Understanding Medical Nutrition Therapy: A Beginner’s Guide to Managing Chronic Illness

Understanding Medical Nutrition Therapy: A Beginner’s Guide For Chronic Illness Management

Medical nutrition therapy (MNT) is a customized nutrition process for individual patients for managing and treating certain health conditions.

This term was first coined in 1994 by the Academy of Nutrition and Dietetics ⁽¹⁾.

Medical nutrition therapy is developed and implemented by a registered dietitian nutritionist (RDN) under the guidance of the patient’s doctor. It can be performed in an outpatient clinic, in a hospital setting or as part of a tele-health program.

In this article, we will talk about the manner in which medical nutrition therapy works and how it helps in treating some medical conditions.

How does Medical Nutrition Therapy Work?

Medical nutrition therapy is based on years of medical research done on the relationship between nutrition, diet and the health outcomes. It should not be confused with nutrition education, which is more about providing basic nutrition information to the general public and is not for the purpose of treating any diseases.

Medical nutrition therapy, on the other hand, directs patients on how to make the best use of their diet to support and help their medical conditions. This therapy not only aims to treat the existing medical diseases, but also is done with the hopes of preventing any new complications.

Who Does Medical Nutrition Therapy? What are the steps taken in it?

For starting medical nutrition therapy, a registered dietitian nutritionist needs to do a comprehensive nutrition assessment for the patient; after which they develop a nutritional diagnosis, care plan, goal along with specific nutrition interventions to help the patient in managing and treating their condition better ⁽²⁾.

The registered dietitian nutritionist provides multiple follow-up visits in aid of supporting the behavior and lifestyle changes of the patient. This consists of monitoring and assessing the patient’s progress and any changes to the patient’s health or the medicines that they are taking ⁽²⁾.

Only a qualified dietitian can provide Medical Nutrition Therapy and it can be done in a hospital or outpatient setting. The initial start of this therapy can be during a hospital stay and can continue into an outpatient setting providing the patient continues to consult an RDN.

Medical nutrition therapy varies in depth and complexity and consists of forming a reduced calorie diet for losing weight to prescribing a high protein diet for encouraging healing of the wounds in patients suffering from severe burns.

In patients suffering from cancer, a registered dietitian nutritionist can recommend intravenous or tube feeding to prevent malnutrition.

What is the Duration of Medical Nutrition Therapy?

How long the patient needs medical nutrition therapy depends on what the patient is suffering from and if they have achieved what they set out to do. In short, the therapy continues till the diagnosis related to nutrition is resolved or till the goal is achieved. However, changes to the plan can be made as needed by the registered dietitian nutritionist and the rest of the medical team.

How Medical Nutrition Therapy Helps in Chronic Illness Management

Medical nutrition therapy is an effective part of the overall treatment and management plan for various diseases such as: 

Heart Disease

Heart disease is an umbrella term used for different conditions affecting the heart function, like hypertension, irregular heartbeat, and plaque buildup in the arteries. If heart disease is not treated, it can cause heart attack, aneurysm, heart failure, stroke and even death ⁽³⁾.

Research shows Medical Nutrition Therapy helps in cutting down the risk factors for heart disease, such as triglycerides, LDL and hypertension ⁽⁴⁾.

The patient is recommended to follow a diet low in cholesterol, saturated fat, sodium and other inflammatory foods ⁽⁴⁾. It is also important that the patient consume a diet which is high in vegetables and fruits for better heart health. As obesity is a major risk factor for heart disease, for which the registered dietitian nutritionist will also encourage lifestyle changes for achieving and maintaining a healthy weight, by increasing physical activity, getting regular exercise and good sleep ⁽⁵⁾.

Diabetes

This is condition where the patient suffers from increased levels of blood sugar and can be of type 1, where there is decreased production of insulin by the pancreas; or type 2, where the body is unable to utilize insulin for regulating blood sugar ⁽⁶⁾.

If diabetes is not treated, then it can cause complications, such as vision and nerve damage, kidney disease, stroke, poor circulation, gum infections and heart disease ⁽⁷⁾.

According to research, Medical Nutrition Therapy helps in controlling or managing diabetes ^{(1, 8)}.

Studies have shown that Medical nutrition therapy helps in reducing certain markers of diabetes, like hemoglobin A1c (HbA1c), which is a measure of long-term blood sugar control ⁽⁹⁾.

This therapy is also effective in managing gestational diabetes, where there is increase in high blood sugar levels during pregnancy and dietary changes go a long way in managing it ⁽¹⁰⁾.

Treatment for diabetes using Medical Nutrition Therapy consist of registered dietitian nutritionist teaching the patient about portion control and carb counting, which helps in controlling the blood sugar by keeping carb intake under control as carbs affect the blood sugar way more than any other nutrients ⁽¹¹⁾.

Cancer

Cancer is a fatal disease where there is rapid and uncontrollable division of abnormal cells in the body. Any part of your body can be affected by cancer ⁽¹²⁾.

One of the main reasons in which the cancer treatment patient seeks registered dietitian nutritionist for Medical Nutrition Therapy is because of the poor appetite of the patient occurring as a result of chemotherapy and other cancer treatments ⁽¹³⁾.

The gastrointestinal lining also can get damaged by radiation therapy making it difficult to eat and digest foods. Because of all this, cancer patients are at high risk for malnutrition. The solution for this is provided via Medical Nutrition Therapy by consuming high calorie nutritional shakes or other protein and fat rich foods, which are easy to digest and eat ⁽¹³⁾.

In severe cases, tube or IV feeding can be recommended by the registered dietitian nutritionist.

Kidney Disease

Kidney disease, if not treated, causes improper filtration of the blood resulting in complications like increased levels of potassium and calcium in the blood, low levels of iron, poor bone health and kidney failure ⁽¹⁴⁾.

Medical nutrition therapy helps by making adjustments to the diet followed by patients suffering from kidney disease, such as limiting certain nutrients like potassium, protein and sodium; whereas some patients may need certain fluid restrictions. All these changes depend on the severity or the stage of the kidney disease ⁽¹⁵⁾.

It is important to treat hypertension in patients suffering from any kind of kidney problems, because high blood pressure increases the risk of kidney disease ⁽¹⁶⁾.

Digestive Conditions

Patients suffering from Crohn’s disease, ulcerative colitis, Celiac disease and irritable bowel syndrome (IBS) can all benefit from Medical Nutrition Therapy ⁽¹⁷⁾.

These digestive problems can cause poor absorption of the nutrients, weight loss, malnutrition, inflammation and accumulation of toxins in the colon ⁽¹⁸⁾.

A registered dietitian nutritionist will develop a customized Medical Nutrition Therapy plan according to the requirements of that particular digestive condition to manage the symptoms and improve the patient’s quality of life.

Patients suffering from inflammatory bowel disease will be recommended to follow elimination diet under the supervision of registered dietitian nutritionist where certain foods are not to be eaten by them and they are gradually added back into the diet to see which ones are causing the symptoms ⁽¹⁹⁾.

When is Medical Nutrition Therapy Needed? Is it a must have?

Like any other treatment, medical nutrition therapy also needs to be done at the right time and place. It is commonly prescribed after an in-depth evaluation by a registered dietitian nutritionist to determine if there is any medical condition which can benefit from this therapy. Medical nutrition therapy is not always needed nor can it benefit each and every ailment. Patients who are hospitalized or are suffering from something, if they eat well and are not at any risk for malnutrition and are following doctor’s instructions with regards to treatment and taking medications may not need medical nutrition therapy.

When a patient is hospitalized, then often a doctor orders a nutritional assessment from registered dietitian nutritionist; who can also be consulted in an outpatient setting, if the doctor suspects the patient has a nutrition-related concern.

In Which Parts of the World is Medical Nutrition Therapy Practiced?

Medical nutrition therapy is commonly practiced across different developed parts of the world, such as North America, Japan, New Zealand and some parts of Europe ^{(20, 21)}.

Medical nutrition therapy is deemed necessary only after a complete in-depth nutritional assessment by an experienced dietitian in an outpatient or hospital setting.

Conclusion

Medical nutrition therapy is well-established, customized, proven, nutritional approach to relieving, managing, and even treating some diseases and medical conditions. This therapy has been proven effective for various long term diseases, such as diabetes, heart disease, kidney disease, cancer and digestive disorders.

This treatment should only be sought or given after a thorough evaluation by a registered dietitian nutritionist and after the doctor has given their assent.

References: