I am a Clinical Researcher in Nutrition and Dietetics at the University of Hertfordshire.  

I initiated the discipline of nutrition and dietetics at the University and led the subject group between 2006-2020.

I am a Fellow of the British Dietetic Association (BDA), Trustee of the BDA General and Education Trustee and member of the BDA Higher Education Instiutions committee.

My contributions to public engagement include initiating and leading the Hatfield Cafe Scientifique 2015-2020.

My research activity focuses on enhancing health and well-being through improved nutrition and optimum practice in both clinical dietetics and public health.  This builds on my clinical experience as a dietitian and is integrated into my teaching activity providing opportunities for undergraduate and postgraduate students to engage in research relevant to practice.

Nutritional assessment and screening

Identifying people at risk of undernutrition and monitoring nutritional status is central to nutrition and dietetic practice.  However this is challenging and often confounded by clinical and practical factors in people who are unwell.  I devised a nutrition assessment tool for use in chronic liver disease and validated this against a four-component model of body composition and clinical outcomes in liver transplant patients. Height is frequently used in assessment and screening but often cannot be measured.  Estimates can be derived from other more easily measured variables, e.g. ulna length, and this is included in national screening guidelines. However, I identified the limitation of using standard formulae for estimating height in people from diverse backgrounds and this led to a collaborative study with six UK universities which resulted in the publication of improved equations for predicting height from ulna length in adults from ethnically diverse backgrounds.

Resting energy expenditure in a clinical context

Estimates of energy requirements are frequently required in order to ensure that sufficient calories are consumed in those at risk of undernutrition and to facilitate weight loss in overweight and obesity. In clinical practice estimates are usually derived from prediction equations but these are known to have limitations.  I have investigated the prediction of resting energy expenditure in patients with cirrhosis and in overweight and obesity through original research and systematic reviews. I have led two systematic reviews to establish the optimum prediction equations in adults and children and adolesents.  This work is running in parallel with exploration of ‘bedside’ or field measurement of energy expenditure.

Dietary interventions

I believe that two key questions need to be addressed when considering interventions:  (1) is the intervention effective and (2) does this meet the needs of patients / service users ?  My research has investigated both in gastroenterology.  Low fat diets have been traditionally advised in gallstone disease but there is limited evidence to support this. To address this, I am leading a systematic review to evaluate this intervention.  The efficacy of other dietary interventions is well-established but less is known about what patients / service users want to achieve when seeing a dietitian.  I have investigated this in patients with liver disease and those with coeliac disease using both qualitative and quantitative research methodology. The findings from these studies can be used to inform goal-setting during dietetic consultations and as selected outcome measures to evaluate whether patients’ needs are being met. 

Behaviour change relating to nutritional wellbeing

 I am currently supervising two PhD students who are investigating behaviour change: 

• Srila Satoh is funded by the Government of Thailand and is focussing on behaviour change techniques in her investigation of interventions for overweight and obese young people aged 5-19 years. Her work includes a systematic review and collaboration with BeeZee Bodies.
• Lynsey Spillman is funded by an NIHR doctoral award and based at the MRC Epidemiology Unit in Cambridge where she is investigating the factors influencing diet and physical activity in liver transplant recipients in the BOLT study.  

I am a Senior Fellow of the Higher Education Academy and my practice focuses on research-informed and research-inspired teaching.  I am committed to building research capacity and twelve of my recent peer reviewed papers have been co-authored by BSc students or recent graduates that I have taught.