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

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

3. 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

4. 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.

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

6. 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)

7. Any Questions?

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

9. 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

10. 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

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

12. 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

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

14. 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.

15. 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.

16. 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

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

18. 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

19. Any Questions???