Registered dietician

Registered Dietitians have a minimum qualification requirement with a professional qualification (a minimum of 4 years training) in Nutrition and Dietetics. Their training spans working within communities, within a food service setting and in both acute and chronic hospital settings alongside other health care professionals and medical consultants taking care of the nutritional aspects of medical treatment - hence the term medical nutritional therapy. . In theory anyone can be a nutritionist. While the terms are sometimes used interchangeably, only Dieticians with the necessary qualifications can call themselves so.

Vitamin D acts as a hormone and affects multiple systems in the body, including the immune system, cardiovascular system, bones and the brain. As we age, we have less on board and may be more prone to the effect of lower levels in our bodies.(1)

When you search the Internet for information about foods high in vitamin D, and speak to your doctor about it, you are likely to find or hear suggestions regarding the efficacy of sunshine and some foods that may contain vitamin D as they have been fortified.

Sadly, Vitamin D deficiency is of increasing nutritional concern. Higher incidence of deficiency, although often undiagnosed, may partly be a result of an 'indoor lifestyle' as well as of the use of sunscreen during warmer summer months. Migration around the globe also plays a role with darker skin requiring more sunlight to produce a sufficient amount of vitamin D. Where darker-skinned individuals migrate to higher latitudes, the shorter window of sunlight allowing for Vitamin D production increases the risk for Vitamin D deficiency.

In the UK, NICE recommends that all people supplement their diets with Vitamin D throughout the winter months. Again, however, if you are already deficient, the suggested level of supplementation may be insufficient to restore Vitamin D in your body to optimal levels, and certainly, the small amounts we could obtain from food that naturally contain some vitamin D (Cod liver oil and some mushrooms) and fortified foods, are unlikely to have a real impact.

Expert assessment and repletion with lifelong adjustments is affordable and cost-effective and can prevent the far-reaching influence deficiency can have on your general health and well-being and risk for several diseases, including but not limited to depression, dementia and cancer.

Minich DM, Henning M, Darley C, Fahoum M, Schuler CB, Frame J. Is Melatonin the "Next Vitamin D"?: A Review of Emerging Science, Clinical Uses, Safety, and Dietary Supplements. Nutrients. 2022 Sep 22;14(19):3934. doi: 10.3390/nu14193934. PMID: 36235587; PMCID: PMC9571539.

Always tired or without energy? Let's take some tablets or a Vitamin B12 injection. That should sort the problem? Right?

Wrong. Here's why.

A supplemental boost of Vitamin B12 might be a brief 'pick-me-upper', but seldom will this route of administration will have a lasting effect. On the one hand, not all individuals are equally efficient at converting the cheaper synthetic Vitamin B12 that usually would be given as part of a multivitamin tablet or injection and on the other, there might be other nutritional factors to consider over and above Vitamin B12. .

Vitamin B12 is vital for energy production and nervous system function and although typically we are able to efficiently extract vitamin B 12 from most foods of animal origin, e.g. meat, fish, chicken, cheese, dairy, milk, and yoghurt, these mechanisms can be disrupted when there is an imbalance in the digestive system or an imbalance in the organisms in the digestive system - the so-called microbiome. Vitamin B12 might also be lost as a result of, for example, high intake of alcohol or the impact of medication, for example, metformin.

It is prudent to look beyond the 'quick fix' approach when you are feeling tired or perhaps have other symptoms, such as changes in memory and retention of new information or a sensation of burning feet.

Diabetes is often described as an epidemic, with more than 5 million people in the UK living with diabetes. Around the world, there are more than 422 million people living with diabetes. Although there is not much one can do to prevent so-called Type 1 Diabetes, Type 2 Diabetes is a largely preventable condition - even more so when you have a family history of diabetes.

Lifestyle and dietary adjustments can serve to protect you from getting diabetes and the same applies to reversing diabetes.

Optimising nutritional status beyond a general 'healthy diet' with personalisation of the types of foods you have most often, the timing of meals, sleep (circadian) cycle adjustments, and a focus on physical activities that promote metabolism are key aspects to consider.

In addition, adjustments to promote a balance of beneficial microorganisms within your digestive system (the microbiome) will help your body work with you, instead of against you, in your endeavours to lose or manage weight. Stress and stressful events in your life, including grief or loss, could trigger diabetes. There are numerous ways to diffuse the impact these life events could have on your health.

