Kent State Interns

Finding the RMR for your client or pt is a crucial first step in diagnosing adequate energy requirements; without this basic info, we can't very well proceed with the NCP. RMR is defined as the energy required for vital bodily functions at rest. The most accurate way to get this number is through indirect calorimetry. This is both way to expensive and time consuming for the daily routine of RDs. For this reason, prediction equations using basic, easy to get data such as, age, weight and height are used. There are a lot of these equations, and some debate as to which one is the most accurate. The study set out to test the accuracy of the Harris-Benedict, WHO, Mifflin-St Jeor, Nelson, Wang equations and three meta-equations of Sabounchi. Both group and individual accuracy were tested. There was also the element of RMR to fat free mass (FFM) introduced as a critical relationship when discussing energy requirements. The envelope please... For group accuracy the award goes to Ha...

The implementation of a nutrition care plan (NCP) for malnourished patients in ICU and peri-operative protocols is fairly straightforward. The problem, waiting to implement the NCP, is more evident in the medicine units where integration of the plan with the overall clinical care plan may not be as straightforward. With the prevalence and problems related to malnutrition in hospitalized patients finally recognized and standardized diagnostic criteria available for early identification, there should not be any doubt that implementation of a NCP is a clinically and morally appropriate course of therapy. Early and adequate intervention of well-documented nutritional deficits may be delayed for a number of reasons. There may be a focus on medical diagnosis first then later on the patients nutrition needs. The care team may be waiting for the pt to regain appetite or have improved symptoms. Many times, a pt may be scheduled for testing that requires a NPO situation, then the testing is ...

As patients with cystic fibrosis (CF) are living longer, incidence of glucose intolerance (insulin resistance) and type 2 diabetes have increased. Previously, glucose monitoring with CF patients was not addressed due to the fact that patients weren't expected to live long enough to develop the added complications of chronic diabetes. The typical diabetic diet style and insulin regimen can not be applied to the energy requirements needed with the CF patient. With diabetics, diets will have restricted energy, simple sugars and fats following a consistent meal schedule. The CF related diabetic has increased energy needs, and the diet will be higher in fat energy and higher in carbohydrates. This diet also requires a more flexible pattern to accommodate the ever changing needs of the CF patient. More frequent glucose monitoring and different insulin requirements are part of the CF diabetic daily routine. Carbohydrate counting is the key to creating a more flexible diet for the CF ...

A malnutrition screening tool was recently evaluated for pediatric patients diagnosed with Cystic Fibrosis (CF). Up to now there has not been a nutrition screening tool for CF patients that considers all relevant clinical variables. The idea is to promote earlier detection of clinical risk. The tool assigned a score of 1 or 2 to 10 risk factors for malnutrition with a maximum malnutrition score of 14. Risk factors included BMI, pancreatic insufficiency, weight gain less than minimum, dietary intake less than 100%, CF related diabetes and albumin < 3.5 mg/dL. It is important to note wt. and % intake. CF patients require a high Kcal diet due to their systems constant battle against disease related factors.Serum albumin is normally not considered an indicator when diagnosing malnutrition status. However, in the case of CF, albumin level is an indicator of serum protein reserves and can reflect acute visceral protein depletion. Albumin has also been associated with severity of pu...

Johnson, S., Figueroa, A., Navaei, N., Wong, A., Kalfon, R., Ormsbee, L., Feresin, R., Elam, M. (2015).   Daily blueberry consumption improves blood pressure and arterial stiffness in      postmenopausal women with pre- and stage 1-hypertension: A randomized, double-blind,   placebo-controlled clinical trial.   Journal of the Academy of Nutrition and Dietetics, 115 (3), 370-377.               Blueberries have earned the reputation as a disease-fighting superfood because they are packed with nutrients.  One cup of blueberries provides protein, fiber, vitamin C and vitamin K and minerals such as manganese as well as iron, potassium and copper.  Anthocyanins, the purple pigment found in blueberries, is a phytochemical that also offers health benefits.             An eight-week study on blood pressure and arterial s...