There are two types of malnutrition:

Malnutrition and malnutrition.

Overweight / obese people can also have a deficiency in protein or vitamins / minerals, weight alone is not meaningful and therefore does not provide any information about the supply of the patient with micronutrients and protein.

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Malnutrition (quantitative malnutrition)

Risks:

• Lagging behind in physical and mental development (retardation)

• Nutritional disorder (= dystrophy)

• Death (in extreme cases)

• Possible deficiency: protein, fat, vitamin and mineral deficiency

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Risk groups:

• People with eating disorders

• elderly people living alone

• Patients in old people's and nursing homes

• homeless people

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Malnutrition (qualitative malnutrition)

Undersupply of vitamins and minerals

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Characteristics: too few vegetables and fruit, dairy products, wholemeal bread, legumes and potatoes

Possible reasons: convenience, time pressure

Risks: Retardation in children, which can be irreparable

Frequent infections, constipation, iodine deficiency, osteoporosis (bone decalcification)

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Risk groups:

• Singles

• elderly

• homeless people

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Why is nutritional therapy important?

Malnutrition increases the risk of disease by weakening the immune system. The aim is to improve your nutritional status. Nutritional therapy supports you in eating a full diet with a supply of all important nutrients and thereby counteracting the lack of energy / protein / vitamins / minerals or energy & protein and ultimately having more strength again.

The aim is to supply all of the fatty acids, micronutrients (vitamins and minerals) that are important to you, energy and protein in the measure that your body is optimally supplied with. For this purpose, foods that promote inflammation are specifically avoided and plenty of anti-inflammatory foods are consumed. An anti-inflammatory diet can improve the state of health.

Blood count: The serum albumin value should be at least 3 (so that there is no protein deficiency).

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Important terms in connection with malnutrition:

• Dehydration (lack of water in the body due to insufficient fluid intake) = subgroup of malnutrition

• Cachexia (pathological, very severe emaciation, from a BMI <18.5)

• Inanition (emaciation to less than 80% of normal weight)

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Conditions that can lead to cachexia:

• chronic diseases cancer, AIDS, rheumatoid arthritis

• eating disorder

• persistent diseases of the gastrointestinal tract (enteritis, indigestion) or the pancreas (especially chronic pancreatitis)

• chronic heart failure

• chronic lung disease with respiratory failure (pulmonary cachexia) cystic fibrosis

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Infant Undersuturing:

Kwashiorkor: Cause: insufficient supply of proteins and energy with food

Marasmus: cause: insufficient supply of proteins and energy with food

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Scores for risk identification of malnutrition (e.g. in hospitals or outpatient departments):

Nutritional Risk Screening 2002 (NRS 2002): Hospital

  - Malnutrition Universal Screening Tool (MUST)

ambulance

  - Subjective Global Assessment (SGA)

  - Mini Nutritional Assesment àGeriatrics

   (MNA® - Score (short or long form)

- Nursing registration of malnutrition and its causes (PEMU) à Stationary long-term or elderly care

Assessment:

Aim: Assessment and evaluation of the nutritional status

Application: if the screening result is conspicuous

Implementation: detailed anamnesis and development of goals and measures for nutritional therapy

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• Needed if the screening result shows malnutrition or if there is an increased risk.

• Assessment modules:

• Medical anamnesis interview

• Anthropometric method

• Relevant laboratory values (biochemical parameters)

• Detailed nutritional history

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Drinking food (astronaut food):

• The ability to prescribe is regulated in the Drugs Directive

• Are reimbursable if there is a lack of or limited ability to eat well.

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Classification of your weight - definition and classification of weight in relation to height.

Special percentile curves apply to children and adolescents; the BMI cannot simply be used here.

BMI and interpretation: BMI: body mass index. Formula: Body weight in kg : (body height in m) 2

Underweight: <18.5

Normal weight: 18.5 - 24.9

Overweight = pre-obesity: 25-29.9

Obesity grade I: 30 - 34.9

Obesity grade II: 35-39.9

Obesity grade III:> 40 = per magna

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Further information on therapy for underweight in the area of eating disorders

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Nutritional therapy

• Anti-inflammatory nutrition as a basis, individually tailored to you

• Holistic therapy - do you have any comorbidities that need to be taken into account during the consultation?

• Overall fat selection, how should it be designed

• How many animal foods (e.g. meat products, milk and dairy products, cheese, fish products, eggs) are recommended?

• What do I have to look out for when choosing animal foods?

• How can I counteract inflammatory processes through diet?

• Body weight: Weight reduction is recommended if you are overweight / obese.

• In the case of insulin resistance and lipid metabolism disorders, also treat them with nutritional therapy

• Avoid micronutrient deficiencies and mineral deficiencies & possibly counteract them with nutrient preparations

• Prevent protein deficiency

• Which nutrients do I need in which ratio?

• Get enough fiber (> 30 g / day) through natural foods, possibly fiber substitution

• Sufficient fluid: total fluid per day: 30 - 35 ml per kg body weight and day. Attention, this is not just a drinking liquid. The liquid from food (approx. 500 - 800 ml) must still be subtracted from this, so that an amount of approx. 1.3 - 2 l of drinking liquid is created.

• add valuable anti-carcinogenic (anti-cancer) secondary plant substances

• A selection of foods tailored to your needs with cooking and technical information (for breakfast, snacks, lunch, dinner)

• Do you like to eat your warm meal in the evening? I am happy to cater to your individual situation and we will create a plan on how you can implement your wholesome diet into your everyday life.

• which oils are good for me? What should I watch out for in relation to the anti-inflammatory diet?

• How much fat spread (butter / margarine / vegetable fat) can I use and which products are recommended?

• Get enough Omgea-3 fatty acids and essential fatty acids

• How can I boost and support my metabolism with natural foods?

• Coordinate sensible meal frequency for your individual case - meal allocation

• Define the desired weight stabilization / normalization & the estimated period for this

• what should be considered with beverages and alcoholic beverages?

• How does exercise affect your body and thus also your diet?

• Avoid blood sugar fluctuations

• Sweetening foods - sweeteners, glucose, fructose, sugar and sugar substitutes, what can I use and in what quantities? How high is the respective sweetness of the different products?

• what should be considered when baking and cooking?

• what are cheap snacks / main meals

• Eating out - what should you watch out for?

• Vacation, boat trip or hospital stay, what should be considered?

• Flatulence, bloating, diarrhea, constipation, vomiting, heartburn, loss of appetite, pain related to eating, what can I do about it?

• Daily plans as an example for practical implementation in everyday life

• Enjoyment training

• Optimizing your eating situation

• long-term maintenance of a jointly defined weight

• Strengthen the stomach and intestines with natural foods

• Additional therapy options

• Dietetic products in support of nutritional therapy

• Food supplements - under certain circumstances, a supplement can be useful

• and other topics

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Any questions? I look forward to your call or email. To contact form

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Assistance:

• KISS self-help groups

• Self-help network

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