Healthy living
study participants to buy the ingredients needed to follow these diets. The best-designed studies, therefore, tend to provide items like olive oil and nuts. But this adds up in cost, especially over the time frame to study hard outcomes.
“If you recruit people in their 20s or 30s for this, you have to follow them for 30 or 40 years to look at hard outcomes such as the development of heart attacks, which is going to cost a tonne of money,” Butler says. “Then other comorbidities come into play as we get older and older, making long term nutrition interventions all the more challenging.” For this reason, researchers tend to rely on retrospective or prospective cohort studies. However, most of the information that is collected regarding food intake – irrespective of study type – is based on 24-hour recall, food diaries or food frequency questionnaires. “It’s very easy for people to criticise these approaches because of the limitations of these particular ways of capturing diet information. But the alternative is we don’t collect this information and then we have really nothing to go on,” Butler says. “The challenge with nutrition is the field itself and how we can better design experiments to capture the outcomes we want to study.”
The importance of getting dietitians involved in CVD Clearly, this is a challenge that won’t be solved overnight, but there is work that can be done in the shorter term to improve doctors’ and patients’ grasp of what we already know. One of the key reasons Butler was keen to lead the Diet Working Group was that he wants to get more dietitians involved in – and enthusiastic about – cardiovascular care.
“The challenge with cardiac rehab in general is [that] it’s often not seen as an important service, and this has been exacerbated by Covid,” he goes on to explain.
“In addition, from a dietetics point of view, cardiac rehab is often treated as a training ground for new dietitians. You would never see this in fields like mental health or eating disorders, which tend to be more protected specialist areas of practice.” Butler can’t understand why there’s not more interest in CVD nutrition. “There’s a huge scope for dietitians to work in the prevention of CVD but also in secondary prevention with people who have had a cardiac event,” he says. “This requires a substantial amount of nutritional research and a huge amount of clinical understanding. You can also build a rapport with patients and work with them to support them leading a healthy life. It’s a fantastic field,”
Ingredients Insight /
www.ingredients-insight.com
Butler comments. Adding that, “Ultimately, CVD prevention is something that affects everyone, so there is massive scope for dietitians to make an impact.”
The good news is that he’s not the only one that thinks so. Working with universities and other partner organisations, the Association for Nutrition (AFN) has published guidance for higher education institutions who want to include nutrition related competencies in their medical curriculums, the theory being that all medics who graduate should have a fundamental knowledge of nutrition.
“There’s a huge scope for dietitians to work in the prevention of CVD but also in secondary prevention with people who have had a cardiac event.”
For Butler, it seems that actually training more doctors, nurses and medical staff in the rudiments of nutrition could be something of a game changer. Butler concludes, “if you can do something evidence-based with a patient at their initial appointment, that might be all that individual needs. It makes perfect sense at a time when the NHS is really struggling.” ●
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A healthy diet is critical to ensure cholesterol plaque does not build up in the arteries.
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Shutterstock.com
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