Changing a diet therapeutically
Medical nutrition therapy
Hannah Jones uses medical nutrition therapy to ensure patients receive high-quality, nutritional care.
According to the registered dietitian, MNT can improve a patient’s health and wellbeing. It offers a better quality of life, fewer hospital visits and shorter hospital stays, and less use of prescription drugs. Healthcare costs are also lowered.
A couple of examples are listed below:
• The cost of dialysis in Bermuda, excluding medication, specialist consultations and other complications, is approximately $200,000 per year. At Island Nutrition, even if a patient is seen by the dietitian every month, there are savings to insurance of $198,700 per year or $794,800 if the patient remains non-dialysis for four years.
• Research indicates that after eight weeks of starting medical nutrition therapy, 50 per cent of patients no longer require antihyperlipidaemic medications. That produces ongoing savings of several hundreds of dollars per year per patient. The actual savings varies depending on the prescription.
If you love Four Star’s pizza, you might recognise Hannah Jones.
The restaurant’s owners put her face on the menu after she created a range of pies for health-conscious customers.
It’s the type of inroad that the 33-year-old registered dietitian celebrates.
“I figured if people are gonna eat pizza the least I can do is give them a healthy option,” she said. “It’s not about following a boring diet, it’s about making better choices.”
Mrs Jones opened Island Nutrition with that in mind. The practice offers medical nutrition therapy and counselling on a referral basis.
It’s a first for Bermuda. There are only a handful of registered dietitians here and, aside from Mrs Jones, none are community-based.
Her clients are referred by doctors for such health problems as obesity, high cholesterol or high blood pressure, bowel disorders, food intolerance, cancer, stroke and learning disabilities.
“My aims are to improve access to high quality nutritional care and reduce healthcare costs by providing appropriate, timely and evidence-based nutritional care to clients both in a clinic setting and in their own homes or care homes,” said Mrs Jones, who has a master’s degree in nutrition from the University of Nottingham.
She moved to the Island from Britain five years ago to work for Bermuda Hospitals Board.
“I was working at King Edward VII Memorial Hospital and recognised a huge gap,” she said in explaining what led to her move into private practice in September. “There’s no community clinical dietitians in Bermuda. In the UK there are many. They see people with health problems and treat them through diet.
“We’re different from nutritionists. A nutritionist isn’t a registered health profession; a nutritionist isn’t a protected name. That’s not to say they all aren’t good, but they don’t have the medical training that a dietitian does. A lot of people think we just say lose weight, eat less but it’s about adapting diet therapeutically; it might end up that we recommend the person actually eat more cheese or use more olive oil.”
Mrs Jones learnt a lot about healthcare while growing up. Her mother ran nursing homes in Liverpool.
“I’ve worked in [health] since I was young enough to have a little job,” she said. “I worked in the kitchens, in the housekeeping department. So it was kind of natural when I became a dietitian that I went into helping people at home.
“There’s a shortage of dietitians in Bermuda and it’s such a rewarding career. We need more young Bermudians to do dietitian courses. So many people are getting missed here: if you can’t make it to the hospital, if you’re unwell and at home, you’re only seen the next time you’re sick enough to go to Emergency. We can stop KEMH admissions by dealing with illness at home, thereby keeping people out of the hospital, reducing healthcare costs and prescription drug use, keeping people in their own environment.”
Mrs Jones met her Bermudian husband George Jones in Mexico about two-and-a-half years ago at the wedding of mutual friends.
“He lost 40 pounds in the first year we were dating,” she said. “It’s about changing portion sizes and the balance of meals.
“I do a lot of motivational and behavioural change, trying to help people work out what else can do that’s a sensible [eating] option. It’s not a case of giving a prescriptive diet. People sometimes want a ‘diet’ plan. They wonder what to eat for lunch, breakfast and dinner, but what do they do when the store doesn’t have the type of food I want them to eat?
“It’s the reason why shakes and bars are not effective in the long-run. People will lose weight but if you don’t teach them how to eat they will gain the weight back in the long-run. I try and teach people how to eat. They have to be able to choose good foods and accept that sometimes they won’t be perfect and deal with family functions, Christmas parties, days on the boat in summer.”
The focus should be on overall health and balance, not the number on the scales, she added.
“If people are slightly overweight, it’s not particularly negative as long as they are [eating well]. On the flip side, in developed countries, something like 40 per cent of people are malnourished on admission to hospital. If you’re living on a diet of processed junk food, you don’t have the reserves, the vitamins; so if you’re ill the body has no nutritional reserve to fight the particular illness you’ve got.”
As a result, people stay in the hospital longer, are more likely to be readmitted, have poor wound healing and poor outcome from surgeries, she said.
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