Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Paediatric Dietitian • • • Quality protein rich diets Probiotics and the gut flora of tube fed children Getting the best out of your dietitian How to make high calorie diets ‘healthier’? ◦ Include the 5 food groups ? Equal proportions ◦ Monounsaturated and Polyunsaturated fats ◦ Protein ◦ Perspective Growth and weight gain is current priority Bread, cereal, potatoes, pasta, rice… Fruit and vegetables Milk and dairy foods Meat, fish, eggs, beans, nuts…. Oils and spreads and foods to eat less often ◦ Get the balance right with fibre – may be too filling ◦ Increase calories with spreads, oils, sauces ◦ Higher calorie – fruit juice, dried fruit, avacado ◦ Sat fat but good source protein, vitamins & minerals ◦ Best source of protein ◦ Increase calories with oils and sauces; try nut butters, humous ◦ Bigger proportion than for healthy population ◦ Add spread, oils, cream, cheese, mayonnaise etc to foods Mono & Polyunsaturated fats ◦ ◦ ◦ ◦ Vegetable oils – fry vegetables, meat, eggs, chips… Spreads – use generously on bread, potatoes, veg… Mayonnaise – as a dip or on sandwiches, potatoes… Nut butters Saturated fats ◦ ◦ ◦ ◦ Cream – add to full fat milk, puddings, sauces, fruit… Cheese – grate or make cheese sauce for veg, pasta… Butter – as above with spreads Coconut milk and cream – add to soup, curry, puddings Aim to include main protein sources twice a day ◦ ◦ ◦ ◦ ◦ ◦ Meat Fish Eggs Soya, Quorn Beans, pulses Nuts Milk, cheese, yoghurt also good sources Pasta ◦ salmon, cream, smoked cheese & brocolli ◦ Tuna, sweetcorn and mayonnaise Scrambled eggs with frozen spinach, cheese & cream Fried fish fingers, croquettes & frozen peas Cheese sauce (made with double cream & full fat milk) ◦ Cauliflower cheese, fish pie, macaroni cheese Rissotto ◦ Roasted butter nut squash (roast with lots of oil) ◦ Chicken, leek and double cream Chicken Korma ◦ curry powder, coconut milk or cream, sultanas, onions and peas/butternut squash Breadsticks or vegetable sticks with dips/cheese spread Dried fruit Breakfast cereal Rice cakes/toast with spread, nut butter, jam… Cheese strings/purple babybel (cheddar) Puddings Custard, rice pudding, delight/whip deserts ◦ Add fresh/frozen berries or banana and double cream Fruit puree & double cream/mascarpone cheese Any children already taking these? Evidence of benefits for diarrhoea, constipation, bowel conditions, atopic conditions No current recommendations for tube fed children Literature search ◦ Specific patient groups (preterm, critically ill) ◦ Inconsistent methods to report dose ◦ Increased risk via tube as increased probiotic survival - more research needed for tube fed children Generally safe to take orally, esp. in foods ◦ Discuss supplements with pharmacist, dr, dietitian ◦ Caution with newborns (not known how affects developing immune system) Ask questions ◦ Evidence based practice (don’t believe everything you read!) ◦ If we don’t know, we can look up the evidence and get back to you (eg probiotics) ◦ Phone/Email between appointments Let us know if practical problems with our advice ◦ Texture modification ◦ Cooking skills/time ◦ Fussy eating/food refusal ◦ ? Pyschology referral – what is available locally Any Questions? Rona Cookson, Paediatric Dietitian September 2016