Apollo Clinical Nutrition Handbook Anita Jatana, Daphnee DK, Haritha Shyam, Priyanka Rohatgi, Kajal Pandya Yeptho
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Acquired immunodeficiency syndrome 67
Acute respiratory distress syndrome 103
Adrenal insufficiency 289
Adrenal medulla 240
Advanced cancer care 148
Air
displacement plethysmography 55
pollution 103
Albumin 185, 186, 206, 208, 223
Albuminuria 119
Alcohol 20, 72, 77, 95, 98, 136, 266, 269
abuse 114
dietary adjuvant therapy 82
effects of 83
intake 61
Aldactone 283
Alkaline phosphates 59
Allergies 110
Allogeneic transplant 145
Alpha-linolenic acid 18
Altered nutritional biochemical parameters 142
Alzheimer's disease 72
Ambulatory acid 154
Amino acid 209
metabolism 183
Amputations 73
Amylophagia 19
Analgesic abuse 114
Androgens 265
Anemia 34, 124, 171, 258
autoimmune hemolytic 289
dimorphic 172
leading to 166
Angiotensin-converting enzyme 283
Ankylosing spondylitis 263
Anorexia 138, 147, 194, 195, 207, 219
cachexia therapy, functional assessment of 141
Anthocyanin 47
Anthropometry 7, 106
Antibiotics 234
Antibody, antiendomysial 172
Antidiarrheal agents 168
Antihistamines 285
Antilymphocyte globulin 195
Anti-microbial agents 288
Antioxidant 97, 108, 157
capacity, total 46
deficiency 211
Antithymocyte globulin 195
Anti-tissue transglutaminase antibodies 172
Anxiety 253
Aortic atherosclerosis 88
Aortic valve 218
Arginine 255
Arrhythmia 90, 218, 289
Arterial disease 87
Artery disease
control 73, 87, 217, 218
peripheral 73, 87
Ascites 182, 185
Ascorbate 47
Aseptic meningitis 289
Aspiration, high risk for 244
Aspirin 284
Asthenia 167
Asthma 102, 103, 110
drugs 284
Atherosclerosis 90, 91
pathophysiology of 91
stages of 92f
Athletes, nutritional status in 279
Attention deficit hyperactivity disorder 19
Autism spectrum disorder 19
Autograft 145
Autoimmune
diseases 290
Autoimmune disorders 206, 291
Azotemia 185
B
Back pain 117
Bariatric surgery 57, 57t, 61
criteria for 57
Basal energy expenditure 197, 235
Basal metabolic rate 28, 29
Basiliximab 195
Benzodiazepine 285
Berger's disease 172
Beta-carotene-rich vegetables 110
Biceps skinfold 220
Bifidobacterium lactis 81
Bile acidification 231
Biochemical test 106
Bioelectrical impedance 55
analysis 141
Biotherapy 145
Biotin 81
Birth
injuries 73
weight 1, 3
Bladder capacity 29
Blood
albumin 214
clot formation 166
composition 15
crystallize 205
flow, hepatic 29
glucose, self-monitoring of 85
loss 166
pressure 42, 43, 70, 90
control 119
diastolic 46
high 24, 205
systolic 29, 46
sugar
fasting 43
low 158
monitoring, regular 84
tests, routine 172
urea nitrogen 222
volume 15
Bloodstream infection 231
treatment of catheter related 231
Body
composition 29, 206, 278
fat 29
immune functions 292
mass
index 7, 15, 28, 42, 43, 53, 54, 87, 106, 138, 189, 189t, 206, 207, 219, 268
loss of 213
weight 31, 106
adjusted 207
assessment of 206
desirable 207
edema-free 207
ideal 207
measures of 207b
percent of usual 207
standard 207
Bolus feeding 245b
Bone
composition 261f
density 270
development 262
elasticity 264
growth 262, 263f
health 261, 262, 269
maintaining 271
long 261
loss 225, 263f
metabolism, regulator of 265
mineral density 263
modeling 262
physiology of 264, 264f
remodeling 262
short 262
tissue 262, 265
trabecular 261
types of 261
Bowel
ischemia 243
obstructions 151
Bowman's capsule 204
Brachytherapy 145
Bradycardia 218
Brain injuries, traumatic 249, 251, 257
Branched-chain amino acid 193
Breast
crawl 21
milk 21
expressed 3
nutritional components of 21t
Breastfeeding 21, 23
benefits of 21
medicine, academy of 23
Breath, shortness of 104, 222
Bronchiectasis 102
Bronchitis, acute 103
Burns 248, 248b, 258
C
Cachexia 139f, 221
clinical consequences of 221
management 220
prevention 221
syndrome, stages of 139f
treatment 221
Caffeine 20
Calcineurin inhibitors 195
Calcitonin 265, 267
Calcitriol 265, 267
Calcium 18, 25, 32, 61, 173, 211, 213, 223, 269, 283
impairment 122
intake 266
Calorie malnutrition 253
Cancer 134, 137, 142, 263
cachexia syndrome 138, 151
immunotherapy, adversity of 288
nutrition support for 290
signs of 137
staging 136
symptoms of 137
treatment 144
Candida infections 283
Carbamazepine 285
Carbohydrate 16, 30, 31, 44, 76, 82, 96, 186, 193, 213, 235, 272, 273, 275
complex 168
counting 79
intolerance 20
loading 272
metabolism 184
requirement 246, 273
role of 77, 78f
simple 52
stores 277
Carbon dioxide production 245
Carcinoma 155
Cardiac cachexia 220, 221b, 222
risk of 219
Cardiac disease 88
Cardiac failure 217
Cardiomyopathy 88
dilated 90, 217, 218
hypertrophic 219
Cardiovascular disease 31, 35, 39, 51, 73, 87, 89f, 117, 124
diagnosis of 90
symptoms of 95
Cardiovascular function 15
Cardiovascular system 9
Carotenoids 268
Catabolic rate 203
Catabolism 203
Catechin 47
Catheter
infections, risks of 287
prevention of 231
Celiac disease 170, 171, 172t, 179, 269
clinical spectrum of 171, 172
demographic distribution of 170
diagnosis of 174
latent 172
management of 175, 176
monitoring 175fc
nutritional
diagnosis 173
monitoring 174
potential 172
silent 172
symptomatic 172
treatment for 176
Centers for Disease Control and Prevention 8, 53
Central nervous system 29
Central venous catheter 228
complications 231
Cephalosporin 284
Cerebral perfusion pressure 258
Cerebrovascular
accident 42, 90
disease 73, 87
Cesarean section 73
Chair rise test 141
Chemotherapeutic drugs 283
Chemotherapy 144, 146
agents 290
hyperthermic intraperitoneal 145
Childhood cancer, nutrition screening tool for 6
Child-Pugh classification 189
Chlordiazepoxide hydrochloride 285
Chlorpromazine hydrochloride 285
Cholangitis, biliary 172
Cholecalciferol 265
Cholesterol 42, 93t, 96, 211
levels 70
total 46, 94
Chromium 81
Chronic obstructive pulmonary disease 102104, 106, 107, 110, 249
causes of 104
symptoms of 104
Ciprofloxacin 283
Circulation time 29
Cirrhosis 183, 185
Clavicular region 254
