1. DIET THERAPY Flashcards
An allowance of food and drink consumed regularly
by an individual.
DIET
T or F. Skipping meals is not a diet.
TRUE
The branch of dietetics that is concerned with the
study of the use of food for therapeutic purposes.
DIET THERAPY/DIETOTHERAPY
The study of the modification of the normal diet to
meet the physiological requirements of the sick
individua
DIET THERAPY/DIETOTHERAPY
The study of the use of food as a factor in aiding
recovery from illness.
DIET THERAPY/DIETOTHERAPY
A diet modified or adapted from the normal diet to
suit specific disease conditions.
THERAPEUTIC DIET
Modifying a regular diet to become therapeutic diet.
THERAPEUTIC DIET
Designed to treat or cure disease.
THERAPEUTIC DIET
Refer to the regular, soft, liquid diets commonly
used in the hospital, differ from one another in
consistency and composition to suit individual
needs and dietary requirements.
ROUTINE HOSPITAL DIETS
Refers to the physical characteristics of the food
CONSISTENCY
Soft, solid, high fiber, low fiber.
CONSISTENCY
Nutrient content of the food.
COMPOSITION
Low protein, high protein.
COMPOSITION
If you are undernourished, restore it using the diet as one of the factor for the recovery for illness.
A. TO MAINTAIN OR RESTORE GOOD NUTRITIONAL STATUS
B. TO CORRECT NUTRITIONAL DEFICIENCIES WHICH MAY HAVE OCCURRED
C. TO AFFORD REST TOO A PARTICULAR ORGAN OR TO THE WHOLE BODY WHICH MAY BE AFFECTED
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
E. TO BRING ABOUT THE CHANGES IN THE BODY WEIGHT, WHENEVER NECESSARY
A. TO MAINTAIN OR RESTORE GOOD NUTRITIONAL
STATUS
Specific deficiency like anemia, especially if it is iron deficiency anemia (IDA), then the diet should be modified into high iron or supplementation of iron.
A. TO MAINTAIN OR RESTORE GOOD NUTRITIONAL STATUS
B. TO CORRECT NUTRITIONAL DEFICIENCIES WHICH MAY HAVE OCCURRED
C. TO AFFORD REST TOO A PARTICULAR ORGAN OR TO THE WHOLE BODY WHICH MAY BE AFFECTED
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
E. TO BRING ABOUT THE CHANGES IN THE BODY WEIGHT, WHENEVER NECESSARY
B. TO CORRECT NUTRITIONAL DEFICIENCIES WHICH MAY HAVE OCCURRED
Combination of consistency and composition.
A. TO MAINTAIN OR RESTORE GOOD NUTRITIONAL STATUS
B. TO CORRECT NUTRITIONAL DEFICIENCIES WHICH MAY HAVE OCCURRED
C. TO AFFORD REST TOO A PARTICULAR ORGAN OR TO THE WHOLE BODY WHICH MAY BE AFFECTED
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
E. TO BRING ABOUT THE CHANGES IN THE BODY WEIGHT, WHENEVER NECESSARY
C. TO AFFORD REST TOO A PARTICULAR ORGAN OR TO THE WHOLE BODY WHICH MAY BE AFFECTED
Inflammation of the pancreas
CHRONIC PANCREATITIS
Abnormal amount of fats in stool
KETORHEA
Indication that fats are not properly digested and metabolized
KETORHEA
Maldigestion of fats because of the absence of ___________.
lipase enzyme
What diet will you give to the patient who has chronic pancreatitis?
Low fat diet
Especially if there is maldigestion and malabsorption disease
A. TO MAINTAIN OR RESTORE GOOD NUTRITIONAL STATUS
B. TO CORRECT NUTRITIONAL DEFICIENCIES WHICH MAY HAVE OCCURRED
C. TO AFFORD REST TOO A PARTICULAR ORGAN OR TO THE WHOLE BODY WHICH MAY BE AFFECTED
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
E. TO BRING ABOUT THE CHANGES IN THE BODY WEIGHT, WHENEVER NECESSARY
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
We have to know the etiology of the disease so we
could address the particular metabolic disorder especially celiac disease and PKU
A. TO MAINTAIN OR RESTORE GOOD NUTRITIONAL STATUS
B. TO CORRECT NUTRITIONAL DEFICIENCIES WHICH MAY HAVE OCCURRED
C. TO AFFORD REST TOO A PARTICULAR ORGAN OR TO THE WHOLE BODY WHICH MAY BE AFFECTED
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
E. TO BRING ABOUT THE CHANGES IN THE BODY WEIGHT, WHENEVER NECESSARY
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
The usual diet prescribed for this is low calorie diet
(obese), high calorie diet (severely malnourished).
