Over 200 passionate dietitians from across Australia and New Zealand converged on Australian Technology Park, for the 3rd celebration of Dietitian Day. The day was a deep dive into the world of dietetics, a world of passion, dreams, challenges and success, as the diversity of our scope of practice and potential was celebrated.
With a zealous opening to the day, Dr. Joanna McMillian encouraged delegates’ to get angry, passionate and fired up. We are the experts in nutrition science and in the landscape of nutrition where everyone eats and everyone is an expert in nutrition, we need to be courageous, we need to speak up and have a tough skin. With a call to action, delegates were encouraged not to sit back on our laurels but to look at the evidence, stand proud and lead Australia to a healthier future.
As dietitians how best can we support our clients and lead Australia to a healthier future – do we focus on food, nutrients, kilojoules, eating behaviour, weight or BMI? Are these different pieces of a puzzle that all fit together or should we be keeping them separate?
Fresh food in its simplicity is pleasurable and nourishing – if we rekindle our perception to focus on shared eating experiences with fresh quality food (in a kitchen, with the family at the table, engaged in conversation), rather than nutrient and kilojoule value of food perhaps we can change the landscape of nutrition education. Stephanie Alexander reflected fondly of the great pleasure and happiness she has with food and eating. Our common humanity and basic need for nourishing food and connection forms the foundation of her consistent messaging promoting eating quality food that is fresh, pleasurable and respected. Living in a culture where food and eating is incredibly important, Stephanie highlights the growing disconnect between the translation of nutrition science, eating behaviour and public health messaging – “I don’t thinking knowing bundles of nutrients helps me, the freshest food is the best food and if it’s a question between food for pleasure or health it’s a very sad question”
Professor Kerryn Phelps, integrative medicine doctor, considered the crowded field of nutrition experts and explored how we can reclaim our space as nutrition leaders and deliver clear, consistent and meaningful evidenced based nutrition messages. To become nutrition leaders Professor Phelps encouraged us to listen and address criticisms – know what it is you want to say and say it well, give the opposing view, read the original research paper and speak to the person who did the original research.
Our messages need to be practical and we need to look at how patients can integrate the advice into day-to-day life. We need to be assessing our clients capacity to self manage their health (health literacy) and we need to go back to the basics of health literacy. Sharing a tool from her own tool box, encouraging clients to think about the advice they would share with their 70 year od self, how are their behaviours now, going to affect them in the future?
A grounding in science and a diverse and broad skill base extends our scope of practice as dietitians beyond the traditional paradigm of clinical, community, food service and private practice. The executive leadership panel (Sally Evans, Helen Ringrose and Marie Sardie) explored how we can work to improve the health of large populations from engaging policy and political will, to partnering with the private sector, to drive investments and change in the public sector. We are surrounded by opportunities everywhere and with a different perspective and a paradigm shift; we all have the ability to see them.
How might we apply this as students, early, mid or late career professionals? Based on what I took away from the panelists we should surround ourselves with the best that are out there – at a strategy, business, academic and policy level. Become multilingual and learn to talk the jargon to the experts, find yourself at their conferences, and make them our greatest allies. We need to seize opportunities, join committees and working groups, take risks and move out of what is safe and familiar to explore new horizons and achieve different outcomes.
In a passionate, fiery debate Fiona Willer, Fiona Sutherland, Professor Clare Collins and Melanie McGrice shared different insights on how we can best support clients’ health. The focus of weight and health permeates every facet of our practice as dietitians – public health, the medical model of health, wellness and wellbeing.
Fiona Willer introduced Health at Every Size (HAES) a movement that promotes healthful behaviours benefit everyone regardless of weight. Long term weight loss is unlikely for most people regardless of method and as dietitians we need to include this information when people come to us seeking weight loss. As Fiona opined we should focus on our core business – helping to empower people to eat well in times of sickness and in health.
Fiona Sutherland (The Mindful Dietitian) proposed mindfulness is a game changer for dietitians. Mindfulness is about cultivating a present moment awareness, non-judgmentally (E.g. tending to the garden, preparing food). As dietitians we can support our clients to cultivate a sense of curiosity about eating and food cues, with the aim that this curiosity and present moment awareness becomes the new natural process for our clients to the process of eating and responding to food, rather than disconnecting and pushing internal cues aside. In turn, allowing clients to respond rather than react and explore what is happening for them in the present moment.
Incorporating lessons in brain anatomy Fiona highlighted how we can support clients to develop their mindfulness muscle, allowing them to calm down their reactive, default, fear-based response driven by the amygdala. Using mindfulness to modify behaviour clients start to become more attuned and can change their eating behaviour and improve their health and well-being.
Clare Collins advocated as APDs we are the only health professionals who can provide evidence based advice on food and nutrition and we don’t want to miss that opportunity, our professional code of conduct indicates we take an evidence-based approach to our practice. We have a range of tools and strategies that can be used to support our clients to be the healthiest they can be. The challenge is to balance the level of energy restriction versus potential adherence. The 5 As provide a foundation to map an approach and help clients achieve an optimal outcome and can help people achieve the most realistic healthy eating patterns they can live with will improve their health.
Understanding and knowing how to work with the different personality types of clients was the designed thinking proposed by Melanie McGrice. If we can understand clients personality and communication style – more specifically their levels of responsiveness and assertiveness we are better positioned to utilize the right tools for our clients, whether their personality is more amiable, analytical, a driver or expressive. The reinforcement that medical nutrition therapy needs to be individualized and guided by evidenced based practice. Reflecting on one of her bariatric clients, Melanie conveyed the serious struggle of someone who can’t participate in life because of their disease (Obesity) and for this patient wellbeing actually means focusing on their weight.
As a new graduate dietitian, I appreciate the complexity of health and wellbeing. What I took away from the presentations and discussion (on a highly emotive topic) was a shift in perspective and awareness of all the tools I have available to me as a dietitian – there is no one size fits all approach. We are trained with the skills to interpret and translate the evidence and our clients are all individuals who come into our care at very different stages of their lives. Clients have the right to safe, effective treatment that will optimize their health and wellbeing. What this looks like we can’t predetermine as a clinician – all we can do is empower the client with the knowledge they need to make an informed decision, respect the clients goals for their health care and be aware of the tools in our toolbox and when we don’t have the right tools for the client, knowing the most appropriate referral streams to best support the client.
Dietitian Connection excelled yet again at inspiring dietitians to think outside the square and demonstrated their commitment to promoting excellence and leadership in dietetics and supporting dietitians to achieve their dreams.
Jacinta Sherlock