Diets modification

Low in Calorie
 Indication:
 Obesity; overweight, cardiac, hypertensive, arthritic or diabetic
individuals; hypothyroidism; prolonged bed rest or in elderly
persons.
 Calories are reduced by limiting carbohydrates and fats while
keeping protein at the normal level of 1.1 gm or more per
kg/body weight per day.
 However, very low calorie diets, 1200 kcal or less, require
vitamin and mineral supplementation
 Food guide
Food group Allowed Restricted
Vegetable All none
Fruits All fresh, canned in water only Candied, canned in syrup
Meat or substitute Boiled, broiled, baked, lean With excessive fat or fried or
beef, pork, chicken, fish, egg, processed with oil, cream,
skim milk, cheese, beans and whole milk, cheese
legumes
Fat None Gravies, sauces, cream, nuts,
coconut, salad dressing
Sugar and sweet desserts Gulaman, gellatin with little Jam jelly, marmalade syrup,
sugar candy, honey, chocolate bars
Beverages Calamansi, coffee, tea with Regular carbonated and alcohol
artificial sweetener,, drinks, milk shake and malted
carbonated drinks in milk
moderation
Soup Fat free meat, chicken, or fish cream soups
broth
 High calorie
 . High Calorie
 a. Indication: Underweight, hyper catabolic conditions like hyperthyroidis
m, injury, burns, fever and infections.
 Just reverse the above regimen for low calorie diet.
 Increase intake of foods in the right column (restricted group for
lowcalorie diet). Increase snacks

 Examples:
 Fats & Oils (Beef Tallow, Lard, Fish Oil, Vegetable Oil)
 Nuts & Seeds (Macadamia Nuts)
 Nut & Seed Butters (Peanut Butter)
 Calories 100g Per 2 tablespoons (32g) Per tablespoon (16g)
 590 calories 188 calories 94 calories

 Other Nut & Seed Butters High in Calories (Calories per

tablespoon): Sunflower Seed Butter (99), Almond Butter (98),
Cashew Butter (94), and Tahini (89
 4: Chocolate (Dark 70-85% Cacao)
 Calories 100g Per bar (101g) Per ounce (28g)
 598 calories 604 calories 167 calories

 OtherChocolate High in Calories (Calories per ounce):

Dark Chocolate 60-69% Cacao (162), and Dark
Chocolate 45-59% Cacao (153)
 Dried Fruit & Fruit Juices (Prunes)
 Calories 100g Per cup (132g) Per 1/2 cup (66g)
 339 calories 447 calories 224 calories

 Other Dried Fruit & Fruit Juices High in Calories (Calories per
1/2 cup): Dried Cherries (266), Dried Blueberries (254), Dried
Pears (236), Raisins (217), Dates (208), Dried Apricots (191),
Dried Peaches (189), Figs (186), Dried Cranberries (185), Dried
Apples (104), Prune Juice (91), Grape Juice (76), Passion Fruit
Juice (74), Pineapple Juice (67) and Pomegranate Juice (27)
 High protein diet
 For people in this age group, who may already have high
cholesterol or other cardiovascular risk factors,
 it's a good idea to grab extra protein not from animal sources
such as red meat, dairy products, and eggs, which are high in
saturated fats
 but from beans, seeds, whole grains, nuts, and fish.
 Protein is a macronutrient necessary for the proper growth
and function of the human body.
 There is considerable debate over the amount of protein a person needs
to consume per day.
 the current recommended daily intake (RDI) for protein is 46 grams for
women aged 19-70, and 56 grams for men aged 19-70.
 Any excess protein is turned into energy by the body, and it is
controversial whether this excess protein causes a strain on the liver.
 A deficiency in protein leads to muscle atrophy and impaired
functioning of the human body in general.

