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Thread: The Nutrition Support Pharmacist's Manual

  1. #1

    Lightbulb The Nutrition Support Pharmacist's Manual

    Last edited by admin; Mon 1st August '16 at 2:10pm.
    Clinical Pharmacy Specialist - Hematology

  2. #2

    Wink [Medical Nutrition] How to estimate REE (resting energy expenditure)

    The total amount of energy (TEE/total energy expenditure) required by an individual is the sum of three basic components:

    • Basal energy expenditure (BEE) or basal metabolic rate (BMR)
    • Energy for physical activity (PA) or exercise
    • Thermic effect of food (TEF)

    Basal energy expenditure is defined as energy used for physiological functions that maintain life, such as respiration and heartbeat, and accounts for approximately 60% of an individual's energy requirement. Because it is difficult to measure basal energy expenditure, we use resting energy expenditure (REE) or resting metabolic rate (RMR) to estimate the BEE/BMR.

    The REE/RMR can be estimated by following equations:

    The Nutrition Support Pharmacist's Manual-screen-shot-2015-12-18-at-1-57-23-pm-png

    After we calculate the estimation of REE/RMR, we can calculate the amount of macronutrients (carbohydrate, fat, and protein) for REE/RMR by following formula:

    C = 0.5*REE/4, F = (0.2~0.3)*REE/9, P = (0.15~0.2)*REE/4

    PS: C means carbohydrate, F means fat, and P means protein
    Clinical Pharmacy Specialist - Infectious Diseases

  3. #3

    Default BMI Criterias for Obesity

    BMI is a parameter used by National Institutes of Health to define obesity.

    Clinical Pharmacy Specialist - Infectious Diseases

  4. #4

    Default [Medical Nutrition] Diet Information Collection

    I.Food- and Nutrition-Related History

    1.Twenty-Four-Hour Recall
    2.Food Record/Food Diary
    3.Food Frequency
    4.Observation of Food Intake/"Calorie Count"

    In general, food and nutrition information is assessed either by collecting data retrospectively or by summarizing data gathered prospectively. All methods have their own limitations. The ultimate goal of collecting dietary information is to determine the nutrient content of food that is consumed and then compare this to standard guidelines appropriate for that individual.
    Last edited by CheneyHsiung; Mon 1st February '16 at 4:06pm.
    Clinical Pharmacy Specialist - Hematology

  5. #5

    Default 1.Twenty-Four-Hour Recall

    When using a 24-hour recall as the dietary assessment method, the clinician guides the client through a recall of all food and drink that has been consumed in the previous 24-hour period. The clinician asks what food or beverage was consumed most recently prior to the interview and then works in reverse order through the previous 24 hours. The clinician questions the client about activities during the period in order to stimulate the client's memory. At the end of the recall, the clinician reviews the information to verify serving sizes and preparation methods and asks for clarification if needed.

    There is a widely accepted and validated method, called AMPM - USDA Automated Multiple-Pass Method, available at which is a variation of 24-hour recall method.

    24-Hour Recall Form

    24-hour recall Date: Patient Name:
    Time Foods and Beverages Serving Size How prepared Where Comments:
    Last edited by CheneyHsiung; Mon 1st February '16 at 4:42pm.
    Clinical Pharmacy Specialist - Hematology

  6. #6

    Default 2.Food Record/Food Diary

    In this method the client documents his or her dietary intake as it occurs over a specified period of time. Typically, the record is kept over a 3- or 5-day period and should include a sampling of both weekdays and weekends. Clients estimate or measure their food intake.
    Clinical Pharmacy Specialist - Hematology

  7. #7

    Default 3.Food Frequency

    The food frequency data collection method is a retrospective review of specific food intake. Foods are organized into groups, and the client identifies how often and in what quantities he or she consumes a specific food or food group. The method can be self-administered. Many food frequency instruments have been specialized and validated to identify food group intake for certain disease states such as cardiovascular disease or designed for use with specific populations. Food frequency data can be collected via online applications using both narrative and pictorial representations of foods and quantities.
    Clinical Pharmacy Specialist - Hematology

  8. #8

    Default 4.Observation of Food Intake/"Calorie Count"

    In an acute care or long-term care setting, actual food intake can be observed and recorded when a kilocalorie (kcal) or kcal-protein count is ordered. If very detailed information is required, as is the case in a research or metabolic study, food may be weighed before and after the meal is served. The patient's food intake is then calculated from differences between the two. Additional food consumed by family members or food brought in from outside the hospital will also need to be recorded.
    Clinical Pharmacy Specialist - Hematology

  9. #9

    Default [Medical Nutrition] Evaluation and Interpretation of Dietary Analysis Information

    After data are collected and analyzed, it is the clinician's job to compare the information to established scientific criteria. These criteria may include the individual patient's needs (based on age, gender, and nutrition assessment) and may be as general as a comparison to the U.S. Dietary Guidelines or as specific as milligrams of vitamin C that should be consumed.

    The assessment of intake is an estimation rather than an exact measurement.

    1.U.S. Dietary Guidelines
    2.USDA Food Patterns
    3.Exchange Lists for Diabetes/Carbohydrate Counting
    4.Individual Nutrient Analysis
    5.Dietary Reference Intakes and Daily Values
    Clinical Pharmacy Specialist - Hematology

  10. #10

    Default 1.U.S. Dietary Guidelines

    The U.S. Dietary Guidelines for Americans, published by the Office of Disease Prevention and Health Promotion of the U.S. Department of Health and Human Services (USDHHS), provide general recommendations for dietary intake that promote health and prevent disease.

    These guidelines are based on decades of nutrition research and reflect the most up-to-date understanding of nutritional requirements. They have been revised six times, with the newest release planned for 2015.
    Clinical Pharmacy Specialist - Hematology

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