Life as a Nutritional Therapist, Amelia Freer

Life as a Nutritional Therapist

life as a nutritional therapist

Life as a Nutritional Therapist, Amelia Freer

life as a nutritional therapist

One of the wonderful things about my profile as a nutritional therapist is that I get lots of budding nutritional therapists asking for advice. And of course I believe that there is plenty of room for more well-trained and enthusiastic nutritionists to help support a population which is suffering from an increasing number of diet-related diseases.

I receive many requests asking where to study, how to get started or those with an interest who are considering a new professional path. Regrettably I am unable to answer each individual request, so I have tried to answer all of the queries and share all that I think is necessary to consider and give you a little more insight into the reality of the vocation and lifestyle of nutritional professionals.

1: Get properly qualified

An online, or weekend course does not properly qualify you for this profession. Nutritional Therapy is a challenging profession that requires a huge amount of time and dedication. Working with an individual’s health, advising and supporting them appropriately needs to be managed responsibly. This is very different to running a glamorous blog! This is an industry that is now starting to achieve better recognition and hence regulation. Ensure that your course is recognised by The British Association for Applied Nutrition and Nutritional Therapy (BANT) (BANT.org.uk) which is the professional body for Registered Nutritional Therapists. Its primary function is to assist its members in attaining the highest standards of integrity, knowledge, competence and professional practice, in order to protect the client’s interests, nutritional therapy and the Registered Nutritional Therapist. BANT offers a wide range of benefits to students and full members and has its finger on the pulse for any changes or new developments within this dynamic profession.

I studied at The Institute for Optimum Nutrition (ion.ac.uk) and absolutely loved it. I have continued my education with The Institute for Optimum Nutrition (functionalmedicine.org). I am not familiar with the other courses available having not done them and suggest you really research each one that is recognised by BANT in order to choose which one feels right for you and your professional goals.

2: Your qualification is just the beginning

The moment you complete your studies is the moment you really start learning as a nutritionist. You have the foundations to practice safely, but you will still need to learn on the job, make mistakes and gain in wisdom, experience and confidence. What works with one client won’t work with another. Gradually you will build up a set of skills, phrases and knowledge which will become your own personal toolbox.

3: Work with the mind as well as the body

You may have a million and one scientific facts up your sleeve about the dangers of eating sugar, but you also need the skills and ability to help support someone who is bingeing on ice cream every evening because they are depressed. The mind and the body are inextricably linked, and food is almost always attached to a great deal of emotion. Understand where your role lies here – it is not your job to ‘fix’ people – you are only part of the process. And be aware when and where is the right time to seek help from colleagues who may be more able to support your client (psychologists, counsellors, GP etc.) to resolve these issues. I have built my own “toolbox” of appropriate practitioners to refer my clients to so that they can get the help they need.

4: It’s not all about looks!

I would say that the majority of clients that seek out a nutritional therapist are not just looking to lose a few pounds. They often have complicated medical histories, multiple symptoms, exhaustion, allergies, take a cocktail of medicines or behavioural problems around food, and need careful and safe support to help them move towards a healthier place. If in doubt, ask for advice from a mentor or specialist, and don’t be afraid to work closely with the other health professionals involved in your clients care. The wider impact of your actions and advice always need to be carefully considered. The best thing about helping these types of clients however, is the hugely positive impact that nutritional changes can have – and the weight loss is just a lovely side effect!

5: Keep developing

Science keeps on moving forwards, and you need to keep up to date with the most relevant changes. Attending regular professional development seminars, workshops or lectures is vital to keep your knowledge current. There are lots of networks and associations for nutritional professionals that provide information about lectures, seminars and events. You can’t stop learning once you have your qualification, even if it has felt like a mammoth mountain to climb!

6: You will often be changing your mind

Following on from the last point, you may find that as your knowledge progresses over time, your views and opinions also change. For example, I used to advise my clients to snack regularly. Now I encourage them to just have three proper meals everyday. Don’t be afraid to hold your hands up every now and again and say ‘Hey, I want to change my mind!’. Be open minded to new developments. You could not have known what was not yet discovered. Don’t adopt a “my way or the highway” approach. Everyone is individual.

7: Be aware that you might need to ‘unlearn’ a few things

Of course, by this I don’t mean go and throw all your textbooks away, but what you need to know is far, far more detailed than what your client needs to know about nutrition. In fact, most clients are not really interested in the science or the facts – they want practical action steps. Bombarding them with all of your passionate knowledge can be overwhelmingly confusing and not attending to their needs. Learning how to make things simple, even when they’re complicated and hard, is a vital skill for a great nutritional therapist. Think about it like an iceberg – just give them the curated tip of your knowledge.

