1. Diet Therapy with Celiac Disease, PKU, and Allergies Leslie Young MS, RD, LDN NS335 Unit 9

2. Last Seminar!!! Unit 9- Graded DB, Quiz and Paper! Unit 10- Ungraded DB, but I highly encourage you to participate. Paper: Please read announcment/help guide. Same format as last paper: Title page, 2-3 page essay, chart note and Reference page. You may send me a rough draft of your chart note by this Sunday if you would like me to review it. Please only email me the chart note. A-assessment (ht/wt/medical history/diet info) D- PES statement: Problem/etiology/symptoms Nutrition dx from “list” related to Medical reason/dx as evidenced by signs/symptoms. I: Intervention: the dietary intervention- be specific and include est’d calories etc M: how will you monitor the patient’s adherence, tolerance and improvements?

3. Last Seminar  It has been a pleasure to be your instructor over the past 9 weeks. I really mean this when I say it: NS 335 is my favorite class to teach. I hope that each of you can walk away from this class with new knowledge about nutrition therapy and the complex diseases we covered. I also hope that you all will stay in touch! I enjoy helping students with recommendation letters (grad school, jobs etc) as well as searching for jobs in the health field. Please let me know if there is anything that I can do as an instructor to improve the quality of instruction. I wish you each the very best in your academic and professional endeavors.

4. Celiac Disease Sensitivity to a flour protein (gluten) Tends to run in families www.advgastro.com/Celiac_Disease.htm

5. Symptoms of Celiac Disease Diarrhea Steatorrhea 2-4 bowel movements daily Loss of appetite and weight Emaciation FTT in children (bloated belly) http://www.pigur.co.il/imgceliac/celiac.jpg

6. Diet Therapy with Celiac Disease The basic principle of diet therapy for celiac disease is to exclude all foods containing gluten-chiefly buckwheat, malt, oats, rye, barley, and wheat. Table 25-1 and 25-2 for a sample food list and menu plan.

7. Patient Education Gluten-Free diet Gluten-Free specialty foods Nutritional needs

8. For more information… http://www.celiac.com/ some information http://www.glutenfreemall.com/ Has cookbooks, self-help books, food products Check out your local health food/natural food stores (Like Whole Foods, Trader Joes, etc)

9. Any Questions?

10. Food Allergies Prevalent in childhood 2-8% of Americans has some form of food allergy Food allergy versus food intolerance

11. Difficulties in Allergy Management Even a small amount of the allergy food can cause a reaction Some patients allergic to one item at one time are not at another Some react to an allergen only when they are tired, frustrated, or emotionally upset. People can be allergic to almost any food chemical

12. Let’s look up about some different allergies Cow’s Milk Allergy Kola Nut Products Eggs Peas / Legumes Citrus Fruits Tomatoes Wheat and other Grains Spices Artificial Food Colors

13. http://www.northvalleyallergy.co m/_images/foodallergy_connecti vity.jpg

14. Phenylketonuria (PKU) Phenylketonuria (PKU) is a genetic disorder in which a baby lacks or has very low levels of the enzyme phenylalanine hydroxylase (PAH). www.webmd.com

15. Causes… It’s inherited! Thanks Mom & Dad!

16. Symptoms… Symptoms usually develop within a few months after birth Early symptoms of PKU include a musty odor to the skin, hair, and urine. Babies may lose weight from vomiting and frequent diarrhea, and may be irritable, have skin problems, and be sensitive to light. If not treated the child can become severely mentally retarded.

17. Diagnosis The Guthrie test – involves analyzing the blood drawn from a child’s heel 46 states mandate that all newborns be screened for PKU. The remaining states practice voluntary screening.

18. Treatment Diet!!!! Infant formulas: Lofenalac Age-Related:Analog, Maxamaid, Maximum See Table 28-1 Table 28-2 for 1 year olds suggested phenylalanine, energy, and protein intake Exchange Lists for Young Children developed Table 28-4 Has Menu Plan for 9 Month Old

19. http://depts.washington.edu/pku/essentials.html

20. For more information www.pkunews.org http://ghr.nlm.nih.gov/condition=phenylketonur ia www.pku.com Great Information and some sample menus for older children

21. Any Questions???