Clinical Nutrition is a field of nutrition that aims to treat through therapeutic diet various diseases that affect the human being. Aside from this, it acts by preventing the onset of diseases with a healthy and balanced diet, essential for the promotion, maintenance and restoration of health or prevention of diseases and by contributing toward the improvement of the quality of life (1,2).
Every living being requires a diet in order to survive and reproduce. In doing so, individuals who are not able to fully satisfy their nutritional needs with the conventional diet are suitable for Nutritional Therapy (3,4). There are three routes of administration for Nutrition Therapy:
- Oral (PO) – the change of foods and fluids for diets with higher protein, carbohydrate and/or fat, mineral and vitamin content (e.g., provision of snacks and/or oral supplements);
- Enteral Nutrition (EN) – the supply of calories, proteins, electrolytes, vitamins, minerals, trace elements and fluids through feeding tube, directly into the digestive tract;
- Parenteral Nutrition (PN) – the supply of calories, amino acids, electrolytes, vitamins, minerals, trace elements and fluids intravenously.
In general, Clinical Nutrition operates on three levels: outpatient (private or public medical offices, clinics, nursing homes, day care centers, spas), hospital (wards, human milk banks, milk kitchens) and home.
1. BRAZIL. Ministério da Saúde. Agência Nacional de Vigil’ncia Sanitária. Resolução da Diretoria Colegiada n. 63, de 06 de julho de 2000. Aprova regulamento técnico para fixar os requisitos mínimos exigidos para Terapia de Nutrição Enteral [Ministry of Health. Brazilian Health Surveillance Agency. Collegiate Board of Governors’ Resolution #63 of July 6, 2000. Approves technical regulation to set minimum requirements for Enteral Nutrition Therapy]
2. BRAZIL. Ministério da Saúde. Secretaria de Vigil’ncia Sanitária. Portaria n. 27, de 13 de janeiro de 1998. Aprova regulamento técnico referente à informação nutricional complementar (declarações relacionadas ao conteúdo de nutrientes). Diário Oficial da União. Poder Executivo. 16 de janeiro de 1998. [Ministry of Health. Health Surveillance Secretariat. Administrative Rule #27 of January 13, 1998. Approves technical regulation concerning the supplementary nutritional information (statements relating to nutrient content). Brazilian Official Gazette. Executive. January 16, 1998]
3. Lochs, H et al. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, Definitions and General Topics. Clinical Nutrition. 2006. (http://espen.info/documents/ENGeneral.pdf)
4. Projeto Diretrizes – DITEN. Recomendações Nutricionais para Adultos em Terapia Nutricional Enteral e Parenteral. 2011. (http://www.projetodiretrizes.org.br/9_volume/recomendacoes_nutricionais_de_adultos_em_terapia_nutricional_enteral_e_parenteral.pdf) [Guidelines Project – DITEN. Nutritional Recommendations for Adults in Parenteral and Enteral Nutrition Therapy. 2011. (http://www.projetodiretrizes.org.br/9_volume/recomendacoes_nutricionais_de_adultos_em_terapia_nutricional_enteral_e_parenteral.pdf)]
5. August DA, Huhmann MB. A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enteral Nutr 2009;33:472–500. (http://pen.sagepub.com/content/33/5/472.full.pdf+html)