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Today'sCPE,
March 2004 - The Muscle Trap
by By Pamela Stuppy, MS, RD
Even young men worry about their figures. Usually "body dysmorphic disorder" is associated with females who think they don't "measure up" to media ideals. However, normally developed males can feel physically inadequate when compared with hyper-developed male professional athletes, body builders, etc. It can lead them to become compulsive about building muscle, spending long hours in the gym, or it can lure them to experiment with supplements and other "quick fix" substances.
This article defines and details some of the consequences of supplement overuse by young men, and provides ammunition for the practitioner to combat the sophisticated marketing used to promote questionable products.
Today'sCPE,
February 2004: Stalking the 'Silent Killer'
by By Ellen Coleman, MA, MPH, RD
Dietitians are in the forefront of an all-out war against cardiovascular disease. The current battlefront is hypertension, which affects about 1 in 4 adult Americans. New research reveals that an aging population is increasingly at risk, and that the onset of hypertension can be detected at an earlier age Ñ new blood pressure classifications for persons aged 18 or older recognize the concept of "prehypertension." New detection and diagnosis protocols, and revised dietary guidelines give dietitians vital information for preventive intervention and counseling. This article discusses recent research, summarizes changes in guidelines and classifications and focuses on implementing the Dietary Approaches to Stop Hypertension (DASH) diet.
The quality of a baby's life is greatly affected by the mother's prenatal nutritional status and diet. Nutrition impacts weight gain, birth weight, gestational age, congenital anomalies, nutritional status and birth defects in the fetus, and the child's health in later life. Nutrient recommendations for pregnant women have changed, especially those for macronutrients (fiber, carbohydrate and fat). Focusing primarily on the Institute of Medicine report on Dietary Reference Intakes (DRI), this article explains those changes and what they mean. New information on timing of nutrient intake, exercise and maternal weight gain is also provided.
Today's
CPE, December 2003: The Anemia and Celiac Disease Connection
by Cynthia R. Kupper, RD, CD
Anemia and celiac disease are two of the most common disorders in the United States, as many as one person in 133, or 2.1 million people could have celiac disease, an immune-mediated disease of malabsorption due to inflammation and damage of the microvilli and villi of the small intestine. When there is damage to the jejunum and duodenum, absorption of many nutrients, including iron, is altered. Even though iron absorption is significantly impacted, celiac disease is not often suspected when a patient presents with persistent anemia. However, from recent survey data, an estimated 78,000 people with anemia in the US could have celiac disease. Clearly, many patients should be screened for celiac disease.
This article explains the causes of celiac-related anemias, explains how to diagnose them and surveys the likely treatment modalities, including a gluten-free diet.
Despite the best pharmacological therapies for epilepsy, as many as 800,000 Americans continue to have intractable seizures. Children, especially, are at risk. Many neurologists are now returning to a dietary therapy that had been overshadowed by the promise of new drugs: the ketogenic diet. Although recognized as highly effective in controlling and even eliminating seizures in children, it requires strict dietary compliance for two to three years to be effective. Thus, it often has been seen as too demanding for families and caregivers, especially during years when nutrition is essential for proper growth and development. Researchers now feel that a shorter trial period can give valuable information on whether continuing it would be suitable, and are using new products and techniques to monitor compliance. This article presents an overview of the history, rationale, indications and drawbacks of the ketogenic diet for children, and offers dietitians valuable information to help them counsel and care for children attempting this therapy
Today'sCPE,
October 2003
The Role of the Dietitian in Nutrition Care Dilemmas
by Sari Edelstein, PhD, RD
End-of-life scenarios are always tragic and stressful for care team members.
Often, there seems to be no right way -- or at least no one way that leaves
everyone feeling that they've done the right thing. For the dietitian, "feed-don't
feed" dilemmas are especially problematic: there is no treatment rationale for
allowing a patient to starve. In this overview article, the author provides
background and guidance, and helps dietitians understand there role, and accept
that sometimes they shouldn't do what they can do to prolong life.
Today'sCPE,
September 2003
Prebiotics: Feeding Friendly Bacteria
by Carol Brannon, MS, RD, LD
The human digestive tract is habitat for over 400 different species of microorganisms.
Some are pathogens, but many are benign, beneficial or "friendly" probiotics,
the most common being strains of lactobacilli and bifidobacteria. Consuming
probiotics in food (such as yogurt) is one dietary strategy to maximize their
presence, but because many probiotics are sensitive to gastric and bile acids,
a better way is to "feed" or stimulate the growth of existing probiotic bacteria
by consuming prebiotics. Defined as "a nondigestible food ingredient that beneficially
affects the host by selectively stimulating the growth and/or activity of one
or a limited number of bacteria in the colon" prebiotics are found in numerous
foods. This article explains and defines the prebiotic concept, gives examples
and shows how dietary modification can enhance the presence and effects of beneficial
microorganisms.
