Dietitian

The dietitian’s role in the rheumatology team is not widely recognised. However, diet and nutrition have important functions in the management of musculoskeletal conditions and is an area which greatly interest patients.

The primary aim of the dietitian is to translate the most up to date scientific research on food, health and disease, into practical guidance to enable people to make appropriate lifestyle and food choices.

Dietitians in rheumatology will assess the current, recent or usual dietary intake of an individual and use this information as a basis for providing appropriate, evidence-based dietary guidance. Dietary advice given to an individual will nearly always need followed-up to assess its impact and evaluate progress. Other members of the family may be involved and lifestyle factors taken into account, so any advice is practical and feasible.

General dietary advice

  • Healthy eating advice
  • Weight management
  • Healthy eating for younger people (JCA)

Specific advice for musculoskeletal conditions

  • Rheumatoid arthritis; gout
  • Advising patients about the (in)appropriateness of so-called ‘diets for arthritis’ and unscrambling the truths from the myths
  • Dietary supplements

Other dietary considerations

  • Cardiovascular disease risk
  • Osteoporosis prevention
  • Metabolic syndrome – dyslipidaemia, obesity
  • Diabetes

Access to dietary advice

Dietitians in rheumatology may be part of the rheumatology multidisciplinary team (MDT) and accept referrals directly from team members. More commonly patients have to be referred to the Nutrition and Dietetic Department for an individual appointment. Dietitians can also be involved in patient group sessions to provide general dietary advice and answer patients’ questions. An alternative way of providing general dietary advice is for the dietitian to educate other members of the MDT sufficiently for them to be able to give safe and evidence based advice and to know when to refer to a registered dietitian (RD).



Training

Training to become a dietitian usually consists of a recognised four-year university-based course leading to a BSc Honours Degree in Dietetics and/or Nutrition. In order to work in the NHS, dietitians must be on the Health Professions Council register. RDs are the only qualified health professionals that assess, diagnose and treat diet and nutrition problems at an individual and wider public health level.