NR 305 Exploring Popular Diet Trends

NR 305 Exploring Popular Diet Trends

NR 305 Exploring Popular Diet Trends

According to Ramsey & Makris (2019), “The ketogenic diet is typically used in the context of epilepsy treatment and is 70% to 90% fat and low (<10%) but adequate protein. Keto, however, is a popular term that refers to a diet that is typically 60% to 70% fat and approximately 20% protein and is used for weight loss and metabolic improvement” (pp. 1734-1735).
I would start by doing a health assessment with her. Referencing Weber & Kelley (2018), I would start by asking her what her typical food intake is throughout the day, how often she eats sweets/how much, and what she usually drinks throughout the day and how much. I would then assess her exercise regimen and how active she is throughout the day.
My advice to her would be to make sure she is mentally ready for this strict of a diet, maintain necessary caloric intake, and continue with the diet because if she were to go back to old eating habits after completing the diet, she would gain weight back. I would also advise her to not be too hard on herself if she strays from her diet a small amount, since mental health and a positive attitude is very important as well.

References:

Ramsey, D.J. & Makris, K.I. (2019). Letters. JAMA Internal Medicine, 179(12), 1734-1736.
Weber, J. R., & Kelley, J. H. (2018). Health assessment in nursing (6th ed.). Wolters Kluwer.

I worked with a woman whose daughter had epilepsy and was unable to control it with medications.  This was about 15 years ago before keto was popular.  I had never heard of it but was very interested in it because she said it completely changed her daughter.  She no longer needed to take as much medication and had much better control over her seizures.  For her it was a much more strict diet, everything had to measure out precisely on a scale and her daughter had to literally lick her plate clean.  But it was amazing to see how it transformed her.  She is still on the diet today but has been able to add more protein and carbohydrates to it.

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Discussion # 3: Diet Trends/Paleo Diet.

I have celiac disease. I must eat gluten free and with no cross contamination or I have terrible reactions including

NR 305 Exploring Popular Diet Trends
NR 305 Exploring Popular Diet Trends

heart palpitations, bloating to a degree of false pregnancy, swelling, nausea/vomiting/diarrhea, worsening migraines, and even neuropathy. There are more symptoms, but these stick out most. The trendy gluten free eaters truthfully hurt my feelings. If I want something substituted for gluten grains, I find that the breads/pastas, etc. are higher in carbohydrates and yet much smaller portions. The trendy gluten free should really read their labels and I find myself constantly with an opportunity to educate patients and friends/family.

Some people with celiac disease opt for a paleo diet as it is inherently gluten free. Therefore, for the purposes of this assignment, my cousin has celiac disease and has an elevated A1C. She wants to try the paleo diet.

The paleo diet is the “hunter-gatherer” diet and “consists of literally meats that can be hunted and fruits/vegetables along with nuts, but avoids diary, processed grains, and legumes” (Masharani, et al, 2015). Diabetics need to count carbohydrates and lower carbohydrate diets improve blood sugar (Weber & Kelley, 2018). Therefore, I would encourage my cousin to take a journal and count carbohydrates in even fruits and vegetables (Weber & Kelley, 2018). I would be on board with my cousin trying a paleo diet while ensuring her diabetes is managed and her celiac disease. There is evidence that in the “short-term” at least that there is better “blood glucose control” with this diet (Masharani, et al, 2015).

Further questions I would ask include:

Are you making sure you still balance your meals with protein and carbohydrates?

Is your endocrinologist on board with your diet change?

Is this sustainable?

Did you make an appointment with a dietitian to see if you can cover all the nutrients you need from your diet?

Do you have a glucometer to make sure your sugars do not run too high or drop too low with this diet change?

 

References

Masharani, U. Sherchan, P, Schloetter, M, Stratford, S., Xiao, A., Sebastian, A., Nolte Kennedy,

M, and Frasset, L. (2015). Metabolic and physiologic effects from consuming a hunter-

gatherer (Paleolithic)-type diet in type 2 diabetes. European Journal of Clinical Nutrition 69, pp. 944-

948.

Weber, J.R. & Kelley, J.H. (2018). Health assessment in nursing (6th ed.). Wolters Kluwer.

An anti-inflammatory diet is a diet based on eliminating foods that can contribute to inflammation. The idea is that eliminating these foods will decrease or eliminate inflammatory conditions. (Janet R. Weber Rn Edd & Kelley, 2018) Inflammatory conditions are diseases such as Rheumatoid Arthritis and Lupus. Inflammatory foods are foods such as processed sugars, processed flours and bread, and most dairy products. This also includes nightshade vegetables, including tomatoes, white potatoes, and eggplant. (Bustamante et al., 2020) Red meat is discouraged on this diet, and it is recommended that one eat two servings of fatty fish per week to, “Lower the omega6 /3 ratio 2:1” (Bustamante et al., 2020, Table 1) There is also a push toward increasing probiotic intake, which includes supplements, yogurt and kefir. The diet I follow also includes soaking all nuts, grains, and beans overnight before eating to remove phytic acid enzyme inhibitors. Phytic acid enzyme inhibitors prevent the absorption of nutrients in these foods. (Gupta et al., 2013) Anti-inflammatory diets are very restrictive, and can be expensive. Most of the ingredients in cooking are fresh, not frozen or canned. It is recommended that you use olive oil, sesame oil or coconut oil, which are also expensive. Sweeteners are pure maple syrup and local honey. Supplements include Turmeric, ginger and cinnamon. It is important to know that these may also increase bleeding risk. That being said, it is possible to get all of the food categories and all of the nutrients you need in a day with adaptation and planning.

 

Questions I would ask my cousin:

* Do you have an inflammatory condition?

* What do you hope to achieve with this diet?

* Are you prepared to adapt this as a lifestyle vs. a “fad diet”?

* Are you prepared to permanently eliminate certain foods from your diet, like bread, tomatoes and alcohol?

* Do you do most of your own cooking?

* Are you aware that this is an expensive diet?

* Do you take blood thinners? Are you at an increased risk for bleeding?

* Do you like tuna, sardines, and other fatty fish?

* How do you tolerate yogurt and probiotics?

 

References

Bustamante, M. F., Agustín-Perez, M., Cedola, F., Coras, R., Narasimhan, R., Golshan, S., & Guma, M. (2020). Design of an anti-inflammatory diet (itis diet) for patients with rheumatoid arthritis. Contemporary Clinical Trials Communications17, 100524. https://doi.org/10.1016/j.conctc.2020.100524Links to an external site.

Gupta, R., Gangoliya, S., & Singh, N. (2013). Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. Journal of Food Science and Technology52(2), 676–684. https://doi.org/10.1007/s13197-013-0978-yLinks to an external site.

Janet R. Weber Rn Edd & Kelley, J. H. (2018). Health assessment in nursing (6th ed.). Lww.