I am an avid twitter user, I am also a dietitian, I work in cancer services and I am employed by the NHS.

As a dietitian I work quite differently from a number of other health care professionals. My job is not to do things to people; it is to do things with people. In other words I pass on my knowledge and expertise, and then I encourage people to utilise it in a way that enables them to help themselves.

During the 10 years I have worked as a Dietitian, I have come to realise that there are a number of factors which influence behaviour and lifestyle choices.  Whilst knowledge is a core requirement to elicit change, in many instances knowledge alone does not make someone follow the recommended path. Sometimes it is a person’s environment, social influences and support structures that make the difference.

To explain my point I want you to take a minute to think about some situations. I want you to think about a time when you have wanted to make a change and it has been easier to do because you have had the support of your family and friends, or because your surroundings have supported your choice. I frequently hear examples from people which involve:

  • exercising with friends,
  • eating well as a whole family,
  • walking meetings with colleagues or a line manager,
  • limiting the availability of high fat, high sugar foods and drinks thereby reducing temptation,
  • making use of sustainable transport routes which allow active travel, or safe and free exercise opportunities such as cycle paths, outdoor gyms, walking groups and access to green spaces; and of course all of these are more tempting when the sun is shining.


Alternatively, you can think about the time it was made harder to exercise because no one wanted to play a game with you, or go for a walk, or take the stairs. Or the time you were trying to eat well and there were bowls of sweets and crisps, and a plate of cakes and biscuits sitting in front of you at a conference, a meeting, or at a friend’s house. Then there was the time you had to attend a drinks reception, or there was a free bar at the party you were attending and despite wanting to limit your intake to just one drink it was just too good an opportunity to pass up! And finally there was that time you wanted to walk to work but there was no pavement to walk on and the speed limit on the road was 60mph… and then it stated to rain! How easy was it then to change your mind and take the car instead?


I revealed above that I am an avid twitter user. For those of you who don’t use twitter it is worth saying that I use it as a professional, and as such I tend to follow people working in health or the area of cancer; however I also follow policy makers, journalists, people affected by cancer and others of professional interest. This means every tweet I read should be relevant to these themes. On more than one occasion I have come across a tweet conversation about diet. These conversations are often between people who have had cancer or clinical colleagues, and sometimes they illustrate that we know the links between diet and alcohol and cancer, but we do not follow the guidelines to limit their associated risks. As a dietitian, a cancer clinician, an advocate for cancer prevention and a person who will die of something someday; I regularly ask myself how we can buck this trend and make it easier to implement these lifestyle guidelines so we can reduce our risk of developing non-communicable diseases and live as well as possible for as long as possible. And whilst pondering this question I often come back to my original point – alongside sharing knowledge, we must create healthier and supportive environments, communities and relationships so that the healthier choice is the preferred and easier option.

With all of that in mind I want you to ask yourself the following questions:

  1. What can I do to improve my own lifestyle?
  2. How do my choices affect others?
  3. How can we work together to make sure each one of us has the knowledge and the support and the environment to make a positive change?


I think that many of the answers to these questions are outlined above, but if you would like more inspiration perhaps you can utilise some of the tools produced here in Scotland. For example you could become an ambassador and support the SCPN’s Healthy Meetings, or you could use some of the resources shared by the Health Promoting Health Service Knowledge Network.  You could also ask your employer to sign up to Healthy Working Lives or help them work towards their next award if they are already signed up. You could also work pro-actively in your community by supporting initiatives such as ‘Junk free Checkouts’. If you have more ideas please share them.

– Debbie Provan

Debbie Provan is National AHP Lead for Cancer Rehabilitation and Macmillan TCAT Project Lead. She is also an SCPN Executive Board Member. Twitter: @DebbieProvanRD. Email: debbie.provan@aapct.scot.nhs.uk.