Nutrition requirements during disease

Question 1

Acne

Answer 1

chromium
vitamin A
vitamin E
selenium
zinc

Question 2

AIDS

Answer 2

protein as high as 2 g/kg body weight

antioxidants

Question 3

Acute bowel inflammation

Answer 3

avoid fiber

Question 4

alcoholism

Answer 4

fatty infiltration of liver
excessive accumulation of vitamin A / vitamin A toxicity
thiamin deficiency (Korsakoff)
Wernick disease / wernicke-korsakoff

Question 5

Anorexia and bulimia

Answer 5

Def in fatty acids, electrolytes, folate, b12, calcium, zinc

Question 6

Biliary insufficiency

Answer 6

taurine
raw beets
choline
spanish black radish
inositol
aloe vera
methionine
dandelion
artichoke
peppermint
rosemary

Question 7

Cancer

Answer 7

elim alcohol
reduce sat fat
fiber foods
carotenoids
vitamin C
cabbage family foods
vit A, E, b carotene, selenium
phytochemicals - flavonoids, sulphorafane, ellagic acid, indoles, flavones, etc
soy phytoestrogens

Question 8

Celiac

Answer 8

prolamin-free diet
enzymes
fiber
prebiotic/ probiotic

Question 9

chronic fatigue syndrome

Answer 9

metabolic abnormalities like acylcarnitine deficiency

Question 10

chronic liver disease

Answer 10

hep A and B
inflammation, nausea, anorexia, decrease in protein synthesis
malnutrition
severe ascites (swelling in peritoneal cavity - belly)
obstructive jaundice

Question 11

colorectal cancer

Answer 11

not too many SCFAs and not too little
olive oil
calcium binding to bile salts (for diamine oxidase inhibition)
DAO is stimulated by meat and alcohol

risk is increased by hydrogenated PUFAs, lard, insoluble fiber, corn oil, beef
decreased by rice, fruits, beans, veggies, olive oil, fish oils, folic acid, calcium

Question 12

osmotic diarrhea

Answer 12

dumping syndrome

lactose intolerance

Question 13

secretory diarrhea

Answer 13

bacterial diarrhea

viral diarrhea

Question 14

exudative diarrhea

Answer 14

ulcerative colitis
radiation enteritis
occurs secondary to mucosal damage
accompanied by blood, mucus, and plasma proteins

Question 15

“limited mucosal contact” diarrhea

Answer 15

crohn’s

from inadequate mixing of chyme and insufficient contact of chyme with intestinal epithelium

Question 16

diarrhea nutritional therapy

Answer 16

replace water and electrolytes (chhicken broth and rice water)
fasting is contraindicated

Question 17

Diverticular disease

Answer 17

therapy - low fat, high fiber diet (45-55 g.d soluble fiber, 2-3 liters water daily, avoidance of seeds, nuts, and plant skins that may damage extravaginated secretions of colonic wall

Question 18

Dumping syndrome

Answer 18

reduction in meal size
increase in frequency
high protein, moderate fat, low starch diet
lying down after eating
avoidance of ingesting liquids with food
avoidance of simple sugars and milk
supplementation with MCTs (prevent steatorrhea); pectin (slows carb digestion, reduces osmotic load); digestive enzymes and multivitamins

Question 19

hyperlipidemia

Answer 19

restricted intake of dietary fats, simple sugars, cholesterol, alcohol, and total calories
increased intake of fiber
exercise

Question 20

Hypertension

Answer 20

sodium restriction

supplemental potassium, calcium, and magnesium

Question 21

hypochlorhydria / achlorhydria

Answer 21

HCl / betaine with food

Question 22

IBD

Answer 22

butyrate enemas
oral butyrate
prebiotic/probiotic combo
pectin - stimulates recovery of damaged villi
“bowel rest” is contraindicated - starvation of enterocytes and colonocytes will exascerbate lesions and delay healing
L-glutamine (35 g/d)
omega 3s (1800-2000 mg/d EPA + 900-1200 mg/d DHA)
Herbs:
Boswelia, cat’s claw (Uncaria), goldenseal
Anectodal herbs:
Garlic, ginger, licorice, onion, slippery elm, turmeric, white willow bark

if nutrient def: ca, K, mg, zn, antioxidants
sulfasalazine - need folic acid

Question 23

Fragrant intestinal gas

Answer 23

decrease legume and starch consimption

supplement with enzymes especially amylase to reduce production of SH2

Question 24

Visceral hyperalgesia (ref to IBS)

Answer 24

intestinal wall distention

triggers intestinal hypermotility

Question 25

IBS

Answer 25

small freq meals
fiber
psyllium and pectin (apples)
peppermint oil
caraway oil
hydration
low fat diet
avoid caffeine, simple sugars, raw veggies
reduce stress

Question 26

Kidney disease - hemodialysis

Answer 26

1.1 to 1.3 g protein/kg daily

Question 27

chronic renal failure macros

Answer 27

less than 30% from fat, 20% from sat fats, 300 mg/d of cholesterol; complex carbs should replace dietary fat
omega 3 FAs and l carnitine may be used to reduce circulating triglyceride concentrations

Question 28

End stage renal disease

Answer 28

Ca - 1200-1600 mg/d elemental ca
use antacids and cathartics cautiously if at all (because already hypermagnesemia so it will add to it)

sodium < 3 g
water 1200-2000 mL
potassium not exceed 60-70 mEq per day
supp with water soluble vitamins (loss of vitamins during hemodialysis)

Question 29

D-lactic acidosis

Answer 29

restriction of carb intake

restructuring of colonic microbial populations

Question 30

Osteoporosis

Answer 30

Ca 1200-2000 mg/d divided doses
vitamin D 600-800 IU/d
magnesium and boron as well

Question 31

short bowel syndrome

Answer 31

cant absorb LCFA
MCTs, dietary fiber, sucrose
restrict: starch and LCFA

Question 32

steatorrhea

Answer 32

sub MCT for LCFA

Question 33

Phenylketonuria

Answer 33

diet low in phenylalanine and high in tyrosine

Question 34

Tyrosinemia type I

Answer 34

causes rickets and fatal hepatomegaly

diet low in phenylalainine and tyrosine content

Question 35

Maple syrup urine disease

Answer 35

defect in enzyme keto acid decarboxylase causes hyperleucinemia causes seizures and may be fatal
therapy - diet low in leucine, isoleucine, and valine

Question 36

Homocystinuria

Answer 36

diet low in methionine

supplement with betaine, folic acid, B6, B12

Question 37

Cystinuria

Answer 37

hypercystinuria with secondary urolithiasis

supp with bicarbonate and high fluid intake