Pravilna prehrana iznimno je važna u prevenciji šećerne bolesti i regulaciji glikemije. Šećerna bolest ubraja se u kategoriju bolesti koje se uspješno mogu prevenirati, dobro liječiti te im se može ...spriječiti ili odgoditi razvoj kroničnih komplikacija. Edukacija o pravilnoj prehrani treba biti individualno prilagođena, pri čemu treba obratiti pozornost na dob bolesnika, način života, socioekonomski status, tjelesnu aktivnost i komplikacije vezane uz šećernu bolest. Kod šećerne bolesti promjena životnih navika, što uključuje pravilnu prehranu, redovitu tjelesnu aktivnost i regulaciju tjelesne mase, može uvelike pridonijeti regulaciji glikemije, a u tipu 2 u nekim slučajevima može dovesti i do njene remisije. Smjernice su rezultat suradnje zdravstvenih stručnjaka koji sudjeluju u liječenju i edukaciji osoba koje boluju od šećerne bolesti. Utemeljene su na dokazima, prema metodologiji GRADE (engl. grading of recommendations, assessment, development and evaluation) koja uz snagu dokaza opisuje i razinu preporuke. Temeljni zaključci ovih smjernica odnose se na procjenu nutritivnih potreba te primjenu medicinske nutritivne terapije, individualno prilagođene osobama sa šećernom bolešću kao i onima koji imaju i neke od
vezanih komorbiditeta.
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•Four different FCDBs were used in the food composition analysis of hospital menus.•The food composition of hospital menus were evaluated during 2 seasons, for 2 diets.•PCA was used ...to identify main dietary similarities/differences in the diet offers.•Bland-Altman method showed no differences, regardless observed diet and FCDB.
This study analysed food offers and compared food composition of daily menus of two most common hospital diets, pancreatic and diabetic diet. In diets that are concentrated on the minimisation of some food components (as minimisation of carbohydrate content in diabetic diet or fat intake minimisation in the pancreatic diet), use of a reliable Food Composition database (FCDB) is an important factor. By use of four FCDBs, Croatian, Danish, USDA and the hospital FCDB, the food composition was analysed. Seven daily offers per two seasons were analysed (seasons: Spring/Summer & Autumn/Winter). Descriptive statistics as well as multivariate tools were used to investigate differences in the food composition, when different FCDB’s were the basis of calculations. Multivariate analysis detected food composition differences in booth diets, when different FCDBs were used (content of energy, proteins, sodium, magnesium, iron & zinc) as well as for offers in different seasons. To be sure that the differences are significant we applied the Bland-Altman test. The results showed different biases and ranges – but none of the food component showed to be significantly different, what would lead to a potential rejection of some of the used FCDB. Those results are a strong confirmation that the Bland-Altman test ensures objective conclusions; like which FCDB is applicable for food composition analysis and menu planning.
patients with different types of dementia may experience changes in nutritional status, which are manifested by specific eating habits. The aim of this study was to determine the nutritional status ...and eating habits of patients at the time of confirmed diagnosis of primary progressive dementia.
The study included 40 outpatients (63% women) diagnosed with either form of dementia. The mean age at diagnosis was 77±6 years and the mean time between the onset of first symptoms of the disease and diagnosis was 3-36 months. Nutritional assessment was determined at the time of confirmed diagnoses and included dietary habits (non-quantitative modified food frequency questionnaire (FFQ)), anthropometric (body weight and height and body mass index-BMI) and biochemical parameters (serum concentrations of vitamin B12, folic acid and 25-hydroxy vitamin D). Dietary habits were collected over a 12-month period with the help of a spouse or close family member.
The results showed that none of the outpatients were malnourished, the largest number of outpatients (43%) were in the normal body mass category followed by 33% in the overweight category. The results of this study confirmed previous findings of higher preference for sweet foods observed in 53% of patients with dementia. Low status of vitamin B12 was observed in 57% of outpatients, folic acid in 24% and 25 (OH) D in 75% of outpatients. Lower frequency of consumption of dark green leafy vegetables and lower consumption of poultry meat, fish and eggs could have an impact on nutrient deficiency.
The poor nutritional status of outpatients with primary progressive dementia is associated with unhealthy dietary habits that may lead to micronutrient deficiencies. Dietary monitoring and intervention should be initiated immediately after the diagnosis of primary progressive dementia with the goal of reducing nutritional deficiencies and preventing further and more severe impairment of cognitive function.
Dijetoterapija akutnog i kroničnog pankreatitisa Orešković, Petra; Martinis, Irena; Tolić, Mandica-Tamara ...
Medicus (Zagreb, Croatia : 1992),
11/2015, Letnik:
24, Številka:
2 ASK niske doze
Journal Article
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Pankreatitis je upalno stanje gušterače koje često iz svojeg akutnog oblika može prijeći u kroničnu bolest. Bolesnici s pankreatitisom imaju povećane nutritivne potrebe zbog upale, dok, s druge ...strane, zbog boli, mučnine i povraćanja pate od energijskog, proteinskog ili nutritivnog deficita. Hipokalcemija i hipomagnezemija mogu se pojaviti već u prvim fazama akutnog pankreatitisa. Bolesnici s dugotrajnim i prekomjernim unosom alkohola mogu, uz proteinsko-energijsku malnutriciju, imati i deficit vitamina i minerala: tiamina, folne kiseline, cinka, vitamina D, K, E, A i B12 te karotena. Osnovni cilj nutritivne njege bolesnika s pankreatitisom jest osigurati adekvatan unos energije. To je osobito važno u bolesnika s akutnim pankreatitisom u kojih se pokazalo da pravilna nutritivna njega može smanjiti komplikacije i skratiti vrijeme boravka u bolnici.
