UK
#NHS
ICU Registered Dietitian. Loves food, diet, nutrition research and media. Intolerant of dodgy health/ nutrition/ medical claims and those promoting them
Tim is not a dietitian. Not even close.
Tim is not a dietitian. Not even close.
Tim is not a dietitian. Not even close.
Tim is not a dietitian. Not even close.
Tim is not a dietitian. Not even close.
😠
We possess incisors and canine teeth (for ripping 🐄flesh) and molars (for grinding 🌽 seeds'n'plant stuff). Our digestive tract is longer than a carnivores, with fewer stomachs than a herbivore. We need vits B12 🐔and C 🍊
We are human. 'Designed' to be an omnivore
#JustSaying
Biochemistry + applied physiology + medicine + microbiology + nutrition + dietetics + pharmacology + food science + psychology + sociology + research = Registered Dietitian + a fantastic career helping others.
#STEM
'International Day of Women and Girls in Science 2021'
Dear
@NHSEngland
Next NHS Survey, ditch the explanation in italics and assign Registered Dietitians and Speech and Language Therapists their own tick box. And don't insult us by aligning our professions and training with that of 'complementary therapists'. Appalling,
@MattHancock
Oh dear. Don't wish to embarrass, but of the 30 earnest statements made by these beautiful, successful people about nutrition and health, 29 are factually wrong. ps mercury and tuna comment? ✅
Disappointed,
@cjsnowdon
. Worked constantly for entire duration of
#Covid_19
,
#ICU
frontline. Had holidays cancelled, accepted 6 day working practices and tag-team with colleague to ensure 4x uplift in ventilated pt numbers, many in multi-organ failure, safely fed
@BDA_Dietitians
As an
#ICU
dietitian in
#CriticalCare
for >30 yrs, can safely say that the phenomenal and untiring support from the public towards
#NHS
workers this
#COVID19
crisis is both unprecedented and humbling. Here's my bill for an emergency plumber callout. We're all
#OneTeam
Thankyou🙏
You're on oxygen therapy for your recurrent lung infection. You are breathless. Your mouth is persistently dry. Compare and contrast your ability to eat chocolate mousse dessert (virtually chew free/smooth consistent texture) v virtuous, crumbly, 'needs some chewing' flapjack.
From today, the UK joins a list of countries with a tax on full sugar soft drinks - which in keeping with evidence worldwide from those countries will have absolutely zero effect on managing the 'obesity crisis' . It's just a tax. Not a health measure
#sugartax
From today UK joins list of countries like Mexico, France and Norway with a tax on full sugar soft drinks - 48p on a £1.30 2 litre bottle of cola/lemonade
Medical students around the world poorly trained in nutrition? OK, because the dietitians role exists. Ditto no medical student expects to take x-rays, so radiographers exist. No med student expects to know every single side effect of drug/combos, so pharmacists exist etc
Forget
#Veganuary
.
#Januhairy
or
#DryJanuary
. Let’s make January
#Januvary
instead. To remind us all that dietary variety is best for health. Food tribalism is unpleasant and irrelevant. And you can do what you like with armpit hair with zero impact on health. You’re welcome 🙂
Believe me, if there was a food or diet that boosted immunity to a level that would not require
#ICU
nursing colleagues to be isolated from the rest of us, full shift in protective gear, accepting the insidious creep of ventilated patient numbers, THEN I'D BE TOUTING IT. BIG TIME
Such an eloquent article from GP
@Dr_Ellie
"We have a whole profession of dieticians in this country that we underuse. Not celeb foodies or nutritionists, but NHS dieticians who are experts in nutrition, food and weight loss"👏👏
Official guidance from
#ESPEN
about nutritional management of
#COVID
ー19
A useful summary of nutrition/malnutrition, immune function and critical care.
But in reality,
#ICU
is different... FWIW a personal interpretation of limited experience thus far..
I'm an NHS dietitian. In typical headgear from the 2020/21
#ICU
collection, and current 2021/22 style. I'm vaxxed x3 because witnessing the vagaries of severe
#COVID19
for the past 22 months in 100's of
#ICU
patients up close has been, frankly, terribly sad. Just
#GetVaccinated
I’m a UK Registered Dietitian. Pretty knowledgeable about nutrition and immune response - whether we’re talking community nutrition deficiencies or SIRS/CARS and sepsis on
#ICU
due to a number of causes (including ‘flu). This simplistic view is dangerously WRONG. Please - ignore
Your body can convert both Protein & Fat to glucose when needed. Therefore carbohydrates are not required by your body. If you are suffering from bloating, water retention, skin problems or any inflammation. eliminate carbs completely for a week & watch these things improve
#keto
Truly, if you are an individual who insists on calling this hospital sandwich 'ultraprocessed junk' you really need to a) learn how to interpret a food label, b) read up on ingredients c) stop commentating in public on matters on which you have little knowledge or understanding
Inconvenient truth about fruit....