8: Balance

This is a hard one, because so many nutritional therapists are passionate about what they do, and so many clients become rather reliant on their nutritional therapists. But you need to create boundaries you are happy with right from the beginning. I assure you that you will have happier clients as a result! I leave work behind at 6pm and do not answer work emails at the weekends. I explain all of this at the beginning of my partnership with a client, so everyone is clear from the start. Have a think about what you’d like your boundaries to be and don’t be afraid to state them clearly to any new client.

9: Money…

This is a tricky one to tackle, but I think it is important. Nutritional therapy is not a lucrative business, and many friends and colleagues I know have really struggled to make ends meet. The successful and glamorous side of the field is very rare, and although there are opportunities (such as book deals, sponsorship, meal delivery services etc.) to make a good profit, it is hard from seeing clients alone. It is definitely more a vocation, something you do because you love doing it, than a profession to make a fortune in! However, it is still an important profession and it’s reputation must be protected and so you need to be professional and run your business efficiently, charging appropriately for your time. Free advice and free consultations puts the client in an awkward position.

10: Sometimes you’ll need to defend yourself

Often I have met people socially who (for some unknown reason), feel obliged to tell me that they think my job is ridiculous. That nutrition is just calories in vs. calories out and people just need to stop being lazy. Where are their manners?! I used to get cross with this, but now I don’t rise to it. Their ignorance is a shame, but it doesn’t need to upset me. The best tip here is just to let it go – for every rude dinner party bully, there are a hundred other people who are on board with your message.

Although, as with every job, nutritional therapy has its challenges, it is also a wonderful, exhilarating and very rewarding job. There is no greater feeling than helping someone win an inner battle they’ve been fighting and become a healthier, happier person. The field is rapidly expanding and becoming a more dynamic and exciting place to work and learn. And so enjoy the journey and ride the wave of knowledge as it sweeps and expands throughout the health care of the future.

Wishing you the very best of luck for your future career!

 

amelia freer

FdSc, Dip ION


Thinking About: Oily Fish

thinking about:
oily fish

We have all seen the headlines that oily fish is apparently yet another ‘superfood’ and therefore something we should be including more of in our diets. But does the evidence support these claims? And if so, what types of oily fish should we be on the lookout for?

Examples of oily fish

Anchovies, Sardines, Pilchards, Herring, Mackerel, Trout, Salmon, Tuna (fresh tuna only)

  What actually is an oily fish?

Oily fish differ from white fish, aside from being darker and stronger in flavour, due to their higher ‘good’ fat content. One such family of ‘good’ fats, the omega-3 fats, are thought to be very important in maintaining our health and preventing ill-health. Oily fish is one of the key sources of omega-3 fats in our diets.

What actually is an oily fish?

Oily fish differ from white fish, aside from being darker and stronger in flavour, due to their higher ‘good’ fat content. One such family of ‘good’ fats, the omega-3 fats, are thought to be very important in maintaining our health and preventing ill-health. Oily fish is one of the key sources of omega-3 fats in our diets.

Examples of oily fish:

Anchovies, Sardines, Pilchards, Herring, Mackerel, Trout, Salmon, Tuna (fresh tuna only)

Can’t we get omega-3 from plant oils, like rapeseed?

Yes, and no. ‘Omega-3’  fatare actually a collection of different fats, which we get from various sources. But it is the long-chain omega-3 fats, known as ‘DHA’ & ‘EPA’ that have been associated with the majority of health benefits in clinical studies. These are mainly found in oily fish, fish oil supplements or some phytoplankton supplement.

Plant sources of omega-3, from walnuts or rapeseed oil for example, provide us with more of the short-chain omega-3 fatty acids. Unfortunately, our bodies are rather inefficient at converting these into the more biologically active long-chain DHA & EPA forms. So, at present, it’s generally considered best not to rely on plant sources as your only source of omega-3 fats. Vegans take note.

The potential benefits of oily fish & omega-3 oils

One of the key benefits of consuming oily fish is therefore thought to come from their high concentration of these omega-3 fatty acids – although they also contain a number of other beneficial nutrients too: protein, vitamin D, iodine, potassium, iron, zinc, selenium, B vitamins and even calcium in the smallest fish (where you eat the bones, such as anchovies & sardines).

