Nutritional Interventions for Children with Cystic Fibrosis
|
|
- Frank Andrew McGee
- 5 years ago
- Views:
Transcription
1 Nutritional Interventions for Children with Cystic Fibrosis Prepared by: Scottish CF Paediatric Dietitians Group Lead Author: Elsie Thomson, Royal Aberdeen Childrens Hospital SPCF MCN Dietetic Protocols Co-ordinator/Editor: Alison Coates, Royal Hospital for Sick Children, Edinburgh Date: October 2012 Review date : October 2014
2 Scottish Paediatric Cystic Fibrosis Managed Clinical Network Protocols and Guidelines Introduction Nutritional Intervention Protocol This protocol has been devised on behalf of the Scottish Paediatric Cystic Fibrosis MCN for use by dietitians and other health professionals working in Cystic Fibrosis (CF) care across Scotland. It is based on current evidence and best practice. It should be used in conjunction with the published CF Trust consensus documents: Standards for the Clinical Care of Children and Adults with CF in the UK, 2 nd Edition, Dec 2011 Nutritional Management of CF, April 2002 Individuals with CF who are well nourished have a better outcome (Steinkamp & Wiedemann 2002) and there is a strong link between lung function and nutritional status. Wasting (poor weight gain) and stunting (poor height gain) are independent predictors of mortality (Sharma et al 2001, Beker et al 2001). For these reasons effective and timely nutritional intervention is essential. Summary of main points All children with CF in Scotland should aim to achieve optimal nutritional status and growth. Practical advice and support from a dietitian on nutritional interventions should be an integral part of ongoing care. Nutritional interventions should be tailored to the individual and family circumstances. A number of nutritional characteristics of CF are associated with poor nutrition: Increased stool energy losses due to fat malabsorption Increased energy demands of CF Anorexia and poor dietary intake Faddy eating and behavioural eating problems Frequent chest infections, CF related diabetes (CFRD), CF related liver disease (CFLD) and gastro oesophageal reflux (G) The majority of children with CF should achieve a normal nutritional status and rate of growth by following a high energy diet and taking adequate pancreatic supplements if pancreatic insufficient (PI). However for some children, nutrition will be a problem and additional nutritional support will be required using oral supplements and / or enteral feeds (Steinkamp & Weidermann 2002, Efrati et al 2006).
3 Aims of nutritional intervention To achieve and maintain good nutritional status and adequate growth from diagnosis To meet energy requirements in patients with CF (estimated % EAR but can be very variable between individuals) To initiate and monitor nutritional support if required All children with CF should have regular dietetic assessment (refer to protocol for dietetic assessment of children with CF), education and advice from a specialist paediatric dietitian with support from a specialist CF dietitian via the Scottish Paediatric CF MCN. Nutritional support should be an integral part of overall care. Frequent chest infections, and possible diagnosis of CFRD, CFRLD and G must also be considered as contributing to poor nutritional status. Oral nutritional supplements and enteral nutritional support should only be implemented after optimising routine nutritional management as follows:. Provision of age appropriate practical and achievable advice regarding a high-energy diet (Table1) Assessment and optimisation of PERT therapy (see PERT protocol) Management of food dislikes and behavioural eating problems (with advice from or referral to a Clinical Psychologist if necessary) Refer to Table 2 for anthropometric criteria indicating nutritional interventions which may be required. Oral Supplements Nutritional supplements have been found most useful for short-term use around the time of infections when appetite may be poor (Cochrane review 2007). A range of oral nutritional supplements can be used depending on age, requirements and taste preferences. Energy dense supplements are most useful. Oral supplements should not replace meals and timing and quantity need careful monitoring. They should be used as an adjunct to a high energy diet. Advice re PERT must be given when recommending supplements. All supplements require PERT except glucose polymers (for example,. Maxijul, Vitajoule ). Children on oral nutritional supplements should be closely monitored to optimise tolerance, adherence and progress.