#trustmeimadoctor
1. The higher your fruit'n'veg intake, the lower your
#CVD
and
#cancer
mortality
2. ... irrespective of your BMI
3. .. and at highest intakes, twice as much fruit than veg was eaten ... 🍅🥕🥦 v 🍎🍐🍊🍇🍌🍉
ENOUGH.
@TwitterSafety
@policy
this advice is dangerous. Inhaling hydrogen peroxide will cause lung irritation/inflammation. Please force takedown.
PS - please update your 'report' menu to include 'harmful to health' during
#COVID19
Dear God,
@BorisJohnson
, have you gone mad? Prue Leith to 'advise' on hospital food? Stop playing pop-tart politics with the lives of sick people. Just listen and take advice from those fab people from
@hospitalcaterer
, providing so much from so little to so many complex diners
Dear
@PrueLeith
Instead of assuming you understand our profession, why not make sure you have a full understanding of our education, training and hospital role before making crass comments in the media about our knowledge and skills?
Asking for a profession.
Thanks
😐
This book is soooo fab, was totally disappointed that I hadn’t written it 😖
Seriously, if you’re interested in nutrition and wellness, do read. And if you’ve been to
@rooted_project
events, you’ll already know how good it will be. Recommend 🙌
#WhatRDsDo
#NotAnAd
.
As a dietitian and a UK taxpayer, it makes me so angry that nutritional advice put out by UK gov bodies appears to have been gleaned from the pages of a womens' lifestyle mag or pressure group copy, rather than Google Scholar 😠
#justsaying
A hungry school child has no influence on their parents birth control plan 40 weeks before they were born.
Access to food is both a human right and a biological need - especially if a child is to reach their full potential physically and mentally.
Well played
@MarcusRashford
🙏
Like to remind teams stressing about early enteral feeding that on a mere volume level, a continuous enteral feed at 25-30ml/h is less than half the volume of saliva swallowed over that same time period 😐
Basically, if you believe fluffy-wuffy empowering statements to be deeply meaningful then you're too self-absorbed to help others ....
#PLOSONE
: Bullshit-sensitivity predicts prosocial behavior
My comments today in
@thetimes
on
#nutriprejudice
. An arbitrary classification of food based on middle class mores and food snobbery, subjectively applied to define a diets 'quality' based on non-nutritional factors like artisanship, provenance and cost
#allfoodfitsinahealthydiet
@doyleysar
@Dr_Ellie
Tbh, the day job treating ICU patients from a deep knowledge of biological sciences, nutrition and medical issues takes most of my brain bandwidth. But agree, rising poverty levels and population preferences for biscuits over fresh broccoli is a bummer... your contribution?
Q: Which has the most iron per serving - a pint (568 ml) of Guinness? Or 150 ml of orange juice? 🤔
A: They're both the same (0.3mg - or 1/20th of average need).
It's an urban myth that Guinness is rich in iron.
Orange juice contains vitamin C that boosts iron uptake, too.
"I never became a physio to rub or poke people... to stick needles into or tape onto people. I became a physio to restore thoughtless, fearless movement to people in pain and to promote the benefits of a healthy and active lifestyle" via
@adammeakins
Male? ✓
Made a fortune from playing about with food? ✓
Written some recipe/ foodie books to keep you in moolah? ✓
Lack qualifications in public health nutrition but have middle class opinions typical of your followers? ✓
.... then of course you're qualifed enough for
@BBCOne
1. Stop listening to chefs who can't run a business
2. Stop listening to pop-tart cardiologists
3. Start recognising that food choice is as much emotional as economic
4. Start listening to successful nutritionists/RDs 'at the coalface' who don't have 'friends in high places'
Hi,
@sajidjavid
. From decades of experience I can honestly say THE best work on improving hospital catering came not from celebrity chefs (Roux/ Grossman etc) but from hospital catering chefs and managers, with protected food and capital expenditure budgets
Fantastic to meet
@PrueLeith
and
@hcashells
to discuss their work following the NHS Hospital Food Review.
Important we keep improving the safety, nutrition, quality and production of food for patients, staff and visitors.
#greatfoodgoodhealth
Behind every person with a tube in their nose like Natalie, there’s a clinical dietitian prescribing and monitoring artificial feeds, tailored for clinical biochem, hydration, disease process, comorbid conditions and goal optimum outcome
#WhatRDsDo
Dear
@PHE_uk
and
@NHSEngland
- about your
#Nutritionista
hydration advice for
#Heatwaveuk
1. Alcohol has negligible effect on hydration
2. Caffeine is not dehydrating, unless you're caffeine naive
3. Sugary drinks do not dehydrate
@SJayToday
My impression as well. One of favourite medical colleagues in class together. Wife died from disseminated ovarian cancer after begin vegetarian all her life. Living in same house for >40 years eating different food; he's fine. These anecdotes powerfully influence one's biases
It's my mum Hazel's ("of all the names in the Bible, my parents had to name me after a nut") 90th 🎂 birthday today.
Normally
#fuelledbycake
, today's celebratory afternoon tea with far flung family on hold. If you'd like to wish her a Happy Birthday, please do 😍
#Happy90thHazel
Long-term participation in physical activity lowers mortality risk from cardiovascular disease and cancer. New study provides evidence that becoming physically active later in adulthood (40-61 years of age) provides similar health benefits
#nevertoolate
😐
Folic acid to be added to UK flour in effort to reduce birth defects Now all we dietitians need to do is persuade affluent, fertile females who avoid gluten/wheat/grains to actually take their folate supplements if they want to avoid
#NTD
in
#pregnancy
Actually, public "must realise that absolutely 100% of Registered Dietitians understand the 'basics of medicine',and that an RD qualification confered by
@The_HCPC
requires evidence of clinical knowledge." Some know even more than junior docs in some areas..😉
@draseemmalhotra
"
#Ketodiet
could be a useful ally in preventing flu"
Tweet doesn't mention it was a secondary outcome from small study on mice🐭
As it's missing from the
@CollegeofMed
copy, just to add that for we humans your
#fluvaccine
is a far, far more potent protector than ditching carbs
"most low carb advocates, including Malhotra, are simply chancers with books to sell... We are asked..to believe a plucky band of former bankers, journalists, engineers and diet book authors and told they have discovered the truth"
@One_Angry_Chef
on form👌
When my dad was on his 6 day peaceful end-of-life pathway, beautifully managed by the staff at Huddersfield Royal Infirmary, I didn't want a packet of vending machine lentil curls at 9pm (even tho' I like them). I wanted a small bar of chocolate
#justsaying
The standard nutritional therapist bio, tbh....
1. Affluent/aspirational lifestyle - usually working with rich people
2. But felt awful/health problems real or imagined
3. 'Cured' self with diet. Then
4.'Studied nutrition'
5. Starts to counsel those in
#1
6. Writes book/blog 🙄
No cleaning teams? No porters? No caterers? No hospital. Merry Christmas to every single hardworking non-clinical member of the hospital team who are the backbone of EVERY
#NHS
hospital.. 👏👏👏
Intravenous
#vitamins
and minerals are used with care in the
#NHS
- they're NOT a harmless 'pick-me-up'. Companies and individuals promoting infusions as a 'lifestyle' approach should be outlawed. Too late for Mrs Sauguniene 😐
@10DowningStreet
@DHSCgovuk
@JasonManford
@McDonaldsUK
I'm an intensive care dietitian. I use this slide in
#MedEd
talks to illustrate
#allcaloriescount
. For debilitated patients with poor appetite, especially those of low body weight, the only food that 'counts' nutritionally is the food that's eaten. Well done, Nana! 👏
Suspect zinc deficiency in patients with high protein demands, increased protein losses eg IBD diarrhoea/ VACS dressings + unexplained skin rash developing. No point waiting 3 weeks for a test result. Give empirical Zn for few days - low toxicity, easily depleted, speedy result👍
Zinc. An interesting trace element. Important for growth, immune function, enzyme function and wound healing. Found predominantly in red meat and shellfish. Deficiency can occur in IBD.
#TraceElementWeek
So tomorrow is the start of
@BDA_Dietitians
#DietitiansWeek
. A week showcasing
#WhatRDsDO
the whole 52 weeks of the year...After completing a minimum 4 year science/medicine/nutrition degree, often more. And being eligible for registration with
@hcpc
🤣RT
@HealthJourno
There's a doctor on BBC Radio 4 The Food Programme saying 'starch breaking down into sugar' wasn't covered at medical school. No surprise, really - it was covered at O Level Biology.
