The Journal: a mirror for dietetics and dietitians. (Editorial).

It is often said that to predict the future we should study the past and to know where we are headed we should see from whence we have come. Recently, I had cause to reflect on where nutrition and dietetics has come from in the past 25 years and how this has been reflected in the Journal. The genesis of Nutrition & Dietetics: The Journal of the Dietitians Association of Australia began in 1944 with the Commonwealth Department of Health not quite ten years after the first dietitians began working in Australia. As you are aware there were differences initially between states in the training and role of dietitians and a national body was not born until 1976. Within ten short years the Dietitians Association of Australia was mature enough to assume responsibility for the Journal. In 1987 the DAA published Journal of Food and Nutrition. Journal of the Dietitians Association of Australia. The previous title was retained with the addition of our subtitle but it is worth remarking that the term for our core business 'dietetics' was not included. In 1989 this was remedied with a change of title to the Australian Journal of Nutrition and Dietetics. Our most recent title change to Nutrition & Dietetics is indicative of our coming of age in the discipline of dietetics. We no longer need to restrict our focus to Australia but instead we take our rightful place on the world stage of nutrition and dietetics. The profession and association can no longer be considered introspective only and we embrace our international colleagues and global responsibilities. As everything old is new again we resumed our original subtitle.

The Journal provides a chronicle of the changing interests and concerns of our discipline. Presently, at the forefront of nutrition are the problems surrounding the prevalence, prevention and treatment of overweight and obesity. Since 1997 (coinciding with the flow of information from the 1995 National Nutrition Survey) 12 articles have concerned overweight and obesity but in the first five years DAA published the Journal and before the epidemic was obvious, only three articles in this area were published. Another example is folate. During the 1990s folate became a much researched vitamin regarding its role in the prevention of neural tube defects and later hyperhomocysteinaemia and cardiovascular disease. The Journal published the proceedings of a conference on folate as a supplement and eight other papers have appeared. Conversely, we can see that some nutrients have become less popular in nutrition. The absence of articles concerning salt and hypertension in the past five years may add weight to Howe's 200 0 Viewpoint paper 'Why are we ignoring the salt guideline' (1). Fat intakes have consistently been a topic of publication but there has been a move from articles concerning total fat intakes to publications about Mediterranean diets and n-3 fatty acids.

At the recent DAA conference our keynote speaker from Malaysia, Dr E-Siong Tee, reminded us of the excessive statistics for Asia concerning prevalence of malnutrition and vitamin A deficiency in children and iron deficiency in women and children. Since the time DAA assumed publication of the Journal, among the vitamins, it is vitamin A that has been the subject of most papers and for micronutrients the one most published about is iron. Many of the articles concerning iron have involved study populations in Australia. Malnutrition in the clinical setting in developed nations persists almost 30 years after Butterworth's 'Skeleton in the hospital closet' (2) was published and the Journal has published almost 20 articles in this field in the past decade. Articles concerning dietary guidelines and recommended dietary intakes have been enduring topics and nutrition of children has occupied more copy than any other age group. Well do we heed the advice that the future of a country lies with the welfare of its childr en. Provision of optimum nutrition to children is perceived as most important.

As well as the knowledge base of dietetics, the Journal mirrors the skills. One of the fundamental skills that makes us dietitians is the ability to assess the dietary intakes of individuals and populations. This skill has been a key element of the majority of articles published. The Journal can also mirror the attributes for which dietitians strive. For example, the theme of our role as advocates has been reiterated over the years. In 1989, Jean McNaughton of the Food and Agriculture Organization (3) urged dietitians to:

...make a better job of empowering people to gain access to the food they need.

At this time she was referring mostly to the problems of malnutrition in the developing world but more than ten years later this theme re-emerges not only concerning our responsibility to developing nations but also in our own country, within our own neighbourhoods, as the problem of food security in Australia is addressed these same words ring true. This time there is the added dimension of our responsibility to sustainability and the environment. In 2001 our then President, Peter Williams (4), raises the role of advocacy.

