Diet therapy

Diet therapy is a method of using food and dietary changes to

improve health, treat medical conditions, or prevent diseases.
Diet therapy refers to the use of diet not only in sickness but also in
prevention of disease and maintenance of health.
Diet therapy generally supplements the medical or surgical
treatment, or in some cases may be the most important aspect in a
patient’s treatment or management such as in case of
Cardiovascular disease.
THERAPEUTIC DIET
Therapeutic diet is qualitative or quantitative modified version of
basic nutritious diet which has been tailored to suit the changing
nutritional needs of a patient or diseased condition.
The factors that are required to be considered for altering the diet
are:
(i)The patients tolerance for food by mouth.
(ii)Economic status
(iii)Food preferences
(iv)Underlying disease condition which requires a change in the diet.

ROUTINE HOSPITAL DIET

Normal or general diet in the hospital setting is a balanced diet
which meets the nutritional needs of an patient and derived by RDA.
(i)Fluid / liquidDiet
(ii)Soft diet
(iii)Normal diet
Liquid diet
A liquid diet is a diet that mostly consists of liquids, or soft food.A
liquid diet usually helps provide sufficient hydration, helps maintain
electrolyte balance, and is often prescribed for people when solid
food diets are not recommended.
(i)Clear fluid
This diet is made up of clear liquids that have no residue, and it is
non gas forming, non-Irritating and non-stimulating to peristaltic
action. A clear liquid diet helps to give enough Fluid to stay
hydrated. Foods allowed are barley water, dal water, clear strained
fruit juice, Whey water, tea and coffee without milk, non-carbonated
beverages, coconut water.
The diet can meet the requirements of fluids and some minerals. It
should not be continued for more than 24 to 48 hours
The amount of fluid is usually restricted to 30 to 60 ml per hour at
first, with gradually increasing amounts being given as the patient’s
tolerance improves.
(ii)Full Fluid Diet
The full fluid consists of food which are liquid, this diet bridges the
gap between the clear fluid and soft diet. Foods allowed are clear
liquids, Strained soups and fruit juices. A person may be able to eat
pureed versions of their favourite foods in addition to a wide variety
of thicker liquids.The main aim of full fluid diet is to add nutritional
requirements for the patients who could not consume solid foods. It
is recommended for following conditions, postoperative conditions,
acute gastritis, acute gastritis, diarrhoea, Swallowing and chewing
problem.
High calorie liquid supplements are given between meals as
needed.
This diet is given at 2 – 4 hour intervals.A well planned full fluid diet
is adequate in calories, protein and fat but may be inadequate in
vitamins, minerals and fibres.
Soft diet
The soft diet is made up of simple, easily digested food and contains
no harsh fibre and low in fat. This diet is one of the most frequently
used routine diets, many hospital patients are placed on this until a
diagnosis is made.
Foods allowed are:
finely ground whole grain
Pureed, cooked and mashed banana
Milk and milk products, Butter, oil, cream and margarine, Custards,
kheer and puddings.
It is used in the following conditions like acute infection ,surgery,
patients who are unable to chew.
Normal diet / Regular diet
It is most frequently used in all hospitals. Many special diets
progress ultimately to a regular diet. A regular diet is a healthy meal
plan that includes a variety of healthy foods from all the food
groups. A healthy meal plan is low in unhealthy fats, salt and added
sugar. The amount and calories and serving size depends on age,
gender, weight and height. This diet is well balanced , adequate in
nutritional value and attractively served to stimulate a possible poor
appetite.
Food allowed
All the food is eaten by the person in good health except spices
containing food, pickles and oily food.
Other therapeutic diet
(i)High fibre diet
(ii)High calorie diet
(iii)High protein diet
(IV)Sodium restricted diet
(V)Low fat diet
(Vi) Renal diet
High fibre
A high-fiber diet includes foods that are high in fiber, such as
fruits, vegetables, whole grains, beans, nuts, and seeds.For a
high-fiber diet, prioritize foods like lentils, beans, whole grains
(oats, brown rice), fruits (berries, apples), vegetables (broccoli,
spinach), nuts, and seeds.
Very low residue diet.
High calories diet
A high-calorie diet is characterized by consuming more
calories than are expended through daily activities and
metabolism, leading to a positive energy balance.
High-calorie foods include those rich in saturated fats, added
sugars, and refined carbohydrates, as well as large portions of
any food.
High protein diet

Sodium restricted diet

A sodium-restricted diet, also known as a low-sodium diet,
limits the amount of sodium (salt) consumed to manage health
conditions like high blood pressure or kidney disease, often
aiming for less than 2gm of sodium per day.
Low fat diet
A low-fat diet is one that restricts fat, and often saturated fat
and cholesterol as well. Low-fat diets are intended to reduce
the occurrence of conditions such as heart disease and
obesity.
Renal diet
A renal diet, also known as a kidney diet, is a specialized eating
plan designed for individuals with kidney disease or limited
kidney function, aiming to manage fluid, electrolyte, and
mineral balance by restricting sodium, phosphorus,
potassium, and sometimes protein intake.

Special feeding method

 Depending upon the patients’ condition, the clinical dietitian
will also have to decide the method of feeding. As far as
possible, the oral route i.e. consuming food through the month
should remain the most preferred route.
Feeding Method
(i)Enteral Feeding
(ii)Parenteral Feeding
Enteral Feeding
Enteral nutrition refers to provision of nutrition support through
the gastro-intestinal tract. Enteral nutrition is also commonly
called tube feeding and is used to provide adequate nutrition
to patients who are not receiving adequate nutrition orally, with
the objective to prevent, improve or reverse malnutrition.
Nasogastric feeding
A soft, flexible polyurethane or silicone tube is passed through the
nose into the stomach. The correct positioning of the tube is verified
by aspirating the gastric contents. Feeding can be administered by
bolus injection or intermittent of continuous infusions.
Nasoduodenal or nasojejunal feeding:
For patients with oesophageal reflux, gastric motility disorders and
persistent nausea and vomiting, nasoenteric tubes placed into the
small bowel are suggested. This feeding, method is also suitable for
short-term enteral nutrition support for 3 to 4 weeks. The tube is
passed through the nose and oesophagus and inserted into the
stomach.
Percutaneous endoscopic gastrostomy (PEG) or jejunostomy (PEJ):
PEG is a non-surgical technique for placing a tube directly into the
stomach through the abdominal wall. Tubes are endoscopically
guided into the stomach or jejunum and then brought out through
the abdominal wall to provide the access for external feeding.
Surgical gastrostomies and jejunostomies
Patients undergoing surgical Procedures or those patients in whom
endoscopic and radiological techniques cannot be carried out,
benefit from surgical gastrostomies and jejunostomies.
Parenteral feeding
(i)Total parenteral nutrition
(ii)Partial parenteral nutrition
Total parenteral nutrition
When all the nutrients required by the patient such as proteins,
sugars, fat, vitamins, minerals and fluid are supplied by the
intravenous route, the mode of feeding is known as Total Parenteral
Nutrition (TPN).
Partial parenteral nutrition
When only a few nutrients are supplied such as dextrose or saline
solution, it is known as Partial Parenteral Nutrition (PPN).
Objectives