This is a continuation of Part 1 of the Clinical Nutrition online course which was mainly involved with setting the historical and theoretical premise of Clinical Nutrition. This second part examines in more depth some of the clinical protocols that can be used to treat a myriad of different diseases. Many of these protocols have been tried and tested in a clinical setting and are known to successfully work - just taking these 'clinical secrets' based on decades of work is worth its weight in gold!

The nutrition course consists of 25 interesting lessons which can all be taken by distance learning either as a stand-alone course for the practitioner who wishes to expand their treatment protocols or as a compulsory module by those taking the Bachelors of Science in Holistic Medicine - BSc (HM). There are hundreds of downloadable .pdf files, videos, links to other sites and ready-made handouts that you can take directly into clinical practice the following day - these have taken many years to produce and refine.

COURSE CURRICULUM

The course consists of:

Lesson 1 - Principles of Clinical Nutrition: Contrasting the practice of nutrition in health and disease

• The spectrum of nutritional problems
• Nutrient requirements
• Management pathways
• Perspectives on the future

Lesson 2 - Nutritional Assessment

• Clinical assessment of nutritional status
• Anthropometric assessment of nutritional status
• Biochemical indices of nutritional status
• immunologic assessment of nutritional status
• Functional tests of malnutrition
• Nutritional assessment tools in clinical decision making

Lesson 3 - Overnutrition

• Etiology
• Clinical presentation
• Clinical assessment
• Treatment approaches
• Prevention

Lesson 4 - Undernutrition

• Pathophysiology of undernutrition
• Pathophysiology of undernutrition complicated by stress
• Chronic undernutrition
• Undernutrition in elderly individuals
• Assessment of undernutrition
• Treatment
• Potential problems with nutritional supplementation in undernutrition
• Prevention

Lesson 5 - Metabolic Disorders

• Energy intake, health, and longevity
• The plurimetabolic syndrome
• Pathophysiology of insulin resistance
• Insulin resistance
• Role of affluence in diabetes, dyslipidemia, and essential
• Hypertension
• Alcohol

Lesson 6 - Eating Disorders

Section l: Anorexia nervosa

• History
• Etiology
• Clinical features
• Epidemiology
• Management of anorexia nervosa

Section ll: Bulimia nervosa

• History
• Etiology
• Clinical features
• Epidemiology
• Management
• Comorbidity with physical problems

Section lll: Binge eating disorder

• History
• Etiology
• Clinical features of BED
• Night eating syndrome
• Prognosis of eating disorders
• Perspectives on the future

Lesson 7 - Adverse Reactions to Foods

• Food intolerance
• Food allergy
• Types of food allergy
• Patterns of food allergic responses
• Diagnostic criteria for food allergy
• Food-sensitive enteropathy
• Specific food allergies
• Multiple food allergy
• Scientific background: the basic mechanisms of immune response to dietary antigen

Lesson 8 - Nutritional Support

• Meeting nutritional needs
• Oral feeding and oral nutritional supplements
• Enteral tube feeding
• Drugs and enteral feeding
• Parenteral nutrition
• Special considerations with nutritional support

Lesson 9 - Ethics and Nutrition

• A brief history of medical ethics
• Medical ethics: the 'four-principles' approach
• Definitions and ethical terms
• Some common ethical dilemmas
• Can we afford it? The principle of justice
• Force-feeding
• Conflict between relatives, friends or proxies, and carers
• Application of ethical principles to artificial nutritional support: clinical scenarios
• Clinical guidelines in ethical care

Lesson 10 - The Gastrointestinal Tract

• Celiac disease
• Inflammatory bowel disease
• Irritable bowel syndrome and diverticular disease

Lesson 11 - Nutrition in Liver Disease

• Diseases of the liver
• Laboratory assessment of liver function
• Manifestations and complications of cirrhosis
• Nutritional management in liver disease

Lesson 12 - Nutrition and the Pancreas

• Diabetes mellitus
• Nutritional management of type 1 diabetes
• Pancreatitis
• Pathogenesis of acute pancreatitis
• Severity scores
• Metabolic consequencies of acute pancreatitis
• Artificial nutrition
• Chronic pancreatitis

Lesson 13 - The Kidney

• Acute renal failure
• Chronic renal failure
• Diabetic nephropathy
• Nephrotic syndrome
• Renal replacement therapy
• Transplantation

