Clinical Nutrition

The Clinical Dietitians are certified by the Commission on Dietetic Registration of the American Dietetic Association as Registered Dietitians (RD). In addition, two RMH dietitians are Certified Nutrition Support Dietitians (CNSD) and one RMH dietitian is a Certified Diabetes Educator (CDE). Three dietitians are scheduled Monday through Friday. One dietitian is scheduled for weekends and holidays.

Contact Information:

RD Office - 540-689-6337
Operator – Have RD paged
Food Service Secretary – 540-689-6333

Medical nutrition therapy is provided to all patients identified upon admission as high nutrition risk by nutrition screening criteria. Other patients may be consulted based on physician order, admitting diagnosis, skin wounds, enteral and total parenteral nutrition.

The Clinical Dietitians assist with menu planning and monitor the meal service provided by the Nutrition Service Representatives. The dietitian may request modification in texture for patients that experience difficulty in chewing or swallowing. Nutrition intake will be closely monitored to ensure that adequate protein and calories are consumed. Nutritional supplements, tube feedings and/or total parenteral nutrition may be recommended by the dietitian.

Nutrition education is provided to the patient and family to ensure compliance with the diet prescription ordered by the physician. The dietitian understands your individual needs and can help you develop a change in lifestyle that includes healthy eating and exercise.

Choosing a Healthy Diet:

To be healthy, you need to eat a variety of foods. The Food Guide Pyramid is recommended because it provides the amount and variety of food you need each day to stay healthy. Consuming a variety of healthy foods ensures that you obtain all the nutrients you need—calories, protein, fat, carbohydrates, vitamins, minerals, fiber and water. The Dietary Guidelines for Americans, 2005 provides the following science-based advice:

• Make smart choices from every food group.
• Find your balance between food and physical activity.
• Get the most nutrition out of your calories.

Eating right and being physically active are the keys to a healthy lifestyle. By maintaining healthy habits, you may reduce the risk of chronic diseases such as heart disease, diabetes, osteoporosis, cancer and increase your chances of a longer life. A healthy meal plan emphasizes:

• Fruits, vegetables, whole grains, skim or low-fat milk and milk products.
• Lean meats, poultry, fish, eggs, beans and nuts.
• Low in saturated fats, trans fats, cholesterol, sodium (salt) and sugar.

Calories:

Our body uses the calories from food to provide the energy needed for basic body functions and physical activity. Excess calories are stored as body fat. The balance between the calories consumed and exercise to use the calories is important to maintain normal body weight.

Protein:

Our body tissues and muscles are composed of protein. Metabolic stress from acute illness, infection, surgery, bone fractures and some chronic diseases can increase the protein needs. The best sources of protein are milk, cheese, meat, poultry, fish, nuts, dried beans and peas.

Fat:

Fat is an essential nutrient because it promotes the absorption of vitamin A, D, E, K and provides essential fatty acids that cannot be manufactured by the body. The type and total amount of fat in your diet is important to prevent cardiovascular disease. The American Heart Association recommends reducing the total fat, saturated fat, trans fats and cholesterol in your diet.

• Total Fat - Fat is a concentrated source of calories because it provides 9 calories per gram. In comparison, protein and carbohydrates provide only 4 calories per gram. To maintain normal body weight, you should include a fat source with each meal; however, total fat should not exceed 20 – 30% of total calories.
• Saturated Fat - Diets high in saturated fat tend to increase the blood cholesterol. Saturated fats are usually solid at room temperature and are provided mainly from animal sources (butter, lard, bacon, poultry skin) and plant sources (palm, coconut and hydrogenated vegetable oils in shortening and margarines). Monounsaturated fats (canola, olive, peanut) and polyunsaturated fats (corn, safflower, soy, sunflower) may be substituted to lower blood cholesterol.
• Cholesterol - High blood cholesterol levels have been linked to heart disease. Many foods from animal sources are high in cholesterol, such as heavily marbled meats, poultry skin, sausage, bacon, processed meats, whole milk and whole milk products, and egg yolk. To maintain a healthy-healthy diet, cholesterol intake should not exceed 200 mg per day. The American Heart Association recommends that total blood cholesterol should be maintained less than 200 mg/dl.

Carbohydrates:

Carbohydrates are the major source of energy for the body. Complex carbohydrates, such as whole grain bread, cereals, pastas, rice, vegetables and fruits, are excellent sources of vitamins, minerals and fiber. Simple carbohydrates, such as sugar, candy, jelly, cakes, cookies and soft drinks should be limited in the diet because they add “empty” calories and provide very little nutritional value. Also, sticky, sweet foods promote tooth decay.

Vitamins:

Eating a variety of foods from the Food Guide Pyramid will supply the minimum daily requirements of vitamins. Be sure to include one serving of fruit high in Vitamin C daily (orange, grapefruit, cantaloupe, etc). Also, include dark green leafy and dark yellow/orange vegetables or fruits in your daily meal plan to obtain the minimum requirement for Vitamin A.

Minerals:

Our mineral needs remain about the same throughout life with the exception of calcium and iron. Adequate intake of calcium is important throughout life to build strong bones and teeth, and prevent bone loss called osteoporosis. Milk, cheese, yogurt, dark green leafy vegetables, salmon, sardines, soybeans and tofu are excellent sources of calcium. Iron is necessary for building red blood cells to maintain normal hemoglobin levels. Rich sources of iron include liver, egg yolk, dark green leafy vegetables, whole grain breads and cereals.

Fiber:

Complex carbohydrates such as whole grain breads and cereals, vegetables and fruits contribute dietary fiber necessary for lowering cholesterol and reducing the risk of diverticulosis and colon cancer. 20 to 35 grams of fiber a day is recommended to maintain normal bowel function and other health benefits.

Water:

Adequate water intake is essential to maintain proper hydration required for body functions and exercise. Eight glasses of water per day is recommended in addition to other fluids.