Therapeutic Nutrition

IMPROVE YOUR ABILITY TO HEAL WITH NUTRITION

Food as medicine is not new, but how many of us really understand how to use food and nutrition not only to boost the body's natural ability to heal but also for preventative and complementary therapy?

In this unique course you can learn how to manage eating patterns to help the body heal from common complaints, to manage conditions and to complement other treatments in response to health issues.

Lesson Structure

There are 9 lessons in this course:

1. Introduction to Therapeutic Nutrition
   • What is Therapeutic Nutrition
   • Where is it Applied
   • Oral Nutrition
   • Nausea and Vomiting
   • Swallowing Problems
   • Weight Loss & Reduced Appetite
   • Nutritional Supplement
   • Artifical Nutrition
   • Enteral Nutrition
   • Parenteral Nutrition (Hyperalimentation)
2. Allergies and Intolerances
   • Food Allergy
   • Foot Intolerance
   • Diagnosis of Food Allergy or Intolerance
   • Dietary Management of Food Allergy and Intolerance
   • Peanut Allergy
   • Cow's Milk Allergy
   • Coeliac Disease
3. Diabetes
   • What is Diabetes?
   • Types of Diabetes
   • Complications Associated with Diabetes
   • Prevention and Treatment
   • Monitoring of Diabetes
   • Therapeutic Nutrition & Diabetes
4. Heart Disease, Hyperlipidemia and Arteriosclerosis
   • Introduction
   • Modifiable Risk Factors
   • Dietary Fat & Cholesterol
   • Other Dietary Factors
5. Renal/Kidney Conditions
   • Glomerulonephritis, Acute & Chronic
   • Nephrotic Syndrome
   • Nephrosclerosis
   • Acute Renal Failure (ARF)
   • Chronic Renal Failure (CRF)
   • Eating the right amount of Energy
   • Fluid Restrictions
   • Sodium Restrictions
   • Diet & Kidney Stones
6. Cancer
   • Dietary Factors associated with Cancer
   • Cancer Therapy
   • Nutritional Side-Effects and Suggested Dietary Management
7. Digestive Disorders & Diet - Oesophagus, Small Intestine, Colon
   • Introduction
   • Irritable Bowel Syndrome (IBS)
   • Inflammatory Bowel Diseases (IBD): Crohn's Disease, Diverticulitis & Ulcerative Colitis
8. Other Metabolic Conditions (eg. Liver, Gall bladder, Pancreas, etc)
   • The Liver
   • Hepatitis
   • Cirrhosis
   • The Gallbladder
   • Gall Stones
   • The Pancreas
   • Acute Pancreatitis
   • Chronic Pancreatitis
9. Strategic Diet planning for a medical condition

Each lesson culminates in an assignment which is submitted to the school, marked by the school's tutors and returned to you with any relevant suggestions, comments, and if necessary, extra reading.

Aims

• Discuss the nature and scope of Therapeutic Nutrition; and identify circumstances where diet may need modification
• Explain different types of food allergy and intolerance and provide information on diagnosis, clinical symptoms and appropriate dietary modifications.
• Explain what diabetes is and describe appropriate dietary adjustments that for people with Diabetes.
• Explain appropriate dietary adjustments that should be made for people with Cardiovascular Disease
• Explain appropriate dietary adjustments that should be made for people with Heart Disease, Hyperlipidemia or Arteriosclerosis
• Explain appropriate dietary adjustments that should be made for people with Kidney conditions
• Explain appropriate dietary adjustments that should be made for people with different types of cancer
• Explain appropriate dietary adjustments that should be made for people with a variety of digestive disorders
• Explain appropriate dietary adjustments that should be made for people with diseases of the liver, gall bladder and pancreas
• Evaluate the dietary requirements of a client or patient who has a medical condition; giving appropriate consideration to that condition, and to identify responsible options for diet planning in response to the situation.

Learn about Dealing with some common Food Intolerances

Dietary management of food allergy involves complete avoidance of the offending food allergen or allergens. Patients require specialised dietetic advice to help them identify foods containing the allergen, to adapt recipes and to follow a nutritionally balanced diet. Treatment for food intolerance is based on avoiding or reducing the intake of problem foods and treating symptoms when they arise. As with food allergy it is important that patients follow a nutritionally balanced diet once any food item is avoided.

PEANUT ALLERGY

A person with a peanut allergy has an allergic reaction to peanuts. Peanut allergies cause about three-quarters of the fatal or near-fatal allergic reactions. Peanuts can trigger an allergic reaction when they are eaten, come in contact with the skin or are inhaled in the form of dust or flour.　

Peanut allergy symptoms　

Allergic reactions to nuts can be quite minor, for example, the presence of a runny nose, skin rash or a tingling tongue. Symptoms may stay the same, but they may also become worse with multiple exposures. In a more severe reaction patients may experience difficulty in breathing, swelling of the throat, dizziness or unconsciousness. This can lead to anaphylactic shock. Other symptoms include hives, tightness of the throat, a hoarse voice, nausea, vomiting, abdominal pain, diarrhea, and light headedness.

