Did you know you can claim back a significant portion of private dietetic fees from your health insurers? VHI healthcare, Aviva, LAYA & GloHealth include registered dietitians on most of their out-patient / day-to-day plans. You can claim between €13 and €80 back per visit to a registered dietitian in private practice! Your dietitian must be qualified, registered and insured with the Irish Nutrition & Dietetic Institute https://www.indi.ie/ and/or CORU, the new statutory body for regulation of health and social care professions in Ireland http://coru.ie/.
A lot of confusion exists between the various titles within the of nutrition profession. Dietitians who are trained in Ireland have dual qualifications and are nutritionists as well. However, other nutritionists or nutritional scientists have no medical training are not permitted to do one-to-one consultations. The term Nutritionist is not protected by law, so people with different levels of training , or in some cases no training at all, can call themselves a "Nutritionist"! In fact, anyone can call themselves a nutritionist!
Other titles such as holistic nutritionist, wellness coach, nutritional therapist, nutritional advisor, nutrition coach and a multitude of other self-professed diet experts are not covered either so you cannot claims back any portion of monies to paid to them!
Here is an article called Know the Difference, published by the Irish Nutrition & Dietetic Institute: Know the Difference V7 short version - April 2016
Here is another good explanatory table from the British Dietetic Association: Dietitian, Nutritionist & Nutritional Therapist (BDA_2014) Trust A Dietitian Campaign
State Registered Dietitian & Nutritionist
Michelle is a state registered dietitian, nutritionist, and member of the Irish Nutrition and Dietetic Institute, the professional body for dietitians in Ireland. She is a first-class honours graduate of Trinity College Dublin & Dublin Institute of Technology, and also holds an honours BSc in Finance from University College Cork. As part of her four years at university studying nutrition, she successfully completed challenging placements in St James Hospital Dublin, South Infirmary-Victoria University Hospital Cork, and The Mercy University Hospital Cork. Through her hospital placements, she has gained experience in many fields including general medicine, diabetes, oncology, upper and lower gastrointestinal surgery, and cardiology. Michelle completed a research thesis in the Coombe Women & Infants University Hospital Dublin, which investigated the link between socio-economic status and diet in pregnant women.
Since graduating as a dietitian in 2013, she has worked in an acute hospital, nursing homes, private practice and in corporate wellness, and joined Cork Nutrition in April 2015. She has a keen interest in working with patients with cardiovascular disease, diabetes, Coeliac disease, gut disorders, and weight management issues, and is passionate about providing practical methods of lifestyle change to her patients. She believes that nutrition has a major role in not only extending the length of an individual’s life but also greatly improving the quality of that life.
Michelle loves to cook! She is interested in all types of recipes and foods but her personal favourite has to be Thai food following a month spent travelling around that beautiful country many years ago. She also loves getting outdoors and plays tag rugby, hikes and cycles in her free time.
Following on from my interview with PJ Coogan this morning on the Opinion Line on Cork's 96FM, here is a link to the podcast if you wish to listen back http://utv.vo.llnwd.net/o16/96FM/2015/03/24/2303OPINIONLINE2.mp3
... and here are some key summary points on Coeliac Disease:
Coeliac Disease isn’t a wheat intolerance or Gluten allergy. It’s an Autoimmune Disease where the immune system mistakenly attacks and destroys healthy body tissue. Coeliac disease causes sufferers to react to gluten, the protein found in wheat, barley, rye and malt. Some Coeliacs are also sensitive to the protein found in oats. If a Coeliac eats gluten, the lining of the small intestine becomes damaged and reduces the ability to absorb nutrients from food. If undiagnosed, it can potentially lead to many complications such as osteoporosis, cancer, infertility, nutritional deficiencies & malnutrition.Signs & symptoms vary in type and severity from one person to the next. The classical symptoms are diarrhoea, constipation, abdominal pain, bloating, pale stools, Dermatitis Herpetiformis, fatigue, vomiting, weight loss, unexplained anaemia (iron, vitamin B12, folate deficiency), recurrent mouth ulcers and alopecia (hair loss). It is a common condition in Ireland, affecting 1 in 100 people. However, it is a significantly under-diagnosed disease; for each person diagnosed there are likely to be 5-10 people who remain un-diagnosed. It is also possible to have Coeliac diseasewithout any symptoms! It is damaging to your health if it goes undiagnosed and untreated.
