Dietitians doing Research: Winners Perspective

The seven winners of the 2016 Research Symposium provide great examples of dietitians involved in research. Here, they talk in more detail about their winning research projects.

Winners are listed below;

Clinical Nutrition – Alastair Duncan, A pilot study to investigate the effectiveness of an individualised diet and lifestyle intervention to reduce type 2 diabetes risk in people living with HIV.

New to Research, supported by Yakult – Neasa Forde, The role of a novel gene-nutrient interaction in blood pressure, measured using ambulatory blood pressure monitoring.

Paediatric in Northern Ireland, supported by BDA Paediatric Specialist Group – Catherine Telford, Average portion sizes of commonly consumed foods among UK children aged 2-4 years.

Paediatric in Birmingham, supported by BDA Paediatric Specialist Group – Amna Mahmood, Parental feeding behaviours in early life and risk of obesity in later childhood.

Public Health – Kirsty Porter,  The role of folate and related B-vitamins biomarkers as predictors of cognitive decline in older Irish adults over a five year follow up period: TUDA+5.

Service Evaluation – Allie Quinn, An Evaluation of the Impact of Participation in Diabetes Structured Patient Education on Patient Behaviour.

Sport and Exercise Nutrition, supported by SENr (sport and exercise nutrition register) – Ahsana Ajrullah, The effects of high intensity interval training (HIIT) versus moderate intensity continuous exercise (MICE) on lipid profile in adults with Metabolic Syndrome - a systematic review and meta-analyses.

Alastair Duncan - Clinical Nutrition stream winner

At the Symposium I presented three pieces of clinical research regarding type 2 diabetes in people living with HIV. There is a higher risk for type 2 diabetes among those treated with antiretrovirals, and clinical outcomes are poorer compared to the general population. My award was for an abstract describing an exploratory diet and exercise intervention that I developed aiming to reduce diabetes risk in those with prediabetes and HIV. I was surprised and delighted when my name was announced at the awards, as standards were high – a credit to dietetics.

I have been working in HIV care for almost 20 years now. For most of this time I have been involved in clinical research in a peripheral way, for example helping recruit participants to large trials. However, the metabolic consequences of HIV and antiretroviral therapy have become problematic to treat, and through discussion with patients I realised that little was known about prevention rather than treatment, particularly regarding type 2 diabetes in HIV.

After an initially unsuccessful application to the NIHR I used feedback to develop my project, and second time round was delighted to be awarded a clinical doctoral research fellowship. I conducted a portfolio of research projects between 2013 and 2016. The diet and exercise intervention for those with prediabetes and HIV demonstrated that despite the effects of antiretrovirals, diabetes risk can be significantly reduced. The next steps are to develop a randomised controlled trial, and to further investigate why some HIV patients find behaviour change particularly challenging.

I would encourage all dietitians to be more involved in audit and research. For clinical dietitians like myself I think a really good starting point is to ask your patients what they think. What is important to them might be unexpected. If you have a few minutes available towards the end of a consultation, ask questions such as "what are your main concerns about moving forward with this plan of action?" or "what do you think we should be researching about your health/ diet?" When you have developed some ideas about research, run these past some patients. Your Trust will have a research and development department who can help you with this. Good luck!

Neasa Forde - New to Research stream winner

I was really delighted to present my abstract at the BDA Northern Ireland (NI) Research Symposium and it was such a surprise to win the New to research award. It was a hugely enjoyable and beneficial experience and a very valuable opportunity to gain an insight into the wide range of research being carried out within the field of dietetics.

My abstract was based on my MSc dietetics research project which investigated the impact of the MTHFR polymorphism on blood pressure in individuals in Northern Ireland, using a novel approach to blood pressure measurement – Ambulatory Blood Pressure Monitoring (ABPM). Previous research carried out at Ulster University has shown that individuals with the MTHFR polymorphism have increased blood pressure levels. This is particularly impactful given that 12% of the population of Northern Ireland have the polymorphic genotype. However previous studies had used a method of blood pressure measurement known as clinic measurement which takes a reading at one moment in time. In my piece of research I used ABPM which is a more accurate and robust blood pressure measurement method, as it provides 24-hr blood pressure readings. Using ABPM I demonstrated a significant increase in blood pressure in individuals with the MTHFR polymorphism compared to those without it.

