Therapeutic Diets

Therapeutic Diets

Modification of nutrients in therapeutic Diets

The general principles of nutrition related to health apply also to the treatment of patients suffering from various diseases. Diet in disease must be planned as part of the complete care of the patient many modifications may have to be made according to the disease and the condition of the patient, but there are certain general principles which may be used for guidance.

Principle of Therapeutic Diets

·  Carbohydrates are usually well – tolerated and are necessary to maintain the stores of liver glycogen.

·  The tolerance of fats varies in different individuals and this nutrient should not be forced if there is nausea and vomiting.

·  In illness, there is usually an increased demand for proteins, due to wasting and this should be given in easily digestible forms such as milk, egg, chicken and fish.

·  The requirements of calcium and iron must be maintained during illness and it is necessary to check.

·  Fat – soluble vitamins often need to be added as concentrates if a patient has to be on a fat – restricted diet for a long time. The demand for Vitamin C is greatly increased in fevers, and it is especially necessary for the healing of wound after surgery.

·  Roughage: Excessive bulk hinders the penetration of the digestive juice, but it may be necessary to include foods with a moderately high residue content to produce daily bowel action.

·  Fluids are very important to prevent dehydration which is common in conditions of fevers, diarrhea and vomiting. In such condition 2,500 –3,000 ml must be given in 24 hours with as much variety as possible, both in appearance and in taste.

1. Diabetes Mellitus

Diabetes mellitus is a condition in which the secretion of insulin by the islets of Langerhans in the pancreas is deficient or absent. It is characterized by hyperglycemia, and glycosuria accompanied by polyuria, polydipsia, polyphagia, and if untreated for a long time by loss of weight.

Table 12: Diabetes Mellitus

Table 13: Daily menu for high blood pressure

2. Hypertension

Hypertension develops due to some reason, there is increased resistance to the normal circulation of blood. This may be temporary, as the result of exercise, pregnancy, or menopause; it may be permanent, associated with atherosclerosis, cardiac failure or chronic kidney disease.

Notes

1. Salt should not be added in cooking

2. One multivitamin tablet providing the daily requirements of all essential vitamins should be included along with the diet

3. Strong coffee is not permitted.

Table 14: Daily menu for Hypertension

3. Coronary Heart Diseases

A majority of coronary heart diseases are due to coronary antheroma (A fatty deposit in the inner lining of an artery) and atherosclerosis, are used to denote conditions in which lipid is deposited in the intima of the blood vessels.

Calories – 1800 – 2000 Kcal; Fat (rich in essential fatty acids) – 60 gm; Proteins – 50 – 60 gm

Note: one multivitamin tablet providing the daily requirements of all essential vitamins should be given daily.

Table 15: Daily menu for coronary heart disease

4. Chronic Renal Failure

Chronic Renal Failure occurs in glomerulone phritis,and chronic pyelonephritis. In this condition,the glomeruli and tubules are heavily damaged.

Diet

The diet in chronic uratemia (presence of abnormal of uric acid salts in the blood) should be below in protein depending on the urea content of blood. The pattern of diet and the daily menu for an adult suffering from chronic renal failure are given in Tables 16 and 17.

Table: 16 Diet for an adult suffering from chronic renal failure

(Calories 1500 – 2000 Kcal; Proteins 15 – 20 gm; Fat 40 – 50 gm, Carbohydrates 300 – 40 gm; Salt free)

Table 17: Daily menu for chronic renal failure

Note: Common salt should not be added during or after cooking. One multivitamin tablet providing the daily requirements should be taken

5. Peptic Ulcer

Chronic ulcer formed in the region of the gastrointestinal tract where the gastric juice comes in direct contact with the mucous membrane is known as peptic ulcer. Such ulcers usually occur in the duodenum (duodenal ulcer) and in the stomach (gastric ulcer). Duodenal ulcer is associated with hyperacidity while gastric ulcer is not.

Diet in Peptic Ulcer

The diet is the most important factor in the treatment of peptic ulcer. Three main types of diets have been used in the treatment of peptic ulcer.

Table 18: Types of therapeutic diet for peptic ulcer

Sippy’s diet consisting of milk and olive oil was used widely. Since it is monotonous and not adequate to meet the calorie needs, it has been replaced by a bland diet containing large quantities of milk.

Table 19: Diet for adult suffering from peptic ulcer (gm/caput/day)

Note: One vitamin C tablet (100mg) may be taken once daily.

Table 20

Table 21: Foods permitted and not permitted in peptic ulcer