Nutrition Care Process to Empower Dieticians

She has also done work on Diabetes in India – Nutrition Guidelines
study. She has worked with the obese in a study on the role of dietitians in
improving outcomes.

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On behalf of ISPEN 2019, Medindia interviewed Dr. Esther Myers to
throw light on this new concept of Nutrition Care Process (NCP) in empowering dieticians.

Q. What are your areas of interests in diet and nutrition?

A. Most of the work that I have done
recently has been with dieticians in terms of improving practice. For example,
I am looking at how dieticians can more effectively implement the Nutritional
Care Process (NCP) and document the care we provide to
patients, as well as the outcomes we can expect.
Because I believe only when we fully document what we have done, can we know
whether or not it was useful and improve our care.

Q. You have researched ‘Diabetes in India Nutrition Guidelines’ or DING study. Please tell us about the main findings of this important study?

A. One of the main things we were
looking at with, the DING study, the dieticians and
Nutritional Guidelines Study in India was whether or not we would be able to
implement the evidence-based guidelines in dietician’s practice in India. The
outcome from the study showed us that it was very difficult for the dieticians
actually to implement the guidelines in the intervention group and there are
barriers in practice in India and elsewhere, but the
additional barriers here need to be addressed before the guidelines could be fully implemented.

Q. Do you think things have improved than what it was before?

A. I am sure that as the health care
environment continues to change, the role of dieticians will change as well.
There has been an increased emphasis on educating dieticians and providing
higher-level training on clinical nutrition, and these things will all position
the dieticians to be in a better position to be able to implement guidelines
when the time comes.

Q. The incidence of diabetes is increasing, and diet plays an
important role – What would be your advice on how to control it?

A. I think dieticians are uniquely
positioned to help clients control diabetes. Because dietician is the one who
can look at how the patient/client regularly eats, what
his/her lifestyle is like. The dietician will then be
able to tailor recommendations to help that person reach the right balance of
energy intake, carbohydrate intake as well as physical activity. We already
know that physical exercise and diet go hand in hand. So, the dietician is ideally positioned to help the clients figure out
what they can do to optimize their health.

Q. Can you please elaborate on your innovative approach to obesity
and weight management?

A. This is about the study with the Insurance
company in North Carolina, Blue Cross Blue Shield. We looked at whether or not
if the insurance company funded dieticians to see patients if their outcomes
will be better than just send them tailored health
promotion material in the mail. The result of the study was that the dieticians
were a very cost-effective way to help the patients and the clients and were
able to achieve better weight outcomes. The actual cost per person to have a
dietician service available was very very low.

Q. How can we collaborate with International associations to improve
our health in India?

A. I am excited about the possibility of incorporating the Nutrition Care
Process (NCP) and the terminology in the
dieticians’ practice as a way for dieticians to practice more effectively. And
so, if there are ways to collaborate in terms of providing training programs or
either quality improvement types of collaborative or some way the dieticians
can systematically evaluate how they practice and then improve their outcomes.

Source: Medindia