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BPJ 15 August 2008

Best Practice Journal

Strategies to improve nutrition in elderly people

Many older people suffer from the “anorexia of ageing”. The best option for treating malnutrition is to enhance normal eating and drinking. Nutritional supplements for weight gain are generally not required unless body weight is unable to be maintained with a normal balanced diet, or if food cannot be eaten safely. View Article

The nutritional management of weight loss in COPD

People with COPD are generally underweight, have reduced muscle mass and are often malnourished, leading to other health problems. Opportunities for dietary intervention should be explored, aiming at early detection and early treatment of involuntary weight loss. View Article

Dietary advice for people with coeliac disease

When people are newly diagnosed with coeliac disease, their nutritional status is often compromised, and they may require repletion doses of vitamins and minerals. For remission a lifelong gluten free diet is required. Gluten free foods are now widely available however label reading is important. View Article

The nutritional management of diabetes

Managing diet is a priority for the health and wellbeing of people with diabetes. Measures such as glycaemic index, glycaemic load, carbohydrate counting and introducing soluble fibre into the diet can be useful in managing glycaemic control. The purchase of special "diabetic" foods is unnecessary. It is more important to read and understand food labels. View Article

Infant formula

Although breastfeeding is the best option for an infant, cows’ milk based formula is recommended if breast feeding does not occur. Soy based formula is rarely indicated and is not necessary for an infant with a cows’ milk allergy or lactose intolerance. Hydrolysed cows’ milk formula and lactose-free or lactose-reduced cows’ milk formula can be used in these circumstances. View Article

Vitamins and minerals: dietary sources supplements and deficiencies

In most cases, nutrient needs can be met by consuming a well balanced diet, without the need for supplements. When a nutrient is unable to be consumed in recommended amounts, fortified foods can provide an alternative source. Supplements may be appropriate in certain circumstances e.g., folic acid during pregnancy. Folate, iodine, iron and vitamin B12 are discussed. View Article

Antipsychotics for dementia

Notification and details of an educational programme on the use of antipsychotics for symptoms associated with dementia View Article

Improving Māori health - increased awareness of issues

Feedback on a survey of GPs about Māori health issues View Article

Using nebulisers safely

Nebulisers are used to deliver bronchodilators to people with asthma or COPD or antibiotics to those with bronchiectasis. There is now substantial evidence that the use of a metered dose inhaler (MDI) with a spacer is just as effective as a nebuliser, even in acute asthma. View Article

Eltroxin (levothyroxine) formulation change

From July 2007, Glaxo Smith Kline has distributed a new formulation of Eltroxin 50 microgram and 100 microgram. Since then, there has been an increase in the number of adverse reaction reports involving Eltroxin, received by the Centre for Adverse Reactions Monitoring (CARM) View Article

Upfront: Mandatory fortification of bread with folic acid

What side is your bread buttered on? Mandatory fortification of bread with folic acid: the debate. View Article

Manaakitanga Tikanga related to food healthy kai.

Advice on Māori customs and protocols relating to food. View Article