A. TO MAINTAIN OR RESTORE GOOD NUTRITIONAL STATUS
B. TO CORRECT NUTRITIONAL DEFICIENCIES WHICH MAY HAVE OCCURRED
C. TO AFFORD REST TOO A PARTICULAR ORGAN OR TO THE WHOLE BODY WHICH MAY BE AFFECTED
D. TO ADJUST THE DIET TO THE ABILITY OF THE
BODY TO METABOLIZE THE NUTRIENTS
E. TO BRING ABOUT THE CHANGES IN THE BODY WEIGHT, WHENEVER NECESSARY
E. TO BRING ABOUT THE CHANGES IN THE BODY WEIGHT, WHENEVER NECESSARY
Guide on how to modify the diet
BASES OF MODIFICATION
What are the normal requirements?
RENI/Dietary Prescription
❖ Guide to Good Nutrition/Food Guide
-10 kumainments
- Food pyramid
- Three basic food groups
and proper nutrition
❖ Food Pyramid/Pinggang Pinoy
Medical history
PREVIOUS NUTRITIONAL STATUS OF THE INDIVIDUAL
Etiology, causes, and characteristics of the disease
PATHO-PHYSIOLOGY OF THE DISEASE
T OR F.
Sometimes, the cause and characteristics might
also be the cure in the therapeutic diet to be
prescribe
TRUE
- Inflammation of the glomeruli
- The kidney isn’t functioning well especially in the filtering of ammonia from protein
- Should not be given high protein diet
- Give low protein diet or zero protein for emergency purposes
CHRONIC KIDNEY DISEASE
Up to how many days the patient should be given
ex: low fat diet or low protein diet
ANTICIPATED DURATION OF THE DISEASE AND INJURY
What are the BASES OF MODIFICATION?
- NORMAL REQUIREMENT
- PREVIOUS NUTRITIONAL STATUS OF THE INDIVIDUAL
- PATHO-PHYSIOLOGY OF THE DISEASE
- ANTICIPATED DURATION OF THE DISEASE AND
INJURY - DIETARY FACTORS TO BE ALTERED
- AMOUNT AND CHARACTER OF THE NUTRIENTS WHICH IS BEING LOST FROM THE BODY
- PATIENTS TOLERANCE FOR FOOD
- SOCIO-ECONOMIC AND OTHER CONSIDERATIONS SUCH AS RELIGION BELIEFS,
CUSTOMS, ETC.
What are the PRINCIPLES OF DIETARY MANAGEMENT?
LIBERALIZATION
INDIVIDUALIZATION
SIMPLIFICATION
❖ As tolerated
❖ As much as possible, we will practice as tolerated
to the patient to hasten the recovery from the illness
❖ As long as still within prescribed diet and
restrictions
❖ Hindi masyadong restrictive and selective ang diet if
within the recovery period
LIBERALIZATION
❖Individualized preparation of the diet for a specific
patient with a specific nutrient needed
❖ There some diseases that requires individualized
diet
❖ Lots of restriction and selection of foods
❖ Ex: Chronic kidney disease, PKU, metabolic
disorders
INDIVIDUALIZATION
❖ Time wise and effort wise
❖ Easy to prepare
❖ Don’t have to look the ingredients everywhere
❖ Affordability and availability
SIMPLIFICATION
An allowance of food and drink consist of
food that are liquid and leave no residue
CLEAR LIQUID DIET
Inadequate of nutrient contents and calorie (Usually inadequate)
Should not be used for more than 2 days
CLEAR LIQUID DIET
➔ Fat free broths
➔ Strained juice
➔ Black coffee
➔ Salabat
➔ Plain gelatin
➔ Plain sugar or hard candies
CLEAR LIQUID DIET
These are examples of food selection
for clear liquid diet but it doesn’t mean
that these foods are applicable and
can be given to all kinds of disease
prescribed with clear liquid diet
➢ Ex: Diabetes (no plain sugar or hard candies)
➢ Ex: Bypass operation on the heart (no black coffee)
INDICATIONS: Pre and post operative conditions.