4 Enteral Tube Feeds Before initiation, consideration should be given to the family s lifestyle and the additional treatment demand of enteral feeding. Most children with CF tolerate whole protein enteral feeds but occasionally Peptide or Elemental feeds may be required due to intolerance, slow gut motility or poor adherence to PERT. Most children will tolerate kcal per ml feeds. Nasogastric and gastrostomy feeding are both suitable but for long term use consider gastrostomy route. Children and families should be given information regarding different methods of feeding and be able to choose feeding route and tube type. Most children with CF feed overnight and continue on a high energy diet during the day but in severe cases daytime bolus feeds may be required. Advice re PERT must be given when initiating enteral feeding and regularly monitored (see PERT protocol for more details). Blood glucose levels should be monitored when initiating enteral feeding as CFRD may develop. A glucose profile is useful. Children and families should have training in administering feeds and looking after tubes. Contact numbers to access support should be provided. Children on enteral feeds should be closely monitored to optimise tolerance, adherence and progress. Parenteral nutrition Exceptionally, some children with surgical gut issues may require parenteral nutrition. Close liaison between the pharmacist and the dietitian is required, particularly in the stages of weaning from PN onto enteral feeds or oral diet. Table 1 : Suggestions for Improving Energy and Protein Intakes Promote regular high-energy meals. Encourage frequent use of energy-dense snacks (eg. crisps, biscuits, nuts, cakes) between meals but not at the expense of intake at meals. Encourage high fat foods e.g. cheese, fried foods, pastry, spreads, chips. Use full fat dairy products e.g. milk, cheese, yoghurts, cream. Promote generous use of spreads and oils (mono and polyunsaturated). Encourage high energy drinks e.g. full fat milk, home-made milkshakes. Encourage desserts, e.g. crumbles/fruit pies & custard, milk puddings, icecream.
5 Table 2: Anthropometric criteria linked with nutritional interventions (Adapted from the Australasian Clinical Practice Guidelines For Nutrition in CF) CATEGY INFANTS <2 CHILDREN 2-18 INTERVENTIONS Acceptable/normal nutritional status Reduced nutritional status / At risk of nutritional failure Nutritional failure Weight and length tracking along percentiles and within 1 centile bands of each other Weight and height percentiles decreasing with time** No weight gain over 6 months <90%Wt /Ht Weight 2 or more centile bands below length <85% Wt /Ht Failure of above nutritional interventions to improve nutritional status BMI percentile 25 th 91 st AND Weight and height percentiles tracking along previous percentiles AND No weight loss BMI percentile 9 th -25 th Weight loss over 3 months Plateau in weight gain over 6 months BMI percentile < 9th Weight falling 2 or more percentile positions WITH Failure of non invasive nutritional interventions to improve nutritional status Routine nutritional care, assessment, education and preventative counselling Nutritional, medical and psychological evaluation to investigate contributing factors eg behavioural eating problems, CFRD Some patients may be at risk of nutritional failure. Consider goal setting, oral supplements and discussion re enteral tube feeding if this fails Further nutritional, medical and psychological evaluation to investigate contributing factors eg behavioural eating problems, CFRD Recommendation for enteral feeding Overweight N/A BMI>98 th Nutritional counselling: Dietary and activity advice Weight maintenance may be appropriate Consider body image issues ** Falling height centiles may indicate stunting despite acceptable height for weight. Compare with mid parental height range
6 References and Further Reading CF Trust consensus document: Standards for the Clinical Care of Children and Adults with CF in the UK, 2nd Edition, Dec _Care_2011_web.pdf CF Trust consensus document: Nutritional Management of CF, April agement.pdf Clinical Paediatric Dietetics, 3rd Edition. Shaw & Lawson (2007) Australasian Clinical Practice Guidelines for Nutrition In Cystic Fibrosis (2006) SteinkampG, Weidemann B. Relationship between nutritional status and lung function in CF Thorax 2002; 57; Sharma R et al. Wasting as an independent predictor of mortality in patients with CF Thorax 2001; 56; Beker et al. Stature as a prognostic factor in CF survival. J Am Diet Assoc 2001; 101; Efrati et al. Long term rehabilitation by gastrostomy in Israeli patients with CF. J Pediat Gastroenterology Nutr 2006; 42; Smythe R & Walters S. Oral Nutritional Supplements for CF. Cochrane Review 2007 Resources CF Trust Fact Sheets: Nutrition A guide for children and parents nd_parents_%28web%29_sept_2010.pdf Nutrition : A guide for feeding infants _Infants_%28WEB%29_Sept_2010.pdf
Dietetic Assessment of Children with Cystic Fibrosis
Dietetic Assessment of Children with Cystic Fibrosis Prepared by: Scottish CF Paediatric Dietitians Group Lead Author: Elsie Thomson, Royal Aberdeen Childrens Hospital SPCF MCN dietetic protocols co-ordinator/editor:
More informationNutritional Assessment & Monitoring of Hospitalized Children
Nutritional Assessment & Monitoring of Hospitalized Children Kehkashan Zehra, Clinical Dietitian Sindh Institute of Urology & Transplantation, Karachi In Pakistan 42% of children aged < 5 years are stunted
More informationDietetic Management of Infants Diagnosed With Cystic Fibrosis
Scottish Paediatric Cystic Fibrosis MCN Dietetic Management of Infants Diagnosed With Cystic Fibrosis Prepared by: Scottish CF Paediatric Dietitians Group Lead Author: Julie Crocker, Royal Hospital for
More informationFirst line nutrition support dietary advice
First line nutrition support dietary advice For patients referred to the Dietetic Telephone Clinic 1 You have been given this leaflet because it was highlighted during your outpatient attendance that
More informationWhat Should I Eat to Help my Pressure Sore or Wound Heal?
