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Topic 25 - Nutritional support in neurological diseases
APNEP
TOPIC 25 - Programa
Topic
25
14 de abril de 2024
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Topic 25 - Nutritional support in neurological diseases
ESPEN
CURSOS LLL 2024
Life-Long Learning Courses
To learn nutritional screening and assessment; the methods used; To know the benefits and limits of laboratory and balance-studies for nutritional assessments; To be aware of the importance of the routine screening all patients for malnutrition and of the continued monitoring of those at risk; To learn how body composition can be measured and to learn how reliable these measurements are; To know the components of energy expenditure in human beings; To know the methods for measurement of energy expenditure; To be able to define how energy intake influences energy expenditure; To be aware of malnutrition; To know how to screen, assess, and monitor patients for nutritional risk and for response to nutritional support. Improvement of competencies and skills in CN, application of effective CN in the treatment of disease and health promotion; To acquire tools to interpret new scientific information, and link with nutrition, better practical management of nutritional support.
Topic 3
Nutritional assessment and techniques
Obesity is one of the most frequent diseases all over the world. It is associated to many complications in all organs and systems of the body and makes difficult the management of these disorders. Genetic and environmental factors interplay in its pathophysiology. Along an intrinsic predisposition, cultural and lifestyle patterns, characterized by excess energy intake and limited physical activity, lead to weight excess. Epidemiological studies have analyzed the associations of macro and micronutrients to the development of obesity. There are also numerous studies about different dietetic approaches, combined with physical activity and behavioral changes. Drug therapy may be indicated when BMI is above 30 kg/m2 and bariatric surgery may be considered for BMI higher than 35 kg/m2, if there are associated comorbidities than can improve with weight loss and there has been failure to lose weight with conventional measures. Long term follow up is mandatory after bariatric surgery to contribute to the prevention of weight regain.
Topic 23
Nutrition in obesity
To identify different factors that may favour malnutrition in patients with neurological diseases. To understand the main characteristics of dysphagia and its relevance for nutritional support in patients with neurological diseases. To know the gastrointestinal consequences of neurological disease, relevant for nutritional support. To recognize the clinical consequences of malnutrition in patients with neurological diseases. To know the deleterious consequences of energy and protein deficits in acute brain and spinal injuries. To know the most appropriate macronutrients needs: amount, time, and route. To know the reasons for undernutrition and the strategies to treat them. To understand the most frequent reasons for nutrition in a stroke patient. To know the compulsory assessment leading to decision of nutritional support. To understand the respective indications of oral and enteral feeding, and the best enteral feeding route according to the clinical situation. To know the outcome of a stroke patient receiving enteral nutrition. To know about nutritional intervention in patients suffering from Multiple Sclerosis or Parkinson's disease. To know the problems of clinical decision making in the timing/safety/efficacy of PEG tube feeding in amyotrophic lateral sclerosis patients. To understand the clinical challenge of establishing and maintaining a tube feeding in neurological patients with advanced dementia. To discuss the indications for gastrostomy in neurological patients with advanced dementia. To know the ethical, legal, and moral implications of nutritional support in patients with neurodegenerative disorders with progressive dementia.
Topic 25
Nutritional support in neurological diseases
Diabetes mellitus (DM) is a chronic metabolic disorder with disturbances not only of carbohydrate metabolism but lipid and protein metabolism as well. At diagnosis, Type 1 DM may be associated to malnutrition. However, Type 2 DM patients are generally obese and may have a relative reduction of fat free mass. Micronutrient deficiencies have been identified as risk factors for development of DM and poorer metabolic control, although therapeutic interventions have met variable success, depending on each individual micronutrient. When patients with stress hyperglycemia or DM require artificial nutrition, they may need the combination of insulin protocols and special formulas characterized by changes of the quality and/or quantity of carbohydrates and lipids, adjusting the energy provision to the nutritional requirements and metabolic control. The indications for specific formulas in diabetic patients are adjusted to the clinical setting and to the metabolic control achieved in the in individual patient.
Topic 21
Consequences of Diabetes Mellitus on the Nutritional Status