So what is a Dietitian?

Dietitians are experts in prescribing therapeutic nutrition. All dietitians have completed a 4-year Bachelor Degree in Nutrition and Dietetics or a 3-year Science Degree followed by a Master Degree in Nutrition and Dietetics. Most dietitians work in hospitals with the HSE and within private hospitals although some work privately. In some Irish hospitals dietitians are called clinical nutritionists.

What is the difference between a dietitian and nutritionist?

A Nutritionist has studied nutrition. While a Dietitian has studied the application of nutrition to help prevent and treat conditions and diseases. As the term nutritionist is not protected nutritionists may vary in knowledge base. There are some qualified nutritionists, who have completed a 3 year degree in nutrition and there are some who may have completed a short course. However nutritionists do not have any professional practical training, and therefore they should not be involved in the diagnosis and dietary treatment of any diseases.

The differences in more detail…

  • A Dietitian will use the science of nutrition to enable people to make informed and practical choices about   food and lifestyle, in both health and disease.
  • A dietitian will have trained in both hospital and community settings as part of their degree.
  • Only Dietitians or Clinical nutritionists can register with the Irish Nutrition and Dietetics Institute (I.N.D.I.).
  • Dietitians have studied the nutrients in food, how nutrients are used by the body, and the relationship between diet, health and disease.
  • Dietitians interpret the science of nutrition into practical evidence-based advice for people and their advice is not based on personal opinion.
  • The title ‘dietitian’ will soon be protected by law In Ireland. However it is a protected term in other countries like the UK.
  • Always check that your dietitian has the letters M.I.N.D.I. behind their name as that means they are fully qualified to help you and that you will be able to claim partial cost back from your health insurer too.

Eating Disorders….

What is an eating disorder? An eating disorder is an umbrella term for an illness which can have a variety of different unhealthy eating and weight control behaviours. These behaviours can become obsessive, compulsive, and/or impulsive in nature and include extreme emotions and attitudes.

How many people does this effect? It’s difficult to get statistics specifically relevant to Ireland but the Department of Health estimates that up to 200,000 people (and their families) in Ireland may be affected by eating disorders. With an estimated 400 new cases emerging yearly, this is cause for concern. Unfortunately eating disorders claim the life of 80 people each year. Frighteningly, every year the death rate among females aged 15-24 years associated with anorexia is more than 12 times higher than the death rate of all other causes combined. These figures are frightening but hopefully encourage action.

Who is at risk? Eating disorders are most prevalent in females in the 15-40 age group. According to a study that was conducted in 2007, 1.2% of Irish girls may be at risk of developing anorexia nervosa and 2% at risk of developing bulimia nervosa. Although eating disorders generally affect women, it’s estimated that 10% of cases of anorexia and bulimia are male and this appears to be increasing. Eating disorders like these often result in treatment within hospitals, accounting for 18% of paediatric psychiatric admissions in Ireland in 2008. Although your child may not have an eating disorder, one study of secondary school pupils showed that over ¼ of girls and over 1/5 of boys had engaged in either bulimic or anorexic behaviour.

What are the signs to look out for?
Anorexia: Some signs include weight loss in a short space of time, loss of periods in women, food restriction, abnormal behaviours and food rituals, mood swings, perfectionism, insecurity, rigid and obsessive behaviour, preoccupation with appearance, and occasionally avoiding company.
Bulimia: Some signs include frequent changes in weight, sore throat, tooth decay, preoccupation with body shape and weight, vomiting and use of laxatives, increase in exercise, fear of weight gain, low mood, tiredness, hair loss, extreme emotions regarding weight change.

Can nutrition input help? A holistic, all round approach to helping someone with recovery is important. Nutritional therapy and nutritional education are integral in helping to create a greater understanding as well as more control over eating and food-related behaviours. Additionally diet is central in helping to repair the body after a period of time with a nutritionally insufficient diet.

Can a special diet help my child with Autism Spectrum Disorder?

Autism Spectrum Disorder is a common developmental disability. It affects the way in which your child communicates and relates to others around them.

A commonly used diet by some people in an attempt to improve these behaviours and mental function is a ‘gluten and casein free diet’. This involves removing casein (a protein found in cow’s milk) and gluten (a protein found in wheat, rye, oats and barley).There is some evidence that a gluten and casein free diet may help some people with Autism. However, there isn’t enough evidence to suggest that it will help everyone with this disorder.

It’s important to note that when you avoid foods, you are more at risk of nutrient deficiencies that will effect growth and development. Plus, children with Autism may find change upsetting. Therefore, it is important to seek advice and to avoid implementing this diet without medical help.

So what is diabetes?

