unani: January 2023

Therapeutic diets

Definition

A therapeutic diet is a meal plan that controls the intake of certain foods or nutrients as part of the treatment of a medical condition and is normally prescribed by a physician and planned by a dietician, often in a hospital setting.

Introduction

A therapeutic diet is usually a modification of a regular diet with addition or deletion of some meal ingredients. It is modified or made to fit the nutrition needs of a particular person especially as part of treatment of some abnormal conditions.

It is modified for-

· Increasing certain nutrients in diet

· To change the texture of a diet

· Remove certain items to combat food allergies or food intolerances

· As part of treatment of deficiency diseases

Reasons therapeutic diets may be prescribed

1. To maintain nutritional status

2. To restore nutritional status

3. To correct nutritional status

4. To decrease calories for weight loss

5. To provide extra calories for weight gain

6. To balance amounts of carbohydrates, fat and protein for control of diabetes

7. To provide a greater amount of a nutrient such as protein

8. To decrease the amount of a nutrient such as sodium or glucose

9. To exclude foods due to allergies or food intolerance

10. To provide texture modifications due to problems with chewing and/or swallowing

Types of diets

Commonly used diets in medical field are-

Modified regular diet

• Balanced diet usually used for ambulatory patients

• At times it is has a reduced caloric content

• Foods such as rich desserts, cream sauces, salad dressings and fried foods may be decreased or omitted

• High protein food may be added in diet in case of persons recuperating after a disease or doing regular weight training

High protein diet

· Used for growing children and adolescents, pregnant or lactating women, before and/or after surgery, patients suffering from burns, fevers, or infections

· Also prescribed for sports persons

· Regular diet with added protein rich foods such as meats, fish, milk, cheese, soya beans and eggs

Low protein diet

· Used for patients with certain diseases and for certain allergic conditions

· Regular diet with limited or decreased protein rich foods

Clear liquid diet

· Includes minimum residue fluids like juices without pulp, broth and clear soups

· Is often used as the first step to restarting oral feeding after surgery or a procedure

· Can also be used for fluid and electrolyte replacement in people with severe diarrhea

· Cannot be used for an extended period as it does not provide enough calories and nutrients

Full liquid diet

· Includes fluids that contains some nutrients and fibres

· Some examples of food allowed are ice cream, pudding, thinned hot cereal, custard, strained cream soups, and juices with pulp

· Used as the second step to restarting oral feeding once clear liquids are tolerated

· Used for people who cannot tolerate even a soft diet

· cannot be used for extended periods

No Concentrated Sweets (NCS) diet

· Is considered a liberalized diet for diabetics when their weight and blood sugar levels are under control

· It includes regular foods without the addition of sugar

· Calories are not counted

· Grain free diet used in diabetes is also a variation of this diet.

Diabetic or calorie controlled diet

· These diets control calories, carbohydrates, protein, and fat intake in balanced amounts to meet nutritional needs, control blood sugar levels, and control weight

· It is often low carbohydrate diet where mono and di saccharide are avoided

· For carbohydrates exchange system is used such as almond flour, coconut flour or buckwheat flour for wheat flour and quinoa for rice as also sugar substitutes like stevia, erythritol etc

· Portion control is used at mealtimes with regular smaller meals

· Most commonly used calorie levels are: 1,200 to 1,600

Low calorie diet

· Used for persons who are overweight or diabetic

· Avoid or limit high calories foods like all high sugar, high fats or fried food items

High calorie diet

· Used for pts who are underweight, or who have anorexia nervosa, hyperthyroidism, or cancer

· Extra proteins and carbohydrates are included to increase calories

· Avoid high-bulk foods such as green salads, watermelon and fibrous fruits

· Avoid high-fat foods such as fried foods, rich pastries, and cheese cake because they digest slowly and spoil appetite

No added salt diet

· It is a regular diet with no extra added salt

· Food is seasoned as regular food

· Used in cases of hypertension

Low Sodium (LS) or salt restricted (SR) diet

· Limits salt below a certain level and salty foods

· Is used for people who may be having edema or who have high blood pressure, heart disease, liver disease, or first stages of kidney disease

Low fat/low cholesterol diet

· Is used to reduce fat levels and/or treat medical conditions that interfere with how the body uses fat such as diseases of the liver, gallbladder, or pancreas

· Also prescribed for patients suffering from heart diseases such as atherosclerosis

