Dietetics

Introduction

“Let food be thy medicine and medicine be thy food”
- Hippocrates

Optimal nutrition is essential for good health and well-being. Nutritional requirements change throughout the different life stages and diseases. If you have been concerned about your ailing health or simply wondering if you are getting adequate nutrition, then fret no longer as the team of dietitians at SKH is at your service! We will understand your needs, conduct a thorough nutritional assessment and provide evidence-based and tailored nutrition advice, to empower you to take charge of your health.

On top of delivering clinical nutrition services in the inpatient and outpatient settings, SKH dietitians also conduct research, education and community outreach programmes that encompass the SKH vision and mission on healthy living, fulfilling life by promoting better health together. Please explore the various links to find out more about the exciting department initiatives.

Services

Clinical Services

SKH dietitians provide clinical services in both inpatient and outpatient settings. The dietitians also work closely with other health care professionals, including various multidisciplinary programmes (please scroll down to the ‘Programmes’ tab for more details).

The patient is referred to the dietitian by a doctor when nutrition assessment and intervention is indicated. The dietitian provides medical nutrition therapy to patients, which comprises nutritional assessment by taking into account the patient’s medical history, diet history and body composition measurements such as triceps skinfold, handgrip strength and body impedance analysis. Thereafter, the dietitian develops an individualised nutrition care plan to help better optimise the patient’s health condition.

SKH Dietitians provide diet counselling and nutrition management to a wide variety of acute and chronic conditions including (but not limited to):

• Cancer (including (Colorectal Cancer) (Medical Nutritional Therapy for Cancer)
• Chronic kidney disease (Medical Nutrition Therapy for Kidney Disease)
• Coronary Artery Disease
• Diabetes Mellitus (Medical Nutrition Therapy for Diabetes Mellitus)
• Eating disorders
• End stage kidney disease and dialysis treatment
• Gastrointestinal diseases (including inflammatory bowel disease and irritable bowel syndrome)
• Gout (Medical Nutrition Therapy for Gout)
• Hyperlipidaemia (Cholesterol; Medical Nutrition Therapy for Lipid Lowering (High blood cholesterol/triglycerides)
• Hypertension (Medical Nutrition Therapy for Hypertension)
• Liver disease (Medical Nutrition Therapy for Liver Cirrhosis)
• Malnutrition / malabsorptive disorders
• Nutrition assessment and Nutrition support
• Osteoporosis (Medical Nutrition Therapy for Osteoporosis)
• Stroke
• Swallowing difficulties (with Speech Therapy) (Medical Nutrition Therapy for Swallowing Difficulty (Dysphagia))
• Weight management (including bariatric and metabolic surgery) (Obesity and Metabolic Syndrome) Medical Nutrition Therapy for Weight Management)

The team of SKH Dietitians also provides nutritional support for patients who are critically-ill or malnourished. Type of nutritional support include:

• Oral nutritional supplements
• Tube feeding
• Parenteral nutrition

Contact Us

For a dietitian’s outpatient appointment, please contact SKH Appointment Centre at 6930 6000. A referral letter from a doctor is required. Video consultation and phone consultation services are also available as part of outpatient services.

Group Education

SKH Dietitians run various group education workshops and hands-on cooking demonstrations to patients and caregivers to support self-care nutrition management in chronic diseases and other conditions, including SKH Diabetes Workshop (Step up, Know your diabetes, be Healthy), Diabetes & Ramadan Workshop and Bariatric Support Group etc.

Food Services

SKH dietitians have contributed to the development of therapeutic diets and work with the Food Services Department in the hospital to ensure that food served to patients are nutritious and suitable for different medical conditions and dietary restrictions.

Programmes

SKH Dietetics work as a team with the other healthcare professionals to run programmes for various populations. These programmes are tailored to the medical conditions of the individuals with the aim of helping them achieve their dietary goals.

S.K.H

Step Up, Know Your Diabetes, Be Healthy (S.K.H.) is a group education program targeted at type 2 diabetes patients who are newly diagnosed or has knowledge deficit. This programme is delivered by a multidisciplinary team consisting of diabetes nurse educators, dietitians, physiotherapist and podiatrists.

SKH MOVING ON

This is a follow up of S.K.H program whereby type 2 diabetes patients are educated on further knowledge and skills in diabetes management by diabetes nurse educators, dietitians, psychologists and physiotherapists. In this program, dietitian will be teaching participants on how to choose wisely when grocery shopping and eating out.

