DIETARY MODIFICATIONS
& DIET THERAPY
OBJECTIVES OF DIET THERAPY
to maintain a good nutritional status
to correct nutrient deficiencies which may have occurred due to the
disease
to afford rest to the whole body or to the specific organ affected by the
disease
to adjust the food intake to the body's ability to metabolize the
nutrients during the disease
to bring about changes in body weight whenever necessary
FACTORS IN PLANNING THERAPEUTIC DIETS
the underlying disease condition which requires a change
in the diet
the possible duration of the disease
the factors in the diet which must be altered to overcome
these conditions
the patients tolerance for food by mouth
REGULAR DIET
A regular diet is a meal plan that includes a variety of foods from all of the
food groups listed below. A healthy plan is low in unhealthy fats, salt, and
added sugar.
A healthy meal plan may reduce risks of heart disease, osteoporosis, and
some types of cancer
A regular diet is composed of all types of food, is well-balanced and
capable of maintaining a state of good nutrition. It is intended for
convalescing patients who do not require therapeutic diets.
MODIFIED DIETS
modifications of the regular diet designed to meet specific patient needs
any diet altered to include or exclude certain components, such as
calories, fat, vitamins and minerals
the normal diet may be modified:
to provide a change in the constituents of the diet
to maintain, restore or correct nutritional status
to include all nutrients in the diet
to increase or decrease the energy value of the diet
to provide foods bland in flavour
to modify the intervals of feeding
DIETS MODIFIED IN CONSISTENCY
LIQUID DIET
consists of foods that are in a liquid state at body
temperature
indicated in some post-operative cases, in acute
illnesses, and in inflammatory conditions of the
gastrointestinal tract
must be given every 2-3 hours while the patient is
awake
usually ordered as clear, full, or dental liquid
CLEAR LIQUID DIET
requires minimal digestion and easily tolerated by the
gastrointestinal tract
often offered to patients before certain GI procedures, after GI
surgery, and after intravenous feeding
consists of clear fluids and foods that are liquids at room
temperature and leave little residue in the intestine
provides fluid and electrolytes but limited in energy and nutrient
content
should not be given for more than 2 days without appropriate
nutritional supplementation
CLEAR LIQUID DIET
includes
plain water
clear or pulp-free fruit juices
clear broths
fruit-flavored or unflavored gelatin
clear sodas
tea or coffee with no cream or milk added
clear sports drinks
popsicles that do not have bits of fruit, fruit pulp, or yogurt
hard candies
excludes
milk and yogurt
juice with nectar or pulp such as prune juice
FULL LIQUID DIET
includes most liquids and some food with small amounts of fiber
offers more diverse flavors and greater nutritional value
provides many of the nutrients needed by the body
may lack vitamins, minerals, and fiber
indications:
recovery from pancreatitis
weight loss surgery (transition between clear liquids and soft diet)
dental or oral surgery
jaw fractures
gasrointestinal surgery
certain digestive diseases
FULL LIQUID DIET
clear liquids
opaque liquids including milk
strained cream soups
strained oatmeal
pureed fruits and vegetables
strained or pureed meats
smoothies and milkshakes
pudding
ice cream
SOFT DIET
soft in texture and consists of liquid and semi-solid
foods
indicated in certain post-operative cases, for
convalescents who cannot tolerate a regular diet
an intermediate step between the liquid and regular
diets
low in connective tissue and indigestible dietary fiber
contain little or no condiments
DIETS MODIFIED IN COMPOSITION
HIGH-CALORIE DIET
normal diet with an increase in the calorie level to 3000 kcal or more
if appetite is poor, small servings of highly reinforced foods are given
may be modified in consistency and flavour, according to specific needs
excessive amounts of foods that have a low calorific value and fried foods
which disturb the appetite should be avoided
prescribed for
weight loss
fever
hyperthyroidism
burns
LOW-CALORIE DIET
controls calories, carbohydrates, proteins and fat intake in balanced amount to meet the
nutritional needs and control blood sugar and weight
normal diet with energy values
reduced to 1500, 1200 or 1000 calories
protein levels should be at 65 to 100 gms
supplements of Vitamin A and thiamine are usually required for diets below 1000 calories
prescribed for reducing body weight in
diabetes mellitus
cardiovascular diseases
hypertension
gout
gall bladder disease
preceding surgery
HIGH-PROTEIN DIET
diets high in plant and animal proteins;
used to treat malnutrition or to increase muscle mass
high protein diet of 100 – 125 g per day
prescribed for a variety of conditions like
fever
hyperthyroidism
burns
surgery
diarrhea
elderly
alcoholics
LOW-PROTEIN DIET
diet in which people reduce their intake of proteins
often prescribed to people with kidney or liver disorders
prescribed for the following conditions
hepatic encephalopathy
acute and chronic glomerulonephritis
nephroslerosis
acute and chronic renal failure
inborn errors of metabolism
FAT-CONTROLLED DIETS
regulate the amount and type of fat allowed
total calories from fats should provide about 25%-35% of the total calories with
10% from saturated fat and 12 – 14% from polyunsaturated fats
intake of cholesterol reduced from the average daily intake of 600 to 300 mg
prescribed for the following conditions
gall bladder diseases
nontropical sprue
celiac disease
cystic fibrosis
atherosclerosis
myocardial infarction
hyperlipidemia
LOW SODIUM DIET
limited amount of sodium in the diet
four levels of sodium restriction are used — 250, 500, 1000 and 2400 mgs
excludes excess salty foods and salt in cooking and at the table
used both to prevent and treat edema
prescribed for
congestive heart failure
hypertension
liver and renal diseases