 Example:
 High protein foods include meat, fish, cheese, tofu, beans, lentils,
yogurt, eggs, nuts, and seeds.
 These are diets high in plant and animal proteins; used to treat
malnutrition or to increase muscle mass. High protein diet of 100 – 125 g
per day may be prescribed for a variety of conditions like
 Fever
 Hyper thyroidism
 Burns
 After surgery
 Diarrhoea
 Elderly
 Alcoholics.
 Low protein diet
 A low-protein diet is a diet in which people reduce their intake
of protein.
 A low-protein diet is prescribed for those with inherited metabolic
disorders, such as Phenylketonuria and Homocystinuria and reduced
protein levels have been used by people with kidney or liver disease.
 Protein is a nutrient needed by the body for normal growth, wound
healing, and the ability to fight infection.
 People with severe kidney or liver disease often must limit the amount
of protein they eat because their bodies cannot use the protein
properly.
 Dangerous waste products can build up in the blood from eating too
much protein.
 Low protein diets are usually prescribed for
conditions like
 Hepatic encephalopathy
 Acute and chronic glomerulonephrites
 Nephroslerosis
 Acute and chronic renal failure
 In-born errors of metabolism.
 In severe liver disorders, when protein cannot be synthesized, excess
ammonia cannot be converted to urea for excretion and the patient
develops hepatic coma.
 this situation protein levels must be decreased or completely restricted
for a few days.
 Patients with Kidney require low protein diets since the kidney cannot
excrete nitrogenous wastes.
 Diets containing 18 to 22 gms of high biological value protein may be
needed for the chronic uremic patients who is not being dialysed.
 Low protein diets are also prescribed for patients with in-born errors of
metabolism that result from lack of enzymes of the urea cycle.
 Low fat
 The National Heart, Lung, and Blood Institute created the
Therapeutic Lifestyle Changes (TLC) diet especially for people
with high levels of LDL (the bad cholesterol).
 The diet caps the percentage of calories you take in from fat,
and also places limits on sodium, dietary cholesterol, and
total calories. (A 5’5” woman who weighs 140 pounds and
doesn't get much exercise should consume about 1,800
calories and no more than 60 and 12 grams of fat and
saturated fat, respectively.)
 Fat controlled diets regulate the amount and type of fat allowed.
 The total calories from fats should give about 30% and 35% of the total calories with
10% from saturated fat and 12 – 14% from poly-unsaturated fats. Even the intake of
cholesterol also is reduced from the average daily intake of 600 to 300 mg.
 Usually fat controlled diets are prescribed for—
 Gall bladder diseases
 Nontropical sprue
 Celiac disease
 Cystic fibrosis
 Atherosclerosis
 Myocardial infarction
 Hyperlipidemia
 Sample menu
 Breakfast
 • Oatmeal (about ¾ cup)
• Banana
• Orange Juice
• Coffee
 Lunch
 • 1/2 tuna salad sandwich (with lettuce, tomato, and light
mayo)
• Cup of low-sodium vegetable soup
• Apple
• Diet soda
 Snack
 • Baby carrots
or
• Low-fat microwave popcorn
 Dinner
 • Salmon with pineapple salsa
• Blue cheese and cherry salad
• Brown rice (about 1/2 cup)
• Glass of wine
 Low cholesterol
 Eating too much saturated fat increases cholesterol levels.
 However, research has shown that cutting down on saturated fat and
replacing it with everyday foods that contain more unsaturated
fat can improve our cholesterol levels.
 eating too much saturated fat increases cholesterol levels.
 his is why it is best to limit the amount of foods we eat that are high
in saturated fats such as:
 Butter
 Ghee
 Hard margarines
 Lard, dripping and goose fat
 Fatty meat and meat products such as sausages
 Full fat cheese, milk, cream and yogurt
 Coconut and palm oils and coconut cream

 Additionally, many foods such as milk chocolate, toffee,

cakes, puddings, pastries, pies and rich biscuits, which are
made from the list above can also increase cholesterol.
 Foods that naturally help to lower cholesterol

