Nutrition
• Clinical Nutrition:
• Abdurehman Mamme(BSc, Msc in
Nutrition)
Method of Instruction
• Lectures
• Questions and answers Section
• Attendance at classes is strictly compulsory
Introduction
Definition of terms
• Nutrition:
Public Health Nutrition is the promotion of good
health through primary prevention of nutrition
related illness in the population.
01/30/25 3
Dietetics: is provision of medical
nutrition therapy and education by
applying the science of nutrition to the
feeding and education of individuals or
groups in health and disease.
Clinical dietitians: work in hospitals,
nursing care facilities and other health
care facilities to provide nutrition
therapy to patients and provide dietary
consultations to patients and their
families.
Gerontological dietitians are
specialists in nutrition and aging.
•They work in nursing homes,
community-based aged care
agencies, government agencies in
aging policy.
• The practice of clinical nutrition is
called Nutrition therapy.
• Clinical dietitians are the educated
and trained professionals who can
deliver nutrition therapy by using
the nutrition care process.
–Nutrition and Disease
• How does nutrition or diet affect the
disease process?
• How does disease affect nutritional
status?
• Can nutrition be used to prevent the
development of chronic diseases?
• Can nutrition be used to prevent
development of complications of a
disease?
Disease Process
• Disease: a process that interferes
with or disrupts body’s normal
function.
• Etiology: description and
identification of the cause of
disease
• Pathophysiology: study of the
disruption of normal physiological
process
Con’t…
• Prognosis: expected or usual course and
outcome
• Acute disease: characterized by a
relatively short duration of symptoms that
are usually severe.
• Chronic disease: developing slowly and
persisting for a long period of time, often
for the remainder of a lifetime (symptoms
may be less severe that with acute
disease)
• Symptom: any subjective
evidence of a patient’s disease or
condition as perceived by the
patient.
• Sign: any objective evidence of
disease as detected by the
examining physician.
Nutrition Care Process (NCP)
• Nutrition care process is a
systematic problem-solving
method that dietetics professionals
use to think critically, make
decisions addressing nutrition
related problems, and provide
safe, effective and high-quality
nutrition care”
nutrition care
process steps:
• Nutrition Monitoring &
Step 4 Evaluation
Nutrition Assessment
Why conduct nutrition
assessment?
•To obtain, verify and interpret data
(signs and symptoms) in order to
make decisions about the nature
and cause of nutrition-related
problems
Steps of Nutrition Assessment
• Review of medical record
• Interview the patient and/or family
• Examine the patient
• Evaluate the data
And document what you have found
Data used in nutrition assessment
• Medical history
• Dietary, lifestyle information (food intake)
• Anthropometric data
• Physical exam (e.g. muscle wasting)
• Biochemical/laboratory data (Fasting
blood glucose)
• Psychosocial information
• Educational needs
Nutrition Diagnosis
• Is the identification and naming of
the specific nutrition problems that
are identified using the nutrition
assessment results.
• It is the missing link between
assessment and intervention.
• Diagnoses/problems are those that
the nutritionist is responsible for
treating independently (not a
medical diagnosis)
Nutrition Diagnosis cont.…
Identification and labeling of a
nutrition problem:
PES Statement
P: Identify problem
E: Link problem to its cause
(etiology); saying “related to”
S: Link etiology to its signs and
symptoms; saying “as evidenced
by”
Con’t
Nutrition diagnosis step is
articulated in PES statement
PES Statement=
Problem…
related to … Etiology…
as evidenced by …Signs or
Symptoms
PES Example
•Inadequate energy intake
(problem) related to lack of
appetite and changes in taste
(etiology) as evidenced by a 5 kg
weight loss in the past 2 months
(signs)
Nutrition diagnostic terminology
Three general domains
Intake
Excess or inadequate intake compared to
requirements
Clinical
Medical or physical conditions that are outside
normal.
Behavioral-environmental
Relate to knowledge, attitudes, beliefs, physical
environmental, access to food or food safety.
Nutrition Intervention
• Specific set of activities and
materials used to address the
nutrition problem.
• It involves both planning and
implementing
Nutrition Intervention steps
1. Prioritize the nutrition diagnoses
2. Identify goals:
3. Plan the nutrition intervention: should be
derived by client involvement.
There are four domain categories of nutrition
intervention:
Food and/or nutrient delivery
Nutrition education
Nutrition counseling
Coordination of nutrition care
4. Implement the nutrition
intervention
The client need to be involved in
this decision-making and action
steps of nutrition care.
Nutrition Monitoring and Evaluation
• Progress should be:
Monitored
Measured and
Evaluated
Enteral and Parenteral Nutrition
Support
• Malnutrition in hospitalized patients is
common.
• Consequences of the malnutrition include
increased risk of infection, etc
• For patients unable to maintain their
nutritional status using oral diets or
supplements, nutrition support via enteral &
parenteral nutrition is the next alternative.
• Enteral Nutrition
Refers to feeding through the GIT via a
tube, catheter which delivers nutrients
distal to/or beyond the oral cavity
Indications
• For patients with functioning GIT but
cannot feed themselves adequately.
E.g. altered mental status, swallowing
dysfunction, disorders of upper GIT
• Types:
Nasogastric - nose to stomach
Orogastric – mouth to stomach
Nasointestinal – nose to SIT
• Those are temporary feeding
types
• Parenteral Nutrition
Administration of drugs or
nutrients by vein/intravenously
It is administration of
concentrated macronutrients,
vitamins, mineral and
electrolytes into a large central
vein
Thank you