What Should I Eat to Help my Pressure Sore or Wound Heal? Information for Patients i UHL Nutrition and Dietetic Service UHL Tissue Viability Team Introduction If you have a pressure sore or a large wound
More informationESPEN Congress Madrid 2018
ESPEN Congress Madrid 2018 Nutritional Management In Cystic Fibrosis Nutritional Requirements Of Cystic Fibrosis Patients M. Garriga (ES) Nutritional requirements of cystic fibrosis patients María Garriga,
More informationEating Well for Wound Healing
Eating Well for Wound Healing 2 Introduction The aim of this leaflet is to help you to have the correct diet to enable your wound to heal. What you eat plays an important role in: Looking after your skin
More informationROLE OF A DIETITIAN & KEEPING HYDRATED. Emily Capener Haematology Dietitian UHW
ROLE OF A DIETITIAN & KEEPING HYDRATED Emily Capener Haematology Dietitian UHW We will cover: PART 1 What is a dietitian Where do dietitans work About an acute dietitians role - Screening - Food charts
More informationDietary information for people with polycystic kidney disease. Information for patients Sheffield Dietetics
Dietary information for people with polycystic kidney disease Information for patients Sheffield Dietetics Introduction What is Polycystic Kidney Disease (PKD)? PKD is a genetic disorder where your body
More informationESPEN Congress Nice From child to adult nutrition. Cystic fibrosis. A. Munck
ESPEN Congress Nice 2010 From child to adult nutrition Cystic fibrosis A. Munck Cystic fibrosis nutrition: from child to adulthood -Positive impact of optimizing nutrition -Monitoring nutritional status
More informationAll resources are sold in packs of 10, unless otherwise indicated.
Patient Information Leaflets (No consultation required) 1000 Iron Deficiency Anaemia - Your Diet Can Help Patient Pick Up 6.00 1001 Dietary Advice for Bone Health Patient Pick Up 19.00 1002 Curing Constipation
More information*subject to VAT **NDR Prescribe available following ongoing review. Nutrition and Diet Resources Printed Resources and NDR Prescribe 03/04/2019
NDR Prescribe Credits NDRCR Bundle of 500 NDR Prescribe Credits 25.00* n/a Patient Information Leaflets (No consultation required) 1000 Iron Deficiency Anaemia - Your Diet Can Help Patient Pick Up 6.50
More informationDIET, NUTRITION AND HEAD AND NECK CANCER TREATMENT
DIET, NUTRITION AND HEAD AND NECK CANCER TREATMENT DIET, NUTRITION AND HEAD AND NECK CANCER TREATMENT HOW HEAD AND NECK CANCER MAY AFFECT NUTRITION Head and neck cancer may make it hard to eat and drink.
More informationAppropriate Use of Prescribed Oral Nutritional Supplement (ONS) in the Community
Appropriate Use of Prescribed Oral Nutritional Supplement (ONS) in the Community Aim This guideline sets out a recommended procedure for the identification and treatment of malnutrition to ensure Oral
More informationA Fact Sheet for Parents and Carers Healthy Eating for Diabetes
A Fact Sheet for Parents and Carers Healthy Eating for Diabetes Healthy eating is important for children of all ages, including those living with diabetes. Children and teenagers with diabetes have the
More informationNutritional management of eating disorders. Louise Watson Clinical Dietitian South Island Eating Disorders Service
Nutritional management of eating disorders Louise Watson Clinical Dietitian South Island Eating Disorders Service Contents Refeeding syndrome Target weight range Measuring height and weight Refeeding syndrome
More informationDietary treatment of adult patients with Cystic Fibrosis Related Diabetes
Dietary treatment of adult patients with Cystic Fibrosis Related Diabetes Francis Hollander, RD Dietician University Medical Center Julius Center for Health Sciences and Primary Care Department of Dietetics
More informationDiet what helps? Lindsey Allan Macmillan Oncology Dietitian Royal Surrey County Hospital, Guildford
Diet what helps? Lindsey Allan Macmillan Oncology Dietitian Royal Surrey County Hospital, Guildford Diet and cancer Diet and cancer Nutrition research Lack of funding RCTs Low quality Small sample sizes
More informationCOBIS Nutrition in Thermal Injuries PAEDIATRIC
COBIS Nutrition in Thermal Injuries PAEDIATRIC 1 NUTRITIONAL MANAGEMENT OF PAEDIATRIC BURNS PATIENTS Aims of Nutritional Support in Burns To promote optimal wound healing To maintain lean body mass To
More informationCase Study. The 4-year journey of feeding intolerance of an enterally-fed child from 9 months of age. Synopsis. Introduction/Overview
