Nutritional Therapy

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Management 4 More General Terms 5 Additional Terms 6 References

More Specific Terms

• calorie restriction; dietary restriction; food restriction
• enteral nutrition
• total parenteral (intravenous) nutrition (TPN)

Introduction

• also see nutrition

Management

• Daily recommendations: (also see recommended daily allowance)

• total calories: 30-35 kcal/kg day ( BMI > 20)
• dietary protein:

• 0.8 g/kg/day (normal adults)
• > 1.5 g/kg/day ( stress)
• 2.0 g/kg/day (severe burns)
• nitrogen balance probably attained at 0.5 g/kg/day (of high quality protein, i.e. egg albumin)
• protein restriction for

• hepatic encephalopathy
• end-stage renal disease

• carbohydrate
• fat - omega-3 fatty acids
• fluid 30-35 mL/kg/day or 1 mL/ kcal diet
• vitamins & minerals

• Meeting nutritional needs:

• to improve a poor appetite try

• frequent, small meals, snacks, food preferences
• food from home
• Megace, Marinol

• diseases affecting food intake

• arthritis

• need assistance in feeding
• cannot open containers
• finger foods

• Parkinson's disease, tardive dyskinesia
• stroke

• difficulty self-feeding
• dysphagia - speech therapy to help stage diet (3 stages of thickened liquids/textures) - aspiration precautions

• Alzheimer's disease

• may forget about eating
• may hold food in mouth, not swallow

• depression, despair

• social isolation

• encourage eating in common diet area

• polypharmacy
• changing taste perception

• chemotherapy, radiation therapy
• aging process

• decreased # of taste buds/ papillae
• changes in olfaction

• critical illness

• hypocaloric vs full enteric nutrition with similar outcomes ( ventilator-free days & mortality) [1]

• burns may be exception

More General Terms

• nutrition
• clinical procedure

Additional Terms

• disease-nutrition interactions
• nutritional assessment
• nutritional deficiency
• nutritional supplement

References

1. The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Initial trophic vs full enteral feeding in patients with acute lung injury: The EDEN randomized trial. JAMA 2012 Feb 22/29; 307:795 PMID: [1]
   - Griffiths RD. Nutrition for critically ill patients: How much is enough? JAMA 2012 Feb 22/29; 307:845 PMID: [2]

nutritional therapy