Ms Jennifer Feighan:

I thank the Chairman and members of the committee for the invitation to give evidence on the important subject of childhood obesity in Ireland. In our longer submission we describe the contribution made by dietitians and the evidence to support the impact of nutrition interventions. The Irish Nutrition and Dietetic Institute, INDI, is the professional organisation for regulated dietitians in Ireland. There are 900 registered dietitians in Ireland and the INDI has a membership of 760. Dietitians are the only health professionals who are qualified to give specialised clinical nutrition advice to patients. They are qualified to degree or postgraduate level and have an extended period of clinical placement in recognised training hospitals. The title of dietitian is also protected by legislation.

Good nutrition starts at home. Prevention of childhood obesity starts before the child is born and involves ensuring that a mother’s nutritional care is optimised because we know that maternal obesity has been found to be the most significant risk factor for obesity in children. Mothers need to be supported to start breastfeeding and to continue for at least six months as breastfed babies are less likely to become overweight while babies who are weaned too soon are more likely to become overweight. We also know that 80% of children who are obese between the ages of 10 and 14 will be obese adults.

We know that there is a link between childhood obesity and socio-economic position. Dietitians are trained to be able to communicate with people from all areas of society and are skilled at explaining complex issues using simple, positive and motivating language. They use these techniques to help children and their families to identify the reasons they are struggling to manage their weight. Preventing childhood obesity involves both home and school life. It encompasses supporting parents to encourage their children to be more active, eat more nutritious foods and reduce screen time. It also involves working with educators to develop a curriculum that includes healthy eating and physical activity and that promotes positive body image.

Dietitians educate families, community workers and teachers in how to promote healthy eating habits, behaviours and attitudes to food. They are also involved in very practical, peer-led cooking courses. Dietitians have a role to play as part of a multi-disciplinary team in the treatmentof childhood obesity and can provide specialist nutrition support such as therapeutic diets and artificial nutrition following weight loss surgery. All of this work is done by dietitians every day and we welcome the recognition that nutrition has a key role to play in so many aspects of health. The HSE alone has over 120 strategic actions relating to nutrition across its various work streams.

We anticipate some challenges when it comes to delivering these, however, due to our low numbers. There are 450 dietitians employed by the HSE, mostly delivering specialist care in hospitals. A total of 144 dietitians work in the community. In Ireland we have one dietitian per 50,000 of population but the international guidance is 1 per 15,000. The national dietetic adviser at the HSE estimates that we need to recruit 80 dietitians per year into the community alone to deliver our national objectives. We look forward to so doing and thank the committee members for their attention.