Clostridium difficile infection 162
Codeine 284
Colitis 289
Colonic diverticulosis 162
Colonic dysmotility 161
Colostomy 161, 161t
Complete blood count 59
Computed tomography scanning 141
Connective tissue 261
Constipation 19, 35, 62, 147, 177, 253, 255
Corticosteroids 194, 195, 285
Cortisone 285
Coumadin 287
C-reactive protein 208, 221
Critical illness
phase of 247fc
stages of 240f
Crohn's disease 159, 161, 164, 165, 165t, 228, 229
Cyclospora cayetanensis 167
Cyclosporine 195
Cyproheptadine hydrochloride 285
Cysteine 82
Cystic fibrosis 6
D
Deep vein thrombosis 151
Dehydration 63, 273
Demographic data 39, 51, 102
Densitometry 55
Depression 73, 253
Dermatitis herpetiformis 171, 172
Desmoid tumor 228
Dextrin 177
Diabetes 24, 36, 85, 115, 197, 224
atlas 66, 67f
complications of 72
control and complications trial 68, 120
diagnosis of 68, 68b
major complications of 72f
medications 84
mellitus 20, 42, 66, 91, 94, 112, 196, 206
acute complications of 73t
chronic complications of 73t
development of 44
gestational 20, 67, 70, 73, 74t, 77, 82, 82t
insulin-dependent 71
noninsulin-dependent 71
pathophysiology of 69f, 70f
post-transplant 197
type 1 68, 67, 68t, 71t, 172
type 2 39, 42, 67, 68, 68t, 71t, 73
prevalence of 66
self-care management in 85
symptoms of 70, 71f
treatment of 84
type 1, pathophysiology of 69
type 2, pathophysiology of 70
types of 67
Diabetic coma 73
Dialysate protein losses 209
Dialysis 209
Diarrhea 63, 117, 147, 157, 158, 173, 194, 195, 253, 255, 283, 285
severity of 168
Diazepam 285
Diet 72
modifications 25
recommendation 96
therapy, long-term 203
Dietary
assessment 8
fat 76
fibers 167
management goals 30
measures 275
nutrient deficiencies 177
pattern 46
protein intake 209
recommendation 107
Digesting starch
rapid 78
slow 78
Digestive juices 156
Digestive system 22
Digestive tract 182
Diglycerides 177
Dilution method 56
Disaccharides deficiency, secondary 174
Distant metastasis 136
Diverticular disease 162
diagnosis 162
medical
management 162
nutrition therapy 162
uncomplicated 162
Diverticulitis 162
D-lactic acidosis 161
Docosahexaenoic acid 18, 97
Donor liver transplant 182
Drug
absorption 282
clearance 29
nutrient interactions 281
Dual energy X-ray absorptiometry 56
Dumping syndrome 62, 157
diagnostic criteria 158
etiology 157
medical nutrition therapy 158
pathophysiology 158
prevalence 157
Duodenum 281
Dysgeusia 285
Dyslipidemia 114, 131, 197, 214, 225
Dyspepsia 155, 156
etiology 155
medical nutrition therapy 156
pathophysiology 155
prevalence 155
treatment of 156
Dysphagia 35, 256
diet 148, 256
consistencies 151f
dysgeusia 252
impairment 256
pureed 257
Dysrhythmias 29
E
Eating disorder 267, 269
Eicosapentaenoic acid 97
Electrocardiogram 96
Electrolyte 222
abnormalities 185
disturbances 223b
status 276
Electronic kids dietary index 6
Emphysema 103
Encephalitis 289
Encephalopathy 182, 185
Enchondroma 262
Endocardium 218
Endocrine 29
disorders 207
Endoscopic procedures 166
Endoscopy 183
Endothelium 291
Energy 3, 9, 11, 16, 21, 30, 31, 75, 82, 107, 222, 223, 268
balance 76
lack of 104
needs 16
oral nutritional supplement 249
requirement 142, 209, 254, 258
restricted diets 45, 46
Enteral feeding
formula 235
routes of 297fc
Enteral nutrition 3, 3t, 179, 192, 234, 239, 243, 255, 296
administration, methods of 298f
complications of 297t
group 108
supplementation 210
Enterocolitis 291
necrotizing 1
Enzymatic deficiency 187
Enzyme 154, 164
deficiency 286
Epicardium 217
Epinephrine 240
Equanil 285
Erythromycin 284
Esomeprazole 283
Esophageal
dilation 155
sphincter, lower 154
stricture 155
Esophagitis 155
Esophagus 154
Essential fatty acid profile 237
Estimated glomerular filtration rate 118, 120
Estrogen 265, 267
deficiency 266
Ethanol 285
Exacerbate anorexia 239
Exercise 48, 109
External beam radiation therapy 145
Eyes 9
F
Famotidine 283
Fast heartbeat 218
Fasting glucose, impaired 20
Fasting plasma glucose 42, 68
Fat 11, 18, 21, 31, 81, 82, 96, 108, 186, 268
and oils, role of 276
in exercise, role of 276
metabolism 184
requirements 258
soluble vitamins 235
understanding 276
Fatigue 73
Fatty acid 242
compositions 45f
long-chain polyunsaturated 15
source of 247
Fatty liver disease, nonalcoholic 95, 182, 184
Feeding
routes 244f
tube
duodenal 286
jejunal 286
Ferritin 141
Fertility 15
Fever 117
Fiber 19, 31, 79, 97, 211, 213
Flat bones 262
Fluid 108, 125, 186, 193, 222, 234
balance 236
management 258
recommendations 60
requirements 2, 142
restriction 211
Folate 32, 62, 211, 223, 268
Folic acid 18, 62, 206, 283, 292
Food 136
and drug
absorption 29
administration 79
interaction 142, 281
and nutrient intake 253
and nutrition evaluation 59
drug interactions 286, 287
risk factors for 282
group 149
high carbohydrate 273
intolerance 63
on drug therapy 282
sources 32
Foot problems 73
Fractures 262
risk of 29, 266
Frequent respiratory infections 104
Fructose malabsorption 163
diagnosis of 163, 164
medical nutrition therapy 163
pathophysiology 163
prevalence 163
symptoms 163
Furosemide 283
G
Gastric
access 243
banding, laparoscopic adjustable 60
drainage 230
emptying 29
rapid 157
esophageal reflux 20
region, lower 154
residual volume 243b
Gastroesophageal reflux disease 154
diagnosis 154
etiology 154
pathophysiology 154
prevalence 154
Gastrointestinal bleeding 182, 185, 187, 206
Gastrointestinal disorders, nutritional management in 154
Gastrointestinal function 15, 142, 252
Gastrointestinal obstructions 155
Gastrointestinal strictures 155
diagnosis 155
medical treatment 155
pathophysiology 155
Gastrointestinal system 9
Gastrointestinal tract 154, 229, 291
function of 15
Gastroparesis 157, 207
diagnostic criteria 157
etiology 157
medical nutrition therapy 157
pathophysiology 157
symptoms of 157
Gastroschisis 229
Genetic 51, 103, 137
predisposition 91
Geriatric nutrition 28
Gestational age 1b
large for 73
Gestational diabetes mellitus 20, 67, 70, 73, 74t, 77, 82, 82t
