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Ashley DePriest

@ashleydepriestrd.bsky.social
634 followers 302 following 279 posts

Dietitian | #WhatRDsDo #ICUNutrition | She/Her | Views my own. open.substack.com/pub/adepriest

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Ashley DePriest @ashleydepriestrd.bsky.social · 30/09/2026
Spent my morning in rounds w/ one of our RDs. Every care team needs a RD lens. When RDs join daily rounds, we catch nutrient gaps, optimize feeding regimens, & tailor plans to each pt’s comorbidities. This not only improves care, but also supports d/charge planning👉 🔻 LOS
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/08/2026
PN Order Writing Basics: NOT so basic! @gaspenga.bsky.social #GASPEN26
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/08/2026
Nutrition Support in head and neck cancer is a challenging practice! We’re learning a lot of great tidbits to improve our practice. #GASPEN26
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/08/2026
Dr. Vivian Zhao: connect the anatomy with the micronutrient need. ❓Where are you feeding? What portion of the GI tract might be missing? 🧑‍🔬Consider all of this when assessing patients for micronutrient supplementation needs. #GASPEN26 @gaspenga.bsky.social
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/08/2026
Micronutrient Deficiencies - where do you see challenges? #GASPEN26 @gaspenga.bsky.social
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/08/2026
One of my favorite times of year: @gaspenga.bsky.social Conference! #GASPEN26
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Ashley DePriest @ashleydepriestrd.bsky.social · 21/08/2026
I saw someone put their colonoscopy prep into a ninja slushy machine and I honestly feel like that is the exact energy we need to reform hospital food service.
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Ashley DePriest @ashleydepriestrd.bsky.social · 20/08/2026
When hospitals talk about 📉 readmissions, nutrition is often missing from the conversation. Yet individualized nutrition therapy has been shown to 📉 nonelective readmissions by ~25–35% across multiple trials. #WhatRDsDo
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Ashley DePriest @ashleydepriestrd.bsky.social · 04/08/2026
When hospitals talk about ⬇️ readmissions, nutrition is often missing from the conversation. Yet individualized nutrition therapy has been shown to ⬇️ nonelective readmissions by ~ 25–35% across multiple trials. Ensure your high risk patients are well nourished! #WhatRDsDo
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Ashley DePriest @ashleydepriestrd.bsky.social · 29/07/2026
1. Anabolic resistance 2. Urea‐Cycle Overload 3. Shutting Down Autophagy 4. Fueling a Metabolic Fire: CO₂, Hyperglycemia, Mitochondrial Strain Read more about why protein should be limited in the acute phase: open.substack.com/pub/adepries...
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Ashley DePriest @ashleydepriestrd.bsky.social · 29/07/2026
A missed opportunity for nutrition intervention is before/after dental surgeries, particularly in the elderly. Profound and severe malnutrition can happen quickly when you can’t chew or even drink due to pain.
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Ashley DePriest @ashleydepriestrd.bsky.social · 29/07/2026
For years I pushed "enteral nutrition first, PN after 7 days." Today, the conversation is becoming more nuanced: If enteral feeding isn't feasible, early short term parenteral nutrition may be a reasonable (and safe!) option. Evidence evolves. Our practice should too.
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/07/2026
Low BMI has never been a prerequisite for malnutrition. The growing emphasis on muscle mass, inflammation, and reduced intake reflects what clinicians have known for years: nutrition status is more complex than weight.
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/07/2026
A patient can have obesity. A patient can have severe muscle loss. Both statements can be true. That's why diagnosing malnutrition requires looking beyond the scale. #WhatRDsDo
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Ashley DePriest @ashleydepriestrd.bsky.social · 24/07/2026
Protein recommendations in critical illness are finally catching up to physiology. Instead of rushing to high protein on day one, we're increasingly talking about progressive delivery as patients stabilize. Critical illness isn't static. Nutrition shouldn't be either.
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Ashley DePriest @ashleydepriestrd.bsky.social · 23/07/2026
The phrase "feed the gut" has served us well. But "feed the patient" may be the more important principle. Sometimes that means enteral nutrition. Sometimes it means parenteral nutrition. Physiology should win over dogma.
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Ashley DePriest @ashleydepriestrd.bsky.social · 23/07/2026
Indirect calorimetry isn't just a research tool. If we're serious about personalized ICU nutrition, measuring energy expenditure may be one of the biggest opportunities to move beyond educated guesses. Are you using IC? How often do you measure?
