What is nutritional therapy?
Nutritional therapy can have a positive influence on the course of various diseases and support recovery. In some cases, a special diet is even the central core of the treatment.
Nutritional therapy as a remedy
Within the scope of the catalog of remedies, nutritional therapy is a prescribable remedy for the supplementary treatment of specified diseases.
These include cystic fibrosis patients. On the other hand, people who suffer from a rare congenital metabolic disease such as phenylketonuria, urea cycle defects or glycogen storage disease (glycogenosis). The prerequisite is that nutritional therapy treatment is absolutely necessary to prevent severe mental or physical impairment or death.
If this is the case, a panel doctor can prescribe nutritional therapy. This is carried out by specially trained therapists (dieticians, ecotrophologists and nutritionists).
Aims of nutritional therapy
The aims of nutrition therapy are
- to promote age-appropriate physical and mental development
- to achieve a stable nutritional status
- to prevent a worsening of the condition and alleviate symptoms
- to avoid complications
- to maintain the success of therapy
- to improve life expectancy
Nutritional therapy can be prescribed as a remedy for certain illnesses. Although it can also support treatment for other illnesses, the costs are not usually reimbursed.
Nutritional therapy as a remedy
Medical nutrition therapy is prescribed by a doctor for cystic fibrosis and certain rare metabolic diseases.
Nutritional therapy for cystic fibrosis
Cystic fibrosis is an energy-sapping disease. Patients therefore need a particularly energy-rich diet with balanced fats. They also need a lot of salt and higher amounts of various vitamins and trace elements.
The psychological aspect is also important in nutritional therapy for cystic fibrosis. Patients often have to eat more than they actually want to. In children in particular, this can lead to an attitude of refusal – eating becomes a struggle. This is where nutritional therapy provides parents with important advice.
Nutritional therapy for phenylketonuria
In people with this rare disease, a special enzyme is defective due to faulty genes. In those affected, the amino acid phenylalanine accumulates in the blood and disrupts the supply to the brain. This can damage brain development, especially in early childhood.
- Meat, fish, eggs
- Milk and dairy products (yoghurt, quark, pudding)
- Cereals (flour, bread, pasta, cakes etc.)
- Legumes (peas, beans, lentils, soy)
Nutritional therapy for urea cycle defects
In patients with urea cycle defects, nitrogen excretion is impaired. The ammonia level in the blood then rises. This causes various symptoms – from lethargy and seizures to coma. Nutritional therapy aims to keep the diet as low in nitrogen as possible. In concrete terms, this means a low-protein diet.
Nutritional therapy for glycogen storage disease (glycogenosis)
In patients with glycogen storage disease, the build-up or breakdown of glycogen is impaired. This molecule serves as an energy store for the muscle cells and is important for a balanced blood sugar level. A whole range of different types of glycogenosis are known, with very different symptoms. Nutritional therapy for glycogenosis is aimed at a high-protein diet in which protein serves as an alternative energy source to carbohydrates.
Nutritional therapy in general
There are also many other areas of application for nutritional therapy, although these are not usually covered by health insurance. These include, for example
Nutritional therapy for achalasia
Nutritional therapy for nephrotic syndrome
Nephrotic syndrome is a kidney disease associated with increased protein excretion and edema formation. Nutritional therapy here is primarily aimed at a diet low in salt and high in protein.
Clostridium difficil
Nutritional therapy can prevent uncontrolled proliferation of the intestinal pathogen Clostridium difficil. This often occurs as part of antibiotic therapies. It is recommended to regularly consume probiotics such as probiotic natural yoghurt.
Nutritional therapy for leaky gut
Nutritional therapy is also said to help with leaky gut syndrome. In this case, the intestinal mucosa allows substances to pass into the body that do not actually belong there, for example partially digested proteins and fats.
It is assumed that these substances can cause symptoms in the body such as allergic reactions, digestive problems, headaches and joint pain.
Leaky gut syndrome can be controlled with a special diet that avoids refined sugar, cereals and pulses, among other things. However, neither the syndrome itself nor the dietary recommendations have been scientifically proven.
Nutritional therapy for obesity (adiposity)
What do you do with nutritional therapy?
Medically prescribed nutritional therapy is clearly regulated in the catalog of remedies. The contents include
- Anamnesis and coordination of the therapy goals
- Individual advice and support, for example with regard to suitable foods, appropriate nutritional principles and dietary measures
- Advice and practical support in the event of necessary substitution of enzymes vitamins, minerals, amino acids, fats or trace elements
- Instructions on enteral nutrition (drinking or tube feeding), implementation of parenteral (intravenous) nutrition in the home environment
- Information about dietary products and food ingredients
- Teaching individually suitable cooking and kitchen techniques, practical information on implementing an individual diet
At the end of the nutritional therapy consultation, a nutrition plan is drawn up that is tailored to the patient’s specific needs. Nutritional therapy can be prescribed in individual sessions or in a group. A session usually lasts 30 minutes.
The procedure for non-medical nutritional therapy, for example for the treatment of obesity or achalasia (see above), is not strictly regulated. Different therapeutic approaches can be chosen depending on the treating therapist.
What are the risks of nutritional therapy?
Risks can arise if the nutritional recommendation is not individually tailored to the patient’s needs, i.e. contains too many, too few or the wrong nutrients. There is then a risk of malnutrition or overnutrition, which can worsen the patient’s condition.
Especially in the case of parenteral (intravenous) and enteral (drink/tube feeding) nutrition, infections can also be caused by invading microorganisms such as viruses, fungi or bacteria. However, if the general hygiene regulations are observed, the risk of this is low.
What do I need to consider after nutritional therapy?
Nutritional therapy is successful in the long term if the associated recommendations are implemented consistently. Therefore, even after the end of the prescribed nutritional therapy sessions, you should stick closely to the nutrition plan you have developed and apply the tips and techniques you have learned.
