NCMA215 – NUTRITION AND DIET THERAPY
WEEK -9
■ Therapeutic diet – is a meal plan that
controls the intake of certain foods or
nutrients. It is part of the treatment of a
medical condition and are normally
prescribed by a physician and planned by a
dietician. A therapeutic diet is usually a
modification of a regular diet. Therapeutic
diets are formulated by doctors and
dietitians.
A. GENERAL DIETS
Standard Hospital Diets
1. Clear Liquid Diet
• consists of liquids without residue or fibers
• used to relieve thirst and maintain water
balance
• diet used for 24-48 hours following acute
• vomiting, diarrhea or vomiting
• allowance of tea, coffee, fat-free broth,
ginger ale, fruit juices in sachet,
• gelatin, fruit ices, hard candy and water
2. Full Liquid Diet
• nutritionally adequate diet consisting of fluids and
foods that liquefy at body temperature
• diet used for acute infections and fever of short
duration and for patients who are ill to chew
• Examples: milk, cream soups, cereal, soft custard,
strained meat in broth, strained citrus fruits,
tomato juice, vegetable puree, eggnog, yogurt
3. Cold Liquid (Yin Diet)
ANNOTATED BY: A. BALLORAN
• diet for patient undergone tonsillectomy and
adenoidectomy
• allowance for ice chips, ice cream, sherbet, ice
drops, popsicle
4. Soft Diet
• nutritionally adequate diet differs from the normal
diet in having reduce the fiber content, consistency
and bland flavor
• used immediately between the full fluid diet and
regular diet following surgery, acute infections,
fever, and GI disturbances
✓ patient with no teeth or ill-fitting dentures;
✓ those who cannot tolerate highly seasoned, fried or
raw foods
The normal diet is modified in the following ways:
✓ meat and poultry are minced and ground
✓ vegetables are cooked – little longer than usual
✓ soft raw fruits may be used
✓ soft rolls, bread or biscuits are used instead of crisp
rolls, crust breads and toast
✓ all desserts on a normal diet may be used
5. Mechanical Soft Diet
■ dental soft or mechanically altered diet
■ foods should be well cooked, easy to chew,
chopped ground or minced
■ foods are best served moist or with gravy and sauce
6. Regular Diet
■ most frequently ordered among the house diets
■ also called general, house, full hospital diet, diet as
tolerated
7. Light Diet
■ a transition between the soft and regular diets
■ for elders who cannot tolerate rich and heavy foods
8. Vegetarian Diet
■ usually low in saturated fatty acid, cholesterol, and
high fiber
■ with disadvantage is inadequate or low level of Vit
B12, Iodine, Calcium, Zinc, Vit. B2 and Vit. D.
TYPES OF VEGETARIAN DIET
a. Vegan diet - total vegetarian, or strict vegetarian
diet or plant in origin
b. Lacto-vegetarian - milk and milk products + items of
plant origin
c. Ovo-vegetarian – eggs and eggs products + items of
plant origin
d. Lacto-ovo-vegetarian – eggs + milk + plant origin
e. Semi-vegetarian – lacto-ovo- vegetarian foods + fish
+ chicken + plant
f. Pesco-vegetarian – fish and fish products + items of
plant origin
9. Restricted Diet
■ a diet limited in a specified amount or type of
nutrient
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 NCMA215 – NUTRITION AND DIET THERAPY
■ cholesterol restricted diet, salt restricted diet
10. Controlled Diet
■ implies careful adjustment of levels of nutrients
from day to day as needed; controlled CHON, K, Na.
B. DIETARY MODIFICATIONS WITH CONSISTENCY
THERAPEUTIC DIET FOR SPECIFIC DISEASE CONDITION
✓ The modified consistency diet includes all the
foods you are allowed to eat in your regular diet
based on your tolerance, This diet may also meet
all your nutrition needs if you make healthy food
choices. Cut starches into small pieces, mash or
puree. Cook fruits: cook or steam vegetable
✓ MODIFIED CONSISTENCY DIET PUREED DIET
MECHANICAL SOFT DIET MODIFIED REGULAR DIET
LIQUID DIET THICKENED LIQUIDS
Sodium Restriction Salt allowed
Mild (3000 mg) >1/2 teaspoon per day
¼ teaspoon per day
Moderate (2000 mg)
1 serving of processed foods
No salt
Strict (1000 mg) No processed foods
Limit bread and milk
Sodium free
Very Strict (500 mg) Restrict natural foods high in
sodium
✓ Acute Glomerulonephritis - Low Na, Low CHON
✓ Acute Renal Failure – Oliguric Phase - Low Na, Low
CHON, High CHO
✓ Addison’s Disease - High Na, Low K
✓ Attention deficit hyperactivity disorder - Finger
foods
✓ Bipolar Disorder - Finger foods
✓ Cerebrovascular Accident - Osteorized Feeding
with Low Na, Low cholesterol, High fiber
✓ Cholecystitis - Low fat, High CHO, High CHON
✓ Chronic Renal Failure - Low CHON, Low Na, Low K
✓ Congestive Heart Failure - Low Na, Low
Cholesterol
✓ Cushing Disease - High K, Low Na
✓ Decubitus Ulcer - High CHON, High Vitamin C
✓ Dengue Fever - Diet c tolerated except dark-
colored food
✓ Diabetes Melitus - Well-balanced diet
✓ Diverticulitis - Low fiber
✓ Dumping Syndrome - High fat, High protein
✓ Hepatic Encephalopathy - Low CHON, High calorie
ANNOTATED BY: A. BALLORAN
✓ Hirschsprung’s disease - High calorie, Low residue,
High CHON
✓ Hyperparathyroidism - Low Calcium
✓ Hyperthyroidism - High Calorie, High CHON
✓ Liver Cirrhosis - Low CHON
✓ Nephrotic syndrome - Low Na, High CHON, High
Calorie
✓ Overweight and Obese - Low calorie
✓ Pernicious Anemia - High CHON, Vitamin B
✓ Tosilitis - Clear liquid diet
✓ Ulcerative Colitis - High CHON, High Calories, Low
residue
✓ Bland - eliminate irritating foods to allow the
stomach lining to heal (ulcer patients)
✓ High Fiber - provide bulk in the stool and bring
water into the colon for patients with constipation
or diverticulosis
✓ Low residue - reduce fiber for patients with
Crohn’s disease, colon or rectal surgery,
esophagitis, diarrhea.
