Dr Barbara Engel
About
Biography
I have been a dietitian for over 25 years and I have covered most areas of dietetics but in particular I have worked in the fields of renal disease, gastroenterology, diabetes and intensive care. I have been the Programme Director for Dietetics for the last seven years.
My main remit as Programme Director is to ensure the Dietetic Programme meets the high standards expected by the British Dietetic Association and the Health and Care Professions Council. These professional and regulating bodies approve and accredit the Dietetics Programme and dietetic students can apply to be dietitians once they have successfully completed the course. As the Team Lead for Dietetics I coordinate the activities of my small but vibrant team to ensure high standards of teaching and excellent placement opportunities for the students. As a teaching fellow I teach on the practical nutrition and dietetic modules, hence the reason that I continue to work as a dietitian when possible as I feel it enhances my ability to teach the practical aspects of nutrition and dietetics and hopefully enthuse students with the wide range of interesting areas which can be covered in our professions.
Until March 2020 I worked one day a week at St Georges hospital as a renal dietitian where I cared for people with renal disease on dialysis in particular looking after the young adults on dialysis. One of my greatest achievements was to look after a young woman who was pregnant and on dialysis and I worked closely with the multidisciplinary team to ensure her nutritional status and biochemical status were maintained so that she had a successful pregnancy. In the last 10 years I have also worked for Central Surrey Health where I was the highly specialist Nutrition Support Dietitian and Team Leader for Acute Dietetic Services. I managed a small team of dietitians and a nutritionist to deliver the dietetic service to the Acute wards and clinics in Epsom General Hospital. I covered Intensive Care, surgical and respiratory wards as well as looking after patients on home enteral feeding and parenteral (intravenous) feeding. I was awarded the Spirit Award for outstanding contribution to patient care (March 2011).
Since March 2020 I have developed and led a Public Health Project called Be Your Best https://www.bybsurrey.org/ . Throughout lockdown my nutrition and dietetic students aided by facilitators been have running a 5 week course for families on healthy eating, the importance of exercise and sleep, budgeting and meal planning. The students have also been running separate sessions for the children and this has resulted in improvements in weight, self esteem and knowledge of healthy lifestyles.
I am active on the Education Committee for the Renal Nutrition Group (specialist interest group of the BDA) and together with my colleague Claire Gardiner from the Leeds Beckett University I ran a 4 day zoom course for dietitians new to the renal field in January 2021. This was attended by 42 dietitians from all over the UK. As a result of this work and other RNG activities which I supported throughout lockdown I was named on the BDA Roll of Honour 2021 for COVID 19 Community Heroes.
University roles and responsibilities
- Programme Leader for BSc (Hons) Nutrition and Dietetics
Affiliations and memberships
ResearchResearch grants
FSA (2008): Awarded grant (N05R0018) £240,000Development of a dose-responsive biological marker for carbohydrate intake based on metabolomics and machine learning.Dr J Lodge, Prof G Frost, Prof J Draper, Dr B Engel, Dr M Beckman
British Renal Society (2007): £22,500A multi-centre trial to assess whether increased dietary fibre intake reduces laxative requirement in PD patients. This project has obtained Portfolio status.D Sutton, B Engel, R Davies, D Kariyawasam, S Perry, S Kennedy
Kings Fund Grant (1996) for pilot project 'Setting up a diet and exercise programme for Renal Transplant Patients': £5000
Royal London Hospital Research and Development (1997-1999): £20,000 to continue work on 'Diet and exercise programme for Renal Transplant Patients'
- Renal disease (MSc project supervisor; development and evaluation of dietary information for renal patients from different ethnic groups)
- Liver disease (MSc project supervisor; evaluation of Nutrition Assessment Score for patients with liver disease)
- Measuring and monitoring nutritional status in chronically ill people: renal disease, multiple sclerosis, diabetes
- Designing intervention trails in order to develop guidelines of best practice for dietitians
- Public health: I have supervised final year projects promoting healthy eating in Transplant patients, nursery and primary schools
- Inflammatory bowel disease, irritable bowel syndrome and the effects of pre and probiotics on bowel health
Research grants
FSA (2008): Awarded grant (N05R0018) £240,000Development of a dose-responsive biological marker for carbohydrate intake based on metabolomics and machine learning.Dr J Lodge, Prof G Frost, Prof J Draper, Dr B Engel, Dr M Beckman
British Renal Society (2007): £22,500A multi-centre trial to assess whether increased dietary fibre intake reduces laxative requirement in PD patients. This project has obtained Portfolio status.D Sutton, B Engel, R Davies, D Kariyawasam, S Perry, S Kennedy
Kings Fund Grant (1996) for pilot project 'Setting up a diet and exercise programme for Renal Transplant Patients': £5000
Royal London Hospital Research and Development (1997-1999): £20,000 to continue work on 'Diet and exercise programme for Renal Transplant Patients'
- Renal disease (MSc project supervisor; development and evaluation of dietary information for renal patients from different ethnic groups)
- Liver disease (MSc project supervisor; evaluation of Nutrition Assessment Score for patients with liver disease)
- Measuring and monitoring nutritional status in chronically ill people: renal disease, multiple sclerosis, diabetes
- Designing intervention trails in order to develop guidelines of best practice for dietitians
- Public health: I have supervised final year projects promoting healthy eating in Transplant patients, nursery and primary schools
- Inflammatory bowel disease, irritable bowel syndrome and the effects of pre and probiotics on bowel health
Publications
Highlights
Engel, B., Davies, S. (2009) Renal Nutrition: chapter in A Practical Manual of Renal Medicine: Nephrology, Dialysis & Transplantation (Editor: Kar Neng Lai) (World Scientific).