Written by Sarah-Jane Reilly studying  a PLC in nutrition and dietetics

 

Diabetes is an increasingly common metabolic disorder that affects the way our bodies use food for energy and growth. When we eat food, it is digested and converted into glucose (simple sugars). These sugars then enter the bloodstream as a source of fuel for our body cells. The pancreas produces a hormone called insulin which helps to regulate the levels of glucose in the blood by enabling glucose to enter cells in our bodies.
Diabetes is a condition that effects the pancreas’ ability to produce insulin and/or our cells ability to respond properly to insulin. Without insulin, the body’s cells cannot convert glucose into energy. As a result of this, there is a higher than normal level of glucose in the blood (hyperglycaemia) which eventually leads to a person developing diabetes.

There are three main types of diabetes:
• Type one diabetes
• Type two diabetes
• Gestational diabetes

Type one diabetes
Type one diabetes is a chronic condition in which the pancreas produces little or no insulin. It is an autoimmune condition that typically first develops in children or young adults. In autoimmune diseases the immune system produces antibodies against part or parts of our bodies…in this case the body’s immune system destroys the insulin producing (beta cells) of the pancreas.
Type one diabetes may be genetically inherited or triggered by viral infections in those who are genetically susceptible to the condition.
Common symptoms of type one diabetes to be aware of include:
• Frequent urination ( in children, frequent bed wetting even after toilet training)
• Unusual thirst
• Extreme hunger
• Sudden weight loss
• Blurred vision
• Nausea
• Irritability
Type one diabetes is treated with insulin.

Type two diabetes
Type two diabetes is a condition where the pancreas stops producing enough insulin for the levels of glucose (sugar) in the blood or when the body develops a resistance to insulin. Type two diabetes can occur at any age. It is becoming increasingly common for young children to develop this condition as childhood obesity rates soar worldwide.

Risk factors for type two diabetes include:
• Being overweight/obese.
• Having a first degree relative with diabetes (parent, brother, sister, child etc.).
• Having a waist measuring more than 80cm if you are a woman or more than 94 cm if you are a man.
• Having impaired glucose tolerance (higher than normal levels of glucose in your blood).
• Having gestational diabetes during pregnancy.
Type two diabetes can be effectively managed through exercise, a healthy diet and is some cases medication.

Common symptoms of type two diabetes to be aware of include:
• Dry mouth
• Increased thirst
• Being hungry all the time
• Unexplained weight loss
• Passing large amounts of urine
• Numbness, pain or tingling in your hand/feet
• Frequent infections

Top dietary recommendations for preventing/managing type 2 diabetes include:

1. Choose high fibre, slow releasing carbohydrates and avoid highly refined carbs.
Unlike highly refined carbs, complex carbohydrates release their energy at a much slower rate. They prevent a sudden spike in the level of sugar in the blood. They provide us with lasting energy and keep us feeling full for longer. We can introduce complex carbohydrates to our diet by substituting foods like white rice for brown rice, white bread for whole-grain bread and cornflakes for bran flakes.
2. Eat regular small meals at set times of the day.
Our bodies are more capable of regulating the levels of sugar in our blood if we eat small portions of food at set times of the day.
3. Exercise!
We all know that exercise helps us to lose weight. But did you know that it can also lower our blood sugar levels and increase our sensitivity to insulin, the hormone which helps to regulate our blood sugar levels?
4. Prevention is key!
Type two diabetes can be prevented by following a healthy diet. This involves being shop smart and food smart. Read the labels on foods, particularly the RDA of each nutrient. Question general food health claims and limit the amount of sugary refined foods you eat.

Gestational diabetes
Gestational diabetes is a type of diabetes that may develop during pregnancy. It occurs when the mother’s body is unable to produce enough insulin. During pregnancy, the mother’s placenta produces hormones that work against the action of insulin. When this insulin cannot get to into the body’s cells, blood sugar levels rise and the mother may develop gestational diabetes overtime.

But not to fear!
According to the American Diabetes Association, you are at low risk of developing gestational diabetes if you meet all of the following criteria:
• You are younger than 25 years of age.
• Your weight is in a healthy range.
• You’re not a member of any racial or ethnic group with a high prevalence of diabetes.
• None of your close relatives had diabetes.
• You’ve never had a high result on a blood sugar test.
• You’ve never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.

According to the HSE, gestational diabetes affects 12% of pregnant women. There is no proven way of preventing gestational diabetes, however, certain steps can be taken to reduce the risks of developing the condition. This steps include:
• Eating a nutritious, well balanced diet, high in fibre and fruit and veg.
• Keeping active and fit during pregnancy.
• Losing excess pounds prior to pregnancy.

Comments from Aveen; If you suspect you have type 2 diabetes you must visit your GP. Diet is imperative in the treatment of type 2 diabetes and you need to include lots of whole foods, fresh vegetables, lean proteins and high fibre foods while limiting sugary foods and saturated fats.Seek help from a dietitian.