Diabetes or Juvenile Diabetes

ACIDITY OR HEART BURN [ACIDITY]
ACIDITY, HEART BURN, WATER BRASH, PEPTIC ULCER
ACIDITY:
Acidity is a common name referred to regurgitation of acid or partly digested food from stomach into food
pipe or mouth.
WATER BRASH / HEARTBURN:

Heartburn / water brash is burning sensation behind the breast bone or sternum. It is due to regurgitation of
sour fluid from the esophagus into the oral cavity. It is normal when it occurs occasionally but frequent and
severe heartburn is a manifestation of some esophageal dysfunction.
PEPTIC ULCER:
Small or big erosion in the mucosa (lining) of the stomach.
CAUSES:
• Stress and tensions.
• Emotional factors like fear, anger, tension etc.
• Overeating, large meals.
• Obesity.
• Alcohol, Cigarette smoking.
• Irregular eating habits.
• Certain drugs like, aspirin, antibiotics, pain killers etc.
• Bending, lying down or physical exertion soon after eating.
• After eating certain food like- onion, coffee, tea, tomatoes, citrus fruits, spicy, pepper, chilies, deep fried
food, aerated drinks.
IN CASE OF HEARTBURN OTHER CAUSES INCLUDE:

• Hyperacidity.
• Duodenal ulcer.
• Reflux of gastric contents into esophagus.
• Inflammation of esophagus, abnormal functioning of esophagus, distention of esophagus.
• Hiatus hernia.
PEPTIC ULCER:
• Genetic factors
• Increased secretion of acid in stomach.
• Blood group O.
• Smoking, alcohol.
• Drug induced- long term consumption of aspirin, antibiotics.
• Type "A" personality – aggressive, anxious, and ambitious.
• Prolonged stress and anxiety.
SIGN AND SYMPTOMS:

ACIDITY:
• Sour eructation, belching.
• Burning in chest after eating.
• Vomiting of sour / undigested particles.
• A feeling that food is getting stuck after swallowing.
HEARTBURN / WATER BRASH:

• Burning sensation in middle of the chest or upper abdomen.
• Aggravated after large meals, stooping or bending after eating.
• Spontaneous appearance of fluid in mouth, which may be salty, sour or bitter.
• Discomfort in stomach, aggravated by hot or cold foods, citrus juices and alcohol.
PEPTIC ULCER:
• Pains are related to meals. –
- Gastric ulcer- pain is worst after eating.
- Duodenal ulcer- pain temporarily better by eating so has to get up at night to eat again.
• In absence of pain – recurrent bouts of heartburn, anorexia, nausea and vomiting.
DIETARY MANAGEMENT:
• Treat the causes- take measures to relieve tensions and stress from life.
• Relax for about 20 minutes before and after eating.
• Eat bland food; less hot food add little or no oil to your food- bland boiled vegetables.
• Eat fresh fruits and salads, ash gourd juice.
• You can have tukmaria, commonly known as falooda seeds (Impatiens balsamina), they have cooling effect
and helps in digestion in hot weathers.
• Avoid citrus fruits, coffee, tea, raw vegetables, meat extracts, condiments spices and apple.
• Avoid canned and processed food- they contain chemical irritants.
• Avoid fried food and fats - you can include sesame oil, mustard oil, oily fish, linseed oil, skimmed milk and
low fat milk products in your diet in small quantities.
• Avoid tobacco and alcohol.
• Eat meals at regular intervals, at regular time.
• Do not overeat; eat small meals at short intervals, little food at every 2 hrs.
• In snacks you can have biscuits (not the cream ones), toast with / without butter, sandwiches, light cake,
curds, butter milk, ice creams, custards and puddings.
• Avoid drinking immediately before meals and drink sparingly during the meals.
• Do not exercise, bend, stoop / sleep immediately after meals.
• Avoid drugs like painkillers, antibiotics, aspirin, NSAID, steroids.
• Drink cold milk before retiring to bed.
ACNE [ACNE]
Acne is an inflammatory disease of the sebaceous glands (oil secreting glands in our skin) and the hair
follicles.
CAUSES:
• Poor eating habits.
• Poor hygiene.
• Hormonal imbalance – during puberty.
• Stress.
• Drugs like corticosteroids.
• Heredity.
• Bacterial infection.
SIGN AND SYMPTOMS:

• Pain in acne.
• Itching.
• Pus or oily discharge.
• White heads / black head formation.
• Scarring.
DIETARY MANAGEMENT:
AVOID:
• Avoid fats and oily food.
• Avoid chocolate, ice-cream, butter, cakes, white bread, sweets and fried food.
• Limit intake of non-vegetarian food.
• Do not break your pimples, it will lead to secondary infections.
• Do not use scented soaps and chemicals on your face.
DO:
• Wash your face frequently, at least 5 times a day, taking care that it does not become too dry.
• Use non-greasy make-up or if possible do not apply cosmetics.
• Use natural cleansers than chemical preparations:
– Wash face with gram flour (channa) and little turmeric in it.
– Massage skin with fresh cucumber, it gives cooling effect on skin.
– You can massage your face with fresh fruits also.
• You can take facial steam to reduce inflammation and infection for not more then 15 minutes and once
fortnight.
• Practice yoga – It will help make your circulation better.
CONSUME:
• Drink plenty of water.
• Drink plenty of fruit juice, coconut water.
• Eat lots of fresh fruits and raw vegetables.
• Increase intake of fiber in your diet - Whole grains, bran, oat, green leafy vegetables, raw vegetables,
salads, dried fruits and fresh fruits.
• Eat whole grains rather then refined flour.
• Possibly eat boiled or lightly cooked food, not highly seasoned food.
• Increase intake of zinc in diet:
– Shellfish, beef and other red meats, eggs and seafood, beef, pork, chicken (dark meat), turkey (dark meat),
milk and milk products, nuts, sea plants especially Japanese sea plants.
• Consume diet rich in Vitamin A:
– Liver oils of fish, egg, milk and milk products, meat, fish, kidney and liver.
– Yellow orange colored fruits and vegetables; and Green leafy vegetables are good source of - carotene.
• Consume food rich in Vitamin C:
– Milk and milk products, citrus fruits, green vegetables.
– Fruits and vegetables when fresh have maximum of vitamin C.
• Increase intake of Vitamin E.
– Wheat germ, whole grain, corns, cereals, pulses, nuts, dark green leafy vegetables, olives.
– Oilseeds and vegetable oils. You can take vitamin E supplements of 22.5 IU (15 milligrams) for adults.
• Replace other oils by sunflower oil for cooking as it is the richest source of vitamin E.
• Add little turmeric to your food; it is beneficial for your skin.
CONSULT PHYSICIAN:
• If your acne does not respond in 2-3 months following the advice listed above see your physician.
• Consult your physician if your acne is infected and there is pus like discharge.
• Consult your physician immediately if you are not sure if it is acne or any other skin eruption.
ACUTE RENAL FAILURE [ARF]
Acute renal failure is a clinical syndrome in which there is rapid reduction of the excretory functions of the
kidney.
If immediate action is taken derangement caused due to renal failure can be reversed.
CAUSES:
• Reduced circulatory blood volume – hemorrhage, dehydration and severe decrease in protein levels in
blood.
• Cardiac failure.
• Acute gastroenteritis.
• In shock due to septicemia or anaphylaxis.
• Thrombosis / embolism in renal arteries or aortic dissections.
• Accelerated hypertension.
• Blood poisoning during pregnancy - from toxins formed by bacteria growing in local area of infection.
• Disseminated intravascular coagulation.
• Glomerulonephritis.
• Acute tubular nephritis.
• Certain drugs which are toxic to the kidney e.g. aminoglycosides, lithium etc.
• Mismatched blood transfusion.
• Virulent malaria.
• Blockage of one ureter when other kidney is absent or non-functioning, usually due to calculi.
• Neurogenic bladder.
• Blockage of the urinary bladder neck, urethral stricture.
SIGN AND SYMPTOMS:

