Cardiovascular Journal of Africa: Vol 32 No 3 (MAY/JUNE 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 3, May/June 2021

132

AFRICA

The importance of dieticians as healthcare workers

The food we eat is a key contributor to our health. While

the phrase ‘you are what you eat’ is often taken lightly, our

food choices play an important role in maintaining a healthy

lifestyle. To help with making the right food choices, dieticians

are the most equipped healthcare workers whose primary

goal is ensuring that you are informed about the importance

of a healthy diet. The main concern is the high amount of

non-scientific information available on the internet.

Registered dietician and founder of Newtricion Wellness

Dieticians, Omy Naidoo, says that ‘a registered dietician is an

important part of any healthcare team because they provide

evidence-based information on, prevention of, and disease-

management nutrition-related advice.’

The expertise of dieticians is used in the prevention and

treatment of chronic diseases such as diabetes and blood

pressure. They also translate complex scientific information

into practical advice.

‘A dietician’s role comes into effect when planning

nutritional and food programmes to promote a healthy diet,

especially when calculating the nutrients a person needs when

creating menus based on a doctor’s advice’, adds Naidoo.

Registered dieticians can work as nutrition experts for

a diabetic patient and help treat diabetes by using medical

nutrition therapy that includes counselling and therapy.

Dieticians also devise strategies and propose healthy eating

habits to reduce blood pressure.

Hospital dieticians play a key role in the journey of a patient

in critical care, surgery, oncology, and various other parts of

hospitalisation. Dieticians work within a multi-disciplinary

team in ensuring the patient meets his/her treatment goals.

Dieticians provide the following important functions:

•

Plan individual nutritional therapies to address specific

health issues, such as unhealthy weight, diabetes or

hypertension.

•

Promote public awareness for proper nutritional stand-

ards and habits.

•

Enhance the accuracy and understanding of food labels.

•

Liaise with food manufacturers to improve the nutritional

quality of prepared foods.

‘Healthcare is void without supplementary nutritional

balance, which is why dieticians intervene in the treatment of

chronic diseases and prevention thereof’, concludes Naidoo.

1083–1085.

European Carotid Surgery Trialists’ Collaborative Group. Randomised

trial of endarterectomy for recently symptomatic carotid stenosis: final

results of the MRC European Carotid Surgery Trial (ECST).

Lancet

1998;

1: 1379–1387.

North American Symptomatic Carotid Endarterectomy Trial

Collaborators. Beneficial effect of carotid endarterectomy in sympto-

matic patients with high-grade carotid stenosis.

N Eng J Med

1991;

325

445–453.

Rothwell PM, Slattery J, Warlow CP. A systematic review of the risks

of stroke and death due to endarterectomy for symptomatic carotid

stenosis.

Stroke

1996;

(2): 260–265.

Rothwell PM, Slattery J, Warlow CP. A systematic comparison of the

risks of stroke and death due to carotid endarterectomy for symptomatic

and asymptomatic stenosis.

Stroke

1996;

(2): 266–269.

Lewis SC, Warlow CP, Bodenham AR, Colam B, Rothwell PM,

Torgerson D,

et al

. General anaesthesia versus local anaesthesia for

carotid surgery (GALA): A multicentre, randomised controlled trial.

Lancet

2008;

372

: 2132–2142.

Warlow C, Sudlow C, Dennis M,

et al

. WHO (World Health

Organization). Cerebrovascular disorders: A clinical and research

classification; Offset publication 1978; No 43. Geneva: World Health

Organization, 1978. Stroke.

Lancet

2003;

362

: 1211–1224.

Executive Committee for the Asymptomatic Carotid Atherosclerosis

Study. Endarterectomy for asymptomatic carotid artery stenosis.

J Am

Med Assoc

1995;

273

: 1421–1428.

10. Holiday A, Mansfield A, Marro J, Peto C, Peto R, Potter J,

et al

. MRC

Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group.

Prevention of disabling and fatal strokes by successful carotid endarter-

ectomy in patients without recent neurological symptoms: randomised

controlled trial.

Lancet

2004;

3: 1491–1502.

11. Liapis CD, Bell sir PRF, Sivenius J, Nicolaides A, Fernandes e

Fernandes J, Biasi G

et al

. ESVS Guidelines. Invasive treatment for

carotid stenosis: indications, techniques.

Eur J Vasc Endovasc Surg

2009;

: 1–19.

12. Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ,

. Stenting and angioplasty with protection in patients at high risk for

endarterectomy investigators. Protected carotid-artery stenting versus

endarterectomy in high-risk patients (SAPPHIRE).

N Engl J Med

2004;

: 1493–1501.

13. Hobson RW, Howard VJ, Roubin GS, Brott TG, Ferguson RD, Popma

JJ,

et al

. Carotid artery stenting is associated with increased complica-

tions in octogenarians: 30-day stroke and death rates in the CREST

lead-in phase.

J Vasc Surg

2004;

: 1106–1111.

14. EVA-3S Investigators. Carotid angioplasty and stenting with and

without cerebral protection: clinical alert from the endarterectomy

versus angioplasty in patients with symptomatic severe carotid stenosis

(EVA-3S) trial.

Stroke

2004;

: e18–20.

15. Song G, Sun R, Chen YF, Ma Y, Wang YB,

et al

. Retinal embolization

after carotid endarterectomy and stenting for carotid artery stenosis

. J

Clin Neurosci

2015;

: 1298–1302.

16. Durand H, Masson V, Matte R, Plante JM, d’Amours M. Regional

anaesthesia in carotid thromboendarterectomy.

Laval Med

1969;

256–261.

17. Rerkasem K, Bond R, Rothwell PM. Local versus general anaesthesia

for carotid endarterectomy.

Cochrane Database of Syst Rev

2004;

CD000126.

18. Stoneham MD, Knighton JD. Regional anaesthesia for carotid endar-

terectomy.

Br J Anaesth

1999;

: 910–919.

19. McCleary AJ, Maritati G, Gough MJ. Carotid endarterectomy; local

anaesthesia?

Eur J Vasc Endovasc Surg

2001;

: 1–12.

20. Paraskevas KI, Mikhailidis DP, Oikonomou K, Verhoeven EL. Local

versus general anaesthesia for carotid endarterectomy: Issues beyond

stroke, myocardial infarction, and death rates.

Angiology

2012;

405–408.

21. McCarthy RJ, Walker R, McAteer P, Budd JS, Horrocks M. Patient and

hospital benefits of local anaesthesia for carotid endarterectomy.

Eur J

Vasc Endovasc Surg

2011;

: 13–18.