What Should I Eat includes information and answers to patient questions regarding diet, nutrition and scleroderma. It is presented by Bethany Doerfler, MS, RD, LDN
Bethany Doerfler MS, RD, LDN discusses top nutrition concerns of scleroderma patients, as well as the results of a recent medical nutrition therapy study. She also discusses strategies for healthy eating, combating GI issues, maintaining muscle, a Mediterranean diet, supplements and more.
http://www.our-diabetic-life.com Intake of large amount of carbohydrates can spike your blood glucose level. Right amount of carbohydrate can make your glucose level under control.
Bethany Doerfler MS, RD, LDN discusses top nutrition concerns of scleroderma patients, as well as the results of a recent medical nutrition therapy study. She also discusses strategies for healthy eating, combating GI issues, maintaining muscle, a Mediterranean diet, supplements and more.
http://www.our-diabetic-life.com Intake of large amount of carbohydrates can spike your blood glucose level. Right amount of carbohydrate can make your glucose level under control.
The presentation has three parts: UNITE for Diabetes Philippines CPG recommendations on medical nutrition therapy (MNT), improving adherence to MNT and use of SMS.
Effective Diet plan for diabetic patientMedisys Kart
Diet Plays major role in diabetes. If you are not taking your diet properly and eating foods that should be avoided then it can be dangerous. So we are sharing some of the diet tips for diabetic patient in ppt so that you can eat right food and get rid of diabetes.
Diabetes is a problem with your body in which glucose level (Sugar level) in blood rise higher than normal. This is also called hyperglycemia. Diabetes affects each and every organ of your body. Learn more about what is diabetes and its types. Get to know its risk factors, its effects on your body, prevention tips and diet tips to reduce diabetes.
Indus Health Plus provides best preventive health checkup packages such as heart checkup, full body checkup packages, fitness checkup, annual corporate checkup, executive checkup, couple checkup and family health checkup at 50% less than market cost with same day reports.
Get avail health checkup packages at https://goo.gl/6nW0re
Call Us: 0-90490-22222
The Simply diet initiative by VS WELLNESS aims to provide highly specific and personalized diet plans to help our clients achieve their desired goals simple diet modifications and control. We are a team of well qualified and experienced dietitians and we pride ourselves with the results of our 1000+ clients till date.
Our wide scope of work includes customized diet planing for weight loss, weight gain, diabetic diet, sport nutrition and diet for people suffering from liver, renal, neural diseases, deficiency related issues along with special diet plans for pregnancy, lactation and diet for all age groups. http://www.simplydiet.co
Diabetes support site importance of nutrition for diabetics presentationMaureen Coughlan
Nutrition is a critical part of diabetes care.Balancing the right amount of carbohydrates, fat, protein along with fibre, vitamins and minerals helps us to maintain a healthy diet and a healthy lifestyle.
Getting the balance right can help the body to stay in prime condition, but what is the right balance of nutrients? People have been arguing over the ideal mix for generations and the discussion still rages today.
For people with diabetes, there is at least one extra consideration for our nutritional needs and that is the question of how our blood sugar levels will respond to different diets.
9 foods to help balance blood sugar levelskittycolbert7
When a person has diabetes, either their body does not produce enough insulin, or it cannot use the insulin correctly, so glucose accumulates in the blood. High levels of blood glucose can cause a range of symptoms, from exhaustion to heart disease.
One way to control blood sugar is to eat a healthful diet. Generally, foods and drinks that the body absorbs slowly are best because they do not cause spikes and dips in blood sugar.
The glycemic index (GI) measures the effects of specific foods on blood sugar levels. People looking to control their levels should pick foods with low or medium GI scores.
A person can also pair foods with low and high GI scores to ensure that a meal is balanced.
Below are some of the best foods for people looking to maintain healthy blood sugar levels.
Concept of vegetarianism and Health benefits for following vegetarian diet pattern including a Food Pyramid for vegetarians are included in this slide. You can get an extra hand full of knowledge about Therapeutic importance of fruits and vegetables
Erectile Dysfuncation and Scleroderma is presented by
N. Bennett, MD, FACS
Associate Professor of Urology, Department of Urology, Northwestern University, Feinberg School of Medicine
Co-Director Andrology Fellowship
Sleep is significantly disturbed for various reasons in chronic illnesses. Treating the sleep disturbance concomitantly with the underlying illness may lead to improved quality of life.
Sleep, depression and pain are interdependent symptoms. Hrayr Attarian, MD discusses sleep in chronic illnesses with a focus on scleroderma.
The presentation has three parts: UNITE for Diabetes Philippines CPG recommendations on medical nutrition therapy (MNT), improving adherence to MNT and use of SMS.
Effective Diet plan for diabetic patientMedisys Kart
Diet Plays major role in diabetes. If you are not taking your diet properly and eating foods that should be avoided then it can be dangerous. So we are sharing some of the diet tips for diabetic patient in ppt so that you can eat right food and get rid of diabetes.
Diabetes is a problem with your body in which glucose level (Sugar level) in blood rise higher than normal. This is also called hyperglycemia. Diabetes affects each and every organ of your body. Learn more about what is diabetes and its types. Get to know its risk factors, its effects on your body, prevention tips and diet tips to reduce diabetes.
Indus Health Plus provides best preventive health checkup packages such as heart checkup, full body checkup packages, fitness checkup, annual corporate checkup, executive checkup, couple checkup and family health checkup at 50% less than market cost with same day reports.
Get avail health checkup packages at https://goo.gl/6nW0re
Call Us: 0-90490-22222
The Simply diet initiative by VS WELLNESS aims to provide highly specific and personalized diet plans to help our clients achieve their desired goals simple diet modifications and control. We are a team of well qualified and experienced dietitians and we pride ourselves with the results of our 1000+ clients till date.
Our wide scope of work includes customized diet planing for weight loss, weight gain, diabetic diet, sport nutrition and diet for people suffering from liver, renal, neural diseases, deficiency related issues along with special diet plans for pregnancy, lactation and diet for all age groups. http://www.simplydiet.co
Diabetes support site importance of nutrition for diabetics presentationMaureen Coughlan
Nutrition is a critical part of diabetes care.Balancing the right amount of carbohydrates, fat, protein along with fibre, vitamins and minerals helps us to maintain a healthy diet and a healthy lifestyle.
Getting the balance right can help the body to stay in prime condition, but what is the right balance of nutrients? People have been arguing over the ideal mix for generations and the discussion still rages today.
For people with diabetes, there is at least one extra consideration for our nutritional needs and that is the question of how our blood sugar levels will respond to different diets.
9 foods to help balance blood sugar levelskittycolbert7
When a person has diabetes, either their body does not produce enough insulin, or it cannot use the insulin correctly, so glucose accumulates in the blood. High levels of blood glucose can cause a range of symptoms, from exhaustion to heart disease.
One way to control blood sugar is to eat a healthful diet. Generally, foods and drinks that the body absorbs slowly are best because they do not cause spikes and dips in blood sugar.
The glycemic index (GI) measures the effects of specific foods on blood sugar levels. People looking to control their levels should pick foods with low or medium GI scores.
A person can also pair foods with low and high GI scores to ensure that a meal is balanced.
Below are some of the best foods for people looking to maintain healthy blood sugar levels.
Concept of vegetarianism and Health benefits for following vegetarian diet pattern including a Food Pyramid for vegetarians are included in this slide. You can get an extra hand full of knowledge about Therapeutic importance of fruits and vegetables
Erectile Dysfuncation and Scleroderma is presented by
N. Bennett, MD, FACS
Associate Professor of Urology, Department of Urology, Northwestern University, Feinberg School of Medicine
Co-Director Andrology Fellowship
Sleep is significantly disturbed for various reasons in chronic illnesses. Treating the sleep disturbance concomitantly with the underlying illness may lead to improved quality of life.
Sleep, depression and pain are interdependent symptoms. Hrayr Attarian, MD discusses sleep in chronic illnesses with a focus on scleroderma.
A patient's inspiring journey and practical tips that are applicable to everyone. Learn how to strengthen certain parts of your body as well as modify exercises to maintain physical health while coping with scleroderma.
Dr. Dean Schraufnagel from the University of Illinois at Chicago presented information about ILD at a Scleroderma Patient Education Conference on Saturday, March 15, 2014 which was hosted by the Scleroderma Foundation, Greater Chicago Chapter.
Benjamin Korman, MD discusses the genetics of scleroderma and the genomic era. Genetics and genomics are complicated, and getting more so every day. Every patient is genetically unique, but new technology will make it easier to understand individuals’ genetic susceptibility to disease and response to therapy.
