NUTRITIONANDNUTRITIONALSTATUSINDISEASE.pptVIP

NUTRITION AND NUTRITIONAL STATUS IN DISEASE CM Viviers (RDSA) Department of Human Nutrition NUTRITION AND NUTRITIONAL STATUS IN ILLNESS ILLNESS CHRONIC LUNG DISEASE (e.g. cystic fibrosis)Nutritional-related problems ● Increased energy needs (↑work of breathing, infections, fever) ● Increased nutrient losses (maldigestion malabsorption of protein/fat) ● Decreased food intake (infections, other illnesses, breathing, cramps) ● Impaired feeding skills ●Outcomes of malnutrition: Growth retardation (FTT, delayed puberty) Malabsorption (steattorrhoea) Poor immune status (recurrent infections) Increased lung disease More rapid progression of disease Increased morbidity CHRONIC LUNG DISEASEDietary treatment Goals: ● Improve growth, development, resistance to infection ● Reduce excessive losses from maldigestion/malabsorption ● Prevent progressive pulmonary disease/complications (glucose intolerance, intestinal obstruction) Strategies: ● Increase intake of energy and protein Supplement breast fed baby with high energy formula Regular and enjoyable mealtimes Larger food portions Extra snacks Select food with high nutrient density Fortify foods/beverages CHRONIC LUNG DISEASEDietary treatment (cont) MCT oil Ω-3 fatty acids Nocturnal feeds Regular re-evaluation of intake ● Replace enzymes Insufficient replacement → poor tolerance of starch fat ● Monitor - Tolerance of lactose, fats, gas forming foods, food consistency Hydration status Micronutrient status ● Provide adequate micronutrients Vitamins A, D, E, K Zinc Iron Calcium CANCERNutritional-related problems ● Altered energy expenditure Alterations in REE → cachexia/weight gain Tumor growth Infections ● Digestion and absorption of nutrients affected ● Changes in CHO, fat, protein metabolism Glucose intolerance Body fat depletion, ↓ HDL, ↑ VLDL Protein depletion, ↓ muscle mass, ↑ muscle breakdown, ↓ rates of synthesis ● Decreased intake Alterations in taste and smell Position of tumor Side-effects of cancer