✓ High Calorie - growing periods, under nutrition,
Chronic Obstructive Pulmonary Diseases and Cystic
fibrosis
✓ Low Protein - Liver and renal failure
✓ High Protein - Hypercatabolic disorder, Protein
Energy Malnutrition
✓ Low Purine - reduce the amount of purine. It is
used with patients who have gout or uric acid
kidney stones.
✓ Low Cholesterol - reduce the intake of cholesterol
in order to lower blood cholesterol levels in client
heart diseases
C. DIETARY MODIFICATION WITH COMPOSITION
LOW CALORIE DIET
■ Calorie restriction or caloric restriction(CR)
o Dietary regimen that restricts calorie
intake, where the baseline for the
restriction varies
o People who are interested in going on a
very low-calorie diet (VLCD) should first
consult a physician.
o A very -calorie diet is any diet plan that
allows 800 calories or less in a day; and the
diet is overseen by a physician.
o the length of such a diet is relatively short,
usually between 3 and 6 months. Any
longer and serious health complications
may arise.
LOW-CALORIE DIETS AND VERY LOW-CALORIE DIETS –
• as you can see, a VLCD is different from what a
person might casually call a calorie diet," which
would commonly consist of 1500 to 1800 calories
per day.
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 NCMA215 – NUTRITION AND DIET THERAPY
• If you’re interested in something less aggressive,
there are plenty of diet plans that will allow for
more moderate calorie restriction.
HIGH CALORIE DIET
• One furnishing more calories than needed to
maintain weight, often more than 3500 – 4000
calories per day
• A diet containing more than 4000 calories per day.
• Some medical conditions require a high calorie
diet to help maintain or promote weight gain
• People with liver disease are at risk of malnutrition
due to poor intake and altered metabolism
• To meet their needs, most people with liver
disease should increase the amount of calories
• People with Huntington’s disease have higher
calories needs because of their constant fidgeting
which increases their metabolic rate.
• Cancer patients tend to have higher calorie needs
because of a poor appetite related to treatment.
• Eating more calories - dense foods, such as whole
milk, cheese and nuts, can help you increase your
calorie intake when you have a poor appetite.
Severe Burns
Underweight
Competitive Athletics
HIGH-PROTEIN DIET
• a diet that contains large amounts of protein,
consisting largely of meats, fish, milk, legumes, and
nuts.
• It may be indicated in protein depletion that
results from any cause, as a preoperative
preparation, or for patients with severe burns and
sepsis.
• It may be contraindicated in liver failure or when
kidney function is so impaired that added protein
could result in azotemia and acidosis.
LOW-PROTEIN DIET
• Is any diet in which the protein intake is reduce.
Anyone diagnoses with kidney or liver disease
may be prescribe a low protein diet
• In any case, a diet which is especially in low
protein should only be undertaken under medical
direction. Reduce amount of protein –considered
high quality or complete protein. –considered low
quality or incomplete protein.
REDUCE AMOUNTF PROTEIN
• Some of each type of protein should still be
consumed each day from the two main sources:
• Animal products (fish, poultry, eggs, meat, dairy
products) – considered high quality or complete
protein
• Vegetable products (brads, cereals , rice , pasta,
dried beans) – considered low quality or
incomplete protein
LOW FAT DIET
ANNOTATED BY: A. BALLORAN
• According to the USDA, a low-fat diet–as the name
implies–is a diet that consists of little fat, especially
saturated fat and cholesterol, which is thought to
lead to increased blood cholesterol levels and
heart attack.
