Therapeutic Diet
a) Diet modification in relation to
medical and surgical condition
of the individual such as Protein
Energy Malnutrition (PEM),
Diabetes, Cardio Vascular
disease, Hepatitis, Renal, Gouts,
Irritable Bowel Syndrome (IBS),
Obesity, cholecystectomy,
partial gastrectomy, gastrostomy,
bariatric surgery and colostomy
etc.
b) Special diet – low sodium diet, fat
free diet, diabetic diet, bland diet,
high protein diet, low protein diet,
low calorie diet, geriatric diet,iron
rich diet, liquid diet, semi-solid
diet, soft diet and high fiber
dietetc
c) Factors affecting diet acceptance,
feeding the helpless patient.
d) Health education on nutrition
needs and methods in diet
modification .
topic:
Diet modification:
🍄 Define therapeutic diet:
A change or change in diet can treat or prevent many diseases known as therapeutic diet”.
“Therapeutic nutrition is concerned with the nutritional modification of the normal diet to meet the needs of the sick individual”.
Meaning of modification:
Dietary modification actually means changing the quantity and quality of nutrients.
🍄 Enumerate method of diet modification:
Change the form of diet i.e. liquid diet or soft diet instead of solid diet.
Decrease or increase the caloric value of the diet.
Change the amount of any nutrients in the food.
High fiber or low fiber diet.
Low or salt restricted diet.
Diet containing excess or less carbohydrate.
Diet containing excess or less fat.
Diet containing excess or less protein.
Increase or decrease meal size.
Increase or decrease the number or frequency of meals.
Change the taste and smell of food.
Increase the interval between meals.
Change route (eg gastric tube feeding)
Enlist principles of diet modification:
It is important to consider the nutritional needs of each patient when making dietary changes.
A normal diet cannot be called a modified diet. A modified diet is a diet that differs from a normal diet.
In the process of change, the changes may be one or more. These changes may be temporary or lifelong.
Dietary changes should be based on facts and findings and should be rational.
Dietary changes in chronic disease are permanent.
The patient should be informed of the purposes and benefits of dietary modification.
Diseases and drugs affect body functions so diet should be modified accordingly.
Diet modification refers to the patient’s altered eating behavior.
Demonstrate diet therapy:
Diet modification in relation to medical and surgical condition of the individual such as:
P.E.M.:
Dietary principle:
It is best to eat a high calorie, high protein, high fat diet with generous vitamins.
Diabetes:
Dietary principles:
High polysaccharides, moderate protein, vitamin, mineral, low fat and high fibrous diet should be given.
🍄 * C.V.D.(cardiovascular disease):
Dietary management in atherosclerosis.
Principle of Diet:
The main principle of the diet is low calorie, low saturated fat, low cholesterol, moderate carbohydrates, protein and high fiber.
🍄 dietary management:-
Changes in the treatment of liver disease play a major role depending on the extent of damage.
Normal diet is difficult in the early stages.
The main objective is to avoid further injury to the liver and to provide nutrients for the regeneration of liver tissue.
A high protein, high carbohydrate and moderate fat diet is generally recommended.
Principle Of The Diet:
High protein, high carbohydrate, moderate or restricted fat (depending on seventy) high calorie foods are preferred.
Sodium should be restricted in case of presence of ascites.
🍄 Dietary management:
Calorie intake should be in the range of 1500 to 1800 kilocalories/day.
Protein intake is minimized by excluding high protein foods especially milk and milk products and non-vegetarian foods.
Use of pulses should be reduced.
If a person passes 500 to 700 ml of urine, 0.5 g protein/kg body weight per day is allowed with free flow of urine.
Intake can be gradually increased to normal intake.
Prolonged protein restriction can lead to anemia.
As the end product of fat metabolism does not rely on the kidneys for excretion, it can be used in moderate amounts.
Carbohydrates serve as the main source of energy for the patient.
In nephritis, the kidneys cannot regulate sodium and potassium levels, so the electrolyte balance is disturbed by limiting sodium and potassium intake.