Michael J. Cuttica MD, Assistant Professor of Medicine at the Northwestern Pulmonary Hypertension Program of Northwestern University discusses Pulmonary Arterial Hypertension in scleroderma patients, including how it is diagnosed and treated.
Pulmonary Arterial Hypertension: The Other High Blood Pressure and its association with scleroderma is presented by
Micheal J. Cuttica MD, MS, Assistant Professor of Medicine, Director; Northwestern Pulmonary Hypertension Program, Northwestern University
The Role of Extracorporeal Photopheresis in Scleroderma is presented by
Jaehyuk Choi
Assistant Professor in the Department of Dermatology
Director of the Extracorporeal Photopherisis Unit
Lawrence S. Zachary, M.D. from the University of Chicago presents on Fat Transfer to the upper and lower extremities in patients with Raynaud's Phenomenon.
Healthy Diet and Scleroderma
Bethany Doerfler MS, RD, LDN
Presented at the Scleroderma Patient Education Conference, Saturday, October 19, 2013 at Northwestern Memorial Hospital.
Hosted by the Scleroderma Foundation, Greater Chicago Chapter and the Northwestern Scleroderma Program.
RESEARCH UPDATE: GENE EXPRESSION IN SSC
Monique Hinchcliff MD, MS
Presented at the Scleroderma Patient Education Conference, Saturday, October 19, 2013 at Northwestern Memorial Hospital.
Hosted by the Scleroderma Foundation, Greater Chicago Chapter and the Northwestern Scleroderma Program.
The utility of assessing gene expression in skin to evaluate treatment response: What becomes of all those skin biopsies? is presented by
Monique Hinchcliff MD, MS
Northwestern Scleroderma Program
Pulmonary Arterial Hypertension Overview
Michael J. Cuttica MD Assistant Professor of Medicine Northwestern Pulmonary Hypertension Program
Northwestern University
Ammie Peters, a life coach from Blessings 2 Good, shares her story. After being diagnosed with a rare blood disease in 1992 and exhausting all treatment options, she almost lost hope, but was able to get healthier, lead a productive life and now encourages other patients to stay positive and never give up hope.
Scleroderma Associated Lung Disease is presented by
Jane Dematte MD, MBA, Director, ILD program
Division of Pulmonary and Critical Care, Northwestern Feinberg School of Medicine
The Rehabilitation Institute of Chicago's Karen Grube presents on the effects of Physical Therapy on Scleroderma. Find out what the current research tells us about PT and Scleroderma and what kind of problems PT can help.
Learn from Bethany Doerfler, MS, RD, LDN, a registered dietitian whose clinical practice and research focuses on providing wellness-based medical nutrition therapy for digestive disorders and allergic bowel diseases. She currently practices in the Division of Gastroenterology and Hepatology at Northwestern Medicine in Chicago, IL. She is the first dietitian to be fully integrated into a gastroenterology division for both research and patient care. This presentation is optimized for Scleroderma patients to learn about their diet options to improve scleroderma symptoms and their gut health.
Stacy Kennedy, MPH, RD/LDN, CSO, Senior Clinical Nutritionist at Dana-Farber Cancer Institute/Brigham & Women's Hospital, offers nutrition advice for ovarian cancer patients and survivors.
First Time Ever!!! Experts simplified more than a thousand Modern Researches including Longest Research on Obesity, Chronic Diseases and mortality to Noble prize winning Ultimate body detox for FASTEST WEIGHT LOSS without EXERCISE and CRASH DIETING. Ultimate detox burns STUBBORN FAT, detoxifies body at cellular level and can cure all chronic diseases . You will get all knowledge in Shortest Time to burn fat without any Hard work , without Compromising with taste.
Life Style Modifications IN PCOD Dr. DEEPIKA KOHLI / Dr. SHARDA JAIN / Dr. J...Lifecare Centre
Polycystic Ovarian Disease (PCOD)
Woman’s hormones go out of balance in PCOD.
It can cause problems with menstrual periods and ovulation, making her difficult to get pregnant
This talk was presented by Michael Macklin, MD from the University of Chicago at the Scleroderma Patient Education Conference on May 4, 2024, hosted by the Scleroderma Foundation of Greater Chicago. This talk includes:
Overview of scleroderma manifestations, organ involvement, brief classifications (limited, diffuse, sine scleroderma)
Overview of current treatment options, need for additional therapies
Overview of plan for multi-disciplinary scleroderma center at the University of Chicago
Potential future therapies in the literature at large
Planned trials/future treatment options at the University of Chicago
For more info about scleroderma and the foundation, head to www.stopscleroderma.org
Interstitial lung disease (ILD) is a common complication of scleroderma that leads to inflammation and scarring of the lungs. In this session, we will review the prevalence of scleroderma-associated ILD (SSc-ILD), classic symptoms, and the approach to evaluating patients with suspected disease. In addition, we will cover various treatments available for patients with SSc-ILD.