Lesson 14 - Nutritional and Metabolic Support in Hematologic Malignancies and Hematopoietic Stem Cell Transplantation

• Rationale for nutritional intervention in hematologic malignancies
• Nutritional and metabolic support following HSCT
• Perspectives on the future

Lesson 15 - The Lung

• Prevalence and consequences of weight loss and muscle wasting
• Causes of weight loss and muscle wasting
• Outcome of nutritional intervention
• Acute lung injury

Lesson 16 - Nutrition and Immune and Inflammatory Systems

• The response of the immune system to activation
• The effects of proinflammatory cytokines
• Control systems for cytokines
• Damaging and life-threatening effects of cytokines
• Influence of malnutrition on key aspects of the cytokine response
• Antioxidant defenses and their impact on immune and inflammatory systems in patients
• Immunomodulatory effects of lipids
• Route and content of nutritional provision and immune function and patient outcome

Lesson 17 - The Heart and Blood Vessels

• Atherosclerosis
• Dietary lipids and coronary heart disease
• Plasma lipoproteins
• Lipoprotein metabolism
• Other dietary factors and coronary heart disease
• Diet and hypertension
• Diet and stroke
• Diet and peripheral vascular disease
• Diet and chronic heart failure
• Micronutrients and cardiovascular disease

Lesson 18 - Nutritional Aspects of Disease Affecting the Skeleton

• Overview of mineral ion homeostasis and bone metabolism
• Age-appropriate biochemical reference ranges
• Pharmaceutical agents commonly used in bone disease
• Diagnostic imaging assessment of the skeleton
• Rickets/osteomalacia (vitamin D deficiency)
• Mineral ion homeostasis in preterm infants
• Corticosteroid-induced bone disease
• Post-transplant bone disease
• Osteoporosis associated with chronic disease
• Anorexia nervosa
• Senile osteoporosis

Lesson 19 - Nutrition in Surgery and Trauma

• The stress response to trauma and its effects on metabolism
• Nutritional support in perioperative care
• Feeding the severely traumatized patient

Lesson 20 - Infectious Diseases

• Human immunodeficiency virus infection
• Tuberculosis
• Malaria
• Gastrointestinal infections

Lesson 21 - Nutritional Support in Patients with Cancer

Section 1: Wasting syndrome in cancer

• Definition and prevalence
• Pathophysiology of cancer cachexia

Section ll: Nutritional support in cancer

• Effect of nutritional support on nutritional status
• Effects of nutritional support on clinical outcome
• Oral nutritional supplementation
• Effects of nutritional support on tumor growth

Lesson 22 - Paediatric Nutrition

• Growth
• The impact of development on nutrition
• Infant feeding
• Preschool children
• Schoolchildren and adolescents
• Undernutrition in children
• Nutrition as treatment
• Overweight in children: fatness and 'obesity'

 

Lesson 23 - Cystic Fibrosis

• Definition and pathology
• Clinical features of cystic fibrosis
• Malnutrition in cystic fibrosis
• Other nutritional considerations in cystic fibrosis
• Nutritional management
• Vitamin supplementation in cystic fibrosis
• Mineral status in cystic fibrosis

Lesson 24 - Water and Electrolytes

• Water, electrolytes, and body composition
• Body water distribution
• Body electrolyte content: distribution and exchangeable fractions
• Intracellular water and the body cell mass concept
• Regulation of body water compartments
• Metabolic links: glucose, water, and sodium
• Body water compartments in chronic starvation
• Impact of acute pathological conditions on the ICW
• Body water in acute illness
• Water and electrolyte metabolism during refeeding
• Implications of water and sodium metabolism in nutrition therapy for specific clinical conditions

Lesson 25 - Illustrative Cases

• Children
• Anorexia of psychological origin and refeeding syndrome
• Malnutrition in the older person
• Bowel disease
• Catabolic illness
• Dysphagia
• Obesity

COURSE MATERIALS

Apart from the online access available to the student, the cost of the Clinical Nutrition - Part 2 Diploma course consists of the following materials:

A paperback book entitled: Clinical Nutrition by Gibney et al - produced by The Nutrition Society to provide students with the required scientific basis in nutrition. It focuses on the sick and metabolically compromised patient and contains all the chapters listed in the lessons above.