Omega-3 fats have been linked to all sorts of potential health benefits. It is important to point out that many of these research findings have not been proven in large-scale population studies, and so may therefore not be applicable to everyone. However, they do give us some enticing hints to possible future uses.

Here are a few examples of current research areas:

  • They may potentially help to reduce blood triglycerides (Musa-Veloso et al., 2010), and blood pressure (Cabo, Alonso and Mata, 2012).
  • They may reduce the risk of stroke (Chowdhury et al., 2012)
  • EPA (one of the long-chain fish oils) could sometimes be beneficial to people diagnosed with major depression (Sarris et al., 2016).
  • They may help to promote optimal growth of the brain and eyes in developing infants when consumed during pregnancy, and may also reduce the risk of pre-term delivery for some babies (Jordan, 2010).
  • They could reduce the risk of autoimmune diabetes in adults (Lofvenborg et al., 2014), although there is no clear evidence that they reduce risk of the more common Type 2 diabetes.
  • They could reduce your risk of developing ‘wet’ macular degeneration (a major cause of adult blindness). (Rahu et al., 2008)

If you do choose to take omega-3 oil supplements, please do make sure it is a high quality form, and that you have discussed it with a healthcare professional

Baked Trout on a Bed of Vegetables

As with all things nutrition related, there is almost always a balance of positives and negatives to consider:

The potential downsides of oily fish 

Unfortunately, most fish and shellfish now contain some levels of pollutants or heavy metals such as PCBs or mercury. The larger oily fish, such as fresh tuna, can contain higher concentrations of these than the smaller fish (Chahid et al., 2014). This may be a concern if you eat a lot of fish, or eat mainly the largest types of fish – such as shark or marlin. Also, farmed fish may contain more pollutants, and less omega-3 fats, than wild or marine fish, although there are some examples of good practice in farmed fish production now (Rodriguez-Hernandez et al., 2017).

I would consider it sensible to therefore try to balance the benefits of eating oily fish (getting the omega-3 fats and other important nutrients) with the risks of eating too much (exposing yourself to an excess of pollutants or heavy metals).

In general, it is advised that this balance falls at around 1-2 portions of oily fish a week, ideally enjoying more of the smaller varieties (mackerel & sardines) than the larger ones (especially tuna): a portion is in the region of 140g, or 1 medium sized fillet (NHS Choices, 2017). You can also enjoy another 1-2 portions of white fish or seafood (i.e., not oily fish) on top of this per week.

A word on fish in pregnancy

Eating fish in pregnancy is good both for you, and for your baby (if you can stomach it!), and is therefore to be encouraged.

However, you can be a bit more vulnerable to the effects of pollutants during this important time, so the dietary advice is slightly different. This advice is also true for those who are considering pregnancy, or are trying to conceive, too.

  • Avoid shark, swordfish and marline altogether, and minimise your intake of fresh tuna. The largest types of fish such as these can contain high levels of mercury which can damage a baby’s developing nervous system.
  • Avoid all raw shellfish, such as oysters.
  • Eat no more than 1-2 portions of oily fish per week – so that means no more than 280g/week. Ideally, try to stick to smaller types; unsmoked mackerel (look in the freezer aisle), sardines in olive oil, and organic or wild salmon or trout.
  • Eat up to 1-2 portions of ‘other’ fish (such as white fish) or seafood products a week on top of this, such as canned tuna. NHS guidelines say no more than 4 cans of tuna a week, but I would suggest 2 cans per week is still a reasonable amount, particularly if you are having your oily fish as well. Eat a variety of fish wherever possible.
  • Be very careful if you are taking fish oil supplements during pregnancy. Some of these, such as cod liver oil, can contain high levels of vitamin A – which can be harmful to your unborn baby. Speak to your midwife or doctor for more information.

I would also generally advise that you follow the same advice for children.

For more information on fish in pregnancy:

A reassuring word in this complex area: It is considered better for you to eat a couple of portions of fish each week than to avoid it altogether due to anxiety regarding mercury or pollutants. The majority of the UK population does not consume enough oily fish to meet suggested dietary guidelines. In other words, be conscious of potential pollutants, but don’t let them put you off eating fish altogether.

Any advice about choosing sustainable oily fish?

Sometimes, it can seem like the more you know about nutrition, the more complicated it can be to decide what to eat. And then adding in environmental mindfulness to that equation can seem rather daunting. But there are lots of resources available to help you make these decisions, and once you’ve done it a couple of times it does get much simpler – I promise.