Sodium is restricted as long as edema persists.
As the swelling subsides, common salt can be gradually used.
Potassium is restricted when urine flow is reduced.
Fresh fruits and fruit juices and vegetable soups should be avoided.
Fluids should be given keeping in mind the output.
A daily fluid intake and output chart should be maintained.
The main principle of the diet is low protein,
moderate carbohydrates; Low sodium should be avoided with less fluid.
principle:
A low calorie, normal protein, vitamin and mineral (except sodium) carbohydrate free, fat free, liberal liquid and high fiber diet should be given.
Peptic ulcer:
dietary management:
Diet is the most important factor in the treatment of peptic ulcers. Some important factors are:
The amount of food given should be small.
Feeds should be given frequently and at short intervals.
Avoid acidic foods that can be gastric irritants.
Nutrlize the nutrition of acid secretion.
Avoid foods rich in fiber as fiber irritates the gastric mucosa.
Principle:
The amount of calories should be adequate according to age, sex and occupation.
Moderate amount of fat.
High protein diet (exceed 50%).
✓ spices and condiments: Little or no spices and herbs and other condiments.
✓ food to be included:
Dairy products like milk, cream, light cheese, boiled eggs, fish and milled rice.
✓ Food to be avoided:
Alcohol strong tea, coffee, carbonated beverages, soups, spices, condiments, heavy sweets, raw vegetables, like cucumber, radish, onion and tobaccos.
REST:-
Give rest and relaxation after diet therapy.
Principles:-
High calorie
Easily digestible carbohydrates
High protein (exceed 50%)
Fat restriction
high vitamins and minerals
decrease liquid diet:- water 3-4 liter
Gout is a metabolic disorder.
In which purine metabolism is disturbed.
So the level of uric acid in the blood increases.
Diet modification:
Low purine diet should be given to the patient.
Inflammation of the gall bladder is called cholecystitis.
Principle of diet:
Low calorie, enough carbohydrate, 50-60gm/day protein, low fat diet should be given to patients.
For prevention of urinary calculi low in oxalic acid, purine, and calcium and phosphate constant diet should be given.
✓ Food to be avoided:
calcium rich food:-
e.g. Milk and milk products, small fishes and leafy vegetables.
Phosphate rich foods:-
e.g. Whole cereals, legumes, nuts and oil seeds, meat, fish, eggs, cheese and organ meat.
Oxalate rich foods:
e.g. Green leafy vegetables, chocolate and coffee, cashew nuts, beetroot and vitamin-C rich foods.
Purine rich diet:-
e.g. Meat, fish, organ meat (kidney, liver, brain etc.).
⭐ Topic:
🍄 Special diet
To introduce hospital diets/ special diet :
A patient’s diet during hospitalization depends on his disease.
The types and preparation of diets are governed by the principles and objectives of diet therapy.
Diets given during hospitalization and their general preparation can be categorized as follows.
Liquid/fluid diet:
Absolute liquid or residue free diet.
Full liquid diet or residue containing diet
Light or soft diet
Full or normal diet
Bland/ non irritant diet
Special diet
🍄 To define special diet:
A special diet is one in which, for therapeutic purposes, one or more nutrients are removed or added.
This is done in patients in whom normal bodily functions are disturbed or altered.
🍄 To classify special diets:
Types of special diet-
Excess calorie or less calorie diet
Fat free or fat reduced diet
Excess protein or low protein diet
Salt free or low salt diet
To learn about the factors affecting special diet:
Dietary habits of the patient or individual.
Calculation of calories/nutrients in special diets
Making necessary changes in cooking methods according to special diet
Informing the patient about the importance and benefits of special diet.
Informing the patient and his relatives about methods of preparing special diets and imparting nutrition education.
To learn about the factors affecting special diet:
Dietary habits of the patient or individual.
Calculation of calories/nutrients in special diets
Making necessary changes in cooking methods according to special diet
Informing the patient about the importance and benefits of special diet.
