Clinical Nutrition

This module focuses on the role of nutrition and diet in the aetiology of major nutrition-related chronic diseases. Most chronic diseases are responsive to improved dietary choices. The dietary management of conditions including weight concern, coronary heart disease, hypertension, Type 2 diabetes mellitus, cancer and chronic kidney disease are outlined. Recognised dietary options such as plant-based diets, Mediterranean diet, DASH diet, vegetarian and MIND diet are discussed in detail. The course concludes with the discussion of isolated food groups and macronutrients in managing chronic disease including low glycaemic index (GI) food, low fat and high protein diets.   

This module outlines the shift to weight-inclusive health care and recognises that both health behaviours and genetics may influence body weight. Weight classifications and limitations of BMI screening are discussed together with contributing chronic disease risk factors. A case study is presented to consider weight management dietary strategies including bariatric surgery, medication, nutrition and physical activity. Evidence based weight management strategies, potential risks of the diet culture, weight cycling and the relationship between dieting and mental health are discussed. A healthy lifestyle is preferable to a diet. People in bigger bodies may avoid medical care until conditions are advanced, to avoid weight bias and stigma.  The non-diet approach looks at common assumptions in health care and the key principles of health at every size, including weight inclusivity, health enhancement, respectful care, eating for well-being and life-enhancing movement. The case study is revisited and options discussed including strategies to engage patients.  

This module focuses on the role of diet in the prevention and treatment of common mental health disorders. The global burden of disease and the links to poor nutrition are discussed. Epidemiology and the role of nutrition in early life, adolescence and adulthood, links diet quality to brain and mental health outcomes. The gut-brain axis is explained including the relationship between mental health, gut health and gut microbiota. The content includes dietary interventions in the treatment of depression based on evidence from studies. Clinical practice guidelines are described. The key issues and barriers to improved diet and therefore improved mental health are discussed. A consistent multidisciplinary approach is required to facilitate best possible patient outcomes.   

Eating disorders are serious mental health illnesses and can occur in any person, crossing boundaries of gender, age, culture and body size. In this module, diagnostic criteria for anorexia nervosa, bulimia nervosa, binge eating disorder, avoidance and restrictive feeding and intake disorder, and other specified feeding and eating disorders are listed. Understanding eating disorders including contributing factors are discussed. High risk populations, early identification signs and screening tools such as SCOFF and Eating Disorder Screen for Primary Care are outlined. The second section covers medical monitoring, inpatient admission criteria, treatment options and referral pathways including the dietician role. All patients with an eating disorder warrant initial medical monitoring to ensure safety, as eating disorders have the potential to negatively impact a wide range of physiological systems. Guides to medical monitoring criteria for inpatient admission and treatment options are explained including the role of the GP and the multidisciplinary team.    

This module focuses on irritable bowel syndrome (IBS). It outlines the diagnosis, burden and pathophysiology of this condition including symptoms of food intolerances and the role of elimination diets as a treatment option. The mechanisms, clinical effectiveness, potential consequences and practical application of a low FODMAP diet are explained in detail. Guides on when to refer a patient to a dietitian are also outlined. The course concludes with a discussion on the role of diet and gut microbiota in the aetiology of gut conditions, including focusing on the microbiota in IBS.  

This module examines the principles of motivational interviewing to guide health behavioural changes. The content includes recognising what triggers can lead to health behavioural change, discusses the challenges to patient’s engaging in change, and suggests various clinical tools to assist with this process. Change strategies including desire, ability, reasons and need, commitment strength measures, sustainability and change talk components are outlined. Four core skills of open questions, affirmations, reflections and summaries whilst practicing advanced listening skills can awaken motivation to change. The content then identifies and offers guidelines to work with resistance and discord and suggests ways to respond to change resistance and guide healthier outcomes.   

This module focuses on the key nutritional problems for patients with diabetes and discusses healthy eating, defines carbohydrates, examines the glycaemic index vs glycaemic load, and includes the nutrition priorities for people with diabetes. The goals of diabetes management include healthy eating to positively influence glycaemic control, blood pressure, hyperlipidaemia and overweight/obesity. A healthy diet, physical activity and in some cases, pharmacological intervention contribute to glycaemic control. Carbohydrates (CHOs) are mentioned before moving to explaining the glycaemic index (GI) and its role in diabetes management. Nutritional priorities are discussed including weight loss, healthy eating and individualised plans. Low carbohydrate diets are defined including their relationship with GI and managing diabetes. The benefits and disadvantages of a low CHO/ketogenic diet in relation to managing diabetes are discussed. A case study reinforces course content.  

GPs play an important role in directing patients with cardiovascular disease (CVD) to evidence-based nutrition advice and resources. This module discusses the evolution of evidence and heart health nutrition recommendations including the National Heart Foundation Eating for Heart Health Position Statement and other recent cardiovascular disease management and heart failure guidelines. Nutrient supplements are discussed together with cardiovascular nutrition controversies including food trends and omega-3, anti-inflammatory dietary components, and weight management. The second section discusses the key principles and evidence for the DASH and Mediterranean diets supported by evidence-based research. Guides are provided for the GP and the patient approach including patients with lower health literacy.

This module introduces the key nutritional considerations for patients with chronic and end stage kidney disease. It gives a broad understanding of the difference in nutrient recommendations and diet quality and identifies what presenting symptoms and issues in kidney disease can lead to further discussions about nutrition. The first section outlines nutrition problems in CKD patients stages 1-5 including chronic diseases such as CVD/diabetes/insulin resistance and/or malnutrition. The second section outlines the complexities of chronic kidney disease including kidney stones, hydration and electrolyte/fluid imbalance. The role of high and low potassium foods, vitamins and trace elements in improving patient outcomes is discussed. The content includes diagrams, guides, case studies and research.