NORMAL AND THERAPEUTIC DIETS

REGULAR OR FULL DIET

Description of the Diet:

 It is also called general, normal or full diet, formerly named as DAT (diet as tolerated)
 Designed for the adult patient who does not need any dietary modification.
 The usual food and drink regularly consumed.

Characteristics of the Diet:

 The diet is aimed at supplying appropriate amounts of calories, protein and other nutrients.
 May be used in educating the patient in the principles of nutrition by example and basis in providing food the patient is
willing and able to eat.
 The diet calls for careful planning of menu, wise selection and proper preparation of foods as well as attractive service so
that it will appeal to patients with relatively poor appetites.
 The quantity of food selected from each food group should vary depending on the energy needs and preferences of the
patient.
 Serves as the basis for the modification of therapeutic diets in the hospital.

Indications for Use:

 For ambulatory patients whose conditions do not require any dietary modification for therapeutic purposes.

Food Allowed:
 All foods are allowed with adequate supply of proper nutrients and enough calories to meet a person’s need for energy.

TYPE OF DIET /
CHARACTERISTICS FOOD SELECTION
INDICATIONS FOR USE

A. MODIFICATION IN CONSISTENCY

1. LIQUID DIET

A. Clear Liquid Diet

 Illness or surgery accompanied by marked  Inadequate in nutritional essentials; food  Foods Allowed:
intolerance to foods; acute inflammatory included are liquid or will become liquid at Clear, fat free broths,
conditions of the GI tract, in conditions body temperature, leave no residue, non strained fruit juices, tea,
when it is necessary to minimalize fecal distending, non-irritating and non- black coffee, salabat, plain
material. stimulating to peristaltic action, should be gelatin. Give small
used for 1 to 2 days only. amounts every 1-2 hours.

B. Full Liquid Diet

 Post-operatively: acute infections, acute  Intermediate between clear liquids and soft  Foods Allowed:
inflammatory conditions of GIT, for GIT, for diet; consists of liquid or strained semi- Those included in the
patients too ill to eat solid or semi-solid liquid foods and foods that liquefy at room clear liquid diet plus
foods, impaired chewing and swallowing and body temperature; free from cellulose strained cream soups,
ability, face lifting, radical mouth surgery. and irritating spices and condiments. pureed strained meat and
fish, veg. purees and
juices, strained lugao &
oatmeal, plain ice cream,
plain gelatin, custard, milk
& milk drinks.
 C. Cold Liquid Diet

 Sometimes referred to as T and A Diet  Cold fluids given to prevent bleeding of the  Foods Allowed:
after Tonsillectomy and Adenectomy operated area, cooked soft and bland foods Plain ice cream, cold milk,
 Tonsillectomy, dental extraction, adenoid which have been allowed to cool may also iced tea, iced coffee, soft
surgery and other minor throat and be given; used only for a limited period. drinks, cooked soft and
swallowing ability, face lifting, radical bland foods which have
mouth surgery. been cooled.

D. Tube Feedings
(blenderized or osterized)

 Esophageal obstruction, surgery of the  Composed of foods included in the soft and  Foods Allowed:
mouth, gastric surgery, severe burns, liquid diet, blended and liquefied to enable All foods included in the
coma, insanity, sever under-nutrition, the mixture to pass thru a polyvinyl tube. soft and liquid diets which
paralysis of swallowing muscles, acute Pectin or apple sauce may be included to are easily blended. 100-
and chronic infections, face lifting. prevent diarrhea; ideally 1cc of diluted 200cc of diluted formula
formula provides one kilocalorie. given in every 2-3 hours is
recommended.

2. SOFT DIET

 Patients who are unable to chew, swallow  Serves as a transition from the full liquid to  Foods Allowed:
or digest foods included in the full diet; the regular full diet; is a nutritionally Those low in cellulose
mild to moderate infection; simple GI adequate diet; is a modification of the content, low in fiber, free
disturbance and convalescence. normal diet in consistency and texture. from tough connective
tissues and strong flavors,
simple and easily
digested.

