{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:40:56Z","timestamp":1792550456634,"version":"4.5.0"},"reference-count":103,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010333","name":"University of Chester","doi-asserted-by":"publisher","award":["QR225"],"award-info":[{"award-number":["QR225"]}],"id":[{"id":"10.13039\/100010333","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nutrition Bulletin"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>People with intellectual disabilities generally have poorer health outcomes compared with those who do not, including outcomes related to nutrition\u2010related non\u2010communicable diseases. Carers support people with intellectual disabilities in many aspects including habitual shopping and preparation of food, but their own nutrition knowledge and the influence this may have on dietary intakes of clients is unknown. We explored the nutrition knowledge of carers of people with intellectual disabilities in residential care settings, their dietary habits and their influence on clients' food shopping and preparation and therefore the diet consumed by their clients. Ninety\u2010seven carers belonging to a large independent care sector organisation specialising in the care of people with an intellectual disability completed a validated general nutrition knowledge and behaviour questionnaire. Seventeen carers from the residential care settings were interviewed to contextualise practice. Knowledge about key dietary recommendations scored highly. Carers who had more work experience were found to have higher scores in \u2018making everyday food choices\u2019 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.034). Daily consumption of fruit and vegetables (at least one portion per day) was observed (for fruit by 46% of the carers and for vegetables by 60% of the carers), whilst most carers reported avoiding consuming full\u2010fat dairy products, sugary foods and fried foods. The concept of a healthy diet; typical dietary habits of clients; role in food acquisition; and training in nutrition emerged as themes from the interviews. Carers discussed various topics including the importance of a balanced diet, cooking fresh foods and control of food portion sizes for clients relative to the care philosophy of a client\u2010centred approach, which encapsulates client autonomy. Gaps in knowledge around specific nutrients, making healthy choices and cooking skills remain. Carers have an influence on clients' dietary choices; they are able to provide healthy meals and share good dietary habits with clients. Further training in nutrition is recommended for impact on clients' health.<\/jats:p>","DOI":"10.1111\/nbu.12600","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T09:18:48Z","timestamp":1673947128000},"page":"74-90","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Nutrition knowledge and influence on diet in the carer\u2013client relationship in residential care settings for people with intellectual disabilities"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3053-3089","authenticated-orcid":false,"given":"Asl\u0131han","family":"\u00d6zdemir","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Health Sciences Hacettepe University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Learning Disabilities, Faculty of Health and Social Care University of Chester  Chester UK"},{"name":"School of Nursing, Midwifery and Social Work University of Salford  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lovell","sequence":"additional","affiliation":[{"name":"Department of Social Work and Interprofessional Studies, Faculty of Health and Social Care University of Chester  Chester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6825-9770","authenticated-orcid":false,"given":"Basma","family":"Ellahi","sequence":"additional","affiliation":[{"name":"Department of Social Work and Interprofessional Studies, Faculty of Health and Social Care University of Chester  Chester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3402\/fnr.v52i0.1857"},{"key":"e_1_2_11_3_1","first-page":"612","article-title":"Using hermeneutic phenomenology to investigate how experienced practitioners learn to communicate clinical reasoning","volume":"12","author":"Ajjawi R.","year":"2007","journal-title":"Qualitative Report"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1258\/1355819054338997"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l84"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11061281"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7294.1115"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/swr\/35.1.11"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/opn.12016"},{"key":"e_1_2_11_10_1","unstructured":"Beverly B. David C. Kerry S. Polly P. Caireen R. Toni S.et al. (2020)National Diet and Nutrition Survey Rolling programme Years 9 to 11 (2016\/2017 to 2018\/2019) \u2010 a survey carried out on behalf of Public Health England and the Food Standards Agency.https:\/\/doi.org\/10.17863\/CAM.81787"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/13668250.2016.1253051"},{"key":"e_1_2_11_12_1","volume-title":"Improving general hospital care of patients who have a learning disability","author":"Bowness B.","year":"2014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/fi5030376"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-4446.2007.00138.