Susan Sandler, M.S., is a Registered Dietitian (R.D.) of Bateman Food
and Nutrition for Healthcare at Terence Cardinal Cooke Health
Care Center in New York, NY
Maintaining weight in HD patients has been shown to reduce some symptoms and avert malnutrition. Identifying the need for more calories is critical to the patient's overall well being.
Weight loss can occur for four reasons:
-dysfunction in cell metabolism (how the cell burns energy)
-increased use of calories due to involuntary movements
-abnormal food- related behaviors which result from the
cognitive and psychological changes that occur as the disease
-social factors, such as inadequate access to high-quality
foods or lack of understanding of appropriate nutrition.
A diagnosis of HD dictates achieving adequate body weight as soon as is
feasible. In HD, adequate weight is a protective 10-20 pounds above ideal
Food problems may be a result of psychological manifestations, emotional
changes, depression, obsessive compulsive disorder or a shortened attention span that renders the patient unable to sit at the table long enough to eat.
Medications may address the underlying psychological causes, but may also have side effects that themselves cause loss of appetite, dysphagia or constipation and should be reviewed regularly with the doctor.
Detecting the need for more calories or more liquids involves three steps