Dietitians work with different specialist teams providing evidence based dietary advice. Patients are referred to the Dietitian by any member of the specialist team.
The speciality areas include:
Diet is fundamental in the treatment of type 1 and type 2 diabetes. The role of the dietitian is to provide education about diet and lifestyle in the management of diabetes. The advice given is also in relation to any medications taken for diabetes.
Dietitians see patients in one to one consultations and group sessions linked to the following diabetes services:
o Pre-conception care
o Diabetes Antenatal clinic
o Intensive treatment clinics
o Adolescent / Young adult clinics
o Continuous subcutaneous insulin infusions (insulin pumps)
o Patient education e.g Carbohydrate counting, DAFNE
The kidneys remove waste products from the body in the urine. When your kidneys are not working well, waste products can build up in the blood. These waste products can be affected by foods that are eaten. Patients who have kidney failure may be required to avoid or limit certain foods and drinks. The dietitian gives specific individual advice based on blood results, nutritional status, medical condition and treatment.
Dietitians see patients with kidney disease when they are attending the renal unit (either Jack Pryor at NNUH or Cromer). They provide advice for patients who need support in the following areas:
o Peritoneal Dialysis
Obesity (Tier 3 service)
Obesity is now recognised as a chronic disease requiring long term management and support. A dietitian has the skills and knowledge to give not only nutritional advice but also promote behaviour change to facilitate long term changes.
The tier 3 obesity service at the Norfolk & Norwich University Hospital, is a new specialised service involving the medical team, dietitians and a psychologist for patients whose body mass index (BMI) is greater than 35 and have other existing medical conditions. The service provides intensive treatment over a six month period to help patients lose weight. This new service can only be accessed via a GP referral.
Cardiology (Cardiac Rehabilitation)
Cardiac rehabilitation is a programme providing patients with information about their heart condition, to enable them to recover from surgery, a procedure or a heart attack. Making changes to lifestyle (that includes diet), will help improve heart health and therefore reduce the risk of further heart problems.
Patients who have had a heart attack are seen by the specialist cardiac rehabilitation team including the dietitian to provide dietary advice and support. The first dietitian appointment is a face to face contact, followed by a group session on nutrition education.
For people with cystic fibrosis, getting the right nutrition is vital. A healthy body weight is necessary to help fight off infections, and it is important there is enough reserve energy to rely on when the person is ill.
The diet of someone with cystic fibrosis should be high in calories, as they will not be able to digest all the food they eat.
Patients with cystic fibrosis require specialised dietary advice and are seen in weekly clinics by the dietitian, with the medical team, specialist nurses and physiotherapist.
Patients who have conditions or surgery that affect their digestive (gastrointestinal) system usually have special dietary requirements. Dietitians give advice to achieve and maintain optimum nutrition and for some conditions following a specific diet reduces or eliminates a patient’s symptoms.
Patients may be seen individually by the dietitian for conditions such as Irritable Bowel Syndrome and Coeliac Disease and jointly with the multidisciplinary nutrition team for conditions such as Inflammatory Bowel Disease and Intestinal Failure.
The nutrition team comprises of Gastroenterologist, Nutrition Nurse Specialist, Pharmacist and Dietitian. The team also assesses patients who may need a feeding tube into their stomach or small intestine to provide nutrition and fluid if they are unable to take sufficient amounts by mouth.
Many people with cancer find that there are times when they can’t eat as much as usual, and often they lose weight.
There are lots of reasons for this: it can be related to the cancer itself, or to the side effects of different treatments. Some people find that they don’t feel hungry, or that they feel full soon after starting a meal. Other people find that food makes them feel sick (nausea), or that their treatment makes some foods taste different.
Some types of cancer make your body use up more energy, even if you’re not very active. This can make you lose weight, even though you may still be eating well.
Patients may be seen individually by the dietitian in the Oncology Outpatient department or when they attend for chemotherapy or radiotherapy or in the specialist head & neck cancer clinics.
Patients who are on anti-retroviral medication for HIV are at an increased risk of cardiovascular disease. This is because the medication can cause an increase in their cholesterol levels. Diet plays an important role in controlling cholesterol levels.
Patients with HIV require specialised dietary advice and are seen at the request of the medical and nursing team.