Shanti Zunes-Wolfe
Nutrition Outline
November 23, 2007
Nutrition: for medical problems and chronic diseases
Introduction:
Good nutrition is important for everyone. Most people can follow a basic healthy
diet as outlined many times previously in this class, although there will be some
differences for every body type, amount of energy spent, and other factors. However, for
some medical issues and chronic diseases, there are some very specific nutritional needs
people may have.1
Preterm/low-birth rate infants:
Infants born preterm or low-birth rate often need a lot more energy than full-term
babies because their bodies cannot always absorb nutrients as easily and should be
growing at an increased rate as well. However, the amount will depend on the individual
infant, based on weight, how early the birth was, how they are being fed, and other
problems the baby may be facing. Besides added protein and fat, low-birth rate babies
often need added vitamins and minerals because many of them have deficiencies,
sometimes the reason for their low-birth rate. 2
On the positive side, between 1983 and 1993, the survival rates of LBW infants
went up more than fifty percent as more information on nutrition and other care was
discovered.3 When given incorrect nutrition, infants can have difficulty growing and
sometimes even suffer brain damage since their brains are growing and changing at such
high speeds.4
1
Williams, Sue Rodwell, PhD, MPH, RD. Nutrition and Diet Therapy: Eight Edition. Mosby-Year Book:
St. Louis, 1997 p.5-6
2
Pipes, Peggy L, RD, MPH, Trahms, Christine M., MS, RD. Nutrition in Infancy and Childhood: Fifth
Edition. Mosby-Year Book: St. Louis, 1993 p.313
3
ibid. p.330
4
ibid. P.332
Developmental Disabilities
Children with developmental disabilities need a nutrition program designed
specifically for the child, as their problems can range from under nutrition to obesity.
Often problems children experience with slow growth and not enough weight gain or too
much weight gain while growing too quickly, iron deficiency, not eating, lack of appetite,
strange eating habits and times, too much appetite, vomiting after eating, extreme food
allergies, not enough water, constipation, and other issues related to feeding. These overweight and over-eating problems often relate to children with Down syndrome, Cohen
syndrome, and several others. Underweight can sometimes relate to those with
hyperactive problems, Rhett syndrome, and cerebral palsy. Many times the underweight
are also deficient in many necessary vitamins and minerals.5
In figuring out a proper diet for handicapped children, figuring out their height
and weight and keeping track of it is very important in making sure their needs are met,
as well as amount of normal exercise.6 Often this nutritional program will include a
special exercise routine depending on their abilities.7
AD/HD—Attention Deficit/Hyperactivity Disorder
AD/HD is still a relatively new disorder for the medical field and we are still
learning a lot about it. It is still somewhat unclear on what causes it—genetics,
something going wrong in the womb, pollution, a generation raised on TV and video
games… It is hard to tell for sure. Although, we do know it is something physical in the
brain, synapses that do not connect correctly. And what we do to control some of the
symptoms—easily distracted, cannot get started on tasks, has difficulty completing tasks
5
ibid. P.343
ibid. P.346
7
ibid. p.347
6
and keeping attention, difficulty listening, interrupts often, talks too much, physical
restlessness, impulsivity, impatience, loses things easily, terrible short-term memory,
etc… is mostly contained by really hard prescription drugs at this point, Ritalin and
Adderal, the two most common, are made of the same drug as the illegal drug “speed.8”
While there are some homeopathic and other more natural treatments that work
well for some people, there has also been some research on how nutrition can help both
children and adults with handling their disability. As Doctor Lester mentioned, many
people with AD/HD also have food allergies and discovering what those are and
changing dietary habits can also sometimes help with some AD/HD symptoms.9 For
example, sugar in some people with AD/HD may not have a normal allergic reaction, but
rather cause a slight brain change that can make it either more active or sleepier. Dairy
and wheat are also common offenders for ADDers. Food can actually have a lot more of
affect on the brain than most conventional medicine admits too. It is also possible that
some people who are diagnosed with AD/HD do not even have the disorder, but are
purely reacting to a food allergy, although it seems with most people in these studies, it is
some of both. So it especially important for people with ADD or ADHD to eat healthy
and get tested for allergies.10
HIV and AIDS and Case Study
AIDS does not kill people, exactly. The Human Immunodeficiency Virus lowers
one’s immune system so that is very easy to die from other problems, including diseases
humans are not even supposed to be able to catch. In the United and States and other first
world countries, a person with AIDS is most likely to die from an illness or an infection.
8
Zimmerman, Marcia, CN. ADD Nutrition Solution. Henry Holt and Company: New York, 1999 p.xiv
Lester, Jeff, OD. Lecture on Osteopathy and Homeopathy. October 12, 2007. Introduction to Holistic
Health, Cabrillo College.
10
opsit. Zimmerman. p.76-79
9
However, in places where people are already having difficulty with getting enough
nutrition, people with AIDS tend to die of problems associated with a lack of nutrition.
When one has a failing immune system, it makes it especially important to eat right and
eat healthy. In a study done in Ghana, they used a high protein diet to increase weight
gain and the patients lived for a longer period of time.11 Between 1998 and 2003, they
studied 3188 cases of people newly diagnosed with HIV, slightly more females than
males, and people of all different ages from zero to over fifty. Since most patients were
quite impoverished, the point of pushing a heavily protein diet was important because
many of the foods recommended in first world countries would be even more difficult to
obtain. Weight loss is usually a signal for HIV patients that death is growing closer, so in
all areas of the world, it is important to focus on keeping up weight.12 In first world
countries, many of the medications suppress appetite so it is just as important here as in
Ghana. It is also important to make sure your body is getting all the vitamins and
minerals that make a healthy immune system, some of which should actually be given at
a higher dosage.
