Van Riper Cynthia L, Wallace Lee Shelly
The University of Nebraska Medical Center Munroe-Meyer Institute, Omaha, NE, USA.
J Am Diet Assoc. 2010 Feb;110(2):296-307. doi: 10.1016/j.jada.2009.12.003.
It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.
美国饮食协会的立场是，注册营养师（RD）和注册营养技师（DTR）提供的营养服务是所有发育障碍者和有特殊医疗需求者全面护理的重要组成部分。营养服务应贯穿一生，其方式应具有跨学科性、以家庭为中心、基于社区且具备文化胜任力。发育障碍者和有特殊医疗需求者经常存在营养问题，包括生长改变（生长发育不良、肥胖或生长迟缓）、代谢紊乱、喂养技能差、药物与营养相互作用，有时还部分或完全依赖肠内或肠外营养。有特殊需求的个体也更有可能患上需要营养干预的合并症，如肥胖或内分泌失调。不良的健康习惯、获得服务的机会有限以及长期使用多种药物被视为健康风险因素。及时且具成本效益的营养干预可促进健康维护并避免并发症。针对有特殊需求者的公共政策随时间推移而演变，导致从机构设施和项目向社区生活的转变。互联网上公共获取技术和健康信息的扩展，对注册营养师和注册营养技师提出了挑战，要求他们为发育障碍者和有特殊医疗需求者提供准确的科学信息。获得国家认证的注册营养师和注册营养技师最有能力为健康和生活质量提供适当的营养信息。
