It is the position of Dietitians Australia that clients can receive high-quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via telehealth. Outcomes of telehealth-delivered dietetic consultations are comparable to those delivered in-person, without requiring higher levels of additional training nor compromising quality of service provision. Dietitians Australia recommends that policy makers and healthcare funders broaden the recognition for telehealthdelivered dietetic consultations as a responsive and cost-effective alternative or complement to traditional in-person delivery of dietetic services. The successful implementation of telehealth can help to address health and service inequalities, improve access to effective nutrition services, and support people with chronic disease to optimise their diet-related health and well-being, regardless of their location, income or literacy level, thereby addressing current inequities. K E Y W O R D S chronic disease, diet, digital health, nutrition, telehealth 1 | BACKGROUND Nutrition-related chronic diseases are the leading cause of ill health in Australia. 1 Within the next 5 years, it is estimated that over 75% of Australian adults will be living with overweight or obesity. 2 One in two Australian adults have a chronic disease, with over seven million (35% of the Australian population) living with nutrition-related chronic disease, including type 2 diabetes, cardiovascular disease, obesity, diet-related cancer, chronic kidney disease and mental health conditions. 1,3 Australia, like many developed countries, has an ageing population, which presents a significant challenge for the healthcare system. Together these will drive up healthcare expenditure and present a multitude of additional societal, geographical and workforce challenges for the healthcare system to manage. 4 Telehealth-delivered nutrition consultations offer a flexible modality to provide effective and cost-effective medical nutrition therapy (MNT), regular monitoring and support to the large numbers of people in the community requiring dietetic services, in particular those with obesity 5 and nutrition-related chronic disease. 6,7 According to the World Health Organisation, the term "telehealth" refers to the remote delivery of health services using information and communication technologies to exchange health information, either synchronously Authors are members of the Dietitians Australia Telehealth Working Group

SummaryObjectivesThis study explored weight bias amongst Australian Accredited Practising Dietitians (APDs) and the effect of client weight status on dietetic practice.MethodsParticipants were 201 APDs, recruited using purposive sampling. A self‐administered questionnaire, the fat phobia scale (FPS), was completed to assess explicit weight bias. Participants were then randomized to receive either a female within the healthy weight range or female with obesity, accompanied by an identical case study for a condition unrelated to weight. Participants assessed the client based on data provided, provided recommendations and rated their perception of the client.ResultsMean FPS scores indicated mild fat phobia. However, dietetic practice was significantly affected by the client's weight status. Dietitians presented with the female with obesity assessed the client to have significantly lower health and were more likely to provide unsolicited weight management recommendations. In addition, dietitians rated the client as less receptive, less motivated and as having a lower ability to understand and sustain recommendations.ConclusionsThe contribution of this study is the exploration of how weight status may impact dietetic practice including assessment, recommendations and perceptions of the client. Dietitians may practice in a manner that represents or could be perceived as negative implicit weight bias, despite the explicit FPS assessing only mild fat phobia. Further research to understand the extent of the problem and how it impacts client outcomes and to test possible solutions is required.

BackgroundThe purpose of this study was to determine if cold water swimmers (CWS) developed hypothermia over a 6-h cold water endurance swim and whether body composition, stroke rate (SR) or personal characteristics correlated with core temperature (TC) change. Nine experienced male and female CWS who were aspiring English Channel (EC) swimmers volunteered to participate. Subjects aimed to complete their 6-h EC qualifying swim (water 15–15.8 °C/air 15–25 °C) while researchers intermittently monitored TC and SR. Data obtained included anthropometry (height, mass, segmental body composition), training volume and EC completion.ResultsOf the nine swimmers who volunteered, all successfully completed their EC qualifying swim. Six CWS had complete data included in analysis. One CWS demonstrated hypothermia (34.8 °C) at 6-h. TC rate of decline was slower in the first 3 h (−0.06 °C/hr) compared to the last 3 h (−0.36 °C/hr) of the swim. Older age was significantly correlated to TC change (r = −0.901, p < 0.05) and SR change (r = −0.915, p < 0.05). Absolute and percentage body fat (BF) were not significantly associated with higher TC. Mean SR over the 6-h swim was 57.8 spm (range 48–73 spm), and a significant (p < 0.05) decline in SR was observed over the 6 h (−9.7 %). A strong, positive correlation was found between SR change between 3 and 6 h and TC over the 6 h (r = 0.840, p < 0.05) and TC from 3–6 h (r = 0.827, p < 0.05). Seven of the nine participants (77.8 %) in this study successfully completed the EC crossing. Successful EC swimmers swam in the pool and open water (OW); however, they swam significantly [t (7) = −2.433, p < 0.05] more kilometres (M = 19.09 km/wk ± 5.55) in OW than unsuccessful (M = 9 km/wk ± 1.41) EC swimmers. There was a significant relationship between EC crossing time and height (r = −0.817, p < 0.05), but no other variables and EC crossing time.ConclusionsCold water endurance swim (CWES) of 6-h duration at 15–16 °C resulted in TC reduction in the majority of swimmers regardless of anthropometry. More research is required to determine why some CWS are able to maintain their TC throughout a CWES. Our results indicate that older swimmers are at greater risk of developing hypothermia, and that SR decline is an indicator of TC decline. Our results also suggest that OW swimming training combined with pool training is important for EC swim success.

This study explored demographics and three characteristics of registered dietitians-optimism, perfectionism, and weight bias and whether they affect three components of dietetics practice-dietetics assessment, dietetics recommendations, and dietitian's perception of the client's success. Methods: A self-administered questionnaire was completed by 92 registered dietitians and student dietitians in New Zealand to assess explicit weight bias.[Correction added on 27 January 2023, after first online publication: in the preceding sentence, '109 registered dietitians' has been updated to '92 registered dietitians'.] Participants were randomised to receive a case study for a condition unrelated to weight accompanied by a photo of a woman with either a smaller or a larger body. Participants then assessed the client based on data provided, provided recommendations, and rated their perception of the client.Results: Mean (±SD) scores indicated mild fatphobia (2.63±0.39) in participating dietitians. Dietitians presented with the photo of a larger client assessed the client to have lower health and were more likely to provide unsolicited weight management recommendations. Additionally, dietitians rated the larger client as less receptive and motivated, and less likely to understand the recommendations adequately, with a lower ability to comply with and maintain these recommendations. Conclusions: Dietitians and student dietitians in New Zealand may practise in a manner that could be perceived as influenced by negative implicit weight bias, despite the explicit fatphobia scale scores assessing only mild fatphobia.Further research examining the extent of the problem in New Zealand, how it impacts client outcomes, and possible solutions are required.