These findings are particularly important given that previous research has demonstrated that supplementation with riboflavin in these individuals can lower their blood pressure. This is a remarkable finding as it means that high blood pressure levels in this group of individuals have the potential to be treated without medication. It is also an effective display of a gene-nutrient interaction which can have a positive benefit for a large portion of the NI population.

The BDA Research Symposium was a great opportunity to present and share this work and findings to others within the dietetic community. It was also really enjoyable to discuss all the positive work that is taking place across the UK and to see how the research aspect of dietetics can meet the practical aspect. I would highly recommend to all dietitians and students to attend and get involved in the next BDA Research Symposium – you won’t be disappointed!

Catherine Telford - Paediatric in Northern Ireland stream winner - supported by BDA Paediatric Specialist Group

I never imagined when I submitted my abstract to the BDA Research Symposium 2016 that I would win the best abstract for the Paediatric stream in Northern Ireland. The research was completed as part of my BSc Dietetics Research Project at Ulster University, Coleraine. It was something I put a huge amount of effort into so I’m delighted to be rewarded for all of my hard work and I am also grateful for the opportunity to be able to share my work with others. I would also like to mention that I would not have been able to complete the research project without the support and guidance of my project supervisors, Dr Maeve Kerr and Dr Kirsty Pourshahidi.

The aim of the study was to examine typical food portion sizes consumed by young children and the associations with measures of adiposity using data from children aged 2-4 years that participated in the National Diet and Nutrition Survey (NDNS). I think I was particularly attracted to the project due to the increasing prevalence of childhood obesity. The study provided a valuable insight into the average food portion sizes of the most commonly consumed foods among young UK children and a potential link between these food portion sizes and measures of adiposity – information which was previously very limited.

Unfortunately, to my disappointment, I was unable to attend on the day to present my abstract but I was still able to follow the day on social media. I would highly recommend that others get involved in future research symposiums as it is an excellent platform for both students and registered dietitians to showcase their research.

Amna Mahmood - Paediatric in Birmingham stream winner - supported by BDA Paediatric Specialist Group

It was a great honour to win this award within the Paediatric stream. I would like to take this opportunity to thank my supervisors, who supported me immensely throughout this work. This award was a pleasant surprise that came to acknowledge the hard work that was motivated by my deep passion for this topic.

I believe parental feeding behaviours in infancy may affect the development of appetite and possibly eventually determine whether or not children suffer from obesity later on in life. The systematic review I conducted of the literature summarises the existing evidence that parental feeding behaviours in early life can lead to childhood obesity. Certain feeding behaviours are directly correlated with the child’s self-regulation of energy and may protect against obesity. Responsive feeding practices can help in reducing anthropometric indicators of childhood obesity risk. Although it is difficult to examine the strength of these practices due to the lack of powered randomised clinical trials, feeding in response to infant distress may be one behaviour contributing to intergenerational transmission of obesity risk.

My work in particular aims to gather more evidence to help identify responsive/protective feeding behaviours that might shape healthy child eating behaviours and improve the quality of diet in childhood.

Kirsty Porter - Public Health stream winner

I was shocked and delighted to be given the honour of winning both the best public abstract and overall abstract at the recent BDA Research Symposium. This Symposium is a great opportunity for health care professionals to present their research in a friendly and encouraging environment.

The role of nutrition is becoming of increasing interest for its role in maintaining cognitive health in later life. I was involved in this prospective follow up study of older Irish adults as part of my PhD at Ulster University which is examining the causes, consequences and public health implications of low B-vitamin status in ageing. This was very exciting for me as this was the first study to investigate all four B-vitamins involved in one-carbon metabolism and the results demonstrated a role for vitamin B6 and riboflavin which has previously been under investigated in cognitive health.