Like Horlicks? Good. A single serving around 600mg of calcium - or three quarters of your daily goal intake. Similar to a Calcichew or an Adcal D3 that you're not managing to take regularly... and it has high bioavailability, too 👍
#WorldOsteoporosisDay
When you're on the ward on a Friday afternoon quietly reading a set of medical notes and overhear the reg tell his junior the Consultant wants this patient on PN....... 😐
That
@bmj_latest
comic column.
Quinoa and kale salad - deficient in sooo many nutrients
Psychologists - aren't qualified to assess nutritional health.
Ditto stent-placing cardiologists
Reduced kcal bought from hospital shops? ≠ reduced personal calorie intake
#JustSaying
Great to see momentum building on this in the mainstream media! We should all be angry! Banning ultra-processed food is not a nanny-state issue. It’s common sense
Dear
@DrAseemMalhotra
Covid-19 is a virus. Its big name is SARS-CoV-2.
SARS=Severe Acute Respiratory Syndrome. The CoV-2 bit is because it's a coronavirus genetically similar to the original (CoV) from 2002.
Viruses are not a 'diet related disease'. However often you write it🙄
Covid-19 is a diet related disease
Covid-19 is a diet related disease
Covid-19 is a diet related disease
Covid-19 is a diet related disease
Covid-19 is a diet related disease
Covid-19 is a diet related disease
Covid-19 is a diet related disease
A beautiful reminder that when you get to 90+ years old feel free to eat white bread with sugar-laden preserves, enjoy afternoon tea with cream cakes and buns.... just remember to add some HBV protein food and take a one-a-day MVM supplement (well, that's what I tell my 92yo mum)
Food fructose studies and blood sugar control. Neat (and timely) meta-analysis of the evidence. And for non-RDs or nutritionists out there, a reminder that when it comes to diet and health, it's
#abitmorecomplicated
than demonising single nutrients/foods .
#OneYearOn
from the start of 🇬🇧lockdown and I'm still viewing tweets from vegan musicians and fat-phobic actresses pushing their
#Covid19UK
dietary ignorance. Whilst nutritionally, we RDs have spent the year up close and professional, maximising nutrition, minimising patient risk
If you’re unfortunate enough to end up in
#ICU
I choose the liquid feed that’ll best match your needs and avoid causing more problems. And fab nurses at your bedside will deliver and monitor it for me
#teamwork
#WhatRDsDo
@CJMcFadden
@KatyRoseRD
@bmj_latest
150kcal snack for someone eating very little who can't or prefers not to eat sweet foods. Used with fluid intake in high output ileostomy - salt helps improve bowel water uptake. Easy to eat 'sideways' with little mess.
Crisps = potato + sunflower/rapeseed oil + salt.
@ocado
pic
Not naming names, but the first thing we dietitians did this morning in the office was to nutritionally deconstruct a colleagues breakfast choice of M&S custard choux bun and come to the conclusion it made a relevant and nutritionally OK choice
Nutritional content of supermarket ready meals and recipes by television chefs in the United Kingdom: cross sectional study The abstract says it all. Much thanks to
@_benprice
for link
@PHE_uk
We
#ICU
dietitians have been up close and professional with
#COVID19
patients for months. We've read those quack musings on diet and
#coronavirus
risk and dismissed them for the media clickbait/IF chasing they are
But THIS?
@One_Angry_Chef
A perfect read👌
When you could really do with a complete overview of serum albumin in health and disease and then
@RobDietitian
obliges with this free-to-access review:
…
1. Please don't write 'E+D well' when all your pt has managed is a ☕️ + slice of toast in the preceding 8 hours.
2. That bedside table heaving with snacks? Means nothing nutritionally unless consumed.
3. Prescribing nutritional supplements? Between meals, please
#TipsForNewDocs
No laughing matter. Case report on N2O use–induced Vit B12 deficiency causing sub-acute combined degeneration of the spinal cord. Functional B12 deficiency associated with SCD. Elevated tHcy and MMA rather than B12 aids diagnosis. Frequently irreversible.
Increasing dairy foods 🥛🧀 from 2 to 3.5 portions/d in
#VitD
replete aged care home residents⬇️fracture risk 33%,⬇️falls 11% and attenuated age-related loss of lean body mass and body weight. No difference in mortality to be expected, given mean age 86y:
The irony of a cardiologist who a) doesn't understand c oncept of low potassium, low phosphate, moderate protein diet for management of renal failure (CKD 3/4)and b) who's blocked me so I'm unable to explain nicely. But, heh, pass this on to him for me. Ta
You know you're a dietitian when the first thing you think when seeing this promo for
@taylorswift13
is "how come she's promoting Early Recovery After Surgery"?? 😂
#ERAS