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Food for Thought

Dietitian Dr Lim Yen Peng dishes on nutrition and the ageing population

IMG_0314You are what you eat. And what you eat becomes even more important when you have a medical condition – apart from dietary restrictions you have to adhere to, getting the right nutrition can help manage your condition and even improve your outcome.

If sieving through what you can and cannot eat, and how much of each food you can take is not your cup of tea (let’s face it, having to analyse every bite would put anybody off their food), help is at hand. Learn how you can manage your condition with expert advice on meeting your nutritional needs from dietitians like Dr Lim Yen Peng, the Head of Department and Principal Dietitian of the Nutrition and Dietetics Department at Tan Tock Seng Hospital (TTSH).

From a young age, Dr Lim had her heart set on Dietetics as a career. She first got a taste of the role observing dietitians at work during her school vacation. Earning an overseas scholarship from the Public Service Commission, she embarked on a Dietetics degree at King’s College London and subsequently returned to serve at TTSH. Dr Lim chose to focus her postgraduate education on the elderly, recognising the need to be well equipped with the knowledge to provide better care for the ageing Singapore population.

“This passion for the profession has been burning brightly since Day One and I have never looked back,” says Dr Lim fervently. “I constantly seek out new opportunities of collaboration and challenge myself and my team of dietitians to create value to our patients. I want to be able to support and develop other dietitians who share the common passion.”

​​Ezyhealth: Tell us how you decided to become a dietitian.

Dr Lim: I was drawn to working in healthcare, being in a role to advise others to improve their health and make a difference. Dietetics combines the scientific knowledge of health, disease, food and nutrition, and the art of applying human psychology and communication to translate such information and advice to individuals or communities.

I was fortunate to be given an opportunity to spend three months with the dietitians at TTSH. I observed how the dietitians built rapport and counselled the patients with individualised advice. I enjoyed the interaction with patients and other healthcare professionals, and at the same, I was quietly attracted to the challenges and potential this young profession can offer.

IMG_0280Ezyhealth: What does your work involve?

Dr Lim: Besides seeing patients at the hospital, I conduct home visits and phone consultations to patients from our Post Acute Care at Home (PACH) service. I also provide consultancy services to nursing homes to support their residents’ nutritional care.

Apart from patient care, my other key responsibilities involve leading and managing the department of 25 dietitians, planning resources, service delivery, establishing policies and procedures, and planning quality improvement projects. I also sit on hospital and national committees related to nutrition and professional issues.

Ezyhealth: How do dietitians work with other healthcare professionals to support patients’ healthcare?

Dr Lim: Dietitians work in a multi-disciplinary team, particularly with the doctors, nurses, pharmacists, and speech therapists. Understanding the patients’ medical conditions such as swallowing status, medication side effects, medication interaction with nutrition and their treatment plans affect our nutrition intervention. We also work closely with nurses who provide valuable input on patients’ clinical progress and psychosocial status so that appropriate dietetic interventions can be provided.

Ezyhealth: Why do people need to get nutritional help?

In the hospital setting, dietitians address the nutritional concerns of patients in relation to their medical conditions.

People get help for a broad range of reasons. Patients with chronic diseases such as obesity, diabetes, kidney failure, high blood pressure and high blood cholesterol need to understand how their existing dietary habits and intake are linked to the management of their conditions. The dietitian conducts an assessment of their diet to diagnose the nutrition problems. This is followed by nutrition counselling on the recommended changes to positively impact on the control of their conditions. For example, appropriate diet changes can potentially reduce the dosage or use of medications, slow down the deterioration of their diseases, and improve health outcomes.

We also have patients who are at risk of inadequate nutrition and require nutrition support. Patients who have surgeries, infections and pressure ulcers will have increased nutritional requirements. Patients with cognitive and swallowing impairment, and those suffering from side effects of chemotherapy or radiotherapy, can present with poor oral intake. Dietitians also provide nutrition prescriptions to critically ill patients at intensive care units and those unable to maintain nutrition orally so that they continue to meet their nutritional needs.

Dietitians can help these patients by understanding the factors and causes relating to their inadequate nutrition, and provide individualised diet strategies and recommendations. Once the patients and their families are equipped with the knowledge and skills, we will be able to work together to help patients obtain adequate nutrition within the constraints and challenges.

Ezyhealth: What are the common issues that you see in patients?

Dr Lim: In the hospital, many patients with diabetes, obesity and stroke require dietary modifications. Malnutrition (under-nutrition), especially in the elderly, is also another common nutrition issue.

Ezyhealth: Poor eating habits often stem from childhood. How can parents encourage their children to eat well?

Dr Lim: The most effective way is for parents to be their role model, and understand what it means to have good nutrition and eating habits. Parents will first have to ensure that they maintain a balanced diet and take regular meals without insensible snacking themselves. Eating habits formed during family meals and at home are crucial. For example, it is a common challenge for kids to like vegetables. As parents, we need to provide a conducive environment by exposing children to a variety of vegetables from a young age, and making vegetables available and enjoyable at each meal. Build on the positive experience of eating vegetables and press on. Over time, you will realise that good habits are formed.

Ezyhealth: A busy and stressful lifestyle also commonly contributes to poor nutrition. How can one maintain a healthy diet in the midst of working hard?

Dr Lim: If you make it a priority to maintain a healthy diet, you will be committed to make plans and goals to ensure that it is achieved. For example, by making a conscious effort to have regular meals and not skip meals, you will be able to better control your intake and reduce the desire for snacking. This can help with weight control. Having fresh fruits such as bananas, apples or pears within easy reach as a snack is a quick and easy way to increase the intake of fruits at work.

No matter how tiring it is, I make an effort to prepare dinner for my family daily so that they can enjoy healthy home-cooked meals.

Ezyhealth: You have a special interest in nutrition care for the elderly. What should caregivers for the elderly be aware of when planning their meals?

Dr Lim: The elderly are prone to developing poor nutrition when they begin to show changes in their ability to chew and swallow, have decreased appetite and intake, and especially if they start to lose weight without any underlying medical reasons.

Caregivers need to be mindful that though dietary restrictions are important in the management of common conditions such as diabetes, high blood cholesterol and high blood pressure in the elderly, the priorities of management can change.

Ezyhealth: We are learning more and more every day about diet and nutrition. How do you keep yourself up-to-date on the latest research and techniques in dietetics?

Dr Lim: I am a member of professional associations both locally and internationally, where I receive regular updates on the latest nutrition trends, reviews and summaries of research. At the same time, I subscribe to journal alerts and attend conferences to keep abreast of the latest research and practices in dietetics. Colleagues at work will also share with the team the latest evidence relevant to our clinical practice after they return from training or conferences.

Ezyhealth: What characteristics or qualities should a dietitian have?

Dr Lim: A dietitian should possess a strong sense of empathy, good communication skills, work well in a team, and display good knowledge and interest in food, nutrition and health.

Ezyhealth: In your line of work, what do you find most rewarding?

Dr Lim: It is recognising that I manage to make a difference to a patient, particularly when the situation has been exceptionally challenging to handle.

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by Melanie Sim
Posted by ezyhealth on Mar 5 2015. Filed under Medical Express. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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