviewed articles and conducted a grey literature search to locate other publications related to sustainability in Canadian dietetic practice. Qualitative, thematic coding methods were used to examine definitions and existing practice. The PRISMA extension for scoping reviews guided reporting.ResultsThe search resulted in 1059 documents and, after screening, 11 peer-reviewed and 16 grey literature documents remained. Ten unique definitions were used, the most common being Sustainable Diets. Definitions were multidimensional, including environmental, social, economic and health dimensions, and 31 unique subtopics. However, existing practice activities appear to reduce actions to one to two dimensions. Existing practice areas well-reflected include Food and Nutrition Expertise, Management and Leadership, Food Provision and Population Health Promotion. Notable gaps include action in Professionalism and Ethics and Nutrition Care.ConclusionsNo single definition supports all professional contexts, and agency in choice of language to define the work is helpful for contextual clarity. Strengthening practitioners' ability to analyse issues using systems thinking and applying this in practice will help to address challenges and reduce risks of trade-offs. Updates to competency standards that reflect the breadth of existing activities, as well as curricular supports or practice standards, are needed. Dietitians are well-positioned to promote sustainable food systems and diets. This research identifies practice activities described in the Canadian published literature and compares these with dietetic competency standards. Increasing practitioners' ability to analyse issues using systems thinking will help address complex challenges. Updates to competency standards and curricular supports are needed to support this area of practice.image The industrial food system is degrading and depleting natural resources needed to support food production and healthy eating.Dietitians are strategically positioned to promote sustainable food systems and sustainable diets.According to published literature, Canadian dietitians use 10 unique multidimensional definitions that include environmental, social, economic and health dimensions. However, practice activities appear to reduce actions to one to two dimensions.Thinking beyond multidimensional perspectives to a complex systems approach would move sustainability in dietetic practice forward.Outlining specific sustainability competencies through practice standards, guideline documents or other supports would further advance incorporating sustainable food systems in practice.