 Plantsdo not contain cholesterol and are usually low

in saturated fat so vegetables and other plant-
based foods should feature regularly in a diet to
lower cholesterol. These include oat cereals,
barley fruit, vegetables, soya foods and
drinks, beans and pulses, nuts
 Foods that can help lower cholesterol
A variety of whole- and multi-grain products, such
as bran and oats.
 Fatty fishes, such as salmon, mackerel and albacore
tuna.
 Foodsrich in antioxidants, such as fruits and
vegetables.
 Foods high in omega-3 fatty acids, such as avocado,
flax seeds, olive oil and canola oil.
 Foods to avoid (or consume in moderation)
 Animal products high in saturated fat (beef, lamb, veal,
pork, duck, goose, cream, cheese, butter, egg yolk)
 Fried foods
 High-fat processed meats, such as hot dogs and sausages
 Simple sugars (found in soft drinks, candy, cakes, cookies
and other baked goods)
 Saturated oils, such as coconut and palm oil
 Shortening, partially hydrogenated margarine and lard
 Low carbohydrates
 A low-carb diet is a diet that restrictscarbohydrates, such
as those found in sugary foods, pasta and bread. It is high
in protein, fat and healthy vegetables.
 Foods to Avoid
 You should avoid these 7 foods, in order of importance:
 Sugar: Soft drinks, fruit juices, agave, candy, ice cream
and many others.
 Gluten Grains: Wheat, spelt, barley and rye. Includes
breads and pastas.
 trans Fats: “Hydrogenated” or “partially hydrogenated”
oils.
 High Omega-6 Seed- and Vegetable Oils: Cottonseed-,
soybean-, sunflower-, grapeseed-, corn-, safflower and
canola oils.
 Artificial Sweeteners: Aspartame, Saccharin, Sucralose,
Cyclamates and Acesulfame Potassium. Use Stevia instead.
 “Diet” and “Low-Fat” Products: Many dairy products,
cereals, crackers, etc.
 Highly Processed Foods: If it looks like it was made in a
factory, don’t eat it.
 Low Carb Food List – Foods to Eat
 Meat: Beef, lamb, pork, chicken and others. Grass-fed is best.
 Fish: Salmon, trout, haddock and many others. Wild-caught fish is
best.
 Eggs: Omega-3 enriched or pastured eggs are best.
 Vegetables: Spinach, broccoli, cauliflower, carrots and many others.
 Fruits: Apples, oranges, pears, blueberries, strawberries.
 Nuts and Seeds: Almonds, walnuts, sunflower seeds, etc.
 High-Fat Dairy: Cheese, butter, heavy cream, yogurt.
 Fats and Oils: Coconut oil, butter, lard, olive oil and cod fish liver oil.
 Low salt/sodium restricted
 Too much sodium in your diet can be bad for you.
 If you have high blood pressure or heart failure, you may be asked to
limit the amount of salt you eat every day. These tips will help you
choose foods that are lower in sodium.
 Your body needs salt to work properly.
 Salt contains sodium.
 Sodium helps your body control many functions.
 Too much sodium in your diet can be bad for you. For most people,
dietary sodium comes from salt that is in or added to their food.
 If you have high blood pressure or heart failure, you will likely be
asked to limit how much salt you eat every day.
 Even people with normal blood pressure will have lower (and healthier)
blood pressure if they lower how much salt they eat.
 Dietary sodium is measured in milligrams (mg).
 Your health care provider may tell you to eat no more than 2,300 mg a
day when you have these conditions. For some people, 1,500 mg a day
is an even better goal.
 This diet is used both to prevent and treat edema.
 Therefore, it is prescribed for congestive heart failure,
hypertension, liver and renal diseases.
 Buy fresh vegetables and fruits whenever possible.
 They are naturally low in salt.
 Canned foods often contain salt to preserve the color of
the food and keep it looking fresh. For this reason, it is
better to buy fresh foods. Also buy:
 Fresh meats, chicken or turkey, and fish
 Fresh or frozen vegetables and fruits
