1 / 19

Diet and Nutrition C c Chong Li

Diet and Nutrition C c Chong Li. Nutrition Therapy Goals. • Prevent or reverse poor nutrition. • Maintain dose and schedule of cancer. treatments. • Manage symptoms. • Maintain or improve weight and. strength. • Maximize quality of life. 1. Objectives:.

amity
Download Presentation

Diet and Nutrition C c Chong Li

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. DietandNutrition C cChong Li NutritionTherapyGoals •Preventorreversepoornutrition •Maintaindoseandscheduleofcancer treatments •Managesymptoms •Maintainorimproveweightand strength •Maximizequalityoflife 1

  2. Objectives: • • • • • • • • • • • Overviewofdigestion/absorption Nutritionimplicationsofsurgery Commonsideeffects Whattoeat Supplements,fadfoods,specialdiets Resources CommonSideEffects Diarrhea Pancreaticexocrineinsufficiency Glucoseintolerance,diabetes Nauseaand/orvomiting Lossofappetite,weightloss 2

  3. CommonSideEffects(continued) • • • • • Tastechanges Earlysatiety Painwitheating Fatigue Constipation NutritionImplicationsof Surgery 3

  4. NutritionAfterWhipple Procedure Goals: •Reducediarrhea •Restoreadequatenutrition •Preventweightloss •Decreasesymptoms CommonSurgeryRelatedSide Effects • • • • • • Poorappetite Lactoseintolerance Delayedgastricemptying Dumping Glucoseintolerance/diabetes PancreaticInsufficiency 4

  5. Diarrhea •Workcloselywithmedicalteam (multiplecausesofdiarrhea): –TreatmentInduced –LactoseIntolerance –BacterialOvergrowth –Pancreatic/DigestiveInsufficiency NutritionTherapyforDiarrhea Independentofcause Limitoravoid: •Lactose(oraddlactase) •Insolublefiber •Foodssweetenedwithsugaralcohol •Sugarsweetenedbeverages 5

  6. NutritionTherapyforDiarrhea Independentofcause Increase: •Solublefiber •Fluids ProbioticsforDiarrhea •Sourcesofprobiotics: –Foods –DietarySupplements 6

  7. LactoseIntolerance •Maybetemporary •Maybeabletotoleratelowlactose foods •Providelactaseenzymespriortoa meal—avoidlimitingdiet SymptomsofPancreaticExocrine Insufficiency • • • • • • • • Feelingsofindigestion Crampingaftermeals Largeamountsofgas Foulsmellinggasorstools Floatingstoolsorgreasy/fattystools Frequentstools Loosestools/diarrhea Unexplainedweightloss 7

  8. EnzymeDosage •Findthebrandandthedosethatworksfor youandstickwithit. •Continuetoincreaseamountoflipaseper meal/snackuntilpancreaticinsufficiency symptomsareminimized/eliminated •Maximum:2500unitsoflipaseper kilogrampermeal(or10000unitsoflipase perkilogramperday). PancreaticEnzymes: Sideeffectsoftoomany •Constipation(mostcommon) •Nausea •AbdominalCramps •Diarrhea (Carefulnottoconfusewithsymptomsof inadequateenzymeuseorchemotherapy orradiationtreatment.) 8

  9. StatusofFDAApprovalProcess ApprovedbytheFDA: •CotazymnotcurrentlymanufacturedintheUnitedStates. •Creon®capsulesmanufacturedbySolvayPharmaceuticals,Inc. •Zenpep®capsulesmanufacturedbyEurandPharmaceuticals,Inc. PendingapprovalbytheFDA: •Pancrease®MTcapsulesmanufacturedbyMcNeil •Pancrecarb®capsulesmanufacturedbyDigestiveCare,Inc. •Ultrase®capsulesmanufacturedbyAxcanPharma •Viokase®tabletsorpowdermanufacturedbyAxcanPharma **Genericsnolongeravailable** GlucoseIntolerance/Diabetes • • • • Medication Meetwithadietitiantocustomizediet. Limitrefinedcarbohydrates. Eatcarbohydratesincombinationwithprotein,fiber,and fats. •Aftertreatment/surgerycomplete: •Followacarbohydratecontrolleddiet. •Consumehighfibercarbohydratefoods. •Whatfoodshavecarbohydrates? 9

  10. Nausea/Vomiting,PoorAppetite, EarlySatiety •Eliminateoffendingodors •Drycrackers/toastfornausea •Avoidoverlysweet,greasy/fried,orhighly spicedfoods •Useroomtempfoods •Oralcare •Eliminatestress •Medication TasteChanges •Rinsemouth •Metallictaste:useplasticutensilsand servingware •Enhancedulltasteusetartflavors •Trynewfoodsorfoodspreviously disliked •Zinc 10

  11. PainwithEating • • • • Avoidhighfiberfoods Chewfoodwell Takepainmedicationproactively Avoidconstipation Fatigue •Beactive: •Choosefoodsthatareless cumbersometochewandswallow 11

  12. Constipation •Hotfluids •Includehighfiberfoods •Limitgasformingfoods, carbonatedbeverages,straws, chewinggum Dumping:symptoms • • • • Flushing Sweating Feelingoflowbloodsugar LooseBM Generallyoccurwithin2hoursofeating. 12

  13. Dumping • • • • • Limitportionsizes Drinkliquidsbetweenmeals Avoidfoodshighinsugar Avoidhotliquids Addsolublefiber,guargum WhatshouldIeat? 13

  14. foods • Choose nutrient dense foods • Be active GeneralNutritionTips • Eatsmallfrequentmeals(6-8/day) • Planmeals/snacksthedaybefore • Getplentyoffluids • Limituse/portionsoffatcontaining • foods • Choosenutrientdensefoods • Beactive

  15. WhatshouldIdrink? Mostpatientsrequire6to12cupsperdayof non-alcoholicfluidperdaytomaintain adequatehydration.(8oz=1cup) LiquidNutritionalDrinks Non-diabetic Diabetic Homemadesmoothies 16

  16. LongTermHealth Plantbaseddiet •2½cupsoffruitsandvegetablesperday. –Evenbetter:3½-4½cupsperday. •HealthyFats •Limitredmeat LongTermHealth •Beactive •Takeenzymes •Takeacidreducingmedication(if prescribedbyyoursurgeon). •Followwithprimarydoctorfordiabetes managementandbonehealth. 18

  17. BeActive •30-60minutesof“purposeful”activityper daymostdaysoftheweek.Weight training/liftingstartasadvisedbyyour surgeon. SupplementRecommendations •“Oneaday”multiplevitaminandmineral supplement •CalciumwithvitaminD •Fishoil/Omega-3 19

  18. FrequentlyAskedQuestions •“ShouldIavoidsugar?” •“ShouldIeatorganic?” Herbal/Vitamin/Mineral Supplements CriteriatoAssistHealthCareProfessionalsinDeterminingWhetherto Recommend,Accept,orDiscourageSupplementUse EvidenceSupportingAction Requirement Efficacy Recommend Evidencesupports efficacy Accept Evidence inconclusiveon Discourage Evidencesupports inefficacy efficacy Safety Evidencesupports safety Evidencesupports safety Evidencesupports seriousrisk

  19. End of the Presentation • Thank you for your attention

More Related