ASSIGNMENT -1

THERAPEUTIC DIET

Definition: A therapeutic diet is a modification of a normal or a regular

diet. It is a modified version of a basic nutritious diet which has been
altered quantitatively/qualitatively to cater to the nutritional needs of a
specific disease conditions.

It is planned to maintain or restore good nutrition in the patient. In most

cases the therapeutic diet is used as a supplement to the medical
treatment of the patient while in other cases such as non-insulin
dependent diabetes mellitus, a therapeutic diet is most important rather
than the medical treatment.

Objectives of a therapeutic diet:

 To maintain good nutritional status
 To correct nutritional deficiencies
 To provide rest to the body or the organ affected
 To adjust the food intake to the body’s ability to digest, absorb and
metabolise nutrients during the disease
 To bring changes in the body’s weight and composition, whenever
necessary
Therapeutic adaptations to a normal diet:
 Change in consistency
 Modifications in energy intake
 Modification in the content of one or more nutrients
 Modification in the fibre content
 Exclusion of certain foods
 Rearrangement in the frequency of feeding
 Modify the mode of feeding
TYPES OF THERAPEUTIC DIETS:

REGULAR CLEAR
SOFT DIET
DIET LIQUID DIET

FULL FLUID DIABETIC

RENAL DIET
DIET DIET

LOW FAT LOW SALT

BLAND DIET
DIET DIET

A) REGULAR DIET
- A regular diet is used for most of the patients in the hospital who
are permitted to eat without any restrictions.
- This diet is also known as normal, general or full diet.
- It is a balanced diet which consists of the optimum amounts of
nutrients from basic food groups.
- Since there is no energy utilisation of a hospitalised patient there
is reduction of 10% energy and too many fatty foods and fried
foods are avoided as they are not easy to digest.
- The protein intake is increased by 10% to counteract a negative
nitrogen balance.
Such a diet provides 1600-2000 kcal and 60-80g proteins.
B) SOFT DIET
- A soft diet is used as a transitional diet between a full fluid diet
and a normal diet. It is nutritionally adequate diet.
- It is soft in consistency, easy to chew, made up simple, easily
digested foods and does not contain rich or highly flavoured
foods.
- It is planned for conditions where mechanical ease in eating or
eating or digestion or both are desired.
- It also leaves a low residue after digestion and absorption.
Thus, it is prescribed in acute infections, some gastro-intestinal
tract disorders and following surgeries.
Such a diet provides 1800-2000 kcal and 55-65g protein.
However, the energy, proteins and other nutrients are adjustable
according to the individual’s needs based on activity, height,
weight, sex and disease condition.
If the patient is not able to consume adequate amount of food,
supplements or between meals feedings are recommended.
Foods allowed:
 Refined cereals like rice and its products like bread, biscuit,
pasta, semolina
 Washed pulses in forms of soups with vegetables and cereals
 Milk and milk products such as curd, cottage cheese
 Eggs and lean products
 Starchy and low fibre vegetables
 Soft fruits-papaya, banana, mango after removing skin and
seeds
 Fruits and vegetables in form of juices and purees
 Fats like butter, cream, vegetable oils
 Salt and sugar in moderation

Foods restricted or in low amounts:

 Raw vegetables and fruits except soft fruits. Avoid skin and
seeds of fruits.
 High fibre vegetables like tomatoes, peas, beans. May only be
used in form of soups or purees
 Whole grain cereals and products like wheat and atta
 Whole pulses and split pulses with husk
  Dried fruits and nuts
 Fried foods, fatty and tough meats, rich gravies, cakes, halwas
etc.
 Spicy foods and pickles
Mechanical soft diet: Patients with no teeth or denture issues
require a soft diet also known as mechanical or a dental soft diet.
Modifications are made to a normal diet:

 Vegetables may be chopped or diced before cooking

 Avoid hard raw fruits and vegetables
 Remove tough skin and seeds
 Consume nuts and dried fruits in chopped or powdered form
 Meats to be finely grounded or minced
 Soft breads and chapatis can be given

