Introduction

Clinical nutrition is nutrition of patients in health care. Clinical in this sense refers to the management of patients, including not only outpatients at clinics, but also (and mainly) inpatients in hospitals. It incorporates primarily the scientific fields of nutrition and dietetics. It aims to keep a healthy energy balance in patients, as well as providing sufficient amounts other nutrients such as protein, vitamins, and minerals.

Normally, individuals obtain the necessary nutrients their bodies require through normal daily diets that process the foods accordingly within the body. Nevertheless, there are circumstances such as disease, distress, stress, and so on that may prevent the body from obtaining sufficient nutrients through diets alone. In such conditions, a dietary supplementation specifically formulated for their individual condition may be required to fill the void created by the specific condition. This can come in form of Medical Nutrition.

In the field of clinical nutrition, malnutrition has causes, epidemiology and management distinct from those associated with malnutrition that is mainly related to poverty.

The main causes of clinical malnutrition are:

• Cachexia caused by diseases, injuries and/or aging
• Difficulties with ingestion, such as stroke, paresis, dementia, depression, dysphagia

Clinical malnutrition may also be aggravated by iatrogenic factors, i.e., the inability of a health care entity to appropriately compensate for causes of malnutrition.

There are various definitions of clinical malnutrition. According to one of them, patients are defined as severely undernourished when meeting at least one of the following criteria: BMI < or = 20 kg/m² and/or > or = 5% unintentional weight loss in the past month and/or > or = 10% unintentional weight loss in the past 6 months. By the same system, the patient is moderately undernourished if they met at least one of the following criteria: BMI 20.1–22 kg/m² and/or 5-10% unintentional weight loss in the past six months.

Rationale

This course includes the Dietary management of Different type of Diseases (weight management, cardiovascular disease, aged care, diabetes, nutrition support, oncology, gastrointestinal diseases, liver disease and renal disease).

Objectives

The course covers the application of dietary modifications in the treatment, management and prevention of different disease conditions. The unit covers the interactions between nutrition and clinical conditions (weight management, cardiovascular disease, aged care, diabetes, nutrition support, oncology, gastrointestinal diseases, liver disease and renal disease).

Outcomes

Students will be able to determine/know the techniques/procedures for Balanced Diet, Menu Planning, Diet for Growth & Development, Diet for Kidney Diseases, RDA, Diet preparation for Pregnancy and Lactation, Diet in Cardiovascular Diseases, Management of Diabetes Mellitus, Importance of Breast-milk, diet in Liver Diseases etc.

Text Books & References

• Nutrition and Dietetics with Indian case studies By Subhangini  Joshi
• Human Nutrition and Dietetics By J.S. Garrow