Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: * For patients with all forms of hepatitis, provide a complete and balanced diet * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver stores of glycogen; include 50-55% total energy as carbohydrate * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) * Fat intake should be moderate to liberal, depending on tolerance. * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy * Extra fluid should be encouraged, unless contraindicated. Hope this helps some. For calorie needs with obesity I use the follow based on BMI: * BMI of 30-35=16-18kcal/kg actual body weight * BMI of 35-40=14-16kcal/kg actual body weight * BMI of >40=12-14kcal/kg actual body weight * BMI of 55-70=10-12kcal/kg actual body weight * BMI > 70=8-10kcal/kg actual body weight From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch Sent: Tuesday, April 10, 2012 10:09 AM To: rd-usa Subject: [sPAM?] Hepatitis C Importance: Low Hi everyone, I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? Thanks for any suggestions. Margie Hirsch MFCS,RD,LD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. thanks! Conger, MS, RD, CD, CDE Outpatient Clinical Dietitian Pager number: karenc4@... Email Confidentiality Footer: The above email may contain patient identifiable or confidential information. Because email is not secure, please be aware of associated risks of email transmission. If you are a patient, communicating to a UW Medicine Provider via email implies your agreement to email communication; see http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm The information is intended for the individual named above. If you are not the intended recipient, any disclosure, copying, distribution or use of the contents of this information is prohibited. Please notify the sender by reply email, and then destroy all copies of the message and any attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > Â > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. thanks! Conger, MS, RD, CD, CDE Outpatient Clinical Dietitian Pager number: karenc4@... Email Confidentiality Footer: The above email may contain patient identifiable or confidential information. Because email is not secure, please be aware of associated risks of email transmission. If you are a patient, communicating to a UW Medicine Provider via email implies your agreement to email communication; see http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm The information is intended for the individual named above. If you are not the intended recipient, any disclosure, copying, distribution or use of the contents of this information is prohibited. Please notify the sender by reply email, and then destroy all copies of the message and any attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > Â > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. thanks! Conger, MS, RD, CD, CDE Outpatient Clinical Dietitian Pager number: karenc4@... Email Confidentiality Footer: The above email may contain patient identifiable or confidential information. Because email is not secure, please be aware of associated risks of email transmission. If you are a patient, communicating to a UW Medicine Provider via email implies your agreement to email communication; see http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm The information is intended for the individual named above. If you are not the intended recipient, any disclosure, copying, distribution or use of the contents of this information is prohibited. Please notify the sender by reply email, and then destroy all copies of the message and any attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > Â > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 Yes please share and thank you for the information. Â Margie Hirsch,MFCS,RD,LD > Â > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 Yes please share and thank you for the information. Â Margie Hirsch,MFCS,RD,LD > Â > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 Yes please share and thank you for the information. Â Margie Hirsch,MFCS,RD,LD > Â > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 I learned it during my internship, don’t remember the resource that we took it from though. From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch Sent: Tuesday, April 10, 2012 11:04 AM To: rd-usa Subject: RE: [sPAM?] Hepatitis C Yes please share and thank you for the information. Margie Hirsch,MFCS,RD,LD > > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa <mailto:rd-usa%40yahoogroups.com> > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 I learned it during my internship, don’t remember the resource that we took it from though. From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch Sent: Tuesday, April 10, 2012 11:04 AM To: rd-usa Subject: RE: [sPAM?] Hepatitis C Yes please share and thank you for the information. Margie Hirsch,MFCS,RD,LD > > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > stores of glycogen; include 50-55% total energy as carbohydrate > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > * Fat intake should be moderate to liberal, depending on tolerance. > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > * Extra fluid should be encouraged, unless contraindicated. > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > * BMI of 30-35=16-18kcal/kg actual body weight > > * BMI of 35-40=14-16kcal/kg actual body weight > > * BMI of >40=12-14kcal/kg actual body weight > > * BMI of 55-70=10-12kcal/kg actual body weight > > * BMI > 70=8-10kcal/kg actual body weight > > From: rd-usa <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] On Behalf Of Margie Hirsch > Sent: Tuesday, April 10, 2012 10:09 AM > To: rd-usa <mailto:rd-usa%40yahoogroups.com> > Subject: [sPAM?] Hepatitis C > Importance: Low > > Hi everyone, > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > Thanks for any suggestions. > > Margie Hirsch MFCS,RD,LD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 Good point! Alice Dowdy, MS, RD Study Coordinator/Research Dietitian 206 744-9206 MS 359720 dowdy@... **Confidentiality Notice** This email communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. Distribution, reproduction or any other use of this transmission by any party other than the intended recipient is prohibited. > Date: Tue, 10 Apr 2012 09:48:25 -0700 (PDT) > > Reply-To: rd-usa > To: " 'rd-usa ' " <rd-usa > > Subject: RE: [sPAM?] Hepatitis C > > Â > > I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. > thanks! > > Conger, MS, RD, CD, CDE > Outpatient Clinical Dietitian > Pager number: > karenc4@... > > Email Confidentiality Footer: > The above email may contain patient identifiable or confidential > information. Because email is not secure, please be aware of associated > risks of email transmission. If you are a patient, communicating to a UW > Medicine Provider via email implies your agreement to email > communication; see > http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm > > The information is intended for the individual named above. If you are > not the intended recipient, any disclosure, copying, distribution or use > of the contents of this information is prohibited. Please notify the > sender by reply email, and then destroy all copies of the message and any > attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > > > > > Â > > > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > > stores of glycogen; include 50-55% total energy as carbohydrate > > > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > > > * Fat intake should be moderate to liberal, depending on tolerance. > > > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > > > * Extra fluid should be encouraged, unless contraindicated. > > > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > > > * BMI of 30-35=16-18kcal/kg actual body weight > > > > * BMI of 35-40=14-16kcal/kg actual body weight > > > > * BMI of >40=12-14kcal/kg actual body weight > > > > * BMI of 55-70=10-12kcal/kg actual body weight > > > > * BMI > 70=8-10kcal/kg actual body weight > > > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > > Sent: Tuesday, April 10, 2012 10:09 AM > > To: rd-usa > > Subject: [sPAM?] Hepatitis C > > Importance: Low > > > > Hi everyone, > > > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > > > Thanks for any suggestions. > > > > Margie Hirsch MFCS,RD,LD > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 Good point! Alice Dowdy, MS, RD Study Coordinator/Research Dietitian 206 744-9206 MS 359720 dowdy@... **Confidentiality Notice** This email communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. Distribution, reproduction or any other use of this transmission by any party other than the intended recipient is prohibited. > Date: Tue, 10 Apr 2012 09:48:25 -0700 (PDT) > > Reply-To: rd-usa > To: " 'rd-usa ' " <rd-usa > > Subject: RE: [sPAM?] Hepatitis C > > Â > > I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. > thanks! > > Conger, MS, RD, CD, CDE > Outpatient Clinical Dietitian > Pager number: > karenc4@... > > Email Confidentiality Footer: > The above email may contain patient identifiable or confidential > information. Because email is not secure, please be aware of associated > risks of email transmission. If you are a patient, communicating to a UW > Medicine Provider via email implies your agreement to email > communication; see > http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm > > The information is intended for the individual named above. If you are > not the intended recipient, any disclosure, copying, distribution or use > of the contents of this information is prohibited. Please notify the > sender by reply email, and then destroy all copies of the message and any > attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > > > > > Â > > > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > > stores of glycogen; include 50-55% total energy as carbohydrate > > > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > > > * Fat intake should be moderate to liberal, depending on tolerance. > > > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > > > * Extra fluid should be encouraged, unless contraindicated. > > > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > > > * BMI of 30-35=16-18kcal/kg actual body weight > > > > * BMI of 35-40=14-16kcal/kg actual body weight > > > > * BMI of >40=12-14kcal/kg actual body weight > > > > * BMI of 55-70=10-12kcal/kg actual body weight > > > > * BMI > 70=8-10kcal/kg actual body weight > > > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > > Sent: Tuesday, April 10, 2012 10:09 AM > > To: rd-usa > > Subject: [sPAM?] Hepatitis C > > Importance: Low > > > > Hi everyone, > > > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > > > Thanks for any suggestions. > > > > Margie Hirsch MFCS,RD,LD > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 Good point! Alice Dowdy, MS, RD Study Coordinator/Research Dietitian 206 744-9206 MS 359720 dowdy@... **Confidentiality Notice** This email communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. Distribution, reproduction or any other use