C) CLEAR LIQUID DIET

- It consists of only clear liquids.
- It is used for post-operative patients to furnish non-gas forming
liquids and nourishment. It is also used for acute diarrhoea
patients.
- When there is intolerance to food, nutrients have to be restricted
in such cases clear liquid diet helps in preventing dehydration
and maintain water and electrolyte balance.
- It is an intermediary transition between intravenous feeding and
full fluid or soft diets following surgery. It minimizes stimulation
of gastrointestinal tract and leaves minimal residue.
- Small amounts of fluids (30-60ml) are served at frequent
intervals to replace fluids and also to relieve thirst.
- Being composed mainly of water, carbohydrates and some
electrolytes, such a diet can provide 400-500kcal, 5g protein,
negligible fat and 100-120g carbohydrate in 24 hours.
 - It is nutritionally inadequate and should only be given for a short
period of time (up to 3 days). Supplementation of proteins,
minerals and vitamins maybe recommended in case of longer
periods.
Foods allowed:
 Tea or coffee (without milk or cream)
 Strained fruit juices
 Clear soups and broths
 Carbonated beverages
 Whey water, coconut water, barley water
 Fruit juice
 Glucose water, lime water, honey

D) FULL FLUID DIET

- It is used as a step between a clear liquid diet and a soft diet.
- It is free from cellulose and irritating condiments and spices.
- It is given to acutely ill patients who are unable to chew or
swallow solid foods, following surgery or other gastrointestinal
disorders.
- This diet can be made nutritionally adequate for maintenance
requirements. Such a diet provides 1500-2000kcal, 55-65g
protein with adequate minerals and vitamins except for fibre.
- It can be used for longer periods as compared to a clear liquid
diet.
- Frequent meals cab ne provided every 2-4 hours.
- Vitamins, iron and protein supplements can be added to the
liquids to enhance nutritive value.
Foods allowed:
 Cream soups and broths
 Refined and strained cereals and pulse gruels
 Strained fruits and vegetable juices an purees
  Milk and milk based beverages
 Soft custards, plain ice-cream, corn-starch puddings
 Tea, coffee, carbonated beverages
 Butter, cream, oils added to food
 Sugar, honey and salt and mild flavouring

E) DIABETIC DIET
- The diabetic diet is for the patients diagnosed with diabetes
mellitus.
- Diabetic diet of a patient varies from type of diabetes, gender,
height and weight of the individual.
- These patients do not produce enough insulin o metabolize
carbohydrates.
- It is rich in fibres, low in fat and low in sugar.
- Sugar heavy foods (candy, sodas, and desserts) are avoided.
- This helps diabetic patient to maintain the desirable weight and
control their glucose level in their blood. It also helps to
prevent diabetes patient from heart and blood vessel related
diseases.

F) RENAL DIET
- The renal diet is for those patients who are diagnosed with
kidney related disorders.
- The diet plan is modified depending on if the patient is on
dialysis.
- The diet restricts sodium, potassium, fluid, and protein
specified levels.
- The protein intake is restricted to 0.5g/kg of body weight.
- The salt intake is restricted to 3g per day, potassium- half of
normal intake, low phosphorus intake 800-1000mg/day.
- Daily water intake should be 2 litres.
 - Magnesium intake is also restricted.

G) LOW FAT DIET

- Low fat diet is used to reduce fat or cholesterol levels and/or
treat medical conditions that interfere with how the body uses
fat such as diseases of the liver, gallbladder, or pancreas.
- This is also known as low cholesterol diet.
- This limits fat to 50 grams or no more than 30% calories derived
from fat.

H) LOW SALT DIET

- Low salt diet is for those patients diagnosed with hypertension,
kidney disorders, liver disease, and cardiovascular diseases.
- In low salt diet only 2000mg of salt intake is allowed, which is
half of the recommended daily intake. This may also be known
as a ‘2 gram Sodium Diet’.
- One teaspoon of salt contains 2000mg of sodium.
- This diet is also recommended for those who have oedema.
- Foods high in sodium are restricted or avoided.
- Limit salt and salty foods such as bacon, sausage, cured meats,
canned soups, salty seasonings, pickled foods, salted crackers,
etc.

I) BLAND DIET
- A bland diet is made of foods that are soft, not very spicy and
low in fibre.
- It consists of foods which are mechanically, chemically and
thermally non-irritating i.e. are least likely to irritate the
gastrointestinal tract. Individuals suffering from gastric or
duodenal ulcers, gastritis or ulcerative colitis are prescribed this
diet.
Foods Allowed:

 Milk and milk products low in fat or fat free

 Bread, pasta made from refined cereals, rice
 cooked fruits and vegetables without skin and seeds
 Eggs and lean tender meat such as fish, poultry that are
steamed, baked or grilled; Cream, butter
 Puddings and custards, clear soups.

Foods Avoided:

 Fried, fatty foods

 Strong flavoured foods; Strong tea, coffee, alcoholic
beverages, condiments and spices
 High fibre foods, hot soups and beverages; whole grains
rich in fibre