SKH FIT-DM

Flexible Insulin Therapy for DM (FIT-DM) is a flexible modular program designed for type 1 diabetes patients. The 4 modules cover essential topics such as carbohydrate counting, capillary blood glucose interpretation and management, exercise and insulin pump. Led by endocrinologists, dietitians and diabetes nurse educators, the program fosters a supportive environment for participants to share experiences, gain valuable insights and build a strong foundation to effectively manage their blood sugars on a day-to-day basis.

Sengkang Weight Improvement Therapy & Complete Health (SWITCH)

This is a programme with a multidisciplinary approach to help individuals lead a healthy lifestyle and in the process, achieve long-term weight loss and weight maintenance. The dietitian is part of the multidisciplinary team which also comprises bariatric physicians and surgeons, psychiatrists, psychologists and physiotherapists.

Bariatric Nutrition Programme (BNP)

The BNP is specially developed for individuals planning to go for bariatric surgery. The individualised, structured programme includes 7 visits over 6 months and consists of comprehensive pre- and post-operative dietary assessments and interventions by a dietitian. It helps identify and address additional factors that may potentially impact on nutritional status pre- and post-surgery. The programme aims to support individuals to follow dietary recommendations at various stages, minimise side effects of surgery and maximise excess weight loss.

Programme for Enhanced Elderly Recovery @ SKH (PEERS)

Frail elderly individuals experience increased morbidity and mortality after surgery, so this prehabilitation programme aims to intervene and improve outcomes by optimising their nutritional and physical function prior to elective surgery. These patients undergo a 2-3 week programme with scheduled dietitian visits, where tailored dietary advice and a nutrition supplement regime are provided to patients to ensure adequate nutrition is achieved, and pre-surgery nutritional status is optimised.

Peritoneal Dialysis (PD) Training Programme

For patients on peritoneal dialysis, good nutrition is needed to prevent malnutrition-related complications such as infections and muscle wasting. For patients newly started on peritoneal dialysis, the dietitian will review their diet, blood results and conduct physical measurements to assess their nutritional status, so as to prescribe the most appropriate diet.

Type 1 Diabetes Clinic

In the Type 1 Diabetes Dietitian clinic, patients with type 1 diabetes are educated on personalized dietary management and equipped with necessary carbohydrate counting knowledge and skills to better manage their blood sugar levels. The specialized dietitian works closely with the endocrinologist and diabetes nurse educators to provide timely and valuable feedback for improved insulin titration and dosing, thereby ensuring that the patients receive the most effective diabetes care.

Nutrition Swallow Clinic (NSC)

Patients with swallowing difficulties may also require a dietitian review to ensure adequate nutrition. To provide timely intervention and coordinated care on safe eating and nutritious dietary options to patients and caregivers, those enrolled in this clinic will be reviewed by both the dietitian and speech therapist in the same setting. This reduces the need for separate appointments and increases the convenience for patients and caregivers.

Dietetics Diabetic Limb Salvage (DLS) Clinic

We work closely with orthopaedics and plastic surgeons, podiatrists, and wound nurses to assist in managing blood glucose levels and ensuring adequate protein and nutrient intake to promote effective wound healing. Through personalised dietary plans and advice, we empower patients to make informed choices for better health outcomes. If you or someone you know is dealing with diabetic foot ulcers, our clinic is here to provide expert guidance and support on the crucial role of nutrition in managing this condition.

Dietetics Inflammatory Bowel Disease (IBD) Clinic

Therapeutic diet plays a crucial role in managing Inflammatory Bowel Disease (IBD). At the Dietetics IBD Clinic in SKH, we specialise in providing comprehensive care for patients with Crohn's Disease and Ulcerative Colitis. Our dietitians work closely with the gastroenterologists to advise patients on specialised therapeutic dietary recommendations that are tailored to the unique needs of each patient. These dietary recommendations, such as Exclusive Enteral Nutrition, Crohn's Disease Exclusion Diet and more, aim to help induce and maintain remission while preventing malnutrition. We are committed to work closely with patients to develop individualised nutrition plans and empower them to make informed dietary choices and manage their condition effectively.

Fodmap Clinic

The Dietitian FODMAP Clinic provides specialised support for individuals following a low FODMAP diet. Led by experienced dietitians, this clinic offers personalised guidance and practical strategies to manage symptoms associated with irritable bowel syndrome (IBS) and other functional gastrointestinal conditions. Through tailored dietary plans and ongoing monitoring, the clinic aims to improve the quality of life for individuals by helping them navigate the complexities of the low FODMAP diet and achieve better digestive health.

