Next-generation solutions to address adaptive challenges in dietetics practice: the I+PSE conceptual framework for action (2022)

Tagtow A, Herman D, Cunningham-Sabo L. Next-generation solutions to address adaptive challenges in dietetics practice: the I+PSE conceptual framework for action. J Acad Nutr Diet. 2022; 122(1): 15-24.

This article focuses on Applications for Professional Practice. The following is taken from the introduction to the article:

“It describes the Individual plus Policy, System, and Environmental (I+PSE) Conceptual Framework for Action (known as the “Framework”) as a roadmap for RDNs across all areas of practice (eg, research, education, clinical, community, and management) to better address adaptive challenges and to formulate multidimensional strategies for optimal impact. The Framework has cross-cutting practice implications for all areas of dietetics practice and can lead to the next generation of solutions to tackle adaptive challenges that better support nutrition and health.

The I+PSE Conceptual Framework for Action (see Figure) is a blueprint for RDNs and their partners to develop and implement multidimensional strategies using a systems orientation to achieve greater responsiveness to adaptive challenges and realize greater impacts.

  • Phase 1 –
    • Once an adaptive challenge is identified, RDNs can apply a determinants of health lens (Figure, phase 1) to closely examine nutrition and health problems and better identify why problems are worsening despite best efforts to solve them. The result of this focused assessment is a stronger diagnosis of the root causes that supports strategic decision-making in phase 2.
  • Phase 2 –
    • Is the formation of coordinated multidimensional strategies that produce a sustainable and synergistic effect.
  • Phase 3 –
    • Is the evaluation of outcomes and impacts of the suite of strategies and the degree to which change has occurred at the individual, practice, program, organizational, policy, and population levels. Encircling the Framework is systems thinking and reflection to support an iterative cycle of robust assessment, planning, implementation, and impact evaluation. The Framework is versatile and can be adapted to a wide range of nutrition issues, areas of dietetics practice, and diverse partnerships.”

Sustainable Food Systems Network (EUFIC)

European Food Information Council (EUFIC)‘s Global Sustainable Food Systems Network facilitates communication and collaboration amongst stakeholders in sustainable food systems (SFS) across the globe. In this community, you will find policy makers, business professionals, civil society organizations, researchers, NGOs/non-profit organizations, funding agencies and interested citizens. The network allows members to:

  • Add to and use the resources section
  • Reach out to members through the chat in a field/topic you are interested in. Network, ask questions, build bridges. Chat conversations are private and confidential!
  • Publish about events you are organizing regarding SFS (on average, 30-120 members attend events shared in the feed!)
  • Peruse the calendar of events shared by other members.
  • Share calls, documents, reports, papers, etc. that you think are interesting for the whole community.
  • Ask the community for feedback and start a conversation, e.g. by creating a poll!
  • Share job openings as “opportunities”. The network currently spans 2000+ people, and their personal networks spread much further.

The SFSN Community leaders send a biweekly newsletter with featured shared events, opportunities, posts, and new members for further dissemination.

If you have any feedback, questions or would like to get more involved, email or contact us directly through the chat (search Community Managers).

Aquatic Foods Toolkit (2023)

A World of Aquatic Foods Resources: Open-access resources designed to empower chefs, foodservice, consumer packaged goods entrepreneurs, healthcare professionals, and other aquatic food advocates in promoting bivalves and sea vegetables.

🌐 You’ll get: Free, open-access toolkits, packed with evidence-based resources, eater insights, tested messaging, nutritional guidance, and inspiring recipes. Access to an interactive Aquatic Foods Ecosystem Map, so you can connect with others creating impact through sea vegetables and bivalves.

Aquatic foods—foods derived from aquatic animals, plants, or algae—have long been enjoyed traditionally by many cultures through the centuries. They have been highlighted in recent landmark reports for their ability to help build a healthy, diversified, equitable, and sustainable food future. Few topics today at the intersection of food, cuisine, health, and sustainability are more exciting than the vast potential of foods from the sea.

For this project, Food for Climate League joined forces with Food + Planet (F+P) and set out to develop narratives that can equip foodservice, CPG, retail, and nutrition professionals to market and promote sustainable aquatic foods successfully. With funding from Builders Initiative, they developed evidence-based health and wellness messaging and narratives for sustainable and nutritious aquatic foods, namely bivalves and sea vegetables.

🪸 The research outlined in the toolkits is a mix of qualitative and quantitative work conducted in 2022 to understand the aquatic foods landscape, including current and potential focus points and narratives around sustainable aquatic foods.

Pollinator Friendly Cookbook

Use this cookbook by Pollinator Partnership to create culinary masterpieces that honor pollinators and the work that they do.

Food is a basic human need, and without pollinators, humans would go hungry! 🦅 🦇 🐝 🦋 🪲 🪰 Birds, bats, bees, butterflies, beetles, flies, and small animals that pollinate plants are responsible for bringing us one out of every three bites of food. More than 200,000 species of pollinators are critical to the stability of our food supply.

In your search for ingredients, we encourage you to support local farmers that practice pollinator-friendly management techniques. Learn more at the Pollinator Partnership website.

