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Nicole Madden RD, diabetes specialist dietitian, spoke to us about branching out from dietetics to consultancy in the food industry. 

On graduating from Surrey University in 2007, I worked as an NHS community dietitian. I went on to specialise in diabetes education, working within the NHS for a further seven years. I particularly enjoyed diabetes education, which led me to work for XPERT Health, a diabetes education charity in West Yorkshire working as the clinical lead for their diabetes programme. 

Today I live and work in Huntingdon in Cambridgeshire, as a freelance dietitian. My company is Completely Nutrition Associates, a dietetic private practice. As part of my business, I provide nutritional support for schools catering. 

I can’t say I joined the foodservice industry on purpose, I needed to work closer to home for a while and spotted an advert asking specifically for a dietitian, which was unusual at the time. I was interviewed and given the job on the same day, finding out later that this wasn’t due to the power of my personality but more due to the rarity of dietitians in this line of work. From that day until now, I have never looked back, and really enjoy working in this branch of my profession. 

The role of dietitian in schools’ catering is much more prevalent since the introduction of universal free school meals and the (EU) regulation on the provision of food information to consumers in 2014. Food allergy affects 3-6% of children in the developed world. According to BSACI (British Society for Allergy & Clinical Immunology) cow’s milk allergy in the UK is the highest in Europe, with approximately half of those children suffering from eczema and gastrointestinal symptoms. 

In my first year, we prepared special menus for around 120 children, today this figure is closer to 500. The dietitian’s/nutritionist’s role also covers medical needs such as texture modification and macro-nutrient analysis, keto, low sodium and high fat, to name just a few. We insist that any child needing a medical menu should have written evidence from a health professional. However, I don’t have access to the child’s medical notes and I often speak with the child’s dietitian and negotiate meals within the menu. 

A typical working day might be analysing the data and running reports, sending out information to kitchens to allow for the safe preparation of our many special menus or updating the website’s information, which allows parents to make safe meal choices. 

I attend meeting with parents, head teachers and caterers. I meet regularly with the speech and language therapists from our special educational need schools. I am a point of reference for our parents and caterers when carbohydrates need to be counted for our type 1 diabetes children. Some children are allergic to substances which are not one of the major 14 allergens such as pea fibre, starch or tomato, and in these cases a fingertip search of the product specification is necessary to avoid these unusual allergens. 

I work closely with the menu development team, planning the new menus each recipe needs to be nutritionally complete and consistently checking product specifications to ensure we use products that suit the needs of our children is imperative. Reading the fine print to check for salt or sugar content becomes second nature. 

Attending tender presentation with the management team to promote the nutritional quality of the company’s food is also part of my role and it is exciting to work in this competitive atmosphere once in a while.

One of my favourite jobs is working at the roadshow workshops. These are run on at the annual basis, all over the county and beyond. These are always great fun and you get to meet up with the caterers you have been working with all year. 

My advice for anyone thinking of joining this hugely rewarding branch of the profession would be to ensure they have a good understanding of the system used to develop a menu. Get involved with all of the stages of that menu development. Have a robust communication system with your suppliers, speak to them often. Handle/transfer the data as little as possible to avoid the chance of error. If you can arrange for suppliers to add product data directly into their Nutritics Supplier Portal, this is the best way to avoid operator error.

Attend a Recipe Analysis Training course. Nutritics offers a course hosted by Regulatory Affairs Specialists to ensure you are performing recipe calculations in line with best practice, and gain confidence in the complex area of nutrition calculation. Susan Church also runs a course a couple of times a year and is endorsed by the Association for Nutrition and the British Dietetic Association. 

When you are working with allergies, you have to be meticulous and have a good eye for detail when checking products. Nothing can be left to chance. Learn how to use the nutritional software and build a relationship with the support team. If you trust the software, you sleep better at night; it's as simple as that, really. 

My biggest challenge was letting go of the reins and trusting everyone to do their part. Special menu preparation in schools is so much bigger than just one person and being able to rely on everyone playing their role is absolutely essential. Make yourself known to the team and appreciate the part everyone plays in a safe and nutritious food service. 

Childhood obesity is our biggest challenge for the future. Major changes are needed to reduce the empty calories consumed by our children and we need to make each calorie justify its place in the diet. The question I am always asked is, “Why do you offer children desserts?” My answer is always the same. Not providing something doesn’t teach you not to choose it. It may even make it something that is sought after. 

We should be teaching children the science of food, why we need it, what nutrients our body needs to thrive and what we mean by ‘an empty calorie’, thus allowing children to make informed choices. We need to continue to provide nutritious foods where every calorie provides good nutrition, irrelevant of its sweet or savoury status. 

Nicole’s top tips

  • Attend a Recipe Analysis Training course.
  • Learn how to use nutritional software and build a relationship with the support team behind it.
  • Make yourself known to the team, from the suppliers to the chefs and appreciate the part everyone plays in a safe and nutritious food service.
  • Get involved in all of the stages of menu development.
  • Handle/transfer data as little as possible to avoid the chance of error.

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