I graduated from the University of Surrey in Nutrition and Dietetics in July 2018 and have been working in Leeds as an NHS Community Dietitian since then. In November 2019, I started as a part-time PGR in the School of Food Science and Nutrition with Dr Ensaff and Dr Holmes as my supervisors.
My work as dietitian has primarily been helping malnourished individuals to improve their nutritional status through advice, counselling and sometimes recommending prescribed oral nutritional supplements. I see housebound individuals, advise nursing homes, run group education sessions and see people 1 to 1 in clinics. I regularly come across numerous challenges that older malnourished individuals face in making significant dietary changes, for example:
- Change in health condition which could increase energy and protein requirements or include dysphagia
- Reduced appetite
- Physical limitations, such as difficulties cooking due to reduced strength or poor manual dexterity
- Social isolation and depression
- Financial limitations
Dietitians play an important role in understanding and helping patients overcome the many barriers that may be faced. There is a lack of research, however, on the effectiveness of common strategies currently used. I have also seen scope for new products and services that could help this growing demographic.
Fortified milk (sometimes called ‘double milk’ in the US) is commonly advised by dietitians for malnourished individuals, both living at home and in care homes. Fortified milk is made by combining a given recipe of skimmed milk powder with whole milk. The resulting milk is high in calories and particularly protein. It can be used in the same way as standard milk, providing flexibility in how and when it is consumed.
Whilst working as a dietitian, I often see that many patients and care homes find it difficult to take on advice regarding fortified milk. My research aims are to explore how patients relate to this strategy (e.g. understanding its benefits, taste, ease of making and digestibility) and the effect on overall dietary intake. Following on from this, I hope to test a suitable intervention and analyse the nutritional impact.
Increased use of fortified milk could help the nutritional status, overall health and quality of life of those who are malnourished in a way that is affordable and sustainable. Furthermore, it has the potential of reducing the financial burden of prescribed oral nutritional supplements on the NHS.