‘It’s a constant changing environment, and we’re just playing catch up’: Hospital food services, food waste, and COVID-19 (2022 Jun)

(available for download at the bottom)

Cook N, Goodwin D,Collins J, Porter J.‘It’s a constant changingenvironment, and we’re just playing catch up’:Hospital food services, food waste, and COVID-19.Nutrition & Dietetics. 2022;1‐10. doi:10.1111/1747-0080.12762

Open access link to article:

Relevant to: 

Foodservice dietitians


The research wanted to understand the impacts of COVID-19 on hospital foodservice practices. Specifically, how COVID-19 impacted the completion of food waste audits and the generation of food waste in hospital foodservice.

Bottom line for nutrition practice: 

  • Foodservice staff are a resilient workforce group
  • Forced changes in resource allocation and usage allowed foodservices to adapt and learn to work with COVID-19 restrictions, potentially beginning the path to post-pandemic services.
  • This stage of the ‘green recovery’ can be led by dietitians and may incorporate food waste audits as a higher priority.
  • The success of electronic menu management tools during this period to combat contact restrictions may see them remain as ‘standard procedure’ for food waste data collection and be selected for uptake in additional hospitals who do not have this technology currently.


  • Aims: Hospital food service operations have been affected by the COVID-19pandemic, particularly resulting in increased waste. The aim of this research was to explore the impact of the COVID-19 pandemic on hospital food ser-vices, particularly on food waste and the completion of food waste audits.
  • Methods: A qualitative interview research design was used. Semi-structured interviews were completed and recorded via Zoom, focusing on the barriers and enablers towards the completion of hospital food waste audits. Twenty-one participants were interviewed from 12 hospitals. No questions were related o the COVID-19 pandemic and its impact on hospital food services, however this issue frequently emerged during interviews. Data were coded following inductive thematic analysis.
  • Results: Five themes were generated from the interviews related to COVID-19and hospital food services; impacts on practice, labour, change, technology and post-pandemic expectations. Participants reported COVID-19 negatively affected food service operations. Changes included increased food waste, con-tact restrictions, and labour shortages. Nonetheless, hospitals embraced the challenge and created new positions, trialled different food waste data collection methods, and utilised technology to support food service operations around COVID-19 restrictions.
  • Conclusions: Despite the impact COVID-19 had on hospital food services, including their ability to audit food waste and increased food waste generation, the response from food services has demonstrated their adaptability to change. Sustainable healthcare, including the aggregate measuring and reduction of food waste in hospital food services, is an essential transition post-pandemic, and may be facilitated through the operational changes forced by COVID-19.

Details of results: 

Five themes were generated from the data after inductive coding was completed: these are below in dot point format with some of the dominant responses presented.

  1. Impacts on practice
    • Infection prevention led to increased pre-packaged single serve food, utensils, crockery and their waste
    • The re-use, storage, or donation of used items was prohibited
    • Waste disposed of in patient rooms
    • Forecasting was impacted by COVID peaks
  2. Change
    • Some changes occurred immediately, others took time
    • Reduction in hospital catering services
    • COVID-19 as an excuse to trialing new practice
    • Ingredients inaccessible and out of stock
  3. Technology
    • Room service was recommended to forecast meal numbers and support food service delivery
    • Electronic menu management systems with waste measurement capabilities were supportive in plate waste data collection but not available at all sites due to cost, equipment, and manual data collection still being part of standard practice
  4. Labour
    • Higher than usual sick leave
    • Failure to hire new staff (>300 interviews completed at one site)
    • Individuals forced to step in to new and unfamiliar roles (e.g. manager to chef)
    • Cumulative pressure on staff throughout COVID including vaccine mandate in Victoria which resulted in loss of staff
    • Nutrition students unavailable to hospitals for placement
  5. Post Pandemic expectations
    • Hope for practice to return to normal as soon as possible or when the pandemic is ‘over’
    • Planning for future emergencies already to counteract drastic changes in service and practice

Of additional interest: 

Editor’s comment:  

@nathan_cook includes the audit tool with descriptions for you available at this link in the side bar.

Conflict of interest/ Funding:  

One author of the research is an editor at the journal, however the journal undergoes a blinded peer review process. Funding was received by Nathan Cook in the form of a scholarship from the King and Amy O’Malley Trust Scholarship and the Department of Nutrition, Dietetics and Food at Monash University as part of his PhD.

External relevant links:  

A blog describing the research article –

Corresponding author: 

Nathan Cook, @nathan_cook, PhD candidate,

Delivering community benefit: Healthy food playbook (tool)

The “Delivering community benefit: Healthy food playbook” is a suite of resources to support hospital community benefit professionals and community partners in developing community health interventions that promote healthy food access and healthier food environments.

If a facility has identified obesity, food access, or diet-related health conditions among the priority health needs in its community health needs assessment (CHNA), then initiatives to promote healthy food access and increased consumption of fruits and vegetables can be important components of an implementation strategy to address these needs.

The playbook has several sections with resources to support different stages of the community benefit or community health planning process. Each resource provides examples and links to learn more. These resources will inspire and strengthen your efforts to promote healthy and vibrant communities with healthy, sustainable, and equitable community food systems.