Numerous studies report on strong correlation between salt intake and an increased risk of some diseases. Salt intake has long been known to influence blood pressure in patients with hypertension, ...increased risk of renal disease, cancer and obesity. Salt is an important spice because many foods without salt have unacceptable taste. The major problem arises from the fact that most salt derives from processed foods and reduction of salt content in these sources is necessary to reduce overall salt exposure. Dietitians and/or foodservice managers have professional responsibility to produce quantity food recipes that are reduced in sodium and acceptable to customers. The daily sodium content was assessed in the menus (12 different diets) served to patients at Dubrava University Hospital in Zagreb and Dr. Josip Bencević General Hospital in Slavonski Brod. The average sodium content in the menus served at these two institutions was 1925 mg/day and 1890 mg/day, respectively. The results indicate that there is sufficient substitute for salt, it is only important to change dietary habits. In conclusion, long-term health benefits will depend on the ability of patients to make long-lasting dietary changes, along with wider availability of lower-sodium foods such as fresh fruits and vegetables, which is consistent with the Dietary Approaches to Stop Hypertension (DASH) diet, and to avoid foods with high salt content.
Kronične nezarazne bolesti povezane s načinom života sve su učestalije. U svakoj zemlji, ovisno o stupnju razvoja, kronične bolesti poput dispepsije, ulkusne bolesti i GERB-a imaju ubrzan porast ili ...su već na visokoj razini. Debljina, nepravilna prehrana, nedostatak tjelesne aktivnosti, pušenje i alkohol čimbenici su rizika za nastanak bolesti gastrointestinalnog sustava. Upravo zbog toga uz terapiju medikamentima, bolesnicima s ulkusom preporučuje se promjena životnih navika te izbjegavanje hrane koja uzrokuje smetnje. Populacijske studije pokazuju da prehrana znatno utječe na tijek bolesti. Poznato je da namirnice i pića poput kave, alkoholnih pića, gaziranih pića, slastica i oštrih začina mogu pogoršati simptome bolesti. S druge strane, prehrana bogata voćem, povrćem, probioticima te lako probavljivim namirnicama može poboljšati kvalitetu života i nadopuniti medikamentno liječenje.
Dijetoterapija bolesti jetre Pavić, Eva; Oreč, Irena; Martinis, Irena ...
Medicus (Zagreb, Croatia : 1992),
01/2008, Letnik:
17, Številka:
1_Nutricionizam
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Kod jetrenih bolesti mijenjaju se metabolički procesi pa se time mijenjaju nutritivne i energetske potrebe. U većine bolesnika s jetrenom bolešću postoji malnutricija najčešće uzrokovana smanjenim ...unosom hrane zbog povraćanja i mučnine. Dijetoterapijom je potrebno bolesnicima osigurati dovoljnu količinu makronutrijenata i mikronutrijenata kako bi se spriječila malnutricija. U bolesnika s razvijenom slikom jetrene encefalopatije, u kojih s obzirom na patogene mehanizme, veći unos proteina pogoršava postojeće stanje, potrebno je voditi računa o ograničenom unosu proteina. Takvim se bolesnicima preporučuje unos razgrananih aminokiselina koje dovode do poboljšanja kliničke slike. Kod svih bolesnika oboljelih od jetrenih bolesti važno je postići promjenu ustaljenih životnih navika i uspostaviti nove u svrhu poboljšanja kvalitete života.
Kolorektalni karcinom (engl. Colorectal Cancer, CRC) je treći najčešći maligni tumor na svijetu. Procjenjuje se da 10-20 % pacijenata oboljelih od karcinoma umire zbog posljedica pothranjenosti, a ne ...zbog samog karcinoma. Nutritivni status bolesnika znatno utječe na ishod liječenja bolesnika s CRC-om, bez obzira na to je li riječ o pothranjenosti, gubitku potporne mišićne mase, normalnoj ili prekomjernoj tjelesnoj masi. Problemi s prehranom trebaju se uzeti u obzir i rješavati od vremena postavljanja dijagnoze, kirurškog liječenja te paralelno s antineoplastičnim liječenjem (kemoterapija, imunoterapija i endokrina terapija) i radioterapijom. Pri tom je važno imati multidisciplinarni tim jer postupci uključuju procjenu statusa validiranim probirnim upitnicima na malnutriciju NRS 2002 (engl. Nutritional Risk Screening 2002) i sarkopeniju SARC-F (engl. Strength, assistance with walking, rising from a chair, climbing stairs and falls), mjerenje mišićne snage i funkcije dinamometrijom šake, analizu sastava tijela bioelektričnom impedancijom, procjenu prehrambenih navika i unosa hrane te savjetovanje o prehrani. Studije daju ohrabrujuće rezultate u primjeni fitonutrijenata zelenog čaja, ekstrakta kvercetina, omega-3 masnih kiselina, probiotika, prebiotika, prehrambenih vlakana i orašastih plodova zahvaljujući njihovim protuupalnim i antioksidativnim svojstvima. Osnovni princip periopeartivne dijetoterapije je adekvatnim namirnicama smanjiti ili spriječiti pojavu nutritivnih deficita i komplikacija koje se povećavaju promjenom nutritivnog statusa, dok u poslijeoperacijskoj i terapijskoj fazi liječenja pozitivno utjecati na bolesnikov oporavak i povratak svakodnevnim aktivnostima.