complications of 73, 73t
pathophysiology of 70
prevalence of 66
Ghrelin 52, 57
Giant cell tumor 262
Global nutrition report 13
Glomerular filtration rate 29, 36, 113, 185, 203
Glomerular renal pathology 205
Glomerulonephritides 115
Glomerulonephritis 115, 131, 205
primary 112
secondary 112
Glomerulosclerosis, focal segmental 205
Glucagon-like peptide-1 57
Glucocorticoid 265, 270
osteoporosis 268
Gluconeogenesis, hepatic 241
Glucose 223
intolerance 214, 258
tolerance, impaired 70
Glutamine 82, 255
Glutathione 82
Gluten
consumption of 171
free diet 173, 178
hidden sources of 177
Glycemic control 77, 208
poor 114
Glycemic index 44, 48, 78, 79, 80t, 273
calculation of 79, 79f
Glycemic load 48, 77, 79
calculation of 79, 79f
Glycogen 276
Graves' disease 172
Growth 4
and development 4f
charts 1, 7, 8
hormone 232, 267
Guillain-Barré syndrome 289
Gums 9
Gut
bacteria 211
function loss 167
hormone, role of 57, 57t
microbiota 289
Gypothyroidism 29
H
H1N1 influenza 23
Hair 9
loss 63
Hamwi's method 207, 252, 253t
Handgrip strength 141, 190, 207, 253
Hashimoto's thyroiditis 172, 290
Head circumference 7
Heart 217
chambers of 218
conditions 218
disease 218
congenital 90, 218
control 87, 211
ischemic 87, 114
failure 90, 218, 222
chronic 219
end-stage 217
medication 284
physiology and functions of 217
structure of 88f
transplantation 217, 225
contraindications for 217, 217t
indications for 217, 217t
nutrition therapy for 217
valve 218
diseases 90
wall, layers of 217
Heartbeat, slow 218
Heartburn 20, 155
Heat stress, risk of 273
Height-for-age 7
Helicobacter pylori 155
Hematocrit 141
Hematopoietic cell transplant 142, 145, 146
Hemodialysis
effects of 207
maintenance 205
Hemoglobin 59, 114, 141
glycated 46
glycosylated 196
Hemorrhoids 19
Hepatic failure 248
Hepatitis 289, 291
B virus 182, 184
C virus 182, 184
chronic 136
Hepatorenal syndrome 185
Herbal supplements 77
High-density lipoprotein 40, 42, 70, 91, 92, 93t, 211
cholesterol 43, 46, 93t, 94
High-fructose corn syrup 44
High-low density lipoprotein 81
Hirschsprung's disease 159
Hormone 265, 269
levels 267
pituitary-releasing 22f
preparations 284
therapy 145
ablative 145
additive 145
Human development index 135
Human immunodeficiency virus 67, 282
Human leukocyte antigen 71, 170
Human milk fortifier 3
Hydration tips 274
Hydrochloric acid 156
Hydrometry 56
Hydrosoluble vitamins 213
Hydroxyproline 264
Hydroxytyrosol 47
Hyperbilirubinemia 73
Hypercalcemia 214
Hypercholesterolemia 131
Hyperglucogonemia 207
Hyperglycemia 20, 73
steroid-induced 151
Hyperkalemia 121, 195, 210, 213
Hyperlipidemia 94, 196, 224
post-transplant 197
Hypermetabolism 142
Hyperoxaluria, primary 187
Hyperparathyroidism 268
Hypertension 35, 42, 73, 87, 93, 98, 112, 114, 115, 185, 197, 214, 224
Hyperthyroidism 29, 268
Hypoalbuminemia 131, 205, 221
Hypocalcemia 151
Hypoglycemia 151, 158, 256
neonatal 73
reactive 63
Hypokalemia 168, 210
Hypomagnesemia 168
Hyponatremia 258, 274
Hypophosphatemia 168
Hypothermia 240
risk of 29
Hypothyroidism 15
I
Ibuprofen 206
Ileostomy 161, 161t
Ileus 194
Immune 29
function 251, 288, 293
Immunoglobulins 21
Immunosuppressive drugs 203
dosages of 213
Immunosuppressive medications
high doses of 213
side effects of 195t
Immunotherapy 145, 288
role of micronutrients in 288
Infant feeding 9
Infection 24, 73, 185, 213
bacterial 194
prevention of 213
risk 239
Inflammation 166, 268
Inflammatory bone disorders 268t
Inflammatory bowel disease 162, 164, 269, 290
classification 164
diagnosis 166
medical nutrition therapy 166
pathophysiology 165
prevalence 165
subdivision 164
symptoms 165
Insulin
resistance 41, 207
sensitivity 29
therapy 84
Intensity stem cell transplant 145
Interleukin-6 46
Interstitial pneumonitis 289
Intestinal adaptation, phenomenon of 230
Intestinal failure 228, 229
associated liver disease 231
cause of 229
classification of 229
complications of 231
etiology of 230
managing 232
nutritional implications of 231
Intestinal fistula 230
Intestinal insufficiency 162
Intestinal ostomy 161
indications for 161t
types of 161
Intestinal rehabilitation 236
Intestinal resections 228
Intestinal transplantation 228, 232, 233
contraindications for 229t
indications for 229t
nutrition therapy for 228
Intra-abdominal sepsis 162
Intracranial pressure 258
Intraepithelial lymphocytes 170
Intrauterine growth restriction 16f
Iodine 18
Iron 11, 18, 32, 62, 143, 211, 213, 237, 292
deficiency 18
anemia 18
Isocaloric nutrition 246
Itching 117
J
Jamar's hydraulic handgrip dynamometer 191, 191f
Jaundice 182, 187
Jejunum 286
K
Kawasaki disease 90
Ketoacidosis 73
Ketone body 242
Kidney 112
function 112, 204, 205
injury, acute 115, 116, 249
physiology 203
and functions of 203
Kidney disease 205
causes of 112
chronic 112, 113, 116, 117, 119t, 203, 205, 206
outcomes quality initiative guidelines 117, 125t
risk factors for 114
stages of 114t, 125
types of 115
Kidney failure
chronic 205
levels of 211, 212t
Kidney transplantation 205
early phase of 213
nutrition therapy for 203
L
Lactase deficiency 286
types of 164
Lactase enzyme, use of 164
Lactation 20
Lactose 21
malabsorption 164
Lactose intolerance 63, 164
etiology 164
medical nutrition therapy 164
pathophysiology 164
prevalence 164
Lambert-Eaton syndrome 151
Late evening snack 192
Lean muscle mass 29
Lean protein foods 275
Lecithin 286
Leptin 52, 267
Librium 285
Ligamentous stiffness 29
Linoleic acid 18
Lipid 44, 246
metabolism 91
profile 58
Lipoic acid 82
Lipoprotein 93
Lips 9
Liver
anatomy of 182, 183f
biopsy 183
enzymes 183
functions of 182
injury, chronic 183
role of 184b
Liver cirrhosis 183
complications 184
epidemiology 183
Liver disease 183, 185, 186, 228
alcoholic 182, 184
chronic 95, 102, 184t, 185
end-stage 188t, 189
etiology of 184
late stages of 186
management of 182
nutritional consequences in 185
Liver failure
acute 187, 205
chronic 184
Liver function