Coeliac Disease should be ruled out in women with fertility issues. It should also be considered and investigated in people with premature unexplained Osteopenia, Osteoporosis, Type 1 Diabetes, and abnormal thyroid function. People with Down Syndrome have a 40 times higher incidence of Coeliac Disease and so should always be screened.
Investigations & diagnosis
Prior to being tested for Coeliac Disease, a high-gluten diet should be consumed for at least 6 weeks prior to any blood tests or biopsies. Because the symptoms of Coeliac disease can mimic other serious conditions such as Cancer or Crohn’s disease, thorough investigation by a qualified medical doctor is essential. Your GP can take a blood test for antibodies - Immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (IgA tTG) and anti-endomysial antibodies (IgA EMA). If antibody results are positive then you should be referred to a consultant gastroenterologist for a biopsy.
Dangers of Self diagnosis
People often self diagnose their gut symptoms as irritable bowel syndrome (IBS), a very dangerous practice indeed! Self-diagnosis kits sold in many pharmacies are also strongly discouraged; they can be difficult to use, and they can give false results. In the event that the kit yields a positive diagnosis of Coeliac Disease, patients typically proceed without nutrition and dietetic treatment, and without medical follow-up regarding long term complications.
A word of caution
Unreliable tests offered by alternative practitioners and many health food shops include Vega testing, Pulse testing, Kinesiology, saliva testing & so-called “Food Intolerance tests” costing up to €250! This is all pseudoscience! There is no scientific evidence to support such claims, diagnostic methods ordiagnoses. The most common diagnosis resulting from such quackery is wheat and dairy intolerance which leads the unsuspecting person to embark on a DIY wheat-free diet! Residual gluten will still be present in the diet of an undiagnosed Coeliac on a DIY wheat-free diet, and there would a high risk of long term medical complications.
Once a positive diagnosis has been made by a medical doctor, the only treatment is a 100% gluten-free diet for life. All Coeliacs, particularly at initial diagnosis, should have a lengthy one-to-one consultation with a qualified state-registered dietitian (RD or clinical Nutritionist www.indi.ie). Whilst nutrition information from other sources such as social media platforms, family members, friends, work colleagues, other Coeliacs and even other health professionals may be very welcome, it is frequently incorrect! Coeliacs should also join the Coeliac Society of Ireland for ongoing support.
Job title: Basic Grade Dietitian, part time position (0.5 WTE)
Date: 19th January 2015.
Introduction: Are you self-motivated, enthusiastic and ambitious? Do you have a fun and outgoing personality? Would you like the opportunity to join the longest established nutrition consultancy and private dietetic practice in Cork?Hours: 2.5 days per week initially, but would expect this to grow to a fulltime post quickly. There will be an initial 3 month probation period.Qualifications:
BSc Human Nutrition & Dietetics (Trinity College Dublin) & Diploma Dietetics (DIT), or UK equivalent of this qualification.
FODMAP training will be a distinct advantage but not essential as training can be undertaken in due course.
Minimum of 1 year post qualification experience, but ideally 3 years experience, to include acute clinical dietetics, running busy OPD clinics, community nutrition, workplace health promotion. Proficient use of nutritional analysis programmes would be a distinct advantage. Candidates must have excellent communication and presentation skills. Must be a car owner with full clean driving licence, as travel will be required for corporate work.
INDI membership (which includes professional indemnity insurance) is essential. Evidence that you have applied to CORU and are awaiting state registration and Garda vetting is also essential.
Commensurate with experience
How to apply:
Please email cover letter & CV to Niamh O’Connor RD MINDI email@example.comClosing date for applications: Sunday 22nd February 2015. Candidates will be short listed and invited to an informal interview in March.
