Initial Step: American Dietetic Association Says Medical Nutrition Therapy is "Integral Component" of Disease Treatment
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CHICAGO – The American Dietetic Association has published an updated position paper calling medical nutrition therapy an “integral component” of health care and the treatment of many different conditions and diseases. When medications are needed along with nutrition therapy, ADA’s position paper urges a team approach to patient treatment that includes registered dietitians.
Medical nutrition therapy is used by registered dietitians to prevent or alter the course of diseases including diabetes, obesity, hypertension, disorders of lipid metabolism, heart failure, osteoporosis, celiac disease and chronic kidney disease. Research studies have shown that people can improve their health and quality of life by receiving medical nutrition therapy interventions, in which RDs counsel clients on behavioral and lifestyle changes that can affect their long-term eating habits and health.
ADA’s updated position paper, published in the June issue of the Journal of the American Dietetic Association, represents the Association’s official stance on the integration of medical nutrition therapy and pharmacotherapy:
It is the position of the American Dietetic Association that medical nutrition therapy, as a part of the Nutrition Care Process, be the initial step and an integral component of medical treatment for management of specific disease states and conditions. If optimal control cannot be achieved with medical nutrition therapy alone and concurrent pharmacotherapy is required, the Association promotes a team approach and encourages active collaboration among registered dietitians and other health-care team members.
ADA’s position paper was written by registered dietitians Beverly J. McCabe-Sellers, nutritionist at the U. S. Department of Agriculture, Little Rock, Ark.; and Annalynn Skipper, owner of Annalynn Skipper and Associates, Oak Park, Ill.
“As the providers of (medical nutrition therapy) services, RDs use MNT to prevent disease and to manage chronic disease by increasing medication effectiveness, maintaining nutrition status and preventing adverse complications,” the authors write.
Evidence demonstrating the effectiveness of medical nutrition therapy is steadily accumulating. Members of ADA’s affiliate, the North Carolina Dietetic Association, have worked for several years with Blue Cross-Blue Shield of North Carolina to fund an MNT benefit of six visits per year to an RD for overweight or obese people who were enrolled in a health promotion program. Results, which have been submitted for publication in a peer-reviewed journal, indicate people who chose to use the RD benefit achieved clinically significant weight loss.
ADA is also one of several health organizations, insurance providers and employers participating in the new Alliance Healthcare Initiative to address childhood obesity. The Initiative is providing more than 6 million children and their families with visits to registered dietitians as part of their health insurance and informing parents about childhood obesity and the expansion of services that are now available to their children.
ADA’s position paper encourages pharmacists and registered dietitians to work closely with physicians and nurses as part of the team that provides individualized and effective management of disease. Should pharmacotherapy be needed, a team approach in which the RD and the pharmacist bring their expertise in food, nutrition and medications is essential. MNT provided by a registered dietitian may also minimize the side effects of pharmacotherapy, the authors write.
“MNT is a growing and changing area of practice. At the same time pharmacotherapy is also expanding. As more is learned about the influence of MNT, it is anticipated that MNT applications will expand and that integration of pharmacotherapy and MNT will continue to be needed. Continuing education in the integration of MNT and pharmacotherapy will be needed as this area of practice evolves,” the authors write.
The American Dietetic Association is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy. Visit the American Dietetic Association at www.eatright.org.