Americans spend billions of dollars on weight loss products. Americans are also infatuated with anything that says "herbal" on the label. Is it any wonder that manufacturers, practitioners and marketers have combined the two trends? The use of weight-loss supplements has increased to about 10 percent of the $17.7 billion supplement market -- herbal preparations record about $1.8 billion in retail sales in 2001. Many weight loss products contain herbs formulated to act as stimulants, appetite suppressants, tonics, diuretics, laxatives and bulking agents. The important questions for dietitians are: "Do they work?" and "Are they safe?" Generally speaking, weight-loss herbal medicine has a spotty reputation. But there are some products that may meet the effectiveness and reliability tests. This article summarizes what is known about herbal weight-loss supplements and offers nutrition practitioners guidance as to their use.
Today'sCPE,
July 2003
AIDS in the 21st Century
by Dale Ames Kline, MS, RD, LD
Once they faced an inevitable and horrific death, with malnutrition, severe weight loss, opportunistic infections, and dementia. But now, AIDS patients can utilize new drug treatments to keep the virus in check and prevent the progression of the disease. Many find they can live fairly normal lives. For the dietetic practitioner, focus must shift to drug-nutrient interactions, side effects of medication and other issues of long-term nutritional health. This article covers the changing nature of AIDS care and treatment, and offers updated information on nutritional management of patients.
Today'sCPE,
June 2003
Nutrition and Alzheimer's Disease
by Marie Dunford, PhD, RD
Alzheimer's disease (AD) is a progressive, relentless, irreversible disease,
which dramatically changes behavior, erases personality and destroys intellectual
capacity. Approximately 7 percent of the population older than 65 have AD --
about 4 million people in the US have it, but the number of new cases will increase
substantially. Drug therapy research is in full swing, but efforts to prevent
or minimize the risk for this disease are also focusing increasingly on diet
and nutrition. This article summarizes current knowledge and research about
AD, and presents hopeful nutrition and diet strategies.
Today'sCPE,
May 2003
Friendly, Functional Microbes
by Pamela Stuppy, MS, RD, LD
Throughout history, people have focussed on maintaining health rather than restoring
it -- prevention is cheap, less invasive and easy to implement; treatment may
have deleterious side effects and other downside risk. In recent years, diet
and nutrition are attracting renewed attention for their preventive effects.
The terms "probiotic," "prebiotic" and "synbiotic"
are becoming mainstream.
Probiotics are non-pathogenic bacteria (and some yeasts) which improve physiology
or provide health benefits beyond. Prebiotics are certain non-digestible food
substances which facilitate proliferation of beneficial bacteria and reduce
pathogenic populations, usually by affecting fermentation in the lower bowel.
Synbiotics is the use of both probiotics and prebiotics simultaneously to produce
a synergistic effect.
This article defines and discusses these "functional foods" and provides
practical guidelines for their use.
Today'sCPE,
April 2003
Educating Healthcare Professionals in Nutrition
by Kathleen M. Rourke, PhD, RN, RD, CHES
Each member of a health care team has a role to play, and the synergy between
them produces the best treatment and outcome. However, dietitians must keep
in mind that other members of the health care team focus first on aspects other
than nutrition, depending on their professional training and orientation --
you wouldn't expect a surgeon to be up to date on parenteral nutrition for post-surgical
patients (although many are). Nutrition is less important to them than other
practice issues and concerns, and is often overlooked or given less attention
in the care plan. Therefore, dietitians must educate team members, and in order
to do so, we must understand what each profession requires in nutrition study
and training -- we must deal with people where they are, not where you wish
them to be. This article summarizes major professions' requirements for nutrition
study, and offers guidelines for improving their appreciation and understanding
of the dietitian's skills, knowledge and role.
Today'sCPE,
March 2003
Fat Loading for Endurance Sports
by Ellen Coleman, MA, MPH, RD
Athletes seeking a finer edge, a sharper angle and stamina beyond their dreams inevitably turn to nutrition. While some load up on supplements, diet has always been a prime competitive strategy. Early so-called "supercompensation" tactics concentrated on carbohydrate intake. From "pasta and beer the night before," scientific carbohydrate-loading diets, which allowed the build-up of glycogen reserves over time, were developed. Now, attention has turned to dietary fat -- for a very good reason: fat is a superior fuel for long-duration exertion, due to the way the body uses it. Ellen Coleman, noted sports nutrition expert, examines this phenomenon from a professional standpoint, offering standards, guidelines and cautions for dietitians working with competitive endurance athletes and weekend wannabes.
Today'sCPE,
February 2003
Dietary Fiber and Coronary Heart Disease
by Ellen Coleman, MA, MPH, RD
Last Fall, for the first time, the Food and Nutrition Board established Adequate
Intake (AI) levels for dietary fiber, based on research demonstrating that consuming
a low-fiber diet increases the risk of coronary heart disease. While research
suggesting that dietary fiber may help to prevent colon cancer and promote weight
control is inconclusive at present, many studies are underway, and it is felt
that these benefits will be recognized soon. This article reviews recent research,
discusses mechanisms of action, and offers practical dietary strategies for
increasing fiber -- and preventing disease.