Dietitians have key responsibility for assessing, diagnosing and treating individuals who have diet and nutrition-related problems and diseases. At the heart of this lies the deployment of effective communications skills which can encourage and facilitate behaviour change in individuals and groups of people. Often when people are first diagnosed with serious and lifelong diseases such as diabetes, the enormity of the diagnosis and the complexity of the dietary advice that they are given cannot be properly absorbed. Patient-centred consultations in which the dietitian builds a rapport and takes time and care to individualise advice are of huge importance. These communications skills do not come naturally to the majority of people and so have to be taught, practiced and developed.

This need for training is now widely recognised in the dietetic profession across the world and approaches to training that involve innovative methods, are being rolled out by universities who train students in the dietetic and nutrition professions. One of the big challenges is to enable students to practice their skills in a safe environment without accessing real patients. This challenge can be overcome by using simulated patients who might be volunteers, other students or in some cases, professional actors. These simulated patients can help students develop and refine their skills before going on clinical placements and finishing their professional training.

Gibson and Davidson reported the findings of a study which examined the impact of simulated patients in Australian dietetic students in their 3^rd and 4^th year of training (http://onlinelibrary.wiley.com/doi/10.1111/jhn.12352/epdf). The study looked at whether students benefitted from having repeated consultations with simulated patients rather than a single experience. It was found that whilst students who had good communications skills after a single consultation had only modest improvements in skills, students who struggled with these skills made greater improvements and developed skills to make them better prepared for clinical placements.

Kirsten Whitehead and colleagues developed a tool for the assessment of communications skills in dietetic consultations (DIET-COMMS: See http://onlinelibrary.wiley.com/doi/10.1111/jhn.12136/abstract). This tool was intended to provide a simple, validated process for use in the training of students who will be engaged in consultations to encourage diet-related behaviour change in patients, and for post-registration dietitians who want to assess or refine their skills. The DIET-COMMS tool and a training package for using it is available at http://www.nottingham.ac.uk/toolkits/play_13244. This site also has some fantastic video examples of good and bad consultations that are useful viewing for student dietitians. Use of tools such as DIET-COMMS will provide simple means of assessing performance of key communications skills that are accessible to students and trainers alike. 

As a university teacher I am always very aware of how challenging some of the assessment are that we set our students. This is often not because the concepts are difficult, but because the assessments involve long pieces of writing. We ask for essays, literature reviews, dissertations and theses, and yet our students have generally come to us because they have a passion for science and for hands-on practical work. For many of you each assignment brings the challenges of 'how do I get started?' and 'how do I plan and structure my writing?'. Sad to say, as teachers we sometimes don't give you an awful lot to go on.

Making a start to a piece of writing can be incredibly tough. There are so many other interesting things to do. Just pop out to see how a friend is getting on and then start... Check Facebook quickly and then start… The flat is an awful mess, better tidy up and then start… Procrastination is easy and it also often covers up a basic fear of writing. Anxiety can stem from a variety of sources that range from the sheer volume of the task (a 10000 word dissertation is a massive job)  through to over-concern about making it perfect. All of these concerns can have a detrimental impact on what you're writing, makes the process painful for you and ensures that it takes you a lot longer. You are your own worst enemy when you're writing.

So to get started, what do you do? Well although I am an experienced writer (I love to write!) but I still suffer from writer's block and struggle to get things underway. My approach is to keep things simple. What is the word limit for the piece? What are the sub-headings that I am going to use? From there I can allocate words to topic- each sub-heading gets a number of words allocated and then I start to just write key words down for each section. Then I start to add the flesh. Importantly I don't write from start to finish. The introduction is sometimes the last thing that I write. Writing is a psychological thing and the thing that stops us doing it effectively is confidence. So, build confidence by picking off the easy sections of the piece first. If you have to choose between 200 words describing statistics on breastfeeding in the UK, or 500 words that discuss contemporary literature on reasons why women choose not to breastfeed, then it's obvious what to go for. Write that easy stuff first. If you're writing a 2000 word piece and break that down into ten 200 word sections then by doing three or four easy bits first, you are suddenly 30% of the way to finishing without breaking sweat.

