Nutrition Management: Assessment and Treatment

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Nutrition Management Assessment and Treatment

• M. Burns, PhD, RD
• FCS 4753

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Session Outcomes

• Explain the differences between the diet for
  detoxification and the diet for recovery.
• Draft two meal patterns that are nutritionally
  adequate for recovering alcoholics.

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Nutritional Assessment

• Anthropometric
• Biochemical
• Clinical
• Dietary
• Emotional
• Financial

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Withdrawal

• Stage One
• 6-12 hours after last drink
• Acute anxiety or panic attack
• Symptoms
• mild agitation, anxiety, insomnia, high blood
  pressure, sweating

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Withdrawal

• Stage Two
• 24 hours after last drink
• slight auditory/visual hallucinations in addition
  to stage one symptoms
• Stage Three
• add seizures, usually acute, single episodes

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Withdrawal

• Stage Four
• 2-3 days after last drink
• Delirium tremens (DTs)
• Medical emergency
• Continuous seizures, rapid pulse, profound
  confusion, elevated heart rate

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Delirium tremens

• Rapid fluid loss due to severe sweating
• Disrupts electrolyte balance
• Severity of DTs can lead to nothing by mouth
• Increases risk of stroke, heart attack, and
  permanent brain damage during acute times

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Diet for Detoxification

• Small, frequent meals
• Electrolyte solution
• High potassium/ sodium foods
• High caloric intake
• Progressive diet
• Minimize caffeine

• Liquids at room temperature
• Liquids between meals
• Bland foods
• Limit milk, fat, poorly tolerated foods
• Multi-vitamin mineral supplement

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Stages of recovery

• Detoxification/ withdrawal
• Initial recovery
• Early recovery
• Mid-recovery
• Late recovery

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Diet for Recovery

• Nutrition management
• Based on myPyramid
• Supplements necessary in earlier phases of
  recovery
• Substance substitution
• Nutrition education is an important component
• Evaluating diet plans

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Nutrition Management

• Increase energy intake via small frequent meals
• Sodium restriction for fluid retention
• CHO-controlled diets for high blood sugar
• Multi vitamin mineral supplement

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Macronutrient Rationale

• Protein (20-35 of calories)
• Healing, growth, body functions
• CHO (40-50 of calories)
• Energy, blood sugar for activity, healing, fiber,
  V/M, mood control, relapse prevention
• Fat (30 calories)
• Weight gain, nutrient dilution, relapse
  potential, promotes satiety

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Moment of Application

• Should dietary supplements be used during
  recovery? Why or why not?
• What is meant by substance substitution?

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Evaluating Nutrition Recovery Programs Red Flags

• Elimination of an entire food group
• Schedule that is hard to follow
• Advocate supplements
• Restrict calories
• Encourage fasting
• Place nutrition before other recovery priorities

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Adequate Balanced Nutrition