Informing the patient and his relatives about methods of preparing special diets and imparting nutrition education.
To learn about indications of various special diets:
✓ LOW CALORIE DIET-
🍄 Low calorie diet is given in following diet
Obesity
Cardio-vascular diseases
Hepatic coma
✓ EXCESS CALORIE DIET
Excess calorie diet is given in following diseases
Malnutrition
Under weight
Infections
Fever
✓ FAT FREE/LOW FAT DIET-
Fat free diet is given in following diseases
Malabsorption syndrome
Obesity
Gall bladder disease
✓ HIGH FAT DIET-
It is given in the following condition
Under nutrition
Under weight
✓ LOW CARBOHYDRATE DIET-
It is given to the pt suffering from diabetes mellitus.
✓ HIGH CARBOHYDRATE DIET–
It is given in the following diseases
Liver disease
addition’s disease
✓ LOW PROTEIN DIET
It is in the following disease
Viral hepatitis
Jaundice
Hepatic coma
✓ HIGH PROTEIN DIET
It is given in the following diseases
Protein energy malnutrition
Before and after surgery
Nephritis
Burn condition
Peptic ulcer
✓ LOW CALCIUM DIET
It is given to patients suffering from renal calculus.
✓ HIGH CALCIUM DIET-
High calcium diet is given to patients suffering from rickets and osteomalacia.
✓ LOW SODIUM DIET
It is given to patients suffering from cardiac failure, hypertension and oedema.
✓ HIGH SODIUM DIET
It is given during hypotension.
✓ HIGH IRON DIET –
It is given to the pt suffering from anemia.
✓ HIGH VITAMIN DIET:
given in various vitamin deficiency disorders like night blindness, conjunctival xerosis (food rich in Vitamin A), to cure BERY-BERY (vitamin-B1 is given, during pellagra (vitamin B3 is given), during scurvy (vitamin C is given) is
✓ HIGH FIBER DIET –
It is given to patients suffering from constipation, obesity, diabetes, high cholesterol level and in cardio vascular diseases.
✓ FLUID OR LIQUID DIET:
A liquid or fluid diet is a component of a diet that can be given in liquid form.
Types of fluid diet-
Clear fluid diet/absolute liquid diet
Full fluid diet
Clear fluid diet/absolute liquid diet:
This type of diet leaves no residue. Clear liquid foods have no nutritional or caloric value, but have an important role in maintaining the body’s fluid balance.
Full fluid diet:
A full liquid diet is given when the patient is unable to accept solid food or is on tube feeding.
The main ingredient of a complete liquid diet is milk which can be mixed with eggs or custard, vitamins, minerals, sugar, glucose or starch can also be given with milk.
✓ LIGHT OR SOFT DIET-
A soft diet can be compared to a full diet but the food served in it can be easily chewed, swallowed and digested.
A soft diet is more useful for old people, who have poor digestion and are prone to convulsions.
✓ FULL DIET:
It is a regular, normal and balanced diet which can be vegetarian or non-vegetarian.
A complete diet is served to patients whose diet does not require modification.
✓ BLAND OR NON IRRITANT DIET-
Bland or non irritant diet is made from such food products…
Are easily digestible.
Are free from stimulation from stomach or intestine.
Have low roughage
⭐ Topic:
🍄 Factor affecting selection and planning of meal
Describe the need for selection of meal:
Eating a healthy diet has many benefits that not only help in weight loss.
Eating foods from each of the major food groups provides the energy, vitamins, and minerals our bodies need to support proper functioning.
A healthy diet is important for both our physical and mental well-being.
Food is the main component of our life.
It not only provides the nutrients we need to maintain our busy lifestyles but can provide an enjoyable experience and is the cornerstone of many social functions.
On the other hand, restricting food intake is a challenge for people struggling with health concerns and weight management.
Learning that controlling eating habits without allowing food to become the enemy is an important part of a healthy lifestyle.
Overweight and obesity are major problems.
Food selection requires resources.
Optimum utilization of these resources should be considered to get the best results.