Each piece of writing that you have to do will be different and will follow different rules depending upon who the target audience is. Obviously if you are preparing an information leaflet or writing a blog post, then that's going to be very different to producing an academic essay or a dissertation. One key step has to be to look at examples that are equivalent. How do they look? How are they structured? What little tricks are used to make them interesting and readable? Authors often make good use of sub-headings, graphs, diagrams and clear paragraph structures to ensure that their writing is appealing.

I have produced a series of blog posts entitled 'How to Write' which were originally aimed at academic writers who are new to trying to get their work published. I've had good feedback from lots of people about this series and apparently they are really useful to undergraduate and postgraduate students. So, if you're putting together a dissertation or a thesis or maybe you've got the chance to go and present your work as an abstract at a conference, why not take a look and see if it helps you write.

One of the most important areas of human nutrition research at the moment is focused on the gut microbiome. This term describes the population of bacteria which live in the human intestine, which comprises more than 1000 different species and tens of trillions of cells. It is estimated that around a third of the make-up of the microbiome is common to all humans, but the remaining two thirds varies in terms of species and the extent of gut colonisation and that, with the number of different permutations of colonists that are possible, is essentially a specific pattern that is unique to each individual. As these bacteria express more than 3 million different genes, their activities within the human gut have a large number of effects on human physiology.

A review article by Milani and colleagues, published in the Journal of Human Nutrition and Dietetics, describes the effects of the gut microbiota on human health. These are highly varied and depend upon the nature of the species involved. Whilst some bacteria are pathogens (eg E. coli, B. fragilis_ and are linked to adverse health outcomes (irritable bowel syndrome, necrotizing enterocolitis, colorectal cancer) others (eg Lactobacilli, Bifidobacteria) are now known to have basic activities that promote health and are a fundamental part of human physiology and metabolism:

• Digestion and adsorption
• Vitamin synthesis
• Immunomodulation
• Inhibition of growth of pathogens

In addition to these functions the gut microbiome is now understood to influence aspects of metabolic function, appetite and influence risk of obesity and diabetes. The nature of the gut microbiome is shaped by a number of different factors. These include genetics, exposure to microbes in the environment and the diet. A lot of the features of the microbiome are set in early life. Babies are born with a sterile gut and initially acquire microbes during delivery (vaginal compared to caesarean deliveries differ in the microbes that babies acquire), breast or bottle feeding, infections and exposure to pets. As we age the microbiome will respond to further infections, rounds of antibiotic treatment and the nature of the food we consume. As set out by Milani and colleagues, there are differences between the microbiomes of meat-eaters and vegetarians and bacterial species respond to dietary intakes of fibre and possibly fats.

If you would like to know more about the role of bacteria in human health, then the review article is short, easily digested and free to access at the Journal of Human Nutrition and Dietetics website.

Summer time is when lecturers and professors disappear for three months, until the students return from their holidays. They kick off their shoes, put on their swimming kit and head for the beach… No, not exactly. Academics work all year round and when the students are away they typically spend their time focusing more on their research activities. A part of that involves going to scientific conferences to present their research to their peers, to hear the research of others and to meet colleagues from all over the world that work in the same field. Sometimes this is in a really nice place, often outside the UK  (I have been to Australia, South Africa, Canada, the USA and a rather fine five star hotel in Majorca) and sometimes it can be quite mundane and ordinary (Leeds, Leicester or Luton).

Whilst there are lots of science presentations and keynote lectures, these meetings are really all about networking- getting to know people and forming professional relationships. We like to get together in formal and in social situations, make friends, talk about science and generally plan world-domination. Networking isn't just for academics though, it is valuable for everyone. You may get the chance to meet and speak with a future employer, with your nutrition hero (!) or with students from other universities who, along with you, will be the nutrition leaders of the future. On this basis going to a conference is something you should really consider as a means of learning about the cutting-edge of our science and as a means of meeting people and making contacts.

