Protein

By Mary Ellen Posthauer RDN, CD, LD, FAND Recently, I attended a webinar that focused on dietary protein and preserving lean muscle mass. There is a wealth of research on this topic, in particular, as it relates to older adults and protecting muscle health during inactivity. Dr. Robert Demling noted the effect of lean body mass (LBM) loss on wound healing. Healing a wound requires increased calories to prevent the body from breaking down protein (LBM) for energy, thus depleting protein stores required for protein synthesis and healing. Lean body mass is metabolically active, transports protein throughout the body and is essential for survival as it contains all of the skeletal and smooth muscles and immune cells. Healthy adults lose between 3-8% of LBM per decade and after age 70 muscle loss increases to 15% per decade. This loss of LBM or sarcopenia is an age-related, insidious loss of lean muscle mass accelerated by physical inactivity and poor nutrition.

By Mary Ellen Posthauer RDN, CD, LD, FAND February is American Heart Month and Valentine’s Day is celebrated around the world on the 14th. So what is the connection between protecting your heart, enjoying candy and flowers with those you love on Valentine’s Day, and wound care? Many of your clients with wounds also have some type of heart disease or have elevated lipid levels. These clients need nutritional strategies for wound healing that also protects their hearts.

As clinicians know, wound healing is a complex biological process that involves the migration and proliferation of cells along with other molecular events like extracellular matrix deposition. Regardless of the process for healing a wound at the cellular level, a patient’s ability to get adequate nutrition can also play a role in this healing process. It has been shown that malnutrition can cause increased levels of infection, along with a decrease in tensile strength. As a result, the lack of nutritious foods further delays the wound healing process, potentially putting a patient at risk of developing a non-healing wound.

by Nancy Munoz, DCN, MHA, RDN, FAND Pressure injuries (pressure ulcers) claim over 60,000 lives and affect over 2.5 million Americans each year. The US health care system spends $9.1–11.6 billion annually in the treatment of pressure injuries. Aside from the financial cost, pressure injury is a devastating health concern that affects quality of life and well-being.

by Mary Ellen Posthauer, RDN, CD, LD, FAND Several years ago when my nutrition blog began, I discussed the issue of relying on laboratory values – in particular albumin, pre-albumin and transthyretin – as markers of nutritional status. Recently, during a discussion of nutrition and wound care, a dietitian expressed her frustration with a surgeon who kept postponing corrective abdominal surgery until a patient's nutritional status improved, as evidenced by the albumin being in the normal range. However, the patient was receiving adequate calories per enteral feeding and had gained weight. The albumin level was not reflective of the nutritional status. This discussion prompted me to revisit the issue of serum proteins as markers of nutritional status.

By Bruce E. Ruben MD A day doesn't go by that I'm not bombarded with information on the newest diet, the latest exercise trend or the fastest way to get in shape. My email inbox opens with message subjects like "click here to drop 10 pounds fast" or "how to get a Kardashian body without surgery." I overhear women at a local breakfast haunt order egg whites instead of whole eggs, because they contain less fat and they are worried about gaining weight. How about the latest craze of ordering sandwiches wrapped in lettuce because everyone is afraid of the dreaded carbohydrates? Our culture is so focused on losing weight, getting in shape, and looking like the latest model on the cover of Vogue or GQ that we have lost sight of what is healthy.