This talk was presented at the Scleroderma Patient Education Conference on May 4, 2024, hosted by the Scleroderma Foundation of Greater Chicago.
For more info about scleroderma and the foundation, head to www.stopscleroderma.org
Overview of scleroderma manifestations, organ involvement, brief classifications (limited, diffuse, sine scleroderma). Overview of current treatment options, need for additional therapies. Overview of plan for multi-disciplinary scleroderma center at the University of Chicago. Potential future therapies in the literature at large. Planned trials/future treatment options at the University of Chicago.
For more info about scleroderma and the foundation, head to www.stopscleroderma.org
This talk was presented at the Scleroderma Patient Education Conference on May 4, 2024, hosted by the Scleroderma Foundation of Greater Chicago.
This session will discuss modalities and demonstrate exercises to improve movement and function in the hands, face and mouth. Suggestions will be also be provided on the use of assistive devices and alternate techniques to accomplish tasks of daily living to increase independence and protect the hands.
This presentation was held on May 4, 2024 by the Scleroderma Foundation of Greater Chicago.
For more information on the foundation and scleroderma, head to our website at www.stopscleroderma.org
Chronic pain is common. If we don’t suffer from it ourselves, chances are we know someone who does. Changes in the structure and function of the brain are thought to underlie chronic pain. The good news is that these changes are not hardwired. Many things can be done to influence how the brain processes pain signals including exercise, healthy eating, and better sleep, as well as thinking more adaptive thoughts, positive emotions, and feeling love and connected. This session will highlight the neuroscience related to chronic pain and how engaging in simple self-management strategies can result in less pain and a more rewarding life.
This presentation comes from the Spring Patient Education conference presented by the Scleroderma Patient Education Conference presented by the Scleroderma Foundation of Greater Chicago.
See the slides from the Scleroderma Foundation of Greater Chicago's Workshop: Improving Mental Health with Chronic Illness. This presentation was held by the mental health professionals at Ellie Mental Health.
This presentation covers gastrointestinal issues, which are commonly experienced by those living with scleroderma. This session is set to be an invaluable resource for patients and caregivers, as it will provide crucial insights and approaches to managing GI issues effectively. Dr. Khanna's vast knowledge and experience make this talk a must-attend event for anyone seeking to enhance their understanding and management of GI symptoms in scleroderma.
Dr. Richardson's presentation focuses on scleroderma's impact on the hands, particularly calcinosis. You can expect to gain valuable knowledge that will empower them in their journey with scleroderma. This talk promises to be an invaluable opportunity for patients to deepen their understanding of these conditions and enhance their approach to managing scleroderma-related symptoms.
This talk will center around the crucial topic of interstitial lung disease (ILD). Gain invaluable insights into the latest advancements in ILD management, potential treatment options, and the importance of clinical trials in advancing care for scleroderma patients.
Dr. Cuttica and Dr. Mylvaganam will co-lead an insightful talk on pulmonary hypertension (PH). Attendees will have the opportunity to learn about pulmonary hypertension, one of the most serious conditions that impact individuals with scleroderma. The talk will give an overview of pulmonary hypertension and potential treatment options.
In this talk we will discuss the most common findings associated with scleroderma. We will discuss some of the methods your dental team can utilize to help manage your condition, and also some ways that you can help yourself and your dental team manage your condition. We will discuss some unique methods for maintaining your oral health care and will conclude with an open Q&A session.
Virtually every aspect of systemic sclerosis can be beneficially impacted by exercise: inflammation, circulation, body warmth, GI, skin, musculoskeletal and lung health.
The therapeutic underpinnings of exercise target the specific mechanisms behind the pervasive SSc-disease biological, physical and psychological manifestations.
This session is intended to empower people living with scleroderma with knowledge of systemic sclerosis and the anticipated impact exercise and physical activity can have on the many manifestations of systemic sclerosis.
At the end of this session, attendees should have a better understanding of the extent of SSc and feel confident in constructing an exercise regimen generally and for their particular needs related to scleroderma.