If individuals start to demand changes they can raise awareness and make a difference ... responsibility for finding new paths to sustainability rests with us.

Another recurring theme is the need for dietitians to extend themselves beyond the 'comfort zone', to be active in the public arena and to make their messages available to all. In 1995, the dream of the DAA President Margaret Way (5) was to see:

... dietitians no longer striving to be politically ... correct one hundred percent of the time. ..concentrating on communicating the key messages ... dietitians who are not afraid of controversy ... convinced that they can make a difference.

and in 2001, Caryl Nowson (6) pleaded for dietitians:

... who are not afraid to put ideas in the public arena ... publicise these resutts at conferences and in the literature ... make mistakes and develop your passion for nutrition and dietetics.

Such themes persist not because dietitians are inherently complacent about the development of their discipline, career and public responsibility but because we acknowledge however far we have come there will always be more to achieve. One accomplishment mirrored by the Journal of which dietitians can be proud is the number of articles now authored by dietitians. In 1989 only 60% of articles published had an author with dietetic qualifications but in 2002 90% of authors had a dietetic qualification. I contend this is indicative of the maturation of the profession with acknowledgment that the development of the evidence base concerning the practice of nutrition and dietetics is dietitians' responsibility. The cynics may suggest that others no longer see the Journal as a valid place to publish but the inclusion of research in university curricula for dietetics and the growing number of dietitians undertaking doctoral degrees has fostered a large number of publications.

The future of the Journal and the future of the profession and the discipline of nutrition and dietetics will continue to be intertwined. The future can be learned from the past. In the first issue of the Journal published by the DAA in 1987, Leah Bernstein (7) provided the forecast for the way forward.

It is therefore important for the scope of the Journal to be far-reaching ... biochemistry, physiology, medicine, psychiatry, sociology, health education, agricultural economics, food technology, administration and management ... the subjects of food, nutrition and dietetics are rapidly expanding.

The value of the Journal will depend to a large extent upon the support it receives.

In 1995 Malcolm Riley (8) provided further direction:

... making some contents available via electronic media ... and including other professional groups in our region in the publication of the Journal.

The latter has been achieved with an international editorial board and Associate Editors from nutrition backgrounds other than dietetics, but we must maintain and build on the Journal's accomplishments. With respect to electronic media the advice of President Sandra Capra (9) in 2000, concerning new technology should be considered:

... there is a risk that not all practitioners will survive in this new world. Those who are left behind or who assume that it will not be taken up rapidly are likely to he affected.

While this was used in reference to the profession it applies equally to our Journal.

Finally, as dietitians continually endeavour to expand our knowledge and heighten our achievements we should be mindful not to neglect all that has preceded us. Much will be learned by searching in the mirror for the teachings of the older wise virgins. Once they are visible you can lead them beyond.

Margaret Aliman-Farinelli

Editor

Nutrition & Dietetics

References

(1.) Howe P. Why are we ignoring the salt guideline? Aust J Nutr Diet 2000;57:225-6.

(2.) Butterworth CE. The skeleton in the hospital closet. Nutrition Today 1974;9:4-8.

(3.) McNaughton J. Editorial: Freedom from Hunger-a basic right? Aust J Nutr Diet l989;46:3.

(4.) Williams P. Sustainability and sustenance. Aust J Nutr Diet 2001;58:145-6.

(5.) Way M. A dream for dietitians. Aust J Nutr Diet 1995;52:114-6.

(6.) Nowson C. The passion and pain. Aust J Nutr Diet 2001;58:207.

(7.) Bernstein L. Editorial: The Journal-A challenging opportunity. J Food Nutr 1987;44:1.

(8.) Riley M. The Journal: past, present ... and future. Aust J Nutr Diet 1995;52:171.

(9.) Capra S. Nutrition and technology-what does the future hold? Aust J Nutr Diet 2000;57:187.