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddrr.1123"},{"key":"e_1_2_11_17_1","volume-title":"The Oxford Handbook of multimethod and mixed methods research inquiry","author":"Creswell J.W.","year":"2015"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2021.1966737"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2017.1316849"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2009.02.014"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2011.09.022"},{"key":"e_1_2_11_22_1","unstructured":"Department of Health and Social Care. (2006)Our health our care our say: a new direction for community services: a white paper. London HMSO. Available at:https:\/\/www.gov.uk\/government\/publications\/our\u2010health\u2010our\u2010care\u2010our\u2010say\u2010a\u2010new\u2010direction\u2010for\u2010community\u2010services[Accessed 5th Sep 2022]"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41415-019-0468-3"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgpopen20X101030"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1744629518773938"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12595"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.08.029"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2004.00617.x"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpmed.2014.11.003"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu7105404"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2011.07.004"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-88"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2013.08.017"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ev.20054"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12480"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12010037"},{"key":"e_1_2_11_37_1","volume-title":"Staff in services for people with learning disabilities","author":"Hatton C.","year":"2002"},{"key":"e_1_2_11_38_1","unstructured":"Hatton C. Glover G.&Emerson E.(2016)Learning disabilities observatory. People with learning disabilities in England in 2015: main report: Public Health England 2016."},{"key":"e_1_2_11_39_1","unstructured":"Health Education England. (2017)Person Centred Approaches: Empowering people in their lives and communities to enable an upgrade in prevention well\u2010being health care and support. Available at:https:\/\/www.skillsforhealth.org.uk\/wp\u2010content\/uploads\/2021\/01\/Person\u2010Centred\u2010Approaches\u2010Framework.pdf[Accessed 5th Sep 2022]"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1123\/ijsnem.21.3.248"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12117"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980008003042"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0080.2007.00218.x"},{"key":"e_1_2_11_44_1","volume-title":"Confidential inquiry into premature deaths of people with learning disabilities (Cipold)","author":"Heslop P.","year":"2013"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2013.02.009"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303240"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12100"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneb.2014.08.003"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12058"},{"key":"e_1_2_11_50_1","volume-title":"Health literacy: a prescription to end confusion","author":"Kindig D. A.","year":"2004"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2016.87"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12254"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdi082"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14066"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6645a1"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.7748\/ldp.2021.e2163"},{"key":"e_1_2_11_57_1","volume-title":"Case study method: key issues, key texts","author":"Lincoln Y.S.","year":"2000"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1192\/apt.8.2.138"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.4236\/ojn.2012.23024"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12001"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2006.00915.x"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3148.2008.00462.x"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017000234"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-020-00563-7"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2017.09.004"},{"key":"e_1_2_11_66_1","unstructured":"NHS Digital. (2021)Statistics on obesity physical activity and diet England. 2021. Available at:https:\/\/www.gov.uk\/government\/statistics\/statistics\u2010on\u2010obesity\u2010physical\u2010activity\u2010and\u2010diet\u2010england\u20102021[Accessed 5th Sep 2022]"},{"key":"e_1_2_11_67_1","unstructured":"NHS England. (2016)Health and Care of People with Learning Disabilities: 2014 to 2015. Available at:https:\/\/www.gov.uk\/government\/statistics\/health\u2010and\u2010care\u2010of\u2010people\u2010with\u2010learning\u2010disabilities\u20102014\u2010to\u20102015[Accessed 25th Sep 2020]"},{"key":"e_1_2_11_68_1","unstructured":"NHS England. (2019)NHS taskforce to drive improvements in young people's hospital mental health learning disability and autism care. Available at:https:\/\/www.england.nhs.uk\/2019\/10\/nhs\u2010taskforce\u2010to\u2010drive\u2010improvements\u2010in\u2010young\u2010peoples\u2010hospital\u2010mental\u2010health\u2010learning\u2010disability\u2010and\u2010autism\u2010care\/[Accessed 9th Sep 2022]"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.12.017"},{"key":"e_1_2_11_70_1","unstructured":"Office for Disability Issues London. (2008)Independent living: A cross\u2010government strategy about independent living for disabled people. Available at:https:\/\/www.bl.uk\/collection\u2010items\/independent\u2010living\u2010a\u2010crossgovernment\u2010strategy\u2010about\u2010independent\u2010living\u2010for\u2010disabled\u2010people. [Accessed 10th Oct 2022]"},{"key":"e_1_2_11_71_1","unstructured":"Office for National Statistics. (2020)Estimates of the population for the UK England and Wales Scotland and Northern Ireland. Available:https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates\/bulletins\/annualmidyearpopulationestimates\/latest[Accessed 5th Sep 