The Effectiveness of Telenutrition in Patient Outcomes

Kelli Baumgardner
Lauren Yacapraro

Bowling Green State University | Capstone Project

Introduction

Summary

The Academy of Nutrition and Dietetics defines telenutrition as the

interactive use by an RD of electronic information and
telecommunications technologies to implement the Nutrition Care
Process with individuals at another location and following state
laws1. Means of communicating when practicing telenutrition include,
but are not limited to: internet, social media, video conferencing,
telephone, email, and smartphone apps. Telenutrition can provide great
opportunities for underserved populations, such as rural and low
income populations, but it still requires more extensive research.
However, reimbursement for dietitians services can be more difficult
when not doing traditional face to face counseling. Additionally, patient
satisfaction and compliance must be assessed further when considering
telenutrition. In order to be an acceptable method of nutrition
counseling, telenutrition needs to prove to be just as effective, if not
more effective, than traditional counseling.

It has been concluded by the Evidence Analysis Library that there is good
evidence that supports the effectiveness of telenutrition as a part of
nutritional consult with a dietitian. It is particularly useful for people
who are in rural and underserved areas. Most research has concluded
that there is no significant difference between traditional counseling and
telenutrition, but both options have positive patient outcomes.4-9 More
studies need to be conducted using varying forms of telenutrition, as
many studies currently only include telephone and video conferencing
as means of communication. Limitations of telenutrition were cited in
several studies. These included relying on satellite locations to use
telenutrition, practitioners missing body language cues of patients, and
issues with reimbursement for services.4,5,10

Qualtrics Results
The survey was designed to assess a population already using electronic
communication on their opinions regarding the acceptability of using
telenutrition as a counseling method.
Telenutrition Impacts on Patient Care

Favored Types of Telenutrition

80
70

Percent

60
50
40
30
20
10
0

Telenutrition Options

The population surveyed

responded that they would be
more likely to communicate with
a dietitian using telenutrition
over traditional methods.
However, there was no
difference in the other
responses.

Participants who ranked the

following forms of
communication in their top three
choices:
77% video-conferencing
65% texting/telephone
46% Electronic
Newsletters/Email

Research
Early telenutrition involved kiosks being placed in locations that
were frequented heavily by low-income women and grocery
shoppers to provide nutrition education.2,3
At home parenteral nutrition and eating disorder populations in
several studies found that there were no significant differences
between using traditional counseling or telenutrition, but all
groups experienced positive results.4,5
Student athletes participated in a study using Twitter as a nutrition
education tool. It was found that Twitter prompts increased
nutrition knowledge, decreased percent calories consumed from
fat, and decreased BMI. Participants reported high satisfaction with
the program.6
Telenutrition in diabetes care had significantly lower A1C levels and
LDL cholesterol than the traditional counseling group.7
In several weight loss studies, telenutrition counseling is just as
effective as traditional counseling with decreased weight , BMI, and
waist circumference, as well as a telenutrition drop out rate of
about half traditional counseling drop outs in one study.8,9
Primary care physicians found telenutrition counseling to be
beneficial to diabetes patients, however had concerns about
increased paperwork and duplication of information.10
In general, most research that has been done shows no significant
difference between telenutrition counseling and traditional face to
face counseling.

Components Necessary for Successful Telenutrition Counseling

Connectivity: High
quality internet
connections to
provide real time
video conferencing

Access: Both
parties must
have access
to the
conferencing

Presentation Clarity:
The materials used
by the RDN must be
easily seen by the
receiving party.

Clinical Applications
Telenutrition can put RD practice at the front of a new movement! Here
are some ways telenutrition can benefit the RD profession:
Become electronically savvy; this can result in RDs getting their
message across further than just when the patient is in the office.
RDs can provide further education by using telenutrition.
More interaction between patient and RD.
Great way to reach less accessible populations, such as rural and
low socioeconomic status populations.
Get involved! This is another great way to connect with patients
and clients and be on the forefront of telehealth.
Gives more opportunity for reimbursement