of this transmission by any party other than the intended recipient is prohibited. > Date: Tue, 10 Apr 2012 09:48:25 -0700 (PDT) > > Reply-To: rd-usa > To: " 'rd-usa ' " <rd-usa > > Subject: RE: [sPAM?] Hepatitis C > > Â > > I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. > thanks! > > Conger, MS, RD, CD, CDE > Outpatient Clinical Dietitian > Pager number: > karenc4@... > > Email Confidentiality Footer: > The above email may contain patient identifiable or confidential > information. Because email is not secure, please be aware of associated > risks of email transmission. If you are a patient, communicating to a UW > Medicine Provider via email implies your agreement to email > communication; see > http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm > > The information is intended for the individual named above. If you are > not the intended recipient, any disclosure, copying, distribution or use > of the contents of this information is prohibited. Please notify the > sender by reply email, and then destroy all copies of the message and any > attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > > > > > Â > > > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > > stores of glycogen; include 50-55% total energy as carbohydrate > > > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > > > * Fat intake should be moderate to liberal, depending on tolerance. > > > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > > > * Extra fluid should be encouraged, unless contraindicated. > > > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > > > * BMI of 30-35=16-18kcal/kg actual body weight > > > > * BMI of 35-40=14-16kcal/kg actual body weight > > > > * BMI of >40=12-14kcal/kg actual body weight > > > > * BMI of 55-70=10-12kcal/kg actual body weight > > > > * BMI > 70=8-10kcal/kg actual body weight > > > > From: rd-usa [mailto:rd-usa ] On Behalf Of Margie Hirsch > > Sent: Tuesday, April 10, 2012 10:09 AM > > To: rd-usa > > Subject: [sPAM?] Hepatitis C > > Importance: Low > > > > Hi everyone, > > > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > > > Thanks for any suggestions. > > > > Margie Hirsch MFCS,RD,LD > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 I looked back into my internship binder and I took those from the hospital that I interned at. These numbers usually turn out to be close to Benedict equation x 0.9-1.0 for obesity. From: rd-usa [mailto:rd-usa ] On Behalf Of Alice Dowdy Sent: Tuesday, April 10, 2012 11:37 AM To: 'rd-usa ' Subject: RE: [sPAM?] Hepatitis C Good point! Alice Dowdy, MS, RD Study Coordinator/Research Dietitian 206 744-9206 MS 359720 dowdy@...<mailto:dowdy%40uw.edu> **Confidentiality Notice** This email communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. Distribution, reproduction or any other use of this transmission by any party other than the intended recipient is prohibited. > Date: Tue, 10 Apr 2012 09:48:25 -0700 (PDT) > From: KAREN CONGER <karenc4@...<mailto:karenc4%40u.washington.edu>> > Reply-To: rd-usa <mailto:rd-usa%40yahoogroups.com> > To: " 'rd-usa <mailto:%27rd-usa%40yahoogroups.com>' " <rd-usa <mailto:rd-usa%40yahoogroups.com>> > Subject: RE: [sPAM?] Hepatitis C > > > > I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. > thanks! > > Conger, MS, RD, CD, CDE > Outpatient Clinical Dietitian > Pager number: > karenc4@...<mailto:karenc4%40u.washington.edu> > > Email Confidentiality Footer: > The above email may contain patient identifiable or confidential > information. Because email is not secure, please be aware of associated > risks of email transmission. If you are a patient, communicating to a UW > Medicine Provider via email implies your agreement to email > communication; see > http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm > > The information is intended for the individual named above. If you are > not the intended recipient, any disclosure, copying, distribution or use > of the contents of this information is prohibited. Please notify the > sender by reply email, and then destroy all copies of the message and any > attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > > > > > > > > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > > stores of glycogen; include 50-55% total energy as carbohydrate > > > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need levels > > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > > > * Fat intake should be moderate to liberal, depending on tolerance. > > > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > > > * Extra fluid should be encouraged, unless contraindicated. > > > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > > > * BMI of 30-35=16-18kcal/kg actual body weight > > > > * BMI of 35-40=14-16kcal/kg actual body weight > > > > * BMI of >40=12-14kcal/kg actual body weight > > > > * BMI of 55-70=10-12kcal/kg actual body weight > > > > * BMI > 70=8-10kcal/kg actual body weight > > > > From: rd-usa <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] On Behalf Of Margie Hirsch > > Sent: Tuesday, April 10, 2012 10:09 AM > > To: rd-usa <mailto:rd-usa%40yahoogroups.com> > > Subject: [sPAM?] Hepatitis C > > Importance: Low > > > > Hi everyone, > > > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient who is > > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) and > > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have known > > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did not > > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this patient? > > > > Thanks for any suggestions. > > > > Margie Hirsch