Here at the Academy, we recognise the value of real-world expertise, and when this is coupled with academic and practical learnings, we are confident our tutors are providing a recipe for success. This is one of the many reasons we are delighted to chat to one of our Culinary Nutrition tutors, Hannah Daw. Hannah was an Associate Registered Nutritionist working in pre-diabetes management with the NHS and is chair of a charity dedicated to treating paediatric feeding disorders. She holds an MSc in Eating Disorders and Clinical Nutrition from UCL and runs her own nutrition practice, providing comprehensive care for children and adults. Hannah is the ideal mentor for anyone interested in enhancing their culinary nutrition knowledge.
Hannah - when did you first become interested in nutrition and what made you pursue a career as a nutritionist?
My interest in nutrition was sparked by my son who was diagnosed with Nephrogenic Diabetes Insipidus at 6 months old. He had to have a feeding tube and I found it difficult to access any meaningful support with his feeding difficulties through the NHS. Due to this I began to consider working with feeding/eating disorders and nutrition. I applied for my MSc in Eating Disorders and Nutrition and have since become interested in lots of different aspects of nutrition and public health.
Can you tell us more about your work with comorbidities and paediatric feeding disorders?
In clinic I support families with children with paediatric feeding disorders (PFD) which is a different diagnosis to an eating disorder. PFD describes functional difficulties when feeding skills are interrupted, rather than mental health difficulties. These feeding difficulties can be related to a wide variety of comorbidities such as autism spectrum condition, gastrointestinal conditions, or sensory processing difficulties.
For example, for a child with autism spectrum condition rigidity of thought or a fear of trying new foods may affect their ability to connect with food or skill-build around eating. Feeding of children with sensory processing difficulties may be affected through aspects such as touch, sight, and smell. From these observations in clinic, we have looked at some research in this area, which is still ongoing.
Recognising this multidisciplinary aspect of feeding difficulties is essential in both diagnosis and treatment. For example, understanding which comorbidities are most prevalent may aid in early intervention and help to inform treatment to better support outcomes.
Is there a common factor you have observed with people suffering from eating disorders or is each case individual to the patient?
With PFD, there can be some common themes in clinic, however, it is a heterogenous population. The current definition outlines “an impaired oral intake that is associated with medical, nutritional, feeding skill and/or psychosocial dysfunction”. This means that this interruption of skill building could be related various causes such as a medical intervention like tube feeding, or oral motor difficulty. Cases are considered on an individual basis and assessed using a multi-disciplinary team as each child is individual.
With your passion for research, is there one area of nutrition or food health that frustrates you – perhaps an area you are looking for answers or a solution for?
I think the area that frustrates me the most is funding and being able to undertake research in this area. There are lots of areas that we need to explore to support patients and clients in a more productive way but there isn’t always the funding to support the research.
Do you worry about diabetes, and have we made much progress over the years in research and management of diabetes?
Diabetes is a super important topic, and it is a significant global health concern, due to its potential for severe complications such as heart disease, kidney damage, and vision loss.
However, over the years, our understanding of diabetes has deepened, recognizing type 1 as an autoimmune condition, and linking type 2 closely to lifestyle factors. We have seen great advances in diagnostic tools, and management which is incredibly exciting. This can be seen in the latest announcement that the NHS plans to identify patients living with type 1 diabetes that will benefit from an “artificial pancreas”. Similarly, we understand more about the ways in which lifestyle and nutrition can support those living with diabetes.
In fact, working with patients with pre-diabetes has been particularly exciting. In my work on the 9-month NHS diabetes prevention programme we would work with our patients educating them on how to effect change through lifestyle and nutrition to reduce their blood sugar levels. It was so rewarding and exciting to see a patient’s HbA1c (a blood marker for blood glucose) reduce simply due to the nutritional and lifestyle changes that they made.
In your nutrition practice, have you noticed people have common patterns of eating or general food behaviour?
I think one area that I have noticed is a common theme is around emotional eating. As humans we have such an interesting relationship with food, that can become complex, based not just around our physically needs but our emotional ones as well. We can use quite simple but effective techniques that support us learning to listen to our bodies and identify whether the feeling was hunger, boredom or satisfying an emotional need.
If there was one food or type of food you would eliminate from world, what would it be and why?
I think my work with eating disorders and PFD means that I tend to stay away from demonising any one certain type of food. Obviously, there are foods that are more nutritionally beneficial to us than others, but I tend to use more language around making a nutritional or a pleasure choice. With those foods that are a pleasure choice then we just need to be mindful of their frequency, but overall, for me it is about moderation not elimination.
…and if there was one food or type of food you would love to see people eat more – what would that be and why?
I am big on fibre, due to benefits around digestive health, blood sugar control, prebiotic effects for gut health and heart health. So, I would love to see everyone reaching their 30g per day. When I look at my plate, I add a wide variety of vegetables and definitely up my quantity to increase my fibre intake.
What would you say is your philosophy of nutrition?
My philosophy is based around managing to have balanced meals that are nutritionally dense but not restricting occasional treats to avoid that “all or nothing” mindset. I also believe that each person is different, and any way of eating has to be enjoyable and manageable depending on that person’s beliefs and situation. It is important to be able to meet ourselves where we are at, making micro changes that are realistic to work towards our bigger goal of health.
Are you concerned with teaching your students how to un-learn misinformation and unhealthy habits and what is your approach to that?
There is a lot of misinformation and fads out there, and it can be really confusing. Staying evidence-based is really important, so reading the latest research, checking guidelines and staying up to date with continuing professional development (CPD) is essential.
What sort of careers can students expect to go into after graduating from the academy.
Nutrition is super wide-ranging, for example you can work directly with people, as a researcher, in corporate education, as a food writer, work in the food industry, or on a wider scale work in public health. The great thing about nutrition is the fact that you can work on the ground or on a bigger scale, it is a really varied career to go into.
What is the most important thing you can hope for your students to take away from studying with you?
I hope that they would take away a love and understanding for the body on a cellular level. It is an amazing machine, and it is exciting to begin to understand how we can help other to support it with modifiable factors such as nutrition.
Hannah is a passionate educator and continues to learn through her own about scientific research. She has co-authored a paper on comorbidities in paediatric feeding disorders which not only contributes to understanding and treating an underrepresented condition, but also offers her students cutting edge insights into the subject.
If Hannah’s work has inspired you, check out our Culinary Nutrition courses and take that first step on your own quest for accurate information and a transformative life experience.