Meet the Dietitian: Community Service series

Chat 2 Comments July 22, 2019 nutritionadsa

 

Meet Community Service Dietitian, Iman Gierdien! She is passionate about forming relationships with patients, remembering faces and seeing the impact she is making on, not only the patients, but on their families too.

Written by Iman Gierdien

The thought of becoming a dietitian never crossed my mind. I didn’t know much about the profession until I came across it when applying for university. After researching, the then unfamiliar occupation showed to be a perfect combination of my interests and hobbies: the human body and food. The more I researched, the more I became excited even though the ‘’mighty’’ google couldn’t fully describe what, and how much, you do as a dietitian.  

So, I started my roller-coaster journey at Stellenbosch University. Four years blinked away, and I was halfway through final year applying for community service. Being married and never having been away from home I naturally chose options close home or big cities. To me family and being close to those who love and support me was more important than the type of facility, the type of work I would do or the state of the working environment.  

My greatest fears then came true; I was only placed after swops and appeals were closed. When I read the name I thought, wow, where is that? I had never heard of it, never even seen it on the list and it was definitely not one of my ‘’many’’ (5) options. Again, I relied on google and google maps to help me along.  

Making the decision to accept the post was difficult. I would be 14hours away from home and family, 7 hours away from my husband and in rural Eastern Cape, deep deep rural. After much deliberation and many tears, I accepted. However, it is nothing close to what I was expecting both socially and emotionally. I have made friends that feel like family and I’m in an environment that is so uplifting and positive even though I came with such a pessimistic attitude.

 I am one of two dietitians at the hospital and together we conquer the challenges thrown at us. We are working with a community riddled with non-communicable disease, TB, HIV, teenage pregnancies and severe malnutrition in its children.  We are working with a community that is set in their ways and beliefs and that is crippled by their economic status.

 However, the best part of work is the people. Being a primary, small, hospital you’re able to form relationships with patients, remember faces and you’re able to see the impact you’re making on, not only the patients, but on their families too with such limited resources and little contact sessions.

 Community service shouldn’t be a year for you to think about how much academic experience you gain. It’s an opportunity to go outside your comfort zone and develop soft skills. It should be about gaining understanding and empathy for the determinants of health and actions so that it allows you to grow into a holistic healthcare practitioner and human.

 So, the greatest advice I could give is to use your community service as a year for you to cultivate the skills that cannot be taught.

AGEING AND ITS NUTRITIONAL CHALLENGES

Chat Leave a comment July 8, 2019 nutritionadsa

Around the age of thirty years, the strength and vigour of the human body naturally begins to decline.  There are gradual losses we have to accept as we make our way into our older adult years; less elasticity, less muscle and bone mass, less energy and physical efficiencies.  Decades later, we reach a time when our health is simply much more vulnerable than younger adults and it takes a different effort to take good care of our health.

We cannot avoid the natural consequences of ageing, but embracing a healthy lifestyle does a lot to help us enjoy our senior years.  Older adults have unique nutritional needs and challenges, and this often demands changing lifelong eating habits.  While overweight can be an issue for some seniors, malnourishment is much more common and the causes of this are variable.  The diminishment of senses, such as smell and taste can lead to a disinterest in food.  Living alone; preparing most of your meals just for one and eating all by oneself can similarly lead to a lack of concern about nutrition that the elderly cannot afford.  Chronic health issues associated with ageing can lead to a poor appetite or an avoidance of eating.

In general, seniors do need fewer calories, but more nutrients.  The body’s ability to efficiently absorb vitamins and minerals declines, and therefore nutrient-rich meals become even more important.  According to Cath Day, a registered dietitian and spokesperson for ADSA, the Association for Dietetics in South Africa, ageing healthily requires greater intake of calcium, magnesium and folate, as well as of Vitamins B12, D, E and K. She says, “These needs can be met with a varied diet of healthy foods.  However, good nutrition exists in the context of a healthy lifestyle.  Interestingly, meals that promote social interactions for older adults in a variety of settings are associated with improved food and nutrient intake or nutritional status.” There are no guidelines for the elderly to take nutritional supplements as a matter of course, but Day adds, ”If deficiencies are noted, supplementation becomes imperative as these need to be corrected through therapeutic supplementation and under the supervision of the medical team.”

Another nutritional priority for seniors is to focus on their protein intake. Sarcopenia is, most commonly, age-related muscle degeneration which leads to weakness, frailty, delayed wound healing and other vulnerabilities in seniors.  Even if it cannot be prevented, you want to decelerate sarcopenia.  Day says, “As dietitians, we often find that older people – over 70 years of age – are less efficient at using the protein in the food they eat. This means that they may not be getting enough. Seniors who suffer from a loss of appetite should monitor their protein consumption strictly.  Tips include eating protein at each meal instead of only at lunch or dinner.  Add yoghurt, cheese or egg for breakfast instead of only eating marmalade on toast. Include protein in your snacks by switching from sugary biscuits or a packet of crisps to peanut butter and banana on toast, whole-wheat crackers topped with cottage cheese and fruit or veggies, beans or sardines on a whole-wheat cracker.”