laboratory assessment of 183
test 58
Liver transplant 182, 187, 194
candidates 187
living donor 182
nutrition therapy for 182
wait-listed for 191
Loop of Henle 204
Lorazepam 285
Low birth weight 1, 18, 24, 114
causes for 24
Low fiber vegetables 235
Low glycemic index carbohydrates, role of 273
Low-density lipoprotein 93, 93t
cholesterol 46, 94
classification of 93t
Low-fructose alternatives 163t
Low-glycemic index 46, 48
Lung 102
cancer 103
capacity 29
diseases
affecting air sacs 103
types of 103
disorders 109
causes of 102
Lymph nodes, regional 136
Lytic cancer 263
M
Macronutrient 72
distribution 76
Macrosomia 73
Magnesium 25, 32, 82, 143, 173, 213, 223, 268, 269, 283
Malnutrition 7, 28, 34, 137, 187, 219, 254
causes of 31, 33t, 188t
chronic 220
consequences of 105, 242
etiology of 187
grade of 7
impact of 188
incidence of 187
inflammation score 208
mild 7
moderate 7
parameters 138, 138b
prevalence of 187, 251
risk of 187, 219, 239, 242, 248
severe 7, 242
Maple syrup urine disease 187
Marathons 276
Maternal iodine deficiency 18
Maternal malnutrition, negative impact of 16f
Mean corpuscular
hemoglobin 141
volume 141
Mechanical ventilation 239
Medical nutrition therapy 44, 63, 66, 74, 75, 76t, 82, 82t, 96, 112, 113, 154, 155, 161, 174, 206, 221, 222, 232, 248b, 268, 286
goals of 75
Mediterranean diet 46, 98, 99f
Menopause period 25
Meprobamate 285
Mesenteric ischemia 229
Metabolic acidosis 121, 206
Metabolic bone disease 232
Metabolic disease 187
chronic 85
Metabolic syndrome 39, 40, 41, 42t, 43, 43f, 47t, 197
causes of 40
diagnosis of 41
pathophysiology of 40, 41f
prevalence of 39f, 47
reversal of 47
risk factors of 41
treatment of 46t
Metabolism 182
Microbiome 154
Microbiota 211, 290
immune functions 289
Micronutrient 31, 32t, 77, 81, 143, 290
deficiencies 253, 290
multiple 171
deficient cancer 288
supplements 211
Mid-upper arm
circumference 7
muscle area 140
Milk
production, physiology of 22f
sugar 164
Mineral 16, 31, 82, 98, 109, 193, 223, 255
deficiencies 166, 267
supplementation 198
Mini-nutritional assessment 30, 96, 140
Mitral regurgitation 219
Mitral valve 218
prolapse 219
Monoamine oxidase 284
inhibitors 284
Monounsaturated fats 44
Monounsaturated fatty acid 31, 44, 97
Morphine 285
Mortality 186
Motility disorders 160
Motor skills 29
Mucosal defense mechanism, reduced 160
Mucosal structure 168
Multicentre growth reference study 8
Multiple organ dysfunction 239
Multiple sclerosis 290
Multivitamin 3, 61
supplementation 167
Muscle
cramps 117
loss 239
mass 138
tissue 272, 273
wasting 249
Musculoskeletal issues 251
Mycobacterium 103
Mycophenolate mofetil 195
Mycophenolic acid 195
Myocardial infarction 218
Myocardial irritability 29
Myocarditis 289
Myocardium 217
N
Nasogastric suctioning 234
Natural killer cells 289
Nausea 15, 117, 147, 155, 157, 195, 219, 255, 285
Neonatal intensive care unit 73
Nephritic syndrome 132, 205
Nephritis 289
Nephrolithiasis 205
Nephron 204, 204f
structure of 132f
Nephropathy 73
Nephrotic syndrome 131, 205
onset of 115
Neurological disorders 35
Neuronal density 29
Neuropathy 73
peripheral 289
Neuropsychiatric anomalies 185
Neutropenic diet 148, 150f
principles of 148
Niacin 211
Nitric oxide 185
Nitrogen excretion 248
Noncommunicable disease 28, 54, 66, 87
Nonketotic hyperosmolar coma 73
Non-nutritive sweeteners 77, 79
Nonsteroidal anti-inflammatory drugs 156, 206, 283, 284
Nonsteroidal drugs 285
Norepinephrine 240
Normal kidney, functions of 113f
Nosebleeds 117
Nutric score 242
Nutrient 32
absorption of 249, 283
adequacy of 222
deficiency 9
extra allowances of 17t
metabolism 184b, 186
reference values 18t
requirement 2fc, 30, 31
guidelines 117
right 21
role of 272
supplements 61, 157
Nutrition 13, 198, 232, 272
assessment 7, 43, 96, 106, 139, 173, 206, 219, 242, 252, 278
components of 107
counseling 278
delivery, mode of 243
education 279
for endurance 272
for sustenance 272
goals, primary 251
intervention 212, 221, 255
management of 102, 145
plays 206
post-bariatric 51
post-transplant 233
recovery 275
rehabilitation 214, 224, 236
risk index 140
risk screening tool 6
Nutrition care
immediate postsurgery 59
planning 254
postoperative 248
preoperative 248
process 5, 5f
Nutrition focused 253, 254
physical finding 9
Nutrition monitoring 175
long term 236
Nutrition screening 206, 242
and assessment 15, 28
tool 140t
Nutrition status 28, 237t
range of 252
Nutrition support 143, 178
hospital strategy for 242
mode of 235
progression of 235t
Nutrition therapy 188, 191, 240
effectiveness of 76
Nutritional care
after cancer treatment 152
re-assessment of 179
Nutritional deficiency, biochemical assessment for 8
Nutritional goals 113
long term 197
Nutritional guidelines, post-transplant 197t
Nutritional intervention 87, 134, 143, 174, 192, 223
modalities 143
Nutritional management 28
Nutritional modifications 16, 23
Nutritional needs 16, 22
Nutritional rehabilitation, long-term 180
Nutritional repletion 142
Nutritional requirement 142, 173, 245, 248, 278
Nutritional screening 5, 43, 96, 139, 252
Nutritional status 240, 247fc, 281, 285
and management 251
drugs on 285
evaluation of 252
Nutritional strategies 177
Nutritional supplement 288
Nutritional support 31, 194
goals of 209
Nutritional therapy 107, 192t, 193t, 194t
O
Obesity 15, 20, 34, 42, 46, 51, 53, 54t, 73, 91, 93, 110, 136, 142, 196, 197, 214, 224
behavioral factors of 35fc
causes of 51
environmental of 35fc
Odynophagia 285
Olanzapine 286
Omega-3 fatty acids 255
Omeprazole 283
Optimal nutrition support therapy 248
Oral administration 281
Oral diet 235
Oral glucose tolerance test 20, 68, 74
Oral glutamine 143
Oral hypoglycemic agents 84
Oral intake 256
Oral nutrition 194
supplement 192
Oral protein-energy supplementation 210
Oral rehydration solution 162
Organic matrix 264
Orthopedic
disease 267
disorders 267
Osteoarthritis 37
Osteoblastoma 262
Osteoblasts 265
Osteocalcin, carboxylation of 269
