05 May 2021

Role of the Public Health Dietitian in Wales

In Wales, most Public Health Dietitians work within the NHS. Nutrition programmes are co-produced alongside health and social care, third sector organisations and communities to improve the health and wellbeing of the population1. Public Health Dietitians in Wales may also work within local authority projects and programmes, national government departments or in private practice.

Public Health Dietitians use their knowledge and expertise to develop evidence based messages and recommendations which promote healthy food and drink consumption. Public Health Dietitians can support organisations and the public in many settings to ensure consistent messages about food and diet are promoted.

Nutrition Skills for LifeTM is an established, multi award winning programme co-ordinated by NHS Public Health Dietitians in Wales. It provides accredited nutrition skills training for community workers/volunteers and peer leaders and supports the development of community food initiatives. The main aim of the programme is to build the capacity of communities to support healthy eating and prevent malnutrition through enabling and empowering community based staff to cascade appropriate nutrition practices through their work.

Obesity

59% or 3 in 5 adults in Wales are overweight (BMI of 25+) or obese (BMI of 30+)2. Prevalence continues to increase and it is estimated that two thirds of the adult population in Wales will be overweight or obese by 20253. It is estimated that obesity costs the wider economy £27 billion.4

Malnutrition

Malnutrition affects over 3 million people in the UK. 28% of patients admitted to hospital in Wales are malnourished5. The cost of malnutrition in Wales is estimated to be more than £1.4 billion per annum.6

Costs of a poor diet

Wales has the highest rate of chronic conditions in the UK7 and increasing prevalence is a major cause of rising costs to NHS Wales8. Diet is a key factor in the prevention of many chronic conditions such as Cardiovascular Disease, type 2 diabetes and some cancers. It is central to the prevention of obesity and malnutrition (or “undernutrition”) and to improve and maintain physical and mental health and wellbeing.

Confusion regarding the effects of food on health

The media frequently publishes confusing and contradictory stories about diet.

  • Exposure to contradictory health information can lead to a disinclination to take on well-established, evidence based health messages regarding food9.
  • Journalists, researchers, university press officers and scientific journals need to work together more closely to ensure clear, consistent nutrition messages are communicated to the public in an engaging way10.

Interventions:

Public Health Dietitians in Wales are key to developing national policy and standards, planning services and managing interventions that address inequalities and impact on the prevention of a range of chronic conditions thereby reducing the burden on the NHS. This supports the Welsh Government’s long term vision is of a ‘whole system approach to health and social care’ which focuses on wellbeing, prevention and early intervention11

Research

Leading research into local food needs. Describing the evidence base regarding food related illness and prevention.

Education

Building capacity within communities to support healthy eating. Facilitating accredited nutrition training for health, social care and third sector workers to ensure that nutrition information given to the public is evidence based and reliable. Facilitating group sessions for members of the public to promote health and wellbeing and support the development of community food initiatives.

Supporting or leading on projects and programmes delivered over a period of time to support communities. This includes working in partnership with other all Wales programmes such as Flying Start and Families First to improve access to affordable, healthy and sustainable food e.g. in schools and community groups. Providing printed and web based information.

Environment

Advising local authorities on food issues relating to health e.g. planning law and restricting the number of fast food outlets, sustainable and affordable food12.

Ensuring that the healthy choice is the easy choice by supporting food outlets to provide healthy food and drink options. This includes commercial food providers as well as pre schools, schools, youth, leisure and community settings, staff dining rooms and organisations participating in the Healthy Working Wales Corporate Health Standard and Small Workplace Health Award13.

Advising on practical approaches that lower environmental impact14.

Empowerment

Delivering training and helping people to develop the skills they need to be able to provide healthy food for themselves and their families. Working in partnership to develop community centred projects to meet community needs15.

 

Cymraeg

Dietegwyr Arbenigol ym maes Iechyd Cyhoeddus

Mae’n hollbwysig bod y rheini sy’n darparu cefnogaeth ac addysg ynglŷn â maeth i Fyrddau ac Ymddiriedolaethau Iechyd Lleol y GIG, awdurdodau lleol, sefydliadau partner a’r cyhoedd yn rhoi gwybodaeth gyson sydd wedi’i seilio ar dystiolaeth. Mae dietegwyr wedi cael hyfforddiant unigryw ac mae ganddynt y profiad i’w galluogi i wneud hyn.