• Scanty Urination. The urinary output may be as little as 20 - 200 ml per day.
• High blood pressure or low blood pressure.
• Potassium excretion is diminished.
• Serum phosphate and sulphate levels are increased and sodium, calcium and base bicarbonate levels are
decreased.
• Symptoms of acidosis (a condition in which the acidity of body fluids and tissues is abnormally high)
– Vomiting.
– Increased rate of breathing.
– Mental impairment.
• Hypertension (high blood pressure).
• Waste products of protein metabolism get accumulated in blood. Serum urea, nitrogen and creatinine
levels are increased.
• symptoms of uremia (presence of excessive amounts of urea and other nitrogenous waste compounds in
the blood)
– Lack of appetite.
– Nausea and vomiting.
– Gastrointestinal bleeding.
– Anemia.
– Lethargy.
– Confusion and stupor.
• Inflammation of the pericardium with hemorrhagic effusion and cardiac tamponade.
DIETARY MANAGEMENT:
Dietary changes are made to correct the fluid and electrolyte imbalance and to maintain proper nutritional
status so as to minimize protein catabolism and uraemia. But these dietary changes should be done under
guidance of a professional dietician.
AVOID:
• Avoid potassium rich food, as in renal failure potassium excretion is decreased, hence serum potassium
level are high which can have deleterious effects on heart.
• Foods rich in potassium and to be avoided are restrict potassium intake to 1,000 mg per day.
• Minimize or avoid protein – (0.5-0.6 gm per kg body weight) if you are not on dialysis and blood urea and
nitrogen is increasing.
• Avoid high sodium diet – Restrict Sodium intake to 500-1,000 mg per day.
• Avoid phosphorus in diet, in renal disease phosphorus levels increase, which cause blood calcium levels to
decrease and can lead to bone loss.
CONSUME:
• Fluid intake is regulated on basis of urinary output, other water loss from vomiting or diarrhea. Total fluid
intake should not exceed – 500 ml + previous day's urine output + total water loss from vomiting or diarrhea
or any other causes.
• You should consume a minimum of 600-1,000 kcal.
• Generally 35-50 kilocalories per kg body weight should be consumed to maintain positive nitrogen balance.
• Have high calorie diet. Increase intakes of fats and carbohydrates.
• Reduce intake of proteins – (40 gm per day / 1.0-1.5 gm per kg body weight) if you are on dialysis or
hemodialysis.
• Consume at least 100 gms of carbohydrate per day, it minimizes tissue protein breakdown.
• If on nasogastric tube feeding administer 700 ml of 15 % glucose.
• Sodium intake is based on measurements of sodium ions in serum and urine. If you are not on dialysis you
should restrict sodium intake.
• Restrict Sodium intake to 500-1,000 mg per day.
• If you are on dialysis sodium can be consumed in accordance with the serum levels of sodium ion.
• In the recovery phase, urine output is increased and a return of the ability to eliminate wastes. Gradually
you can increase intake of protein, potassium, phosphorus and sodium. Fluid and electrolyte balance should
be monitored and dietary changes should be done accordingly. It will take at least six months to come back
to normal routine diet.
• During kidney disease body's need for certain vitamins and minerals changes. Normally in healthy condition
we get adequate amount of vitamins and minerals form our regular diet, but as in kidney disease diet limits
certain food groups, hence one needs to take certain vitamin and mineral supplements. Take these
supplements under the guidance of your physician.
• Vitamin C supplements, helps to increase immunity and combat the infection.
• Vitamin B complex, certain B vitamins like B6, B12 and folic acid along with iron and EPO (erythropoietin,
given in renal failure to avoid anemia) and iron prevents anemia. Other B vitamins like – thiamine, riboflavin,
pantothenic acid and niacin helps to convert food into energy.
• Iron supplements can be taken, but consult your physician.
• You can also take calcium supplements; it binds the phosphorus from food and serves to provide extra
calcium that your body needs. Along with calcium you can take vitamin D supplements, helps to keep bones
healthy.
• Consume 2 table spoon of fresh flax seed oil, reduces / slows the process of further renal damage.
CONSULT PHYSICIAN:
• Consult physician immediately if any of the above sign and symptoms appear, as timely treatment and
management can reverse the changes and prevent any further damage of the kidney.
• Diet and water intake should be under strict medical guidance.
ALCOHOLISM [ALCOHOLISM]
Alcoholism is one of the most common forms of addiction. When the drinker chronically indulges in drinking
large quantities of alcohol their body also gets used to absorbing large quantities of alcohol so when there is
sudden deprivation of alcohol they experience withdrawal symptoms i.e. their body cannot function
normally without alcohol.
CAUSES:
• Emotional disturbance.
• Poor self esteem.
• Abuse.
• Guilty feeling.
• Stress and an excuse to forget worries.
• Peer pressure.
• Excessive production of histamine predisposes to alcoholism.
• Hereditary factors.
• Metabolic imbalance.
• Hypoglycemia increases the craving for alcohol.
• Food allergies – sugar, barley, corn, sugar cane, grapes etc.
• May be vitamin and mineral deficiency.
SIGN AND SYMPTOMS:

• Continual craving for alcohol.
• Cannot drink moderately.
• Unsteady gait.
• Inability to think or any decisions.
• Psychological and social dysfunctioning.
• Obesity.
• Brain damage – memory loss, gait change, speech disturbances etc.
• Hypertension.
• Hypoglycemia.
– Irritability
– Depression
– Aggressiveness
– Insomnia
– Fatigue
– Restlessness
– Confusion
– Desire to drink and nervousness
• Vitamin and mineral deficiencies.
– Pellagra
– Scurvy
– Anemia
– Osteoporosis
– Night blindness
– Beriberi, etc.
INCREASED RISKS FROM CHRONIC DRINKING.
• Fatty liver
• Cirrhosis of liver
• Severe damage to pancreas, intestines.
• Stroke
• Renal failure
• Heart attack
• Cancer
• Poor blood circulation to the brain.
WITHDRAWAL SYMPTOMS:
• Anxiety
• Feels feverish
• Sleeplessness
• Disorientation
• Tremors
• Hallucinations
• Delirium tremens
• Convulsions
• Depression
• Over sensitivity to noise, light.
DIETARY MANAGEMENT:
Alcoholism cannot be corrected by any medical treatment or nutritional management. About 50% of
alcoholics who enroll in the rehabilitation program relapse back in the first few months of treatment. It
needs strong will power and sheer determination to abstain from alcohol. The first and the foremost thing is
abstinence from alcohol, and then the dietary management and medical intervention comes into the part.
IMPORTANT NOTES FOR DRINKERS:

• Set a daily limit of alcohol and stick to it.
• Control drinking by counting and measuring all the drinks.
• Men should not exceed 2 units of alcohol per day and women should not have more then 1 units. One unit
of alcohol is 280 ml beer, 115 ml of wine or a 30 ml of spirits(gin, rum, vodka, or whiskey).
• Always eat something while you drink as it slows the absorption of alcohol.
• Avoid missing meals when you drink.
• Avoid people and environment that encourages drinking.
• Drink slowly and make every second drink a soft drink.
• Never drive after drinking.
• Take proper well balanced diet to avoid weight loss and protein deficiency.
• Consume about 2,000 – 3,000 calories a day.
• About 60% of calories should come from carbohydrates especially from fresh fruits, vegetables and grains.
• Protein should contribute to about 15% of the total calorie intake.
• Remaining 25% should come from fats.
AVOID:
• Avoid alcohol completely. Be determined not to touch alcohol.
• Avoid foods you are allergic to.
• Avoid sugars and wheat from the diet.
• Do not use fenfluramine (a drug to reduce weight) if you are alcoholic.
CONSUME:
• Alcoholics are found to be deficient in many nutrients; hence a proper balanced diet is essential for
recovery and to maintain proper health.
• Most alcoholics are found to be deficient in B vitamins (B2 - riboflavin, B1 - thiamine, B6 - pyridoxine, B9 -
folate), food rich in B vitamins should be consumed daily; some B vitamins also reduce the craving for
alcohol.
• Consume 400 µgm of folic acid daily, as folic acid deficiency is common in alcoholics.
• Consume a minimum of 1.5 mg of vitamin B2 (riboflavin) daily.
• Increase intake of vitamin B1, thiamine up to 50 mg daily, to correct the deficiency and it helps to treat
delirium tremens, alleviate the withdrawal symptoms in abstinence of alcohol and prevents further brain
damage.
• Consume 2 mg of pyridoxine (vitamin B6); most of alcoholics are deficient in vitamin B6 as it is destroyed by
alcohol. Deficiency can only be corrected if alcohol is completely avoided.
• Increase intake of vitamin B5 (pantothenic acid) to 7 mg daily, it protects liver from toxic effects of alcohol.
• Consume 500 mg of vitamin B3 (nicotinic acid) daily, reduces craving for alcohol.
• Consume a minimum of 100 mg of vitamin C daily. Vitamin C deficiency can be seen in about 85 – 90 % of
alcoholics.
• Increase intake of zinc to at least 15 – 20 mg daily, most of them show low levels of zinc; zinc also reduces
the craving for alcohol and also minimizes the toxic effects of alcohol.
• Alcoholics are usually anemic, increase intake of iron rich food; iron also helps in alleviating the depression
and the withdrawal symptoms.
• Alcoholics are severely deficient in magnesium, consume 400mg of magnesium daily, will correct the
deficiency and magnesium also minimizes the withdrawal symptoms after cessation of alcohol.
• If you are suffering from any heart or kidney ailments, talk to your physician before making any changes in
your magnesium intake.
• Consume food rich in lithium, not more then 500 µg of lithium should be consumed as it is toxic in high
doses. Foods rich in lithium.
– Eggs, processed meat, fish, milk and milk products.
– Potatoes and vegetables grown in lithium rich soil.
• Adequate protein (55 gm daily) intake should be maintained, as alcoholics have difficulty getting enough
protein and calories to maintain proper weight.
• Consume 4,000 – 5,000 IU of vitamin A, but do not exceed the intake as vitamin A is toxic in high doses and
can cause further liver damage.
• Alcohol interferes with the action of antioxidants such as vitamin C, vitamin E and selenium.
• On cessation of alcohol these antioxidants are most needed, at least the daily values for these vitamins and
minerals. Daily values for vitamin E is 30 IU, for vitamin C is 85 mg and for selenium is 70 µg.
• If you are taking any anticoagulant drugs avoid vitamin E supplements and consult your physician before
making any dietary changes.
• Alcoholic are found to be deficient in Gamma-linolenic acid (GLA), it is an essential fatty acid from the
omega-6 family. GLA alleviates the withdrawal symptoms, as it is a precursor for the prostaglandin E1. They
are found in plant seed oils- evening prime rose, black current, borage, fungal oils, spirulina (blue green
algae), etc.
• If you cannot get all the required amount of vitamins and minerals from your diet then you can take
multivitamin/ mineral supplement with your physician's advice.
CONSULT YOUR PHYSICIAN:

• If you have habit of drinking and want to quit alcohol.
• If you have any heart, kidney or liver ailments, before making any dietary changes.
• Consult your physician before taking any mineral or vitamin supplements.
ANGINA PECTORIS [ANGINA]

Pain in the region of heart on exertion is known as angina pectoris.
CAUSES:
• Inadequate supply of blood and oxygen to the heart is the main reason.
• Atherosclerosis of the coronary artery.
• Arteriosclerosis.
• Increased triglycerides and cholesterol.
• Sedentary life.
• Obesity.
• Lack of exercise.
• Sudden emotional upsets.
• Chronic consumption of alcohol.
• Chronic smoking.
• Drug abuse like – cocaine etc.
• Hypertension.
• Diabetes mellitus.
• Family history.
SIGN AND SYMPTOMS:

• Pain in chest – crushing, constricting, sharp, burning pain with feeling of strangling and suffocating,
• Pain may radiate to both arms or mostly along the left arm to the little finger and the jaw, teeth, neck
throat, epigastric region and between the shoulder blades.
• Pain is precipitated from exertion or on physical activity and subsides on rest.
• Pains last for few seconds to few minutes.
• May be associated with – short breath, anxiety, palpitation and nausea.
DIETARY MANAGEMENT:
• Cut down salt (common table salt) intake in your diet to avoid hypertension. Intake should not exceed
more then 2 to 2.5 gm a day.
• Avoid foods rich in cholesterol: ground nut oil, ghee, butter, whole milk, eggs, lard (fats derived from pig
meat), tallow (fats derived from goat or sheep mutton), oily fish, meats and red meat – all non-vegetarian
food contain cholesterol in varied amount.
• Avoid non-vegetarian food especially red meat.
• Increase intake of foods that contain PUFA's (poly unsaturated fatty acids) flax / linseed oil is the richest
source of PUFA's. Other oils that contain PUFA's are sesame oil, mustard oil and olive oil. As all oils are high
in fats, its consumption should be limited. The intake of oils should not exceed 20gms a day.
• Sesame oil and almond oil hinders the absorption of LDL (low-density lipoproteins), so it is advisable to use
replace other cooking oils by sesame oil.
• Increase your intake of water.
• Consume whole grain cereals and whole pulses.
• Take high fiber diet - whole grains, bran, oat, green leafy vegetables, peas, beans, potatoes, raw
vegetables, salads, dried fruits and fresh fruits.
• Eat fruits and vegetables with the skin.
• Cut down the intake of sugar and other sweeteners.
• Replace whole milk with semi-skimmed or skimmed milk.
• Avoid fat-rich portions of flesh foods. Instead have lean meat.
• Avoid fat-rich desserts and fried snacks like cakes, pastries, puddings etc
• Instead of frying food boil, steam, grill or roast food.
• Avoid coffee and caffeinated drinks, junk food – pizza, burgers etc.
• Consume food rich in magnesium
– Nuts and sea food, green leafy vegetables, sea plants like Japanese sea plants, whole grains, Peas, lotus
stem, pulses, legumes and oil seeds
• Increase intake of vitamin C, it maintains the elasticity and integrity of the artery walls.
– Citrus fruits, green leafy vegetables.
– Eat vegetables- cabbage, broccoli, tubers- potatoes and sweet potatoes.
• Reduce calcium intake (reduce but do not completely avoid calcium as it is needed for maintenance of our
body):-
– milk and sea food, nuts, green leafy vegetables, whole grains, peas, lotus stem, pulses, legumes and oil
seeds
– Should avoid custard apple and banana as they are high in calcium.
NOTE:
• Reduce weight if obese.
• Stop smoking and alcohol consumption.
• Exercise regularly.
• Take brisk walks for 40 minutes daily morning.
• Practicing yoga and breathing exercises plays a very important role in lowering the cholesterol levels.
• Do some relaxation techniques like yoga, meditation etc to relieve the stress Change your lifestyle to
reduce stress-physical or mental.
APTHOUS ULCER [APTHOUS ULCER]
Small erosions in the oral cavity or on the tongue. They disappear in 7-10 days.
CAUSES:
• Emotional stress.
• Local trauma- ill-fitting dentures or a sharp tooth.
• Allergy to local applications like toothpaste.
• Poor oral hygiene- not brushing teeth regularly.
• In females can be associated with menstrual cycle.
• Smoking, alcohol, spicy food.
• Drugs like antibiotics.
• Low immunity in any illness.
• Vitamin deficiency especially- B-complex, folic acid.
• Gastric disturbances.
SIGN AND SYMPTOMS:

• Tiny shallow erosions in the oral cavity or on the tongue.
• The base of the ulcer may be gray or white in color.
• Increased salivation.
• Burning pain on the affected part on touch, contact with food / drink.
• Ulcers may bleed.
• Bad breath.
• Fever in case of infection.
DIETARY MANAGEMENT:
• Treat the causes.
• Avoid hot, spicy food.
• Eat bland food.
• Do not eat / drink too hot or too cold food.
• Avoid sweets and carbohydrates.
• Avoid smoking and alcohol.
• Eat liquid / semi solid food, which you can easily swallow to avoid pain.
• Eat lots of vitamin C, vitamin B12 and folic acid -
– Fruit juice – citrus fruits like- orange, lime, sweet lime, strawberries, grape fruits, mango, amla (Indian
Gooseberry) etc.
– Vegetable soups – tomatoes, green leafy vegetables - spinach, tangerines etc.
– Eat boiled vegetables - cabbage, broccoli, tubers- potatoes and sweet potatoes.
– Milk and milk products.
– Boiled or scrambled egg.
– Wheat, rice (brown) porridge.
• If pain is not too much you can have well-cooked (soft) meat, kidney, liver, pork, sea food- shellfish,
shrimps, crabs, lobsters.
• Wash your mouth with water and little turmeric.
ARIBOFLAVINOSIS OR HYPORIBOFLAVINOSIS [ARIBOFLAVINOSIS OR

HYPORIBOFLAVINOSIS ]
Ariboflavinosis is due to deficiency of vitamin B2 (riboflavin).
CAUSES:
• Deficiency of vitamin B2 (riboflavin).
• It can be associated with PEM (protein energy malnutrition), alcoholism.
SIGN AND SYMPTOMS:

• Dryness of mucous membrane of – mouth, eyes, genitalia.
• Mouth lesions - chilosis or angular stomatitis.
• Magenta-colored tongue.
• Normochromic, normocytic anemia.
• Seborrhea.
• Vascularization of the cornea.
DIETARY MANAGEMENT:
Avoid:
• Avoid alcohol.
CONSUME:
• Consume food rich in riboflavin (vitamin B2):
– Most fruits except commercially dried fruits including raisins, dates, prunes; avocado. You can have fruits
dried at home.
– Animal origin: liver, kidney, lean meat, eggs, milk and milk products are good sources of vitamin B2.
– Plant origin: green leafy vegetables, legumes, nuts, whole grain cereals and pulses contain good amount of
vitamin B2. Sprouting increases riboflavin content of cereals and pulses.
– Some amount of vitamin is destroyed from cereals and pulses in processing. And some riboflavin is
destroyed on exposure to light hence should not be stored in glass.
• You can take riboflavin supplements, 6 mgs per day.
CONSULT PHYSICIAN:
• Consult physician if above listed symptoms are worst.
ARTERIOSCLEROSIS OR ATHEROSCLEROSIS [ARTERIOSCLEROSIS OR ATHEROSCLEROSIS]
Arteriosclerosis is a disease process which is commonly called "hardening of arteries". It is caused mainly by
deposits of calcium and fats on the inner lining of the artery walls which leads to the thickening and loss of
elasticity of the artery walls. Eventually there is narrowing of the artery which decreases the blood flow to
their respective tissues.
Atherosclerosis is a clot formation in the narrowed arteries and thickening of arteries takes place only in
advanced stages or old age.
CAUSES:
• High levels of cholesterol, triglycerides and low-density lipoproteins (LDL) in the blood.
• Diets rich in fats – oils, butter, cream, cheese etc.
• Obesity.
• Diabetes.
• Excess intake of calcium (arteriosclerosis).
• Stress.
• Sedentary life.
• Smoking.
• Family history of atherosclerosis.
SIGN AND SYMPTOMS:
Arteriosclerosis
• Symptoms of high blood pressure.
• Recurrent kidney infections.
• Poor circulation to fingers and toes giving rise to tingling and numbness.
ATHEROSCLEROSIS:
• Pain in limbs when walking.
• Fatigue.
• Giddiness.
• Paralysis.
• Stroke.
• Cardiac diseases.
• Ischaemic heart diseases.
• Myocardial infarction.
• Cerebro-vascular diseases.
DIETARY MANAGEMENT:
• Avoid foods rich in fats, oils, butter, ghee, nuts etc.
• Remember vegetable oils like safflower oil, cotton seed oil, mustard oil, etc do not contain cholesterol.
• Increase intake of foods that contain PUFA's (poly unsaturated fatty acids): flax / linseed oil is the richest
source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, cottonseed oil, maize oil,
sesame oil, rich bran oil, ground nut oil, mustard oil and olive oil. As all oils are high in fats, its consumption
should be limited; the intake should not exceed 20gms a day.
• Sesame oil and almond oil hinders the absorption of LDL (low-density lipoproteins), so it is advisable to
• Consume food rich in magnesium.
– Sea food, sea plants like Japanese sea plants, green leafy vegetables, nuts, whole grains, peas, lotus stem,
pulses, legumes and oil seeds.
• Avoid eating junk food – pizza, burgers etc.
body):-
– Milk and sea food, nuts, whole grains.
– Should avoid custard apple which is high in calcium.
– Note: Calcium from green leafy vegetables and cereals are not absorbed adequately due to presence of
oxalic acid, phytic acid and fiber. Hence vegetables and cereals should be consumed regularly.
• Consume lots of fresh fruits and vegetables.
• Increase intake of fiber: whole grains, bran, oat, green leafy vegetables, peas, beans, potatoes, raw
– Citrus fruits, green leafy vegetables and vegetables- cabbage, broccoli, tubers.
ASTHMA [ASTHMA]
It is an episodic chronic respiratory disorder in which there is airflow obstruction causing difficulty in
breathing.
CAUSES:
• Hereditary.
• History of allergy – skin allergy, asthmatic etc.
• Mostly inhaled allergens cause asthma.
ALLERGENS CAN BE:

– Environment - smoke, dust & pollution and petrol fumes.
– Pollen and molds from grass, flowers and trees.
– Strong perfumes
– Paints & varnishes
– Tobacco smoke
– Animal dander
– House dust mite
– Chemical fumes
FOOD, WHICH CAN CAUSE ALLERGY ARE:

– Sour food
– Citrus fruits
– Cold food & drinks
– Artificially colored & flavored foods
– Fish
– Beer, wine
– Vinegar
– Grapes
– Canned vegetables
• Infection of lungs, bacterial or viral.
• Emotional stress
• Over strenuous exercise
• Inhalation of old air
• Climatic changes
• Allergy to certain drugs.
• Chain smoking.
SIGN AND SYMPTOMS:

• Initially feeling of distress and restlessness with painless tightness in the chest.
• There may be cough, sometimes with phlegm.
• A wheezing / whistling sound when breathing.
• Mild to moderate shortness of breath.
• Shortness and rapid breathing followed with a feeling of Anxiety, sweating and inability to lie down on the
back.
• Usually the sufferer finds comfort in sitting bent forwards and near the windows.
DIETARY MANAGEMENT:
• Try to recognize and avoid the factors that trigger the asthmatic attacks.
• Keep a diary and try to trace a pattern or relation between your allergic reaction and the allergen.
• Families with history of allergy should avoid artificial food, eggs, cocoa, juices and wheat preparation to
infants till the age of six months. Only breast feed infants for the first six months to strengthen the immune
system.
• Avoid food and drinks known to cause allergy - cow milk, vinegar, lemon juice, grapes, instant tea, corn
syrup, fruit toppings, cold food and drinks, canned food, food additives, beer and wine.
• Eat balanced nutritious diet.
• Eat fresh unprocessed food.
• Consume Bitter gourd (Karela) cooked or juice, it strengthens the immunity.
• Every morning, drink boiled mixture of – ½ cup water, little ginger, 2-3 leaves of sweet basil (tulsi) and mint
leaves, or you can eat the raw leaves, this will boost up you immunity.
• Boil a mixture of Bishops weed (Ajwain), tea leaves and water and inhale the steam, acts as decongestant.
• Consume garlic and onions, will be beneficial, but avoid them if you are on homeopathic medicine.
• Consume lots of Vitamin B complex.
– Liver, kidney, pancreas, yeast (Brewer's yeast), lean meat especially pork, fish, dairy products, poultry, egg,
shrimps, crabs and lobsters,.
– Milk and milk products, green leafy vegetables, legumes, nuts, whole grain cereals.
– Carrots, bananas, avocado, raspberries, artichoke, cauliflower, soy flour, barley, cereals, pasta, whole
grains, wheat barn like rice and wheat germ, dried beans, peas and soybeans.
• Increase intake of magnesium in your diet.
– Sea food, nuts, green leafy vegetables.
– Peas, lotus stem, pulses, whole grains, fruits.
NOTE:
• Avoid smoke, pollution, and dust as far as possible.
• Try to reduce stress, anxiety and tension, practice yoga will help to relax and relive stress.
• Yoga will also help by breathing exercise. Breathing exercise will help better utilization of available lung
space.
BARTTERS SYNDROME [HYPOKALEMIA]
BARTTER'S SYNDROME (HYPOKALEMIA)

Barter's syndrome is due to Hypokalemia (low potassium levels in the body).
CAUSES:
• Renal potassium wasting - hyperplasia of the juxtamedular and medullary cells (inner linings of the kidney),
renal tubular defects.
• Alteration of blood pressure.
SIGN AND SYMPTOMS:

• Weakness.
• Periodic paralysis.
• Polyuria.
DIETARY MANAGEMENT:
Avoid:
• Avoid tea, coffee and caffeinated drinks.
• Avoid aerated drinks.
CONSUME:
• Have well balanced diet.
• Consume sodium chloride (common table salt) generously, to maintain the balance between the intra
cellular and extra cellular fluids:
– Generously use salt in cooking.
– Other sources of salts are - baking powder and baking soda (sodium bicarbonate), monosodium glutamate
and sodium benzoate. These are commonly known as Worcestershire sauce, soy sauce, onion salt, garlic salt
and buillon salt.
– Consume foods rich in sodium like- milk, egg white, meat, poultry, fish, green leafy vegetables, beet root,
radish, carrot, cauliflower, lotus stem, pulses, spices like cumin seeds etc.
– Japanese sea plants – arame, hijiki, kombu and nori.
– Seaweeds, rye, tomatoes, lettuce, celery and olives are good source of chloride.
• Increase intake of potassium in your diet:
– Fish like cod, salmon, flounder and sardines are very good source of potassium.
– Vegetables like lima beans, peas, broccoli, tomatoes and potatoes with their skins.
– Japanese sea plants – arame, hijiki, kombu and nori.
– Green leafy vegetables like spinach, parsley and lettuce contain potassium.
– Fruits like citrus fruits (oranges), apple, banana and apricots (dried ones) are high in potassium.
– Water of green coconut is the best source of potassium.
CONSULT PHYSICIAN:
• Potassium supplements can be taken with advice of your physician.
• Consult your physician for proper treatment of the disease.
BERIBERI [BERIBERI]
Beriberi is a vitamin B1 (thiamine) deficiency. There are different types of beriberi – dry (Wernicke-korsakoff
syndrome), wet (cardiovascular disease), oriental and infantile.
CAUSES:
• In adequate intake of thiamine.
• Eating diet in which most calories are derived from polished rice (oriental).
• Excessive alcohol consumption (dry and wet beriberi).
• Inadequate intake in breast feeding mothers (infantile).
• Other cause can be – patients under dialysis, patients receiving high doses of diuretics.
• Rarely – genetic inability to absorb thiamine.
SIGN AND SYMPTOMS:

Dry beriberi:
• Glucose metabolism is affected so there is weakness.
• Pain, tingling numbness in hands and feet.
• Difficulty walking.
• Muscle wasting with loss of function or paralysis of lower extremities.
• Strange eye movements – nystagmus.
• Mental confusion and speech difficulties.
• Brain damage – affecting language and thinking.
• Coma.
• Death.
Wet beriberi:
• General swelling.
• Increased heart rate.
• Tachycardia (increased pulse rate).
• Lung congestion.
• Enlarged heart – congestive heart failure.
Infantile beriberi:
• In infantile beriberi the child is usually breast fed & can have sudden convulsions, cyanosis and can go in
coma.
DIETARY MANAGEMENT:
Avoid:
• Avoid alcohol.
• Avoid eating unpolished rice or cereals.
CONSUME:
• Increase intake of thiamine (vitamin B1):
– Thiamine is found in almost all foodstuffs of animal and plant origin. Fats oils and sugars do not contain
thiamine.
- Nuts and seeds
– Animal origin: lean meat especially pork, fish, dairy products, poultry, egg yolk are good sources of
thiamine.
– Yeast is a very good source of thiamine.
– Plant origin: cereals, pasta, whole grains like rice and wheat germ, dried beans, peas and soybeans are
good source of vitamin B1.
– Fruits and vegetables are not high in thiamine content.
• You can take thiamine supplements.
CONSULT PHYSICIAN:
• If any of the above symptoms are observed consult your physician as immediate supplementation of
injectable thiamine is essential.
BRONCHITIS [BRONCHITIS]
Inflammation of the large air passages which carry air from the windpipe to lungs is known as bronchitis.
CAUSES:
• Smoking is the main cause.
• Allergy like – such as air pollutant.
• Infection – viral or bacterial.
• Occupation – coal miners, grain handlers, metal molders and people working with dust.
• Pre existing disease as pneumonia, emphysema etc.
SIGN AND SYMPTOMS:

• Cold with nasal discharge.
• Cough with yellow greenish sputum.
• Breathlessness.
• Chest pains.
• Fever with headaches and loss of appetite.
• These entire symptoms can increase in severe condition.
DIETARY MANAGEMENT:
• Avoid dairy products like milk, butter, cheese because these will increase mucus secretion in the
respiratory system.
• Avoid hot spicy and highly seasoned food.
• Avoid cold food, cold drinks, ice, ice-creams and aerated drinks.
• Drink luke warm water.
• Boil a mixture of Bishops weed (Ajwain), tea leaves and water and inhale the steam, this acts as
decongestant. Do this at least 2-3 times a day.
• Gargle with warm water, a pinch of salt and turmeric to sooth your throat.
• Have only fruits for 4-5 days later can have raw salads, vegetables and sweet fruits for next 5-6 days.
• Have hot vegetable soups.
• Have bland and boiled food.
• Include turmeric, garlic, ginger and onions in your diet but avoid if you are on homeopathic medication.
• Consume lots of vitamin C: foods of animal origin are poor in vitamin C.
– Fresh citrus fruits, green vegetables.
• Increase consumption of vitamin B:
– Milk and milk products, eggs, shrimps, crabs and lobsters.
– Lean meat especially pork, fish, dairy products, poultry, egg yolk, Liver, kidney, pancreas, yeast (Brewer's
yeast).
– Carrots, bananas, avocado, raspberries, artichoke, cauliflower, soy flour, barley, cereals pasta, whole
grains, barn like unpolished rice and wheat germ, dried beans, peas and soybeans.
– Green leafy vegetables, legumes, nuts, whole grain.
• Consume lots of vitamin A; it maintains the integrity of the respiratory mucosa: Liver oils of fish like cod,
shark, and halibut are richest source of vitamin A.
– Animal sources: egg, milk and milk products, meat, fish, kidney and liver.
– Yellow orange colored fruits and vegetables, dark green leafy vegetables.
• Have ginger powder or fresh ginger juice in honey before retiring to bed.
• Every morning, drink boiled mixture of – ½ cup water, little ginger, 2-3 leaves of sweet basil (tulsi) and mint
leaves, or you can eat the raw leaves, this will boost up you immunity.
NOTE:
• Avoid smoking.
• Take rest at home and keep your self warm.
• Change occupation if possible in case of miners, etc. or take precautions to prevent the particles being
inhaled.
• Practice yoga, will help by breathing exercise.
• Treat the cause.
CANCER [CANCER]
Cancer is the term that is used to describe a wide variety of malignant diseases. It is the second commonest
cause of death in the world.
CAUSES:
• The exact causes for cancer is not known.
• It is multi-factorial disease – many factors contribute or predispose this condition.
• Modern diet – increased intake of junk food and decreased intake of fibers and roughage.
• Age, environmental pollutants or social, emotional factors influence the disease.
• Family tendency.
• Exposure to radiations.
• Occupational exposure to pollutants – lung cancer.
• Increased consumption of cigarettes - lung cancer.
• Tobacco chewing – oral cancer.
• Chronic alcoholics – liver cancer.
• Use of contraception, excess sexual freedom, virginity, women with no children – cervical and uterine
cancer
• Late marriages, women who have not breast fed there children – breast cancer.
• Non vegetarian diet especially high consumption of meat and red meat.
• Obesity hypertension and diabetes have been seen to be associated symptoms.
SIGN AND SYMPTOMS:

• Most of the time there is no presentation no pain, cancer usually is detected accidentally and by the time it
is detected it has spread in the whole body.
• Painless swelling in breast or at the site of cancer.
• Intracranial space occupying lesions can present with fits, severe headaches, vomiting, papilloedema.
• Abdominal lesions can cause constipation.
• Bronchial lesions present with cough & shortness of breath.
• Hemorrhage from various orifices.
• Pain either due to nerve compression or due to distension of an organ.
• There can be deep bone pains or referred pains.
• In terminal cases depression, loneliness & irritability.
• Tumor may cause obstruction affecting ingestion, digestion absorption, malabsorption through secondary
intestinal changes.
• Pain, fatigue, depression, Anxiety, Nausea vomiting and diarrhea.
• Taste changes- mouth blindness develops – bitter and sweet thresholds are altered. Patient will avoid
chocolate, coffee, tea, red wine, citrus fruits red meat cheese due to altered taste
• Low intake of food can cause severe weakness
• Anorexia.
• Anemia.
• Loss of weight.
• Cachexia.
• Food aversion
• Early satiety
• Loss of body cell mass
• Emaciation- loss of subcutaneous fat and body protein leading to weight loss and muscle weakness.
• Metabolic disorders – altered metabolism of fats, proteins, carbohydrates, glucose, vitamins, minerals and
electrolytes.
• Hyperglycemia
• Immunodepression- changes in the function of the immune system.
• Hyponatraemia and Hypercalcaemia
• Acid-base imbalance
• All these symptoms can be exacerbated by cancer treatment like chemotherapy or radiation.
DIETARY MANAGEMENT:
• Give high energy and high protein diet.
• Wide variety of food should be selected to ensure all vitamins and minerals are included in the diet.
– Increase intake of antioxidants like vitamin A, vitamin C, vitamin E, selenium.
• Include Japanese sea vegetables (arame, hijiki, kombu, nori) in diet if available, they are remarkably
nutritious.
• Wheat grass juice is recommended – grow wheat grains in a pot – grass comes up in a weeks time so its
advisable to plant seven pots so as to have every days supply. Extract juice from these grass and consume
twice a day. It helps you to develop immunity and remove toxins from the body.
• Consume ½ cup of bitter gourd every morning. Advisable to add little ginger and turmeric to it. You can also
add honey or jaggery to it, to alter its bitter taste if required.
• Daily eat 3-4 mint and basil leaves.
• Have high energy food / drink like sugarcane juice, fats.
• Consumption of sesame seed / oil is advised as it is a very good tonic and has anti-cancer properties.
• During the cancer affections and treatment, there is high demand for energy hence fats are required in
high amount. Hence it is recommended to fry food rather than grilling them.
• Vegetarians should increase their consumption of pulses and legumes (peas and beans).
• Consumption of fresh fruits and raw vegetables is advised.
• Milk and milk products should be avoided to those patients with intestinal damage who are also lactose
intolerant or those who cannot tolerate, digest or absorb a normal diet in such case liquid supplement
formula can be used.
• Multivitamin supplements may be required in case of digestive and metabolic disorders. Should be taken as
indicated by your physician.
• Tube feeding can be used in patients who cannot or are unwilling to take food orally.
• Parentral feeding – is considered when there is gastro-intestinal tumors or gastro-intestinal tract is not
functioning
CHRONIC HEART FAILURE [CHF]
CHRONIC HEART FAILURE / RIGHT HEART FAILURE / COR-PULMONALE

Chronic heart failure is a syndrome which results in a low cardiac output and congestive symptoms due to
abnormality of cardiac function.
CAUSES:
• Right ventricular infarction (death of a part of the chamber of the heart due to lack of blood supply to it).
• Valvular heart disease (pulmonary or tricuspid valve disease)
• Isolated right ventricular cardiomyopathy (a chronic disorder of the muscles of the heart)
• Primary pulmonary hypertension
• Secondary pulmonary hypertension - Left heart failure
- Chronic lung disease (cor pulmonale)
SIGN AND SYMPTOMS:

• Weakness, fatigue.
• Scanty urination.
• Headache.
• Sleeplessness.
• Restlessness.
• Sluggish mental state.
• Cough.
• Labored breathing at rest or on mild to severe exertion.
• Breathlessness that prevents the patient from lying down and makes them sit propped up (orthopnoea).
• Lack of appetite.
• Nausea.
• Vomiting.
• Fullness after meals.
• Pain in the right upper part of the abdomen situated below the ribs.
• Need to pass urine at night.
• Swelling of feet.
• Generalized massive swelling of the legs, trunk and genitalia due to retention of fluid.
DIETARY MANAGEMENT:
• Cut down salt (common table salt) intake in your diet; do not exceed more then 2 to 2.5 gm a day.
• Reduce intake of fluids, it should be under medical guidance.
• Take frequent small, bland, low caloric feeds at the onset of disease.
• Eat boiled food, without spices.
• Instead of frying - boil, steam, grill or roast food.
• Add very little salt to food; do not add salt to cooked food.
• Avoid other sources of salts like- baking powder and baking soda (sodium bicarbonate), monosodium
glutamate and sodium benzoate. These are commonly known as Worcestershire sauce, soy sauce, onion salt,
garlic salt and buillon salt.
• Avoid salt-preserved foods like ketchups, sauces, pickles, canned and processed foods.
• Consume food rich in magnesium
– Nuts and sea food, green leafy vegetables, sea plants like Japanese sea plants, whole grains Peas, lotus
• Increase calcium intake:-
seeds
• Avoid diet rich in saturated fats e.g. meat, eggs, milk products, cheese, butter etc.
meat), tallow (fats derived from goat or sheep mutton) – all non-vegetarian food contain cholesterol in
varied amount.
source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, sesame oil, olive oil etc. As all
oils are high in fats, its consumption should be limited. The intake of oils should not exceed 10-15 gm a day.
• Replace whole milk with semi-skimmed or skimmed milk.
CHRONIC RENAL FAILURE [CRF]
Chronic renal failure is a progressive or slow continuous destruction of the kidney cells and so kidney is not
able to perform its normal function of filtering waste from the blood; as a result the waste remains in the
blood.
CAUSES:
• Pre-existing renal diseases e.g. glomerular disease.
• Hypertension i.e. high blood pressure.
• Diabetes.
• Hereditary renal disorders. E.g. polycystic kidney.
• Metabolic disorders e.g. gout.
• Certain drugs and pain killers.
SIGN AND SYMPTOMS:

• symptoms can manifest in any part of the body.
• Mild Variety: There may be no symptoms.
• Moderate Variety:
– Anemia.
– Increase frequency of urination at night.
– Vomiting.
– These patients can easily get infected - fever, burning urination, loss of appetite, lethargy, loss of weight,
etc.
SEVERE VARIETY:
– Loss of appetite.
– Nausea & Vomiting.
– Bleeding in the digestive tract.
– Weakness & Lethargy.
– Giddiness & Confusion.
– Muscle twitching.
– Headache.
– Abdominal pain.
– Swelling of the body.
– Breathlessness.
– Increased blood pressure.
– Inability to concentrate.
– Loss of memory.
– Cramps.
– Convulsion.
– Dry skin, pigmentation and itching.
– Loss of calcium from bone leading to soft bones and bone pain.
DIETARY MANAGEMENT:
Dietary changes are made to correct the fluid and electrolyte imbalance and to maintain proper nutritional
status so as to minimize protein catabolism and uraemia. But these dietary changes should be done under
guidance of a professional dietician.
AVOID:
• Avoid potassium rich food, as in renal failure potassium excretion is decreased, hence serum potassium
level are high which can have deleterious effects on heart.
• Foods rich in potassium and to be avoided are: restrict potassium intake to 1,000 mg per day.
• Minimize or avoid protein – (0.5-0.6 gm per kg body weight) if you are not on dialysis and blood urea and
nitrogen is increasing.
• Avoid phosphorus in diet, in renal disease phosphorus levels increase, which Causes blood calcium levels to
decrease and can lead to bone loss.
CONSUME:
• Fluid intake is regulated on basis of urinary output, other water loss from vomiting or diarrhea. Total fluid
intake should not exceed – 500 ml + previous day's urine output + total water loss from vomiting or diarrhea
or any other cause.
• You should consume a minimum of 600-1,000 kcal.
• Generally for adults 35-50 kilocalories per kg body weight, for children 80-110 kcal / kg and for infants 100-
120 kcal / kg should be consumed to maintain positive nitrogen balance.
• Have high calorie diet. Increase intakes of fats and carbohydrates.
• Reduce intake of proteins – (40 gm per day, if on haemodialysis protein intake can be increased to 1 gm per
kg body weight per day and patients on peritoneal dialysis, loses more protein so daily protein requirement is
1.0-1.5 gm per kg body weight).
• The food should be high in calories and low in protein.
• High protein sources like fish, chicken, meat and pulses should be taken in smaller quantities.
• Avoid canned, baked, processed and preserved foods.
• Salted cheese, butter and nuts should be avoided
• Foods high in protein should be taken in little quantities –Canned, preserved, baked and processed foods
should be avoided.
• Avoid salted nuts, cheese, butter and other salted food items.
• Consume at least 100 gm of carbohydrate per day, it minimizes tissue protein breakdown.
• If on nasogastric tube feeding administer 700 ml of 15 % glucose.
• Sodium intake is based on measurements of sodium ions in serum and urine. If are not on dialysis you
should restrict sodium intake.
• Restrict Sodium intake to 500-1,000 mg per day.
• If you are on dialysis sodium can be consumed in accordance with the serum levels of sodium ion.
• If on haemodialysis you can consume 1.5 to 2.0 gm of sodium per day and if you are on peritoneal dialysis
you can have 2 to 3 gm of sodium per day.
• For children sodium intake should not exceed 50mg per kg per day.
• During kidney disease body's need for certain vitamins and minerals changes. Normally in healthy condition
we get adequate amount of vitamins and minerals form our regular diet, but as in kidney disease diet limits
certain food groups, hence one needs to take certain vitamin and mineral supplements. Take these
supplements under the guidance of your physician.
• Vitamin C supplements, helps to increase immunity and combat the infection.
• Vitamin B complex, certain B vitamins like B6, B12 and folic acid along with iron and EPO (erythropoietin,
given in renal failure to avoid anemia) and iron prevents anemia. Other B vitamins like – thiamine, riboflavin,
pentothenic acid and niacin helps to convert food into energy.
• Iron supplements can be taken, but consult your physician.
• You can also take calcium supplements; it binds the phosphorus from food and serves to provide extra
calcium that your body needs. Along with calcium you can take vitamin D supplements, helps to keep bones
healthy.
• Consume 2 table spoon of fresh flax seed oil, reduces / slows the process of further renal damage.
CONSULT PHYSICIAN:
• Consult physician immediately if any of the above sign and symptoms appear, as timely treatment and
management can prevent any further damage of the kidney.
• Diet and water intake should be under strict medical guidance.
CROHNS DISEASE [CROHNS DISEASE]
Crohn's's disease is a non-specific granulomatous inflammation involving single or multiple areas of intestine.
Most commonly it affects the terminal ileum or the ileocaecal region.
CAUSES:
• Genetic- family history of Crohn's's disease or ulcerative colitis.
• Smokers are more likely to develop the disease.
• Mycobacterium Para tuberculosis is found in some cases.
• High intake of refined sugar and less intake of fiber.
SIGN AND SYMPTOMS:

• Depends on the site of the disease.
– Intestine:- abdominal pain, diarrhea, obstruction symptoms, mass in the
right iliac fossa,
- Rectal bleeding, perianal disease (in colon),
- Proctitis (in rectum).
– Extra intestinal: Aphthous ulceration.
- Erythema nodosum.
- Pyoderma granulosum
- Eye complications like conjunctivitis etc.
- Acute arthritis.
• Complications like – strictures of intestine – obstructive symptoms.
• Fistula may develop between loops of bowel adjacent to the bladder or vagina.
- Haematuria and recurrent UTI indicate fistula into the bladder.
- Flatus or feculent vaginal discharge signifies a vaginal fistula.
• Perianal disease. Carcinoma may complicate long standing disease.
DIETARY MANAGEMENT:
• In acute phase of disease rest and take only liquids- water with salt and sugar, fruit juices- water melon,
etc, start dioralyte in case of severe diarrhea.
• Later start with semi solid, light and bland diet – porridge, soups, fruit juices etc.
• Add a pinch of turmeric to food, it has anti inflammatory properties and its action is seen more in the
colon.
• Try to consume more of antioxidants (vitamin A, E, C, Selenium etc.)– Most fruits and vegetables contain
bioflavonoids, which is a good antioxidant.
• Eat well balanced diet, will boost up your immunity.
• Consume Almond Milk,Eggs,Oatmeal,Vegetable-Based Soups,Salmon,PoultryTropical Fruits, including
bananas, papaya, mango,Pureed Beans,Avocado,Butter Lettuce,Roasted Red Peppers (with the skin
removed),Smooth Peanut Butter/Almond Butter
• Limit fried and fatty food.
• Avoid intake of milk and milk products.
• Increase intake of vitamins and minerals – most vitamins and minerals are present in vegetables and fruits
so try to consume vegetarian food more.
• If possible avoid / limit non- vegetarian food.
• Avoid refined sugars, tea, coffee and aerated drinks, alcohol.
• Avoid raw fruits and vegetables.
• Avoid food that you are allergic to.
COMMON COLD OR CORYZA [COMMON COLD OR CORYZA]
COMMON COLD / CORYZA