Osteochondroma 262
Osteoclasts 265
Osteocytes 265
Osteogenesis imperfecta 263
Osteoid osteoma 262
Osteoma 262
Osteomalacia 233, 263
Osteomyelitis 263
Osteopetrosis 266, 268
Osteoporosis 37, 37f, 109, 171, 262, 263, 265, 266, 268, 269, 283
development of 263
Osteoprotegerin 267
Osteosarcoma, risk of 267
Osteosclerosis 266
Ostomy 161
Overeating 52
Overweight 54t, 136
Oxandrolone 285
Oxidative cellular injury 240
Oxygen consumption 245
P
Paget's disease 262, 267, 268
Pagophagia 19
Pain, abdominal 117, 155, 171
Painkillers 284
Palliative care 148
Pancreatic beta-cell dysfunction 70
Pancreatitis, severe acute 243
Pancuronium 285
Paralysis 258
Paralytic ileus 258
Paraneoplastic syndromes 151
Parathormone 265
Parathyroid hormone 59, 123, 263, 267
Parenteral nutrition 1, 2t, 159, 179, 193, 228, 233235, 245, 256
group 108
partial 255
total 210, 256
Parkinson's disease 36
Paroxysmal renal colic 205
Pediatric malnutrition screening tool 6
Pediatric nutrition
risk score 6
screening tool 6
Pediatric Yorkhill malnutrition score 6
Penicillin 284
Peptic ulcer 156
diagnostic criteria 156
etiology 156
medical nutrition therapy 156
pathophysiology 156
prevalence 156
Peptide tyrosine-tyrosine 57
Percutaneous endoscopic gastrostomy 143
Periactin 285
Pericarditis 90, 289
Perimenopause 25
Perinatal death 73
Peripheral vascular disease 87
Peritoneal dialysis, effects of 207
Peritonitis, bacterial 185
Pharmacokinetic interactions 281
Phosphorus 122, 125, 211, 213
high 126, 127
levels 125
low 126, 127
medium 126, 127
Physical inactivity 136
Placenta 16
Plasma
cell dyscrasias 112
glucose 74
homocysteine 59
Platelet count 141
Pleural mesothelioma 290
Pneumoconiosis 103
Pneumonia 103
Polycystic kidney disease 205
Polycystic ovary syndrome 43, 95
Polydipsia 73
Polymyositis 172
Polyphenol 47
Polyunsaturated fats 44
Polyunsaturated fatty acid 31, 97, 108
Polyuria 73
Polyvinyl chloride 232
Postjejunal resections 159
Postpyloric feeding 244
Postrenal transplantation 213t
Potassium 32, 125, 213, 223, 269, 283
high 128, 129
low 128, 129
moderate 128, 129
Potential nutritional, side effect 195
Prealbumin 223
Precachexia 139f
Prednisone 285
Pre-eclampsia 73, 95
Pregnancy 14, 18, 20
weight gain 16
Premenstrual syndrome 25
Pressure ulcers 257
risk of 239
Presurgery nutrition management 58
Preterm delivery 73
Pretransplant nutrient requirements 222t
Pretransplant nutrition
goals 208
requirement 209
therapy 191
Probe test 154
Protein 3, 18, 21, 30, 31, 45, 76, 81, 82, 96, 108, 209, 222, 223, 268, 274
and energy intake 213
binding capacity 29
deficiency 63
diets, moderate-high 46
energy
malnutrition 113
wasting 205, 207
hypercatabolism 214
intake 246
losses 249
metabolism 184
needs 16
requirement 118, 125t, 142, 209, 246, 254, 258
rich foods 275t
supplements, pros and cons of 277
synthesis, hepatic 185
Proteinuria 114, 205, 210
Proton therapy 145
Pruritus 291
Pseudoephedrine 284
Psoriasis 290
Pulmonary artery 218
Pulmonary diseases 259
Pulmonary edema 103
Pulmonary function 15
Pulmonary stenosis 219
Pulmonary valve 218
Pyridoxine 184, 186
Q
Quality of life 228, 232
Quercetin 47
R
Radiation 137
therapy 145, 146
types of 145
Radiotherapy 145
Ranitidine 283
Rash 117, 291
Red blood cells 112
Refeeding syndrome 195, 245
Reflexes 29
Refractory cachexia 139f
Regurgitation, complication of 243
Rehabilitation 251
long term 257
setting, nutritional management in 251
Renal blood flow 29, 185
Renal disease 36, 112, 127, 232
chronic 203
end-stage 112, 205
progressive 116f
stages of 113
Renal failure
acute 115
chronic 116, 131
functional 185
malnutrition in 207b
Renal function 16
Renal stones 205
Renal transplant
contraindications for 203t
indications for 203t
Replenish carbohydrate 276
Reproductive readiness 15
Residual volume 29
Resistant starch 78
Respiratory allergies 102
Respiratory compromised 249
Respiratory diseases 102
chronic 102
Resting energy expenditure 197
Resveratrol 47
Retinopathy 73
Rheumatoid arthritis 172, 290
Riboflavin 292
Risperidone 286
Roux-en-Y gastric bypass 60
Ryle's tube 256
S
Saccharomyces boulardii 168
Salivation 29
Sarcopenia 139
diagnosis of 270
Sarcopenic obesity 34
Saturated fats 44, 96, 211
Saturated fatty acid 96
Scapular region 254
Scleroderma 172
Sclerosing cholangitis, primary 172
Sclerotic cancer 263
Secretory proteins 186
Sedentary lifestyle 94, 114
Selenium 157, 237, 290
Sensitivity 29
Sensory 29
functions 251
Sepsis 142, 240
Septic shock 240
Serotonin 267
Serum
calcium 59
creatinine 114
electrolyte 234, 247
folate 59
proteins 186, 208
triglycerides 42
Sesamoid bones 262
Sexual dysfunctions 73
Shock state, uncontrolled 243
Short bowel syndrome 158, 160b, 228, 233
etiology of 159, 159t
medical nutrition therapy 159
pathophysiology 159
Shoulder
dystocia 73
region 254
Sick day management 84
Sickle cell nephropathy 112
Sinoatrial node 218
Sirolimus 195
Sjögren's syndrome 172
Skeletal fluorosis 263
Skeletal health, assessment of 270
Skeleton disorders 265
Skin 9
complications 73
pigmentation 29
Skinfold
measurement 7, 220
suprailiac 220
thickness 55, 207, 220, 253
triceps 140, 189, 220
Sleep apnea 72
Sleeve gastrectomy 52
Small bowel transplant 233b
Small intestinal villi 171
Small intestine bacterial overgrowth 160
etiology of 160, 160t
medical nutrition therapy 161
pathophysiology 161
Smoking 224, 269
Smooth muscle cells 91
Sodium 32, 77, 82, 125, 193, 213, 222, 223, 283
and potassium balance 210
glucose cotransporter-2 84
intake 210
restriction 249
Soft diet 60
choices 60
Soft foods 157
Soluble fiber 236
Somatotropin 265
Sound 29
Spinal cord
compression 151
injury 243, 252, 253, 253t, 258
Spironolactone 283
Splanchnic vasodilators 185
Sports food 277
Sports medicine, academy of 277
Sports nutrition 272
requirements 272
role of supplements in 277
Steatohepatitis 231
nonalcoholic 43, 184
Steroids, amounts of 213
Stomach 154, 286
dysfunctions 155
