Therapeutic Nutrition and Diet Planning

Therapeutic Nutrition and Diet Planning

Introduction

·       Therapeutic nutrition refers to the adaptation of normal diet to meet the nutritional requirements of patients suffering from specific diseases.

·       It plays a crucial role in disease management by modifying the intake of nutrients, consistency of food, or timing of meals according to the condition of the patient.

·       The primary objectives of therapeutic diet planning are:

·        To maintain or restore optimum nutritional status.

·        To correct deficiencies or imbalances.

·        To relieve symptoms and aid recovery.

·        To prevent disease progression or complications.

Diet therapy is based on three principles

1. Modification of nutrients – increasing, decreasing, or eliminating specific nutrients.
2. Modification of consistency – soft, liquid, or bland diets.
3. Modification of feeding patterns – frequency, portion size, and meal timing.

Therapeutic Diets for Patients with Diseases

a) Peptic Ulcer

• Condition: Sores develop in the lining of the stomach or duodenum due to excess acid, H. pylori infection, or stress.
• Objectives: Neutralize gastric acid, reduce irritation, and promote healing.
• Dietary Guidelines:
• Small, frequent meals.
• Avoid spicy, fried, highly seasoned foods, coffee, alcohol, and smoking.
• Include easily digestible foods: milk, curd, rice, bananas, boiled vegetables.
• Moderate protein (milk proteins are soothing).
• Adequate vitamins (especially Vitamin A & C for healing).
• Restricted: Alcohol, strong tea/coffee, fried food, chili, pickles, carbonated beverages.

b) Coronary Heart Disease (CHD)

• Condition: Narrowing/blockage of coronary arteries due to atherosclerosis.
• Objectives: Reduce blood cholesterol, prevent obesity, and maintain heart health.
• Dietary Guidelines:
• Low saturated fats (ghee, butter, red meat).
• Use unsaturated fats (olive oil, sunflower oil, groundnut oil).
• High fiber diet: fruits, vegetables, whole grains.
• Avoid trans fats, fried foods, excess salt, and refined carbs.
• Adequate intake of omega-3 fatty acids (fish, flaxseed).
• Restrict cholesterol < 200 mg/day.
• Encourage antioxidants (Vitamin C, E, beta-carotene).

c) High Blood Pressure (Hypertension)

• Condition: Persistent elevated blood pressure (>140/90 mmHg).
• Objectives: Control blood pressure, prevent complications (stroke, heart failure).
• Dietary Guidelines:
• Low sodium diet (DASH diet recommended).
• Avoid processed foods, pickles, papads, and canned foods.
• Increase potassium, magnesium, calcium (bananas, spinach, dairy, pulses).
• Maintain healthy weight, avoid excess fat and alcohol.
• Moderate protein intake.
• Encourage lifestyle modifications – more fruits, vegetables, whole grains.

d) Gout

• Condition: Uric acid crystal deposition in joints leading to inflammation.
• Objectives: Reduce uric acid levels and prevent recurrence.
• Dietary Guidelines:
• Low purine diet (avoid red meat, organ meats, fish like sardines, anchovies).
• Restrict alcohol (especially beer).
• Encourage plenty of fluids to flush out uric acid.
• Complex carbohydrates and moderate protein intake.
• Avoid legumes like lentils and peas in excess.
• Maintain ideal body weight.

e) Renal Failure

• Condition: Impaired kidney function leading to inability to excrete waste.
• Objectives: Reduce nitrogenous waste, control electrolytes, and prevent acidosis.
• Dietary Guidelines:
• Low protein diet (except in dialysis where protein is increased).
• Restrict sodium, potassium, and phosphorus depending on lab values.
• Fluid intake according to urine output.
• Energy from carbs and fats.
• Avoid high potassium foods (banana, orange, potato) in advanced cases.
• Supplement vitamins (especially water-soluble).

f) Diabetes Mellitus

• Condition: Impaired carbohydrate metabolism due to insulin deficiency/resistance.
• Objectives: Maintain normal blood glucose, prevent complications.
• Dietary Guidelines:
• Balanced diet with controlled carbohydrate intake.
• Prefer complex carbs (whole grains, legumes, vegetables) over refined sugars.
• Distribute carbs evenly throughout the day.
• Moderate protein and low-fat intake.
• Avoid concentrated sweets, sugary drinks, fried foods.
• Encourage high fiber foods.
• Weight control and regular physical activity are essential.

g) Low-Fat Diet

• Indication: Used in gallbladder disease, pancreatitis, obesity, heart disease.
• Dietary Guidelines:
• Total fat intake < 20–30% of total calories.
• Restrict fried foods, cream, butter, cheese, fatty meats.
• Use lean meats, skim milk, low-fat dairy.
• Include complex carbohydrates and high fiber foods.
• Prefer baking, steaming, or grilling instead of frying.

h) Diet for Adolescents

• Condition: Adolescence is a period of rapid growth requiring increased nutrition.
• Dietary Guidelines:
• High protein for growth (milk, eggs, pulses, meat).
• Adequate calories from complex carbs.
• Calcium and iron-rich foods (milk, green leafy vegetables, ragi).
• Adequate vitamins, especially Vitamin D and B-complex.
• Avoid junk food, carbonated beverages, and excess sweets.
• Encourage healthy snacking (nuts, fruits, sprouts).

i) Diet for Pregnancy and Lactating Mothers

• Condition: Increased nutritional demand for fetal growth and milk production.
• Objectives: Support maternal health and optimal growth of fetus/infant.
• Dietary Guidelines:
• Increased calories: +300 kcal/day in pregnancy, +500 kcal/day in lactation.
• High protein intake (milk, pulses, fish, meat, eggs).
• Calcium and Vitamin D for bone development.
• Iron and folic acid to prevent anemia and neural tube defects.
• Adequate fluids to support milk secretion.
• Avoid alcohol, smoking, excess caffeine.
• Frequent small meals to reduce nausea in pregnancy.

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