Management of peanut allergy

Long term management involves complete avoidance of all sources of peanuts. Unlike many other food allergies, it is rare to grow out of peanut allergy and, therefore, dietary exclusion needs to be life long. Although avoiding whole peanuts is straightforward, the difficulty lies in the fact that peanut products can also be ‘hidden’　in a variety of processed foods e.g. in cakes, biscuits, ice cream, confectionery, breakfast cereals and in cooking sauces.

Sensitive individuals must, therefore, read food labels carefully to ensure that they are free from any ingredients of peanut origin. In addition, confusion also lies in the fact that peanut and peanut products may be listed under different names e.g. as monkey nuts, mixed nuts, peanut oil, and ground nut oil.

Approximately 35 to 50% of children with a proven peanut allergy also have allergies to tree nuts (walnuts, cashews, almonds, pecans, hazel, pine, pistachio, and Brazil nuts) and because of this most children with a peanut allergy also avoid tree nuts.　 In addition, young children who are allergic to peanuts are encouraged to avoid all nuts. This is due to the risk of them developing sensitivities to other nuts and to the difficulty of accurately identifying various nut products.

Unfortunately, despite family and child efforts to avoid peanuts and tree nuts, accidental ingestions are common. Exposures frequently occur in restaurants, children’s parties and in daycare settings and schools.　 Exposures can happen accidentally, for example, as a result of the accidental ingestion of shared food, or by eating foods not known to contain peanuts or peanut byproducts such as peanut oil.　 Cross contamination may also occur through contaminated cutlery, utensils, table surfaces, food preparation areas either at school or in the workplace.

COW’S MILK ALLERGY　

Cow's milk allergy is the most common food allergy in young children. Fortunately, most babies outgrow milk allergies by their second or third year. Cow’s milk allergy is caused by the milk protein in cow's milk allergy. Cow's milk protein allergy can develop in both breastfed and formula-fed children although studies show that breastfed children are less likely to develop any form of food allergy.　

Symptoms　

Symptoms can be sudden, including wheezing, swelling of the throat, hives, other itchy bumps on the skin, and bloody diarrhea. Very rarely children may have a severe anaphylactic reaction. Slower-onset reactions are much more common. These symptoms may include loose stools (possibly containing blood), vomiting, gagging, refusing food, irritability or colic, and skin rashes. Slow onset reactions are more difficult to diagnose because the same symptoms may occur with other health conditions.　

Diagnosis　

Accurate diagnosis of cow’s milk allergy is vital as removing cow’s milk from a child’s diet will affect their nutritional intake.　 A baby with a suspected milk allergy should have an individualized medical assessment, treatment plan, and follow up. A doctor should review the child's medical history and recommend any appropriate modifications to a child’s diet or any specific milk formulas that may be required. In some mild cases, the doctor may recommend re-introducing milk after a few months of following a milk-free diet to see if the child still has symptoms of milk allergy. In other cases, the doctor may refer the child to an allergy clinic. Here further investigations may take place including skin tests or blood test to detect IgE that is involved in immediate allergic reactions.

How is a cow's milk allergy treated? 　

Cow’s milk allergy is treated through a milk free diet. This diet should be undertaken with the supervision of a dietitian, who will provide milk-free recipes and a list of alternative products to ensure a nutritionally adequate diet. This is necessary to avoid nutrient deficiency specifically of calcium, riboflavin and vitamin D. All pregnant and breast-feeding mothers, children and adults on a dairy-free diet, must have their calcium replaced; otherwise this could lead to dental and bone problems (osteoporosis). The type and dosage of calcium supplement can be advised by the doctor and dietitian. 　

Whilst it is relatively easy to recognise the major sources of milk protein such as cow’s milk, yoghurt and cheese, it is much harder to identify manufactured products that contain milk.　 For example sausages, fish fingers, pie crusts, biscuits and breakfast cereals may all contain milk. People with cow’s milk allergies must be given thorough advice to help identify milk from food labels and milk free lists or diet sheets. If a child has been diagnosed with a severe milk allergy, the doctor may prescribe special medications in addition to a dairy-free diet such as antihistamines or epinephrine (Epipen or Ana-kit).　

MILK PROTEIN INTOLERANCE

Milk protein intolerance is a delayed reaction to milk protein. In contrast to milk allergy, milk protein intolerance produces a non-IgE antibody and is not detected by allergy blood tests.　

Symptoms　

Milk protein intolerance produces a range of symptoms including eczema, vomiting, diarrhea, and stomach cramps, but not hives or breathing problems (symptoms of milk allergy). Children who have milk intolerance often grow out of it by the time they go to school.

Treatment