Engel, B. (2008) Renal Nutrition: chapter 11, pages 315-362 in Renal Nursing: 3rd Edition (Editor: Thomas, N.) (Elsevier).
Engel, B. (2006) Renal Nursing: chapter on Renal Nutrition (Elsevier).
Engel, B. with co-author Bartram, J. (2006) Oxford Handbook of Nutrition: chapter on Renal Nutrition.
Engel, B., Davies, S. et al. (2004) Longitudinal measurements of total body water and body composition in healthy volunteers by online breath deuterium measurement and other near-subject methods. International Journal of Body Composition 4(3):99-106.
Asghar R.B., Green S., Engel B., Davies S.J. (2004) Relationship of demographic, dietary, and clinical factors to the hydration status of patients on peritoneal dialysis. Peritoneal Dialysis International 24(3):231-9.
Smith D., Engel B. et al. (2002) Comparative measurements of total body water in healthy volunteers by on-line breath deuterium measurement and other near-subject methods. American Journal of Clinical Nutrition 76(6):1295-1301.
Engel, B. (2003) Nutritional Management of Diabetic Renal Transplant Recipients in Nutritional Management of Diabetes (Frost, G. et al.) (J. Wiley and Sons).
Nutritional Management of Renal Disorders. Encyclopaedia of Food Science, Food Technology and Nutrition. Academic Press. Updated and revised edition in print 2002.
Toigo, G., Aparicio, M., Attman, P.O., Cano, N., Ciancaruso, B., Engel, B. et al. (2000) Expert Working Group report on nutrition in adult patients with renal insufficiency (ESPEN Guidelines) Clinical Nutrition 19(3):197-207
Griffiths, A., Engel, B. (2001) Nutritional assessment and supplementation in patients with ESRD. British Journal of Renal Medicine 6(3):21-24.
Engel, B., James, G., Singh, S., Vennegoor, M. (1999) Setting Standards and achieving optimum nutritional status RNG Working Party (Winner of Elizabeth Washington Award - British Dietetic Association)
Engel, B. (1996) Renal Dietitians - Setting standards in Care. British Journal of Renal Medicine 1(2):21-23.
Engel, B., Kon, S.P., Raftery, M.J. (1995) Identification of Malnutrition in Hamodialysis Patients. Journal of Renal Nutrition 5(2):62-66.
Malnutrition is common among dialysis patients, but there is insufficient literature on the problem from resource-poor settings of the sub-Saharan region. We conducted a cross-sectional investigation of dietary intake and nutritional status of haemodialysis (HD) patients to inform the current status of this population group in the region. HD patients aged >= 18 years, with dialysis vintage of >= 3 months, at one nephrology unit in Tanzania were assessed for their habitual diet and nutrient intake. Anthropometric measures and biochemistry tests were also performed. The diet was predominantly starchy food based, accompanied by a limited selection of vegetables. Fruits and animal protein were also minimally consumed (1 portion/day each). Fruit consumption was higher in females than males (median (25(th), 75(th)) = 2 (1, 2.3) versus 0.5 (0, 1.7) portions, p = 0.008). More than 70% of participants had suboptimal measures for protein and energy intake, dietary iron, serum albumin, muscle mass, and hand grip strength (HGS). Inadequacies in protein and energy intake and dialysis clearance (URR) increased with the increase in body weight/BMI and other specific components (MAMC and FMI). Consumption of red meats correlated significantly and positively with serum creatinine (r = 0.46, p = 0.01), potassium (r = 0.39, p = 0.03), and HGS (r = 0.43, p = 0.02) and was approaching significance for a correlation with serum iron (r = 0.32, p = 0.07). C-RP correlated negatively with albumin concentration (r = -0.32, p = 0.02), and participants with C-RP within acceptable ranges had significantly higher levels of haemoglobin (p = 0.03, effect size = -0.28). URR correlated negatively with haemoglobin concentration (r = -0.36, p = 0.02). Patients will benefit from improved nutritional services that deliver individually tailored and culturally practical dietary advice to enable them to make informed food choices whilst optimizing disease management.
The principal objectives of the D-FINES study are to compare vitamin D status, food intake, bone health indices and sunlight exposure in Caucasian and Asian women living in Southern England. It is known that in women both muscle and fat mass influence whole-body BMD(1) and the aim of the present subsidiary study was to examine for differences in body composition and compare the relationship between body composition components in Asian and Caucasian women. Measurements of body composition were undertaken in seventy-two Asian and 227 Caucasian women in autumn–winter (A/W) with a follow-up assessment in spring–summer (S/S) by dual X-ray absorptiometry (QDR-4500; Hologic Inc., Bedford, MA, USA). Measures of whole-body bone mineral density (BMD), whole-body bone mineral content (BMC), fat mass and lean mass were undertaken. Regional as well as total measurements were available.