Education

SKH dietitians are very much invested in education as the department not only believes in the quote ‘in teaching others, we teach ourselves’, but also that the knowledge shared ultimately benefits patients.

Dietetics students

SKH Dietetics is involved in clinical placements for both local and overseas final year Dietetics students. An experienced dietitian will work closely with the university coordinator to facilitate the students’ learning, enabling them to translate theoretical knowledge into clinical practice during their clinical placement. This is done through providing the students with appropriate learning opportunities and guidance in the hospital’s inpatient and outpatient settings.

Inter-professional Education

SKH dietitians actively come up with initiatives to promote inter-professional education. Recently, a team of dietitians in the department developed course materials on the institution’s e-learning platform for junior doctors, with the objective of equipping them with basic nutritional knowledge for safe initial nutrition-related decisions (e.g. ordering the correct therapeutic diet / nutrition formula for a patient) before a dietitian comes in to do a proper nutritional assessment and intervention.

SKH dietitians also conduct various evidence-based nutrition talks for other healthcare professionals such as doctors, nurses and other allied health to increase their nutritional knowledge in specific areas. Some examples include:

• training SKH nurses and other allied health professionals on the administration of a nutrition screening tool to help identify and refer patients who are malnourished to the dietitian for appropriate nutritional assessment and intervention
• giving a talk to General Practitioners at a forum on the scientific evidence and application of a low FODMAP diet for patients with irritable bowel syndrome

Community Services

SKH dietitians embody the SKH mission “Better Health Together” by working closely with the community to build a culture of healthy living. Dietitians continuously support and promote the health of the community by providing nutrition talks, workshops, community engagements, supermarket tour, cooking demonstrations and media replies. Below are some of the contributions made by our SKH dietitians towards the community.

Community Health Fair

In collaboration with other healthcare professionals, SKH dietitians organised various community engagements aimed at increasing awareness on the importance of nutrition for good health in which they shared facts and practical tips on preventing cancer, beating diabetes, ageing well etc.

HealthierSG Roadshows

SKH Dietitians played a role in supporting SKH's participation in the selected HealthierSG roadshows. They engaged the public through interactive nutrition activities and joined a celebrity chef in a cooking demonstration to share healthy cooking tips. The aim was to empower participants to make informed choices about nutrition and lifestyle, ultimately contributing to the goal of promoting a healthier Singapore.

Secrets of Dietitians’ Kitchen

Besides diet counselling and nutrition education, we understand the importance of translating nutrition recommendations into practical cooking tips, helping our patients to enjoy foods in healthier ways and how to turn them into nourishment. Hence, the dietetics department organised “The Secrets of Dietitian’s Kitchen” which showcases dietitian-approved healthy and therapeutic yet simple and budget-friendly recipes pertaining to the theme of each session. This programme aims to promote healthy cooking and healthy eating through practical food preparation tips amongst patients and their caregivers.

Enhancing Nutritional care at Home (ENHance)

Patients with high care needs who are discharged from hospital face nutritional issues such as malnutrition and tube feeding issues. Community nurses who play a pivotal role in the long-term care of these patients may not have received prior training in nutrition. This, along with the lack of community dietetics services put patients’ nutritional statuses at risk of deteriorating leading to hospital readmissions. Thus, SKH dietetics developed a 4-module online training course focused on empowering community nurses with nutrition knowledge to bridge the gap in nutritional care between the hospital and home settings. It has been well received throughout the SingHealth cluster and by home care service providers.

SENiors In the cOmmunity eating right (SENIORs)

The dietetics team conducted nutrition-related training to selected Active Ageing Centres (AAC) in the North-Eastern region of Singapore to raise health awareness and empower the seniors on healthy eating. Through the use of gameplay, seniors were introduced to Food Mahjong (FMG) which incorporates fun attributes of boardgames and adopts familiar mahjong phrases to impart healthy-eating principles, focusing on adequate protein, calcium, vitamins, and minerals. As part of the training, AAC staff and volunteers were trained to facilitate FMG gameplay for their seniors, creating sustainability. This initiative was well received among the AACs, with potential plans of expansion to the wider North-Eastern community.

World Alzheimer’s Month (WAM)

WAM is one of the key examples that showcases the versatility of SKH dietitians in providing useful tips on how to improve the food intake and nutrition statuses for People with Dementia (PWD) via physical game booths and an online webinar for members of the public.

Media Replies

Recognising social media as a great way to form connections with the general public, SKH dietitians contribute various media posts on SKH’s social media platforms where evidence-based nutrition information are disseminated to the community and nutritional misinformation given by pseudoexperts are debunked. Please refer to ‘Resources’ tab for more details.

Resources

Nutri-Connect

Check out healthy eating tips provided by our Dietitians on SKH’s Youtube channel and Instagram page can be found via Nutri-Connect (skh.com.sg)

Tips for Mindful Eating

https://www.facebook.com/411127015637864/posts/2605767609507116/?d=n

Sustainable Healthy Eating

Join our Dietitians in a four-part video series to learn more on incorporating concepts of sustainability into your diet and lifestyle for a healthier, better you and the Earth!

1. What is sustainable healthy living & eating?
2. The 3Rs to sustainable healthy eating: Reduce, Reuse, Recycle
3. Reduce food waste and encourage more plant-based food
4. Cooking demonstration: Tofu Scramble

Recipes

Nutritious Stir-fried Beancurd

https://www.skh.com.sg/news/patient-care/healthy-vegetarian-recipe-nutritious-stir-fried-beancurd#

Healthy Nasi Lemak

https://www.skh.com.sg/news/patient-care/healthier-option-of-nasi-lemak-with-only-half-the-fats

Chicken Roulade

https://www.healthxchange.sg/news/chicken-roulade-mushroom-spinach-stuffed-chicken

Tan-Thai-Lising Fragrant Pineapple Fried Rice – Tasty and aromatic, yet low-fat, low-salt, high fibre!

泰香四溢美味凤梨炒饭 – 香喷喷又令人垂涎，且低脂肪、低盐份和高纤维!

Golden Wholemeal Breakfast Cup Recipe	Steamed Purple Sweet Potato Gingko Nut Egg Pudding Recipe

Research

Invited Speaker

8th OBES Congress 2023

• Transforming Lives through Nutrition for Patients Undergoing Bariatric Surgery in North-Eastern Singapore – Joanna Tan Xiao Yen

7th OBES Congress 2022

• Dietary intervention for MAFLD – Metabolic associated fatty liver disease, To fast or not to fast – Jessica Ong Qun Hui

Oral Presentation

SingHealth Allied Health Conference 2021

• Makan Away Frailty - An Innovative Board Game to Empower Singapore Seniors with Nutrition Knowledge to Combat Frailty - Candy Chan Hiu Nam, Cherie Tong Chung Yan
• Empowering Nurses to Enhance Nutritional Care at Home – Lee Rui Jia, Candy Chan Hiu Nam, Cherie Tong Chung Yan

SingHealth Allied Health Conference 2022

• Bariatric Nutrition Programme – The Person Beyond the Fats - Joanna Tan Xiao Yen, Goh Su Ning Candy, Jeremy Tan Ee Li, Cherie Tong Chung Yan

Poster Presentation

Singapore Allied Health Conference 2022

• Self-administered Nutrition Screening is Feasible Amongst Oncology Outpatients to Identify Malnutrition Risk for Early Nutrition Intervention - Goh Su Ning Candy, Peh Hui Yee, Cherie Tong Chung Yan

Asian Conference for Frailty and Sarcopenia 2023, Singapore

• Ng WL, Tay L, & Tong CCY (2023). Empowering Pre-frail Seniors: Assessing the Effects of a Community Nutrition Education Intervention on Nutritional Intake and Sarcopenia Markers. [Poster Presentation].

SingHealth Duke-NUS Scientific Congress 2023

• Ng WL, Tay L, & Tong CCY (2023). Empowering pre frail older adults: A community nutrition education intervention to improve nutrition knowledge and intake to avoid frailty progression. [Poster Abstract]. Enhancing Nutrition Care at Home through an Effective Online Nutrition Course for Community Nurses – Lee Rui Jia, Lee Hui Bing, Tan Shi Ning, Cherie Tong

Centre for Allied Health and Pharmacy Excellence (CAPE) Allied Health Congress 2023

• Enhancing Nutrition Care at Home through an Effective Online Nutrition Course for Community Nurses – Lee Rui Jia, Lee Hui Bing, Tan Shi Ning, Cherie Tong

Asian Pacific Digestive Week 2023, Bangkok

• Tey TT, Poh HW, Koh FH, Foo FJ, Ng WL, Yan ZH (2023). Time to Biologic Initiation in Inflammatory Bowel Disease Patients - A Retrospective Single Centre Study in Singapore. [Poster Abstract].
• Yan ZH, Poh HW, Koh FH, Foo FJ, Ng WL, Tey TT (2023). The Demographics and Management of Inflammatory Bowel Disease in a Single Centre in Singapore. [Poster Abstract].