medical nutrition therapy for certain conditions Flashcards
Acne
considerations:
1. hyperkeratinzation of hair follicle blocks duct
2. hormonal imbalances (esp endocrine)
3. sebum production affected by hygiene and cosmetics
4. Bacterial activity increases inflammation
AVOID/REDUCE
1. sugar and processed carbohydrates
2. fried foods and trans fats
3. milk
4 iodine rich foods
Include/Increase:
Protein intake (45% of caloric intake) to influence hormonal balance
supplements:
1. vitamin A, E
2. vitamin C
3. Zinc
5 selenium
6. brewers yeast for chromioum
*clients with gout should take chromium instead
AIDS/ Wasting disease
considerations:
1. decreased food intake
2. malabsorption/diarrhea
3. altered metabolism (increased REE)
4. Endocrine abnormalities
AVOID?REDUCE
1. sugar, white flour, fruit juice, honey, processed foods
2. saturated fat
3. fried foods and trans fats
4. alcohl, nicotine, caffeine
r. avoid elimination diets
INCLUDE/INCREASE:
Natural, whole foods
2. high caloric intake
3. protein intake up to 2 g/kg of body weight
4. High fiber intake
5. filtered water
6. antioxidant rich foods.
supplementation:
1. High potency hypoallergic MVM
2. BEta-carotene
3. acetyl-1-carnitine
4. EFAs
5. probiotics
* taken apart from protein rich meals
Acute Bowel Inflammation (colitis)
considerations:
1. exacerbated by dietary fiber
AVOID/REDUCE:
1. Dry, fresh, or ripe fruits (except bananas)
2. whole grain
3. tough/fibrous meat
4. nuts, seeds, dried beans, corn
INCLUDE/INCREASE
1. canned fruits & fiber free fruit juices
2. Pulp free vegetable juice
3. cooked, seedless, low fiber veggies (asparagus, spinach, beets)
4. high refined flour
Alcoholism
consideration
1. metabolic damage
2. nutritional deficiency
3. cerebral atrophy
4. esophagitis, gastritis, ulcers
5. pancreatitis
6. fatty liver, cirrhosis
7. arrhythmias, myocardial degeneration, hypertension, angina
8. hypoglecemia
9. decreased protein synthesis
10. increased serum liver triglycerides
11. osteoporosis
AVOID/REDUCE:
1.vitamin A (susceptible to toxicity)
2. simple sugars, fruit juice, dried fruit
3. processed carbohydrates
INCLUDE/INCREASE
1. increase consumption of food, since alcoholics tend to not eat.
2. whole grains
3. vegetables
4. beans
5. high fiber fruits
Supplements
vitamin A
B complex
vitamin C
Vitamin E
Magnesium
selenium
zinc
carnitine
glutamine
L.acidophilus
Allergies/chemical sensitivity
considerations
1. food additives
2. preservatives
3. colorings
4. true food allergies
Reduce/decrease
1. suspected offending food item
Increase/INCLUDE
1. whole unprocessed foods
2. elimination and reintruction diets for sensitivities
Supplements
1. HCL
2. Pancreatic enzymes
3. probiotics
Anorexia Nervosa Bulimia
considerations:
1. unidentified food sensitivities
2. zinc deficiency-induced
3. ketosis
4. intestinal atony
5. osteopenia
6. hypothyroidism
7. hypercortisolism
8. amenorrhea
9. neuropathy
10. acid damage to upper digestive tract. (bulemia)
Reduce/decrease:
caffeine
alcohol
tobacco
Include/increase
1. easily tolerable complete liquid diet
Supplements:
1. electrolytes
2. EFAs
3. Folate, B12
4. calcium
5. zinc
Biliary insufficiency
considerations
1. fat malabsorption
reduce/decrease:
1. fried foods
2. fatty meals
Include/increase:
1. raw beets
2. dandelion greens
3. artichokes
4. peppermint tea
5. rosemary
6. spanish black radish
supplementation:
1. Taurine
2. choline
3. inositol
4. aloe vera
5. methionine
burns
considerations:
1. Increased REE
2. Increased oxidative stress
3. water loss
Cancers
considerations:
1. Improve effectiveness of chosen therapy without interference
2. Decrease risk of development through dietary intervention
REDUCE/AVOID:
1. high calorie , low nutrient foods
2. processed foods and candy
3. soft drinks
4. alcohol
5. saturated fats
INCLUDE/INCREASE
1. High fiber, nutrient dense foods
2. small cold water fish
3. carotenoid and vitamin C rich foods
4. cruciferous vegetables
5. phytochemicals (flavanoids, sulfurafane, ellagic acid, indoles, flavones, saponins, and triterpinoids)
6. soy phytoestrogens
supplements:
1. antioxidants (vitamins A, C, E, beta carotene, selenium)
2. MElatonin
3. flavonoids (genestein or quercetin)
4. ashwaganda
5. coriolus mushroom extract
Cardiovascular disease
considerations:
1. low antioxidant status
2. EFA deficiency
3. Elevated CRP
4. Magnesium and potassium deficiencies
5. insulin resistance
6. hypothyroidism
REDUCE/AVOID:
1. smoking,
2. saturated and trans fats
3. processed foods
4. reduce dairy and red meat
5. caffeine
INCLUDE/INCREASE
whole fruits and veggies
2. MUFAs and Omega-3s
3. Grains, legumes, raw nuts and seeds
Supplements:
1. high potency MVM
2. vitamin C
3. Vitamin E
4. Fish oil
5. inositol hexaniacinate
6. Garlic -inhibits platelet aggregation
7. panthethine for diabetics-lower serum lipids
celiac disease
considerations:
1. fluid/electrolytes imbalances
2. malabsorption of B vitamins, iron, calcium, magnesium, zinc, fats, and sugars
3. weight loss, edema, steatorrhea, dermatoses, folate deficiency seizures, anemia, osteoporosis *
4. Bone pain, joint pain, food allergies **
5. Bacterial overgrowth in the ileum
- secondary to malabsorption
** secondary to increased intestinal permeability
REDUCE/AVOID:
1. gliadin (wheat, rye, barley, triticale, oats) and prolamins (buckwheat, millet)
2. initial elimination of dairy
3. any food allergens
SUPPLEMENT:
1. Gluten free MVM
2. zinc
3. pancreatic enzymes
chronic fatigue syndrome
considerations:
1. decreased liver function due to exposure to environmental toxins.
2. stressors /emotional state
3. increased gastric permeability
4. chronic infection/impaired immune function
5. chronic candida infection
6. unidentified food allergies
7. hypothyroidism
8. hypoglycemia
9. hypoadrenalism
Reduce/avoid:
1. caffeine
2. refined s ugar
3. suspected food allergens
4. alcohol
increase/Include:
1. whole, organic foods
2. water
3. regular small meals/snacks
4. consider medical food replacement
supplement:
1. high potency MVM
2. vitamin C
3. vitamin E
4. Thymus extract
5. magnesium citrate
6. pantothenic acid
7, NADH
8. l-carnitine
9 fish oil
D-Lactic acidosis
results from lactobacilli colonization of colon that ferment carbohydrate to D-lactate
Nutritional requirements:
restriction of carbohydrate intake and restructuring of colonic microbial populations
Intestinal Gas and flatulence
odorless intestinal gas secondary to aerophagia (swallowing air while eating)
fragrant intestinal gas methane from fermentation of indigestible stachyose and raffinose in legumes.
nutritional requirements:
decrease legume and starch supplement with enzymes (amylase)
Irritable Bowel syndrome
colitis, spastic colon, functional bowel disease
abdominal pain relieved by bowel movement constipation w. episodic diarrhea
stool may contain mucus/blood
Nutritional requirements:
small frequent meals
increase fiber
prebiotics/probiotics
psyllium and pectin (apples)
maintaining hydration
low fat diet
avoiding caffeine, simple sugars and raw vegetables
reduce lactose
reduce fructose in all forms
reduce fat to 40 to 50 g/day
