Eat For You Dietitian

I think I have a small section about what I do for a living, however it is not something I refer to here regularly.

I have been working as an NHS Community Dietitian since qualifying about 2 years ago. I have a BSc(Honours) in Nutrition and a Postgraduate Diploma in Dietetics. Why is Community in my title? Well I am not based in hospitals, so to put into context during the Covid-19 pandemic I was not on the frontline. Many of my colleagues based in the acute hospital were on the frontline and hats off to them. I was prepared to be redeployed, however that did not occur and as the focus was getting people well in hospital, after that it was keeping them well once they got home and avoiding readmissions. That’s where I come in alongside many other Allied Healthcare Professionals.

Usually I am carrying out general dietetic outpatient clinics, visiting vulnerable individuals at home, undertaking group education sessions on a variety of nutrition topics amongst other duties. In the past 4 months this has all changed. I am primarily contacting my patients over the telephone. This comes with its pros and cons and can depend on the individual I am communicating with. As they say, you say a lot with your eyes. During a face-to-face consultation, not only is a healthcare professional listening, but they are also taking into account your body language. How engaged are they? Is there something else occupying their mind? Do they understand what I’ve just told them? All of these questions are unanswered during a telephone consultation.

Unfortunately my department hasn’t been lucky enough to gain access to video consultation networks just yet.

What I have definitely noticed, is more referrals for dietary advice for Irritable Bowel Syndrome (IBS). This is not surprising considering IBS affects 10-15% of the population.

IBS is defined as ‘a functional bowel disorder in which recurrent abdominal pain is associated with defecation or a change in bowel habits’ according to NICE guidelines.
No one individual is the same and as part of a full dietetic assessment I gather not only information about what a person is eating daily, also how they are eating, who with and several other environmental factors, which some people look at me strangely when I ask. However it is all key information when tailoring dietary advice for the person sitting in front of me.

My top key recommendations:

1. Hydrate first thing in the morning. If it’s not your thing, make it your thing. Are you waiting for the kettle to boil, drink a glass of water whilst you wait. Have a bottle of water ready for when you wake up. Chances are you’re scrolling for at least 5 minutes after your alarm so make it the scroll and hydrate time. Hydrate, hydrate please!
2. Portion control with your fruit. Yep, not the food you thought I was going to say. Don’t finish a whole punnet of berries, or a whole bowl of mixed fruits in one go. Fistful sized portion in one sitting, 3 times a day maximum.
3. Notice your stress triggers. Is it your full inbox, buzzing phone, endless to-do list, family members nagging you. Try and get away from these whilst you eat. Obviously during isolation this is not so easily done. Maybe it’s sitting in a different spot, reading a book, listening to a podcast or just listening to the birds/cars/people outside.
4. Movement. You don’t have to be a fitness fanatic but moving our bodies is good for us. Period. Walking, dancing, running, strength training, stretching, whatever it is. Find your preference and do it. If you’re a complete beginner then some guidance would be useful. For walking there is the Active 10 app, for running the Couch to 5k app, yoga or stretching movements you can access Yoga with Adrienne on Youtube for free or download the Free version of Fiit app.
5. Too much of anything is likely going to upset your gut. The most common sentence I hear is ‘I think I’m intolerant to gluten/wheat and lactose because after I eat a whole pizza my symptoms are worse.’ That’s a big meal= big party for your digestive tract to digest. If you don’t feel anything in your gut after a whole pizza then hats off to you. Think of the amount you are having, is it a whole bowl of pasta, don’t go switching to gluten free automatically. It’s more expensive and well pasta is just yum! Trial a smaller portion next time.

The overall aim with my IBS patients is to educate and empower them to be able to enjoy food. Education and awareness in knowing what are there trigger foods and in what quantities. The best feedback I have received is when one of my patients says they can finally go to a BBQ or a party without fear. Amazing!

If you are struggling on your own then yes go to your GP to seek advice, you can request a referral to a dietitian. Ensure they do the required investigations to eliminate any other causes for your symptoms. If you are going to the internet for advice, please ensure they are reputable sources, and not solely saying exclude whole food groups. IBS is a multifactorial condition, what we eat is only one factor and that is the main thing to remember.