Optimal VLCAD treatment management requires ongoing assessment of clinical and nutritional status. Outcome measures from dietary history, anthropometrics, and clinical and laboratory assessment ( RECOMMENDATION TABLE #2, Laboratory and Clinical Findings in Severe VLCAD Deficiency ) are used to determine appropriateness of therapy recommendations.
A thorough medical and social history is also essential for understanding an individual's clinical needs and ability to effectively adhere to therapy recommendations.
Assessment of nutrition-focused physical findings includes a physical exam, patient interview, and/or medical record data. Special attention to weight and growth status, gastrointestinal symptoms (constipation, diarrhea, vomiting), and abnormal skin or hair characteristics are important in VLCAD.
See: Laboratory and Clinical Findings for VLCAD. ( RECOMMENDATION TABLE #2, Laboratory and Clinical Findings in Severe VLCAD Deficiency )
Food and Nutrition-related history includes: assessment of food and nutrient intake, food and nutrient administration, medication and complementary medication use, knowledge/beliefs/attitudes surrounding nutrition, behavior, access to food and food/nutrition related supplies, physical activity and function, and nutritional quality of life. Special attention to adequacy and effectiveness of the most recent dietary therapy prescription includes typical intake, medical food consumption (type, amount, and nutrient content), and total nutrient intake. Total nutrient intake includes fat (total, long chain, medium chain, and essential fatty acids), protein, energy, vitamins and minerals, fiber, and fluids.