1. Other Health Issues

2. Dysphagia Difficulty swallowing Strokes, MS, trauma Signs Swallowing pain, coughing-choking with eating Risks Aspiration, bacterial pneumonia

3. Dysphagia Alter diet consistency Solid food textures Liquid consistencies Carbohydrate added to pureed foods http://www.thickitretail.com/Forth ePublic/Usage.aspx http://www.thickitretail.com/Forth ePublic/Usage.aspx  Cornstarch, maltodextrin product Positioning Temperature

4. GERD-Reflux-Heartburn Abnormal relaxation of lower esophageal sphinctor, abdominal pressure Small meals Remain elevated Weight loss, exercise

5. Gastric By-Pass for Weight Loss http://www.mayoclinic.com/health/gastric- bypass/MM00703 2-4 oz of food and beverage at a time Reduces amount of food consumed (portions) Reduces calorie and nutrient absorption resulting in weight loss Malnutrition/Dehydration

6. Gluten Free Diets - Celiac Omit wheat, barley, rye; oats from cross contamination Celiac disease Immune mediated disorder that damages the small intestine. Gluten proteins cause t-cell reaction, resulting in inflammation, villi atrophy, malabsorption and malnutrition http://www.youtube.com/watch?v=yGmWf0et4hg Used for a variety of other health reasons…. Many new gluten-free products on the market Follow same guidelines as peanut allergies

7. Irritable Bowel Disease “Motility” disorder Diet Eliminate food irritants Probiotics Fiber to tolerance Small meals and snacks Stress management Exercise

8. Diverticular Disease “Pouches” Diverticulosis High fiber Diverticulitis Inflammation Low fiber (less than 10 gram fiber) http://www.youtube.com/watch?v =Mwa1qu9W2mM http://www.youtube.com/watch?v =Mwa1qu9W2mM

9. Probiotics….What, Function and Why? Probiotics- Healthy bacteria normally in the intestine First line of immune function GI tract point of entry Strengthens intestinal lining, alters pH Antimicrobial Improves peristalsis Probiotic Loss GI illness, antibiotics, chemotherapy, illness related to poor immune system, poor diet

10. Goal of Using Pro-Biotics Restore Add back Maintain

11. 100’s of Bacteria’s Lactobacillus acidophilus Lactobacillus GG Bifidobacterium S. boulardii L. casei L. lactis L. plantarum L. reuteri RC-14 L. rhamnosus GR-1

12. Sources Eat a variety of sources Yogurt, yogurt drinks, fermented foods, miso/tempeh Supplements No regulation Get a variety of pro- biotics

13. Kefir L. casei L. lactis L. acidophius L. plantarum L. rhamnosius S. diacetylactic S. florentinus B. bacterium longum Leuconostoc cremoris B. bacterium breve

14. Dannon Dan Active L. Bulgaricus S. Thermophilus L. Casei Immunitas

15. Pre-biotics Fructoogliosaccharides Fiber Probiotic food, decrease pH, cell energy, natural antibiotic Inulin Fortified into foods Chickory root Yogurt, granola bars, cereals

16. Hospital-Long Term Care Diets Clear Liquid Broth, bouillon, clear pop, clear fruit juices, fruit ice, popsicles, gelatin Full Liquid Clear liquid, yogurt, pudding, milk, milk drinks, all fruit and vegetable juices, refined hot cereals (cream of wheat, malt-o- meal), cream, butter, margarine Pureed Blendarized, thick it type foods Soft Full liquid, pureed + soft cooked vegetables, canned fruits, banana, mashed potatoes, cream soups, banana, chopped/ground meats, cooked pasta, barley, rice, eggs, etc.

17. Eating Disorders Definition Severe alterations in eating patterns causing physiological changes. The alterations are associated with food restricting, binge eating, purging, and fluctuations in weight. Involves psychological and cognitive changes in a persons perception of their body. Anorexia- starvation Bulemia- binge and purging Anxiety and/or depression often co-diagnosis

18. Fig. 12.p411a

19. Diet In Perspective May begin with “a diet” Irrational fear of food and weight → symptoms (distorted body image, abnormal food intake behaviors) Treat the cause to eliminate symptoms Psychological issues Diet can NOT cure Not treatment starting point

20. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Symptoms of Anorexia Nervosa Low body temperature Fainting/fatigue Loss of heart tissue/ decreased heart rate Lanugo Low metabolic rate/ cold intolerance Little subcutaneous fat Low bone mass Muscle tears/stress fractures Hair loss Bruising Loss of menstrual periods Blood potassium imbalance Iron-deficiency anemia Dental decay Swollen salivary glands Irritation of the esophagus Stomach ulcersLow white blood cell count/decline in immune function Constipation Symptoms of Both Disorders Symptoms of Bulimia Nervosa