“FIRST things first,” said Bryony Campion, a dietitian specialising in stroke care at the DGH, “we are definitely not the food police.”
It’s as good a place as any to start because if you mention the dietitian department to anyone outside the hospital most imagine bossy experts in white coats telling you to stop eating all the food you enjoy.
“We don’t give people a list of foods they cannot eat and expect them to get on with it,” she added. “These days we take a much wider approach focused on the individual and their relationship with food, what is important to them and how we can work with them to make sure they get their nutritional requirements.”
That can be easier said than done. Her colleague, Briony Young, is a dietitian in acute care and says the job comes with a host of challenges, not least convincing people to try new things or change the diet they have had over a period of years or even decades.
“Different patients bring different challenges,” she says, “and there are some who perhaps have never learnt to cook or prepare food – for instance older gentlemen who have recently lost their wives who will struggle without our support. Our community colleagues also provide care for these patients when they at home.
“In the hospital my job tends to be helping people who are undernourished. In fact, malnourishment actually costs the NHS more every year than treating obesity does but does not get anywhere near the same level of publicity.
“There are many reasons why someone might be under-nourished. There are strong links to deprivation and poverty but it might also be because someone cannot go to the shops to get food, cannot prepare it or even has a medical condition stopping them eating. It is our job to help them overcome those problems because someone who is well-fed is more likely to get better than someone lacking the right nutrition.”
Miss Campion, who spends her working days helping people who have suffered strokes, says often it can be hard to work with people who have communication difficulties.
“A lot of stroke patients may not be able to speak so we try and find ways to get round that. We are currently working on a photographic menu for patients to point out what they like. We also work very closely with the patients and their families because, for instance, there is no point in serving someone sweet foods if they have never liked them.
“We also have to find out what sort of food people can manage because some people may not be able to take solids. Our speech and language therapy colleagues advise us as to the suitable consistencies we can give patients.”
And, Miss Young is quick to point out, dietitians at the DGH don’t just deal in food and energy drinks. A lot of their work is more clinical and they spend time on the wards advising doctors regarding feeding patients through tubes.
As part of their training, Bryony and Briony learnt skills outside the usual nutritional sciences – including cooking and psychology – both of which have come in handy. And they say one of the most important parts of their job is knowing how to relate to patients. “You definitely need to be a people person,” says Miss Young. “We do not tell people what they have to eat but sometimes there can be some negotiation involved.” says Miss Campion
“For some people is very important. It is something they enjoy and can be a very social thing so we cannot just tell them they cannot eat certain things. Often it is about meeting somewhere in the middle.”
The team is clearly passionate about food, but do they feel obliged to follow their own advice? Miss Campion laughs, “I guess we might be under pressure to practice what we preach,” she says. “But to be honest, we all enjoy cooking and eat healthily.”
She is quick to add however that, “that does not mean we don’t include the odd chocolate or glass of wine though. It is important people enjoy what they eat.”
So, are there any five-a-day style tips they can offer people? Miss Campion said, “We are more involved in supporting hospital patients to eat enough than long term healthy eating. We would ask people to keep an eye on elderly neighbours.
“If you know someone on their own and struggling, offering your help can be very rewarding – just picking them things up from the shop or inviting them around for dinner can make a big difference to them.”
r More information from the British Dietetic Association’s Mind the Hunger Gap campaign website at www.mindthehungergap.com