The loss of muscle mass also leads to a lower fluid requirement; but despite less need, the elderly still have a much higher risk of dehydration.  The reasons for this are variable – it could be a side-effect of medication, a fear of incontinence or simply the diminishment of thirst as the self-regulatory mechanism against dehydration.  Seniors need to be aware of the risk; monitor their hydration and adjust their fluid intake accordingly.

While a healthy old-age demands this kind of focus on nutrition and, the adoption of different eating habits, Day reminds that diet alone cannot make people live well for longer.  She says, “A varied diet made up of good quality protein, lots of fresh vegetables and fruits, beans and legumes, whole-wheat breads and brown rice, healthy fats such as olive oil is vital.  However, seniors need to embrace other healthy living habits as well.”

Healthy lifestyle habits also include:

• Maintaining a normal weight
• Getting regular physical exercise.
• Drinking alcohol sensibly
• Not smoking.
• Finding your purpose in life as a senior and interacting socially often, such as sharing meals with family and friends; going on outings; pursuing interests and hobbies; learning something new
• Assessing your stress levels and managing your stress if necessary through meditation or yoga or mindful techniques such as deep breathing

Meet the Dietitian – Estée van Lingen

Chat Leave a comment July 1, 2019 nutritionadsa

We chatted to Estée van Lingen, a dietitian who is passionate about growth and evolving in her field. And is willing to share a chocolate brownie or cheesecake!

 

Why did you become a Registered Dietitian?

I have always been passionate about food as well as helping others achieve their goals. With Dietetics I get to work with both! Nutrition is also a field that is consistently growing it is also nice to keep on evolving with it and keep on learning and not just a set of rules that we learn in University and stick with for the rest of our careers.

What do you enjoy most about the work you do? What are the most satisfying moments?

Clients that are actually motivated and come to you for help. When they then leave your office feeling like they have learned a lot and you have made everything so clear and easy for them and then they go home eager to start implementing it.
Its always satisfying when clients achieve their goals following the advice you gave them but not just that. The fact that they also believe you made a difference in their lives and that you played a key role. Even if it was just for clearing bloating or improving energy levels.

What has been your career highlight?

Being able to start my own private practice without working in a private practice setting before. I would never have though that I could actually achieve it and now to just keep on seeing my practice growing on a daily basis. It has been a true blessing that I would never have been able to achieve without help from my heavenly Father and the support of family & friends.

What are the most challenging aspects of your career?

Convincing clients that a healthy balanced diet is the way to go especially if they have been following other diet trends with success.

How do you cope after a day of nutrition disaster and bad eating choices?

We all make mistakes, and yes dietitians also have bad days, believe it or not ☺
I just tell myself its ok and it’s not a train smash so I just have to get back on the wagon tomorrow or with the next meal and start afresh. We can’t keep on getting stuck in the past, then we will never be able to move forward.

What are the three things that you think people should stop saying when they meet a dietitian?

• I know I am fat. Do you think I am obese?
• What do you think about the banting diet?
• I want to lose the weight quickly, how can we speed weight loss up with supplements?

Tell us about what work you have done in the past as well as what work you are currently involved in?

I have finished my community service in a government hospital where after I went into a corporate company doing catering. I was responsible for compilation of meal plans for special diets eg Diabetes, high cholesterol, IBS, soft diets etc for in a hospital set up as well as healthy meal alternatives in canteens. I also did training with the chefs and staff on what healthy meals consist of as well as special dietary needs for patients in hospital. I then started my private practise where I still consult with clients to assist them with weight loss as well as special dietary needs.
Where did you study your undergraduate degree and where did you do your community service?

I studied at NWU (Potchefstroom campus) for my 4 year Dietetics degree (incl honours) and then completed my community service in Tambo Memorial hospital in Boksburg.
Tell us about your community service experience.

It was great to learn from other dietitians in the government setup as well as see what things are like in a public setting as well as the different needs there is for patients. I also enjoyed helping people that was not able to afford Dietetic services otherwise and it made my heart melt when you could see the difference you made in their lives. It also was frustrating at times when you really wanted to assist people but did not have the right resources due to unpaid accounts or lack of funds. But overall it was a life-changing experience
Have you continued studying and what do you do to keep up to date on nutrition?

I have not continued studying a degree but have done a few shorter courses/ diplomas in Sports as well as Advanced sports nutrition. I also keep up to date with the latest research through CPD activities/ events/ articles as well as attend congresses

 

What should clients look out for when deciding which dietitian to work with?

Have a look at the Dietitians website/ Facebook profile and have a look at what their passions are, what clients they see and compare it to your goals you want to achieve.
If a close friend or doctor refers you they are normally doing it after seeing great results themselves or with their clients so trust their judgement.

What is your favourite dish and your favourite treat food?

My favourite dish is any form of seafood including sushi. I normally enjoy a treat of a nice dessert such as a chocolate brownie or cheesecake which I normally would share with someone.