muscle, paralysis of 157
Stress 83
metabolic response to 240
states of 246
Strict gluten free diet 177
Subcutaneous fat 29
Subscapular skinfold 220
Substantial resection 228
Sulfa drugs 284
Superior mesenteric
artery thrombosis 228
vein thrombosis 228
Surgery 144, 146
Sweat glands 29
Swelling 117
Syndrome of inappropriate antidiuretic hormone secretion 151
Syngeneic transplant 145
Synthetic dysfunction 182, 187
Systemic lupus erythematosus 172, 206
T
Tachycardia 218
Tacrolimus 195
Taste acuity 29
Teeth 9
Temporalis 254
Tetracycline 283
Therapeutic nature 255
Thiamine 184, 223
Thick oral secretions 147
Thirst sensation 29
Thorazine 285
Thrombocytopenia 289
Thyroid
disease 95
function 29
stimulating hormone 267
Thyroxine 265
Tidal volume 29
Tissue
atrophy, high risk of 249
perfusion 29
TNM staging system 136, 136b
Tobacco 266
Tongue 9
Total iron-binding capacity 59, 141
Toxic
free radicals 288
substances 155
Toxicities 288
Toxins 15
Transfatty acids 97
Transient ischemic attack 87
Trauma 228, 248
abdominal 229
severe 248
Traumatic injury 240
Tricuspid valve 218
Triglyceride 43, 46, 94, 220
concentrations 211
medium-chain 160
Tropical sprue 167
causes 167
diagnosis 168
medical nutrition therapy 168
prevalence 167
symptoms 167
treatment 168
T-score 270, 270f
Tuberculosis 103
Tubular necrosis 213
Tubulointerstitial nephritis, chronic 112
Tumor 262
abdominal 159
modification environment 289
necrosis factor-alpha 46, 48
primary 136
Tyrosinemia 187
U
Ulcerative colitis 161, 164, 165, 165t
Ulcers 194
Upper gastric region 154
Uremia 207
Urinary excretion 283
Urinary tract infection 205
Urine albumin-to-creatinine ratio 118
Uterine environment 16
V
Valproic acid 285
Vascular disease 87
Vasculitis 112
Vegan diet 99
Venous thromboembolic complications 151
Vertebral fracture recognition 270
Very low density lipoprotein 93
Visual acuity 29
Vital micronutrients, role of 289
Vital organs 219
Vitamin 16, 31, 47, 82, 98, 109, 166, 186, 193, 198, 211, 247, 255, 269
A 19, 184, 186, 235, 237, 265, 268, 269, 289, 292
deficiency 168
and minerals 276
functions 184
B1 61, 166, 184
B12 32, 61, 81, 158, 184, 223, 237, 268, 289, 290, 292
absorption 283
deficiency 292
serum 59
B3 81
B6 184, 206, 211, 289
C 32, 82, 143, 157, 206, 211, 237, 265, 268, 269, 282, 288290, 292
deficiency 105
D 19, 25, 32, 61, 81, 110, 124, 166, 173, 184, 186, 205, 211, 236, 237, 268, 269, 283, 289, 290, 292
absorption of 233
deficiencies 290, 291
insufficiency 232
metabolism 214
monitoring of 283
supplements 283, 290
D3 213, 265
E 32, 81, 184, 186, 235, 289, 292
K 25, 32, 166, 184, 235, 265, 269, 283, 285
Vitiligo 291
Volvulus 228
Vomiting 15, 117, 147, 195, 230, 255, 285
W
Waist circumference 42, 44, 53, 55
Waist-to-hip ratio 42, 54, 55, 55t
Warfarin 285, 287
Water from tissues, loss of 158
Weight 7, 54
category 17
gain 142
management 279
stabilization, nutrition care for 63
Weight loss 47, 249
presurgery 59
involuntary 142
Weight velocity 4
standards 5t
Weight-for-age 7
Weight-for-height 7
Wheezing 104
White blood cell count 141
Wound healing 213
X
Xerostomia 147
X-ray absorptiometry 56
Z
Zinc 11, 32, 62, 82, 211, 237, 269, 289, 292
Z-score 7, 270
×
Chapter Notes

Save Clear


Apollo Clinical Nutrition Handbook
Disclaimer
The contents of the book are updated nutrition resource for management of patients. They are based on currently available evidence and relevant guidelines, recommendations and research which have been used by the authors. The field of medical nutrition is a dynamic science, these nutritional facts which are widely accepted today, may be discredited in the coming years which we all have witnessed in recent years with changes in the medical nutrition therapy and will need to be updated as newer scientific theories gets evolved.
The publisher, authors, contributors and editors will not be held liable for any errors or discrepancies due to new developments in medical science.
Apollo Clinical Nutrition Handbook
Editors Anita Jatana Consultant Dietetics Indraprastha Apollo Hospitals New Delhi, India Daphnee DK Chief Clinical Dietician and Head Department of Dietetics Apollo Hospitals Chennai, Tamil Nadu, India Haritha Shyam Chief Dietician Apollo Hospitals Hyderabad, Telangana, India Priyanka Rohatgi Chief Clinical Dietician Apollo Hospitals Bengaluru, Karnataka, India Kajal Pandya Yeptho Chief Dietician Indraprastha Apollo Hospitals New Delhi, India Foreword Berthold Koletzko
Jaypee Brothers Medical Publishers (P) Ltd
Headquarters
Jaypee Brothers Medical Publishers (P) Ltd
EMCA House, 23/23-B
Ansari Road, Daryaganj
New Delhi 110 002, India
Landline: +91-11-23272143, +91-11-23272703
+91-11-23282021, +91-11-23245672
Corporate Office
Jaypee Brothers Medical Publishers (P) Ltd
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
Phone: +91-11-43574357
Fax: +91-11-43574314
Overseas Office
J.P. Medical Ltd
83 Victoria Street, London
SW1H 0HW (UK)
Phone: +44 20 3170 8910
Fax: +44 (0)20 3008 6180
© 2022, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. The CD/DVD-ROM (if any) provided in the sealed envelope with this book is complimentary and free of cost. Not meant for sale.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Apollo Clinical Nutrition Handbook
First Edition: 2022
9789354650895
Printed at
Dedicated to
All those who provide strength to strengthen due to the sheer relevance of their contributions in furthering nutrition science and promoting public health in the country.
India has nurtured excellent frontline and healthcare professionals in various fields, credit for this goes to the hard work and dedication of our scientific fraternity.
As a nation the dieticians, doctors, academicians, researchers and students have contributed enormously to India's rapid ascent in the last 75 years. The evolution of nutrition as a modern science coincides with the growth of independent India.