And finally! I know the high level to which all RD’s are trained so that is not what I will be assessing! Make your cover letter stand out! One of the most important criteria for the person I will choose to join Cork Nutrition will be personality! Good luck!
Niamh is delighted to announce that she will be opening another new nutrition & dietetic clinic at The Mater Private Hospital Cork on Tuesday the 28th January 2014. Clinics will be on Tuesdays from 10am to 7pm, by appointment only, for inpatients, out-patients, GP referrals and self-referrals.
If you would like a practice information leaflet with further details, please email Niamh directly - firstname.lastname@example.org
Here are the contact details for the new service:
Dept of Clinical Nutrition & Dietetics,
Mater Private Hospital,
Citygate, Mahon, Cork
Appointments: (021) 601 3200
Secretary: Ms Susan O'Connell, suite 12
What is the difference between a Dietitian, nutritionist or nutritional therapist, and how to find a qualified registered Dietitian or regulated nutrition expert
Whilst the Irish Nutrition and Dietetic Institute (INDI) recognises the choice of the consumer and patients to use complementary or alternative therapies, a key role of the INDI is to ensure that the public are protected from unregulated or inappropriate advice on nutrition. This leaflet informs the public on how to select or check the credentials of any nutrition advisors or practitioners, and to provide information on how to find a qualified Dietitian. The key differences between the roles and functions of Dietitians (clinical nutritionists), nutritionists and nutritional therapists are outlined.
Many people claim to be experts in nutrition yet have very limited knowledge and do not offer protection to the public. Choosing the right person from whom to seek help and advice can sometimes be a confusing task. This is not helped by an increasing number of self- proclaimed or alternative ‘nutrition practitioners’ emerging from informal courses. Such courses are not recognised by the State or by Irish Universities.
Unfortunately, for those who use the services of these unqualified ‘nutrition practitioners’, the advice or therapy provided may be ineffective, inappropriate and potentially unsafe.
What is a Dietitian?
A Dietitian is a health professional who has a Bachelor's degree specialising in foods and nutrition, as well as a period of practical training in a hospital and a community setting. It takes at least four years of full-time study at a university to qualify as a Dietitian. Many Dietitians further their knowledge by pursuing a master's or Doctoral degree. Dietitians apply the science of nutrition to promote health, treat and prevent malnutrition and provide therapeutic dietary guidelines for patients, clients and the public in health and illness.
The title "Registered Dietitian” and "Dietitian" will be protected by law so that only qualified practitioners who have met the required education qualifications and continue to maintain their knowledge and skills through continuing professional development, can use that title. CORU is responsible for regulation of health and social care professions under the Health and Social Care Professional’s Act, 2005, in Ireland. Dietitians have public protection as their mandate. Dietitians are held accountable for their conduct and the care they provide both through the regulation process and also through membership of the Irish Nutrition and Dietetic Institute (INDI). All members of The INDI are bound to comply with the code of ethics and professional practice
The term Nutritionist is not protected by law so people with different levels of training and knowledge can call themselves a "Nutritionist".
BSc. (Hons) Human Nutrition and Dietetics or a related science degree with a postgraduate diploma or master’s degree in Dietetics. Dietitians are the only nutrition professionals to be regulated by law, and are governed by an ethical code to ensure that they always work to the highest standard.
Dietitians are qualified to work with healthy and sick people in a broad range of settings including hospitals, primary care and private practice. Dietitians also work in education, research, industry, government and consultancy. Dietitians are the only nutrition professionals that can be employed by the HSE.
Dietitians do not sell any nutrition supplements in relation to their nutritional advice in the clinical setting.
Nutritionist or Public Health Nutritionist
BSc (Hons) or MSc in Public Health Nutrition, Human Nutrition or Nutritional science.
Nutritionists or Public Health Nutritionists are qualified to provide information about food and healthy eating and often work in roles including public health, health improvement, health policy, local and national government as well as in education and research.
