Issue 136 face to face

F2F

FACE TO FACE Ursula meets: Ursula Arens Writer; Nutrition & Dietetics Ursula has a degree in dietetics, and currently works as a freelance nutrition writer. She has been a columnist on nutrition for more than 30 years.

If you would like to suggest a F2F date (someone who is a ‘mover and shaker’ in UK nutrition) for Ursula, please contact: info@ network healthgroup. co.uk 8

Ursula meets amazing people who influence nutrition policies and practices in the UK.

MARTIN LAU Dietitian at charity: Arthritis Action Rugby enthusiast

There are not many dietitians working for health charities and this made Martin a natural choice for my curiosity.

He is the first dietitian employed at the charity Arthritis Action, and seven years on, he is very much the national expert on this subject.

What Martin enjoyed most at school was rugby. Trailing far behind this was biology: he loved the physiology parts, with a view on how to improve his sports performance. He passed his A levels in biology and chemistry and went to the University of East London (UEL). He obtained his degree in microbiology and environmental sciences on the side of his rugby activities. On graduation, he was not able to find a job and was on the cusp of finding a way to play rugby full time. “My father was not at all happy with this career suggestion, especially as midlife progression was bleak, other than coaching,” said Martin.

A job posted by a sports supplement company for a technical manager seemed perfect. The job was local, involved sports, and included aspects of health and nutrition - everything was right for a young, sports-mad science graduate. Martin admits a slight ‘cringe factor’ to his years discussing the use of fat-burners, but he was popular with UK and US senior staff and was made technical director of the company. A talk by a sports dietitian made a big impression on him, and he realised that his interest in nutrition was much deeper than his employer could accommodate.

His ever-patient father agreed to fund

www.NHDmag.com July 2018 - Issue 136

his further education, relieved that the rugby career was being side-lined.

“I already had a science degree, so could have done the shorter postgraduate course in Dietetics. But, as there was a four-year wait for this, the tutor at London Metropolitan University suggested I might as well do the degree course from scratch,” said Martin. He really enjoyed all his student clinical placements and realised that despite the universal predictions that his nutrition career would be in sports and performance, the medical aspects of clinical practice gave him more satisfaction.

In 2007, Martin got his first Band 5 job as a dietitian in Hastings. “I was always particularly interested in the care of stroke patients and I learnt so much from colleagues.” His next job was at Maidstone Hospital. The much longer commute was balanced with greater professional opportunities.

Martin particularly valued the friendly and supportive relationships within the specialist medical teams and, at the suggestion of a gastroenterologist, Martin learnt how to place nasogastric tubes and nasal bridles (although he rarely practiced these skills).

A chance remark by a rheumatologist sparked Martin’s professional interest in arthritis. He had wanted to support a patient with arthritis, but the consultant looked at him with blank surprise and said, “Don’t feed her - then she’ll feel better.” In later conversation, the consultant referred to studies that claimed short-term fasts followed by

vegan diets resulted in short-term improvements of symptoms. The quandary was that at some stage when food intakes were increased again, symptoms of pain reappeared, so food reduction could only offer temporary alleviation.

It was while Martin was considering diets for arthritis patients that a job appeared for a full-time post with The Arthritic Association, a charity later renamed, Arthritis Action. Discussion around foods and diets formed a large part of support for members and the then CEO had decided it was time to provide in-house gold-standard advice on the matter by employing a dietitian.

There were many myths and very strongly held views on the subject and Martin had to immerge himself into the science and debates: “I was often cornered by angry members or irate trustees,” Martin explained. Fortunately, he always had the rock-steady support of the then Therapies Manager and the previous CEO, and in the seven years of employment, he has gained considerable expertise on diet and arthritis.

In 2015, Arthritis Action moved its head office to Westminster in Central London. “I attend member meetings in both London and Eastbourne and also have lots of contact with rheumatologists and dietitians,” said Martin. He also has other responsibilities within Arthritis Action as service development manager, responsible for the online self-management programme and support for both members and potential members.

In recent years, there has been interest in many dietary products and diets for the treatment of arthritis, so I asked Martin to comment on a bottle of glucosamine tablets I pulled out my rucksack.

“Their use was mentioned in 2008 medical guidelines for osteoarthritis, but later 2014 guidelines revoked any support for these products.” Martin explained. “There are various forms and some more expensive and more soluble products may help, but overall data does not support their use.” Long chain omega-3 fatty acids (fish oils) have been shown to help people with rheumatoid arthritis, but trials claiming benefits usually used very high dosages (around 3g). Arthritis Action funded a small trial showing benefits of a Mediterranean diet on some markers of osteoarthritis, and general weight loss advice was usually beneficial in those who were overweight.

Arthritis Action funded a small trial showing benefits of a Mediterranean diet on some markers of osteoarthritis

Martin has been exposed to very frequent comment from nutrition therapists and alternative health practitioners on diet and food choices given to people with arthritis. He has had to balance some benign and perhaps helpful effects from placebo outcomes, versus calling out dangerous and misleading therapies. He has always been keen to extend and open out decisions on food choice in arthritis management to other healthcare professionals, whilst being alert to the abuse of vulnerable patients. He seems a great diplomat, but not afraid to confront those he thinks are muddled, or who are promoting untested therapies too aggressively.

How did Martin feel about being the solo expert as opposed to being part of a dietetic team in a hospital? “I miss that,” said Martin, thinking of himself now as more of a ‘Jack of all trades’, but he has developed many new skills and deep expertise in his current role. He was really keen to communicate to me that he is always happy to be contacted by dietitians who want guidance on dietary aspects of arthritis.

I was moved by Martin’s description of the career-debate tussle between himself (the warrior) and his father (the worrier). Is Martin the dietitian, rugby’s loss, or is Martin the rugby player, dietetics’ gain? I think the latter. In any case, he loves being a dietitian and even more so, his father loves the anything-but-rugby career his son has chosen. Martin is still passionate about sports too: he regularly plays American football and is completing his accreditation as a strength and conditioning coach. www.NHDmag.com July 2018 - Issue 136

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