Contributors Foreword
Berthold Koletzko MD PhD
LMU University Hospitals, Munich, Germany
Improving the Practice of Nutritional Care for the Benefit of Patients
The important role of the diet for health has been appreciated and emphasized since the very beginnings of medicine. Hippocrates, the famous Greek physician of the 5th century BC that is often considered as the Father of Medicine, stated “The most famous doctors cure by changing the diet and lifestyle of their patient and, by using other substances. Such capable doctors have the knowledge and ability to use the therapeutic properties of most natural or man-made products”.1 Similarly, the Canon of Medicine from the 10th and 11th centuries AD ascribed to Ibn Sina (Avicenna) of Persia, one of the most significant physicians and thinkers of his time, highlighted changes of lifestyle and especially of diet as a particularly important therapeutic approaches for the treatment of diseases.2 With the advent of modern medicine and the enormous success of pharmacological, surgical and other current treatment modalities, the importance of nutrition for disease courses has often received less attention. However, this has changed in recent years due to accumulating scientific data that convincingly demonstrate the great impact of nutritional status on patient's outcome and quality of life. Many studies documented disease-related weight loss and underweight continue to be highly prevalent in both adult and pediatric hospital patients, and to be associated with increased care needs, prolonged length of hospital stay, delayed rehabilitation, lower quality of life, and increased morbidity and mortality.3,4 In addition, many people suffer from “hidden hunger”, i.e. micronutrient deficiencies in the absence of underweight that have marked adverse effects on body functions and health.5 Numerous studies documented that adequate and professional nutritional care can markedly reduce morbidity and mortality. For example, a recent meta-analysis showed clear benefits of oral and enteral nutritional support interventions in more than 6,800 non–critically ill medical inpatients enrolled in 27 controlled clinical trials.6 Patients receiving nutritional support had a 27% reduced risk to die, compared with patients in the control group (8.3% vs. 11.0%; odds ratio [OR], 0.73; 95% CI, 0.56–0.97). An even greater reduction in mortality to less than one half was found in the more recent trials published 2015 or later that reflect current clinical conditions (OR, 0.47; 95% CI, 0.28–0.79). Nutritional support was also associated with a significant reduction in non-elective hospital readmissions (14.7% vs. 18.0%; risk ratio, 0.76; 95% CI, 0.60–0.96). Obviously, nutritional care can benefit patients, and it can also contribute to reducing healthcare-related costs.
Evidence-based guidelines for translating the results of research into clinical application have been established.713 However, an important prerequisite for the practical implementation of good quality nutritional care is that healthcare professionals from all fields involved in patient care need to be empowered with easily usable, current evidence-based information and practical skills to enable application at the bedside.14 This book can contribute a great deal to this important goal, given that the chapters cover the most relevant key topics of clinical nutrition and provide succinct summaries of current knowledge and practical guidance for direct translational application in patient care. My sincere wish and hope is that this book will find a broad readership and will contribute greatly to enhancing the practice of nutritional care, for the benefit of many patients.
REFERENCES
  1. Tsiompanou E, Marketos SG. Hippocrates: timeless still. J R Soc Med. 2013;106(7):288–92.
  1. Avicenna IS. The Canon of Medicine of Avicenna [Translated to English by Oskar Cameron]. 2nd edn. New York: AMS Press Inc.;  1973.
  1. Hiesmayr M, Tarantino S, Moick S, Laviano A, Sulz I, Mouhieddine M. Hospital Malnutrition, a Call for Political Action: a Public Health and Nutrition Day Perspective. J Clin Med. 2019;8(12):2048.
  1. Hecht C, Weber M, Grote V, Daskalou E, Dell'Era L, Flynn D. Disease-associated malnutrition correlates with length of hospital stay in children. Clin Nutr. 2015;34(1):53–9.
  1. Lenaerts B, Demont M. The global burden of chronic and hidden hunger revisited: New panel data evidence spanning 1990–2017. Glob Food Sec. 2021;28:100480.
  1. Gomes F, Baumgartner A, Bounoure L, Bally M, Deutz NE, Greenwald JL. Association of Nutritional Support with Clinical Outcomes among medical inpatients who are malnourished or at nutritional risk: An updated systematic review and meta-analysis. JAMA Netw Open. 2019;2(11):e1915138.
  1. Weimann A, Braga M, Carli F, Higashiguchi T, Hubner M, Klek S. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr. 2021;40(7):4745–61.
  1. Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021;40(5):2898–913.
  1. Pironi L, Boeykens K, Bozzetti F, Joly F, Klek S, Lal S. ESPEN guideline on home parenteral nutrition. Clin Nutr. 2020;39(6):1645–66.
  1. Bischoff SC, Escher J, Hebuterne X, Klek S, Krznaric Z, Schneider S. ESPEN practical guideline: Clinical Nutrition in inflammatory bowel disease. Clin Nutr. 2020;39(3):632–53.
  1. Bischoff SC, Austin P, Boeykens K, Chourdakis M, Cuerda C, Jonkers-Schuitema C. ESPEN guideline on home enteral nutrition. Clin Nutr. 2020;39(1):5–22.
  1. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48–79.
  1. Mihatsch WA, Braegger C, Bronsky J, Cai W, Campoy C, Carnielli V. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition. Clin Nutr. 2018;37(6 Pt B):2303–5.
  1. Brands B, Tran NN, Baudendistel-Happ E, Sanchez-Garcia M, Fischer MR, Koletzko B. Global e-Learning in Early Nutrition and Lifestyle for International Healthcare Professionals: Design and Evaluation of the Early Nutrition Specialist Programme (ENS). Nutrients. 2021;13(3):775.
Preface
This book is written for qualified practicing health professionals as a reference for the medical nutritional intervention in various clinical states. Medical nutrition therapy (MNT) has gained importance in the past decade and today forms an integral part of prevention and curative therapy for patients with disease and also plays an important role in enhancement of human health. We have in India today, diseases, which are at two ends of the scale—the two extreme ends of the nutritional spectrum, the noncommunicable diseases (NCDs), and nutritional diseases at the other end, representing malnutrition and its associated nutritional deficiencies.
In the light of the above, it is imperative that we provide adequate knowledge to the medical fraternity as well as the public at large, the insight of how nutrition is essential for both preventive and therapeutic purposes. The present book is an honest attempt to reach out to the medical fraternity and the caregivers, the knowledge of the new findings, innovation, and all different aspects of nutrition therapy in various clinical conditions. The new discoveries in the 20th century have transformed the world of medicine and have enriched the science of nutrition. The focus from macronutrients and micronutrients has now also moved on to research, understanding the role of diet in treatment of various disease conditions and prevention of NCD, which has seen a huge increase. This is due to cultural change at regional, national, and global levels moving from balanced homemade meals to calorie-dense fast foods. In addition to the above, the mechanical gadgets, modern lifestyles have embraced sedentary behaviors. To bridge the gap—facts from fads, what we need now is to promote the knowledge and inculcate a deep thinking among all, the value of right nutrition for a healthy life.
