DIET - an allowance of food and drink consumed regularly by an individual.

 Nutrition therapy – interventions used in the treatment of a disorder or illness and

includes diet therapy , nutrition counseling or the use of specialized nutrition therapies
such as supplementation with nutritional or medical foods and nutritional support through
enteral or parenteral methods
Definition of terms
 Recommended Dietary Allowance - recommended levels of energy and nutrient
intakes for a a specific population group.
 Based on average requirement
 It has “plus “ allowance , called margin of safety to cover variations in individual
requirements and incomplete utilization of food
Definition of terms
 Dietary history – a record of the usual day – to – day food intake of an individual.
It is part of the nutritional history and can be taken by means of recall or by food record
 Nutritional hisotry – record of events related to the act of nourishing the body. It
includes dietary history, socioeconomic factors such as income, educational backround
and other data relevant to nutritional status
DIET
THERAPEUTIC DIET
AND
NUTRITION
Definition of terms
 Therapeutic diet – a diet modified or adopted from the normal diet to suit specific
disease conditions, one designed to treat or cure disease , or to support medical
management of a disease
 Dietary guidelines – qualitative advice on healthy eating
 Food exchange lists – gropuings of food with similar carbohydrate , protein and
fat content designed to facilitate planning of computed diets and serve as basis for further
classifying foods according to content of other components
Desirable body weight
 Desirable body weight
 Children : (Age in years x2 ) + 8
 Adults : ( height in cm -100 ) – 10 %
 Infants weight
 Doubles at 5-6 mos.
 Triples at 12 mos.
 Quadruples at 24 mos.
TOTAL CALORIE REQUIREMENT
 INFANTS – 120 – 110 KCAL / KDBW
 CHILDREN – 100+ (100 x AGE IN YEARS)
 ADULTS 1 KCAL / KDBW/ HR + PHYSICAL ACTIVITY = % ABOVE
BASAL
 BEDREST- 10
 SEDENTARY -30
 LIGHT – 50
 MODERATE -75
 HEAVY – 100KCAL
DISTRIBUTION OF TER

 CHO – 10-70 % OR AVERAGE OF 60

 CHON – 10%
 FATS – 20-25 AND 30-45%

Therapeutic diets
 Modifications of the normal diet
 Change in consistency.
 Increase or decrease in energy values
 Greater or lesser amount of certan nutrients
 Increase or decrease in bulk
 Alterations in flavor
 Include or exclude specific foods
 Modify intervals of feeding
diets
 Indication

 Characteristics

 Food selection
Clear liquid diet
 Illness or surgery marked by intolerance to food, acute inflammatory conditions
of the GIT, for conditions requiring:decreased fecal material.
 Inadequate in nutritional essentials, liquid at room temperature.use for 1 -2 days
only.

 Clear fat free broths , strained juices,tea and coffee , salabat, plain gelatin , sugar
plain, hard candies

Full liquid diet

 Post –op , acute infection, acute inflammatory conditions of the G.I.T. for patients
too ill to eat solid or semi solid foods, impaired chewing and swallowing ability
 Liquid at room temp. and free from cellulose and and irritating spices and
condiments. 6-8 small feedings recommended
 Strained cream or soups, pureed strained meat and fish,strained fruit juices ,plain
ice cream and plain gelatin, constarch pudding and milk and cocoa
Soft Diet
 Patients who are unable to chew, swallow or digest foods included in the full
diet.mild to moderate infectionSimple GI disturbances and convalescence
 Modification in consistenncy and texture
 Foods low in cellulose content low in fiber free from connective tissues and
strong flavors, simple and easily digested
Low residue diet
 Dysentery , diarrheas , pre-op and post –op when it is desired to reduce fecal
residue, as in colostomy, ileostony , and bowel resection.
 Made of foods which form the least anount of fecal matter, inadequate in vitamins
and minerals therefore supplementation is instituted
 Cereals strained soups, chicken –(no skin)
LORES
Bland diet
 Gastric and duodenal ulcers, gastritis , ulcerative colitis, in some cardiac cases in
order to provide rest to the heart
 Foods are non iiritating
 Mildly flavored foods without fiber, connective tissue, and should be non
irritating and non – stimulating ( avoid – alcohol , coffee black pepper and chili powder
Mechanically soft diet
 Poor dentures , lack of teeth, presence of sores and mouth lesions, mechanically
unable to chew, masticate and digest foods.
 Foods given require little chewing
 Grinded, chopped , minced and pureed food
High fiber diet
 Atonic constipation, Atherosclerosis, diverticulosis, DM
 More than 10 grams
 Full diet with emphasis on long fibered vegetables , raw fruits and vegetables,
whole grain cereals and coarse breads
High caloric
 Underweight, protein energy malnutrition, fevers and infections, hyperthyroidism,
burns, growth pregnancy and lactation
 3 meals with inbetween feeding – gradual rather than drastic. Vitamins and
minerals at or above RDA. Contains greater amount of total energy
 Cereals, bread, butter , cream and other fats and sugar
Low caloric
 Obesity and those cases where excess weight is a complicating factor as DM,
CVD, renal Dx , HPN , gout , gall bladder Dx and preceeding surgery
 Contains reduced amount of energy to effect a negative energy balance
 Sufficient bulk , low in calories . Avoid high fat foods and high CHO foods
VEGETARIAN DIET
 VEGAN – INCLUDES FRUITS VEGETABLES, NUTS , SEEDS. EXCLUDES
ALL SOURCES OF ANIMAL PROTEIN, FORTIFIED FOODS AND NUTRITIONAL
SUPPLEMENTS
 LACTOVEGETARIAN DIET- VEGAN DIET PLUS MILK AND MILK
PRODUCTS
 OVOVEGETARIAN DIET- VEGAN + EGGS
 LACTOOVOVEGETARIAN DIET- VEGAN + FISH
 RED-MEAT ABSTAINERS – CONSIDERED AS VEGETARIANS –
ABSTAIN FROM RED MEAT
 VITAMIN B 12 – RISK DEFICIENCY ASSOCIATED WITH
MEGALOBLASTIC ANEMIA
 RISK – TOXIC LEVELS OF VITAMIN A CAUSING ANOREXIA,
IRRITABILITY,DRY SKIN AND HAIR LOSS
DIETARY ADJUSTMENTS FOR SPECIFIC DISEASES
 AMOEBIASIS-LIBERAL FLUIDS ,LIQUID TO BLAND,LOW RESIDUE,
HIGH CALORIC AVOID RAW FOODS
 PARASITISM – HIGH CALORIC ,HIGH PROTEIN INC. IN IRON AND
VITAMIN C
 CDT – HIGH CAL, HIGH CHON, HIGHVITAMIN AND MINERAL
SUPPLEMENTS. SOFT, BLAND AND MOD TO LOW FAT
 TB – SUFFICIENT CAL. HIGH PROTEIN, VIT. B6
,CALCIUM, IRON, VIT A,C,K. CELLULOSE AND AGAR

 INFECTIOUS HEPATITIS – HIGH CARB. F&E REPLACEMENT, SMALL ,

FREQUENT MEALS
 AIDS AND IMMUNOSUPRESSED PATIENTS – FOOD SAFETY, NO RAW,
UNDERCOOKED FOOD
 RABIES – HIGH CALORIC AND BLENDERIZED FEEDING
 GASTRECTOMY – SMALL FREEQUENT FEEDINGS
 HIGH FAT AND PROTEIN, DRY SOLID,LOW FIBER AND LOW RESIDUE,
NO ALCOHOL OR SWEET CARBONATED BEVERAGES,HIGH CALORIC,
SIMPLE CHO RESTRICTED

 ILEOSTOMY AND COLOSTOMY – CLEAR FLUID AT FIRST, LOW

RESIDUE AND BLAND, HI CALORIE AND HIGH PROTEIN, VIT. B
SUPPLEMENTED
 JEJUNOILEOSTOMY – LOW FAT, LOW CHO , LOW FIBER , HIGH
PROTEIN AND SIX SMALL FEEDINGS
 PERITONITIS AND INTESTINAL OBSTRUCTION – NPO AND CLEAR
LIQUIDS TO LOW RESIDUE

 BURNS – HIGH CALORIC ,CHON , CHO, MAY REQUIRE TPN OR TUBE

FEEDING, ORAL NUTRIENT SUPPLEMENTS, VIT. B1 AND C, ANTACIDS TO
PREVENT CURLING’S ULCER. NGT TO PREVENT GASTRIC DISTENTION,
EARLY ACUTE GASTRIC DILATION AND PARALYTIC ILEUS WITH BURN
SHOCK.MONITOR BOWEL SOUNDS.
 FIRST 24-48 HOURS ( LOW POTASSIUM)
 48-72 HOURSHIGH POTASSIUM
BURNS- EMERGENT,HYPOVOLEMIC AND DIURETIC
 IMMEDIATE SHOCK PERIOD(1-3)- FLUID THERAPY, ELECTROLYTES
SODIUM AND CHLORINE BY USE OF SALINE SOLUTION
 RECOVERY PERIOD(3-5)-CAREFUL I AND O
 SECONDARY FEEDING PERIOD(6 – 15)
 HIGH CHON , VIT C, HIGH CAL AND VIT B COMPLEX
BURNS
 TOTAL ENERGY REQUIREMENTS
 [ 25 KCAL X PRE BURN WEIGHT (KG.)] + [ 40 KCAL X % BSA BURNED]
– ADULT
 CHILDREN – 30 KCAL TO 100 KCAL

 FLUIDS – 4 ML. / KBW X BSA = TOTAL 24 HOURS

THERAPEUTIC DIET FOR SPECIFIC CONDITIONS
 AGE – CLEAR LIQUID
 AGN – LOW NA , LOW CHON
 ADDISON’S – HIGH NA , LOW K
 ANEMIA , PERNICIOUS – HIGH CHON , VIT. B.
 ANEMIA SICKLE CELL – HIGH FLUID
 GOUT – PURINE RESTRICTED
 ADHD AND BIPOLAR – FINGER FOODS
 BURN – HIGH CAL. HIGH CHON
 CELIAC – GLUTEIN FREE
 CHOLECYSTITIS – HIGH CHON, HIGH CARB, LOW FAT
 CHF – LOW NA , LOW CHOL.
 CROHNS – HIGH CHON AND CHO, LOW FAT
THERAPEUTIC DIET FOR SPECIFIC CONDITIONS
 CYSTIC FIBROSIS – HIGH CAL., HIGH NA
 LITHIASIS----ACID ASH FOR ALK. STONES------ALK. ASH FOR ACID
STONES
 DECUBITUS ULCERS – HIGH CHON , HIGH VIT C
 DIARRHEA – HIGH K AND NA
 DUMPING SYNDROME – HIGH FAT, HIGH CHON,DRY
 HEPATIC ENCEPHALOPATHY-LOW CHON
 HEPATITIS – HIGH CHON,HIGH CAL.
 HIRSPRUNGS – LOW RESIDUE, HIGH CHON AND CHO
 CIRRHOSIS – LOW CHON
 MENIERE’S LOW NA
 MI AND HPN – LOW CHOL.,FATS,NA
 HYPERTHYROIDISM- HIGH CAL. AND CHON
 HYPOTHYROIDISM – LOW CAL. , LOW CHOL, LOW SAT. FAT
THERAPEUTIC DIET FOR SPECIFIC CONDITIONS
 NEPHROTIC SYNDROME – LOW NA, HIGH CHON , HIGH CAL.
 HYPERPARATHYROIDISM – LOW CALCIUM
 HYPOPARATHYROIDISM – HIGH CA, LOW PHOSPHORUS
 OSTEOPOROSIS – HIGH CALCIUM AND HIGH VIT. D
 PANCREATITIS – LOW FAT
 PUD – HIGH FAT, HIGH CARB. LOW CHON
 PKU – LOW CHON / PHENYLALANINE
 PIH – HIGH CHON
 PEDYA FOR CONS AND DIARR - BRAT

THERAPEUTIC DIET FOR SPECIFIC CONDITIONS

 RENAL FAILURE (ACUTE) – LOW CHON,HIGH CARB
 LOW NA (OLIGURIC PHASE)
 HIGH CHON , HIGH CAL AND RESTRICTED FLUID (DIURETIC PHASE
 RENAL FAILURE (Chronic) – LOW CHON , LOW NA , LOW K
EXAMPLES
EXAMPLES
EXAMPLES
EXAMPLES
DAILY SERVINGS
 BREAD CEREAL PASTA RICE 6-11
 VEGETABLES 3-5
 FRUIT 2-3
 MEAT,POULTRY, BEANS
EGGS AND NUTS 2-3/4
 MILK,YOGURT AND CHEESE 2-4
 FATS OILS SWEETS SPAR.
Transcultural Diet- dietary prohibitions( pg. 199)

 HINDU- all meats and animal shortening

 ISLAM- pork , alcohol and beverages(extracts of lemon and vanilla) , animal
shortening and gelatin made of pork
 JUDAISM – pork , fowl , shellfish and scavenger fish( without scales or fins) ,
blood by ingestion(transfusion –o.k.), packed fods – kosher-properly presserved or fitting
 KOSHER- no meat and milk altogether
 Pareve – made without milk or meat items
 MORMON – alcohol, tobacco, beverages with caffeine stimulants
 7TH DAY ADVENTIST – pork , certain seafoods including shelfish, fermented
beverages , vegetables are encouraged
 YIN AND YANG – cold foods in hot illness , vice versa
 Hot – rash , fever , sorethroat , surgery , ulcer , infection
 Cold – Ca , HA , stomach cramps and colds

Acid-ash diet
 Retards the formation of alkalinic renal stones
 Indicated to patients with renal calculi (Alkaline stones)
 E.g. cheese, cranberries, eggs, meat, plums, prunes,
 whole grains
Alkaline ash diet
 Retards the formation of acid renal stones.
 Indicated to patients with renal stones (Acidic stones)
 E.g. fruits (except cranberries, plums, prunes), milk, vegetables
Bland diet
 Low fiber, mechanical irritants, chemical stimulants
 Indicated for patients with gastritis, diarrhea, biliary indigestion, and hiatal hernia

BRAT Diet
 Banana, Rice, Apple. Toast
 Indicated for patients with diarrhea
Butterball diet
 Spare protein but high in carbohydrates
 Indicated for patients with liver disorders
Clear liquid Diet
 To relieve thirst and help maintain fluid balance
 Indicated for post-operative patients and following vomiting and gastroenteritis
Diabetic Diet
 Well balance diet
 The purpose is to maintain near to normal blood glucose level
 Indicated to patients with diabetes mellitus

Full liquid diet

 It serves to provide nutrition to patients who cannot chew or tolerate solid foods
 Indicated to patients with stomach upsets, post-surgical patients, after progression
from clear liquid diet
Giordano Diet
 Spare protein
 Indicated to patients who suffers from Chronic renal Failure
Gluten free Diet
 No to B R O W – Barley. Rye. Oat, Wheat
 This is the diet of a patient who suffers from celiac’s Disease
Halal Diet
 No pork diet
 Diet of the Moslems
High Fiber Diet
 Fruits and vegetable
 It speeds up the passage of food to the digestive tract, it softens the stool,
 Indicated to patients who are constipated, with diverticolosis, with
hyperlipedemia

High Protein Diet

 Lean-meat, cheese, eggs,
 Indicated to patients with nephrotic syndrome
Kosher Diet
 Meat ad milk cannot be served simultaneously
 Diet of the Orthodox Jews
Low carbohydrate diet
 Indicated to patients with dumping syndrome
Low fat/cholesterol Diet
 It serve the purpose of reducing hyperlipedemia, and to patients with intolerance
to fats
 Indicated to patients with cardiovascular diseases, patients who underwent
resection of the small intestines, hypertension cholecystitis and cholelithiasis

Low Residue diet

 Reduces the bulk of stools
 Indicated to patients with ulcerative colitis, diverticulitis, patients who will
undergo surgery of the GI tract
Low Sodium Diet
 Indicated to patients with cardiovascular and renal disorders
Purine restricted diet
 To reduce uric acid
 Indicated to patients with gouty arthritis, renal calculi, and hyperuricemia
Sodium-restricted diet
 Indicated to patients with heart failure, hypertension, renal diseases, PIH, and
steroid therapy
Soft diet
 Used to provide nutrition for those patients who have problems in chewing
 For patients with ill-fitting dentures; transition from full-liquid to general diet,
patients with gastrointestinal disturbances such as gastric ulcers and cholelithiasis

 Tyramine-free Diet
 Use to prevent hypertensive crisis for patients who are taking-in MAOI
antidepressant.
 No to ABC’s- Avocado, Banana, Canned and Processed Foods, and also, no to
fermented foods
 Vegan Diet
 Diet of the Seventh Day Adventists
Yin Diet
 Cold deserts after a surgery. It is a Chinese belief.

Water Soluble Vitamins

 Vit. C. (Ascorbic Acid)
 prolonged deficiency- scurvy
Vit. B Complex
 Vit. B1 (Thiamine)
 Prolonged deficiency- Beri-beri
 Vit. B2 (Riboflavin)
 Prolonged deficiency- Skin Lessions
 Vit. B3 (Niacin)
 Prolonged deficiciency- Pellagra
 Vit. B6( Prridoxine)
 Peripheral Neuritis
 Vit. B9 (Folic Acid/ Follacin)
 Prolonged deficiency- Megaloblastic Anemia
 Vit. B12 (Cobalamine/ Cyanocobalamine)
 Prolonged deficiency- Pernicious Anemia
 Panthotenic Acid
 Deficiency- fatigue, sleeplessness, nausea, poor coordination
 Biotin
 Deficiency- fatigue, depression

Fat-Soluble Vitamins
 Vit. A. (Retinol)
 Deficiency- Night Blindness and Opacity of the Lens
 Vit, D( Ergocalciferol)
 Deficiency to Children: Rickets
 Deficiency to Adult: Osteomalacia
 Vit. E(Tocoferol)
 Defieciency- Anemia
 Vit. K( Menadione)
 Deficiency- Bleeding
The following diseases need a high folic acid diet except
 Malnutritional anemia and IDA
 Chronic Alcoholism and IDA
 Pregnancy
 Lactation and chronic alcoholism
 Bleeding disorders of pregnancy