Nutritional medicine

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The Nutritional Medicine is a multidisciplinary medical discipline that current scientific knowledge about physiology and pathophysiology of the human diet for prevention , cure and relief of disease uses.

Nutritional medicine deals with research into nutritional-physiological findings, the development of nutritional therapeutic applications ( nutritional therapy ) and the establishment of these findings in all sub-areas of medicine. It also expressly refers to healthy people. On the one hand, nutrition is understood as providing people with macro ( carbohydrates , fats , protein ) and micronutrients ( vitamins and trace elements ) and, on the other hand, as a nutritional intervention, i.e. therapeutic intervention. The latter refers to clinical nutrition (English: Clinical Nutrition) only to sick people who are medically or nursing care.

Clinical nutrition

Clinical nutrition includes all nutritional measures that are used or recommended for sick people of all age groups who are receiving medical or nursing care. In addition, the structure, conception, theory and scientific derivation as well as the practice of these measures are summarized.

Acutely or chronically ill people who are cared for either permanently (for example in long-term care facilities) or temporarily as outpatients are the target group of clinical nutrition. It serves preventive and therapeutic purposes in order to maintain or improve the quality of life by improving the clinical course of an illness, promoting recovery or increasing or maintaining performance. These include, for example, food fortification, artificial nutrition and disease-specific foods for immunonutrition .

In the health care facilities, various areas of responsibility deal with clinical nutrition, for example kitchens that provide communal catering (care catering), dietetics (nutritional history and advice with or without nutritional intervention), care of overweight patients by a special team (nutritional or nutritional counseling). Obesity team), nutritional support (provision of food or nutrients for conventional or enteral or parenteral nutrition, for special or oral balanced diets; serving of meals) as well as coordination and monitoring of clinical nutrition by a nutrition committee.

Methods

Nutritional medical therapy is based on the nutritional history and physical examination , as well as possible technical and laboratory tests. In this way, the diet-related risk profile of a patient ( overweight , underweight and malnutrition ) can be assessed. In hospitals, these tasks are usually carried out by a nutrition team .

Many diseases can be positively influenced by adequate nutrition. Several studies have shown that a needs-based perioperative diet improves wound healing and reduces morbidity and mortality . Even if you are overweight, you should be fed in case of serious illness, as fasting increases morbidity and mortality. If natural oral nutrition is not possible, various methods of artificial nutrition are used. Whenever possible, preference is given to enteral nutrition over parenteral nutrition. The nutritional intervention is always only part of the overall therapy . Attempting to cure serious illnesses solely through diet is considered a malpractice in nutritional medicine .

Like other medical disciplines, research in nutritional medicine uses evidence-based medicine wherever possible . The research results are included in nutritional medicine guidelines , which are published in Germany by the German Society for Nutritional Medicine (DGEM) , among others .

Continuing education (Germany)

The designation "nutritional medicine" has been recognized as additional training for doctors in the model further training regulations of the German Medical Association from 2018 . The state medical associations are responsible for implementing the further training regulations .

literature

  • Hans Konrad Biesalski, Stephan Bischoff, Christoph Puchstein: Nutritional medicine . 4th, completely revised and expanded edition. Georg Thieme, Stuttgart 2010, ISBN 978-3-13-100294-5 .
  • Heinrich Kaspar: Nutritional medicine and dietetics , Elsevier, Munich / Jena 2004, ISBN 3-437-42011-9 ; 11th edition, 2009.
  • Peter Schauder, Günter Ollenschläger: Nutritional Medicine: Prevention and Therapy 3., completely revised. and exp. Ed., Elsevier, Urban and Fischer, Munich / Jena 2006, ISBN 978-3-437-22921-3
  • Current nutritional medicine , journal for metabolic research, clinical nutrition and dietetics, Thieme, ISSN  0341-0501
  • H. Koula-Jenik, M. Kraft, M. Miko, R.-J. Schulz (Ed.): Guide to Nutritional Medicine , Urban & Fischer, Munich / Jena 2006, ISBN 3-437-56530-3
  • Obesity: causes, clinical picture, secondary diseases. Schattauer Verlag, Stuttgart ISSN  1865-1739
  • Robert Jütte : History of Alternative Medicine. From folk medicine to today's unconventional therapies. CH Beck, Munich 1996, ISBN 3-406-40495-2 , pp. 144-164 ( nutritional therapies and vegetarianism ).
  • Kurt Widhalm (ed.): Nutritional medicine. 3. Edition. Cologne 2009.

Web links to specialist societies

European and German-speaking professional societies that deal with the establishment and further development of nutritional medicine are:

supporting documents

  1. ↑ L. Valentini, D. Volkert, T. Schütz, J. Ockenga, M. Pirlich, W. Druml, K. Schindler, PE Ballmer, SC Bischoff, A. Weimann, H. Lochs: Guideline of the German Society for Nutritional Medicine (DGEM) - DGEM terminology in clinical nutrition. 2013 ; accessed on December 27, 2018
  2. ↑ (sample) advanced training regulations 2018 November 2018, section C, additional advanced training in nutritional medicine, pp. 313–314; Document server of the German Medical Association . Retrieved December 2, 2019.