 Look for these words on labels:
 Low-sodium
 sodium-free
 No salt added
 Sodium-reduced
 Unsalted
 Check all labels for how much salt foods contain per
serving.
 Stay away from foods that are always high in salt. Some common ones
are:
 Processed foods, such as cured or smoked meats, bacon, hot dogs,
sausage, bologna, ham, and salami
 Anchovies, olives, pickles, and sauerkraut
 Soy and Worcestershire sauces, tomato and other vegetable juices,
and most cheeses
 Many bottled salad dressings and salad dressing mixes
 Most snack foods, such as chips, crackers, and other
 When you cook, replace salt with other seasonings. Pepper, garlic,
herbs, and lemon are good choices. Avoid packaged spice blends. They
often contain salt.
 Use garlic and onion powder, not garlic and onion salt. DO NOT eat
foods with monosodium glutamate (MSG).
 When you go out to eat, stick to steamed, grilled, baked, boiled, and
broiled foods with no added salt, sauce, or cheese. If you think the
restaurant might use MSG, ask them not to add it to your order
 Use oil and vinegar on salads. Add fresh or dried herbs. Eat fresh
fruit or sorbet for dessert, when you have dessert. Take the salt
shaker off your table. Replace it with a salt-free seasoning mix.
 Low potassium diet
 Potassium is a mineral that is found in many foods.
 It keeps the heart beating regularly, helps to maintain fluid
balance, and allows the nerves and muscles to work
properly.
 The kidneys are the main organ that controls the correct
level of potassium in the blood.
 People who take certain medicines or who have chronic
kidney disease must sometimes, under the direction of
their clinician, limit the amount of potassium in their diet to
keep their potassium level close to normal.
 WHY SHOULD I REDUCE POTASSIUM IN MY DIET?
 Normally, the level of potassium in your body is balanced by
eating foods that contain potassium and getting rid of
excess potassium in the urine.
 However, some people with chronic kidney disease cannot
get rid of enough potassium in their urine because the
kidneys do not work well.
 In these people, the level of potassium in the blood can
become higher than normal, causing a condition known as
hyperkalemia (hyper = high, kal = potassium, emia = in the
blood). Eating a low-potassium diet can lower the risk of
developing hyperkalemia.
 The potassium level is measured by taking a small sample of
blood from a vein. A typical normal range for potassium is
3.5 to 5 meq/L. A level greater than 6 meq/L or less than
3 meq/L is considered dangerous. Blood potassium must be
well regulated to prevent serious complications.
 Hyperkalemia does not usually cause noticeable symptoms
until the potassium level is very high, usually >6 to
6.5 meq/L. At this level, dangerous complications can
develop, including an irregular heart rhythm, severe muscle
weakness, paralysis, or even sudden death.
 HOW MUCH POTASSIUM DO I NEED?
 In general, experts recommend eating a diet that contains at
least 4700 mg of potassium per day [1].
 However, most people with moderate to severe chronic
kidney disease or acute kidney injury should eat less than
1500 to 2700 mg of potassium per day.
 People with moderate to severe chronic kidney disease have
kidney function (ie, glomerular filtration rate, or "GFR")
below 45 mL/min (normal is 100 to 120 mL/min).
 Fruit – One to three servings of low-potassium fruit per
day
 ●Vegetables – Two to three servings of low-potassium
vegetables per day
 ●Dairy and calcium rich foods – One to two servings of low-
potassium choices per day
 ●Meat and meat alternatives – Three to seven servings of
low-potassium choices per day (approximately 15 percent of
calories)
 ●Grains – Four to seven servings of low-potassium grains
per day
 Foods prepared with white flour (eg, pasta,
Grains
bread), white rice

