A core value within the St Andrews Practice is having the scope to offer a holistic approach to clients. Within mental health and neurodiversity, we have become increasingly aware of the gut – brain link and how ‘the body keeps the score’ when it comes to trauma and emotion – including impacting gastrointestinal issues. Neurodevelopmental conditions, and sensory processing, can impact dietary preferences. That’s not to mention the reciprocal nature of food and mood – how dietary preferences can significantly impact mood, and mood can result in our desire to comfort eat , or not feel able to eat at all. Within our psychology clinic, disordered eating presents frequently as a means of managing distressing emotions. Hence eating behaviours, for some of our clients are an emotive topic, negatively impacting wellbeing and mental health.
Recognizing this as an unmet need, we are excited to introduce Melissa Kaplan, Dietician to our team, to complement our team’s skill set. We caught up to discuss all things dietetics (and what to have for dinner!).
Melissa, what attracted you towards a career in dietetics?
Learning that food can be more than just tasty, that it has the power to help to me perform better and even heal, I had to learn how to use it for all its worth. As a dietitian I can share my love of food as medicine as well as help interpret the science of food into practical advice for people. I also have a personal interest in athletics and therefore a natural inclination towards sports nutrition.
I think that’s really important because in this world of often too much information it can feel very difficult to know where to begin and what is the best advice. Information overload can be especially difficult where there are high levels of anxiety, or neurodiversity.
There are a lot of different ‘experts’ out there. That can also feel overwhelming! What is the difference between a dietician, a nutritionist and nutritional coaches/therapists?
That’s a great question. So registered dietitians are the only qualified health professionals that can assess, diagnose, and treat dietary and nutritional problems at an individual level. Registered dietitians work with both healthy and sick people. To attain registration, we need a BSc in Dietetics or equivalent. Our training courses are structured and require a period of supervised practice, including in NHS settings, where students must demonstrate clinical and professional competencies before applying for registration. Candidates must be Health Care Professions Council (HCPC) approved. Dieticians are trained to translate scientific research on food, health, and disease into practical guidance. Dieticians work with the NHS, in private practice, industry, education, research, sports, media, public relations, publishing, government and NGOs. In the NHS, service pressures result in it being hard to access dietetics without a minimum criteria, yet so much of the general population can potentially benefit from a dietetic consultation.
Nutritionists work in public health, policy, and in the private sector and are qualified to provide information about food and healthy eating but not about special diets for medical conditions. The title nutritionist is not protected by law – so anyone can call themselves in a nutritionist. Nutritional Therapists apply the use of recommendations for diet and lifestyle to alleviate or prevent ailments often based on complimentary medicine recommendations – not recognised as valid treatment in conventional medicine. Some of these recommendations may include guidance on detoxification, colonics, avoidance of toxins or allergens, and the use of nutraceuticals/nutrition supplements. There is a non-compulsory registration that is possible through the Complimentary and National Healthcare Council which is self-regulated.
So dieticians have a greater depth and breadth of expertise, draw on the evidence base within conventional medicine and are regulated by the HCPC.
Yes, exactly that! We are the only nutrition professionals regulated by law.
So my next question is about the link between diet and mental health?
This is a huge topic (and worthy of its own blogpost!), so I’m just going to highlight a couple of things here. Research affirms that what we eat can impact our brain, cognitive and mental health. There is a well-established link between various mental health conditions, including mood disorders, with heightened dietary inflammation – characterised by a greater consumption of foods that are associated with inflammation (eg, trans fats and refined carbohydrates) and lower intakes of nutritional foods, which are thought to have anti-inflammatory properties (eg, omega-3 fats). Similarly, multiple studies have found a link between diets high in sugar and depression. Overconsumption of sugar triggers imbalances in certain brain chemicals which can contribute to vulnerability to depression.
The findings highlight the importance of eating an anti-inflammatory diet, rich in fruits and vegetables (think Mediterranean diet: low in processed foods, rich in healthy fats, above ground veggies and nuts/seeds). So, anti-inflammatory diet isn’t just important to manage physical health, but could be beneficial for our mental health too. Whilst the causal roles of dietary inflammation in mental health have not yet been established, improving diet can be a behavioural change worth considering alongside the recommended therapy and medication treatments.
The other area which we have spoken a lot about is how stress and trauma can be linked to gastrointestinal issues, so my role as a dietitian can provide support and advice regarding diet planning tailored according to need.
That’s really thought provoking. I’m thinking when low in mood we often crave comfort and potentially inflammatory/high sugar/carb foods…
Yes, and a dietician’s role can be here to develop healthier meal plans but factor in the effect on motivation when depressed and to provide encouragement and goal setting around change.
What about neurodevelopmental disorders –why might someone with ADHD or ASC benefit from seeing a dietitian?
NICE guidelines for the management of ADHD in adults (2019) recommend medication and environmental modification as the first line treatments for ADHD, however, they do also indicate exploring diet as an adjunct. Research does suggest that for some people dietary changes can help improve symptoms. There is some evidence that people with ADHD can be more likely to have adverse reactions to food, causing speculation that eliminating problematic foods might help to improve symptoms – although this is not a standard in the NICE guidelines. Individuals with ASC often experience sensory processing difficulties resulting in some textures and tastes being intolerable. As a dietician I can work with young people from 12 upwards whose diet may be affected by ASC.
Why do some people develop food intolerances?
A food intolerance is difficulty digesting certain foods and having an unpleasant physical reaction to them. It is often unclear why a person cannot tolerate certain foods. An individual might have some symptoms such as bloating, diarrhoea, gas, or nausea /vomiting after eating certain foods. Some common culprits that cause food intolerance could be a food additive, chemical or contaminate such as MSG, caffeine, alcohol, artificial sweeteners or toxins, viruses or bacteria that have contaminated food. Also, artificial colours and preservatives may cause discomfort. Food intolerances can develop over time. So, for example, at some point you may have been able to digest milk and milk products, but then all of a sudden, your body cannot. This is quite normal and can be managed with some guidance.
One final question….what would be your perfect , nutritious meal?
There are many things to consider when creating a nutritious meal but ensuring adequate vitamins, minerals, fibre, proteins, healthy fats, unrefined grains, and hydration is a great start. My ultimate healthy meal is wild salmon with fresh herbs, greens like spinach or broccoli and sweet potatoes roasted with cinnamon and spices.
Thank you Melissa, we are all looking forward to having you work alongside our team!
Contact Melissa via info@thestandrewspractice.com for queries and to book a consultation. Melissa is now seeing clients from ages 12 upwards within the practice.