Rôl y Dietegydd Iechyd Cyhoeddus yng Nghymru

Yng Nghymru mae’r rhan fwyaf o Ddietegwyr Iechyd Cyhoeddus yn gweithio o fewn y GIG. Caiff rhaglenni maeth eu cyd-gynhyrchu ochr yn ochr ag adrannau iechyd a gofal cymdeithasol, sefydliadau trydydd sector a chymunedau er mwyn gwella iechyd a lles y boblogaeth1 . Efallai y bydd Dietegwyr Iechyd Cyhoeddus yng Nghymru hefyd yn gweithio o fewn prosiectau a rhaglenni awdurdod lleol, adrannau llywodraeth genedlaethol ac mewn practisau preifat.

Bydd Dietegwyr Iechyd Cyhoeddus yn defnyddio eu gwybodaeth a’u harbenigedd i ddatblygu negeseuon ac argymhellion seiliedig ar dystiolaeth sy’n hyrwyddo bwyta bwydydd ac yfed diodydd iach. Gall Dietegwyr Iechyd Cyhoeddus gefnogi sefydliadau a’r cyhoedd mewn nifer o leoliadau i sicrhau bod negeseuon cyson am fwyd a diod yn cael eu hyrwyddo.

Rhaglen sefydledig, aml-wobrwyedig yw Sgiliau Maeth am OesTM a gydlynir gan Ddietegwyr Iechyd Cyhoeddus y GIG yng Nghymru. Mae’n darparu hyfforddiant sgiliau maeth achrededig ar gyfer gweithwyr cymunedol/ gwirfoddolwyr ac arweinwyr cymheiriaid ac yn cefnogi datblygiad mentrau bwyd cymunedol. Prif nod y rhaglen yw meithrin gallu cymunedau i gefnogi bwyta’n iach ac atal diffyg maeth drwy alluogi a grymuso staff yn y gymuned i raeadru arferion maeth priodol drwy eu gwaith.

Gordewdra

Mae 59% neu 3 o bob 5 oedolyn yng Nghymru dros bwysau (BMI o 25+) neu’n ordew (BMI o 30+)2 . Mae’r niferoedd yn parhau i gynyddu ac amcangyfrifir y bydd dwy ran o dair o oedolion Cymru yn ordew erbyn 20253 . Yr amcangyfrif yw bod gordewdra yn costio £27 biliwn4 i’r economi ehangach.4

Diffyg Maeth

Mae diffyg maeth yn effeithio ar dros 3 miliwn o bobl yn y DU. Bydd 28% o’r cleifion a dderbynnir i’r ysbyty yng Nghymru yn dioddef o ddiffyg maeth5. Amcangyfrifir bod diffyg maeth yn costio dros £1.4 biliwn y flwyddyn i Gymru6.

Costau diet gwael

Cymru sydd â’r gyfradd uchaf o gyflyrau cronig yn y DU7 ac mae’r niferoedd cynyddol yn un o brif achosion cynnydd mewn costau i GIG Cymru8 . Mae diet yn ffactor allweddol mewn atal llawer o gyflyrau cronig megis clefyd cardiofasgwlaidd, diabetes math 2 a rhai canserau. Mae’n ganolog i atal gordewdra a diffyg maeth ac er mwyn gwella a chynnal iechyd a lles corfforol a meddyliol.

Dryswch ynglŷn ag effeithiau bwyd ar iechyd

Yn aml bydd y cyfryngau yn cyhoeddi storïau am ddiet sy’n ddryslyd ac yn gwrth-ddweud ei gilydd.

  • Gall derbyn gwybodaeth am iechyd sy’n gwrth-ddweud ei hun arwain at amharodrwydd i dderbyn negeseuon sefydledig, wedi’u seilio ar dystiolaeth ynglŷn â bwyd9
  • Mae angen i newyddiadurwyr, ymchwilwyr, swyddogion y wasg prifysgolion a chylchgronau gwyddonol gydweithio’n agosach er mwyn sicrhau bod negeseuon maeth clir a chyson yn cael eu cyfathrebu i’r cyhoedd mewn ffyrdd sy’n ennyn brwdfrydedd10.

Ymyriadau

Mae Dietegwyr Iechyd Cyhoeddus yng Nghymru yn allweddol i ddatblygiad polisi a safonau cenedlaethol, cynllunio gwasanaethau a rheoli rhaglenni sy’n mynd i’r afael ag anghydraddoldebau ac sy’n cael effaith ar atal ystod o gyflyrau cronig ac felly lleihau’r baich ar y GIG.

Ymchwil

Ymchwil blaenllaw i anghenion bwyd lleol. Disgrifio’r sail dystiolaeth o ran salwch cysylltiedig â bwyd a ffyrdd i’w atal.

Addysg

Meithrin gallu o fewn cymunedau i gefnogi bwyta’n iach. Hwyluso hyfforddiant maeth achrededig ar gyfer gweithwyr iechyd, gofal cymdeithasol a thrydydd sector er mwyn sicrhau bod gwybodaeth am faeth a roddir i’r cyhoedd yn seiliedig ar dystiolaeth ac yn ddibynadwy. Hwyluso sesiynau gr p ar gyfer aelodau’r cyhoedd i hyrwyddo iechyd a lles a chefnogi datblygiad mentrau bwyd cymunedol.

Cefnogi neu arwain ar brosiectau a rhaglenni a gyflwynir dros gyfnod o amser i gefnogi cymunedau. Mae hyn yn cynnwys gweithio mewn partneriaeth â phob un o raglenni eraill Cymru megis Dechrau’n Deg a Teuluoedd yn Gyntaf i wella mynediad at fwyd fforddiadwy, iach a chynaliadwy e.e. mewn ysgolion a grwpiau cymunedol. Darparu gwybodaeth wedi’i hargraffu ac ar y we.

Amgylchedd

Cynghori awdurdodau lleol ar faterion bwyd sy’n ymwneud ag iechyd e.e. cyfraith cynllunio a chyfyngu ar niferoedd siopau bwydydd parod, bwyd cynaliadwy a fforddiadwy11.

Sicrhau mai’r dewis iach yw’r dewis hawdd drwy gefnogi siopau bwydydd parod i ddarparu bwydydd a diodydd iach. Mae hyn yn cynnwys darparwyr bwyd masnachol yn ogystal â lleoliadau cyn-ysgol, ysgolion, ieuenctid, hamdden a chymunedol, ffreuturiau staff a sefydliadau sy’n cymryd rhan yn Cymru Iach ar Waith y Safon Iechyd Corfforaethol a Gwobr Iechyd y Gweithle Bach12.

Cynghori ar ddulliau ymarferol sy’n lleihau effaith ar yr amgylchedd13.

Grymuso

Darparu hyfforddiant i gynorthwyo pobl i ddatblygu’r sgiliau sydd eu hangen arnynt er mwyn gallu darparu bwyd iach iddynt eu hunain a’u teuluoedd. Gweithio mewn partneriaeth i ddatblygu prosiectau sydd â’r gymuned yn ganolog iddynt er mwyn diwallu anghenion y gymuned14.

 

 

References

1. https://www.publichealthnetwork.cymru/en/topics/nutrition/nutrition-skills/ 

2. http://gov.wales/docs/statistics/2017/170629-national-survey-2016-17-population-health-lifestyle-en.pdf

3. http://www2.nphs.wales.nhs.uk:8080/PubHObservatoryProjDocs.nsf/85c50756737f79ac80256f2700534ea3/93cea84901926a258025820b0059c112/$FILE/Health&determinantsinWales_Summary_Eng.pdf

4. https://www.gov.uk/government/publications/adult-obesity-applying-all-our-health/adult-obesity-applying-all-our-health

5. http://www.bapen.org.uk/media-centre/press-releases/378-bapen-publishes-results-of-biggest-malnutrition-survey-ever-undertaken-wales

6. http://senedd.assembly.wales/documents/s71701/CCAP%2012%20British%20Dietetic%20Association.pdf

7. http://www.wales.nhs.uk/healthtopics/conditions/chronicconditions

8. http://www.health.org.uk/sites/health/files/PathToSustainability_

9. NAGLER (2014) Adverse outcomes associated with media exposure to contradictory nutrition messages. Journal of Health Communication. 2014; 19(1): 24–40.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4353569/

10. Kininmonth (2018) Quality assessment of nutrition coverage in the media: a 6-week survey of five popular UK newspapers https://bmjopen.bmj.com/content/7/12/e014633

11. A Healthier Wales: our Plan for Health and Social Care https://gov.wales/docs/dhss/publications/180608healthier-wales-mainen.pdf

12. Obesity and the environment: regulating the growth of fast food outlets. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/296248/Obesity_and_environment_March2014.pdf

13. http://www.healthyworkingwales.wales.nhs.uk/home

14. https://www.carbontrust.com/resources/reports/advice/sustainable-diets/ Accessed January 2017

15. The Role of European Public Health Dietitians EFAD Briefing Paper - Final Version - 210217 http://www.efad.org/media/1358/briefing_paper_on_role_of_european_ph_dietitian.pdf