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Nutritional therapy: diagnoses, prescription

by Josephine Andrews
Published: Last Updated on 181 views

An individually tailored nutritional therapy can usefully support the treatment of many diseases. For some diseases, nutritional therapy is used as a prescription-capable remedy – the costs are then covered by health insurance. This applies to nutritional therapy for the supportive treatment of cystic fibrosis and various congenital metabolic diseases. Here you can read everything you need to know about nutritional therapy, when to use it and how to do it.

What is nutritional therapy?

Nutritional therapy can have a positive effect on the course of various diseases and support recovery. In some cases, a special diet is even the central core of the treatment.

Nutritional Therapy as a Cure

In the context of the catalog of remedies, nutritional therapy is a prescription-ready remedy for the supplementary treatment of specified diseases.

These include cystic fibrosis patients. On the other hand, people who suffer from a rare congenital metabolic disease such as phenylketonuria , urea cycle defects or a glycogen storage disease (glycogenosis). The prerequisite is that the nutritional therapy treatment is absolutely necessary to prevent severe mental or physical impairment or death.

If this is the case, a panel doctor can prescribe nutritional therapy. It is carried out by specially trained therapists (dieticians, ecotrophologists and nutritionists).

Goals of nutritional therapy

The goals of nutritional therapy are:

  • promote age-appropriate physical and mental development
  • achieve a stable nutritional status
  • prevent disease worsening and relieve symptoms
  • to avoid complications
  • to get the success of the therapy
  • to improve life expectancy

When do you do nutritional therapy?

Nutritional therapy can be prescribed as a remedy for certain medical conditions. In the case of other diseases, it can also support the treatment, but the costs are usually not reimbursed.

Nutritional Therapy as a Cure

Medical nutritional therapy is prescribed by a doctor for cystic fibrosis and certain rare metabolic diseases.

Nutritional therapy for cystic fibrosis

Cystic fibrosis is an energy-draining disease. Patients therefore need a particularly high-energy diet with balanced fats. Also a lot of salt and higher amounts of various vitamins and trace elements.

The psychological aspect is also important in nutritional therapy for cystic fibrosis. Patients often have to eat more than they actually want. Especially with children, this can lead to an attitude of refusal – eating becomes a struggle. Here nutritional therapy supports the parents with important advice.

Nutritional therapy in phenylketonuria

In people with this rare disease, a specific enzyme is defective due to faulty genes. In those affected, the amino acid phenylalanine accumulates in the blood and disrupts the brain supply. This can damage brain development, especially in early childhood.

Depending on their age and the severity of the defect, people with phenylectonuria must eat a diet low in phenylalanine or strictly free of phenylalanine. Nutritional therapy for phenylketonuria is therefore aimed at avoiding

  • meat, fish, eggs
  • Milk and milk products (yoghurt, quark, pudding)
  • Cereals (flour, bread, pasta cakes etc.)
  • Legumes (peas, beans, lentils, soy)

Nutritional therapy for urea cycle defects

Nitrogen excretion is disturbed in patients with a urea cycle defect. Then the ammonia level in the blood rises. This causes various symptoms – from lethargy to seizures to coma . Nutritional therapy aims to eat as little nitrogen as possible. In concrete terms, this means a low-protein diet.

Nutritional therapy for glycogen storage disease (glycogenosis)

In patients with glycogen storage disease, the accumulation or breakdown of glycogen is disturbed. This molecule serves as an energy store for the muscle cells and is important for a balanced blood sugar level. A number of different types of glycogenosis are known, with very different symptoms. Nutritional therapy for glycogenosis aims at a high-protein diet, in which protein serves as an energy source as an alternative to carbohydrates.

nutrition therapy in general

In addition, there are many other areas of application for nutritional therapy, which, however, are usually not covered by health insurance. These include, for example:

Nutritional therapy for achalasia

Nutritional therapy can make eating easier for people with achalasia. Esophageal disease is characterized by progressive narrowing of the esophageal outlet and increasing rigidity of the esophageal muscles.

Nutritional therapy in nephrotic syndrome

Nephrotic syndrome is a kidney disease associated with increased protein excretion and edema formation. The nutritional therapy here aims primarily at a low-salt and protein-rich diet.

Clostridium difficil

Nutrition therapy can prevent an uncontrolled multiplication of the intestinal germ Clostridium difficil. This often occurs as part of antibiotic therapy. It is recommended to regularly consume probiotics such as probiotic natural yoghurt.

Nutritional Therapy for Leaky Gut

Nutritional therapy is also said to help with the so-called leaky gut syndrome. The intestinal mucosa allows substances to pass into the organism that do not actually belong there, such as partially digested proteins and fats.

It is believed that these substances can cause symptoms in the body such as allergic reactions, digestive problems, headaches and joint pain.

With a special diet that avoids refined sugar, cereals and legumes, among other things, leaky gut syndrome can be brought under control. However, neither the syndrome itself nor the dietary recommendations have been scientifically proven.

Nutritional therapy for obesity (obesity)

Nutritional therapy is also used for obesity (morbid obesity). The aim is to bring those affected closer to balanced, calorie-conscious eating.

What does nutritional therapy do?

The medically prescribed nutritional therapy is clearly regulated in the remedy catalogue. Content includes:

  • Anamnesis and coordination of therapy goals
  • Individual advice and support, for example with a view to suitable foods, suitable nutritional principles and dietary measures
  • Advice and practical support in the event of a necessary substitution of enzymes, vitamins, minerals, amino acids , fats or trace elements
  • Instructions for enteral nutrition (drink or tube feeding), implementation of parenteral (intravenous) nutrition in the home environment
  • Information about dietetic products and food ingredients
  • Mediation of individually suitable cooking and kitchen techniques, practical information on the implementation of an individual diet

At the end of the nutrition therapy consultation there is a nutrition plan that is tailored to the specific needs of the patient. Nutrition therapy can be prescribed in individual sessions or in a group. A unit usually lasts 30 minutes.

The procedure for non-medical nutritional therapy, for example for the treatment of obesity or achalasia (see above), is not regulated in a binding manner. Depending on the therapist treating you, different therapeutic approaches can be chosen.

What are the risks of nutritional therapy?

Nutritional therapy aims to support healing, to improve the patient’s condition noticeably or to avoid consequential damage from an illness.

Risks can arise if the nutritional recommendation is not individually tailored to the patient’s needs, i.e. contains too many, too few or the wrong nutrients. Malnutrition or overnutrition can then threaten, which can worsen the condition of the person concerned.

Especially with parenteral (intravenous) and enteral (drinking/tube feeding) nutrition, infections can also occur due to invading microorganisms such as viruses, fungi or bacteria. However, if the general hygiene regulations are observed, the risk of this is low.

What do I have to consider after the nutritional therapy?

Nutritional therapy brings long-term success if the associated recommendations are consistently implemented. Therefore, even after the prescribed nutrition therapy sessions have ended, one should stick closely to the nutrition plan that has been developed and apply the tips and techniques learned.

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