This is the most common and most frequent viral infection affecting all age groups and is highly contagious.
CAUSES:
• Viral infection.
• Person to person
• Inhalation of droplets from infected people through cough and sneeze.
• Cold weather and changing weather favors.
• Low resistance due to fatigue, exhaustion, loss of sleep, stress, depression.
• Unhygienic family practices.
SIGN AND SYMPTOMS:

• Sense of uneasiness.
• Burning sensation in nose with sneezing, nose block and clear nasal discharge.
• Headache.
• Burning and watering of eyes may be present.
• With or without fever.
• In later stage will develop hoarseness, sore throat, dry cough and yellow cloudy discharge.
• Loss of appetite.
• Lack of energy.
• Muscle pain and fever may accompany.
DIETARY MANAGEMENT:
• In case of profuse water nasal discharge fluid intake should be increased.
• Drink plenty of water, can add a pinch of turmeric and ginger powder to it.
• You can consume juices especially of citrus fruits as they have high vitamin C content – lemon, orange,
sweet lime, pineapple etc.
• Consume hot soups, especially chicken soup.
• Take raw fruits and vegetables. Apple is good for cold, should consume at least one apple a day.
• Include garlic, ginger and onions in your food.
• Increase intake of vitamin A in your diet – all yellow fruits and vegetables contain Vitamin A. Meat, fish,
kidney and liver, liver oils of fish like cod, shark, and halibut are richest source of vitamin A. If you are a
vegetarian you can have fish liver oil supplements but because over dose can be toxic.
• Boil a mixture of Bishops weed (Ajwain), tea leaves and water and inhale the steam, helps to decongest the
nose block due to cold. Should do at least three times a day.
• Drink boiled mixture of – ½ cup water, little ginger, 2-3 leaves of sweet basil (tulsi) and mint leaves, or you
can eat the raw leaves, this will boost up you immunity and control your cough and cold.
• Avoid milk and milk products – cottage cheese.
• Avoid spicy food, eggs, sweets and cold refrigerated drinks.
• Avoid cold drinks, cold water, ice creams and aerated drinks.
• Avoid all food with preservatives and additives.
NOTE:
• Avoid contact with infected people.
• Go out for a walk in fresh air.
• Do not self medicate.
CONSTIPATION [CONSTIPATION]
Difficulty in passing stool or passes once in 2 / 3 days, stools can be hard or soft is termed as constipation.
Even ineffectual urge or a sensation of incomplete stools can be termed as constipation.
CAUSES:
• Modern life style – not eating enough and drinking little water, lack of exercise.
• Emotional or psychological problems.
• Sedentary life.
• Eating too much of meat and dairy products.
• Chronic abuse of laxatives.
• Bottle fed babies.
• Pregnancy.
• Certain drugs like antacids, iron, calcium, blood pressure medications.
• Certain digestive tract diseases.
• School going children are shy to tell teacher, and later develops a habit to ignore the urge.
• Cooking in aluminum, iron vessels.
SIGN AND SYMPTOMS:

• Stools every 2nd or 3rd day.
• Difficulty in expelling feces from rectum.
• Painful evacuation of feces.
• Pain sometimes remains for hours after passing stool.
• Hard stools.
• Occasional blood in stool due to fissure, fistula or piles.
DIETARY MANAGEMENT:
• Drink at least 2-3 liters of water a day.
• Eat high fiber diet – whole grains, bran, oat, green leafy vegetables, peas, beans, potatoes, raw vegetables,
salads, dried fruits and fresh fruits.
• Avoid food that can cause constipation like pomegranate etc.
• You can take one spoon isabgul (fiber, Psyllium) in water before retiring to bed.
• Walk after every meals.
• Drink 2- 4 glasses of warm water every morning.
• Limit intake of laxatives.
NOTE
• Do not suppress the urge to pass stools.
• Get a regular time fixed to the toilet.
CORONARY HEART DISEASE [CHD]
Coronary heart disease (CHD) is due to inadequate blood supply to the heart muscle (myocardium) due to
the obstruction in the coronary artery (artery that supplies blood to the heart muscle). This obstruction in
arteries is due to atherosclerosis.
CAUSES:
• Atherosclerosis in coronary artery.
• High calcium intake.
• Older Age.
• More commonly seen in males.
• Family history of atherosclerosis.
• Sedentary life.
• Obesity.
• Eating habits- junk food, high fat diet.
• Stress.
• Smoking.
• High levels of cholesterol, triglycerides and low-density lipoproteins (LDL) in the blood.
• Diabetes.
• Hypercholesterolemia.
SIGN AND SYMPTOMS:

• Angina pectoris.
– Tight pressing in chest
– Severe pain across the chest.
– Pain after exertion or hard work.
• Myocardial infarction.
– Reduced functional capacity of heart
– Breathlessness on exertion.
– Pain in chest.
• Congestive heart failure
– Accumulation of fluid in lungs and other parts of the body.
– Difficulty in breathing on slightest exertion
– Pain in chest on exertion.
DIETARY MANAGEMENT:
source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, sesame oil, mustard oil and
olive oil. As all oils are high in fats, its consumption should be limited. The intake of oils should not exceed
20gms a day.
/ replace other cooking oils by sesame oil.
• Consume food rich in magnesium:
body):-
seeds
– Should avoid custard apple as they are high in calcium.
COUGH [COUGH]
It is a violent exhalation to an irritant stimulus.
CAUSES:
• Mechanical irritations- inhalation of dust, irritants, pungent fumes.
• Smoking.
• Foreign body in larynx.
• Postnasal drip.
• Compression of air passage.
• Acute / chronic upper and lower respiratory tract infections.
• Reflex irritation of vagus nerve by wax in the middle ear, distention of stomach, supradiaphragmatic
abscess or liver abscess.
• Thermal stimulus – inhalation of cold air.
• Bovine cough due to laryngeal paralysis in aortic aneurysm.
• Psychogenic cough.
• Habitual.
SIGN AND SYMPTOMS:

• Dry cough in early stages of respiratory tract infections, asthma, tropical eosinophilia.
• Wet or productive cough in bronchiectasis, lung abscess etc.
• Paroxysmal in whooping cough, bronchial asthma.
• Nocturnal cough in asthma, pulmonary oedema, postnasal drip in chronic sinusitis, reflux oesophagitis.
• Croupy cough, it is harsh, hoarse cough in laryngeal infection.
• Hacking cough which is short, dry, and irritable e.g. in smokers cough.
• Toneless, whispering, aphonic cough in destructive lesion of vocal cords.
• Exertional cough in early LV failure and mitral stenosis.
• Cough related to meals suggests hiatus hernia, esophageal diverticulum, or tracheo-oesophageal fistula.
Complications of cough:
• Syncope.
• Rib fracture.
• Spontaneous pneumothorax.
• Hernia at weak hernial sites.
DIETARY MANAGEMENT:
• Have one spoon of mixture of honey and ginger powder before retiring to bed.
• Avoid food / environmental factors to which you are allergic.
• Consume hot soups.
• Take raw fruits and vegetables. Apple is good for cough, should consume at least one apple a day.
• Include garlic, ginger and onions in your food.
• Drink boiled mixture of – ½ cup water, little ginger, 2-3 leaves of sweet basil (tulsi) and mint leaves, or you
can eat the raw leaves, this will boost up you immunity.
• Avoid milk and milk products – cottage cheese.
• Avoid spicy food, oily food, eggs, sweets and cold refrigerated drinks.
• Avoid cold drinks, cold water, ice creams and aerated drinks.
• Avoid all food with preservatives and additives.
• Stop smoking and ingestion of alcohol.
• In case of severe pain in throat due to cough- eat soft bland food, semi solid food, soups, and boiled
vegetables and fruit juices.
NOTE:
CYSTINE STONES [CYSTINE STONES]
KIDNEY STONES / URINARY CALCULI (CYSTINE STONES) :

