Public Health Dietetics

Such a lot has changed since I was invited to write this blog in March 2020. Schools have closed, most businesses have shut up shop, the population has been advised to stay at home. Key workers are trying to keep the wheels on the wagon through this unprecedented disruption on a global scale.

Initially I thought about blogging about the previous pandemic which hasn’t been tackled with anything like the current urgency – the obesity crisis, but that’s for another day. My interest has always been in how diet and nutrition affects large numbers of the population and preventing the conditions which ensue from mal-nutrition. The first report about general nutrition guidelines was in 1983, NACNE. I was a sixth former taking 2 sciences and Domestic Science, which wasn’t counted as a science! I thought I was likely to go into teaching but when the Careers Advisor suggested looking at Dietetics I was gripped. One of the tasks for A level Dom Sc. was designing a menu for a specific type of household – an older couple, a family with 2 young children, a student living alone. Ever since I am fascinated by what people choose to eat, and why.

Even as a student I knew that being hospital based wasn’t my bag and am delighted to say that Community Dietetics departments are now widespread. However these are mainly condition specific service such as diabetes or nutrition support for example, few have dedicated health development Dietetic staff who can disseminate balanced eating to the local population. If there is one this mostly sits with Public Health departments, now in local authority. Since qualifying 30 years ago I have worked in many roles where diet and lifestyle messages have been paramount in the prevention or management, or both, of a condition – CVD, familial hyperlipidaemias, T2DM, weight management. In my naivety I was sure that at this point in my career everyone would be putting healthy eating messages into practice. But it’s only gotten more difficult to navigate a healthy diet. Confusion is being fuelled by self styled nutrition experts, dubious research and sensational media.

Call me biased, which maybe I am, but eating foods which in effect are the ingredients in the combinations we actually eat, in as much variety as possible, covering all the food groups (see the eatwell guide) is one of the great pleasures in life. If we hand over responsibility to others to feed us, which we have, then we need to be sure they have our best interests at heart. Convenient, ready to heat, processed, coloured, sweetened and preserved beyond all recognition, packaged, advertised and marketed means someone is making their cut, and usually that’s not aligning with foods’ health promoting properties. Buying time and low effort as high energy, low nutrient products in portions way beyond sensible amounts have unfortunately changed our foodscape dramatically. And we are paying the price with our health. I am so delighted that doctors of the future will consider lifestyle choices, especially food intake, THE most influential aspect of preventing poor health for the vast majority of us. Nutrition on prescription based on food not ‘food products’ rather than reaching for the medication is surely the way forward. There must be a truth in the saying ‘an apple a day………’.



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