Many wonder the difference between a dietician and a nutritionist. While the latter worked with those who are healthy, a dietician handles patients. I had the privilege to speak to a Senior Dietician from Parkway Cancer Centre (PCC), Singapore, Dr Gerard Wong on his role as a dietician, as well as some advice.
“My role as a dietician in terms of general health and wellbeing, is to talk to people who are sick and what they can do in terms of food to try to improve the condition. The most common patient I meet are diabetics”, Dr Gerard shared.
He elaborated further by explaining that while he talks to patients with cancer and chronic diseases, the main core of a dietician is to help patients improve their conditions through their food intake. “They may still need medications, but if they can get away with fewer medications, or we can better manage their condition, I often think it is the better option”, he mentioned also.
However, as a dietician, he still gets the emotional and psychological stress when he meets patients with health deterioration. “It is heart-wrenching because you’ve followed them for so long that they have become your friend and you are familiar with their family, you get close to them, understand their feelings, but unfortunately you see them passed”.
But not all patients etched an emotional sentiment in him. There was one he shared of a woman who introduced her child to him. She was one of the pregnant women that he took care due to her gestational diabetes. “She thanked me for what I did, and it made me feel good”, Dr Gerard said.
Nevertheless, keeping a healthy diet is important, with or without illnesses. To him, it all comes down to if an individual wants to manage their condition without or with less medication. “Aside from that, there is a lot of lifestyle condition that can be attributed to illnesses and diseases such as poor dietary habit, poor lifestyle, lack of exercise, and smoking. And in a way, cancer and chronic diseases’ risk factor comes from being overweight and obese”, Dr Gerard disclosed that it is important to note all these to prevent chronic conditions.
“The most important thing I usually tell people is to make small changes in what we do and what we eat. The first step though is very simple, I often say that if you do not know what you are eating, it is best not to eat it”, he advises.
Dr Gerard gave an example of canned food such as luncheon meat, or processed meat. “Have you ever asked where does the meat come from? Which part of the animal it comes from?” he questioned.
Processed meat, he mentioned, contains high sodium, and high intake of salt which is associated with stomach cancer and throat cancer. “Know that by practising that simple message of only eating food you know eliminates a lot of risk factor”.
Apart from that, Dr Gerard shared that he does not eat fast food unless he is compelled to. “I often think it is important to see who prepares your food. Fast food chain usually employs young people looking for earning. And what do they need to know? They don’t need to know much, just need to know how to thaw food and reheat them”.
The Singaporean doctor said he prefers to eat at hawker store where the cook prepares everything from scratch. To him, there is more love and care from the food at the hawker store compared to those at fast food joints as big companies usually manufacture food with profit in mind.
As a dietician, it was a surprise that he did not recommend the food pyramid. But that is because he said the food pyramid is there to serve as a general guideline. Nevertheless, different individuals have different eating needs. “So that is where we need to see what is important to them, their condition, if they have cancer or chronic diseases, and what they can do to manage their diet”.
While he talks thoroughly about food, he did not forget to advise on chemotherapy patients with lack of appetite. The experienced doctor in the field mentioned that he tries to offer different strategies. “I often tell them the number one thing when doing chemotherapy is to eat enough. Whatever they feel like eating, just eat. During these sessions, eating enough is more important than eating healthy”.
The next advice he gave chemotherapy patients is to eat small, frequent meals. “If you do not feel like eating sometimes, you cannot eat a big meal. Instead of three big meals, you might eat six small meals a day”.
Lastly, Dr Gerard shared that as a chemo patient that refuses to eat, their protein intake will be low. To overcome this situation, he said that there are different ways to increase protein intake. One way he mentioned was to offer porridge with fish.
Dr Gerard graduated from Flinders University, South Australia with a Bachelor in Nutrition and Dietetics and obtained further certificates in renal nutrition from the Northern Adelaide Renal and Transplant Service as well as sports nutrition for dietician from Sports Dietician Australia, Canberra, Australia.
He started work as a dietician at one of Parkways’ clinic counselling patients with chronic diseases. However, his love for sports also saw him working alongside some of Singapore’s top athletes in preparation for major games as well as Australian state athletes who would later go on to represent their Nation.
In Australia, he played a key role in helping children with type 1 diabetes and their families manage the condition but also consulted with patients with type 2 and gestational diabetes. Part of his work also revolved around bridging the language and culture gap of Indigenous Australians with kidney failure, helping them understand the dietary strategies needed to get the best outcome while on dialysis.
He is currently practising at Parkway Cancer Centre, developing his speciality in cancer nutrition. He derives joy from being able to effect changes and improve patients’ health outcomes. In amongst seeing patients, he also conducts nutrition workshops, helping to dispel some of the common myths surrounding cancer and nutrition.