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The concept of medical Nutrition Therapy (MNT) was introduced in 1994 by the American Dietetic Association which is the world’s largest organization of food and nutrition professionals. MNT was formulated with the view to propagate the importance of therapeutic nutrition.
MNT or nutrition therapy is thus defined as nutritional diagnostic, therapy, and counselling services for the management of disease.
Research suggests that the health and the quality of life of the patients who received MNT intervention improved. Academy of Nutrition and Dietetics suggests that the MNT is an “integral component” of the health care and the management of the different diseases such as diabetes, heart diseases, osteoporosis, chronic kidney disease and cancer.
Thus, MNT is a tailored dietary prescription that involves diet counselling depending upon the person’s dietary requirements. It involves an individualized dietary assessment and can be offered to anyone who has an altered nutrition profile, including infants, children, adolescents and adults. It is also of significant importance in pregnant and nursing women and in different medical conditions (diabetes, obesity, hypertension, dyslipidaemia, and cardiovascular diseases).
MNT consists of 2 steps
Step 1 – Conduction of nutrition assessment – The first step of MNT includes the complete analysis of the medical, nutrition and medication history of the patient. The data thus obtained help the Registered Dieticians) RDs to stratify the patients based on the risk of nutritional deficiencies. This step includes checking the person’s nutrition status, and providing the correct food or nutrients to manage the conditions such as diabetes, heart disease and cancer.5,7
Step 2 – Development and implementation of the nutrition care plan – The second step of MNT is to develop a nutrition plan based on the assessment. The nutrition plan may include providing simple changes in the diet of the patient. RDs ensure the implementation of the nutrition care plan. The nutrition therapies suggested by the RDs help the patients to manage the disease condition.5,7
In chronic diseases such as diabetes mellitus, gestational diabetes, obesity, hypertension, disorders of lipid metabolism, heart failure, osteoporosis, celiac diseases, and chronic kidney diseases, adoption of MNT has proved beneficial.
|American Association of Clinical Endocrinologists(AACE)/American Diabetes Association(ADA) nutritional guidelines for the management of diabetes|
|Intake of hypocaloric (weight loss) diet: 250 to 1000 kcal/day deficit|
|Target: decrease weight by 5% to 10% for overweight/obese, 15% for class 3 obesity|
|Target: decrease BMI by 2 to 3 units|
|Intake of carbohydrates (preferably low-glycemic index): 45% to 65% daily energy intake and not less than 130 g/d in patients on low calorie diet|
|Intake of protein: 15% to 20% daily energy intake|
|Intake of dietary fat: <30% daily energy intake|
|Intake of saturated fat: <7% daily energy intake|
|Intake of cholesterol: <200 mg/day|
|Intake of fiber: 25 to 50 g/day|
|Intake of trans fats: minimize or eliminate|
|· Normal BMI: 18 to 22.9 kg/m2|
|· Overweight: 23 to 24.9 kg/m2|
|· Obesity: >25 kg/m2|
Studies in persons with obesity have suggested that MNT can statistically and significantly reduce the body weight.8 A dietician can help in making definitive lifestyle changes such as including regular exercise in daily regime, moderation in alcohol consumption, abstaining from smoking, stress reduction, and modifications in diet such as lowering the intake of total and saturated fatty acids, increasing plant based diets along with monitoring the sodium content in the diet.11
In cases where optimal management of specific disease states and conditions cannot be achieved with MNT alone and pharmacotherapy is required, a team approach with active collaboration among registered dieticians and other health care team members should be promoted.8
Role of dietician in management of MNT for patients receiving pharmacotherapy8
As the nutritional professionals possess the expertise in the composition of food and nutrient metabolism, as MNT providers they customize food intake in collaboration with food preferences and lifestyle habits of an individual.8
Nutrition supplements are not intended to substitute food and cannot replicate all the nutrients present in whole foods; however supplements are a useful and effective way to obtain essential nutrients that might otherwise be lacking in routine diet.13
Use of supplements is recommended in the following situations13,14:
MNT is a tailored dietary prescription that involves diet counselling depending upon the person’s dietary requirements. MNT is of significant importance in pregnant and nursing women and in different medical conditions. In chronic diseases adoption of MNT has proved beneficial and is an “Integral component” of the health care and management of different diseases such as diabetes, heart diseases, osteoporosis, chronic kidney disease and cancer. Active collaboration among registered dieticians and other health care team members including pharmacists should be promoted in cases where optimal management of specific disease conditions requires pharmacotherapy along with MNT. Nutrition supplements are recommended for those who lack nutrients in their diet, have a condition associated with altered nutrient metabolism, or have an increased nutrient requirement due to certain physiological states.
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The information and references in this article are intended solely for the general information and do not constitute legal or other professional advice on any subject matter. The information contained herein is correct as the date of this document to the best of our knowledge. We suggest that you evaluate any recommendations and suggestions independently. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as referred in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended that require medical treatment under a doctor's care.The content of this article is not intended to offer personal medical advice, diagnose health problems or for treatment purposes. It is not a substitute for professional medical advice. Please consult your health care provider for any advice on medications. These articles have been created and curated by Signutra’s medical team and are property of the Company. Copyright of these articles vests with Company.