MFCS,RD,LD > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2012 Report Share Posted April 10, 2012 thanks! Conger, MS, RD, CD, CDE Outpatient Clinical Dietitian Pager number: karenc4@... Email Confidentiality Footer: The above email may contain patient identifiable or confidential information. Because email is not secure, please be aware of associated risks of email transmission. If you are a patient, communicating to a UW Medicine Provider via email implies your agreement to email communication; see http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm The information is intended for the individual named above. If you are not the intended recipient, any disclosure, copying, distribution or use of the contents of this information is prohibited. Please notify the sender by reply email, and then destroy all copies of the message and any attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > Â > > I looked back into my internship binder and I took those from the hospital that I interned at. These numbers usually turn out to > be close to Benedict equation x 0.9-1.0 for obesity. > > From: rd-usa [mailto:rd-usa ] On Behalf Of Alice Dowdy > Sent: Tuesday, April 10, 2012 11:37 AM > To: 'rd-usa ' > Subject: RE: [sPAM?] Hepatitis C > > > > Good point! > Alice Dowdy, MS, RD > Study Coordinator/Research Dietitian > 206 744-9206 MS 359720 > dowdy@...<mailto:dowdy%40uw.edu> > > **Confidentiality Notice** This email communication and any attachments > may contain confidential and privileged information for the use of the > designated recipients named above. Distribution, reproduction or any > other use of this transmission by any party other than the intended > recipient is prohibited. > > > > > Date: Tue, 10 Apr 2012 09:48:25 -0700 (PDT) > > From: KAREN CONGER <karenc4@...<mailto:karenc4%40u.washington.edu>> > > Reply-To: rd-usa <mailto:rd-usa%40yahoogroups.com> > > To: " 'rd-usa <mailto:%27rd-usa%40yahoogroups.com>' " <rd-usa <mailto:rd-usa%40yahoogroups.com>> > > Subject: RE: [sPAM?] Hepatitis C > > > > > > > > I'm interested in the calorie needs calculation you use for the obese. I have never seen this and am wondering where it is from. > > thanks! > > > > Conger, MS, RD, CD, CDE > > Outpatient Clinical Dietitian > > Pager number: > > karenc4@...<mailto:karenc4%40u.washington.edu> > > > > Email Confidentiality Footer: > > The above email may contain patient identifiable or confidential > > information. Because email is not secure, please be aware of associated > > risks of email transmission. If you are a patient, communicating to a UW > > Medicine Provider via email implies your agreement to email > > communication; see > > http://www.uwmedicine.org/Global/Compliance/EmailRisk.htm > > > > The information is intended for the individual named above. If you are > > not the intended recipient, any disclosure, copying, distribution or use > > of the contents of this information is prohibited. Please notify the > > sender by reply email, and then destroy all copies of the message and any > > attachments. See our Notice of Privacy Practices at www.uwmedicine.org. > > > > > > > > > > > > > > > In my book, Nutrition and diagnosis-related care it has the following for Hepatitis: > > > > > > * For patients with all forms of hepatitis, provide a complete and balanced diet > > > > > > * Diet should provide 30-35kcal/kg (probably less since your pt is obese) provide sufficient carbohydrate to replenish liver > > > stores of glycogen; include 50-55% total energy as carbohydrate > > > > > > * Intake of protein should be 1-1.2g/kg for acute hepatitis. Well nourished or chronic active hepatitis patients may need > levels > > > that just meet the DRI (0.8g/kg; > age 65-0.91g/kg) > > > > > > * Fat intake should be moderate to liberal, depending on tolerance. > > > > > > * Supplement diet with B-complex vitamins, vitamin K, Vitamin C, and Zinc for anorexia and to improve encephalopathy > > > > > > * Extra fluid should be encouraged, unless contraindicated. > > > > > > Hope this helps some. For calorie needs with obesity I use the follow based on BMI: > > > > > > * BMI of 30-35=16-18kcal/kg actual body weight > > > > > > * BMI of 35-40=14-16kcal/kg actual body weight > > > > > > * BMI of >40=12-14kcal/kg actual body weight > > > > > > * BMI of 55-70=10-12kcal/kg actual body weight > > > > > > * BMI > 70=8-10kcal/kg actual body weight > > > > > > From: rd-usa <mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] > On Behalf Of Margie Hirsch > > > Sent: Tuesday, April 10, 2012 10:09 AM > > > To: rd-usa <mailto:rd-usa%40yahoogroups.com> > > > Subject: [sPAM?] Hepatitis C > > > Importance: Low > > > > > > Hi everyone, > > > > > > I was hoping for some assistance on the latest nutrition recommendations on for patients with hepatitis C. I have a patient > who is > > > morbidly obese with hepatitis C. FYI-She also has dementiaShe has a history of mildly depleted albumin levels (around 3g/dl) > and > > > depleted prealbumin levels (around 16mg/dl). The patient's weight has remained relatively unchanged in the 7 years I have > known > > > her. She has a very good appetite. I had her on a protein supplement for awhile which did not impact her protein levels. I did > not > > > think there would be much change anyway because she has liver disease. Is there something else I should be doing for this > patient? > > > > > > Thanks for any suggestions. > > > > > > Margie Hirsch MFCS,RD,LD > > > > > > Quote Link to comment Share on other sites More sharing options...
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