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DEVELOPMENT OF ACADEMIC EDUCATIONOF NUTRITIONISTS IN THE REPUBLIC OF MACEDONIA
Vera P. Simovska-Jarevska, MD., PhD
Vesna Antoska-Knights, PhD
Tatjana Kalevska, PhD
Tatjana Blazevska, MSc
University St. Clement Ohridski of Bitola,
Faculty of Technology and Technical Sciences-Veles
Republic of Macedonia
Corresponding Author:Ass. Prof. Simovska-Jarevska P. Vera, MD., PhD
University St. Clement Ohridski of Bitola
Faculty of Technology and Technical Sciences-Veles
Str. Dimitar Vlahov bb, 1400 Veles
Telephone number: +389 (43) 221 202
Fax number: +389 (43) 221 204
Republic of Macedonia
Email: [email protected]
http://www.ttfv.uklo.edu.mk
Co-author email adresses:[email protected]
Abstract: Objectives, Introduction, Methods, Discussions and Conclusion.
Objectives: Supporting proactive partnership in defining national standards for the formulation of academic
study programs in food and nutrition sciences, supporting introduction of innovative food technologies,
nutrition and dietetics, forming a set of competencies upon completion of studies and creating and rolling out
website and e-learning tools.
Introduction: Social and national needs of the country are to educate and produce highly trained scientific
staff, specialized in nutrition at Bachelor, Master and Doctoral degree levels including: 1st cycle qualification
in engineer technologist-nutritionists, 2nd cycle qualification in nutrition, food quality and safety and 3th cycle
qualification in innovative food technologies and nutrition.
Methods: The model of designing, planning and implementation of curriculums is in accordance with
European standards for improvement of academic and practical curricula and EFAD/DIETS2 advanced
competencies for nutritionists/dietitians. Proactive work with the industry is related to internships placements.
Innovative application of ICT, e-learning and creating a website are intended for collaboration with other
national and European nutrition networks.
Discussions: In order to improve population health, by improving the quality of nutrition and nutrition
practices through education and research, we development and implementation of the new academic
programs for food, nutrition and dietetics, and innovative technologies in higher education in the Republic of
Macedonia in accordance with European standards of EFAD/DIETS2.
Conclusion: With more than 350 students enrolled, the Bachelor’s academic study program has shown to be
successful, increasingly popular and commanding rising interest among the youth. Both the academic staff
and the students of nutrition have taken part in various activities including the Tempus collaborative research
project of the European Commission entitled “Foodlinks”, focused on the link between the academia and the
food industry and two domestic projects.
Keywords
Nutrition, Academic education, Research, Descriptors, Competencies, e-learning, Higher academic
institution.
1. IntroductionNumerous nutrition and food technology education programs started being implemented in higher education
institutions across the United States, Europe and the Balkans. Higher education institutions in Slovenia and
Croatia currently focus particularly on introducing Food Technology in the academic studies of nutrition, in
order to increase availability of nutrition professionals in reformulation of food products and support and
facilitatate iimprovements of the existing food technologies.
Unhealthy nutrition practices are one of the key risk factors for developing main non-communicable diseases
in the Republic of Macedonia. Studies have confirmed that the country's population has unhealthy eating
habits. Also, in the country, there is no nutrition and dietetics curriculum for higher education institutions.
Analyzing the results of numerous scientific findings that confirm the important role of food and nutrition in
health promotion and prevention of nutrition-related diseases, we developed the academic study programs
for food science, innovative food technologies, and human nutrition and dietetics.
The Republic of Macedonia experienced a turning point for the nutritionist profession in 2009 when the
Steering Committee for Advancement of Healthcare system was launched at the Macedonian Ministry of
Health. After numerous discussions about the deficit of professional staff in the country, the experts of the
Steering Committee emphasized the need for an academic study for the food, nutrition and dietetics. For the
first time tangible results were seen and laws and regulations have been produced to advance the subject.
