Nutrition special diets

MAINTAINING ADEQUATE NUTRITION. A special diet (eg, foods high in iron or foods high in folic acid) may be prescribed. If the diet is taken poorly, the nurse notes this on the patient s chart and discusses tiie problem with tiie primary health care provider. 

The causes of human copper deficiency include (1) low intake - malnutrition, total parenteral nutrition (TPN) (2) high loss - cystic fibrosis, nephrotic syndromes and (3) genetic factors — Menkes disease. Copper deficiency may also be associated with chronic malabsorption, a situation which is made much worse in cases of gastric and bowel resection. Several special diets, including powdered milk, liquid protein and standard hospital diets are a means of inducing copper deficiency. The amount of copper in US food has decreased steadily since 1942, and may be related to the rising incidence of coronary artery disease. A copper deficiency may also occur as the result of the use of chelators for other purposes for example, diethyl dithiocarbamate is an in vivo metabolite of ANTABUSE (disulfiram). 

Not all calcium present in the diet is absorbed by the small intestine and mechanisms are present to ensure only amounts appropriate to body needs are absorbed. These processes are complex and involve the interaction of special transport protein, vitamin D and parathormone. Thus, abnormalities of calcium metabolism may result from many different disease processes. Diseases affecting the bowel may prevent normal absorption, diseases of the parathyroid gland may result in inappropriate levels of parathormone for calcium requirement and a nutritionally inadequate diet may cause vitamin D deficiency with consequent disordered calcium absorption. 

Diet The diet should be evenly balanced and in accordance with the principles of present-day dietetics it must also be tolerated by the patient. There is no special diet for viral hepatitis patients. The water and electrolyte balance is often disrupted in cases of acute viral hepatitis, possibly with the occurrence of oedemas and ascites (so-called hepatitis oedematosa) (48, 77, 131) (s. p. 297) or impaired renal function (60, 120) - as is recognizable from the diuresis which normally develops at the onset of the convalescence phase. An even balance of water and electrolytes should be maintained - this is very much supported by the patient lying flat. In the event of inadequate nutrition or malnutrition, particularly when nausea and vomiting occur, substitution measures are advisable (e.g. vitamins, glucose and electrolyte infusions). 

Cirrhosis In compensated liver cirrhosis without obvious malnutrition or undernourishment, no special diet is neeessary, and normal balaneed nutrition is adequate. 

Anorexia or unusual or absent taste Dietary intake and special diets, including enteral or parenteral nutrition... 

Dietary/nutrition applications cater for bed tray management and recording of special diets. Inventory management, purchasing, and recipe management as part of the functionality may typically be included. 

One study, published in a major nutrition journal in 2005, involved 34 people with high cholesterol. They were divided into three groups, then randomly placed into three different treatment scenarios. They followed each treatment for one month, during which all food and medication was provided and monitored. The control treatment involved placing the subjects on a very low saturated fat diet The second treatment combined a very low saturated fat diet with a 20 mg dose of a popular statin medication. The third treatment combined a very low saturated fat diet with a special diet containing specific "doses" of cholesterol-lowering foods that included the following ... 

Dietitians specialize in helping individuals learn about good nutrition and the need for a balanced diet. This requires them to understand biochemical processes, the importance of vitamins, and food labels, as well as the differences between carbohydrates, fats, and proteins in terms of their energy value and how they are metabolized. Dietitians work in a variety of environments including hospitals, nursing homes, school cafeterias, and public health clinics. In these environments, they create specialized diets for individuals diagnosed with a specific disease, or create meal plans for those in a nursing home. 

Some cancer surgeries create the need for specialized nutrition and diet therapy. 

New Zealand, which has a similar situation of marginal intakes and status, decided not to intervene on a population or nationwide basis but instead has taken steps to ensure that particular high-risk groups, notably people receiving total parenteral nutrition or children receiving special diets for phenylketonuria prevention, are adequately supplied. 

Animal Nutrition. Sulfur in the diets of mminant animals is beneficial to the animals growth (see Eeedsand FEED ADDITIVES). Sulfur increases feed intake, cellulose and dry matter digestion, and the synthesis of microbial protein. This results in increased meat, milk, and wool production (43). The special uses for sulfur in agriculture demonstrate a significant and continuing need for increased use of sulfur (44). 

It might be expected that EN via tubes would have been used widely before the development of parenteral nutrition (PN) however, this was not actually the case. EN via tubes inserted down the mouth or nose into the stomach and also via rectal tubes was used occasionally in the decades before the development of PN in the 1960s.1 However, modern techniques for enteral access, both the placement of the tubes themselves and the materials for making pliable, comfortable tubes, had not yet been developed. Before the PN era, the formulas delivered by the tube route often were blenderized foods. The National Aeronautics and Space Administration effort in the United States in the 1960s led to the development of low-residue (monomeric) diets for astronauts. These diets were adapted for use in sick patients requiring EN. Nonvolitional feedings in patients who cannot meet nutritional requirements by oral intake thus include EN and PN these techniques are collectively known as specialized nutrition support (SNS). 

These findings indicate that, at least for the energy requirements of astronauts, no special nutrition is required. Whether it will be possible to prevent loss of muscle and bone during prolonged flights by nutritional supplements is being considered. This approach is supported by the fact that supplementation or changes in diet can have beneficial effects in some diseases (Chapter 18 and see below). 

Reference Intakes (DRIs). In the past, the recommended dietary allowances (RDAs), which are the levels of intake of essential nutrients that are considered to be adequate to meet the known nutritional needs of practically all healthy persons, were the primary reference value for vitamins and other nutrients. The DRIs also include other reference values, such as the estimated average requirement (EAR) and the adequate intake (AI). The RDA, EAR, and AI reference standards define nutritional intake adequacy. Since these recommendations are given for healthy populations in general and not for individuals, special problems, such as premature birth, inherited metabolic disorders, infections, chronic disease, and use of medications, are not covered by the requirements. Separate RDAs have been developed for pregnant and lactating women. Vitamin supplementation may be required by patients with special conditions and for those who do not consume an appropriate diet. 

The nutritional requirements of insect species exhibiting different feeding habits like scavengers, parasites, predators and phytophagous insects, are similar in a qualitative sense (O. Each insect species needs, however, a particular quantitative composition of nutrients in its diet to complete development ( ). The presence of toxic substances in plants, secondary plant substances as they were formerly called by phytochemists, forms a barrier which phytophagous insects have overcome by specialization. Thus, an insect can tolerate or detoxify the secondary plant substances present in its host plants, while the majority of these substances being present in other plants still acts as toxins (J ). In this way phytophagous insects are adapted to the metabolic qualities of their host plants, i.e. a particular chemical composition of nutrients and secondary plant substances. 

Council for Agricultural Science and Technology. 1982. Diet, Nutrition, and Cancer A Critique. Special Pub. No. 13. Council for Agricultural Science and Technology, Ames, Iowa. 

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