CLEAR LIQUID DIET
- Intermediary between clear liquid and soft diet
➔ Consist of liquid or strained semi-fluid
foods or foods that liquefy at room
temperature
➔ Free from cellulose and irritating spices
and condiments
➔ Can be planned to be nutritionally
adequate
FULL LIQUID DIET
*After two days, the patient cannot
immediately have soft diet, instead,
give full but still liquid in consistency
➔ Pureed strained meat and fish
➔ Oatmeal
➔ Strained lugao
FULL LIQUID DIET
➔ Post operative condition
➔ Acute infection
➢ Most affected organ is the tonsils
➔ Face lifting
FULL LIQUID DIET
➔ Cold fluids given to prevent bleeding of the
operated area
➔ Cooked soft foods and bland which have
been allowed to cool may also be given
COLD AND LIQUID DIET
(T (Tonsillectomy) AND
A (Adenectomy) Diet)
➔ Plain ice cream
➔ Cold milk
➔ Iced tea
➔ Coffee
➔ Soft drinks
COLD AND LIQUID DIET
(T (Tonsillectomy) AND
A (Adenectomy) Diet)
● INDICATIONS
➔ Tonsillectomy
➔ Adenectomy
➔ Dental extraction
➔ Other minor throat
COLD AND LIQUID DIET
(T (Tonsillectomy) AND
A (Adenectomy) Diet)
➔ Made up of food which form the least
amount of fecal matter
➔ Inadequate in vitamins and minerals
➔ This diet is given several days before the
operation and only liquids 24 hours before
surgery to decrease intestinal residue
➢ Especially if the operations is within
the intestine
➔ After surgery, the diet progresses as
follows a clear to full liquids, soft low
residue, and regular as tolerated
➔ Avoid foods that are gaseous or that may
cause stomach obstruction.
➔ Encourage fluid intake of at least 2L/day. If
the patient is dehydrated or has low urine
output, encourage an additional 1-2L/day.
MINIMUM/LOW RESIDUE DIET
*Vegetables and fruits are a high
residue diet and are usually high in vitamins and minerals. In a low residue diet, fruits and vegetables or high fiber foods are avoided.
➔ Plain, strained lean tender
➔ Well cooked fruits
➔ Vegetables
➔ Beef
➔ Chicken (no skin)
➔ AVOID milk & milk products
MINIMUM/LOW RESIDUE DIET
INDICATIONS
➔ Diarrhea
➔ Pre and post operation
➔ Colostomy
➢ Operation in the colon and large
intestine
➔ Ileostomy
➢ Operation in the ileum or the last part
of the small intestine
MINIMUM/LOW RESIDUE DIET
Chemically (free of spices, condiments,
and other high flavored foods),
mechanically (free from coarse textures
and the size should be reduced to small
pieces; ex: instead of whole fish, give
flake. instead of giving small back sizes of
meat, give ground beef or pork) and
thermally non-irritating (should not be so
hot and so cold)
BLAND DIET
FOOD SELECTION
➔ Mild in flavor
➔ No coarse fibers and tough connective
tissues
➔ Non stimulating and any food tolerated by
the patient
➔ AVOID black pepper, chili powder, strong
coffee, and alcohol
BLAND DIET
INDICATIONS
➔ Gastritis
➔ Ulcers
BLAND DIET
➔ Extracted from bland diet because one of
the description of the bland diet is
mechanically non-irritating
➔ Food given requires little chewing
➔ Spices and flavorings are allowed. The
only limitation is the portion and texture of
the food.
MECHANICAL SOFT DIET
● FOOD SELECTION
➔ Full diet but reduced into small portions by
grinding, chopping, and mincing, etc.