Some medical treatments can also trigger diabetes.

Let's tackle the problem together!

Living with IBS is not easy, particularly as so many treatment options only bring temporary relief. Although the FODMAP diet has been shown to improve symptoms, this type of eating pattern is not recommended for a prolonged period of time as invariably, the impact might be more harmful than beneficial as the diet is void of several nutrient factors considered essential for the functioning of your gut in addition to being deficient in an array of nutrients.

The key to addressing irritable bowel syndrome is a personalised review to understand the triggers for symptoms. Treatment protocols should take into consideration the underlying causes of bowel dysfunction and address them.

Perhaps you've had a couple of courses of anti-biotics recently or travelled the world and picked up travellers' diarrhoea?

Consider this too: Babies born via C-section or those not breastfed might be more prone to IBS.

Or this:

Did you diligently sanitise during the COVID-19 pandemic yet still had a positive test? This could be a trigger for your tummy's distress.

Instead of yet another 'treat the symptom' program, which exclusion diets like the FODMAP essentially are, take action to find the root causes of your distress and then address these. The BetterEat Gut Reset Program is an expert-led journey of discovery and recovery. This holistic registered dietitian-developed program has been tried and tested in practice with a life-changing impact on thousands of patients.

Click here to book your session

Although surgical techniques today are often less invasive than a few decades ago, the human body still reacts with a cascade of changes in response to 'insults' - including surgery. Regardless of the type of surgery you've had, adaptation of food and nutrition could significantly enhance your healing and recovery. Early intervention is key, as it looks to support you with the necessities to promote cellular regeneration. You need help soon after surgery. It's called acute care medical nutrition therapy. There's a myriad of metabolic active ingredients - including particular vitamins, minerals, adjusted fats or perhaps more available forms of protein that are required in your body to drive the recovery process. Reliance on 'toast and tea, even for a day or two, may have detrimental consequences and delay recovery.

These early adjustments also help prevent longer-term side effects e.g. those associated with, e.g., the administration of antibiotics or steroids or loss of muscle tissue after a period of inactivity after surgery.

The body-wide impact of gastric surgery is often unappreciated. Nowhere is it more evident than in the commonplace scenario where the first food or drink offered post-operatively, might be squash! Squash is a product void of nourishing ingredients, likely consisting of a combination of colourants, flavourings, preservatives, and sugar alternatives that are not considered supportive of a healthy digestive environment.

Early intervention and support after gastric surgery is key to helping you transition back to a healthy 'normal'. Ideally, dietary adjustment, including modifying the type, quantity, and source of protein, carbohydrates, fats, and vitamins, should be initiated as soon as possible after surgery.

If you are scheduled for surgery, consider having a pre-operative assessment with a registered dietitian to allow you to plan for your discharge and post-operative period. This will also mean you will have easy access to your specialist online dietitian should any queries arise after surgery and you won't have to delay access to optimal nutrition therapy.

The colon is not just a tube holding whatever is left of your food. In addition to performing critical functions, including the re-absorption of metabolites that keep our bodies functioning, it is also home to more organisms found in a similar area than in any other place on earth—the human microbiome.

The microbiome is our essential partner in life - not a passenger taking a ride along. It plays a key role in various regulating functions in our body, including the production of neurochemicals, regulation of inflammation, blood glucose and absorption and even susceptibility to developing Alzheimer's Disease 1. Therefore, when you are going to have or you've had colon surgery, early nutrition intervention will have a substantial impact on your recovery. Nutrition therapy prescribed by a registered dietitian has to consider the wider impact recovery may have over and above the management of bowel symptoms like diarrhoea or constipation or maintaining hydration. The oversimplified recommendations that only centre around adjustments to the texture of foods - for example, being recommended a 'soft' diet, cannot be seen as a holistic recovery plan and could potentially prolong discomfort and could delay full recovery.

If you are scheduled for surgery, consider having a pre-operative assessment with a registered dietitian to allow you to plan for your discharge and postoperative period. This will also mean you will have easy access to your specialist online dietitian should any queries arise after surgery and you won't have to delay access to optimal nutrition therapy.