The most substantial product of the work of the Committee is the “Green Book” which integrated all
necessary national healthcare reforms [1]. At the same time, the University of Bitola “St. Clement of Ohrid”
started developing a new academic curriculum in the field of nutrition. The multidisciplinary nature of nutrition
is reflected in the academic study programs, which includes experts of nutrition and sports medicine,
biochemists, biostatisticians, tecnologists, and engineers. In 2010, the University introduced the Bachelor’s
Degree program which currently enrolls more than 350 undergraduate students. The Program for
Nutritionists at the Faculty of Technology and Technical Sciences Veles is offered in three different towns
across the country: Veles, Bitola and Kicevo. The Master’s and Doctoral degrees including 2nd cycle
qualification in nutrition, food quality and safety, and 3 th cycle qualification in food technologies and nutrition
are designed to train professionals to identify, understand and solve, through scientific methods, problems of
nutrition and dietetics, and innovative food technologies. Graduates are expected to assume leadership roles
in academia, government, industry or other private-sector enterprises. They will be expected to advance
knowledge in human nutrition through research, and advocate the application of such knowledge through
public health policies and programs.
2. Academic curriculum in the field of nutrition
2.1. The curriculum The need to introduce a Bachelor’s, Master’s and Doctoral degrees (1st, 2nd and 3th Bologna cycle
qualifications) of multidisciplinary studies in Nutrition in the Republic of Macedonia is a result of numerous
scientific findings that confirm the lack of knowledge for the important role of food, innovative food technology
and proper nutrition on national level. In addition, one of the main goals for creating the program was the
need to have own staff in the country that will work in the domain of food science and facilitate production
and processing, so existing issues can be addressed, and new ones will be prevented from arising. In
summary, it is foreseen that the new nutrition professionals will assist in education, health maintenance,
prevention and treatment of diseases on individual and national level.
A major in Nutrition within University of Bitola “St. Clement of Ohrid” is established within two focus areas of
work: one is Nutrition and Dietetics, and the other Food Technology and Biotechnology. With the
development and implementation of the program in 2010, a new multidisciplinary educated academic profile
was introduced, entitled “Engineers of Technology - Nutritionists”. The new title was recognized and
acknowledged by the European Federation of the Associations of Dietitians (EFAD).
The process of designing and implementing the National Framework for Higher Education Qualifications in
the Republic of Macedonia is in consonance with the overarching Framework for Qualifications of the
European Higher Education Area [2] and the Official Gazette of the Republic of Macedonia, 2010 [3].
The first two Bologna cycles have been associated with the following European Credit Transfer System
(ECTS) credit ranges:
- Bachelor’s degree, or 1st cycle qualifications that typically include 240 ECTS credits equivalent to level 6 of
European Qualifications Framework (EQF). - Master’s degree, 2nd cycle qualifications that typically include 60 and 120 ECTS credits equivalent to level 7
of EQF and
- Doctoral degree, 3th cycle qualifications that include 180 ECTS credits equivalent to level 8 of EQF.
The academic curriculum and structures of the practice placements of both Bachelor’s and Master’s
programs is based on the framework for ECTS calibration [2, 4] and the following statements of the
European Federation of the Associations of Dietitians (EFAD): the European Dietetic Benchmark Statement
(EDBS) [5] and the European Dietetic Competencies and their Performance Indicators (PIs) [6]. The Master’s
and Doctoral Degree Programs are based on the model of the European Commission/EACEA: Thematic
Network for Dietetics - DIETS2 (2010-2013) [7]. The Work Package 2 (WP2) of DIETS2 developed advanced
level benchmark competence statements for European dietitians entitled European Dietetic Advanced
Competences (EDAC) [7].
The model of design, planning and implementation of the curricula in the 1st, 2nd and 3th cycle qualifications is
based on the methodology proposed in the Dublin description of program design (2004) and the EU
Educational Structures project “Tuning” (2009). In 2011, Public Health National Organization for the
promotion of health entitled “HEPA Macedonia” became an associate member of the European Thematic
Network for Dietetics and a team member of the DIETS2/WP2 “Second and third cycle competences for
dietitians”. The membership and recognition acquired has contributed to a great degree in the development
of the profession of nutrition and dietetics within the Republic of Macedonia [8].
2.2. THE THERORETICAL PART OF THE STUDY PROGRAM Study program is divided into the four sub-groups:
2.2.1. Basic Sciences: biology, physics, chemistry, nutritional biochemistry (cell and molecular basis of
disease and metabolic complications), anatomy, nutritional anthropometry, physiology, histology, genetics,
immunology, biostatistics and mathematics, computers, and methods of scientific research.
