Pediatric

Pediatric Nutrition: First things first

With over 25% of the world’s children experiencing failure to thrive (FTT), stunted growth, and or delayed development, it is a good time to look at the various facets of pediatric nutrition that require particular attention (1).  Recent assessments of pediatric malnutrition have indicated that the influence of one or more micronutrient deficiencies on the trajectory of a child’s health may be far greater than previously thought and that clinicians must consider a much larger number of nutritional factors than energy and protein intake (2).  An over reliance on assessing nourishment by the use of typical anthropometric values, can provide a false sense of adequacy.  While the classic model of FTT relies upon the use of height and weight growth charts and percentiles, there may be neurological or other developmental delays that are equally tied to malnutrition. Continue reading

sugar

Should Sugar Be the Second Ingredient? A comparative look at enteral formulas designed for diabetes patients and why Liquid Hope is still the best.

Many RDs and clinicians ask us if Liquid hope is suitable for those with diabetes.  Absolutely.  I think the question is asked so frequently because Liquid Hope does not state anywhere on its package or in its literature that it is designed specifically for diabetes.  In contrast, descriptions of commercial formulas such as Glucerna 1.2 and Diabetisource AC 1.2 contain language that clearly delineates them from other formulas.  They are apparently formulated specific to the condition of diabetes and contain the appropriate ingredients and nutritional qualities.  Really? Let’s take a closer look at what they are and what’s in them: Continue reading

Ileostomies

5 Things All RDs Should Know Regarding Ileostomies and Nutrition

Ileostomies are quite common in both short and long-term care.  They are performed for a wide variety of reasons, but they often present very similar challenges to the overall health of the patient. Due to their impact on nutrient availability and the functional capacity of the GI as a whole, many patients experience high levels of gut wall-derived inflammation, hyperglycemia, dysbiosis, and micronutrient deficiencies. Continue reading

Dirty Dozen

Be Wary of Enteral Formulas Built Around Dirty Dozen Ingredients

Organizations such as The Environmental Work Group, www.ewg.org, that are essentially our only sentinels with respect to chemicals in our produce and other foods, have made it very clear.  There are certain foods that carry inordinately high pesticide and herbicide levels and they should only be consumed if organically grown.  These are labeled as Dirty Dozen fruits and vegetables.  The list is updated each year but the core members generally stay the same. Continue reading

Gastroparesis

National Gastroparesis Month: Why fat, dairy, and consistency matter

This month is Gastroparesis month and it is unfortunately, a poorly understood condition affecting hundreds of thousands of individuals each year. Sometimes the symptoms are episodic, but often they are chronic. Essentially there is a prolonged delay of gastric emptying and it results in a myriad of issues that range from GERD (gastro esophageal reflux disease) bloating, nausea, and vomiting to constipation and additional lower GI abnormalities that can all be significant complications. Continue reading

Enteral Nutrition Support

A New Approach to Enteral Nutrition Support: Redefining true care, nutritional adequacy, and compatibility.

The critically and chronically ill patient typically has several biochemical processes that are severely compromised.  These aberrant pathways are the target of pharmacological intervention and are typically the only dimension of patient care associated with the outcome.  Supporting the patient’s most fundamental nutrition needs are equally important, yet this dimension of care receives very little attention. Continue reading