1. Ferreiro AL, Choi J, Ryou J, Newcomer EP, Thompson R, Bollinger RM, Hall-Moore C, Ndao IM, Sax L, Benzinger TLS, Stark SL, Holtzman DM, Fagan AM, Schindler SE, Cruchaga C, Butt OH, Morris JC, Tarr PI, Ances BM, Dantas G. Gut microbiome composition may be an indicator of preclinical Alzheimer's disease. Sci Transl Med. 2023 Jun 14;15(700):eabo2984. doi: 10.1126/scitranslmed.abo2984. Epub 2023 Jun 14. PMID: 37315112; PMCID: PMC10680783.

The bowel is often thought of as a 'tube' that serves to transport what is left after our body has extracted what it needs from our food. This cannot be further from the truth. The bowels are responsible for the breakdown of foods to allow the absorption of nutrients essential to every single function in our cells. The bowel also serves as a reservoir for the re-absorption of elements we require to function optimally – almost like a scarce commodity recycle plant.

The cells of the bowels are so specialised that they can 'read' not only e.g. that you've had a meal that contains fat but will react to the type of fat you've had.

The colon, in particular, is also home to more organisms found in a similar area than in any other place on earth—the human microbiome.

A better understanding of the complex nature of the bowel allows us to consider dietary adjustment synchronous with cancer prevention. Although there are some really simple additions you could try to reduce your risk of bowel cancer, like including raw cabbage on a weekly basis, trying to have at least 5 different types of plant foods every day and consuming fermented foods like kimchi, kefir, kombucha or tempeh every week, if you have a family history of bowel cancer or have struggled with irregularity of discomfort all your life, a more specialised approach formulated by a registered dietitian with expertise in a functional approach to nutrition, can help safeguard you against one of the most preventable (1) cancers globally.

Brenner H, Chen C. The colorectal cancer epidemic: challenges and opportunities for primary, secondary and tertiary prevention. Br J Cancer. 2018 Oct;119(7):785-792. doi: 10.1038/s41416-018-0264-x. Epub 2018 Oct 4. PMID: 30287914; PMCID: PMC6189126.

Prescription of anti-acid medication is extremely commonplace in modern medicine and their deprescribing seldom happens once you have been on them for a longer period of time since it can be very hard to discontinue and rebound acid production will likely result in extreme symptoms of reflux. It is important, though, to acknowledge that stomach acid is a vital component of digestion and balance in the gut, and when acid production is permanently ' disabled' due to anti-acid medication, there may be downstream impact that might be difficult to negate for example lower absorption of essential amino acids and minerals.

Although chronic reflux and heartburn are undesirable, specialist nutrition adjustments and lifestyle modification can mitigate the need for lifelong anti-acid medication when the right therapeutic changes are made. Simply avoiding so-called ' acid' foods will unlikely have a monumental impact. Considering lifestyle and stress management, postural and nervous system involvement, activity and food type and timing of meals and subclinical deficiencies should all be considered when a holistic approach to heartburn and reflux is to be implemented with success.

Dementia, alongside cancer, is probably one of the most feared diagnoses today. What if I told you something as simple as quality sleep and sufficient amounts of Vitamin D can help prevent and perhaps even reverse the changes in the brain associated with the development of dementia? You might think, well, I'm taking a sleeping tablet because I've not been sleeping well for many years that should sort it?

Addressing prevention through nutrition and lifestyle is not a 'quick-fix' application, and we have to consider the different nutrients involved in brain health, neurochemical production, and whether our diet provides all of these as well as the potent anti-inflammatory effect diet and lifestyle can have - also in the brain. It may be useful to take a few steps back and consider whether you have these necessary nutrients on board? For example, something as simple as sufficient magnesium can promote the production of the sleep 'hormone' melatonin. Magnesium is lost during food processing and is one of the nutrients that have been found to be an 'at risk of deficiency' nutrient in young adults and females in the UK.

No. Beware of articles online promoting the next big fad. The ‘big secret’ is personalising your nutrition approach to suit your unique genetic make-up and physiology and making adjustments when you are or have been ill or as you move through the different life stages. Alongside personal adjustments, it is also vital to consider your impact on the environment and vice versa. Including a variety of plant foods and an awareness of ultra-processed foods and their potential impact on your health typically is one of the cornerstones of a holistic approach to nutrition.

'General' recommendations, e.g. 'eating lots of fruit or porridge for breakfast might not suit you, or perhaps an underlying deficiency is causing malfunction. Even something as simple as adequate hydration could have a remarkable impact. It is astounding how many people do not drink enough water in their day-to-day lives.