Professional Diploma of Medical Nutrition Management

COURSE OUTLINE

Module 1 – diet and depression
This module focuses on the role of diet in the prevention and treatment of common mental health disorders. The global burden of disease and the links to poor nutrition are discussed. Epidemiology and the role of nutrition in early life, adolescence and adulthood links diet quality to brain and mental health outcomes. The gut-brain axis is explained including the relationship between mental health, gut health and gut microbiota. The content includes dietary interventions in the treatment of depression based on evidence from studies. Clinical practice guidelines are described. The key issues and barriers to improved diet and therefore improved mental health are discussed. A consistent multidisciplinary approach is required to facilitate best possible patient outcomes.

Module 2 – eating disorders
Eating disorders are serious mental health illnesses and can occur in any person, crossing boundaries of gender, age, culture and body size. In this module, diagnostic criteria for anorexia nervosa, bulimia nervosa, binge eating disorder, avoidance and restrictive feeding and intake disorder and other specified feeding and eating disorders are listed. Understanding eating disorders including contributing factors are discussed. High risk populations, early identification signs and screening tools such as SCOFF and Eating Disorder Screen for Primary Care are outlined. The second section covers medical monitoring, inpatient admission criteria, treatment options and referral pathways including the dietician role. All patients with an eating disorder warrant initial medical monitoring to ensure safety, as eating disorders have the potential to negatively impact a wide range of physiological systems. Guides to medical monitoring criteria for inpatient admission and treatment options are explained including the role of the GP and the multidisciplinary team.

Module 3 – nutrition in chronic kidney disease
This module introduces the key nutritional considerations for patients with chronic and end stage kidney disease. It gives a broad understanding of the difference in nutrient recommendations and diet quality and identifies what presenting symptoms and issues in kidney disease can lead to further discussions about nutrition. The first section outlines nutrition problems in CKD patients stages 1-5 including chronic diseases such as CVD/diabetes/insulin resistance and/or malnutrition. The second section outlines the complexities of chronic kidney disease including kidney stones, hydration and electrolyte/fluid imbalance. The role of high and low potassium foods, vitamins and trace elements in improving patient outcomes is discussed. The content includesdiagrams, guides, case studies and research.

Module 4 – childhood nutrition
This module outlines the role of nutrition for optimising health outcomes for infants, toddlers and young children. It includes nutrition guidelines, breastmilk and formula feeding, introduction to solids and family foods, and practical considerations including fussy eating, faltering growth, weight issues and constipation. Australian dietary guidelines for children and adolescents are outlined including infant feeding guidelines and principles of healthy eating. Assessment of breastfeeding adequacy, choice of formula, introduction to solids, allergy prevention and inappropriate feeding practices are included. The second section discusses fussy eating and food refusal, practical advice, avoidant restrictive food intake disorder (ARFID) and faltering growth. Expected growth and weight gain assessment guides are provided together with practical nutrition advice. The areas of childhood obesity and constipation in childhood include resources, guidelines and possible contributing factors.

Module 5 – advanced sports nutrition
This module outlines the constituents of dietary supplements in sports nutrition and risks of supplement contamination. Effective dietary supplements for athletes of all ages and sport endeavour are outlined. The first section focusses on safe and legal supplement use in athletic populations. It discusses dietary supplements, the reasons for using supplements, prohibited and non-approved substances, the risks of a positive test and reducing contamination risk. The second section discusses the effective use of dietary supplements with athletes, supplement categorisation systems and optimizing dietary intake/ergogenics including medical supplements and vitamin use. The role of an accredited sports dietitian to ensure dietary adequacy and supplement effectiveness is outlined. The importance of monitoring supplementation including the consumption of specific dietary supplements, adverse health effects, legalities, supplement use inventory, efficacy for use and effectiveness in the individual sporting context are included.

Module 6 – motivational interviewing for behavioural change
This module examines the principles of motivational interviewing to guide health behavioural changes. The content includes recognising what triggers can lead to health behavioural change, discusses the challenges to patient’s engaging in change and suggests various clinical tools to assist with this process. Change strategies including desire, ability, reasons and need, commitment strength measures, sustainability and change talk components are outlined. Four core skills of open questions, affirmations, reflections and summaries whilst practicing advanced listening skills can awaken motivation to change. The content then identifies and offers guidelines to work with resistance and discord and suggests ways to respond to change resistance.

Module 7 – ageing, medication and nutritional management
This module commences with discussing normal vs pathological ageing, the physiological changes of ageing and how nutrition is one of the major determinants of successful ageing. Nutrient, vitamin and mineral absorption is discussed along with deficiencies in these areas. Recommended dietary intake guides are presented including the impact of medications and polypharmacy, and pharmacokinetic changes over the ageing process. The relationship between ageing, malnutrition and polypharmacy is discussed including the relationship between medication/nutrient interactions. Unit two presents two comprehensive case studies that detail observations, history taking, investigation choices and presenting symptoms and signs. Management strategies include the medication/nutrient relationship, statin induced symptoms and key learnings for each case. Early access to appropriate nutrition care assists in the journey of successful ageing and quality of life.

Module 8 – food allergies and intolerances
This module defines food allergies, allergy prevention and dietary advice during pregnancy and infancy. Worldwide infant feeding guidelines for prevention of allergies and infant introduction to foods guidelines are included. Determining food allergy vs intolerance, sensitization vs tolerance and symptom history suggestive of lgE and non-lgE are discussed with supporting clinical images. Nutritional information regarding the management of infants and children with suspected food allergies is addressed including anaphylaxis reactions and eczema conditions. The role of the GP for referral and testing options for allergic reactions is included. Common and less common food allergens are described including cross reactivity and co-reactivity. Cows milk allergy, food protein induced enterocolitis syndrome and eosinophilic oesophagitis are discussed in detail. The module concludes with outlining food intolerances including pharmacological food chemical reactions, artificial and natural food chemicals.