Selection or selection of food is very important in meal planning.
Feeding many people in a way that is satisfactory can be a complex issue.
Many decisions are required and careful thought and planning is important.
🍄 Enlist the factors considered in selection of meal:
✓ Food selection:
The types of food we select depends on:
THE MONEY
LIKES AND DISLIKES
•ADVERTISEMENT
NUTRITIONAL NEEDS
•FOOD PURCHASING
PRODUCTION COST
THE SEASON
DEMAND FOR ITEM
•ADVERTISEMENT
•AMOUNT OF PROCESSING
FACTORS THAT DETERMINE THE AMOUNT OF MONEY WE SPEND ON FOOD
The more money we have, the more food we can buy and the more choices we have.
People who have a lot of money can afford a variety of food and eat away from home.
People with low incomes have limited choices and it becomes a difficult task to buy enough food to meet the needs of the family.
If you have a limited food budget, you can save money by buying food in season and buying cheaper cuts of meat, as well as comparing prices at different stores.
We eat to stay alive and healthy.
At the same time, most people also eat to enjoy the food.
People tend to eat foods they like and avoid foods they dislike.
Foods are usually disliked because…
They are new and never tried in their color, taste and texture.
They don’t look attractive.
Food is associated with some bad feeling, the way it is cooked, it is not attractive.
Food is enjoyed anytime. Food is enjoyed because it provides us with certain sensations. The aromas and flavors that come from food are detected by special nerves in the sense organs of taste and smell.
There are also sights and temperatures that have a big impact on the enjoyment of food.
Cooking food often develops flavor and changes the texture of food.
Many foods are traditionally eaten hot or cold.
If food is too hot or too cold, its true taste may be masked and it may cause discomfort in eating.
Another major influence on food choices is advertising.
Advertisements have a way of persuading people to make a choice.
Food manufacturers and stores advertise their products through television, radio, magazines, newspapers, posters and leaflets.
Good advertisements are appropriate, honest and truthful.
They do not mislead people about the product.
They show people a sense of responsibility.
They conform to fair competition behavior with different manufacturers and businesses.
Our food choices will also depend on your dietary needs.
Everyone has a biological need for food.
Without that food necessary for life a person becomes weak and sick.
People vary the amount of food they need for reasons such as health, age and activity.
So while our food choices will depend on each of these factors, our nutritional knowledge helps us choose foods that provide the nutrients we need to meet our needs.
Food shopping can be a boring or an interesting venture depending on one’s approach to it.
To make food shopping interesting you need to know a lot about the market place and ways to get the most out of your food budget.
What things can be done to avoid wasting time and money while buying food….
First of all one needs to know the factors that determine the price of the things you want to buy…
Cost of production
the season
Goods market supplies
Goods Demand Advertisements Processing Amount
In the case of food, production costs include money spent on land clearing, sowing, harvesting and processing.
The final price of the product is determined by this amount plus other transportation costs, profit and handling charges.
Foodstuffs are always cheaper when they are in season because they are plentiful and therefore in greater supply.
When the market is oversupplied, commodity prices rise and commodity prices fall.
Food items that are out of season become scarce and hence their prices are high.
These are ways in which manufacturers and sellers tell us that they have specific goods and services for sale.
Advertising costs money.
The cost of advertising a product is added to the cost of production to create the cost of the product.
The more advertisements, the higher the price of the product.
Processing adds value to products and costs money.
Processed foods cost more than unprocessed foods to provide convenience.
Do you now see why these factors affect the price of products? After learning about these factors how do you buy your items so that we don’t spend too much money.
Food budget is one of the biggest expenses for most people.
Careful planning and shopping can lead to significant savings.
Generally, if one is rich, more money is spent on food and if one is poor, less is spent.
Shop food with expertise, personal preferences.
Values and lifestyles determine food choices and thus reduce the amount of money we spend on food.
For example bargaining skills will help us to buy goods at the cheapest price.
Buying food in season and in bulk also helps keep costs down.
