THERAPEUTIC NUTRITION BRE211

Learn About How What you Eat Affect Health - Open Flexible Learning

Learn about how food consumed affects health
Learn how food and illness can be related
Understand how changing eating patterns can be used to complement other health treatments

Therapeutic nutrition involves eating for optimal nutrition and health. Therapeutic diets may be required as therapy for a disease e.g. coeliac disease or to treat malnutrition arising from low energy and nutrient intakes or due to increased energy and nutrient needs.

Explore Relationships between Diet and Different Medical Conditions

Therapeutic nutrition involves managing diet and nutrition as therapy for a disease or poor health, e.g.:

Coeliac diseasee
Malnutrition arising from low energy and nutrient intakes; or due to increased energy and nutrient needs.

Course Structure and Content

There are 9 lessons in this course:

Introduction to Therapeutic Nutrition
Allergies and Intolerances
Diabetes
Heart Disease, Hyperlipidemia and Arteriosclerosis
Renal/Kidney Conditions
Cancer
Digestive Disorders - Oesophagus, Small Intestine, Colon,
Other Metabolic Conditions (eg. Liver, Gall bladder, Pancreas, etc)
Strategic Diet planning for a medical condition

Duration: 100 hours

Aims for Learning

Discuss the nature and scope of Therapeutic Nutrition; and identify circumstances where diet may need modification
Explain different types of food allergy and intolerance and provide information on diagnosis, clinical symptoms and appropriate dietary modifications.
Explain what diabetes is and describe appropriate dietary adjustments that for people with Diabetes.
Explain appropriate dietary adjustments that should be made for people with Cardiovascular Disease
Explain appropriate dietary adjustments that should be made for people with Heart Disease, Hyperlipidemia or Arteriosclerosis
Explain appropriate dietary adjustments that should be made for people with Kidney conditions
Explain appropriate dietary adjustments that should be made for people with different types of cancer
Explain appropriate dietary adjustments that should be made for people with a variety of digestive disorders
Explain appropriate dietary adjustments that should be made for people with diseases of the liver, gall bladder and pancreas
Evaluate the dietary requirements of a client or patient who has a medical condition; giving appropriate consideration to that condition, and to identify responsible options for diet planning in response to the situation.

Where and how can Therapeutic Nutrition be Used?

A therapeutic diet may be provided orally (through eating and drinking), enterally (through a tube directly into the gastrointestinal tract or parenterally through the veins of the circulatory system. Here are just a few examples of the application of therapeutic nutrition:

Oral nutrition

Oral nutrition is interpreted as food or other nutrients taken by mouth. Oral nutrition support is the first step for who are suffering from weight loss or are unable to eat and drink enough to meet their energy and nutrient requirements. Oral nutrition support is provided for people who are able to swallow safely and have a functioning digestive system. The overall aim of oral nutrition support is to provide a balanced diet with enough protein, fluid and macronutrients to meet the patient’s nutritional needs and help improve clinical outcomes.

Oral nutrition support must respond to the specific needs of an individual. For example, people suffering from nausea and vomiting, swallowing difficulties, weight loss or reduced appetite will each require different forms of oral nutrition support.

Nausea and vomiting

Nausea and vomiting are symptoms of an underlying disease and not a specific illness. Nausea is the sensation that the stomach wants to empty itself, while vomiting (also called emesis), is the act of forcible emptying of the stomach. There are many causes of nausea and vomiting. For example, the symptoms may result from medications and medical treatments e.g. chemotherapy, pregnancy, mechanical obstruction of the bowel and acute gastritis which can include food poisoning, gastric flu and infections.

It is important that people are aware of what is causing their nausea and vomiting and it is important for them to receive medical advice especially if symptoms persist or are associated with pain, fever or vomiting blood.

Where patients have experienced vomiting it is important to give the stomach time to rest while still avoiding dehydration. Clear fluids should be attempted for the first 24 hours of an illness and then the diet should be advanced as tolerated. Clear fluids are easy for the stomach to absorb and include water, sports drinks, jelly, ice lollys and clear soups.

When solid foods are tolerated nausea may be helped by:

Eating small meals and snacks throughout the day and avoiding eating large meals.
Not eating fried foods, spicy foods or foods with strong odors.
Choosing plain foods such as toast, crackers, salty snacks and ginger flavored drinks and foods.
Prescription medications can also help control the nausea or vomiting.

Swallowing problems

Chewing and swallowing problems (also called dysphagia) can result from strokes, cerebral palsy, Parkinson's disease, muscular dystrophy, multiple sclerosis and dementia. The cause of swallowing difficulties must always be investigated by a doctor. If food and liquid cannot be swallowed safely it may be aspirated or drawn into the lungs. As the airways become blocked, the person will begin to choke and this choking fit may be fatal for frail, elderly people especially. The aspiration of food and fluid into the lungs can also cause aspiration pneumonia.

Once the cause of swallowing difficulties has been investigated, people may be advised to follow a specific diet. Examples include a minced diet where all food is minced for easier chewing or swallowing or a pureed diet, where a blender or food processor to puree foods to the consistency of infant food, while soft and smooth foods, such as apple sauce, certain puddings and eggs can be served in their normal form. Thickened fluids may be recommended as a remedy to chewing and swallowing problems. Artificial food thickeners are available from the pharmacy while natural thickeners include tapioca, flour and instant potato flakes.

Weight loss and reduced appetite

Unintentional weight loss is a decrease in body weight that is not voluntary. In other words, the person did not try to loss the weight by dieting or exercising. There are many causes of unintentional weight loss. Examples include, cancer, depression, drugs such as chemotherapy drugs, Eating disorders, loss of appetite and malnutrition. Painful mouth ulcers or a loss of teeth may also prevent someone from eating normally and result in weight loss in that person.

Weight loss and poor oral intake can have a serious impact on a person’s clinical outcome following a surgical procedure, thus resulting in reduced immune function, poor wound healing and potentially longer hospital stays.

Here are some tips to help people with poor appetite and weight loss, you may think of or know of others

Try to eat small and frequent meals and snacks, for example, every 2 hours. Suitable snacks include cheese and crackers, sandwiches, savory biscuits, ready made desserts such as yogurt, rice pudding and creme caramel.
Take advantage of times when you do feel well, and have a larger meal then. Many people have a better appetite first thing in the morning, when they are well rested.
If your doctor allows, have a small glass of wine or beer during a meal. It may help to stimulate your appetite
During meals, sip only small amounts because drinking may make you feel full. If you want to have more than just a small amount to drink, have it 30-60 minutes before or after a meal.
Fortify foods e.g. with milk powder and foods high in fats and sugars.

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