As this profession is not regulated by law, anybody can call themselves a nutritionist. However, those who hold the appropriate qualifications can register with the UK Voluntary Register of Nutritionists (UKVRN). This, is a UK register, there is no register of Nutritionists in Ireland. Nutritionists are not required to be registered in order to work in Ireland.
In many cases Dietitians have a dual qualification which qualifies them to practice as Dietitians and Nutritionists.
There are all sorts of courses of differing lengths which claim to train nutritional therapists. Nutritional therapists are not eligible to register with the UK Voluntary Register of Nutritionists and will not be eligible to register with CORU, the multi-profession health regulator in Ireland.
Nutritional therapists provide nutritional advice in private clinic settings. Some may offer nutritional tests such as food intolerance testing or hair analysis which are not evidence based within conventional medicine. Some may also offer treatments such as supplements, detox diets, and food exclusions for which there is little robust scientific evidence.
Products or supplements may be offered as part of the consultation process.
How to find a Qualified Dietitian/clinical nutritionist or regulated Nutrition Expert
Outside of the state regulation of Dietitians, nutrition advice is largely a self-regulated industry where anyone can set up and practice without a recognised or regulated qualification, meaning there is no real protection for consumers or patients.
When looking for nutritional advice in relation to your health, it is advisable to ask the practitioner about their background and qualifications to ensure they are appropriately qualified and regulated. You can find a qualified Dietitian by:
• contacting your local hospital, GP surgery or Primary Care Centre
• searching under the Find A Dietitian section on www.indi.ie
The INDI is the professional organisation that represents over 600 Dietitians across Ireland. INDI sets national standards for undergraduate dietetic programs, dietetic placements, and graduate degree practicum programs. www.indi.ie. For more information on the regulation of health care professionals in Ireland see www.coru.ie.
NutriCountTM provides professional menu analysis & calorie posting for food businesses in Ireland, and is a sister company of Cork Nutrition Consultancy.
Browse our new website today! www.NutriCount.ieNutriCountTM name and logos are registered Trademarks in the Republic of Ireland (Irish Patents Office), and are owned by Niamh O’Connor.
NutriCountTM is also registered with the Companies Registration Office of Ireland (CRO registered no. 475125).
It's that time of year again - time to join RTE's Operation Transformation and choose a leader to help you on your journey to health and wellness! Cork Nutrition Consultancy is delighted to support Cork's own Deirdre Galvin-Hosford, who is origially from Bandon and now lives in Whitechurch Co. Cork with her husband Will, and their two young sons Jack & Cian.
Deirdre's sister Imelda runs the Bread Basket in Bandon, a business which was set up jointly with their late father Finbarr, and which Imelda now runs. Before any of us knew that Deirdre would be leading the nation, I had been working with Imelda analysing the menu at the Bread Basket, to help her customers choose healthier options and being mindful of the calories. This Calorie posting initiative was launched at The Bread Basket's 1st Anniversary on Friday 9th November 2012.
When Deirdre was chosen as a leader for RTE's Operation Transformation we then decided to go one step further and we designed a new "Operation Transformation Menu" for The Bread Basket! This menu offers a wide variety of low calorie meal options suitable for most people on weight reducing diets who want to choose a healthy lunch to help them lose weight.
Have a look at the menu here!
Bread Basket Bandon: Operation Transformation Menu January 2013
You can also meet Deirdre and show your support this coming Saturday 19th January 2013 at the first of the Operation Transformation Roadshows, sponsored by SafeFood, at Mahon Point Shopping Centre, Cork. The event runs from 12 midday to 3.30pm and includes "Swap & Save" presentations by Dietitians from the Irish Nutrition & Dietetic Institute. The one and only Karl Henry will also be on hand with his expert advice on exercise and fitness. See you there!
Details of all the nationwide roadshows here:
Follow me on Twitter @CorkNutrition and @NutriCount_IRL for more updates and health tips!