This talk will review the best practices for monitoring for the early detection of interstitial lung disease (ILD) and pulmonary hypertension (PH), the two most common and serious lung diseases that occur in patients with scleroderma. It will also cover the many new medications approved for the treatment of ILD and PH and when these medications are indicated. The goal is for patients with scleroderma to understand the recent advances in the diagnosis and treatment of scleroderma-associated lung diseases that are leading to improved outcomes.
In this talk, Dr. Brown will expand your knowledge of how scleroderma impacts the GI tract. This presentation is crucial as an estimated 90% of scleroderma patients suffer from gastrointestinal complications.
Dr. Brown is well-known for his exceptional ability to make complex medical information easy to understand.
Presented by Murray Baron, MD at the Scleroderma Patient Education Conference, hosted by the Scleroderma Foundation Greater Chicago Chapter on Saturday, October 12, 2019 in Chicago, IL. For more about the foundation visit scleroderma.org/chicago.
Presented by Jennifer Mundt, PhD at the Scleroderma Patient Education Conference, hosted by the Scleroderma Foundation Greater Chicago Chapter on Saturday, October 12, 2019 in Chicago, IL.
Presented by Jane Dematte, MD at the Scleroderma Patient Education Conference hosted by the Scleroderma Foundation on Saturday, October 12, 2019 in Chicago, IL
Presented by Darren M. Brenner, MD at the Scleroderma Patient Education Conference hosted by the Scleroderma Foundation Greater Chicago Chapter on Saturday, October 12 in Chicago, IL.
Presented by Dr. JoAnna Harper, PharmD at the Scleroderma Patient Education Conference hosted by the Scleroderma Foundation Greater Chicago Chapter on April 27, 2019 in Oakbrook, IL.
More from Scleroderma Foundation of Greater Chicago (20)
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
1. What should I eat? Patient
Questions
Bethany Doerfler MS, RD, LDN
2. Answering Your Questions
• Someone who I know that had scleroderma said that she is feeling much
better on gluten free diet. Is there any scientific basis to it?
• Besides sugar, white carbs and saturated fats, what are foods to avoid and
reduce inflammation?
• What supplements help gain energy? What are the best juices to fight
inflammation? How does dairy effect digestive tract?
• Benefits of vegan and gluten free diet Implications of low iron ferritin level
• Wondering why my child does not gain weight even if she eats whatever?
• What is the best way to obtain calcium if you are lactose intolerant?
• What is the best way for someone with scleroderma to lose weight?
• What are anti-inflammatory foods?
4. Average daily per capita calories from the US food availability,
adjusted for spoilage and other waste
ERS Food Availability (Per Capita) Data System http://www.ers.usda.gov/Data/FoodConsumption/
10. Is a Mediterranean Diet Anti-Inflammatory?
Fruits &Vegetables
Whole Grains
Healthy Fats
Lean Proteins
REDUCE Inflammation
Refined sugars
Refined starches
Saturated fats &trans fats
INCREASE inflammatory markers
Esposito K. Effect of a Mediterranean-style diet on
endothelial dysfunction and markers of vascular
inflammation in the metabolic syndrome: a randomized
trial. JAMA 2004; 292: 1440– 6.
11.
12. How do I eat Healthy on Lower Fiber Diet?
Breakfast: cooked oatmeal sliced bananas or
berries & lactose free milk
Lunch: Chicken & vegetable soup, Reduced fat
Greek Yogurt & ¼ cup crushed cheerios for crunch
Snack: banana & creamy nut or seed butter
Dinner: Baked chicken, roasted sweet potato &
cooked string beans or peas
Dessert: 1 oz dark chocolate or ½ cup sorbet or 1
all fruit popsicle
13.
14. Diet Therapy for GERD: Conventional
Wisdom
ACG Guidelines:
Weight loss
HOB elevation
Cessation of eating 2-3 hours before bed
Smoking cessation
Routine and global elimination of foods is not
recommended
Katz PO et al. Am J Gastroenterol 2013;108:308-328
15. Small Particle Size Improves Symptoms of GP
RCT
20 weeks, each subject got 7
visits with RD
Nutrient Composition Same
across groups
25%-30% fat calories
6 mini meals
All symptoms of GP improved
No difference in changes in
body weight or blood sugars
16. Large Particle vs. Small Particle Size Foods:
Improved GP symptoms DM
Eggs Pureed
cabbage
Rye Crisp Fruit Sauce
Eggs cabbage
Fresh bread Fresh fruit
Olausson EA. Am J Gastroenterol. March 2014
18. What are FODMAPs?
Lentils, cabbage, brussel
sprouts, legumes
Sorbitol
Raffinose
Honey, apples, pears, peaches,
mangos, fruit juice, dried fruit
Apricots, peaches, artificial sweeteners,
artificially
sweetened gums
Wheat (large amounts), rye (large
amounts), onions,
leeks
Excess
Fructose
Fructans
Fermentable oligo-, di-, monosaccharides and polyols
1. Shepherd SJ, et al. Clin Gastroenterol Hepatol. 2008;6:765-771;
2. Shepherd SJ, Gibson PR. J Am Diet Assoc. 2006;106:1631-1639.
19. High FODMAP Diets Induce Increased Breath
Hydrogen and Symptoms in IBS Patients
• Design
Single-blind crossover study in 15 healthy and
15 IBS patients
2-day consumption of high-FODMAP diet (50
g/d) or low-FODMAP diet (9 g/d)
• Results
Higher levels of breath hydrogen produced with
high FODMAP diet
Gastrointestinal symptoms and lethargy
induced by high FODMAP diet in IBS but not
control patients
Breath hydrogen production
40
35
30
25
20
15
10
5
0
Health-HFD Healthy-LFD
IBS-HFD IBS-LFD
N=29
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Hours
Breathhydrogen(ppm)
HFD=high-FODMAP diet; LFD=low-FODMAP diet
Ong DK et al. J Gastroenteorl Hepatol. 2010;25:1366-1373.
20. Non-Celiac Gluten Sensitivity (NCGS)
• Defined by panel of experts from 14 countries in 2011
• “Non-allergic and non-autoimmune condition in which
the consumption of gluten can lead to symptoms similar
to those seen in Celiac Disease”
• Negative antibodies (except IgG)
• Grossly normal histology
• Clinical improvement on a GFD in the absence of
antibodies and intestinal mucosal abnormalities
Sapone et al. BMC Medicine 2012 10:13
21. Non-Celiac Gluten Sensitivity (NCGS)
Also known as:
Gluten sensitivity (GS)
Gluten intolerance
Verdu EF, et al. Am J Gastroenterol 2009; 104:1587–
1594
”
22. Summary
•Global limitation of acidic foods not necessary
•Weight loss
•Technique driven weight loss aids patients
GERD
•Utilize texture modifications
•5-6 small meals
•Avoid excessive weight loss
•Assess and treat malnutrition
Gastroparesis
& Nausea
•Modify Textures
•Low FODMAP diet
Gas, Bloating
& Diarrhea
23. Seeking Information on Supplements &
Complementary Therapies
• National Institute of Health Office of Dietary Supplements:
http://dietary-supplements.info.nih.gov/
• Look up your supplement:
http://ods.od.nih.gov/health_information/health_information.aspx
• Complementary and Alternative Medicine
http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm
• Institute of Medicine
http://www.iom.edu/?ID=4829
• Department of Health and Human Services Agency for Healthcare Research
and Quality
http://www.ahrq.gov/
23
24. What do I tell my patients?
• Eat real food
• Limit refined sugars
Sugar Sweetened Beverages and excess carbohydrates
• Balance dietary fats
Plant based is best
• Include more plant based foods: cooking peeling help improve tolerance
• Balanced animal protein
Nitrate Free
• Multivitamin, Calcium & Vitamin D, B12 and sometimes iron
Editor's Notes
To be clear Inflammation does not cause autoimmune diseases or SSC but reducing inflammation may improve overall wellness and how the organs function and risk of developing other chronic diseases such as CVD. This is not the same thing as saying you need to be gluten free or dairy free. Although we see a lot of cross over with Celiac and other auto immune disorders, simply eliminating gluten or dairy is not the whole picture
Randomized controlled trial where DM What is really important is that there was no
Sugary drinks are the largest single source of calories in the American diet and account for half of all added sugars Americans consume. Calorie consumption from sugary drinks doubled between 1977 and 2002.The American Heart Association wants us to consume no more than 150 calories of added sweets in the diet daily. Americans eat more PUFA from Omega-6 than anything else and need specific suggestions on improving the Omega-3:Omega-6 ratio of diet.
In order to be successful with any diet or healthy eating approach, patients need extensive resources and strategies. Although several resources exist, directing people towards resources can be helpful for patients.