2.2.2. Food Science and Innovative Food Technology: a) Food Science and Innovative Food Technology: nutritional values of common foods, the innovative
technology for food, reformulation of food production, food processing, modeling and optimization in food
technology, biotechnology and robotics in food industry.
b) Science of Nutrition and Dietetics: nutrition care model and process, methodology of nutritional
assessments, examination of dietary intake, nutritional testing, modification of diet in people with different
dietary habits, modeling and optimization in nutrition, cultural and socio-economic conditions, hygiene of
nutrition for healthy and sick people, medical terminology and classification of diseases, international
dietetics and nutrition terminology (IDNT), medical nutrition therapy (MNT), nutrition care process, common
types of diet therapy and diagnostic procedures, modeling and optimizing in nutrition, techniques of food
preparation, sensory evaluation, microbiology, food safety and hygiene of food, practice based on data and
evaluation of practice.
2.2.3. Administration of Food Services: management, planning and production of food legislations,
economics, marketing, food equipment, packaging and distribution.
2.2.4. Public Health Nutrition: nutrition and physical activity, health promotion, nutritional epidemiology,
planning, coordination and evaluation of public health strategies and policies, sociology, ethics,
communications and cultural aspects of nutrition.
Further, to improve population health, by improving the quality of nutrition education and research at
advanced level we determined the following objectives:
- Supporting proactive partnership in defining national standards for the formulation of Doctoral study
program for the innovative technologies for food and nutrition;
- Forming a set of competencies upon completion of studies;
- Application of information and communication technology (ICT) and e-learning.
Proactive work with the industry and private companies is related to practice placement and internships. An
Innovative application of ICT, e-learning and creating a website are intended for collaboration with other
national and European nutrition networks.
Robotics in food technology as a subject with basic concepts of definitions, classifications, historical
development, application and examples of robots in the food industry is implemented.
In addition, the Master and Doctoral programs are especially focused on the scientific and research aspects
to enable the students developing and conducting various types of research applying diversified
methodology. Modelling and optimization in nutrition is very important in planning meals for groups and
individuals. Data base of nutritional composition of foods with mathematical and numerical methods covers
the central concepts of practical optimization techniques: fundamentals of linear optimization and simplex
method, viewing software for optimization, programming and analysis, basics of fuzzy optimization.
Study programs will bring about education and creation of our own nutritionists who will be able to meet the
domestic and global issues relating to food and nutrition, inclusion of the researchers and experts in the
projects and in the healthcare teams, university and research institutions and the food industry. They will be
qualified to execute tasks liked to production of healthy, quality, safe, environmentally friendly and affordable
food for domestic and export needs. Also, these nutritional experts will contribute to changes in public health
policy and health education strategy (2014 - 2020) in the area of “Health Enhancing through Nutrition
Education”.
2.3. Implementation and resultsWith more than 350 students enrolled, the Bachelor’s academic study program has shown to be successful,
increasingly popular and commanding rising interest among the youth. The study program lasts 8 semesters
or 4 years, each semester totaling 60 ECTS credits. The lessons are conveyed by an academic staff
possessing multidisciplinary educated profiles ranging in the areas: nutritional medicine and dietetics, food
technology and biotechnology and natural and computer sciences. Both the academic staff and the students
of nutrition have taken part in various activities including the Tempus collaborative research project of the
European Commission entitled “Foodlinks”, focused on the link between the academia and the food industry.
Another domestic project financed by the University Research Centre “St. Clement Ohridski” of Bitola that
joined academic staff and students was “Monitoring of Eating Habits and Physical Activity Behavior among
the Macedonian Population”. That project was implemented countrywide during 2011 and2012.
Some of the many project outcomes were scientific articles published in the international journals [9, 10, 11].
The students were actively involved in the initial process of conducting the survey for the research. Also, with
60 graduate students enrolled, the Master study has shown rising interest among graduated engineers of
technology-nutritionists.
3. Conclusions - The first national “cross-sectional” study in the Republic of Macedonia with title: “Monitoring of Eating
Habits and Physical Activity Behavior among the Macedonian Population” conducted by the Faculty staff
(2011/2012) with an aim to analyse and evaluate data on socioeconomic differences in educational levels
and income on the consumption of the main health related foods and physical activity levels of the population
(10–64 years) is essential for planning and evaluation of the NCDs prevention program. The research
provides results for health-policy decision-making and can be used to evaluate specific health promotion and
NCDs prevention programs [9, 10].