A. Minimum Residue Diet

 Disease and conditions involving the  Made up of foods which form the least  Foods Allowed:
bowel like dysentery, diarrheas, and pre- amount of fecal matter, inadequate in Plain and strained soups;
and post-op periods when it is desired to vitamins and minerals and must therefore lean and tender beef, liver,
reduce fecal residue, as in colostomy and be supplemented; used for a limited time chicken (no-skin), fish and
bowel resection. only. It has limited fiber. other sea foods, soft-
cooked eggs, well-cooked
strained veg. and strained
fruit juices; margarine and
butter in moderation; rice
and other cereal, plain
cakes, plain gelatin,
refined sugars, black
coffee and tea.

 Foods Avoided:
Milk and milk drinks,
cheese, raw eggs, veg.,
fruits (except juices &
those strained), coarse
breads & cereals, tough
meat, fried foods, rich
desserts.

B. Low Residue Diet  up to 2 cups of milk is

(if this diet is ordered, a soft diet is allowed.
given)
 C. Bland Diet

 Gastric and duodenal ulcers, gastritis,  An allowance of food and drink which is  Foods Allowed:
ulcerative colitis, in some cardiac cases in chemically, mechanically and thermally Those which are mild I
order to provide rest to the heart. non-irritating, foods likely to cause flavor, no coarse fiber and
dyspepsia omitted; regularity as well as tough connective tissues,
frequency of meals is advised. The modern non-stimulating and any
trend of management is towards food tolerated by the
liberalization. patient.
 Foods Avoided:
Black pepper, chili
powder, strong coffee and
alcohol.

D. Mechanical Soft Diet

 Poor dentures, lack of teeth, presence of  Food given requires little chewing.  Foods Allowed:
sores and lesions in the mouth. Those included in the full
diet may be given but
reduced to small places by
grinding, chopping,
mincing, etc

E. Low Fiber Diet

 Spastic constipation, diverticulitis and  Contains a minimum of indigestible  Avoid gristle and tough
other gastrointestinal disturbances. carbohydrate and tough connective tissues. connective tissues in
meats; seeds and skins of
fruits and veg., whole
grain cereals, coarse
bread.

F. High Fiber Diet

 Atonic constipation; arthesclerosis,  Normal diet with fiber increased to more  Foods Included:
diverticulosis, diabetes mellitus. than 10g. daily, concentrated foods Those in the full diet with
replaced by those of greater bulk. emphasis on long-fibered
veg.; raw fruits & veg.,
whole grain cereals,
coarse breads

B. MODIFICATION IN COMPOSITION

1. CALORIE

A. High Calorie
 Underweight, protein energy malnutrition,  Contains a greater amount of total energy  Foods Included:
fevers and infections, hyperthyroidism, to effect a positive energy balance; All foods in normal diet
burns, growth, pregnancy and lactation. minerals and vitamins remain at or above with increased amounts of
recommended levels; gradual rather than cereals, breads, butter,
drastic increase in the amount of food cream and other fats and
given; 3 meals with in-between feeding. sugars.

 Foods Avoided:
Excessive amounts of
bulky low caloric foods,
fried foods or those which
may interfere with
appetite.
 B. Low Calorie
 Obesity and those cases where excess  Contain a reduced amount of total energy  Foods Included:
weight is a complicating factor as diabetes to effect a negative energy balance; Protective foods are
mellitus, CVD, renal disease, HPN, gout, protein, minerals and vitamins remain at emphasized; sufficient
gall-bladder disease, preceding surgery or above recommended levels; bulk, low in calories for a
distribution of CHO and fats may follow satisfied feeling.
normal pattern as long as total calories
are reduced; drastic reduction should be  Foods Restricted /
avoided. Avoided:
High-fat foods, high CHO
foods.

2. CARBOHYDRATE

A. High Calorie
 Renal and liver disturbances, toxemia of  CHO in the diet are increased by 50%  Foods Included:
pregnancy, preparation for surgery, above the normal. Emphasis on rice and
Addison’s disease, hyperthyroidism. other cereals, breads and
bakery products,
Rootcrops, noodles,
sugars and sugar
products, native cakes
and the like, fruits, dried
beans and legumes.

B. Low Calorie
 Hyperinsulinism, dumping syndrome,  CHO in the diet are reduced by 50%  Foods Included:
obesity, epilepsy, celiac disease. protein and/or fats increased. Foods high in protein;
adequate to high fat foods
in certain conditions; MCT
preferred.

3. PROTEIN

A. High Protein
 Growth, pregnancy, protein-energy  A regular diet with proteins, increased by  Foods Included:
malnutrition, burns, surgery fractures, 50-100% above the normal allowance All foods in the regular diet
fever, debilitating conditions, pernicious about 1/3-1/2 and 1/2-2/3 of the total with emphasis on milk,
anemia, nephritic syndrome, renal disease protein in diets of adults and children eggs, cheese, meat,
without azotemia, hepatitis, cirrhosis respectively. Should come from proteins poultry and fish.
without impending coma, hyperinsulinism, of HBV; enough CHO and fats should be
dumping syndrome, celiac disease. provided for protein-sparing effect.

B. Low Protein
 Acute glomerulonephritis, uremia, hepatic  Protein restricted to 50% below the  Foods Avoided:
coma; chronic glomerulonephritis with normal allowance or about 20-30gm per Protein foods in excess of
nitrogen retention. day; about 2/3 of the total protein prescribed amount.
prescribed should come from HBV
proteins; adequate CHO and fats to spare  Foods Limited:
proteins; sodium and potassium may be Legumes, nuts, cereals
restricted. and vegetables.

C. Protein-free and Zero Protein

 Hepatic coma, acute anuria  Used only as an emergency measure;  Foods Included:
high CHO and fats to prevent tissue Fruit juices if potassium is
breakdown. not restricted; sugar;
butter-sugar mixtures as
butter balls, butter soup,
butter pudding, etc.,
4. FATS AND LIPIDS

A. Low Fat
 malabsorption with steatorrhea, acute,  severely restricted fat diet allows from 10-  Foods Included:
acute attacks of pancreatitis and 15% of TER as fat calories or Skim milk, egg, lean meat,
cholecystitis, in type 1 hyperproteinemia, approximately 20-30gms fat/day; all foods cottage cheese, cereals,
celiac disease. rich in fat not allowed or restricted; foods fruits, vegetables, sugars.
cooked by methods not requiring addition
of fat; emphasis on vitamin A-rich foods.  Foods Avoided:
Fatty meats, rich dessert,
fried foods.

B. Modified Fatty Acid Ratio

 Coronary artery disease, diabetes mellitus,  Calories from fat approximately of normal  Foods Avoided:
hypercholesterolemia, hyperglyceridemia, level but food sources of PUFA are Fats of meats; butter,
artherosclerosis, emphasized; intake of SFA reduced; hydrogenated margarine,
Type II-V, hyperlipoproteinemia. maintain P/S ratio of 1:1. whole milk, cream cheese,
coconut oil.

C. Low Cholesterol
 Arthesclerosis, hypercholesterolemia, type  Eggs limited to 2-3 per week; dietary  Foods Allowed:
II-V, hyperlipoproteinemia, gallbladder cholesterol reduced less than 300mgs per Lean meat only or fish; 2-3
stones with cholesterol esters, coronary day. egg yolks/weeks, egg
disease. white as desired, skim
milk, cottage cheese,
vegetables and fruits,
tapioca, cornstarch or rice
pudding prepared with
skim milk; honey, sugar.

 Foods Avoided:
Glandular organs, oyster,
roe, caviar, animal fat,
cream cheese, whole milk,
cream, butter, ice cream

5. Minerals

A. Sodium Restricted
 Restriction depends on individual needs;  Diets where the sodium content is limited  Foods Allowed:
less severe restriction when diuretics are to a specific level which may range from Special attention given to
used. mild restriction to severe restriction; the choice of foods which
provides an adequate diet with a are naturally low in sodium
prescribed level of sodium according to content.
individual needs.
 Foods Avoided:
Canned, cured process
foods which uses salt and
sodium-containing
flavoring agents and
preservatives; salt, patis,
vetsin and toyo are
omitted from the table or
the tray.
 Levels of Restriction

I. 200-250mg. Na (9-11mEq)
 Severe hypertension; intended primarily  Lowest level of sodium restriction  Foods Allowed:
for hospitalized patients whose salt Rice or oatmeal is
tolerance is low; caution is employed to substituted for regular
avoid sodium depletion, azotemia and bread at breakfast. Jam
refractory heart failure. used instead of margarine;
meat limited to 4
exchanges per day,
unsalted vegetable oil for
cooking; only low sodium
milk, Lonalac, is used if
milk is desired.

 Foods Avoided:
Butter, margarine,
commercial baked
products. All others above.

II. 500mg. Na (22mEq)

 Strict Sodium Restriction  Foods Allowed:
Ordinary evaporated milk
is used but not more than
more than 2T/ day.
 Severe CHF, renal disease with edema;
Include the food plan in a
cirrhosis with ascites; pulmonary edema.
200mg. Na diet plus 2
exchanges or regular
bread and 2 exchanges of
butter per day.

III. 1000mg. Na (43mEq)

 Moderate sodium restriction,  Foods Allowed:
Include the food plan in a
 Serious CHF; used as maintenance diet
500mg. Na diet plan plus
for nephritis, toxemia of pregnancy, ACTH
1/4 t NaCl/day. In a
therapy; for patients with a tendency to
sodium restricted high
develop edema.
protein diet, this additional
salt is omitted.

IV. 2000-3000mg. Na (87-140mEq)

 Patients with moderate heart damage;  Mild sodium restriction, essentially a  Foods Allowed:
maintenance diet in renal disease; steroid normal diet; moderate use salt in food May allow moderate use of
edema, edema of hepatic origin, preparation salt in preparation.
premenstrual tension, mild CHF
 Foods Avoided:
Further addition of salt,
toyo, patis or other salty
condiments at the table or
on the tray. Highly salted
foods.

V. No Added Salt (3-4g Na)

 Liberal sodium restriction – no salt is
added to food during cooking and serving.
 B. Potassium Restricted
 Renal failure, hyperkalemia, Addison’s  The potassium content of the diet is  Foods Allowed:
disease, oliguria, anuria. reduced to about 1.0 to1.5gms/day. Cereal and breads,
sugars, fats; protein foods,
fruits and vegetables
within the prescribed
amounts.

 Foods in restricted
amounts:
Milk, cream, eggs,
meats, fish, poultry,
fruits, vegetables

C. Calcium Restricted
 The calcium content of the diet is  Foods in restricted
 Calcium stones, hypercalcemia, reduced to approximately 150 and amounts:
recurrent pancreatits, diagnostic test for 350mgs. per day in adults and children Milk, cheese, eggs, nuts,
hyperparathyroidism. respectively. meat, fish and other high
calcium foods.

6. ASH Content

A. Acid ash diet

 Kidney stones, calcium and magnesium  Acid-Ash foods are emphasized; neutral  Foods Included:
phosphates, carbonates and oxalates. foods used as desired. Acid-ash food; meat fish
poultry, eggs, whole
grain cereals, bread,
noodles; prunes, corn,
lentils.

 Neutral Foods:
Butter, sugar, plain
candies, oils and fats,
coffee, tea

 Foods Limited:
Milk, fuits, vegetables

B. Alkaline ash diet

 Kidney stones-uric acid and cystine calculi  Alkaline-ash foods are emphasized, acid  Foods Included:
–ash foods limited to those necessary for Large amounts of fruits,
good nutrition. Neutral foods as desired. vegetables, milk.

 Neutral Foods:
Butter, sugar, plain
candies, oils and fat,
coffee, tea

 Foods avoided Limited:

Meat, poultry, fish,
cheese, noodles, cereals,
breads, prunes, corns,
lentils

References:
[Link], Celeste , Jamorabo-Ruiz (2010). NDAP Diet Manual 5th Edition
[Link]-Ruiz et al. (2011). Nutrition and Diet Therapy for Nursing, Merriam & Webster Bookstore, Inc.
3. Ma Lourdes Cruz-Caudal, RND, MEM (Published 2019). Basic Nutrition and Diet Therapy Textbook for
For Allied Health 2nd Edition, C&E Publishing Inc.