In the study, they focused on twenty-five participants between twenty-one and
sixty, with weight between 43 and 55 kg. Within seven months, all had shown the
nutritional therapy was working well for them. The first month showed the most
dramatic weight increase, and most had leveled off by the second month, but were able to
keep up a fairly healthy and regular weight. The author’s of this study, feel that with
more people they could show further change in later months, but with such a small group,
Tabi, Marie, MD, PhD, RN, Vogel, Robert L., PhD. “Nutritional Counseling: An Intervention for HIVpositive Patients,” Issues and Innovations in Nursing Practice. October 2005. p. 677
12
ibid. p.678
11
they were unable to.13 The conclusion is that nutritional counseling is extremely
important for all people with HIV, whether or not it has become AIDS because the longer
one can keep their immune system healthy and their weight up, the longer their lifespan is
likely to be.14
Osteoporosis
To avoid getting osteoporosis in the first place, one has to be sure to get enough
calcium, vitamin D, and exercise, while avoiding alcohol, cigarettes, excess protein, and
excess phosphate. While this is important for everyone, women middle-aged and older
are the most susceptible and may want to take additional supplements. These days, most
people who get osteoporosis are actually more deficient in vitamin D than calcium.15
Diabetes
Patients with Type I diabetes need to take special care of their diet and need to
match their insulin therapy with their nutrition intake. And exercise must also be part of
the routine.16 Protein should be 10-20% of calories and fat should stay under 30%, with
very little being saturated, and carbohydrates should fill the rest, with the majority being
complex carbohydrates. It was once thought simple sugars should always be avoided by
diabetic patients, but it has been shown that while one should still be careful, it is not as
damaging as was assumed.17 There is not need for special fiber, vitamins, or minerals,
but alcohol consumption should be limited.18
Depression
13
ibid. p.680
ibid. p. 681
15
Baker, Herman, PhD. “Nutrition in the Elderly: Nutritional aspects of chronic diseases,” Geriatrics.
September 2007. p.21-22
16
Heimburger, Douglas C., MD,MS Weinsier, Roland L., MD, PhD. Handbook of Clinical Nutrition:
Third Edition. Mosby-Year Book: St. Louis, 1997 p.373
17
ibid. p.374-376
18
ibid. p.377
14
There is a certain kind of depression and mood swings that is linked to sugar
sensitivity. This is a problem where someone who is sugar sensitive becomes addicted to
sugar and ends up with mood and depression problems closely linked to their diet. The
foods they crave are usually filled with sugar or white flour. The person who is sugar
sensitive is not at fault for being this way in the first place, but there are ways they need
to change their diet and eating habits to help with their brain chemistry change.19
One of the problems is that because of the amount of sugar and simple
carbohydrates in the diet, there is going to be problems with blood sugar levels, making
the levels spike, just to fall very quickly. While changing one’s diet is difficult, the most
important thing for a person who is depressed from sugar sensitivity is to start eating
three healthy meals a day, trying to wean out the amount of unhealthy carbs and sugar for
healthier carbohydrates and proteins. A good breakfast is especially important.20
Conclusion
Many medical problems can be helped with a specific diet, but everybody should
eat the best they can. It is important to remember that desserts and unhealthy snacks
should be an exception and not a rule: Okay now and then, just not every day. If you
suspect you may have an allergy to a food that is regularly in your diet it is important to
get tested. Allergies do not always show themselves in the normal manner. And do not
forget that supplements can help if you are not getting all your nutrition from meals.
19
DesMaisons, Kathleen, PhD. Potatoes Not Prozac: Are you sugar sensitive? Fireside Book: New York,
1998 p.39-55
20
ibid. 95-98
Bibliography:
Baker, Herman, PhD. “Nutrition in the Elderly: Nutritional aspects of chronic diseases,”
Geriatrics. September 2007.
DesMaisons, Kathleen, PhD. Potatoes Not Prozac: Are you sugar sensitive? Fireside
Book: New York, 1998
Heimburger, Douglas C., MD,MS Weinsier, Roland L., MD, PhD. Handbook of Clinical
Nutrition: Third Edition. Mosby-Year Book: St. Louis, 1997
Lester, Jeff, OD. Lecture on Osteopathy and Homeopathy. October 12, 2007.
Introduction to Holistic Health, Cabrillo College
Pipes, Peggy L, RD, MPH, Trahms, Christine M., MS, RD. Nutrition in Infancy and
Childhood: Fifth Edition. Mosby-Year Book: St. Louis, 1993
Tabi, Marie, MD, PhD, RN, Vogel, Robert L., PhD. “Nutritional Counseling: An
Intervention for HIV-positive Patients,” Issues and Innovations in Nursing Practice.
October 2005.
Walsh, William E., MD. Food Allergies: The complete guide of understanding and
relieving your food allergies. John Wiley & Sons: New York, 2000.
Williams, Sue Rodwell, PhD, MPH, RD. Nutrition and Diet Therapy: Eight Edition.
Mosby-Year Book: St. Louis, 1997
Zimmerman, Marcia, CN. ADD Nutrition Solution. Henry Holt and Company: New
York, 1999