- In line with the strategic development plan of the University St. Clement Ohridski of Bitola, the next step for
the program will be further improvement and development of the role of nutritionists with Bachelor’s, Master’s
and Doctoral degrees (1st, 2nd and 3th Bologna cycle qualifications of multidisciplinary nutrition studies) in the
healthcare strategy and in the prevention of NCD’s [12], but also in the domain of food production, food
technology and biotechnology.
- With the improved number of nutritionists in the country, an opportunity arises for development of a
National Association for Nutritionists in the Republic of Macedonia [13].
4. A list of abbreviations:NCD’s – Noncommunicable diseases
UN – United Nations
WHO – World Health Organization
FAO – Food and Agriculture Organization
EFAD - European Federation of the Associations of Dietitians
ECTS - European Credit Transfer System
EQF - European Qualifications Framework
EDBS - European Dietetic Benchmark Statement
PIs - European Dietetic Competencies and their Performance Indicators
EC - European Commission
EACEA - Education, Audiovisual and Culture Executive Agency
DIETS2 - Thematic Network for Dietetics
WP - Work Package
EDAC - European Dietetic Advanced Competences
EU – European Union
MNT - Medical Nutrition Therapy
IDNT - International Dietetics and Nutrition Terminology
ICT - Information and Communication Technology
HEIs – Higher Education Institutions
Competing InterestsThe authors declare that they have no competing interests.
Authors’ Contributions VSJ participated in the model of designing, planning and implementation, and coordination of curriculums
related to science of Nutrition and Dietetics, Medical Nutrition Therapy as well as Public Health Nutrition
creating the first national “cross-sectional” study in the Republic of Macedonia entitled “Monitoring of Eating
Habits and Physical Activity Behavior among the Macedonian Population”. As an expert in the European
Commission, she was contributed in the implementation of the Bologna Declaration (1999), Dublin
description (2004), EC "Tuning" project (2009), European standards for improvement of academic and
practical curricula (2010) and EFAD/DIETS2 advanced competencies (2013) in the higher education
institution. She carried out the human nutrition and dietetic practice placements in the country participating
as a team member of the project of the European Commission: EACEA/DIETS2-WP2 “Second and third
cycle competences for dietitians”. Also, she was participant in the research project of the European
Commission entitled: “FOODLINKS” - Improving Academia-Industry links in food safety and quality. She
drafted the manuscript.
VAK contributed by innovative application of ICT, e-learning and creating a website intended for collaboration
with other national and European nutrition networks, in these doctoral studies. Also as a contribution was
implementing new modern subjects as a Modelling and optimisation in nutrition and food technology and
Robotics in food technology. She is participant in “FOODLINKS” - the international research project of the
European Commission for part of implementing e-learning and participant in EC/FP7 project: “Embodied
Cognition in a Compliantly Engineered Robot”.
TK contributed in creating a section of the multidisciplinary Doctoral study program with title: “Food and
innovative technologies” focused on the process-technology function of food production in accordance with
the demands of the contemporary technique, technology and science of food, which will enable education of
doctors of science (PhD), trained for independently leading original and scientifically relevant researches,
capable of analysis of foodstuff-technological processes, development and implementation of innovative
technologies in foodstuff processing engineering and use of methodologies for obtaining minimally
processed food with optimal nutritive values and functional bioactive characteristics. Also, she was
participant in the research project of the European Commission: “FOODLINKS” - Improving Academia-
Industry links in food safety and quality. Working with the local industry, she participated in the regional
project: “Implementation and audit of quality systems ISO 9001 and ISO 22000”.
TB carried out the molecular genetic studies. She participated in design of the study programs focused on
basic sciences, applied microbiology and helped to draft the manuscript.
All academic staff of the Faculty of Technology and Technical Sciences–Veles contributed towards
implementation of the national “cross-sectional” study by making substantial contributions to acquisition of
data, and analysis and interpretation of data. Also, they contributed towards the Doctoral degree programs
by making substantial contributions to conception and design. SM, DD and DNN were involved in drafting the
manuscript, but they does not meet the criteria for authorship.
All authors read and approved the final manuscript.
The source of funding
All authors contributed towards the academic study design, planning and implementation without finacial
support working as volunteers.
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