Senin, 14 November 2011

Nutrition Planning Resources on the Web

I was recently asked the question:

"BIDMC does not have any sample menus to give to patients – either for weight loss or for healthy eating in general. Our nutritional counseling still consists of meeting with a nutritionist and being advised regarding “good” vs. “bad” foods, getting some instruction on calculating calorie content and some advice how to turn a list of foods into a meal.

I’ve checked around on the internet and there are some commercially available programs that will generate menus, based on the kind of diet that one wants but they seem to have substantial constraints in terms of items that are included and how easy it is to exclude things.
 
What I’m a interested in finding out is the possibility of creating an EHR interface that would allow either a patient or a physician to generate not a diet, but a two week menu  which would be customized to dietary preferences and a set of calories.

So for example if I have a patient that needs to lose 30 pounds, doesn’t eat breakfast, is a pescatarian and would like to consume 1/3 of their calories at lunch and the rest at dinner, is there a way of doing that?"

Margo Coletti, our Director of Knowledge Services (formerly the Medical Libraries) researched the question and wrote the following answer

"There is no database currently that produces menus with that much specificity.  However, Nutrihand Pro comes very close.

BIDMC subscribes to the Nutrition Care Manual which is available through our Intranet Portal.  The Client Education tab at the top lists several menus for weight loss and for various health conditions and dietary restrictions (MI, tyramine-restricted, diabetic, etc)

The Joslin Clinic has excellent nutritionists for you to refer your diabetic or prediabetic patients to. These nutritionists will work with the patient to tailor menus to their needs.

Joslin also has an excellent weight loss program for diabetics.  The nutritionists, again, will work with patients to tailor their menus.

There are also several databases that produce nutrition facts for a given food or food product. Here are some that the Joslin Clinic uses in their nutrition education:
http://www.calorieking.com/ (One can download a free CalorieKing-Joslin Food Awareness Toolbar to count carbs)
http://caloriecount.about.com/ (Nutrition information with a recipe analysis feature)
http://calorielab.com/ (Information on calorie content of foods and caloric expenditure of activities)
http://www.dietfacts.com/ (Nutrition information website that includes many restaurants)
http://www.eatright.org/ (Website for the American Dietetic Assn)
http://nal.usda.gov/fnic/foodcomp/search/ (Nutrient Data Laboratory; provides extensive nutrition information and values for potassium, sodium, protein)

I hope this is helpful."

Per their website, Nutrihand is free when you join with your nutritionist or dietitian.  If you're getting professional help offline, it enables you and your counselor to work together online on meal plans, shopping lists, and fitness goals. You can print out reports to bring to your sessions. Diabetics who use insulin pumps can upload data from their glucometer on a private and secure network and chart or graph glucose levels, blood pressure , and other personal data to adjust pump settings and track health status.

We'll study these resources and incorporate the most useful ones into our patient and provider portals.

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