FACE TO FACE Ursula meets: EULALEE GREEN • Pre- and antenatal nutrition expert Ursula Arens Writer; Nutrition & Dietetics Ursula has a degree in dietetics, and currently works as a freelance nutrition writer. She has been a columnist on nutrition for more than 30 years.
• Vitamin D-a-titian • Community health projects leader
The night was cold; the tomato soup was hot. We meet after Eulalee’s day of work at the Portland Hospital (the private maternity hospital in Central London). She seems unsure why I would want to meet up with her. But I had the feeling that she had a story to tell. Here it is. School was not easy, because Eulalee declares she has dyslexia. Subjects she was channelled into by well-meaning teachers were arty and crafty. But after a hospital visit, she was inspired, and declared that she wanted to become a paediatric psychiatrist. Healing and caring for children became the magnet for her motivations. “While thinking about a career, someone told me that nutrition was the basis of all health. This struck me as such an obvious and powerful truth, that I decided I wanted to be a dietitian,” said Eulalee. The more-than-slight barrier was her science qualifications – the lack of. She attended an adult technical college while jobbing and managed to obtain the golden-three science A Levels: Biology, Chemistry and Physics. “Because of my dyslexia, my exam grades were always a bit lower than my course work grades, but I managed to pass,” said Eulalee. She had to leave her home in Manchester to study dietetics and thought London offered the best options. She was anxious about being a bit older and a bit dyslexic. “North London Polytechnic (now London Metropolitan
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Ursula meets amazing people who influence nutrition policies and practices in the UK.
University) were particularly friendly and welcoming, and invited me to come along for tea and chats. So of course this is where I chose to study.” Her first job was a half-year post with the charity, Coronary Prevention Group. They were involved in an occupational health project funded by London Transport, so Eulalee spent a lot of time giving lifestyle and dietary advice to bus drivers and tube drivers. “They were at higher risk of heart disease because they work long shifts and the jobs are sedentary, so it was important to be able to give targeted support on being healthier to these great guys.” Eulalee’s next job was a full-time dietitian post at St Thomas’ Hospital. “The job offered rotations to different departments and community clinics, which I really enjoyed.” She then did several split posts as a paediatric and a community dietitian – and she had a baby. Plus, on a part-time basis, she completed the MSc in Health Promotion at Brunel University for her role in public health. “The MSc dissertation taught me so much about motivations behind health behaviours, and also the really important role of careful language to support and inspire people to better health,” said Eulalee. The smaller theme of Eulalee’s career has been community-based support for children at home requiring enteral feeds. She suggests that caseloads
"It was really important to promote vitamin D supplements to all mothers with infants and our project resulted in greatly improved uptakes”
for dietitians are (too) high and that perhaps the BDA could more assertively critique these situations. The larger theme of her career has been the development of health strategies to support babies and young children. One of her projects was to promote the use of vitamin D supplements in the London Borough of Ealing. “About 50% of the population is Asian or Black, and there were many cases of rickets. There were a few deaths due to hypercalcaemic seizure. It was really important to promote vitamin D supplements to all mothers with infants and our project resulted in greatly improved uptakes,” said Eulalee. Just targeting at-risk groups is one way to achieve results, but Eulalee was now becoming more forceful: blanket policies were usually more successful. If messages were clear and consistent and delivered to everyone, at-risk groups also did better. Another project was promoting greater rates of breastfeeding, to allow Baby Friendly accreditation. “I spent a lot of time with health visitors, to consider ways to support new mothers. But it was a difficult time for the profession for several reasons, including many new duties to support child protection. Surprising allies turned out to be the clinic booking clerks. Friendly casual enquiries about breastfeeding turned out to be the quickest way to identify mothers needing extra support,” said Eulalee. The rates doubled. Eulalee now splits her time between her paediatric post at the Portland Hospital, her community enteral feeds post at the Homerton Hospital and her private work advising on women’s health, especially on pre- and antenatal
nutrition, via her consultancy ‘Family Nutrition Coach’. She has tried to slip out of management roles, because she enjoys small project work the most, and working with patients (rather than mountains of admin). Her on-the-side role is also as current treasurer of the BDA Freelance Dietitians Group. “There are so many sad situations reported by the Child Development Team and I feel that some of the adverse outcomes could be avoided with better preconception and antenatal nutrition,” said Eulalee. She is concerned about the inadequate vitamin D, folic acid and iodine status of many pregnant women. She also feels that weights should be checked at every antenatal appointment, as advised by the Royal College of Obstetricians and Gynaecologists (but in contrast to NICE guidance). The UK government has announced a consultation on mandatory folic acid fortification of flour. Was this good news, I asked her? “Of course,” she said. But many people do not feel it should be done for the benefit of ‘just-thefew’ pregnant women. She thought that a much stronger health message could be about the possible benefits of folic acid in reducing the risk of stroke in the older population. Later that night I had a dream about Eulalee. She showed big biceps and was wearing boxing gloves. Yes, she is a fighter. And yes, she fights for the little ones. And yes, she is a great vitamin D-a-titian. www.NHDmag.com March 2019 - Issue 142