· Limits fat to 50 grams or no more than 30% calories derived from fat

· Is low in total fat and saturated fats and contains not more then 250-300 mg cholesterol

· Oils, animal products, meats, seeds etc are avoided

High fiber diet

· Is prescribed in the prevention or treatment of a number of gastrointestinal, cardiovascular, and metabolic diseases

· Also used for regular bowel movements and to avoid constipation

· Increased fiber should come from a variety of sources including fruits, legumes, vegetables, whole grains etc or supplements

Low fiber diet

· Used for pts with digestive and rectal diseases such as colitis or diarrhea

· Eliminates or limits foods high in bulk or fiber such as raw fruits and veggies, whole grains and cereals, nuts, seeds, beans and peas, coconut, and fried foods

Renal diet

· Is for patients suffering from renal/kidney diseases

· The diet plan is individualized depending on if the person is on dialysis

· The diet restricts sodium, potassium, fluid, and proteins

· Lab work is to be followed closely to daily alter the diet

Soft diet

· Is used when there are problems with chewing and swallowing.

· Changes the consistency of the regular diet to a softer texture.

· Includes chopped or ground meats as well as chopped or ground raw fruits and vegetables.

· Is for people with poor dental conditions, missing teeth, no teeth, or persons with eating disorders

Pureed diet

· Changes the regular diet by pureeing it to a smooth liquid consistency

· Indicated for those with wired jaws extremely poor dentition in which chewing is inadequate

· Often thinned down so it can pass through a straw.

· Is for people with chewing or swallowing difficulties or with the condition of dysphasia

· Foods should be pureed separately

· Avoid nuts, seeds, raw vegetables, and raw fruits

· Should be nutritionally adequate

Food allergy modified diet

· Food allergies are due to an abnormal immune response to an otherwise harmless food.

· Foods implicated with allergies are strictly eliminated from the diet.

· Appropriate substitutions are made to ensure the meal is adequate.

· The most common food allergens are milk, egg, soy, wheat, peanuts, tree nuts, fish, and shellfish.

Gluten free diet

· This diet is for Persons with celiac disease or gluten intolerence

· Would include the elimination of wheat, rye, and barley.

· Replaced with potato, corn, and rice products.

Food intolerance modified diet

· The most common food intolerance is intolerance to lactose (milk sugar) because of a decreased amount of an enzyme in the body.

· Other common types of food intolerance include adverse reactions to certain products added to food to enhance taste, color, or protect against bacterial growth

· Common symptoms involving food intolerances are vomiting, diarrhea, abdominal pain, and headaches after a particular food

· That item of diet causing symptoms should be avoided

Bland diet

· Consists of easily digestible or partially digested foods that do not irritate the digestive tract

· Used for pts with ulcers and other digestive diseases

· Avoid coarse foods, fried foods, highly seasoned foods, spices, pastries, raw fruits and veggies, alcohol, carbonated beverages, nuts, coffee, tea, smoked and salted meats and fish.

DASH diet

· It is- Dietary Approaches to Stop Hypertension, used to control hypertension (DASH).

· The DASH diet is mainly based on fruits, vegetables, low-fat or fat free dairy, whole grains, fish, poultry, legumes, and nuts.

· It recommends reducing sodium intake, sweets (in drinks and foods) and red meat. It limits saturated and trans saturated fat

· It advocates increasing the intake of potassium, magnesium, protein, fiber and nutrients thought to help control blood pressure

Mediterranean diet

· The principal aspects of this diet include proportionally high consumption of unprocessed cereals, legumes, olive oil, fruits, and vegetables and olives

· Moderate consumption of fish, dairy products (mostly cheese and yogurt), and meat products

· The diet has many health benefits in cardiovascular and other systemic diseases and hypertension

· Has been known to reduce all cause mortality

Low-FODMAP diet

· restriction of consumption of all fermentable carbohydrates

· FODMAP- fermentable oligosaccharides, disaccharides, monosaccharides and Polyols

· recommended only for a short time

· recommended for managing patients with irritable bowel syndrome (IBS)

· can reduce digestive symptoms of IBS including bloating, flatulence. and farting

Low fiber diet

· A low-fiber diet is a low-residue diet eliminating dietary fiber from the diet

· intended to reduce certain constituents of the bowel

It may be prescribed for patients with functional gastrointestinal disorders

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