Clinical Nutrition and Nutritional Support

On successful completion of this module, you will be able to:

• Explain how clinical and functional metabolic states influence nutritional needs.
• Describe methods of assessment of clinical and functional metabolic state.
• Discuss the way malnutrition and disease influence body composition, metabolism and function (especially of the gut), and nutritional demands.
• Describe the different types of nutrition support.
• Discuss the causes of malnutrition and their consequences for nutritional needs.
• Evaluate how nutritional support is organised in a clinical setting, the range of feeds and feeding methods available, including novel substrates, and their effectiveness.
• Interpret how nutritional requirements are affected by common clinical disease states.
• Reflect on the methods of nutrient delivery in own clinical setting, their effectiveness and limitations, the role of conditionally essential nutrients, the opportunities for utilisation of functional foods and the organisation of nutritional support.

Indicative content includes, some or all of the following topics:

• Nutritional assessment in the clinical setting.
• Assessment of clinical and functional metabolic state; assessment of gastrointestinal function in health and disease; effect of functional state on nutritional status; nutrition and immune status; effect of status on clinical outcomes
• Metabolic stress: anorexia and starvation, injury, infection, burns, surgery, etc.
• The gastrointestinal tract in the inflammatory state.
• Nutritional requirements and metabolic stress: macronutrients and micronutrients.
• Special clinical situations: nutritional and biochemical aspects of inflammatory bowel disease, pancreatitis, liver disease, alcoholism, renal disease, diabetes, cancer cachexia, stroke, multiple organ failure (in the ITU setting), malabsorption, anorexia and bulimia etc.
• General principles of nutritional support; routes of support, including:
  • Food
  • Oral nutritional supplements (ONS)
  • Enteral nutrition (EN)
  • Appropriate use of parenteral nutrition (PN)
  • Peripheral PN 
  • Home PN and home enteral tube feeding (HETF)
  • Percutaneous endoscopic gastrostomy (PEG) feeding
  • Complications of PN
  • Refeeding syndrome
  • Paediatric nutritional support.
• Benefits of nutritional support.
• Novel substrates, functional foods, immunonutrition.
• Common myths in clinical nutrition.
• Nutritional support teams: roles and dynamics.
• Ethical issues: case studies.

The learning and teaching methods include:

• Lectures (9am to 6pm during three day module)
• Workshops (these may be included at the lecturer’s discretion)
• Journal club (the lectures usually include discussion of scientific papers)
• Class discussions (5-10 minutes following each lecture)
• Pre-course reading (this is circulated to students before the module).

Assessment for the module is optional for those taking it as a short course. Assessment is compulsory if it is being taken as part of an award programme. Please contact the course leader, Martin Whyte, or the Programme Administrator, Angeliki Panagiotara, for further details.

Summative assessment

The summative assessment for this module consists of: 

• Coursework: a range of subject areas will be assessed, demonstrating learning outcomes across the range for the module.
• You will be required to submit the coursework electronically on a set deadline two months following the module.

In order to complete the assessments you will, as a starting point, be required to demonstrate knowledge obtained from the course material and reading. The essays will also require you to discuss and reflect on the material. Coursework essays are expected to be well researched and referenced.

Formative assessment

You will receive feedback electronically and module organisers will be available for further discussion if necessary.

You will be required to do some reading prior to the module starting, take a look at the reading list.