Case Study The 4-year journey of feeding intolerance of an enterally-fed child from 9 months of age Library image Emma Liesl Silbernagl, Clinical lead HEN Dietitian, Home Enteral Nutrition Team, Lewisham
More informationQuick reference guide to prescribing adults oral nutritional supplements (ONS)
Quick reference guide to prescribing adults oral nutritional supplements (ONS) Produced by the Medicines Management Team, West Suffolk Clinical Commissioning Group in conjunction with the Dietitians, West
More informationDietary management. Dr Alison Culkin Lead Intestinal Failure Dietitian St Mark s Hospital RSM December 2017
Dietary management Dr Alison Culkin Lead Intestinal Failure Dietitian St Mark s Hospital RSM December 2017 Overview Effect of resection on absorption Evidence for dietary management in short bowel Practicalities
More informationDiet & Diabetes. Cassie Ricchiuti Diabetes Dietitian. Lives In Our Communities. Improving
Diet & Diabetes Cassie Ricchiuti Diabetes Dietitian Improving www.shropscommunityhealth.nhs.uk Lives In Our Communities www.shropscommunityhealth.nhs.uk Dietary management of diabetes Type 1 Consistent
More informationTOPICS IN CLINICAL NUTRITION
Convegno Nazionale della Rete delle Strutture di Dietetica e Nutrizione Clinica della Regione Piemonte TOPICS IN CLINICAL NUTRITION Stresa Grand Hotel Bristol 29-30 Settembre/01 Ottobre 2016 LA NUTRIZIONE
More informationGuideline for the Prescribing of Oral Nutritional Supplements in Adults (NUT2)
Guideline for the Prescribing of Oral Nutritional Supplements in Adults (NUT2) Author Medicines Optimisation Team, Sunderland CCG Approved by Sunderland Medicines Optimisation and Guideline Group Current
More informationHow Do I Eat Well when I have A Dry or Sore Mouth or Throat? /04/2018
Patient Information Leaflets 1000 Iron Deficiency Anaemia 10 5.00 01/05/2017 1001 Bone Health 10 15.00 01/05/2017 1002 Curing Constipation Through Diet 10 5.00 01/05/2017 1005 Worried About Gaining Weight
More informationMedium Chain Acyl CoA Dehydrogenase Deficiency
Medium Chain Acyl CoA Dehydrogenase Deficiency WHAT is MCADD? MCADD occurs due to a deficiency of the enzyme medium chain acyl-coa dehydrognease (MCADD). This enzyme breaks down certain fats in the food
More informationGuidance for Oral Nutritional Support in patients with disease related malnutrition
Guidance for Oral Nutritional Support in patients with disease related malnutrition NICE (CG3, 6) define oral nutrition support (ONS) as the modification of food and fluid by: fortifying food with protein,
More informationGP, Community Nurse and Specialist Nurse Oral Nutritional Supplement (ONS) Formulary for Adults
GP, Community Nurse and Specialist Nurse Oral Nutritional Supplement (ONS) Formulary for Adults ALWAYS use the Food First approach before considering prescribing ONS (This includes over the counter ONS
More informationNutritional Challenges In Management of Children with Neurological Impairment. Sarah Donohoe Community Children's Dietitian
Nutritional Challenges In Management of Children with Neurological Impairment Sarah Donohoe Community Children's Dietitian References Feeding and Nutrition in Children with Neuro Disability Peter Sullivan
More informationDietary Treatment to Help Prevent Recurrence of Kidney Stones
Dietary Treatment to Help Prevent Recurrence of Kidney Stones Information for patients, relatives and carers For more information, please contact: Department of Nutrition and Dietetics Scarborough Hospital
More informationWeight loss guide. Dietetics Service
Weight loss guide Dietetics Service Contents Section 1 - thinking about losing weight? Section 2 - Carbohydrate Section 3 - Fruit and vegetables Section 4 - Protein & Dairy Section 5 - Fatty foods Section
More informationRaising Awareness of Undernutrition. Annemarie Aburrow, Dietitian Reducing Undernutrition Conference 17 th November 2016
Raising Awareness of Undernutrition Annemarie Aburrow, Dietitian Reducing Undernutrition Conference 17 th November 2016 Session Aim: To provide an awareness of the issue of malnutrition, and provide staff
More informationNutrition. A Guide. A guide to the nutrition of babies and children with liver disease
A Guide A guide to the nutrition of babies and children with liver disease Why is nutrition so important?... 4 What is a nutritional assessment?... 5 Why do some children with liver disease have poor nutrition?...