Networking is all about making use of connections between groups of colleagues to develop your career. Attending events that encourage networking is important for anyone who wants to  improve their career prospects. Who you know and how you know them can influence the development of collaborative projects, facilitate sharing of information and maybe even help you get a job. Networking can be formal or informal and works through face-to-face contact (a chat over a buffet lunch maybe) and electronic routes (sites like LinkedIn are good for developing networks). Meeting people through work or study is very much like forming personal friendships and you will mix with colleagues in your field, maybe from your own department or university and maybe from the other side of the planet. Some of them you will like a lot and form a bond with, others may not be your cup of tea, but better to find out at a conference than when you've committed to work with or for them. Conferences provide a great venue for all sort of networking activities and exploring of possibilities.

Conferences can be incredibly expensive to attend for academics such as myself. They charge registration fees in addition to the costs of travel to exotic locations and accommodation. However, all conferences ensure that they remain accessible for students. There is always a cheap student rate for registration, so if you can find a conference that is nearby and cheap to get to, then you should definitely give it a go. In the nutrition world there are lots of options that might be useful to students at all levels. The Nutrition Society has an annual summer meeting and a winter meeting every year where you can see research presented by experts in their field and where postgraduate students often present for the first time. The society also has an annual postgraduate student meeting run by and for postgraduate students. For dietitians there is the annual BDA Research Symposium which is a great place to present undergraduate dissertation work and you might also consider going to BDA Live for a broader networking experience. 

Unless you have been living off-planet for the last 20 years or so, you will be aware that obesity prevalence has risen sharply all across the world. We now view obesity as a greater threat to health than undernutrition and it is implicated in the development of heart disease, type-2 diabetes, several types of cancer and a wide spectrum of other health problems.

The standard approach to tackling obesity in individuals is to introduce an energy restricted diet to induce a loss of fat mass. To do this we depend upon personalised calculations of actual energy requirements so that we can ensure that the restricted diet delivers energy below requirement, but whilst still maintaining physiological functions.

Determining energy requirement can be done in a variety of ways, but mostly clinicians rely on predictive equations to determine energy expenditure. These include the Mifflin-St Jeor, Henry, Scholefield, Harris-Benedict, Owen and Katch-McArdle equations. These generally take into account height, weight, age and physical activity levels. All of the equations make assumptions about the individual and are prone to error associated with ethnicity, age and, most importantly, the BMI of the subject. Accuracy tends to be better in lean individuals and the equations lose accuracy with overweight and obesity. Given the importance of estimating energy requirements in order to achieve weight loss in obese individuals, there is a need to identify which equations are most useful for this population.

Angela Madden (University of Hertfordshire) and colleagues carried out two systematic reviews of the literature (http://onlinelibrary.wiley.com/doi/10.1111/jhn.12355/full ) to consider which predictive equations were the most accurate and precise in estimating resting energy expenditure (REE) and total energy expenditure (TEE) in healthy obese adults. They considered 25 studies which were able to directly compare calculated REE and TEE with measurements made using doubly-labelled water and other techniques. The reviews showed that none of the available equations for measuring TEE were accurate in obese people and as such they cannot be recommended for this purpose.

Importantly the reviews found that there was considerable variation in accuracy of equations to measure REE, with BMI as the main determinant of that accuracy. The important outcome of the work is that we have some guidance on which equation to choose based upon the body composition of the individual.

Although a single equation for all individuals is not ideal, Madden and colleagues recognised that in clinical practice, having just one equation for all obese people has greater utility. On this basis they suggest that the Mifflin equation is most appropriate for patients with BMI>25 kg/m².

I have a number of different roles as an academic working in nutritional sciences. On the one hand I am responsible for teaching across a number of degree subjects (nutrition, dietetics, nutrition and food science) and on the other I am an active researcher with an interest in pregnancy, infancy and childhood nutrition. On top of these roles I do work outside my University of Nottingham contract as the Editor-in-Chief of the Journal of Human Nutrition and Dietetics.