MECHANICAL SOFT DIET
● INDICATIONS
➔ Poor dentures
➔ Lack of teeth
MECHANICAL SOFT DIET
● DESCRIPTION
➔ Contains minimum indigestible CHO and
tough connective tissues
LOW FIBER DIET
● FOOD SELECTION
➔ AVOID tough and connective tissues in
meat, seeds, skin of fruits and vegetables,
whole grain cereals and coarse bread
➔ Whole foods especially whole grains are
avoided
LOW FIBER DIET
● INDICATIONS
➔ Spastic constipation
➢ Fiber can increase bulk in the stools
➢ Spastic constipation produce large stools and dry stools that are not easy to excrete
➔ Diverticulitis
➔ GI disturbances
LOW FIBER DIET
● DESCRIPTION
➔ Normal diet with fiber increased
➔ Prescribed with high consumption of water
HIGH FIBER DIET
● FOOD SELECTION
➔ Include food avoided in low fiber diet
HIGH FIBER DIET
● INDICATIONS
➔ Atonic constipation
➢ Lazy bowel
➢ Lazy bowel has no muscle tone so it
needs to be pushed
HIGH FIBER DIET
● DESCRIPTION
➔ Plan to provide for an increase in calorie
intake above physiologic needs to allow an
increase in body weight
HIGH CALORIE DIET
● FOOD SELECTION
➔ Food in normal diet
➔ AVOID excessive amount of fried food
which may interfere with appetite
HIGH CALORIE DIET
● INDICATIONS
➔ Underweight
HIGH CALORIE DIET
● DESCRIPTION
➔ Plan to provide an intake below calorie needs and designed to allow for loss in
weight
LOW CALORIE DIET
● FOOD SELECTION
➔ AVOID high fat food
➔ AVOID CHO
LOW CALORIE DIET
● INDICATIONS
➔ Overweight
➔ Obesity
LOW CALORIE DIET
● DESCRIPTION
➔ CHO is increased by 50% above normal
TER
➢ Normal TER is 1000 and we have to
give 500 which is 50% of 1000
HIGH CARBOHYDRATES
● FOOD SELECTION
➔ Rice
➔ Cereals
➔ Root Crops
➔ Dried beans
➔ Legumes
HIGH CARBOHYDRATES
● INDICATIONS
➔ Renal liver disturbances
➢ Low diet from protein and fats, so the
main source for the body is only
carbohydrates
➔ Preparation for surgery
➢ Diet should be increased in
carbohydrates to have many glycogen
stores so that during muscle wasting,
body weight wouldn’t be affected
HIGH CARBOHYDRATES
● DESCRIPTION
➔ CHO is reduced by 50% but CHON and
FATS are increased
➔ Decreased in carbohydrates but not as
extensive compared to ketogenic diet
LOW CARBOHYDRATES
● FOOD SELECTION
➔ Foods high in CHON
LOW CARBOHYDRATES
● INDICATIONS
➔ Obesity
➔ Celiac disease
➔ Epilepsy
LOW CARBOHYDRATES
● DESCRIPTION
➔ CHON increased by 50 - 100% above
normal TER
➔ One of the function of protein is to mend
worn out tissue together with Vitamin C
HIGH PROTEIN
● FOOD SELECTION
➔ Milk
➔ Eggs
➔ Cheese
➔ Meat
➔ Poultry
➔ Fish
HIGH PROTEIN
● INDICATIONS
➔ Pregnant
➔ Lactating
➔ PEM
➔ Surgery
➔ Burns
➔ Fever
➔ Disease of the liver
➢ Especially not the progressive type
➢ 1st stage
HIGH PROTEIN
● DESCRIPTION
➔ Restricted to 50% below of the normal
CHON requirement
LOW PROTEIN
● FOOD SELECTION
➔ Give legumes, nuts, cereals, and
vegetables in limited amounts
➔ AVOID K and Na
LOW PROTEIN
● INDICATIONS
➔ Hepatic Coma
➔ Acute glomerulonephritis
➢ The protein cannot pass through the
liver for detoxification, and the kidneys
cannot filter well because the
glomerular filtration rate is gradually
malfunctioning because of the
inflammation of glomeruli
➢ To afford rest to the liver by not giving
a lot of protein
LOW PROTEIN
● DESCRIPTION
➔ Used only as an emergency measures,
give high in CHO and FATS to avoid tissue
breakdown
CHON FREE/ZERO CHON
● FOOD SELECTION
➔ Fruit juices if K is not restricted
CHON FREE/ZERO CHON
● INDICATIONS
➔ Hepatic Coma
➔ Acute Anuria
CHON FREE/ZERO CHON
● DESCRIPTION
➔ Severely restricted fats allowed 10-15% of TER
➔ All foods rich in fats not allowed or restricted
➔ Foods cooked by method not requiring addition of fats
LOW FAT DIET
● FOOD SELECTION
➔ Skim milk
➔ Lean Meat
➔ Cereals
➔ Fruits and vegetables
➔ Sugar
➔ AVOID fatty meats, rich desserts, and fried
foods.