More informationNutrition Inspection Notebook (Updated April, 2011)
Nutrition Inspection Notebook (Updated April, 2011) Publication code: HCR-0412-049 Name of Care Service: Address: Date of Inspection: Care Homes for Older People This Notebook is a tool to assist the Professional
More informationLatest Nutritional Guidelines: What s new for practice? Paul Pipe-Thomas Specialist Dietitian
+ Latest Nutritional Guidelines: What s new for practice? Paul Pipe-Thomas Specialist Dietitian + Evidence Based Guidelines Last nutritional guidelines published in 2003. New guidelines published in May
More informationThe use of high energy peptide feed to aid feed intolerance and promote growth in a paediatric oncology patient
The use of high energy peptide feed to aid feed intolerance and promote growth in a paediatric oncology patient Author: Samantha Armstrong, Registered Dietitian (BSc Hons) Specialist Paediatric Dietitian,
More informationOrlistat (Xenical) and a reduced calorie diet
University Teaching Trust Orlistat (Xenical) and a reduced calorie diet Dietitians Ladywell Building 0161 206 1223 All Rights Reserved 2016. Document for issue as handout. You have been advised to take
More informationLifelong Nutrition. Jemma O Hanlon BHlthSc(Nutr & Diet) APD AN Accredited Practising Dietitian Accredited Nutritionist
Lifelong Nutrition Jemma O Hanlon BHlthSc(Nutr & Diet) APD AN Accredited Practising Dietitian Accredited Nutritionist Outline a Macronutrients a Micronutrients a Glycaemic Index a NHPAs The Australian
More informationWHOLE: Wellbeing and Healthy Choices for Older Adults and their Carers
WHOLE: Wellbeing and Healthy Choices for Older Adults and their Carers Malnutrition in Older Age This dietary information fact sheet is intended for informational purposes only. It is not a substitute
More informationWHY DO WE NEED FAT? It is now known that Omega-3 and Omega- 6 polyunsaturated fats, or good fats, are particularly good for heart health.
KNOW YOUR FATS WHY DO WE NEED FAT? Fat can contribute positively to our diet, as long as we choose the right types of fats and moderate our intake to the appropriate amounts. Fat has many valuable functions
More informationChildhood Obesity in the UK - Dietetic Approaches
Childhood Obesity in the UK - Dietetic Approaches Julie Lanigan RD, Ph.D. Principal Research Fellow Childhood Nutrition Research Centre UCL GOS Institute of Child Health Chair, British Dietetic Association
More informationNATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SCOPE. Nutrition support in adults: oral supplements, enteral and parenteral feeding.
NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE 1 Guideline title SCOPE Nutrition support in adults: oral supplements, enteral and parenteral feeding. 1.1 Short title Nutrition support 2 Background a) The National
More informationThe use of peptide feed to resolve tolerance issues in a jejunally fed post-op cancer patient
Case Study The use of peptide feed to resolve tolerance issues in a jejunally fed post-op cancer patient e mag ary i Libr Beth Simmons (BSc Hons) Dietetics, Home Enteral Feeding Dietitian, South Warwickshire
More informationPediatric Nutrition Care as a strategy to prevent hospital malnutrition. Div Pediatric Nutrition and Metabolic Diseases Dept of Child Health
Pediatric Nutrition Care as a strategy to prevent hospital malnutrition Div Pediatric Nutrition and Metabolic Diseases Dept of Child Health Child is not a miniature adult Specific for child growth and
More informationEmma Jordan Specialist Paediatric Dietitian
Emma Jordan Specialist Paediatric Dietitian - Referred by school nurse age 11 years and 6 months - Presenting complaint: Low dietary intake, mainly vegetarian, low fat intake, getting increasing fussy
More informationA parent s. guide to. (pancreatin)
A parent s guide to (pancreatin) www.creon.co.uk/patient What s inside Your child has been prescribed Creon (pancreatin). This booklet will help you understand exactly what it is, how it works and why
More informationNutritional Management of stomas
Nutritional Management of stomas Tracy Russell Specialist Dietitian Western General Hospital, Edinburgh Mairéad Keegan Dietetic Team Lead Hairmyres Hospital, East Kilbride Overview of Presentation General
More informationNUTRITIONAL MANAGEMENT OF CHYLOTHORAX. Lekha.V.S Senior Clinical Dietitian HOD- Department Of Dietetics Apollo Children's Hospital
NUTRITIONAL MANAGEMENT OF CHYLOTHORAX Lekha.V.S Senior Clinical Dietitian HOD- Department Of Dietetics Apollo Children's Hospital INTRODUCTION Nutrition therapy is a key component in the care of patients
More informationPrescribing Guidelines for Oral Nutritional Supplements (ONS) for adults
Worcestershire Area Prescribing Committee Prescribing Guidelines for Oral Nutritional Supplements (ONS) for adults September 2017 Review Date September 2020 Version 3.0 1 Version Control: Version Type
More informationA model of how to eat healthily
Average adult A model of how to eat healthily Shows the different types of food we need to eat and in what proportions to have a well balanced and healthy diet Not a model of each meal Applies to most
More informationThe Institute of Medicine January 8, 2009
Meeting the Challenges of Generating Useful Evidence and Using it Effectively in Obesity Prevention Decision-making The January 8, 2009 Promoting Healthy Weight using The Bright Futures Guidelines Joseph