This has become pertinent issue in modern times since our societies are being constantly bombarded with several messages from the print and visual media that create an illusion of health where food fads and dietary supplements rule without supporting clinical studies or data. As we got started on our joint knowledge venture into the world of health and nutrition, our first focus was to demonstrate that nutritional science is an evolving field of study, continually being updated and supported by research studies and trial.
This book is organized using a functional approach and is based on research and practical experiences. It comprises of chapters by experts in a diverse range of disease state, their cause and treatment. It will be a guide for the health professionals to make right choices to implement nutritional practices that will benefit the patients in clinical setting and help in the right advice at discharge. Powerful tool of scientific knowledge—used to design dietary guidelines and recommendations that will promote health and prevent disease. It is noteworthy that the authors have especially tried to include all aspects of patient care.
The book covers not only the nutritional needs for the patients recovering from NCDs such as obesity, diabetes, cardiovascular, metabolic, neurological, and renal disorders but will also venture into pediatric and even geriatric nutrition. Women's nutrition and health is another important area where lots have been researched upon but so little is implemented in clinical practice especially in developing nations. Focus on nutrition for prenatal and postnatal has to be given special emphasis since this is the cornerstone for propagation of human civilization.
Another aspect of medical science is critical care medicine where timely medical as well nutritional intervention is a cornerstone for survival. Thus, critical care nutrition is another important aspect that is also covered as separate chapter in the book. Nutrition can only be effective, if our digestive systems function optimally, hence nutrition for gut health is the other cornerstone for health which is also given due focus here. This has also gained more importance in recent areas with celiac disease becoming a new modern epidemic.
There are also certain other medical conditions where nutrition becomes important for both survival and recovery like burn patients, and those who have undergone transplantation or are recuperating from a trauma condition. Similarly, cancer is another condition where nutritional intervention has been shown to be major component that determines disease prognosis in conjunction with standard treatment. Chronic obstructive pulmonary disease (COPD) and asthma are on rise and their management is important to prevent repeated hospitalizations.
This book is for important “Nutritional Gatekeepers”, who can access to update nutrition resource for management of patients. These nutritional facts which are widely accepted today may be discredited in the coming years which we all have witnessed in recent years with changes in the MNT and will need to be updated as newer scientific theories get evolved.
Scientific research-based strategies focused with an interdisciplinary team approach could improve medical outcomes with optimal treatment and continuity of care post discharge. I am confident that this publication will prove very useful, educative reference for the doctors and clinical dieticians.
Anita Jatana
Daphnee DK
Haritha Shyam
Priyanka Rohatgi
Kajal Pandya Yeptho
Acknowledgments
The completion of this book could not have been possible without the participation and assistance of so many esteemed people whose contributions are sincerely appreciated and gratefully acknowledged. The group would like to express their deep appreciation, indebtedness and heartfelt gratitude to Dr Sangita Reddy, Joint Managing Director, Apollo Hospitals Group, for seeding the idea of this book into our mind. Her vision for the department and her deep insights about nutrition coupled with her unceasing support and guidance helped translate the idea into reality, and encouraged us all. “The Apollo Dietetics Group” to write this book which would work as a reference for the practicing dieticians and doctors. Her vision and insight of nutrition at large and constant guidance and mentoring has been the driving force to make this book a reality. The encouragement and blessings of the Apollo Hospitals Group Chairman, Padma Vibhushan Dr Pratap C Reddy, who is always a guiding force behind all our academic ventures for which we are forever grateful. We sincerely acknowledge with gratitude the support and guidance we receive from the leadership of Dr Preetha Reddy, Vice Chairperson, Apollo Hospitals Group, Ms Suneeta Reddy, Managing Director, Apollo Hospitals Group and Ms Shobhana Kamineni, Executive Vice Chairperson, Apollo Hospitals Group who have offered their unrelenting support to achieve this dream. We sincerely thank Dr Hari Prasad, President, Apollo Hospitals, for his constant guidance and enthusiastic encouragement for this project. Our most sincere gratefulness for the continuous support given by Mr P Shiv Kumar, Managing Director, Indraprastha Apollo Hospitals, Dr Ashok Hooda, Director (Medical Services), and Dr (Brig) Amit Roy, Deputy Director (Medical Services) who gave us this opportunity to go ahead in our clinical venture with their best wishes. We are immensely grateful to Dr Anupam Sibal, Group Medical Director who sparked the right stimulus in us. His able mentorship and expert guidance all throughout the journey have helped us in putting the chapters together and to make this book a success. Our special word of thanks to Dr Anjali Arya, Manager (Medical Services), for her constant and invaluable help at every step.
We are grateful to Professor Berthold Koletzko, Division of Metabolic Diseases and Nutritional Medicine, Dr von Hauner Children's Hospital, Munich, Germany, for his feedback and enthusiastic support with an encouraging foreword for this book.
We would like to acknowledge and express our gratitude to Dr Veenu Seth, Nutrition Consultant and Former Associate Professor and Head, Department of Nutrition and Dietetics and Dr Kalyani Singh, Nutrition Consultant and Former Associate Professor and Head, Department of Nutrition and Dietetics, Lady Irwin College, Delhi University who took out time from their busy schedule for guidance and editing support. Their suggestions and advice helped us refine our ideas and approach, throughout the creative process.
A special word of credit and thankfulness to the dynamic team of “The Apollo Dietetics Group” for their tremendous hard work of research in contributing towards their respective chapters despite their commitments to their routine work. Brilliant scientific inputs by Daphnee DK, Haritha Shyam, Priyanka Rohatgi, S Ramaya, Babita G Hazarika, Lekha Sreedharan, Kajal Pandya Yeptho, Champa Mazumdar, Varsha Gorey, Sunita Sahoo, Sandhya Singh, Ashwini B, Rajalakshmi P, Vijayalaxmi Sirasangi, A Sathya, S Nandhini, Syeda Amena Omer, Champakamala C, Sowmya Kalluri, Priya Chitale, Tamanna Chowdhury, Ananya Konar, Rajeswari A, Padmini BV, Gayathri Muppioi, Kanika Narang, Swati Srivastav, Shubh Rana, Suhani Seth, Binnu Singh, Sameya Sultana. Gratitude and best wishes to the entire Apollo Dietetics Team and hoping there will be more such successful projects in the future.
This book would not have been possible without the able support of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India. Their technical support, guidance, manuscript evaluation and patience are highly commendable.
About the Editors
“The Apollo Group Dieticians” have extensive experience and are practicing clinical nutrition at various multispecialty hospitals across the country. The team has been instrumental in raising the bar of Medical Nutrition Therapy across all Apollo Group of Hospitals. They are a part of the multidisciplinary team actively involved in patient care and are instrumental in improving clinical outcomes. Their expertise also involves educating patients and caregivers for therapeutic nutrition in both outpatient and inpatient settings. This dynamic team is actively involved in spreading health awareness through various outreach programs. Updating with the new advances in the field of clinical nutrition and simultaneously upskilling knowledge for evidence-based guidelines is a constant endeavor by them. They are also very actively involved in the field of nutrition research, besides patient care. This book is the outcome of the undaunted efforts and tremendous hard work of the dieticians of Apollo Group of Hospitals.