Buying food from the farm gate instead of eating from retailers also cuts costs.
When we buy food, buy them from places where prices are low and where the food sold is of good quality.
Buy food that is clean and where food is stored well.
🍄 Define meal planning:
Meal planning is planning meals with adequate nutrition for each member of the family within available resources.
The term ‘available resources’ means whatever the family has in terms of time, energy and money.
🍄 Describe Importance of meal planning:
Meal planning is important to meet the nutritional needs of family members.
It helps us decide what to eat each day and at each meal.
Here we can call it our ‘Daily Food Guide’.
Meal planning helps us to:…
(a) Meeting the nutritional needs of family members
(b) Make food economical
(c) caters to the dietary preferences of individual members
(d) Save energy, time and money.
🍄 Describe about factors affecting meal planning:
What guidelines do we keep in mind while planning meals…
What we consider to make meal planning effective…
There are many factors like-…
NUTRITIONAL ADEQUACY
AGE
SEX
PHYSICAL ACTIVITY
ECONOMIC CONSIDERATIONS
TIME, ENERGY AND SKILL CONSIDERATIONS
SEASONAL AVAILABILITY
RELIGION, REGION, CULTURAL
VARIETY IN COLOR AND TEXTURE
SATIETY VALUE
For example, we know that a growing child needs more protein, a pregnant or lactating woman needs calcium, etc.
When planning meals, you will include food groups from different foods, namely energy-giving foods, body-building foods, and protective-regulatory foods.
We may have observed in our family that the diet of different members of different age groups varies in quantity.
Newborns drink only milk, toddlers eat very little food, teenagers eat even more and a variety of foods.
Similarly, we may have seen our grandfather eating less food and also preferring soft and easy to digest food.
Males have higher dietary requirements than their female counterparts as adolescents and adults.
A laborer not only eats more but also requires more energy because he is engaged in hard work.
His body uses more energy when working hard.
So, if you plan for such a person, you will include more energy-giving foods in the diet.
Foods like milk, cheese, meat, fruits, nuts etc. are expensive.
However, alternative sources like toned milk, seasonal fruits and vegetables are less expensive and nutritious at the same time.
So we can plan a balanced diet to suit every budget.
Tips for economy:
Buy food in bulk if you have enough space to store it
Buy from reasonable price shops like ration shops, super markets, cooperative stores etc.
Compare prices and quality when buying.
Use leftovers.
Family meals can be elaborate with various dishes but we can make it simple by cooking simple yet nutritious dishes.
For instance, a working mother can prepare paucity pulao instead of preparing three or four items for dinner
Off-season foods are expensive and less nutritious, while in-season foods are fresh, nutritious, tasty and cheap.
Therefore, seasonal foods should be used while planning
For example, if we are North Indian, you will consume more wheat, while people near coastal areas will consume more coconut, fish etc.
Similarly if you are South Indian then our staple food would be rice.
Religious beliefs prevalent in the family also have an influence.
For example, if we are vegetarians, there is no meat or meat products in our diet, Hindus do not eat beef and Muslims do not eat pork, etc.
Menu-1:
Chapati
Rice
Arhar dal
pumpkin vegetable
curd
Salad (radish and onion)
Menu-2
Chapati
Rice
Rajamah
Fried ladyfingers
Carrot strip
Salad (cabbage, cucumber. beetroot)
Papad
menu else..
Because it has variety in terms of color, texture, taste and method of preparation.
These factors help us to make the food more appealing, appealing and hence more acceptable in the form of curd, cheese etc.
Similarly, if one does not want to consume green leafy vegetables in cooked form, what alternative would we suggest, so that it can be consumed in adequate quantity..?
Yes, it can be used in various ways –
Mixed with flour and made into parantha or puris, or culets or pakoras.
It can also be served in the form of Kofta, Idli, Vada etc.
A meal that produces insufficient satiety will lead to the onset of hunger pangs, which in turn will affect a person’s work capacity and efficiency.
SATIETY: A feeling of fullness after eating