Objective: To assess and develop a consensus among a European panel of public health nutrition workforce stakeholders (academics and employers) regarding core functions required for effective public health nutrition practice. Design: A modified Delphi study involving data from two rounds of questionnaires administered among a panel of public health nutrition workforce stakeholders. Setting: Europe. Subjects: A panel of fifty-three public health nutrition development stakeholders, including thirty-three academics and twenty employers, sampled from eighteen European countries. Results: Panellists rated 50 % (19/38) of the initially listed functions as core (i.e. without which public health capacity is limited), using a majority cut-off (.50 %).

Objective: To assess and develop consensus among a European panel of public health nutrition stakeholders regarding the competencies required for effective public health nutrition practice and the level of proficiency required in different practice contexts. Design: A modified Delphi study involving three rounds of questionnaires. Setting: European Union. Subjects: Public health nutrition workforce development stakeholders, including academics, practitioners and employers, from twenty European countries. Results: A total of fifty-two expert panellists (84 % of an initial panel of sixty-two Delphi participants) completed all three rounds of the Delphi study. The panellists rated the importance of fifty-seven competency units possibly required of a public health nutritionist to effectively practice (Essential competencies). Twentynine of the fifty-seven competency units (51 %) met the consensus criteria ($66?7 % agreement) at the second round of the Delphi survey, with the highest agreement for competencies clustered within the Nutrition science, Professional, Analytical and Public health services competency domains. Ratings of the level of competencies required for different levels in the workforce indicated that for a public health nutrition specialist, advanced-level competency was required across almost all the twenty-nine competencies rated as essential. There were limited differences in rating responses between academics and employer panellists throughout the Delphi study. Conclusions: Competencies identified as essential can be used to review current public health nutrition practices and provide the basis for curriculum design and re-development, continuing education and workforce quality assurance systems in Europe. These are all important tools for systematic and strategic workforce development. Keywords Public health nutrition Workforce development Competencies Consensus Delphi methodThe capacity of the public health workforce is a key contributor to the ability of communities to address public health nutrition issues (1) . Workforce capacity is influenced by a range of determinants including the quality of workforce preparation and continuing professional development, workforce size, organisation and support (2) . With respect to workforce preparation and continuing professional development, competency-based approaches have been widely embraced recently as a process central to the professionalisation of public health and its related disciplinary groups (3)(4)(5)(6)(7) , including public health nutrition (7) .In the European context, workforce development that encourages optimal workforce mobility and collaboration in research and practice requires the development of comparably competent practitioners who are capable of developing and undertaking effective population-based strategies to meet nutrition and public health objectives. This has been the position of workforce development scholars for at least the last decade (8,9) . Competency standards provide the architecture for workforce developmen...

Biomarkers of dietary intake can be important tools in nutrition research. Our aim was to assess whether plasma alkylresorcinol (AR) and β-carotene concentrations could be used as dietary biomarkers for whole-grain, fruits and vegetables in a healthy Nordic diet (ND). Participants (n = 166), 30-65 y with a body mass index of 27-40 kg/m(2) and two more features of metabolic syndrome (International Diabetes Federation definition, slightly modified), were recruited through six centers in the Nordic countries and randomly assigned to an ND or control diet for 18 or 24 wk, depending on study center. Plasma AR and β-carotene were analyzed and nutrient intake calculated from 4-d food records. Median fiber intake increased in the ND group from 2.5 g/MJ at baseline to 4.1 g/MJ (P < 0.001) at end point (week 18 or 24), and median (IQR) fasting plasma total AR concentration increased from 73 (88) to 106 (108) nmol/L, or 45%, from baseline to end point (P < 0.001). The AR concentration was significantly higher in the ND group (P < 0.001) than in the control group at end point. β-Carotene intake tended to increase in the ND group (P = 0.07), but the plasma β-carotene concentration did not change significantly throughout the study and did not differ between the groups at follow-up. In conclusion, an ND resulted in higher dietary fiber intake and increased plasma total AR concentration compared with the control diet, showing that the total AR concentration might be a valid biomarker for an ND in which whole-grain wheat and rye are important components. No significant difference in plasma β-carotene concentrations was observed between the ND and control groups, suggesting that β-carotene may not be a sensitive enough biomarker of the ND.