LOW FAT DIET
● INDICATIONS
➔ Steatorrhea
➢ Fats in the feces
➢ More than 7%-10% of fats
➔ Acute attack of pancreatitis
➔ Cholecystitis
LOW FAT DIET
● DESCRIPTION
➔ Dietary cholesterol reduced to less than
300 mg per day
LOW CHOLESTEROL
● FOOD SELECTION
➔ Egg yolk limited to 2-3 per week
➔ Egg white as desired
➔ Lean meat only or fish
➔ Skim milk
➔ Fruits
➔ Vegetables
LOW CHOLESTEROL
● INDICATIONS
➔ Atherosclerosis
➢ Deposition of fats in the wall of the
arteries
➔ Hypercholesterolemia
➢ Large amount of cholesterol in the
blood
➔ Coronary artery disease
LOW CHOLESTEROL
➢ Deposition of fats in the wall of the arteries
Atherosclerosis
➢ Large amount of cholesterol in the blood
Hypercholesterolemia
● DESCRIPTION
➔ Sodium content is limited to specific level
which may range from mild to severe restriction
➢ Mild is 2000 mg per day
➢ Severe restriction is 1500 mg per day to 1000 mg per day
➔ Provides an adequate diet with a prescribed level of sodium according to individual needs
Na RESTRICTED DIET
➔ AVOID canned, cured process food which uses salt and sodium containing flavoring agents and preservatives
➔ Salt, patis, and toyo are omitted from the table or on the patient’s tray
➔ Give foods that contains natural sodium
Na RESTRICTED DIET
● INDICATIONS
➔ Hypertension
➔ Congestive heart failure (CHF)
➔ Pregnancy induced hypertension (PIH)
Na RESTRICTED DIET
● DESCRIPTION
➔ K content of the diet is reduced to about
1.0-1.6 mg/day
➢ Half of the normal requirement
K RESTRICTED DIET
● FOOD SELECTION
➔ Give cereals, breads, sugar fats, protein
foods, fruits and vegetables within the
prescribed amounts
➔ Restrict amount of milk, cream, eggs,
meat, fish, and poultry
➢ Contain higher amount of potassium
K RESTRICTED DIET
● INDICATIONS
➔ Renal failure
➢ Potassium will be accumulated in the
blood that may result to hyperkalemia
that affects the heartbeat and leads to
heart attack
➔ Hyperkalemia
➔ Addison’s disease
➔ Anuria
➔ Oliguria
K RESTRICTED DIET
● DESCRIPTION
➔ Reduced to approximately 150 to 350
mg/day in adults and in children
respectively
➔ Normal is 1000 to 2000 mg/day
Ca RESTRICTED DIET
● FOOD SELECTION
➔ Restrict amount of milk, cheese, eggs,
nuts, meat, fish, and other high calcium
foods
Ca RESTRICTED DIET
● INDICATIONS
➔ Calcium stones
➔ Hypercalcemia
➔ Pancreatitis
Ca RESTRICTED DIET
❖ DESCRIPTION
● A house diet, general diet, or regular diet
● Designed for patient who require no special
dietary modifications or restrictions
FULL DIET
❖ FOOD SELECTION
● Give liberal diet
FULL DIET
❖ INDICATIONS
● Patient who do not need dietary modification
FULL DIET