Introducing a Clinical Nutrition Referral Service to the Cork Fertility Centre
Nutrition is the cornerstone of good health and wellbeing. It is particularly crucial at certain stages of life including fertility, conception, pregnancy, foetal brain development, childhood growth, and has a significant role to play in the prevention and treatment of chronic diseases. The specific types of nutrition consultations relevant to fertility are outlined briefly here:
General Nutrition and dietetic review to check overall nutritional adequacy of the diet
Coeliac Disease is an autoimmune disease caused by intolerance to Gluten. Undiagnosed Coeliac Disease can lead to impaired fertility in women, so all women with impaired fertility should have blood tests carried out to diagnose or rule out Coeliac Disease.
PCOS (Poly Cystic Ovarian Syndrome). PCOS is one of the leading causes of fertility problems in women and, if not properly managed, can lead to additional health problems such as diabetes in later life. Dietary and lifestyle management have been shown to improve symptoms; research has shown that weight management & low GI diet is advocated as the primary therapy in overweight women with PCOS. Women with PCOS should also have an oral glucose tolerance test (OGTT) carried out to determine whether or not impaired glucose tolerance or insulin resistance has developed.
Sperm DNA fragmentation. As you may already know, Cork Fertility Centre is currently conducting a research study examining DNA damage in sperm and its effect on Intrauterine Insemination (IUI) outcomes. The results of this study will determine if these tests of sperm DNA damage are useful in deciding the best treatment options for future couples. Although it is likely that nutrition has a clear role to play here too, there is currently no conclusive scientific evidence on the benefit of dietary supplementation. However, the levels of Certain vitamins and minerals in the diet may improve sperm count and/or sperm quality. They include zinc & vitamin C.
Nutrition is a very ‘hot’ topic, especially when it comes to kids. This blog is aimed at parents, to give some insight into the world of nutrition, healthy eating for kids & the new ‘epidemic’ of the western world – childhood obesity.
Despite the fact that millions of euro have been pumped into health promotion over the past 20 or more years, advising us to eat less fat, to take more exercise, to be a healthy weight and so on, the statistics show that our health has worsened significantly, our body weight has increased significantly, our diet it as high in fat as it has been for the past 10 years, and our knowledge our nutrition & healthy eating is appalling! So how confident can we be that our knowledge of children’s nutrition is up to scratch if we are so unsure and confused about what we, as adults, should be eating?
Did you know that if your child consumes a super-sized takeaway meal (such as a burger, large fries, large drink and a dessert/milkshake/ice-cream) they would have to run a full 26 mile marathon to burn off the calories in this meal? If not, then maybe you should read on!
Overweight & Obesity in Irish Children- the silent epidemic
Infants are meant to be plump! They have special fat called ‘Brown adipose tissue’ which is very metabolically active, and essentially is like a little furnace to keep babies warm. Babies should double their birth weight by 5 months old & they shouldweigh three times their birth weight by their first birthday. Percentage body fat should start to decrease after the first 12 months. Therefore a very plump 2 or 3 year old may be cause for concern. New guidelines suggest that a child should now be assessed for overweight/obesity at their 2nd birthday. There is a very fine line between a “Fine healthy child with puppy fat” and an obese child at risk of life threatening medical problems. At present, it is predicted by health experts that children may well die before their parents in this generation, from preventable chronic diseases.
Obesity is a very complex issue, with a very complex aetiology. It is the end result of many factors such as genetics, underlying medical conditions, diet, physical activity level & other environmental factors. Organic or medical causes of obesity, such as hypothyroidism, are rare. In fact 95% of cases of obesity in children are nutritional and lifestyle in origin. Obesity cannot occur unless there is nutritional abundance, i.e. too much food or calories. Lifestyle of adults and children has changed dramatically in the past few decades. TV/video viewing, computer games & the internet have taken over as the preferred pastimes for many children in preference to physical activity & organised exercise as hobbies. The apparent decrease in priority of physical education in schools has also compounded this problem.
