Diet therapy in advanced practice nursing : nutrition prescriptions for improved patient outcomes

670 Pages·2014·4.358 MB·English

by  Ferraro, Katie, Winter, Cheryl

Diet Therapy in
Advanced Practice
Nutrition
Nursing:
Prescriptions for
Improved Patient
Outcomes
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Diet Therapy in
Advanced Practice
Nutrition
Nursing:
Prescriptions for
Improved Patient
Outcomes
Katie Ferraro, MPH, RD, CDE
Assistant Clinical Professor, Nutrition
University of California San Francisco
School of Nursing
San Francisco, California
Cheryl Haas Winter, MS RD, MS APRN,
CDE, BC-ADM, FNP-BC
Family Nurse Practitioner
DiabetesAmerica & DiabeteSteps Rx
Houston, Texas
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Katie Ferraro, MPH, RD, CDE is
a Registered Dietitian, Certified
Diabetes Educator and nutrition
consultant based in San Diego,
California. Specializing in nutri-
tion communications and cur-
riculum development, Katie’s
approach to primary care nutri-
tion is, “If you can’t beat ‘em…
teach ‘em!” She is an Assistant
Clinical Professor of Nutrition
in the graduate schools of nurs-
ing at the University of California
San Francisco and the University
of San Diego. Katie obtained her
undergraduate degree in Dietetics from Texas Christian University and
Master of Public Health in Public Health Nutrition from the University
of California, Berkeley. She is a former Peace Corps Volunteer (Nepal)
and an avid traveler and intrepid taster of new foods. You can find
Katie online at www.ingrainhealth.com.
Cheryl Haas Winter, MS RD, MS
APRN, CDE, BC-ADM, FNP-BC
is a masters-prepared registered
dietitian and masters-prepared
advanced practice registered
nurse, who is board-certified as a
family nurse practitioner. Cheryl
has been passionate about the
powers of food and nutrition since
high school, which is why she
first became a registered dietitian.
Believing food and nutrition to be
the best medicine for prevention
and treatment of disease eventu-
ally led her to become a registered
nurse, and then family nurse practitioner, so that her patients were sure
to be prescribed necessary medical nutrition therapy. Being focused
on preventing and treating obesity and diabetes, Cheryl also became
board-certified in advanced diabetes management, and practices as a
diabetes specialist healthcare provider in the Houston, Texas markets
at DiabetesAmerica. Additionally, she is a weight-management special-
ist and certified diabetes educator/consultant with her own company,
http://DiabeteStepsRx.com.
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Dedication
As a long-time nutrition educator of advanced practice nurses, this
book is written for and dedicated to you. While I do not share your
advanced practice nursing scope of practice, I certainly do honor and
admire the unfailing dedication and compassion you show to your
patients. I know the realities of your practice: you are short on time,
working in settings that are strapped for cash, and with patient popu-
lations whose needs often appear endless. This book is for you, a small
and humble attempt to educate your patients about the importance of
food and nutrition.
Despite much discussion and data about the importance of preven-
tion, we live and work in a healthcare environment that favors pills and
procedures over sourcing the real roots of problems. For so many of
our patients, food and nutrition issues are at the core of poor health;
but they are also part of the cure for the prevention and treatment of
many conditions. In a healthcare setting such as ours, where insur-
ance companies don’t blink to pay $25,000 for bariatric surgery, but
nothing for preventive nutrition counseling with a registered dietitian,
I applaud the work that you do in helping to educate patients about the
importance and real impact that food and nutrition can have on health.
My co-author Cheryl Haas Winter and I believe that all patients
should have a right to evidence-based diet therapies that can most
positively impact their health outcomes. We hope that you will find
the nutrition information and diet therapy guidelines in this book to
be valuable resources in providing your patients with the most current
and scientifically proven approaches to using food as medicine.
Katie Ferraro, MPH, RD, CDE
Like Katie, I am very passionate about the importance of food and
nutrition in the treatment and prevention of disease. However, being a
generation older than Katie, during my infancy as a registered dieti-
tian, I was part of a medically oriented healthcare system designed
to treat illness with drugs and medicine, not with food and nutrition.
I often struggled with convincing my fellow colleagues about the ben-
efits of incorporating medical nutrition therapy in the patient’s medi-
cal treatment in order to improve their outcomes. Unfortunately, as
far as many of these colleagues were concerned, I was just the lady
from the hospital kitchen, a stigma that registered dietitians still have
to contend with to this day. I also discovered, during this early part of
my nutrition career, that treating illness medically was more lucrative
than preventing illness. For example, still today, our healthcare system
would rather pay to amputate a diabetic limb instead of paying for
nutrition and diabetes education that could prevent it. Frustrated by
this model, but ever so passionate about the importance of medical
nutrition therapy, led me to join the medical profession as a nurse and
then nurse practitioner, where I felt that I could better make a differ-
ence for my patients and be in a position to be able to prescribe this
very important and necessary treatment: medical nutrition therapy.
During my nursing training, I also discovered that there was next to
no “nutrition” education provided to student nurses or student nurse
practitioners, so it became clear to me why I struggled as a young, pas-
sionate registered dietitian in a medically oriented healthcare system.
Like medical schools, nursing programs were also practically void of
nutrition courses, so why would these healthcare professionals pri-
oritize nutrition therapy? How crazy is it that doctors and nurses, the
most instrumental part of the healthcare team, lack the knowledge and
skills for this most valuable medical treatment: nutrition?
No matter what healthcare profession you are in, we all know that
“knowledge is power.” Isn’t that what we tell our patients? I am thrilled
to be part of this “knowledge is power” movement along with Katie
Ferraro to educate my fellow nurses and nurse practitioners, because
I know that this is an incredible group of caring and dedicated health-
care professionals, who like me, love their patients, and only want the
best for them. For me, I dedicate “Diet Therapy in Advanced Practice
Nursing: Nutrition Prescriptions for Improved Patient Outcomes,” to
all my fellow nurses and nurse practitioners who love and care for
their patients.
Cheryl Haas Winter, MS RD, MS APRN, CDE, BC-ADM, FNP-BC
Contents
1. Diet by Design: Healthy Meal Planning . . . . . . . . . . . . . . . . . . . 1
2. Face-to-Face: Nutrition Screening,
Assessment, and Counseling Techniques . . . . . . . . . . . . . . . . . 33
3. Finding Your Weigh: Mastering Weight Management . . . . . . 113
4. From Infants to Ancients:
Nutrition Throughout the Lifecycle . . . . . . . . . . . . . . . . . . . . . 168
5. Matters of the Heart: Nutrition and
Cardiovascular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
6. A Not-So-Sweet Metabolic Disruption:
Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
7. A Pain in the Gut: Nutrition in
Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
8. Blood and Bones: Nutrition in Musculoskeletal
Disorders, Rheumatic Disease, and Anemias . . . . . . . . . . . . 421
9. Nutrition in Hepatobiliary, Pancreatic,
and Kidney Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 453
10. Skin, Surgery, and Stress: Nutrition in
Metabolic Stress, Cancer, and HIV/AIDS . . . . . . . . . . . . . . . . 493
11. When Food Won’t Do: Nutrition Support . . . . . . . . . . . . . . . . . 523
12. Nutrition as a Complementary and Alternative Medicine . . . . 555
Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 599
Appendix B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619
Appendix C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 624
Appendix D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 632
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 635