Nutrition Intervention PDF

Dr. Nefisa H. El Banna Prof. of clinical nutrition Ph D. from UNIV of Illinois USA Home Economics Hellwan University Nutrition Intervention : Food and Nutrition Delivery  Diet refers to whatever you eat and drink each day. Thus it includes the normal diet you consume and the diet people cons...

Dr. Nefisa H. El Banna Prof. of clinical nutrition Ph D. from UNIV of Illinois USA Home Economics Hellwan University Nutrition Intervention : Food and Nutrition Delivery  Diet refers to whatever you eat and drink each day. Thus it includes the normal diet you consume and the diet people consume in groups (hostel diet). Diet may also be modified and used for ill persons as part of their therapy (therapeutic diets).  Nutritional care is the use of nutritional knowledge in planning meals and the preparation of these meals in an acceptable and attractive manner to feed people Therapeutic diets are based on a general, adequate diet that has been modified as necessary to provide for individual requirements. In general, the therapeutic diet should vary as little as possible from the individual’s normal diet. Personal eating patterns and food preferences should be recognized, along with socioeconomic conditions, religious practices, and any environmental factors that influence food intake. The Nutrition or Diet Prescription : The diet or nutrition prescription designates the type, amount, and frequency of feeding based on the individual’s disease process and disease management goals. The prescription may specify a caloric level or other restriction to be implemented. It may also limit or increase various components of the diet, such as carbohydrate, protein, fat, specific vitamins or minerals, phyto chemicals, fiber or water the Mediterranean Diet Pyramid has been developed to represent the eating pattern of the Mediterranean culture and to demonstrate a reasonable diet for reducing chronic disease Energy Density diet It focuses on energy density as a guide to selecting foods and reducing energy intake. The diet is low in fat and rich in fruits and vegetables which give the diet a high-water content. This diet reduces calorie intake by providing bulkier foods with more water and less fat, thus enhancing satiety  Atkins new diet(Low-carbohydrate,high protein,high-fat). Carb: ≤20%Protein: 25-40%Fat: 255- 65%Strictly limits carb to less than 100-125 g/d.  Atkins diet promotes quick weight loss (much is water loss rather than fat) Ketosis causes loss of appetite hospital diet Energy Allowance: The general or regular hospital diet should be planned to meet the energy need for most healthy adults of normal weight. Protein Allowance The RDA for protein is 0.8g/kg of body weight for adults. General or regular hospital diets should provide a level of protein slightly higher than requirements for normal adults since many hospitalized patients will have increased protein needs.  Minerals and Vitamins: Appropriate levels of vitamins and minerals for stressed individuals are difficult to accurately determine. Individual responses vary; and true deficiencies with clinical signs and symptoms may take weeks, months, or even years to develop. To determine appropriate levels of vitamin and mineral intakes, the following should be considered 1 requirements for healthy individuals 2 nature of the disease or injury 3 body stores of specific nutrients 4 normal and abnormal losses through the skin, urine, or intestinal tract 5 drug- nutrient interactions. Fluids : A healthy adult at rest and not perspiring 1800 to 2500ml/day of water(or approximately 1ml/kcal consumed) to provide for urinary excretion and replace insensible fluid losses. Modifications of the Normal Diet : Normal nutrition is the foundation on which therapeutic diet modifications are based. Regardless of the type of diet prescribed, the purpose of the diet is to supply needed nutrients to the body in a form that it can handle. Adjustment of the diet may take any of the following forms:  Increase or decrease in the type of food or nutrient consumed ( sodium-restricted diet, lactose-restricted diet, fiber-enhanced diet , high-potassium diet)  Rearrangement of the number and frequency of meals ( diet for diabetes, post gastrectomy diet)  Increase or decrease in energy value of diet (weight- reduction diet, high-caloric diet)  Change in route of delivery of nutrients(enteral or parenteral nutrition)  Elimination of specific foods (allergy diet, gluten- free diet)  Change in consistency of foods ( liquid diet, pureed diet, low-fiber diet, high- fiber diet)  Adjustment in the level, ratio, or balance of protein, fat, and carbohydrate ( diet for diabetes, ketogenic diet, renal diet, cholesterol-lowering diet) Nutrition care for the hospitalized patient Food is an important part of nutrition care. Attempts should be made to the patient preferences. Attention to color texture, composition, and temperature of the food, coupled with a sound knowledge of therapeutic diets, is required for menu planning. Standard Diets Used in Hospitals All hospitals have basic, routine diets designed for uniformity and convenience of service. These standard diets are based on the foundation of an adequate diet pattern with nutrient levels as derived from the DRIs. The most important consideration of the type of diet offered is providing foods that the patients is willing and able to eat and that fit in with any required dietary restrictions. Types of standard diets vary but can generally be classified as general or regular, modified consistency, or liquid. Regular/General Diet A diet that has no restrictions is referred to as the " regular" diet. This diet is a basic, adequate, general diet of approximately 1600 to 2200 kcal ; it usually contains 60 to 80 g of protein, 80 to 100 g of fat, and 180 to 300 g of carbohydrate. Clear Liquid Diet Clear liquid diets are seldom used these days. They furnish fluids, some electrolytes, and small amounts of energy and consist of clear liquids such as tea broth, beverages, clear fruit juices, and gelatin. Milk and liquids prepared with milk are omitted. clear liquid diets used manly as transitiosn diets immediately after surgery. Consistency Modifications Further modifications in consistency may be needed for patients who have limited chewing or swallowing ability. Chopping, mashing, pureeing, or grinding food modifies its texture.