• it is important to know that dietary fat is needed
for good health, as fats supply energy and fatty
acids, in addition to supplying fat-soluble vitamins
like A, D, E, and K
LOW CARBOHYDRATES
• dietary programs that restrict carbohydrates
consumption usually for weight control or for the
treatment of obesity
• foods high in digestiblecarbohydrate consumption
usually for weight control or for the treatment of
obesity. bread, pasta) are limited or replaced with
foods containing a higher percentage of proteins
and fats(e.g., meat, poultry, fish, shellfish, eggs,
cheese, nuts, seeds, peanuts, and soy products)
and other foods low in carbohydrates (e.g., most
salad vegetables) although other vegetables and
fruits(especially berries) are often allowed.
• The amount allowed of these foods varies with
different low – carbohydrates diets carbohydrate
diets.
• Such diets are sometimes ketogenic (i.e. they
restrict carbohydrate intake sufficiently to cause
ketosis) for example, the induction phase of the
Atkins diet.
• Apart from obesity, low carbohydrates diets are
often used as treatments for dome other
conditions, most notably diabetes and epilepsy,
but also for chronic fatigue syndrome low-
carbohydrate as well. -carbohydrate diets are
often used as treatments for some other
conditions, most notably diabetes and epilepsy,
but also for chronic fatigue syndrome (see ketosis)
and polycystic ovarian syndrome
ALOW SODIUM DIET
• Is a diet that includes no more than 1,500 to 2,400
mgs of sodium per day. (One teaspoon of salt has
about 2,300mg sodium.)
• People who follow a vigorous or moderate
exercise schedule are usually advise to limit their
sodium intake to 3, 000 to 3,000mg per day and
those with moderate to severe heart failure are
usually advised to limit their sodium intake to
2,000mg per day.
LOW POTASSIUM DIET
• Potassium is a mineral that assists in maintaining
normal blood pressure and proper contraction of
the heart.
• The nervous system, digestive system, muscles
and heart are kept healthy
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 NCMA215 – NUTRITION AND DIET THERAPY
• It is found in whole grains, vegetable, milk, fruits, ■ Tyramine rich diet
peas and dried beans o use to prevent hypertensive crisis for
• Need of a low potassium diet If an individual has patients who are taking in MAOI anti-
kidney problems, excess potassium can depressant
accumulate up to dangerous levels in the blood. o > No to ABC – avocado, banana, canned,
This causes irregular heartbeats, confusion or a processed, smoked, aging and fermented
heart attack. In this case, a low potassium diet is foods
recommended. If the diet contains less than 2000 ■ South Beach Diet
mg of potassium per day, then it is called as a "low o diet developed by the Miami-based
potassium diet". cardiologist Arthur Agatston, M.D., who
• Low potassium foods1 serving of the following says that the key to losing weight quickly
can be considered to be low potassium food. 1 and getting healthy isn’t cutting all
serving implies ½ cup. More than 1 serving of the carbohydrates and fats from your diet,but
following can make it high potassium food. choosing the right carbs and the right
General foods Bread (bread products) fats.
• Cake - angel, yellow ■ Monothropic Diet
• Coffee (maximum 8 ounces) o A diet that involves eating only one food
• Cookies (without nuts or chocolate) item, or one type of food, for a period of
• Noodles time to achieve a desired weight
• Pasta reduction.
• Pies (w/o chocolate or high – potassium foods) ■ DASH diet
o (Dietary Approaches to Stop
• Rice
Hypertension). A recommendation that
• Tea maximum 16 ounces
those with high blood pressure consume
LOW PURINE DIET
large quantities of fruits,
• low-purine diet is an eating plan that limits foods
■ Elemental diet
that contain purine. Purines are a natural
o A medical, liquid-only diet, in which liquid
substance found in some foods.
nutrients are consumed for ease of
• When your body digests purine, a waste product
ingestion.
called uric (say: yu-rick) acid is produced.
■ Ketogenic diet
• a build up of uric acid crystals in the joints can
o A high-fat, low-carb diet, in which dietary
cause a type of arthritis known as gout.
and body fat is converted into energy. It is
• Purines are found in many healthy foods. The
used as a medical treatment for epilepsy.
purpose of a low-purine diet is not to completely
■ Paleo diet
avoid purines.
o foods include meat, fish, eggs, seeds,
• Instead, the goals are to limit and monitor how nuts, fruits and veggies, along with
much purine is in the food you eat, and to learn healthy fats and oils. Avoid
how your body responds when you eat different processed foods, grains and sugar.
foods that contain purine is in the food you eat, ■
■ BRAT diet
■ banana, rice, apple, toast
■ indicated patients with diarrhea
■ Butterball diet
■ spare protein but high in CHO indicated
with liver disorders
■ Giordano diet
■ spare protein, indicated for patients with
CHRONIC RENAL FAILURE
■ Giordano-Giovannetti diet
o a low-protein, low-fat, high-
carbohydrates diet with controlled
potassium and sodium intake, used in
chronic renal insufficiency and liver failure
■ Kosher
o meat and milk cannot be served
simultaneously diet for Orthodox Jews

ANNOTATED BY: A. BALLORAN 4|Page