The formation of crystals and calculi due to mineral deposits in urine are known as urinary calculi, when
formed in kidney are known as kidney stones but can form any where in the urinary tract and they are
named depending on the site where they are formed.
Cystine stones are formed from cystine, an amino acid that is found in protein. Less then 1% of kidney stones
are made from cystine.
CAUSES:
• Family history of kidney stones.
• Hot climate and dehydration.
• Working in hot environment.
• Decreased intake of water.
• Deficiency of vitamin B6 and magnesium.
• Sedentary life style.
• Hereditary disease - renal tubular acidosis develop kidney stones.
• Cystic kidney disease.
• Hormonal disorder.
• Drugs used to treat HIV.
• Cystine stones: usually develop in children.
• Hereditary disease – cystinuria (high homocystine level)
SIGN AND SYMPTOMS:

• When kidney stones are small they are passed unnoticed with the urine.
• Large stones cannot easily pass through urinary tract and are painful.
• Sudden onset of pains.
• Sharp, cramping pains in the back and side in the area of kidney or lower abdomen.
• Pain in the abdomen radiating down to the groin.
• Painful urination. Restlessness
• Hard Abdomen
• Increased pulse
• Nausea & Vomiting.
• Profuse sweating.
• In males – excruciating pains in the testicles as the stones passes out.
• Red urine
• Painful urination
• Pus in urine
• In case of an infection along with the above mentioned symptoms.
• Fever with Chills.
• Frequent urge to pass urine.
DIETARY MANAGEMENT:
Kidney stones have tendency to reoccur, it can be prevented by some dietary changes. Depending upon the
type of stones you can make necessary changes in your diet and prevent stone formation.
• Fluid intake:
– Drink lots of water, fruit juice, vegetable juice and other drinks. At least 50% total fluid intake should be
water.
– Drink about 3-5 liters of water as water dilutes urine and there by hinders the stone formation.
– Drink enough to ensure the passage of 2000 ml / 70 oz of urine per day.
– Never let yourself to become dehydrated. Drink more water if you are doing strenuous work or are working
in hot humid climate.
– You can drink barley water and coconut water daily, it helps in removing stones.
– You can have 1-2 unit of beer; it is good for flushing out the stone. Take care not to over indulge. One unit
is about 285 ml beer.
• Drink lots of orange juice or other citrus fruit juices like – grapefruit, cranberry and grape juice. Citrus fruits
especially orange juice is rich in potassium and citrate, potassium citrate is commonly used to prevent kidney
stones.
• Reduce sodium intake. High sodium intake increases the risk of kidney stone by increasing urinary
saturation of calcium phosphate and monosodium rate and decreases the inhibitory activity against calcium
oxalate crystallization.
• Increase intake of fiber – bran, whole grains, oat, green leafy vegetables, peas, beans, potatoes, raw
• Consume good amount of B-complex vitamin daily, especially pyridoxine (Vitamin B-6) and B-1 (thiamine)
as their deficiency is associated with formation of stones.
• Reduce intake of sugar as it is associated with kidney stones.
• If possible stick to vegetarian diet. Studies have shown that plant sources of oxalates and calcium are not
the cause for stone formation. Diet high in animal protein affects certain minerals in the urine which aids in
the formation of kidney stones.
• Large quantities of water should be consumed to dilute the concentration of cystine in urine, which is
difficult. Drink at least a gallon of water per day and third of it should be drunk during the night.
• Consume buffered vitamin C, in the form of ascorbate.
• Consume diet low in mithionine:
– Foods high in methionine: broccoli, mushroom, cauliflower, potatoes, spinach, corn, avocado, nuts –
peanuts, pistachio, macadamia nuts; tofu, green beans, beans sprouts, dried beans – kidney beans, black
beans, tempeh, milk and eggs.
• High-homocysteine levels increase the risk of heart disease, avoid meat and saturated fats.

• If you have continuous pain with the above mentioned symptoms contact your physician for proper
diagnosis and treatment.
• Do not make changes in diet before medical evaluation of the stone / urine.
• If you notice blood or pus in urine see you physician immediately.
• If you have fever, frequent desire to urinate, continuous pain it is suggestive of infection see your physician
immediately.
• Do not self medicate or take any supplements without consulting your physician.
• If you pass stone in urine take it for medical evaluation / chemical analysis of its content.
DANDRUFF [DANDRUFF]
Dry white flakes of skin, on your scalp is known as dandruff.

• It is not a health risk, but is a source of embarrassment.
• Some people have the wrong notion that it is because of bad hygiene or washing the hair often - this is a
false belief. It is just that people having dandruff shed more skin then others.
• However some dermatologists suggest that is caused by a yeast fungus that is believed to breed in a
combination of sebaceous oil and dead skin cells.
CAUSES:
• A family history of dandruff.
• Excessive sweating of the scalp.
• Excessive mental and physical stress.
• Use of alkaline soaps.
• Cold dry winter season.
• Psoriasis of scalp.
• Seborrhoeic dermatitis.
• Improper carbohydrate and sugar consumption.
• Nutrient deficiencies – B-complex, essential fatty acids, selenium.
SIGN AND SYMPTOMS:

• Flakes of skin which may be small and white or large greasy and yellow.
• Itching on scalp, eyebrows, nose or ears.
• It can be worse in winters.
DIETARY MANAGEMENT:
Avoid:
• Avoid fatty and oily food.
• Avoid dairy products (except yoghurt) – cheese, cottage cheese and seafood.
• Avoid sugar, white flour and chocolate
• Avoid excess alcohol.
• Avoid stress.
• Even though dandruff is dry flaking skin do not normally apply excessive oil as it may provide an
environment for yeast to breed.
DO:
• Add one tea spoon of vinegar to the rinsing water after washing your hair.
• Before washing your hair, apply a mixture of 8 table spoon of pure organic peanut oil and 2 table spoon
lemon juice and massage into the scalp. Leave it for 10-15 minutes then shampoo.
• You can replace oil with coconut milk or coconut water; leave it over night and shampoo.
• Wash hair with natural, herbal ingredients rather than chemical – take mixture of amla (Indian goose berri)
powder, aritha (sapindus Laurifotius) powder and shikakai (Acacia Concinna) powder, soak it in water over
night and wash hair with the mixture.
• Practice yoga, helps in relieving stress and will increase blood circulation.
• Natural live yoghurt is recommended as a natural conditioner.
• Avoid harsh hair dyes and hair creams.
• Softly massage your scalp when you shampoo or oil. This will help blood circulation and prevent skin from
drying and cracking.
CONSUME:
• Eat large percentage of your diet as raw fruits and vegetables.
• Consume (3-4) nuts and seeds daily.
• Consume linseed oil – 2 table spoon.
• Consumption of Aloe vera juice is also helpful.
• Consume Kelp and Japanese sea plants frequently as they supply many minerals like iodine which are
better for hair growth and healing of the scalp.
• Increase intake of zinc in diet:
– Shellfish, beef and other red meats, eggs and seafood, milk and milk products, nuts, sea plants especially
Japanese sea.
• Consume diet rich in antioxidants like Vitamin A, Vitamin C and Vitamin E.
source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, maize oil, sesame oil, olive oil.
As all oils are high in fats, its consumption should be limited. The intake of oils should not exceed 20gms a
day.
• Consume lots of Selenium:
– Fish, shellfish, eggs, red meat, chicken, liver, grains, Brazil nuts, garlic, wheat germ and brewer's yeast.
• Consume lots of Vitamin B complex:
– Liver, kidney, pancreas, yeast (Brewer's yeast), lean meat especially pork, fish, dairy products, poultry, egg,
shrimps, crabs and lobsters,.
– Milk and milk products, green leafy vegetables, legumes, nuts, whole grain cereals.
– Carrots, bananas, avocado, raspberries, artichoke, cauliflower, soy flour, barley, cereals, pasta, whole
grains, wheat barn like rice and wheat germ, dried beans, peas and soybeans.
DEPRESSION [DEPRESSION]
Depression is a medical illness, which constitute feeling of hopelessness, feeling low with sadness and loss of
interest in regular and social responsibilities. It affects the body, mood, and thoughts of the person.
TYPES OF DEPRESSION:
Major depression:
It is a severe and short lasting form of depression, which is manifested by various symptoms that interfere
with the ability to work, sleep, eat, study and enjoy. At least five or more symptoms must be present and
should last for at least 2 weeks.
DYSTHYMIA:
It is chronic, less severe and long lasting form of depression; some times it can last for years together.
BIPOLAR DISORDER:
It is also known as manic-depressive illness. It is not as common as other forms of depressions; it is
characterized by repeated mood swings of abnormally high moods and low feeling, i.e. periods of mania and
depression.
CAUSES:
• Genetic. In some cases it runs in families especially the bipolar disorder.
• Environment:
– Unhappy family atmosphere.
– Very cold weather with short days and long nights.
• Social conditions:
– