Unit 1 - Intro to Clinical Nutrition Therapy Flashcards
What is the rationale for Clinical Nutrition Therapy?
the bidirectional relationship b/t nutrition & health explains why diets can influence good health, & that balanced & adequate nutrition (standard diet) can affect both the short-term & long-term outcomes of medical tx
Some disorders in nutrient metabolism can lead to metabolic diseases w/ significant health consequences, including…
- poor development
- intellectual disability
- behavioural problems
- coma
- death in severe & untreated cases
In most of these metabolic disorders, clinical nutrition therapy instead of medications is the primary tx for life to alleviate their serious health complications
What do dietary supplements include?
vitamins, minerals, AA’s, herbs, & other compounds taking orally in diverse forms (ex: tablets, powders, gels, & liquid), & separately from food
Who needs dietary supplements?
dietary supplements cannot substitute for an adequate & balanced diet
- however, for some people, certain nutrients may be required either to correct deficiencies or to reduce risk of disease
What are Dietary Intake Standards developed for?
for the public & are referred to as Dietary Reference Intakes (DRIs)
What are Dietary Reference Intakes (DRIs)?
DRIs are the general term used for the nutrient intake standards for healthy people
- developed for most of the essential nutrients & are updated periodically
- intended for use as reference values for planning & assessing diets for healthy people
What are Recommended Dietary Allowances (RDA’s)?
are levels of essential nutrient intake judged adequate to meet the known nutrient needs of almost all (98%) of healthy people while decreasing the risk of certain chronic disease
What special considerations are given to pts who have increased nutritional requirements such as:
a) Specific nutrient deficiencies (i.e. malabsorption disorders)
b) Inadequate macro or micronutrient consumption
c) Patients who follow restrictive diets i.e. Vegans, food allergies, etc.
d) Life cycle stages with increased demand for specific nutrients
e) Medical conditions that interfere with the ingestion, digestion, absorption, or excretion of
nutrients
f) Drugs or medications that interfere the use of specific nutrients
g) Extremely limited exposure to sunlight (in the case of Vitamin D)
Regular diets:
Many pts can meet their energy & nutrients needs by eating balanced, unmodified diets
Modified diets:
Required by some pts, that is altered by changing its texture, nutrient content, or the foods included in the diet
- may benefit pts w/ chewing or impaired swallowing (DYSPHAGIA)
What are the 8 ways that food products are modified?
- Enrichment & Fortification of Foods
- Mechancially Altered Diet
- Blenderized Liquid Diet
- Clear Fluid Diet
- Modified or Restricted Fat Diet
- Low-Fiber Diet
- Low-Sodium Diet
- High-kilocalorie & High-Protein Diet
Enrichment & Fortification of Foods:
Manufacturers may add vitamins and minerals to foods that were lost during processing (ENRICHMENT) or add new vitamins and minerals to foods that do not naturally occur in those foods (FORTIFICATION).
Mechanically Altered Diet:
Diets that contain foods with altered texture may be advised for patients with chewing or dysphagia. These restrictive diets contain mostly pureed, ground/minced, or moist foods, which easily form a soft food diets (BOLUS).
Blenderized Liquid Diet:
A blenderized diet is most often obtained by mechanically altering foods with added liquid. There are foods that cannot be easily liquefied (e.g. some nuts, seeds, and raw vegetables). However, other foods such as breads and cereals, and cooked fish and meat can be easily blenderized.
Clear Fluid Diet:
Clear fluid diets consist of clear fluids and foods at room temperature. These diets are easily digested and tolerated by the gastrointestinal (GI) tract. They also leave little undigested material (residue). However, the nutrients and energy content of clear fluid diets are limited. For example, pulp-free juices, carbonated beverages, and clear meat broth.
Modified or Restricted Fat Diet:
Modified or restricted fat diets can be prescribed to patients, for example, who have cardiovascular disease, at risk or post stroke patients, elevated lipids, co morbidities such as diabetes and hyperlipidemia, etc.
Modified fat diets are prescribed on an individualized basis.
Low-Fiber Diet:
Low-fiber diets often restrict whole-grain breads, cereals, nuts, most fresh fruits, dried fruits, legumes, and many vegetables. These diets are usually recommended during acute phases of intestinal disorders such as the case of structuring disease in Crohn’s Disease, However, long- term fiber restriction is not commonly recommended. Adequate amounts of fiber and fluid are recommended as a means of treating and/or prevention of constipation.
Low-Sodium Diet:
Low-sodium diets limit the use of salt when cooking and at the table, excludes most prepared foods, and limit consumption of milk and milk products. People on low-sodium diets should carefully inspect food labels and consume only low-sodium foods because processed foods are high in sodium. Low-sodium diets can help to prevent or correct fluid retention. Low sodium diets are also suggested to reduce blood pressure.
High-kilocalorie and High-Protein Diet:
This diet is used to increase kcal and protein intakes in patients who are eating poorly and/or have malnutrition. Usually high-fat foods are added to high-protein diet to increase energy intakes. Although current advice recommends a total fat intake of 20-35% kcalories, the high- protein diets may exceed 35% kcalories from fat.
Examples of foods included in the high kcal and high-protein diets are milk products, meat, and foods prepared with cream, butter, and margarine.
What are the diets for hospitalized pts?
are within a diet compendium, which are under review. In hospitals, pharmacist will see that there is a Standard diet, which is the basis from which diets are modified.
These modified diet orders, which are available commercially, are made by dietitians after they have assessed the patients.