The psychological effect of obesity in children can be quite profound & should not be underestimated. Bullying of obese children is frequently reported. Obese children are more likely to be viewed by their peers as lazy & unfit, although this is wholly untrue.
Research has revealed frightening statistics on the current overweight & obesity levels. In Ireland, over the past 20 years there has been a 127% increase in overweight and obesity, and Ireland now has the second highest rate of obesity in Europe. This unfortunately includes children living in Ireland, so our eating habits & lifestyle choices are certainly rubbing off on our kids.
25% of three-year-olds are overweight
20% of primary school children (aged 5-12 years) are overweight
20% of teenagers are overweight
This equates to over 300,000 children and the epidemic is growing at a rate of 10,000 new cases every year. So that’s the equivalent of Croke Park Stadium, full, four times! That is most certainly a health problem of epidemic proportions. It would be very convenient to blame our “genes” or those of our ancestors, but this silent epidemic has numerous possible causes and far reaching consequences if not tackled seriously now. Last year I attended a childhood obesity conference and had the pleasure of listening to research results from consultant paediatricians based in Great Ormond St Childrens’ Hospital London. They have identified 15 different genes which may increase a person’s risk of obesity but even if a child had all the genes, it would only account for a 1 point change in Body Mass Index (BMI), which essentially means that the obesity epidemic is 99% related to nutrition & lifestyle factors.
I could talk (write!) about this topic for hours and hours but lets just take a quick look at the main dietary factors that protect against childhood obesity and the factors that increase the risk
Factors that protect your child against obesity
It is difficult to over-feed an infant who is breast-fed. The feed is the correct concentration, nothing has been added to it & the infant regulates their intake of milk at each feed. When they have enough they stop feeding!
On the other hand, bottle-fed infants do not regulate their milk intake in quite the same way. The feed is often made up more concentrated than recommended (believe it or not!), and/or solids such as baby rice may are sometimes added to the bottle. Bottle fed infants may also be persuaded to drink more then they need!
2. Delay Weaning (the introduction of solid food) until aged 6 months
Solids should not be introduced to your baby’s diet until the infant is 6 months old; these are the guidelines of the Irish Nutrition & Dietetic Institute & The Dept. of Health. Research into weaning practices in Ireland has shown that many infants are weaned onto solid foods too early and this leads to a much higher risk of the child developing obesity. Research has also shown that an increasing number of women are overweight themselves at the time of conception, which seems to compound the entire issue further in terms of diet and lifestyle factors that the infant is subsequently exposed to. The final piece to this puzzle is that recent research has also shown that mothers are aware of the correct age to wean their babies onto solids, but make a personal decision to ignore the scientific recommendations. All in all, this constitutes a proverbial recipe for disaster. If the infant cannot take the food from a spoon, then solids should be introduced at a later stage. Solids such as baby rice should NOT be added to the bottle.
3. Reduce the amount of energy (calories) in children’s diets by having a tailored diet prescribed by an experienced paediatric dietitian. You can search on www.indi.ie for a dietitian in your geographical area or log onto www.corknutrition.ie/sedi for a list of experienced consultant freelance dietitians in Ireland.
4. Set a good example to young children by eating healthily yourself. Easier said than done some days I hear you say!
5. Control treats. Remember that treats do NOT have to edible! Why not look at non-food options as treats for your child especially if your child has a tendency to gain weight.
6. Control portion sizes. Use child-friendly plates, bowls etc; Order children’s portion sizes in restaurants; watch out for the restaurants which offer and promote “Kids Size Me” menus (this is a recent initiative of The Restaurants Association of Ireland); limit food treats to ‘mini or fun size’ instead of giving children large portions or adult servings.
7. Encourage exercise. Children need to be active for at least 1 hour every day. This can be a formal sport or activity, or just playing with their friends, cycling, kicking a ball, playing rounders, chasing etc! The more fun it is the longer they will exercise for! Computer games can also play a role on the days when the weather is too bad to send kids out to play – Xbox, Wii Fit & dance mats are great indoor alternatives!