Evidence-based practice is fundamental for effective dietetic practice and I am a big advocate of supporting research as part of our profession. Research also has the potential for us as a profession to be at the forefront of making positive changes for patient education and treatments. Successful research involves working as part a team and I was very privileged to have worked with the folate group at Ulster University both with my supervisors and fellow PhD student Katie Moore. Their support and encouragement has given me the confidence to participate in research and disseminate our research to the wider field and public. 

Allie Quinn - Service Evaluation stream winner

I was delighted to receive the award for best abstract in the Service Evaluation stream – it really was a pleasant surprise when I was asked to collect my award as I felt it was only a “small piece of work”.

I am a Diabetes Dietitian and DESMOND educator in the South Eastern Trust, providing structured patient education for people newly diagnosed with type 2 Diabetes. I was curious to know if this service was making an impact on my patients’ behaviours. DESMOND has already carried out research in this area, but it was encouraging to see that all my patients had also made positive lifestyle and diet changes after attending. I had just planned to share my findings with my team but my manager encouraged me to enter my abstract and I’m glad she did.
This was the first time the BDA has hosted a Satellite Symposium in Northern Ireland. It was good to see how much work is going on regionally and meet with colleagues and dietitians-to-be! I followed the main Symposium in Birmingham on Twitter which gave me a good insight into what is happening across the UK.

The Research Symposium is an excellent opportunity for us, as dietitians, to showcase our work. I always used to associate research with University and, whilst great research happens there, dietitians working in clinical practice can also capture fantastic data about the impact and patient outcomes achieved in their day-to-day work. We have the patients whilst universities have to recruit so we can use this to our advantage. At the Northern Ireland Symposium, Dr Mary Ward from Ulster University, NICHE, encouraged dietitians to carry out research and reminded us that the university is happy to support and guide anyone new to research. If you have an idea – go for it, there are plenty of people out there to help turn your good work into a valuable piece of research. 

Well done to everyone involved in organising and participating in both events. I will be encouraging everyone to consider entering in the future. If you hear yourself saying “but it’s only…” stop and think! It doesn’t matter how small or insignificant your piece of work might seem to you, others might think differently, I am proof of that!

Ahsana Ajrullah - Sport and Exercise Nutrition stream winner

I was pleasantly surprised to be accepted to present the abstract for my project at the BDA Research Symposium 2016. I recently completed my project as a final year dietetic student at the University of Nottingham so I was delighted when I won the award for the new category in Sports and Exercise Nutrition.

The aim of the project was to do a systematic review and meta-analysis looking at the effects of high-intensity-interval training (HIIT) versus moderate-intensity continuous exercise (MICE) on different cardiovascular disease risk factors associated with metabolic syndrome in adults. This was essentially a group project, but the individual authors independently looked at different risk factors. My project focused on lipid profile.

I thoroughly enjoyed working on the project as I got to work with other final year dietetic students who were also doing a systematic review and meta-analysis for the first time. It was a great way to learn and develop a variety of research skills, alongside working efficiently as a team. We were also very thankful to be supported by Dr Duane Mellor whose passion for research and endless achievements inspired us to aim high as newly qualified dietitians!

Having completed the review and meta-analysis, I felt much more confident in understanding the process of developing a research question and understanding why the research was necessary. I also gained insight into the use of different tools when looking at specific areas of research, such as exercise. I have gained strong critical thinking skills through reviewing a number of papers. The process and interpretation of conducting a meta-analysis was an invaluable addition to the project.

The Research Symposium was a very enjoyable day and a fantastic opportunity to learn about all the other research projects. Everyone seemed genuinely interested in the various projects presented, with a variety of interesting questions and conversations amongst all involved. It felt like a safe space for someone completely new to research, but also had some very inspiring experienced researchers come along too. I am keen to incorporate more research into my future clinical practice.

I would highly recommend others to get involved!