New Book
by
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Book of Human Diet and Digestion
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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