More informationDietary advice for patients after fundoplication surgery
Dietary advice for patients after fundoplication surgery Nutrition and Dietetics Patient Information Leaflet Introduction The operation you have had has made the food pipe (oesophagus) less flexible where
More informationOPTIMISING NUTRITION IN CF ADULTS DR HELEN WHITE
OPTIMISING NUTRITION IN CF ADULTS DR HELEN WHITE MULTISYSTEM DISEASE Pancreatic insufficiency Nutritional status CF related diabetes Fat soluble vitamin status Bone health Greater complexity of care in
More informationAppropriate prescribing of specialist infant formula feeds
Appropriate Prescribing of Specialist Infant Formula Feeds Purpose of the guidance These guidelines aim to assist GPs and Health Visitors with information on the appropriate use of infant formula that
More informationNational Hospital for Neurology and Neurosurgery. Healthy eating after a spinal cord injury Department of Nutrition and Dietetics
National Hospital for Neurology and Neurosurgery Healthy eating after a spinal cord injury Department of Nutrition and Dietetics If you would like this document in another language or format, or require
More informationNutrition in Children Undergoing Treatment for Malignancy: Information and Advice for Shared Care Centres
Reference: Written by: Karen Whitehouse Peer reviewer Dr Jeanette Payne Approved: May 2015 Approved by D&TC: 13 th March 2015 Review Due: May 2018 Intended Audience This document contains information and
More informationManaging dietary problems in pancreatic cancer Contents
13 11 20 Information and support Managing dietary problems in pancreatic cancer Contents Eating after a Whipple procedure Vomiting Diabetes Pancreatic enzyme replacement supplements Nutritional supplements
More informationCase Study. Synopsis. Introduction/overview. Hannah Roberts Specialist Paediatric Dietitian County Durham and Darlington Foundation Trust
Case Study The use of a 1.5 kcal/ml whey peptide based feed to help promote gastric emptying and feed tolerance in a paediatric patient with neurodisability age y im ar Libr Hannah Roberts Specialist Paediatric
More informationHow many Enzymes Do I Need?
How many Enzymes Do I Need? 1, 2,3,4 enzymes? This education pack is not intended to replace any advice given from a specialist CF team How many enzymes do you need with your food? The number of enzyme
More informationUnintended Weight Loss and the Supplement Solution. Nancy Barwick, MS, RD, CD Midwest Regional Dietitian
Unintended Weight Loss and the Supplement Solution Nancy Barwick, MS, RD, CD Midwest Regional Dietitian Learning Objectives Identify the Resident at nutritional risk. List three problems related to weight
More informationMCADD. MEDIUM CHAIN ACYL CoA DEHYDROGENASE DEFICIENCY. Dietary management guidelines for dietitians
MCADD MEDIUM CHAIN ACYL CoA DEHYDROGENASE DEFICIENCY Dietary management guidelines for dietitians AUTHOR Marjorie Dixon Principal Paediatric Dietitian, Great Ormond Street Hospital for Children, NHS Trust,
More informationThe use of high energy peptide feed to aid feed intolerance and promote growth in a paediatric oncology patient.
The use of high energy peptide feed to aid feed intolerance and promote growth in a paediatric oncology patient. Samantha Armstrong, Registered Dietitian (Bsc. (Hons)) Specialist Paediatric Dietitian Birmingham
More informationDietary advice... where to start?
Dietary advice... where to start? Content The New Eatwell Guide & nutritional knowledge the basics Where to start... dietary advice Common ED dietary problems Meal Plan Food goals... normal eating and
More informationNutrition and Dietetics Patient Information Leaflet
Dietary advice for patients following fundoplication surgery Nutrition and Dietetics Patient Information Leaflet Introduction The operation you have undergone has made the food pipe (oesophagus) less flexible
More informationWhat to do when you have Type 2 diabetes. An easy read guide
What to do when you have Type 2 diabetes An easy read guide What is diabetes?? Sometimes your body does not make enough insulin. Sometimes your body can t use insulin properly. Insulin helps you to use
More informationNutrition Competency Framework (NCF) March 2016
K1 SCIENCES understanding of the basic sciences in relation to nutrition Framework (NCF) March 2016 1. Describe the functions of essential nutrients, and the basis for the biochemical demand for energy
More informationLose It To Win It Weekly Success Tip. Week 1
Lose It To Win It Weekly Success Tip Week 1 Writing down your goals will keep you on track. Revise or add to your goals at any time. Start by setting a long-term weight loss goal. Next, set a goal for
More informationSt Bede s RCVA Primary Packed Lunch Policy
St Bede s RCVA Primary Packed Lunch Policy Approved by Governors Spring 2017 Policy for Packed Lunches (brought in from home) Over-arching Rationale The underlying purpose for considering pupil s packed
More informationSCHOOL FOOD POLICY. School Food Policy. Mission Grove Primary School. Approved by Governing Body. Date : Review Date :
School Food Policy Mission Grove Primary School SCHOOL FOOD POLICY Approved by Governing Body Date : Review Date : Ethos At Mission Grove Primary School, we pride ourselves on being a healthy school, and
More informationNutrition in children with special needs. Dr. Meenakshi J.
