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B12 deficiency causes megaloblastic anemia plus neurologic issues (paresthesias, memory loss), distinguishing it from folate deficiency.

Celiac disease requires strict lifelong elimination of gluten. IBS and Crohn’s may need dietary modifications but not gluten elimination.

In COPD, excess carbohydrate increases CO₂ production through carbohydrate oxidation, exacerbating respiratory acidosis. Higher fat (30–45% kcal), moderate carbohydrate, and adequate protein support energy needs while reducing ventilatory load. Protein must still meet requirements to preserve lean mass. Nutrition support must balance respiratory quotient, patient tolerance, and comorbidities such as heart disease or diabetes.

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