Nutrition and Diet Therapy
Fontanilla, Krizza Mae
Frias, Andrea R.
BSN 209
Topics:
Low Cholesterol - High Blood Cholesterol,
Atherosclerosis, Heart Attack or Stroke
Low Carbohydrate - Type 2 Diabetes
Low Salt/ Sodium Restricted - Heart Failure
Low Potassium - Chronic Kidney Disease
Low Purine / Purine Restricted - Gout
LOW CHOLESTEROL DIET
CHOLESTEROL
- is an oil-based substance. It does not mix
with the blood, which is water-based.
- Cholesterol has four primary functions,
without which we could not survive.
These are:
● contributing to the structure of
cell walls
● making up digestive bile acids in
the intestine
● allowing the body to produce
vitamin D
● enabling the body to make
certain hormones
Cholesterol Recommendations
Having high cholesterol increases your
risk for clogged arteries and heart disease.
Following dietary guidelines, doctors used to
recommend that you consume no more
than 300 milligrams (mg) of dietary
cholesterol per day — 200 mg if you
had a high risk of heart disease.
FAT:
● Major energy source of the body,
but is not the body's only source
of energy
● Too much fat in the diet can be
harmful
● Bad for the circulatory system
because it raises blood
cholesterol levels
● Contributes to having heart
attack or stroke
Cholesterol
● When cholesterol levels rise above
normal limits and stay high, some
cholesterol is left behind the arteries.
● Then the waxy substance called
cholesterol plaque builds up on the artery
walls, that reduces or blocks the blood
flow.
● Organs supplied by these arteries then
become damaged because they cannot
get the oxygen and nutrients they need.
● When a blood flow is blocked, a stroke
occurs.
● When a plaque completely blocks a
coronary artery, a heart attack takes
place.
● Cholesterol made by the liver
● Cholesterol comes from eating animal
products such as meats, egg yolks, organ
meats, whole milk and milk products.
Dietary fats
● Can be saturated or unsaturated.
● Saturated fats solidify or remain solid at
room temperature.
● Unsaturated fats do not, and they are
liquid at room temperature.
● To reduce blood cholesterol levels, it is
important to limit saturated fats. They are
mainly found in meats and dairy products
made with whole milk.
Low Cholesterol
- Cholesterol is a waxy fat-like substance
found in foods of animal origin.
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 Nutrition and Diet Therapy
Cholesterol in the blood is derived from
two sources-from the diet and that which
is produced by the body.
The average diet provides at least 450 mg
cholesterol per day, the recommended
intake is 300 mg or less per day. The
current interest in cholesterol is due to its
role in cardiovascular diseases
particularly atherosclerosis-a condition
characterized by the hardening of walls
of the arteries.
Foods commonly omitted from the diet:
● all types of internal organs
● egg yolk
● seafoods
● pastries and other rich desserts
● chocolates (bars, candies, beverages)
● whole milk and products
● processed meats such as longganisa,
hotdog, corned beef
● viands cooked with coconut cream or
“gata”
● alcoholic beverages
● animal fat or lard
● too much intake of butter and
mayonnaise
SPECIAL CONSIDERATIONS
1. Limit sugar and alcohol. They provide few
nutrients but many calories. Therefore, they
contribute to high cholesterol by increasing body
weight. An overweight body contains excess fat
that is saturated
2. Certain habits, such as cigarette smoking and a
sedentary life, can increase the risk of heart
disease.
3. Fish should be eaten often, 3 or more times per
week. Research indicates that certain deep-sea
fish– mackerel, salmon, herring, albacore tuna,
lake trout – contain an oil called Omega-3 fatty
acid. This oil may help to lower blood
cholesterol. Fish oil supplements, however, are
not recommended
because they add too many calories.
4. Avoid high sodium content in foods. Some
patients with high cholesterol also have high
blood pressure. Reducing sodium can help to
keep blood pressure within normal limits. Table
salt is about ½ sodium. Sodium is also an
ingredient in many commercially processed
foods.
5. Increase complex carbohydrates, (pasta, whole
grains, and potatoes) in the diet. Like fats, they
are an excellent source of energy without the
harmful effects fats can have on the body. But,
read labels of commercially prepared baked
goods, cookies, and crackers.
6. Eat 20 to 30 grams of dietary fiber every day.
Foods such as legumes, oats, barley, brown rice,
apples, strawberries, and carrots are good to eat
because they contain soluble fiber.
7. Choose meat carefully. Grading of meats
(Prime, Choice, or Good) refers to fat content,
with Prime grades having the most fat.
8. Eating out can be a challenge. Avoid fast food
restaurants; their foods are usually high in fats
and sodium.
STEP 1 AND STEP 2 DIETS
Purpose:
● Decrease total dietary fat, especially
saturated fat
● Decrease dietary cholesterol
● Limit sodium intake
● Increase intake of fiber and complex
carbohydrates
● Decrease calories if needed to reach a
healthy body weight
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 Nutrition and Diet Therapy
The Step-1 diet is the first level of treatment for
high blood cholesterol in most adults and children
over the age of two. The Step-2 diet is more
restrictive, and is used when a person currently
has or did have any of the following:
● A high blood cholesterol, even after
following Step-1 diet for 6 to 12 weeks
● Evidence of atherosclerosis (fatty
deposits in the arteries)
● A heart attack or stroke
Low-carb foods include:
LOW CARBOHYDRATE
CARBOHYDRATES
• This food group has the largest effect on
blood glucose levels because when they
are digested carbohydrates are broken
down into glucose (sugar).
• Carbohydrates or carbs are one of three
main food types that the body needs to
work properly. The other two are protein
and fat. Carbs give the body energy. The
body breaks carbs down to use
immediately or later.
• If the body does not need to use the carbs
for energy as soon as a person eats them,
it stores them in the muscles and liver to
use later. However, if the body does not
use these stored carbs, the body converts
them to fat.
• Many people follow low-carb diets on
the basis that if the body does not receive
extra carbohydrates, it will not store
excess fat.
• The idea, then, is that the body will burn
some of the stored fat rather than the
carbs, which will promote fat loss.
● lean meats, such as sirloin, chicken
breast, or pork
● fish
● eggs
● leafy green vegetables
● cauliflower and broccoli
● nuts and seeds, including nut butter
● oils, such as coconut oil, olive oil, and
rapeseed oil
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● some fruit, such as apples, blueberries, your fat intake significantly. This is a
and strawberries popular weight loss diet.
• Ketogenic diet involves reducing
● unsweetened dairy products including
carbohydrate intake to less than 50 grams
plain whole milk and plain Greek yogurt per day or 10% of total calories per day
with relatively higher consumption of
fats and proteins. Carbohydrates are
✓ Low-carb diets limit the number of
broken down into glucose, which
carbohydrates a person eats. Instead of typically serves as the body’s main fuel.
carbs, people focus on eating proteins, • Because of the decrease in carbohydrates
healthful fats, and vegetables. eaten, the body is forced to utilize other
compounds as fuel such as ketone bodies.
✓ A low-carb diet may therefore help keep
your blood sugar in check and keep your
insulin level low to potentially aid with
weight loss. Because doctors often
recommend that those with type 2
diabetes lose weight to better their blood
sugar, this approach could possibly
directly and indirectly improve blood
glucose levels.

Type 2 Diabetes is a condition which occurs Traditional Low Carb

when the body is no longer able to deal with the
increasing level of glucose (sugar) in the blood.
• This approach includes 50 to 100 g of

• Treatment of Type 2 Diabetes requires carbs per day; this is where many people
that you follow a healthy lifestyle which start because it’s less restrictive than a
includes following healthy eating keto diet meal plan but can still deliver
guidelines and taking regular activity.
results.
• As most people with Type 2 Diabetes are
overweight it is important that you lose
weight gradually. Losing 1-2 lbs. a week
is a safe amount to lose. Bottom Line:
Carb intake between 20–90 grams per day has
been shown to be effective at improving blood
Different Types of Low-Carb Diets
sugar control. However, it's best to test blood
Ketogenic Diet sugar before and after eating to find your personal
carb limit.
• This is the strictest plan, requiring you to
eat less than 50 g of carbs per day and up

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 Nutrition and Diet Therapy
Foods to Eat
You can eat the following low-carb foods until
you're full, and you should make sure to get
enough protein at each meal.
● Meat, poultry and seafood.
● Eggs.
● Cheese.
● Non-starchy vegetables (most
vegetables except those listed below).
● Avocados.
● Olives.
● Olive oil, coconut oil, cream, sour cream
and cream cheese.
Foods to Eat in Moderation
The following foods can be eaten in smaller
quantities at meals, depending on your personal
carb tolerance.
● Berries: 1 cup or less.
● Plain, Greek yogurt: 1 cup or less.
● Cottage cheese: 1/2 cup or less.
● Nuts and peanuts: 1–2 oz or 30–60
grams.
● Flaxseeds or chia seeds: 2 tablespoons.
● Dark chocolate (at least 85% cocoa): 30
grams or less.
● Winter squash (butternut, acorn,
pumpkin, spaghetti and hubbard): 1 cup
or less.
● Liquor: 1.5 oz or 50 grams.
● Dry red or white wine: 4 oz or 120
grams.
Foods to Avoid
These foods are high in carbohydrates and can
significantly raise blood sugar levels in diabetics:
● Bread, pasta, cereal, corn and other
grains.
● Starchy vegetables like potatoes, sweet
potatoes, yams and taro.
● Legumes, such as peas, lentils and beans
(except green beans and snow peas).
● Milk.
● Fruit other than berries.
● Juice, soda, punch, sweetened tea, etc.
● Beer.
● Desserts, baked goods, candy, ice
cream, etc.
Meal Plan
Breakfast: Eggs and Spinach
● 3 eggs cooked in butter (1.5 grams of
carbs).
● 1 cup sautéed spinach (3 grams of
carbs).
● 1 cup blackberries (6 grams of carbs).
● 1 cup coffee with cream and optional
sugar-free sweetener.
Total digestible carbs: 10.5 grams
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Lunch: Cobb Salad Total digestible carbs for the day: 37 grams

● 3 oz (90 g) cooked chicken.

● 1 oz (30 g) Roquefort cheese (1/2 gram
of carbs).
● 1 slice bacon.
● 1/2 medium avocado (2 grams of carbs).
● 1 cup chopped tomatoes (5 grams of
carbs).
● 1 cup shredded lettuce (1 gram of
carbs).
● Olive oil and vinegar.
● 20 grams (2 small squares) 85% dark
chocolate (4 grams of carbs).
● 1 glass of iced tea with optional sugar-
free sweetener.
Total digestible carbs: 12.5 grams
Dinner: Salmon with Veggies
LOW PURINE DIET
• Purines are found in high levels in foods
like shellfish, organ meats, high-fructose
corn syrup-sweetened soft drinks, and
alcoholic beverages.
• Purines are substances that are present in
all living things, including our bodies.
They are also found in varying levels in
the foods we eat. When your body breaks
down purines, they form uric acid.
• Low-purine foods that may help reduce
uric acid in the body include fruits,
vegetables, whole grains, legumes, nuts,
and low-fat dairy.
Gout is a type of arthritis that develops when high
levels of a chemical called uric acid in the blood
cause uric acid crystals to build up in a joint. This
can lead to inflammation and pain, often in the
big toe, as well as other joints. Gout attacks, or
flares, are often extremely and suddenly painful
and debilitating.

● 4 oz grilled salmon.
● 1/2 cup sautéed zucchini (3 grams of
carbs).
● 1 cup sautéed mushrooms (2 grams of
carbs).
● 1/2 cup sliced strawberries with
whipped cream.
● 1 oz chopped walnuts (6 grams of
carbs).
● 4 oz (120 g) red wine (3 grams of
carbs).

Total digestible carbs: 14 grams

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 Nutrition and Diet Therapy

Low-Purine Diet Sample Menu and Eating • Eating too much salt causes the body to
Plan retain too much water, worsening the
Day 1 fluid build up that happens with heart
Breakfast: Oatmeal + sliced peach + almond failure.
butter
Lunch: Greek yogurt + chopped tomato and
cucumber salad + whole wheat pita bread
Dinner: Spinach and feta cheese omelet + whole
grain toast + mashed avocado

Day 2
Breakfast: Cottage cheese + melon + bran cereal
flakes
Lunch: Egg salad sandwich on whole wheat bread
+ lettuce + tomato
Dinner: Whole wheat pasta + cannellini beans +
broccoli + garlic + sprinkle of parmesan cheese

Day 3
Breakfast: Whole grain cereal + low-fat milk +
sliced strawberries
Lunch: Black bean soup garnished with chopped
tomato and scallions + tortilla chips
Dinner: Veggie burger + whole wheat bun +
roasted sweet potato wedges
LOW SODIUM
• Sodium is a mineral found in many
foods, especially salt. Eating too much
salt causes the body to keep or retain too
much water, worsening the fluid buildup
that happens with heart failure.
• People with heart failure may improve
their symptoms by reducing the amount
of sodium in their diet.
• You should have no more than 2,300
milligrams of sodium each day if you’ve
got heart failure. Less than 1,500 mg a
day is ideal.
• Low sodium diet helps minimize the
amount of extra fluid around your heart,
lungs, and in your legs.
Recommended Sodium Intake
Getting too much sodium in your diet can
increase your risk for high blood pressure.
Healthy Americans should limit sodium to no
more than 2,300 milligrams per day, and those
with an increased risk for heart disease should
only get 1,500 milligrams of sodium per day in
their diet. Limit processed foods, which are
among the main sources of sodium in the diet, and
use herbs and spices to flavor foods instead of salt
when cooking at home.
Low Sodium Diet Meal Plan
Breakfast
Fresh fruit - 1 medium, 1 mg sodium
Low-sodium cereal (hot or cold) - 1 cup, 115 mg
sodium
Milk - 1 cup, 120 mg sodium
Lunch
Lean roast turkey on whole wheat bread with
low-sodium mustard
Raw carrot sticks
Applesauce

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 Nutrition and Diet Therapy
Milk
Vanilla wafers
Dinner
Grilled chicken
Boiled potatoes
Steamed fresh vegetables
Tossed salad and low-sodium dressing
Fresh melon
Snacks
Fruit
Walnuts or almonds
Raisins
Yogurt
Cooking Tips
✓ Use fresh ingredients or foods with no
added salt.
✓ Avoid convenience foods such as canned
soups, entrées, and vegetables, pasta and
rice mixes, frozen dinners, instant cereal,
and puddings and gravy sauce mixes.
✓ Use fresh, frozen, no-added-salt canned
vegetables, or canned vegetables that
have been rinsed before they are
prepared.
✓ Avoid mixed seasonings and spice
blends that include salt, such as garlic
salt.
✓ Before using a salt substitute, check with
your doctor.
LOW POTASSIUM
• This essential mineral keeps your
muscles healthy and your heartbeat and
blood pressure steady.
• Potassium is a mineral found in many of
the foods you eat. It plays a role in
keeping your heartbeat regular and your
muscles working right. It is the job of
healthy kidneys to keep the right amount
of potassium in your body. However,
when your kidneys are not healthy, you
often need to limit certain foods that can
increase the potassium in your blood to a
dangerous level. You may feel some
weakness, numbness and tingling if your
potassium is at a high level.
• If your potassium becomes too high, it
can cause an irregular heartbeat or a heart
attack.
• A normal amount of potassium in a
typical diet of a healthy American is
about 3500 to 4500 milligrams per day.
A potassium restricted diet is typically
about 2000 milligrams per day.
• The recommended serving size for these
low-potassium foods is 1/2 cup. You
don't want to overdo it. Too much of a
low-potassium food makes it a high-
potassium food.
Chronic Kidney Disease
• Is a long term condition where the
kidneys don’t work as well as they
should.
• It’s a common condition often associated
with getting older. It can affect anyone,
but it’s more common in people who are
black or of south Asian origin.
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 Nutrition and Diet Therapy

342 grams of carbohydrate x 4 kcal/gram

= 1368 kcal
110 grams of protein x 4 kcal/gram = 440
kcal
25 grams of fat x 9 kcal/gram = 225 kcal
1368 + 440 + 225 = 2033 kcalories
Carbohydrate: 1368 ÷ 2033 = 0.67 x 100 =
67%*
Protein: 440 ÷ 2033 = 0.22 x 100 = 22%*
Fat: 225 ÷ 2033 = 0.11 x 100 = 11%*

NUTRITION CALCULATIONS
Energy-yielding nutrients
Nutrient Energy (kcal/g)
Carbohydrate 4
Protein 4
Fat 9
a. Calculate total calories

• A serving of canned peas provides 12

grams of carbohydrate and 5 grams of
protein. How many calories does one
serving provide?

12 grams of carbohydrate x 4 kcal/gram = 48 kcal

5 grams of protein x 4 kcal/gram = 20 kcal 48 kcal
+ 20 kcal = 68 kcal

b. Calculate % of total kcal provided by

carbohydrate, protein and/or fat.

• Mary’s usual diet provides an average

intake of 342 grams of carbohydrate, 110
grams of protein, and 25 grams of fat.
How many kcalories does she consume?
What percentages of her calories are
consumed from each macronutrient?