Nutrition in children with special needs Dr. Meenakshi J. 1 Factors affecting growth and nutrition in children with special nutritional factors Inadequate intake primarily related to feeding dysfunction
More informationFood and nutrition for journey-based outdoor education
Food and nutrition for journey-based outdoor education Adrienne Forsyth BSc BSc(Hons) GradDipEd MSc PhD Accredited Practising Dietitian & Accredited Exercise Physiologist a.forsyth@latrobe.edu.au latrobe.edu.au
More informationHarnessing habituation, via reducing dietary variety, to enhance obesity treatment
Harnessing habituation, via reducing dietary variety, to enhance obesity treatment Hollie A. Raynor, PhD, RD a & Leonard H. Epstein, PhD b a University of Tennessee b University at Buffalo UO1 DK088380;
More informationFood Policy. Last reviewed: December 2017 Next review: December 2021
Food Policy Last reviewed: December 2017 Next review: December 2021 INTRODUCTION WASHINGBOROUGH ACADEMY WHOLE SCHOOL FOOD POLICY The school is dedicated to providing an environment that promotes healthy
More informationTHE METABOLIC SYNDROME
Nutrition Fact Sheet THE METABOLIC SYNDROME This answer is brought to you by many of the Australian nutrition professionals who regularly contribute to the Nutritionists Network ( Nut-Net'), a nutrition
More informationDietary advice when you have a colostomy
Dietary advice when you have a colostomy Information for patients Name Your Dietitian Dietitian contact number: 0118 322 7116 What is a colostomy? A colostomy is a surgical procedure that brings out the
More informationTo see a description of the Academy Recommendation Rating Scheme (Strong, Fair, Weak, Consensus, Insufficient Evidence) visit the EAL.
WWW.ANDEAL.ORG HEART FAILURE HF: EXECUTIVE SUMMARY OF RECOMMENDATIONS (2017) Executive Summary of Recommendations Below are the major recommendations and ratings for the Academy of Nutrition and Dietetics
More informationWHAT ARE AUSSIE KIDS
WHAT ARE AUSSIE KIDS REALLY EATING? A DEEP DIVE INTO CONSUMPTION AMONG AUSTRALIAN CHILDREN & ADOLESCENTS A SECONDARY ANALYSIS OF THE 2011-12 NATIONAL NUTRITION AND PHYSICAL ACTIVITY SURVEY INFORMATION
More informationAGING GRACEFULLY WITH THE RIGHT NUTRITION
AGING GRACEFULLY WITH THE RIGHT NUTRITION Pamela Er Dietitian Department of Dietetics National University Hospital Introduction Elderly people above the age of 65 years old, with good nutritional status
More informationDietary & Lifestyle Advice for Gastro-Oesophageal Reflux, Hiatus Hernia, Oesophagitis and Heartburn
Dietary & Lifestyle Advice for Gastro-Oesophageal Reflux, Hiatus Hernia, Oesophagitis and Heartburn Information for patients, relatives and carers For more information, please contact: Department of Nutrition
More informationNutritional Protocol for Blood and Bone Marrow Transplantation (BMT)
Nutritional Protocol for Blood and Bone Marrow Transplantation (BMT) Scope This protocol details pre, during and post BMT nutritional assessment and management for all forms of BMT undertaken by OxBMT,
More informationJanice Scott MS, RD, CSP, LD Clinical Nutrition Manager Texas Scottish Rite Hospital for Children
Janice Scott MS, RD, CSP, LD Clinical Nutrition Manager Texas Scottish Rite Hospital for Children Nutrition and Disability are intimately linked. Malnutrition can directly cause or contribute to disability
More informationBEST PRACTICE GUIDELINE
BEST PRACTICE GUIDELINE 1.0 PURPOSE: NUTRITION & FOOD SERVICES Clinical Nutrition Number: 100.210 Name: Approved by: Nutrition Assessment Health Record Form Guidelines - Acute Care Date: November 2007
More informationAdvice on taking enzyme replacement capsules
Advice on taking enzyme replacement capsules Hepatobiliary Services Information for Patients i University Hospitals of Leicester NHS Trust Introduction What is the pancreas? The pancreas is part of your
More informationNutrition- more protein, more calories Deepa Kariyawasam
Nutrition- more protein, more calories Deepa Kariyawasam Senior Renal Dietitian - King s College Hospital How pleased would you be if your patient ate all this food? Malnutrition incidence Risks of malnutrition
More informationThe degeneration of motor neurones leads to impaired mobility, speech, swallowing and breathing.