Academic journals fill a very important niche, and over a short period of time, their roles have changed. In these modern times of instant information, the journals are far distant from being magazines for only the learned to browse and now act as repositories for research findings, to be searched out by other researchers, students, policy makers and practitioners according to their need.

As an editor of an academic journal it therefore seems natural, particularly on a horrible, rainy, depressing day, to ponder the nature of why we do research in this discipline. There are of course many reasons, some noble and altruistic, but many of which are quite mundane and unglamorous and perhaps not what you would expect. For some researchers the act of research is driven by the simple need to pay the bills and keep a roof over their heads. Universities value and indeed profit from the research achievements of their academic staff. This inevitably pressurises staff to perform research activities in order to achieve or maintain academic tenure or attain promotion. This is not really the motivation that the general public believes drives the earnest men and women in white coats, but is an important truth. If you see your university lecturers looking a bit tense, remember that there will be people up above pushing them to deliver excellence.

I have started on a negative there though and there are other reasons why we do research. At the end of the day, I do it simply because I love it. Most, if not all, of my colleagues feel the same. It is the part of my job that gets me up in the morning. To discover something new is the greatest buzz imaginable and to have that work published is an immense pleasure. To put myself at risk of being trite, I'd say if fulfills that basic human instinct to find out, to make a difference and make the world a better place.

For those of us in the nutrition and dietetics field there are other drivers. Research gives us the ability to formulate the critical knowledge and evidence base that allows public health interventions, dietetic treatment, behavior change strategies, disease prevention, pharmacological treatment and so many other innovations to happen. The nutrition research community is varied. Some of us are practical people, searching for solutions to specific problems. For example, how might we design a school-based intervention to prevent obesity in childhood? Others are less applied and want to understand how things work, to pull apart the systems of the body, uncovering ever-increasing levels of complexity. For example, how do micronutrient influence methylation of DNA, expression of genes and cell proliferation during fetal development?

Research is the oil that drives the wheels of progress. The work done today will be the basis of the health measures of the 2020s and 2030s. This point cannot be overstated and as a still relatively young man (50ish at any rate) I am amazed by how much of the routine established knowledge of today would have been fantasy in my undergraduate days. Things that we do routinely, for example sequencing genomes or measuring biomarkers of disease, were major challenges or impossible 20 years ago.

Nutrition is a relatively young science, but sadly has attracted more than its fair share of problems. Bad science, flawed methods, conflated results, incorrect conclusions abound and form a nasty mix with the occasional bit of fraud and fakery and the plethora of quacks out to make a fast buck. Nutrition is however fundamental to understanding of health and disease. The church is broad and the abundance of literature vast. What nutrition and dietetics now needs is a robust underpinning, so that the potential to make a real difference to disease prevention, management and treatment can be delivered. The next generation of nutrition researchers is at university now just waiting for the excitement of novel discovery to sweep them up and carry them along this important path.

My name is Simon Langley-Evans and I am Head of School of Biosciences and Professor of Human Nutrition at the University of Nottingham. I am currently the Editor of the Journal of Human Nutrition and Dietetics. I was very pleased to be invited to provide a regular blog for the NHD magazine student zone.
It’s a long time since I was a student myself (graduated with my BSc in 1986 and PhD in 1990) but I have been teaching in higher education for more than 20 years, contributing to courses ranging from nutrition, biochemistry and health studies, through to nursing, midwifery and dietetics. One of my passions is mentoring people at all levels and it has given me great pleasure to see some students that I taught at undergraduate level move up through further degrees to fantastic jobs in industry and in some cases become academic colleagues.
In my regular blog for NHD magazine I want to discuss a whole range of things that will hopefully be of interest to nutrition and dietetics students. This will include some comment on new papers that come up in the journal, hot topics in our field and maybe some things that you have never thought about before, for example, what is research and why is it so important to nutritional science?
I hope that my blogs will stimulate some thought and maybe inspire you to look at things in a different way. I would love it to become a bit of a dialogue, so if you have any comments do post them and I will try and answer.