Imbalanced Nutrition

Dear Ashley,
Remember that night when I was a little intimidated to ask you about why the chef at the restaurant had to make you separate food at dinner?  I did not know it would lead to hearing your whole story, and I could not have known how it would change my perspective on priorities in healthcare. 
Knowing that you can't enjoy the same foods as everyone else must make you feel left out sometimes.  I was really impressed by how faithfully you maintain your diet.  I hope you have been able to maintain your weight since I last saw you, because I remember you said that it's hard for you to gain weight.  Fortunately, you found a nutritionist who can help with that.  Here are the suggestions I have based on what I learned through researching.
-Amanda

Imbalanced nutrition, less than body requirements, related to dietary restrictions, as evidenced by intolerance of gluten and dairy and low body weight. 

• Weigh herself regularly to see if intake is sufficient to maintain weight (Carpenito-Moyet, 2010).
• Assess for other injuries or sources of stress that may require increased intake.  It is important to keep her body strong in every way possible.
• Supplement her diet if she is losing weight.  Sometimes it is necessary to encourage her to eat a lot of the foods that she is not sensitive to and enjoys.
• Provide a diet high in nutrient-rich foods, as adolescents are at especially high risk for dietary imbalances due to strong food preferences (Thompson, Dennis, Higgins, Lee, & Sharrett, 2005).
• Provide emotional support, as a maintaining a consistently restricted diet can be discouraging and challenging for individuals of all ages.  Try to avoid an attitude of what she is “allowed” and “not allowed” to eat, as this teaches an unhealthy perspective on food (Mariani et al., 1998). 
• Assess serum electrolyte, lipid, protein, and blood cell levels to detect possible imbalances due to diet or malabsorption (Aurangzeb, Leach, Lemberg, & Day, 2010).  Take supplemental vitamins as necessary.
• Assess for new or changing intolerances.  For younger individuals, changes in food sensitivities are common and should be brought to the attention of a nutritionist immediately.  Regularly seeing a nutritionist who is familiar with her gluten and lactose intolerances can ensure her diet remains balanced.