Case Study Management of regurgitation and weight-loss in an enterally fed patient living with Motor Neurone Disease Library image Jacqui Griffiths, MND Dietitian, Leeds MND Care Centre Synopsis: This
More informationConsultation Group: Lead Community Dietitians Aberdeen, Aberdeenshire and Moray CHP. Review Date: October Uncontrolled when printed.
Policy For The Prescribing and Administration Of Oral Nutritional Supplements In Adults By General Practitioners And Primary Care Staff Working Within NHS Grampian Co-ordinators: Dietetic Prescribing Advisor,
More informationAssessment and monitoring of CKD stages 1-3
Assessment and monitoring of CKD stages 1-3 Annual Paediatric Nephrouroradiology and Network Symposium 2014 Pearl Pugh Paediatric Renal Dietitian Nottingham Children s Hospital Goals of Dietetic Management
More informationOutline. Types of Bariatric Surgery. Adjustable Gastric Band (LAP-BAND) Bariatric surgery
Bariatric surgery Rona Osborne, Specialist Obesity Dietitian Glasgow and Clyde Weight Management Service November 2012- Weight Management Training Outline Types of Bariatric surgery Evidence Clinical Guidelines
More informationThe eatwell plate is based on the Government s Eight Guidelines for a Healthy Diet, which are:
The eatwell plate The eatwell plate is a pictorial food guide showing the proportion and types of foods that are needed to make up a healthy balanced diet. The plate has been produced by the Food Standards
More informationA Guide to Prescribing Adult Oral Nutritional Supplements in West Kent CCG
A Guide to Prescribing Adult Oral Nutritional Supplements in West Kent CCG Aim This guideline has been designed to support primary care prescribers initiating nutrition support for adults in West Kent.
More informationAre you eating & drinking enough?
Are you eating & drinking enough? A guide to the MUST & GULP screening tools GULP Dehydration Risk Screening Tool To complete GULP, tick the boxes which represent your findings. Add up the total tick scores
More informationHealthy Eating Policy
Healthy Eating Policy Implemented Term 1 2015 Reviewed Term 4 2015 Galilee Healthy Eating Policy Purpose: This policy aims to guide parents, students and staff at Galilee Catholic School in food choices
More informationNutrition Update. Dr Emma B. Williams British Nutrition Foundation 2 nd November The British Nutrition Foundation
Nutrition Update Dr Emma B. Williams British Nutrition Foundation 2 nd November 2013 Outline Snacking Hydration Snacking September 2013 www.blackwellpublishing.com/nbu Snacking Explore the literature in
More informationNHS Tayside Diabetes Managed Clinical Network Patient Information Leaflet. Healthy Eating and Your Diabetes
Tayside Diabetes MCN NHS Tayside Diabetes Managed Clinical Network Patient Information Leaflet Healthy Eating and Your Diabetes Why is Healthy Eating Important? Healthy eating is important to everyone
More informationEating Well After Gastro-intestinal Surgery
Lady Sobell Gastrointestinal Unit Wexham Park Hospital Introduction Eating Well After Gastro-intestinal Surgery This leaflet contains general information to help you with eating after surgery. If you need
More informationMANAGING YOUR CHOLESTEROL
MANAGING YOUR CHOLESTEROL WHAT IS CHOLESTEROL? Cholesterol is a white waxy substance found in every cell of our bodies. It comes from The liver our body makes most of it from the fat we eat in food A little
More informationThe Metabolic Syndrome
The Metabolic Syndrome This answer is brought to you by many of the Australian nutrition professionals who regularly contribute to the Nutritionists Network ( Nut-Net'), a nutrition email discussion group.
More informationLyrebird Preschool NUTRITION POLICY. Reference: Education and Care Services National Regulations: Regulations 78-80, 168
Lyrebird Preschool NUTRITION POLICY Reference: Education and Care Services National Regulations: Regulations 78-80, 168 AIMS: To ensure children and parents are given support and education regarding nutrition
More informationDietary advice when you have an Ileostomy
Dietary advice when you have an Ileostomy Information for patients Name Your Dietitian Dietitian contact number: 0118 322 7116 What is an Ileostomy? An Ileostomy is a surgical procedure that brings out
More information