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Ashley DePriest @ashleydepriestrd.bsky.social · 22/07/2026
Personalized nutrition isn't about starting nutrition and following up in a week.  It's measuring energy expenditure when possible, recognizing physiologic phases, and adjusting nutrition as the patient changes, not forcing every patient into the same protocol. #WhatRDsDo
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Ashley DePriest @ashleydepriestrd.bsky.social · 21/07/2026
Nutrition is a science. Inpatient nutrition requires knowledge, nuance, and close monitoring. 💪Registered Dietitians are the perfect people for the job! #WhatRDsDo
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Ashley DePriest @ashleydepriestrd.bsky.social · 15/07/2026
Fiber is an underutilized nutrient in enteral nutrition management. We recommend fiber for long term health in patients who are eating but often discharge patients home on non-fiber containing enteral formulas. Don’t forget the fiber!
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Ashley DePriest @ashleydepriestrd.bsky.social · 08/07/2026
Protein provision is no longer about more is more. Protein dosing, especially for ICU, needs precision. And the dietitian is the best person to manage it.
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Ashley DePriest @ashleydepriestrd.bsky.social · 30/06/2026
Wellness trends are creeping into US inpatient care: high calorie (i.e. sugar) oral supplements for cancer patients get unfairly demonized, for example, while “natural” enteral formulas are touted as superior. We must balance patient choice with solid evidence, a nuanced discussion AI can’t mimic.
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Ashley DePriest @ashleydepriestrd.bsky.social · 24/06/2026
If you’re a dietitian looking to level up your clinical influence at the bedside, check out my Substack! I share tips and resources for how to turn your progress notes into action and move siloed expertise into collaborative systems. Subscribe for weekly articles! open.substack.com/pub/adepriest
open.substack.com
Ashley DePriest | Substack
Registered dietitian helping clinicians turn evidence into action, progress notes into influence, and siloed expertise into collaborative systems. Click to read Ashley DePriest on Substack. Launched a...
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Ashley DePriest @ashleydepriestrd.bsky.social · 22/06/2026
Today’s reminder: having order-writing privileges as a dietitian is great, but it’s not the summit of dietitian impact. The real work lives in how we think about and implement nutrition care, not just whether we can sign the order.
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Ashley DePriest @ashleydepriestrd.bsky.social · 12/06/2026
As dietitians we are often trained to make our recommendations as a to do list: ▪️start tube feeds ▪️add MVI ▪️start EN But that often brings up more questions about implementation. Framing your recommendations as solving a problem vs a task is more clear & effective.
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Ashley DePriest @ashleydepriestrd.bsky.social · 10/06/2026
A rejected nutrition recommendation isn’t always about the evidence. Sometimes it’s about bleeding risk you didn’t know about. Or a respiratory status conversation happening in the background. Or a dozen other variables that never make it into a journal article.
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Ashley DePriest @ashleydepriestrd.bsky.social · 09/06/2026
What’s the male equivalent of this? Because that is the exact reaction I got from an ortho when explaining my sharp L knee pain with decreased range of motion that occasionally buckles during padel and shin loses feeling when running all he did was an xray. 😩 I can only take so much ibuprofen!!!!
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Ashley DePriest @ashleydepriestrd.bsky.social · 08/06/2026
I have a ton (maybe literally) of old cook books (a lot from the 1950s and 60s). There are so many recipes with prunes - prune cakes, prune cookies, prune juice. When did we stop eating so many prunes?!
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Ashley DePriest @ashleydepriestrd.bsky.social · 04/06/2026
There are subtle ways we are accidentally undermining our clinical authority. I wrote about it here, check it out:
open.substack.com
Easy to Ignore
How Dietitians Accidentally Undermine Their Own Influence
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Ashley DePriest @ashleydepriestrd.bsky.social · 29/05/2026
ICU patients typically receive only 50–60% of recommended energy and protein in the first week. The EuroPN cohort found patients hit just 65% of protein targets across European ICUs. Why?
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Ashley DePriest @ashleydepriestrd.bsky.social · 26/05/2026
He was not happy to have been left alone!
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Reposted by Ashley DePriest
Kamala Harris @kamalaharris.com · 25/05/2026
Today, we pause to remember the Americans who laid down their lives in service to our nation. May we always honor their legacy and support the loved ones they left behind.