2022]"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12396"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1600726"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028618"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.304159"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003727-200610000-00011"},{"key":"e_1_2_11_77_1","unstructured":"Public Health England. (2016)Dysphagia or swallowing difficulties. Available at:https:\/\/www.gov.uk\/government\/publications\/dysphagia\u2010and\u2010people\u2010with\u2010learning\u2010disabilities\/dysphagia\u2010in\u2010people\u2010with\u2010learning\u2010difficulties\u2010reasonable\u2010adjustments\u2010guidance[Accessed 5th Sep 2022]"},{"key":"e_1_2_11_78_1","unstructured":"Public Health England. (2018)The Eatwell guide booklet. Available at:https:\/\/www.gov.uk\/government\/publications\/the\u2010eatwell\u2010guide[Accessed 10th Oct 2022]"},{"key":"e_1_2_11_79_1","unstructured":"Public Health England. (2021)Population screening: reducing inequalities for people with a learning disability autism or both. Available at:https:\/\/www.gov.uk\/government\/publications\/population\u2010screening\u2010supporting\u2010people\u2010with\u2010learning\u2010disabilities\/population\u2010screening\u2010reducing\u2010inequalities\u2010for\u2010people\u2010with\u2010a\u2010learning\u2010disability\u2010autism\u2010or\u2010both[Accessed 10 Oct 2022]"},{"key":"e_1_2_11_80_1","unstructured":"Public Health England. (2022)Obesity Profile: short statistical commentary July 2022. Available at:https:\/\/www.gov.uk\/government\/statistics\/obesity\u2010profile\u2010update\u2010july\u20102022\/obesity\u2010profile\u2010short\u2010statistical\u2010commentary\u2010july\u20102022~:~:text=There%20is%20large%20variation%20in from%2010.5%25%20to%2040.3%25[Accessed 10th Oct 2022]."},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-020-0616-5"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1610"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232676"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1177\/1362361316661261"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3156.1998.tb00040.x"},{"key":"e_1_2_11_86_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2014.82"},{"key":"e_1_2_11_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2016.09.006"},{"key":"e_1_2_11_88_1","unstructured":"Schulz P.J.&Nakamoto K.(2011)\u201cBad\u201d literacy the internet and the limits of patient empowerment. 2011 AAAI Spring Symposium Series."},{"key":"e_1_2_11_89_1","doi-asserted-by":"publisher","DOI":"10.1177\/147332500200100107"},{"key":"e_1_2_11_90_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2011.01175_37.x"},{"key":"e_1_2_11_91_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2011.01530.x"},{"key":"e_1_2_11_92_1","doi-asserted-by":"publisher","DOI":"10.1080\/0968759042000235299"},{"key":"e_1_2_11_93_1","doi-asserted-by":"publisher","DOI":"10.3109\/13668251003717928"},{"key":"e_1_2_11_94_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000065"},{"key":"e_1_2_11_95_1","volume-title":"People with learning disabilities in Scotland: 2017 health needs assessment update report","author":"Truesdale M.","year":"2017"},{"key":"e_1_2_11_96_1","unstructured":"Turner S.&Robinson C.(2021)Health Inequalities and People with Learning Disabilities in the UK: 2011. Implications and actions for commissioners and providers of social care. Evidence into practice report no. 4. Available at:https:\/\/www.ndti.org.uk\/assets\/files\/IHaL_2011_healthinequalitiessocialcare_guidance_final.pdf[Accessed 5th Sep 2022]."},{"key":"e_1_2_11_97_1","unstructured":"UK Public General Acts. (2018)The Data Protection Act 2018. Available at:https:\/\/www.legislation.gov.uk\/ukpga\/2018\/12\/contents\/enacted[Accessed 5th Sep 2022]"},{"key":"e_1_2_11_98_1","unstructured":"United Nations. (2022)Convention on the Rights of Persons with Disabilities (CRPD). Available at:https:\/\/www.un.org\/development\/desa\/disabilities\/convention\u2010on\u2010the\u2010rights\u2010of\u2010persons\u2010with\u2010disabilities.html[Accessed 5th Sep 2022]"},{"key":"e_1_2_11_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2009.12.003"},{"key":"e_1_2_11_100_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-018-0200-4"},{"key":"e_1_2_11_101_1","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12275"},{"key":"e_1_2_11_102_1","unstructured":"Wood A.&Grieg R.(2010)Supported living\u2010making the move: developing supported living options for people with learning disabilities. NDTi Housing and Social Inclusion Project Discussion Paper One. Bath: National development Team for Inclusion."},{"key":"e_1_2_11_103_1","volume-title":"International classification of functioning, disability and health (ICF)","author":"WHO (World Health Organization)","year":"2013"},{"key":"e_1_2_11_104_1","unstructured":"WHO (World Health Organization). (2018)Increasing fruit and vegetable consumption to reduce the risk of noncommunicable diseases. Available at:https:\/\/www.who.int\/elena\/titles\/fruit_vegetables_ncds\/en\/[Accessed 25th Jan 2022]."}],"container-title":["Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nbu.12600","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nbu.12600","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nbu.12600","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T12:21:38Z","timestamp":1692274898000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nbu.12600"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,17]]},"references-count":103,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/nbu.12600"],"URL":"https:\/\/doi.org\/10.1111\/nbu.12600","archive":["Portico"],"relation":{},"ISSN":["1471-9827","1467-3010"],"issn-type":[{"value":"1471-9827","type":"print"},{"value":"1467-3010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,17]]},"assertion":[{"value":"2022-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}