Dr Sammie Gill is a Specialist Gastroenterology Dietitian. She spent two years working at the British Dietetic Association as a Policy Officer in evidence-based practice. She then undertook her Postdoctoral Research Associate role at King’s College London in nutrition and functional gut disorders followed by a clinical role in gastroenterology at Ashford and St Peter’s Hospitals NHS Foundation Trust. She now works as Scientific Research and Development Manager at Symprove Ltd, in addition to ad hoc clinical dietetic work.
Hi Sammie, please could you tell us a bit about yourself?
Dietetically speaking, I graduated around five years ago now and have since been very fortunate to have undertaken roles within the food industry, as well as clinical work and research. Dietetics is so diverse – it’s one of my favourite things about the profession!
Where does your interest in nutrition and dietetics stem from?
My interest stems from speaking with other dietitians I met throughout my time at Coventry University, including lecturers and dietitians who were part of the research team when I was doing a PhD. My PhD supervisor Dr Ricardo Costa (who is now based at Monash University in Australia) is also a dietitian, so I got to pick his brains a lot too!
Where did you undertake your nutrition and dietetic training and clinical placements?
I did a Postgraduate Diploma (in nutrition and dietetics) at the University of Chester from 2013-2015. My first placement was at Royal Bolton Hospital, then second and third was a mix of acute and community on the outskirts of Liverpool.
What led to you specialising in gastroenterology?
Gastroenterology sparked my interest very early on. A large part of my PhD involved researching probiotics and immune function which fuelled my interest further! It fascinated me that this organ, once thought to only function in the digestion of food, plays such a crucial role in shaping our physical and mental health and impacting other organs of the body such as the brain, kidneys and heart. The gastrointestinal tract is this hub of activity where 70% of our immune system sits, over 99% of our genetic material lies and the trillions of microbes (collectively known as the gut microbiota) reside. They outnumber our human cells and are capable of carrying out thousands of functions. It’s such an incredibly exciting area to work in, and while our understanding has come on leaps and bounds, we still generate more questions than answers – that’s what keeps it interesting.
Please tell us more about your gut-related clinical research
The focus of my research at King’s College London was investigating novel dietary fibre combinations for the management of IBS. This was based on the fact that back in the 1970/80’s, fibre was viewed very differently (as a bit of a bland and boring nutrient which only helped to bulk out stools) and our understanding of how it worked in the gut was limited. We now know that different types of fibres have different characteristics and functionalities. My research explored whether combining different fibre types in supplement form or food form (in this case, a cactus plant native to Mexico called Nopal) could help alleviate symptoms in patients with IBS.
How do the findings from your research translate to clinical practice?
I think the key message is choosing the correct types of dietary fibre and being specific in your clinical recommendations. For example, psyllium husk is a soluble, viscous and poorly fermented fibre and may help to improve stool output (that is frequency, consistency and weight) in those with constipation.
Why is it important that dietitians are involved in clinical research?
Undertaking research is the foundation of evidence-based practice, and dietitians should be at the forefront, driving forward novel nutrition-related research to advance dietetic practice. The process itself is also an exciting and thought-provoking one, all the way from initial protocol development to manuscript submission. It’s incredibly rewarding to have the opportunity to do further research in an area you have a genuine passion and interest for, with potential to help shape guidelines and recommendations.
What are the most common functional gut disorders in the UK?
The most common functional gut disorder in the UK is IBS, which affects around 10-20% of the population. Functional bloating is thought to affect up to 30% of the population, whereas constipation and acid reflux affects around 20%.
What role does nutrition play in the management of common functional gut disorders?
Nutrition is absolutely key, though people respond differently to different approaches and therefore it requires a tailored approach. For example, in IBS, some patients may require dietary manipulation, whereas for others, the low FODMAP diet may be more appropriate. Probiotics, fibre supplements, or medications are all possible options depending on the patient and symptom profile. Beyond nutrition, management might involve reducing stress by targeting the gut-brain axis or addressing other lifestyle factors such as sleep or relationships with food.
Research into the gut microbiome and probiotics is rapidly evolving. What are the major research ‘breakthroughs’ that you have seen during your career?
I think there has been (and continues to be) really exciting work in the area of probiotics for mental health (i.e. psychobiotics) and their potential for use in those with milder forms of depression or anxiety. There is also new and novel work which targets the gut microbiome emerging in neurological conditions such as Multiple Sclerosis (MS) and Motor Neurone Disease (MND). There are currently two randomised controlled trials underway at King’s College London and Sheffield Hallam University investigating the use of a multistrain probiotic and its impact on the microbiota in people with Parkinson’s Disease. Although still in its infancy, I believe that precision probiotics is where things are headed in the future. This approach is an exciting one and could address the heterogeneity inherent to probiotic strains and the host gut microbiome.
Is a ‘food-first’ approach important for helping patients to optimise gut health? What are the key nutrients/food groups to consider?
Absolutely! For gut health, it’s all about diversity. In fact, results from the American Gut Project (largest study of its kind investigating how diet, lifestyle and disease influences the gut microbiome) found that those people who consumed more than 30 different types of plants each week had more diverse gut microbiomes compared to those who consumed 10 or fewer types. In other words, fill up on dietary fibre and naturally occurring prebiotic foods through consumption of wholegrains, beans and pulses, fruit and vegetables, nuts and seeds. Variety is key because each of these foods contain different types of fibre and different types of fibre feed different gut microbes. Trialling fermented foods (or making your own!) can provide a source of live microbes, which is another good way to optimise gut health.
What led to you working in the food industry?
I knew a number of dietitians working in the food industry already – all of their roles seemed so different and varied. As nutrition experts, I feel that dietitians are well-placed to fill these roles and embed an evidence-based ethos.
Please provide a brief overview of your role as Scientific Research and Development Manager for Symprove Ltd
No two days are the same, that’s for sure. My role involves overseeing research collaborations, proposals and on-going trials, supporting communications for healthcare professionals (HCPs) and consumers, and managing the dietetic-led service (where customers can get in touch directly with questions/queries).
How do you apply your dietetic knowledge in your role as Scientific Research and Development Manager at Symprove Ltd?
It’s especially important when working with the Marketing Team on HCP communications and when I receive questions/queries from dietitians or members of the public.
What does a ‘typical’ working day look like for you?
A typical day might involve meetings with university research groups to discuss potential collaborations, answering nutrition and dietetic questions/queries from the public or dietitians, maintaining the Research and Development (R&D) portfolio, and developing and/or reviewing documents/materials.
What do you most enjoy about your job at Symprove Ltd?
I really like the fact that there’s a very close-knit team at Symprove Ltd headquarters. I also love the day-to-day variation as well as working with people with diverse and different skill sets to my own.
What advice would you give to other dietitians with an interest in gastroenterology? Where can they go for further information on this area?
There are so many great information outlets – I’d suggest becoming part of the BDA gastroenterology group. You could also follow gastro dietitians, researchers and gastroenterologists on social media – it’s a great source of information for CPD. I’d also recommend familiarising yourself with the work undertaken by charities and organisations such as Guts UK, Coeliac UK, The IBS Network, BAD UK, Crohn’s and Colitis UK and the World Gastroenterology Organisation.