A Marine stands guard in Arlington National Cemetery on Memorial Day in Arlington, Va., May 25, 2009. (Official White House Photo by Lawrence Jackson)
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Ashley DePriest @ashleydepriestrd.bsky.social · 25/05/2026
We write: “Start EN when the patient is HD stable” “Monitor tolerance closely” “Consider PN if needed” Then wonder why it isn’t followed. Specificity builds trust AND credibility. How would you adjust these phrases for better credibility?
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Ashley DePriest @ashleydepriestrd.bsky.social · 23/05/2026
I’ve started a Substack! Sure I’ll talk about data and trials (you know I love to!) But I’ll also be sharing about things we aren’t formally taught, like how to build influence with your clinical teams. Check out my first post, I hope you’ll subscribe!
open.substack.com
Why Evidence Alone Rarely Changes Practice
Because the "right" recommendation doesn’t always win.
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Ashley DePriest @ashleydepriestrd.bsky.social · 22/05/2026
Friendly reminder to wear your helmet when biking and scootering.
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Ashley DePriest @ashleydepriestrd.bsky.social · 11/05/2026
When sending patients home on EN it’s so easy to just continue what they are receiving inpatient. Consideration for usual long term nutrition, such as fiber intake, needs to be considered. Unless contraindicated, no patient should go home with fiber-free formulas for long term nutrition. #WhatRDsDo
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Ashley DePriest @ashleydepriestrd.bsky.social · 05/05/2026
🧵 A 53yo woman. BMI 15.6. GJ tube. Readmitted 3 weeks post-discharge. A new "Teachable Moment" in @jamainternalmed.com and it's frustrating because it's NOT rare. jamanetwork.com/journals/jam... 1/3
jamanetwork.com
Gastrojejunostomy Tube Intolerance
This Teachable Moment describes a patient who underwent a recent gastrojejunostomy tube placement, who returned to the hospital after 3 weeks with gastrointestinal distress and leakage at the insertio...
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Ashley DePriest @ashleydepriestrd.bsky.social · 30/04/2026
Which of these patients require more or less calories and protein? What if I told you they are the same height and weight? Without indirect calorimetry, it is very likely all three would receive the same! Do you agree with that approach?
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Ashley DePriest @ashleydepriestrd.bsky.social · 29/04/2026
Please save the date! We have a great lineup of speakers (more to come!) and you can join us both in person in Atlanta or virtually from anywhere.
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Ashley DePriest @ashleydepriestrd.bsky.social · 21/04/2026
Discussing essential fatty acid deficiency at our @gaspenga.bsky.social dinner tonight! Have you cared for a patient with #EFAD? How did you identify and treat? #nutritionsupport @doseofdavis.bsky.social
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Ashley DePriest @ashleydepriestrd.bsky.social · 22/03/2026
Hope you will join me today at 10:30 central for a discussion on AI in critical care nutrition! #SCCM26
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Ashley DePriest @ashleydepriestrd.bsky.social · 20/03/2026
It’s been a long time coming! Together with my co-chair, Beth Taylor DCN, RD, and council sponsor, Tony Gerlach, we are excited to announce the start of a new SCCM Nutrition Knowledge Education Group! 1/3
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Ashley DePriest @ashleydepriestrd.bsky.social · 11/03/2026
If you know a #dietitian, please tell them Happy RD Day today!
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Ashley DePriest @ashleydepriestrd.bsky.social · 05/03/2026
“Did you get a lactate?” Vs “Do we have a lactate?” makes all the difference when communicating with your team. Inclusive language helps build rapport.
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Ashley DePriest @ashleydepriestrd.bsky.social · 04/03/2026
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Ashley DePriest @ashleydepriestrd.bsky.social · 04/03/2026
Follow our new @gaspenga.bsky.social account for all things nutrition support!
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Ashley DePriest @ashleydepriestrd.bsky.social · 02/03/2026
We desperately need patient phenotyping for who is and not sensitive to inulin/FOS. 😣 When it works, it works. And when it doesn’t…. 💩💩💩
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Ashley DePriest @ashleydepriestrd.bsky.social · 28/02/2026
Hey, so I highly recommend watching the NFL combine while on the treadmill.
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Ashley DePriest @ashleydepriestrd.bsky.social · 24/02/2026
I can guess a patient’s height within a smaller CI/margin of error than a measured knee height sign me up for the carnival! 🎡
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Ashley DePriest @ashleydepriestrd.bsky.social · 15/02/2026
Leucine has been underrated. #ASPEN26
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