Non-dairy creamer, fruit punch, drink mixes

Beverages (eg, Kool-Aid), tea (<2 cups or 16 ounces per
day), coffee (<1 cup or 8 ounces per day)

Angel or yellow cake, pies without chocolate

Sweets or high-potassium fruit, cookies without nuts
or cho
 Apples (1), apple juice, applesauce,
apricots (canned), blackberries,
blueberries, cherries, cranberries, fruit
cocktail (drained), grapes, grape juice,
grapefruit (½), mandarin oranges, peaches
Fruits
(½ fresh or ½ cup canned), pears (1 small
fresh or ½ cup canned), pineapple and
juice, plums (1 whole), raspberries,
strawberries, tangerine (1 whole),
watermelon (1 cup)
Alfalfa sprouts, asparagus (6 spears), green
or wax beans, cabbage (cooked), carrots
(cooked), cauliflower, celery (1 stalk), corn
(½ fresh ear or ½ cup), cucumber,
Vegetables eggplant, kale, lettuce, mushrooms (fresh),
okra, onions, parsley, green peas, green
peppers, radish, rhubarb, water chestnuts
(canned, drained), watercress, spinach
(raw, 1 cup), squash (yellow), zucchini
 Chicken, turkey (3 ounces), tuna, eggs,
baloney, shrimp, sunflower or pumpkin
seeds (1 ounce), raw walnuts, almonds,
Proteins
cashews, or peanuts (all 1 ounce), flax
seeds (2 tablespoons ground), unsalted
peanut butter (1 tablespoon)
Cheddar or swiss cheese (1 ounce), cottage
Dairy products
cheese (½ cup)
 Reducing potassium levels in vegetables
 It is possible to remove some of the potassium in certain
vegetables with high potassium levels.
 Leaching is a process of soaking raw or frozen vegetables in
water for at least two hours before cooking to "pull" some
of the potassium out of the food and into the water.
 You should not eat these vegetables frequently because
there is still a lot of potassium in the food after leach
 Wash and then cut the raw vegetable into thin slices.
Vegetables with a skin (eg, potatoes, carrots, beets,
rutabagas) should be peeled before slicing.
 ●Rinse the cut vegetables in warm water.
 ●Soak the vegetables for at least two hours or overnight. Use
a large amount of unsalted warm water (approximately 10
parts water to 1 part vegetables). If possible, change the
water every four hours. Drain the soaking water.
 Rinse the vegetables again with warm water.
 ●Cook vegetables as desired, using a large amount of unsalted
water (approximately 5 parts water to 1 part vegetables).
Drain the cooking water.
 Low purine diet
 Purines are a natural substance found in some foods. ... When your
body digests purine, it produces a waste product called uric acid. A
buildup of uric acid crystals in the joints can cause certain health
issues.
 A low-purine diet is a meal plan based on foods that are low in purine
content.
 Purine is a substance that is found in foods and is produced naturally
by the body.
 Purines are broken down by the body and changed to uric acid. The
kidneys normally filter the uric acid, and it leaves the body through
the urine.
 However, people with gout sometimes have a buildup of uric acid in
the blood.
 This buildup of uric acid can cause swelling and pain (a gout attack). A
low-purine diet may help to treat and prevent gout attacks.

 The following foods are low in purine.

 Eggs, nuts, and peanut butter
 Low-fat and fat free cheese and ice cream
 Skim or 1% milk
 Soup made without meat extract or broth
 Vegetables that are not on the medium-purine list below
 All fruit and fruit juices
 Bread, pasta, rice, cake, cornbread, and popcorn
 Water, soda, tea, coffee, and cocoa
 Sugar, sweets, and gelatin
 Fat and oil

 What other guidelines should I follow?

 Increase liquid intake. Drink 8 to 16 (eight-ounce) cups of liquid each
day. At least half of the liquid you drink should be water.
 Liquid can help your body get rid of extra uric acid.
 Limit or avoid alcohol. Alcohol (especially beer) increases
your risk of a gout attack. Beer contains a high amount of
purine.
 Maintain a healthy weight. If you are overweight, you
should lose weight slowly. Weight loss can help decrease
the amount of stress on your joints.
 Regular exercise can help you lose weight if you are
overweight, or maintain your weight if you are at a normal
weight.
 Talk to your healthcare provider before you begin an
exercise program.