Inspired by a commitment to respond to community health needs, Health Care Without Harm’s Healthy Food in Health Care program carried out a national research project to support hospital community benefit professionals and community partners in developing initiatives that promote healthy food access and healthier food environments. The project was supported by a grant from the Robert Wood Johnson Foundation

Healthy Food in Health Care Pledge (Tool)

You can encourage your Health Care institution to sign the Healthy Food in Health Care Pledge below, which is a framework by Health Care Without Harm US & Canada that outlines steps to improve the health of patients, communities, and the environment.

In addition to encouraging your Health Care systems to sign, implement, and report on this pledge, you could adapt this pledge to other situations – schools, churches, or other groups or institutions you are working with to signal to the marketplace about their interest in local, nutritious, sustainable food. Share back with us if you do this, and we will encourage others to sign!

The pledge

As a responsible provider of health care services, we are committed to the health of our patients, our staff and the local and global community. We are aware that food production and distribution methods can have adverse impacts on public environmental health. As a result, we recognize that for the consumers who eat it, the workers who produce it and the ecosystems that sustain us, healthy food must be defined not only by nutritional quality, but equally by a food system that is economically viable, environmentally sustainable, and supportive of human dignity and justice. We are committed to the goal of providing local, nutritious and sustainable food. This Healthy Food in Health Care Pledge is a framework that outlines steps to be taken by the health care industry to improve the health of patients, communities and the environment.

Specifically, we are committed to the following healthy food in health care measures for our institution.

We pledge to:

  • Work with local farmers, community-based organizations and food suppliers to increase the availability of locally-sourced food.
  • Encourage our vendors and/or food-management companies to supply us with food that is, among other attributes, produced without synthetic pesticides and hormones or antibiotics given to animals in the absence of diagnosed disease and which supports farmer health and welfare, and ecologically protective and restorative agriculture.
  • Increase our offering of fruit and vegetables, nutritionally-dense and minimally processed, unrefined foods and reduce unhealthy (trans and saturated) fats and sweetened foods.
  • Implement a stepwise program to identify and adopt sustainable food procurement. Begin where fewer barriers exist and immediate steps can be taken. For example, the adoption of rBGH free milk, fair trade coffee, or the introduction of organic fresh produce in the cafeteria.
  • Communicate to our Group Purchasing Organizations our interest in foods that are identified as local and/or third-party certified.
  • Educate and communicate within our system and to our patients and community about our nutritious, socially just and ecological sustainable food healthy food practices and procedures.
  • Minimize or beneficially reuse food waste and support the use of food packaging and products which are ecologically protective.
  • Develop a program to promote and source from producers and processors which uphold the dignity of family, farmers, workers and their communities and support sustainable and humane agriculture systems.
  • Report annually on the implementation of this pledge. 

StratKIT Platform – Sustainable public procurement and catering network & Sustainable Public Meal Toolkit (website)

StratKIT Platform sustainable public procurement and catering network offers open knowledge resources on sustainable public procurement and catering services. The details are in the StratKIT report.

The Sustainable Public Meal Toolkit provides experience-based advice on how to set up innovative strategies and activities for sustainable public procurement and catering services. The toolkit was developed in the Baltic Sea Region countries but can be used in many more places due to the generic descriptions in the tools. Start the change in your municipality, your company, your school, your hospital, or elsewhere! The tools, collected during the Interreg-BSR project StratKIT, range from strategic approaches to concrete activities in public catering facilities.

More than fifty tools are available for stakeholders involved in the provision of public meals, whether they be policymakers, procurers, caterers, producers, suppliers, consumers, or other public and private bodies. While all tools originated from BSR countries, some have been developed and piloted within the StratKIT project. Each tool is presented as a step-by-step procedure. To find tools suitable for your situation, you can either browse them all or find collections of tools for different topics in the thematic gateways. Add the most suitable tools to your own collection to download and print.

The Food Sustainability Index (FSI) as an Educational Tool (2016)

Food systems are at the heart of the 17 UN Sustainable Development Goals (SDGs). The Food Sustainability Index (FSI), now in its fourth iteration, has been developed by Economist Impact with the support of the Fondazione Barilla. The FSI examines how food systems are performing across three pillars: food loss and waste, sustainable agriculture, and nutritional challenges. Its 38 indicators and 95 sub-indicators address societal, environmental and economic themes in 78 countries. Discover data and make detailed comparisons by region, income group, country, index pillar or indicator. Deep dive into country profiles, rankings and correlations.

This resource was created as a transparent, diverse and evidence-based learning module. The FSI has an intended audience of university students and graduate students, but can be used for anyone who interested in learning more about the connection of food and nutrition to sustainable food systems and the Sustainable Development Goals.

The first edition of the FSI was published in 2016 and ranked the food sustainability of 25 countries. In 2017 this was expanded to 34 countries, followed by 67 countries in 2018. The 2021 Index examines the food systems of 78 countries, using 95 individual metrics across three key pillars: food loss and waste, Sustainable agriculture, and nutritional challenges. The Index now covers more than 92% of global GDP and 92% of the global population.