Investigating the current state of the Italian workforce in the context of inherited metabolic diseases: an in-depth survey of dietitians across the country

ABSTRACT – Objective: To investigate the expertise, role, and involvement of Italian dietitians in the dietary man- agement and nutritional follow-up of patients affected from inherited metabolic diseases (IMDs) in referral centers. Materials and methods: A total of 17 (2014 Survey) and 27 (2024 Survey) multiple-choice or short-answer questions were distributed online to affiliated Italian centers, categorized per general information, types and char- acteristics of activities, number of healthcare professionals in the facilities and their education/training. Results: One to three dietitians are present in most metabolic centers, but 60% of participants devote no more than half of their working time to IMDs (2024 Survey). The number of patients per dietitian in a unit is currently one hundred or more for 60% of respondents. The distribution of resources and workforce is very uneven among the affiliated centers and poorly aligned with the allocated full-time equivalents. The training and education of specialized dietitians, as well as the amount of investment in research activities to advance the understanding of nutritional management and the outcomes of these pathologies, appear insufficient. The involvement of the figure of the dietician in the process of sharing knowledge and experience through databases and conferences and in the elaboration of national guidelines still appears insufficient. Conclusions: The role of the dietician has evolved over the last decade, becoming indispensable within a mul- tidisciplinary team dedicated to IMD. Therefore, future initiatives must focus on the specialized education and training of this figure and an adequate recognition of his or her activities within a truly interdisciplinary activity.