Transcript Double cream

Paediatric Dietitian
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Quality protein rich diets
Probiotics and the gut flora of tube fed
children
Getting the best out of your dietitian
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How to make high calorie diets ‘healthier’?
◦ Include the 5 food groups
 ? Equal proportions
◦ Monounsaturated and Polyunsaturated fats
◦ Protein
◦ Perspective
 Growth and weight gain is current priority
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Bread, cereal, potatoes, pasta, rice…
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Fruit and vegetables
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Milk and dairy foods
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Meat, fish, eggs, beans, nuts….
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Oils and spreads and foods to eat less often
◦ Get the balance right with fibre – may be too filling
◦ Increase calories with spreads, oils, sauces
◦ Higher calorie – fruit juice, dried fruit, avacado
◦ Sat fat but good source protein, vitamins & minerals
◦ Best source of protein
◦ Increase calories with oils and sauces; try nut butters,
humous
◦ Bigger proportion than for healthy population
◦ Add spread, oils, cream, cheese, mayonnaise etc to foods
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Mono & Polyunsaturated fats
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Vegetable oils – fry vegetables, meat, eggs, chips…
Spreads – use generously on bread, potatoes, veg…
Mayonnaise – as a dip or on sandwiches, potatoes…
Nut butters
Saturated fats
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Cream – add to full fat milk, puddings, sauces, fruit…
Cheese – grate or make cheese sauce for veg, pasta…
Butter – as above with spreads
Coconut milk and cream – add to soup, curry, puddings
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Aim to include main protein sources twice a
day
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Meat
Fish
Eggs
Soya, Quorn
Beans, pulses
Nuts
Milk, cheese, yoghurt also good sources
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Pasta
◦ salmon, cream, smoked cheese & brocolli
◦ Tuna, sweetcorn and mayonnaise
Scrambled eggs with frozen spinach, cheese & cream
Fried fish fingers, croquettes & frozen peas
Cheese sauce (made with double cream & full fat milk)
◦ Cauliflower cheese, fish pie, macaroni cheese
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Rissotto
◦ Roasted butter nut squash (roast with lots of oil)
◦ Chicken, leek and double cream
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Chicken Korma
◦ curry powder, coconut milk or cream, sultanas, onions
and peas/butternut squash
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Breadsticks or vegetable sticks with dips/cheese
spread
Dried fruit
Breakfast cereal
Rice cakes/toast with spread, nut butter, jam…
Cheese strings/purple babybel (cheddar)
Puddings
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Custard, rice pudding, delight/whip deserts
◦ Add fresh/frozen berries or banana and double cream
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Fruit puree & double cream/mascarpone cheese
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Any children already taking these?
Evidence of benefits for diarrhoea, constipation,
bowel conditions, atopic conditions
No current recommendations for tube fed
children
Literature search
◦ Specific patient groups (preterm, critically ill)
◦ Inconsistent methods to report dose
◦ Increased risk via tube as increased probiotic survival
- more research needed for tube fed children
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Generally safe to take orally, esp. in foods
◦ Discuss supplements with pharmacist, dr, dietitian
◦ Caution with newborns (not known how affects
developing immune system)
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Ask questions
◦ Evidence based practice (don’t believe everything
you read!)
◦ If we don’t know, we can look up the evidence and
get back to you (eg probiotics)
◦ Phone/Email between appointments
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Let us know if practical problems with our
advice
◦ Texture modification
◦ Cooking skills/time
◦ Fussy eating/food refusal
◦ ? Pyschology referral – what is available locally
Any Questions?
Rona Cookson, Paediatric Dietitian
September 2016