Attending EFAD; Learning from the continent and the UK contribution

I was fortunate enough to win a competition sent through from the British Dietetic Association (BDA) on behalf of ‘California Prunes’; for which I had to complete a survey in order to win tickets to the European Federation of the Association of Dietitians (EFAD) Conference 2019, travel costs and a fee towards accommodation. I was the only winner from the United Kingdom but there were a few winners from various European countries. The theme of the conference was ‘Breaking Professional Boundaries’, attendees of the conference were Dietitians from across Europe alongside a handful of delegates from the rest of the world.

The schedule of the conference was jam packed including a variety of plenary and parallel sessions.

Initial plenary sessions focussed on the European Dietetic Action Plan. Key themes of the plenary sessions included sustainable diets and collaborative approaches to person-centred care. The first plenary session on ‘Food Systems and Sustainability’ presented by Tim Lang from City University of London , Tim discussed the Eat Lancet report which can be found here. I felt this fitted in nicely with the BDA’s One Blue Dot Toolkit which is an environmentally sustainable diet project to make sustainable diets policy a reality including useful resources to implement into practice as appropriate.

Following this, Tommy Cederholm Professor of Clinical Nutrition at Uppsala University in Sweden emphasised the need for a collaborative approach between professions and that it is important for our role as Dietitians that we emphasise the impact of clinical nutrition on medical care and treatment outcome. I am sure as a profession we already know this, however we need to shout from the rooftops about the positive impact we already have and can have on patient outcomes.

The first breakout session I attended focused on ‘Nudging for Public Health’; nudging for plant based diets and healthy eating in the workplace and the practical application of nudging for childhood obesity.  The main message from this was that cannot make these changes alone and takes a wider societal change to contribute to behaviour change. It was also interesting to note that a Dietitian in the Netherlands was employed by a number of hospitals to contribute to nudging and choice architecture in hospital dining rooms to improve staff uptake of healthy choices. Something we will see more of in the future in the UK?

Another focus of the plenary sessions was hydration; some of the research presented included the impact of improved water intake on improved glycaemic control and that dehydration can impact on insulin sensitivity. I attended the breakout session “Media Communication – the Influential Power of the Dietitian”. This session did not cover what I anticipated and this was surprisingly due to the fact that Dietitians in some European countries are not regulated in the same way we are in the UK. However the key message was that 90% of nutrition and weight loss people received online is false! The rest of the session focussed on what we can do to change this picture – creating social media profiles such as twitter to know your key stakeholders, learn their language, and drive the nutrition agenda. Something that I plan to do is to take myself out of my comfort zone with the digital world… I am still working on it!  

The second day started with an e-health tools focus on digital information systems and support to improve accessibility and efficiency.  Tom Van Daele from Thomas More University of Applied Sciences presented on the possibilities of e-health working with mental health; applications, websites, wearable technology and virtual reality. I have been to a few presentations on virtual reality technology and I have never been able to envisage how we can implement this in practice as Dietitians but Tom presented on recent work around cue exposure such as; virtual reality of attending a restaurant and looking at the menu and making informed choices. A thought for future me, could we use this in other areas such as supermarket demonstrations, meal preparation etc? I think we are quite a bit off this in practice but none the less, an interesting tool for future.  

I also attended the obesity parallel session which is of particular interest due to my role in the implementation of the type 2 diabetes prevention framework focussing on healthy weight. Hilda Mulrooney from Kingston University presented on the Public Health publications in the UK and the implications on these. Firstly, promotion of healthy foods e.g. sugar tax, sugar reformation programme, updating nutrient profile and food labelling and kcal reformulation aiming to decrease overall kcal content of dietary intake 20% by 2024. Physical activity and how the money from the sugar tax is being pushed into diet, activity and sport funding. Pre-conception and pregnancy including Healthy start, banning energy drinks, kcal labelling and restrictions on HFSS promotions by location and price including TV and online promotion. Dr Odysseas Androntous presented on childhood obesity which is classified as an intermediate disease linking to complications in adulthood. Ellen Govers presented on the TASTE trial focussing around obesity stigma and the fat phobia scale, she also discussed the low carbohydrate diet and the need to be aware of fibre content of those following this lifestyle choice. Finally, Antonis Vlassopoulos presented on weight loss maintenance, which as we all know is the key to success. Weight loss maintenance is rarely part of guidelines for weight management however is vital, we invest money and time in strategies and interventions but tend to overlook the maintenance stage. Interestingly, if someone was to lose 10% body weight during a 3 month intervention and then regain the weight they still have a lower risk than someone who did not lose the 10% in the first place. We need more studies and research into weight maintenance, the take home message was that people need to “stick” to a new behaviour, it doesn’t matter what that behaviour may be and having a menu of options available to the people we work with.

Overall, I felt that the conference consisted of great opportunities to attend a variety of breakout sessions covering clinical dietetics and public health. The event also hosted an ‘Innovation Mile’ where sponsors and exhibitors displayed new resources, equipment and technology from across Europe. At the end of innovation mile was ‘Assessment Street’ where we could get our measurements taken such as body fat mass, hand grip strength, amongst others.

The conference was a fantastic opportunity to network with colleagues, hear about research from across Europe and promote the innovative work that is going on across Scotland. It was apparent from discussions with other delegates that the UK is leading the way in terms of our dietetic presence across acute, community and public health sectors. Which is interesting, given that across Scotland we feel that we have work to do to grow our presence and professional impact even further!

Each day there was a lunchtime poster presentation, I attended this on day 1 and day 2 and it was interesting to see the work presented. There were a wide range of topic areas covered, we traditionally think of poster presentations of clinical work that we have undertaken to show evaluation and improved outcomes but a lot of the presentations included qualitative data. I came away from the poster presentations thinking – what we already know; we aren’t singing our own praises loud enough to promote the work that we do across the patch as Dietitians. Surely we can do more to showcase the amazing work we do across Scotland?! In the future this would be a great opportunity to showcase more of our pioneering work across Scotland to European delegates. I will certainly be looking closely for area that I can submit poster presentations and even speak at events to promote the work that we are doing locally. I am also the chair of the BDA Glasgow & West of Scotland Branch, we are responsible for supporting members with local, accessible CPD. I hope through my time as chair we are able to support members to attend CPD opportunities which they may not ordinarily get the opportunity to within their workplace such as; EFAD, BAPEN etc.

You can find out more about the conference by searching #EFAD2019 and #EFADConference2019 on Twitter. Copies of presentations from throughout the conference are available here: https://efadconference.com/lookingback/

Written by: Lorna Breeze, Registered Dietitian

@LornaEBreezeRD

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