Nutrition Elective

The nutrition elective is available to second and third year pediatric gastroenterology fellows. It is a four-week program divided between Children’s at Egleston and Children's Specialty Services.

Goals and Objectives

  • Know how to assess nutritional status by anthropometrics, balance studies, body composition analysis and measurement of energy expenditure  
  • Recognize the clinical and biochemical manifestations of nutrient deficiencies and nutrient excess  
  • Understand the special nutritional needs of patients with IBD, short bowel syndrome, cholestatic liver disease, end-stage liver disease, renal disease, neoplasia and immunodeficiency states 
  • Become competent in nutritionally rehabilitating patients who are undernourished
  • Recognize metabolic syndromes as well as other obesity related manifestations
  • Implement better health programs

Program Description

The fellows will have an opportunity to learn pediatric nutrition by a combination of formal didactic exercises and informal bedside teaching. Problem-based, integrative case studies will constitute an important aspect of the didactic process.

Fellows will have direct experience via responding to pediatric nutrition consults, rounding with specialty dieticians, observing both the outpatient (obesity) clinic and the nutrition rehabilitation program at Children’s at Egleston.

Didactic Exercises

  • Integrated case studies (nutritional assessment, nutrient biochemistry, macronutrient deficiency, micronutrient deficiency, short gut, IBD, liver disease, renal failure and immunodeficiency) to be discussed weekly
  • Prepare and present a nutrition related topic (journal article, case report or review) at the nutrition conference on the fourth Tuesday of the month
  • Attend nutrition conferences at Children’s at Egleston
  • Obtain and evaluate:
    • 24-hour dietary recall from a patient or test individual
    • 24-hour or three-day diet diary from patient or test individual
    • New parenteral nutrition orders. This will be done in order to identify the relevant issues (pros and cons) with obtaining these as measures of dietary assessment in pediatrics.

Clinical Experiences

  • Weekdays early morning: Round with subspecialty dietician
    • First week: GI (M, Tu), Hematology/Oncology (Th) and Renal (Fri)
    • Second week with Hepatology/Transplant (M, Tu), Hematology/Oncology (Th) and Renal (Fri)
    • Third and fourth weeks: Rotate with metabolic team at Children’s at Egleston
    • Every Wednesday: Attend neonatology/short bowel nutrition rounds
  • Answer nutrition consultations to be precepted by the dietician and follow those patients during the rotation under the direction of the subspecialty dietitian
  • Attend specialty clinics when available: eating disorders clinic, obesity clinic, adult and pediatric nutritional rehabilitation clinics

Academic Expectations

During the rotation, it is expected that the fellow will review the literature and textbooks. It is optional to write a case report if an interesting patient or problem is encountered during the rotation.

Recommended Texts:  

  • Nutrition in Pediatrics: Basic science and clinical applications. 3rd Edition. Walker, Watkins and Duggan eds.
  • Pediatric Nutrition Handbook. 5th Edition. AAP