Seeking help the diet way

Despite reticence from some professionals, nutritional therapists are enjoying a surge in popularity

THE IDEA of paying someone to give you advice on what to eat would have seemed ludicrous a generation ago. Now, with over 150 nutritional therapists working in private practice in Ireland, people are attending this new category of complementary therapist to find ways to improve chronic mental and physical conditions through diet.

"We frequently see people who have been diagnosed with irritable bowel syndrome (IBS). Often, routine eating habits exacerbate the problem and we help to identify potential irritants in the diet and expand their menu repertoire to include key nutrients previously missing," explains nutritional therapist, Heather Leeson.

High cholesterol, depression, digestive disorders and suspected thyroid problems are common reasons someone might attend a nutritional therapist.

"Some clients with depression experience a huge improvement in mood when they embark on better eating habits, and this can give them confidence to review their treatments with their GPs," says Leeson. "In many cases, changes to the diet help prevent the development of a more serious disease."

Leeson is a member of the Nutritional Therapists of Ireland (www.ntoi.ie), the relatively new self-regulatory organisation which accredits nutritional therapy courses, upholds a professional code of ethics, stipulates that practitioners must be insured and requires continuous professional development for its members.

She strongly advises members of the public to check that a nutritional therapist is a member of the NTOI before setting up an appointment with them.

It's also important to remember that nutritional therapists cannot diagnose medical conditions. And that they are trained to immediately refer patients to GPs in so-called red flag situations. This would include patients with symptoms such as blood in their stools or any form of unexplained pain.

Nutritional therapist, Anna Collins, says that at times, it is also possible for a nutritional therapist to recommend that clients see other health professionals. "For instance, I would recommend that a patient with an eating disorder which has an emotional component should see a talking therapist as well. And, sometimes, I recommend clients to osteopaths and vice versa," she says. Collins is also keen to emphasise that people need to tackle the stress levels in their lives alongside changes to their diet. "I give stress management tips to about 75 per cent of clients. A good diet will be useless if the individual doesn't tackle the stress in his/her life as well," she says.

While nutritional therapists are enjoying a certain popularity among the general public at the moment, their arrival has received a more cautious welcome from the already established professions of dieticians and nutritionists. So, what's the problem?

"Basically, I see that dieticians and nutritionists have a scientific training to degree level or beyond while nutritional therapists in general have completed part-time diploma or certificate courses," says Dr Eileen Gibney, lecturer in nutrition at University College Dublin.

The professions also tend to have a different approach to improving nutritional status of their clients, according to Gibney. "There is a crossover between nutritionists who generally work in food research or health promotion and dieticians who work in hospitals or private practice," explains Gibney. "But nutritional therapists tend to recommend supplements more often, whereas dieticians and nutritionists believe that people should be able to get most of their nutrients if they work hard on having a balanced diet."

Another significant difference between dieticians and nutritionists, and nutritional therapists is that the latter tend to draw on a range of laboratory tests to identify nutritional deficiencies, whereas dieticians and nutritionists base their recommendations on population studies of nutritional requirements.

Margot Brennan, spokeswoman for the Irish Nutrition and Dietetics Institute (INDI) says that the public needs to be aware of "the limitations of practice of nutritional therapists".

"It's important that the public is aware of the differences in training. Nutritional therapists simply don't have the range of knowledge of the effects of nutrients on medication that dieticians have," she says. Brennan also points to the imminent State registration of dieticians as part of the Allied Health Professionals Council, as a way of distinguishing the professions.

Nutritional therapist, Heather Leeson, believes there is room for both professions. "We don't see ourselves in competition with dieticians. Our services should complement theirs. While most dieticians are hospital- or clinic-based, we see people in the community," she explains.

"In many cases, we reach people who might not present themselves to a doctor as they may have vague feelings of malaise, lack of energy, poor digestion, etc but don't consider themselves in need of medical help," adds Leeson.

"Nutritional therapy is much more established in Britain, Australia, the United States and in the Scandinavian countries than it is here. We believe that we can help prevent and alleviate chronic health problems - which can only assist a health system that is already overburdened," she says.