Thesis (MNutr)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Introduction: Nutritional genomics is a new and emerging field aimed at investigating the complex interactions between genetics and diet and the joint influence this has on disease prevention and health promotion. Research is accelerating at a rapid pace and although still in its infancy, it is important for registered dietitians (RDs) to be knowledgeable and keep abreast of these developments as it promises to revolutionize dietetic practice. International studies have demonstrated low confidence and involvement as well as poor knowledge of both genetics and nutritional genomics amongst RDs. To date no similar studies have been conducted amongst South African (SA) RDs. Methods: A cross-sectional descriptive study was conducted using a national survey of 1881 dietitians registered with the Health Professions Council of South Africa (HPCSA). Data was collected using an existing and validated questionnaire as developed for use in a similar study amongst RDs in the United Kingdom (UK). The self-administered questionnaire consisted of 4 sections to assess the following aspects: i) involvement and confidence in activities relating to genetics and nutritional genomics ii) knowledge of genetics and nutritional genomics iii) factors associated with knowledge and iv) demographic information. The main method of questionnaire distribution was via email (70%) using the Association of Dietetics in South Africa (ADSA) distribution service and questionnaires were posted to those RDs not registered with ADSA (30%). Results: The response rate was 15.2% (n = 279). Results showed low involvement in activities relating to genetics (n = 47, 17%) and nutritional genomics (n = 72, 25.8%). The majority of respondents indicated low confidence in performing activities relating to genetics (n = 161, 58.7%) and nutritional genomics (n = 148, 53.8%). However, a significant positive association was found between involvement and confidence for all activities (p < 0.001). The mean total knowledge score was 48.5 (±19%) and considered as low, with the mean genetics score of 58.5 (± 24%) being significantly higher than the nutritional genomics score of 31.9 (±23%), p < 0.001. Those respondents who reported involvement in discussing the genetic basis of a disease (p = 0.02); providing guidance to patients with genetic disorders (p = 0.01); providing training or education on human genetics (p = 0.01) and discussing with patients how diet may interact with genes to influence risk (p = 0.03) also had higher total knowledge scores. Factors associated with knowledge were greater genetics content in university studies (p < 0.001); higher qualification (p = 0.01); participating in related continuous professional development (CPD) activities (p <0.001) and considering genetics of greater importance to dietetic practice (p = 0.03). Conclusions: The results of this study indicate that there is overall low involvement, confidence and knowledge of genetics and nutritional genomics amongst SA RDs and this compares well with international studies. Recommendations therefore include the development of a competency framework for genetics and nutritional genomics for undergraduate dietetic education as well as CPD activities in order to provide the driving force for the development of this field in SA. / AFRIKAANSE OPSOMMING: Inleiding: Voeding genomika is 'n nuwe en ontwikkelende veld wat die komplekse interaksies tussen dieet en genetika bestudeer, asook die gesamentlike invloed wat dit op gesondheids- bevordering en siekte voorkoming het. Navorsing is vinnig besig om uit te brei en alhoewel dit nog in die begin fase is, is dit belangrik vir geregistreerde dieetkundiges (GDs) om op hoogte te bly van die nuutste ontwikkelinge, aangesien dit die potensiaal het om 'n merkwaardige invloed op die dieetkunde praktyk te hê. Internasionale studies het lae selfvertroue en betrokkenheid, asook lae kennis van genetika en voeding genomika onder GDs bevind. Daar is tans geen studies beskikbaar onder Suid Afrikaanse (SA) GDs nie. Methodes: 'n Dwarssit studie is onderneem deur gebruik te maak van 'n nasionale opname van al 1881 dieetkundiges wat by die Health Professions Council of South Africa (HPCSA) geregistreer is. Data is ingesamel deur 'n gevalideerde self-geadministreerde vraelys wat ook begruik is vir 'n eenderse studie onder dieetkundiges in die Vereenigde Koninkryk (VK). Dit het bestaan uit vier afdelings om die volgende aspekte te evalueer: i) betrokkenheid en selfvertroue in aktiwiteite te make met genetika en voeding genomika ii) kennis van genetika en voeding genomika iii) faktore wat met kennis geassosieer word asook iv) demografiese inligting. Die hoof metode van data insameling was deur middel van epos (70%) met behulp van die Association for Dietetics in South Africa (ADSA) se epos databasis. Vraelyste is aan diegene gepos wat nie geregistreer was by ADSA nie (30%). Resultate: Vyftien persent (n = 279, 15.2%) van GDs het op die vraellys gereaggeer. Resultate het lae betrokkenheid in aktiwitiete met betrekking tot genetika (n = 47, 17%) en voeding genomika (n = 72, 25.8%) gewys. Die meerderheid van die deelnemers het lae selfvertroue gerapporteer in die uitvoering van aktiwiteite wat genetika (n = 161, 58.7%), asook voeding genomika (n = 148, 53.8%) behels. Daar was 'n statistiese beduidende positiewe assosiasie tussen betrokkenheid en selfvertroue vir alle aktiwiteite (p < 0.001). Die gemiddelde kennis telling was 48.5 (±19%) wat as laag beskou kan word. Die gemiddelde kennis vir genetika van 58.5 (± 24%) was statisties beduidend meer as die vir voeding genomika 31.9 (±23%), p < 0.001. Deelnemers wat betrokkenheid aangedui het in die bespreking van die genetiese basis van 'n siekte (p = 0.02); raadgewing aan pasiënte met genetiese siektes (p = 0.01); lewering van opleiding met betrekking tot genetika (p = 0.01) asook die bespreking van die interaksie van dieet en genetika met pasiënte en die invloed hiervan op risiko (p = 0.03), het ook beduidende hoër totale kennis gehad. Faktore wat met kennis geassosieer word is die genetika inhoud in voorgraadse studies (p < 0.001), hoër kwalifikasies (p = 0.01), voorgesette professionele onderrig (VPO) (p <0.001) asook diegene wat genetika as belangrik beskou vir dieetkunde praktyk (p = 0.03). Gevolgtrekking: Die resultate van hierdie studie wys dat daar oor die algemeen lae betrokkenheid, selfvertroue en kennis is van genetika en voeding genomika onder SA GDs. Dit vergelyk goed met international bevindinge. Aanbevelings is dat 'n raamwerk vir die kennis van genetika asook voeding genomika ontwikkel word vir voorgraadse dieetkunde studies, asook die ontwikkeling van VPO aktiwiteite wat die dryfkrag sal voorsien vir die ontwikkeling van hierdie veld in SA.