Intensive fishing and unsustainable farming practices are threatening our fish populations. Check out the Marine Conservation Society’s easy to use website to help guide the most sustainable seafood choices:

goodfishguide.org

In general, I look out for either organic or wild fish whenever I can get hold of them.

A few of my preferred fish suppliers:

  • lochduart.com – responsible, eco-friendly farmed salmon from Scotland.
  • fish4ever.co.uk/welcome-to-fish-4-ever – ethical canned fish
  • reelfish.co.uk – ethical canned tuna (I tend to just stick to the ones in spring water)
  • newlynfreshfish.co.uk – mail order fresh fish from the traditional fishing port of Newlyn in Cornwall, packed in a leak-proof box with plenty of ice so it reaches you in great condition. You can phone or email them to arrange delivery of seasonal, wild fish to your preferences – or simply order one of their ready-made selection boxes.

Disclaimer: Please discuss this topic with your doctor or nutrition professional (visit my FAQ page for info) if you are interested in finding more information, or considering taking supplements. There are certain instances where increasing your intake of omega-3 fats is not advisable. As with all articles on ameliafreer.com, this is no substitution for individual medical or nutritional advice.

Cabo, J., Alonso, R. and Mata, P. (2012) ‘Omega-3 fatty acids and blood pressure’, British Journal of Nutrition, 107(S2), pp. S195–S200. doi: 10.1017/s0007114512001584.

Chahid, A., Hilali, M., Benlhachimi, A. and Bouzid, T. (2014) ‘Contents of cadmium, mercury and lead in fish from the Atlantic sea (Morocco) determined by atomic absorption spectrometry’, Food Chemistry, 147, pp. 357–360. doi: 10.1016/j.foodchem.2013.10.008.

Chowdhury, R., Stevens, S., Gorman, D., Pan, A., Warnakula, S. and Chowdhury, S. (2012) ‘Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: Systematic review and meta-analysis’, BMJ, 345(oct30 3), pp. e6698–e6698. doi: 10.1136/bmj.e6698.

Jordan, R.G. (2010) ‘Prenatal Omega-3 fatty acids: Review and recommendations’, Journal of Midwifery & Women’s Health, 55(6), pp. 520–528. doi: 10.1016/j.jmwh.2010.02.018.

Löfvenborg, J.E., Andersson, T., Carlsson, P.-O., Dorkhan, M., Groop, L., Martinell, M., Tuomi, T., Wolk, A. and Carlsson, S. (2014) ‘Fatty fish consumption and risk of latent autoimmune diabetes in adults’, Nutrition & Diabetes, 4(10), p. e139. doi: 10.1038/nutd.2014.36.

Musa-Veloso, K., Binns, M.A., Kocenas, A.C., Poon, T., Elliot, J.A., Rice, H., Oppedal-Olsen, H., Lloyd, H. and Lemke, S. (2010) ‘Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid dose-dependently reduce fasting serum triglycerides’, Nutrition Reviews, 68(3), pp. 155 167. doi: 10.1111/j.1753-4887.2010.00272.x.

NHS Choices (2017) Fish and shellfish. Available at: http://www.nhs.uk/Livewell/ (Accessed: 3 February 2017).

Rahu, M., Chakravarthy, U., Young, I., Vioque, J., de Jong, P.T. and Bentham, G. (2008) ‘Oily fish consumption, dietary docosahexaenoic acid and eicosapentaenoic acid intakes, and associations with neovascular age-related macular degeneration’, The American Journal of Clinical Nutrition, 88(2), pp. 398–406.

Rodríguez-Hernández, Á., Camacho, M., Henríquez-Hernández, L.A., Boada, L.D., Valerón, P.F. and Zaccaroni, A. (2017) ‘Comparative study of the intake of toxic persistent and semi persistent pollutants through the consumption of fish and seafood from two modes of production (wild-caught and farmed)’, Science of The Total Environment, 575, pp. 919–931. doi: 10.1016/j.scitotenv.2016.09.142.

Sarris, J., Murphy, J., Mischoulon, D., Papakostas, G.I., Fava, M. and Berk, M. (2016) ‘Adjunctive Nutraceuticals for depression: A systematic review and Meta-Analyses’, American Journal of Psychiatry, , p. appi.ajp.2016.1. doi: 10.1176/appi.ajp.2016.15091228.