Dr Sanjith Saseedharan, Head of Department-Critical Care, S.L. Raheja Hospital Mumbai explains that nutrition therapy often gets relegated to the backseat since heavy patient-inflow is forcing doctors to focus more on getting the patients out of ICU. In the process, nutrition management gets delegated to nutritionists, and sometimes even to nurses. A nutrition support team which at minimum comprising of doctors, clinical nutritionists and pharmacist thus forms an important part of meaningful patient recovery
Nutrition plays an important role in improving overall outcomes, my reducing length of stay in the hospital and duration of mechanical ventilation, helping wounds heal quickly, faster functional recovery and improving surgical outcomes . However, it is yet to get its due in India since most members of the medical fraternity are more focused on pharmacological treatment procedures and medications. Very few doctors in the country have a focus on functional improvement after illness and enhanced quality of life which is a result of optimal nutrition practices.
This is because the curriculum of MBBS and postgraduate courses does not lay emphasis enough about the importance of nutrition in illness and recovery. It is time to incorporate nutritional therapy as an integral part of medical education. In the absence of doctors’ nutrition advice, patients often take the wrong route of taking what comes on social media/hearsay/gym trainers etc as truth. This is transfer of misinformation compounds the problem.
Take for instance, the question of protein supplements, which is a high value product for the industry. Most people do not know how much to consume, what to consume, what are the differences, where it should not be take and so on and so forth. There is information available online, however , this information may not be right and many websites seem to give advice which are not ratified by societies and governing bodies like the Indian society of parenteral and enteral nutrition or the Indian dietetic association.
Most hospitals in the country follow guidelines that are laid down by the prestigious societies like the ASPEN, PENSA and other world societies. There is an urgent need to adapt these guidelines to Indian setting. Hence there is an urgent need to have common, India-specific guidelines in the screening , assessment and management of clinical nutrition.
This calls for renowned doctors, clinical nutritionists, pharmacists hospitals to come together and work with associations like ISPEN and create a common nutrition protocol. This would help a lot in setting things right and giving a direction to one and all.
Nutrition therapy often gets relegated to the backseat since heavy patient-inflow is forcing doctors to focus more on getting the patients out of ICU. In the process, nutrition management gets delegated to nutritionists, and sometimes even to nurses. A nutrition support team which at minimum comprising of doctors, clinical nutritionists and pharmacist thus forms an important part of meaningful patient recovery.
There is no denying the fact that some changes are happening but not enough changes. There is a need for doctors’ total involvement in nutrition management.
Innovation is fast emerging as a critical tool in the journey towards optimum nutrition, not just in India, but globally. Technology is making targeted nutrition possible, be it nutrigenetics, customised solutions or microbiota-based solutions which is a very big tool. I’m sure technology would drive nutrition improving overall health outcomes and patient-wellbeing. Medical professionals who are technologically competent would be able to tackle nutrition-related issues with relative ease. As it is seen in various fields artificial intelligence will play a very important role in making clinical nutrition scientific, objective, safe and most importantly effective in improving patient outcomes and recovery.
Hence we need an integrated approach, envisaging the creation of nutrition support teams involving different departments and personnel including those responsible for disease-management, nutrition management, physiotherapist, technical support and so on. “Nutrition Support Teams are relevant because issues relating to nutrition are important right from hospital admission to discharge. Besides, such teams can make the difference in the quality of recovery from illness.
Relevance of nutrition therapy has steadily been growing since the days of globalisation which infused food habits that are alien to the people of India. Today, the country is dealing with issues of under and over-nutrition, and this is posing a great challenge to the medical community. It is important that we address this on a community level too soon, else we may have an entire generation of unhealthy, less productive individuals which will thus lead to economic slowdown. As the president elect of the Indian society of parenteral and enteral nutrition, I will strive to prevent this.
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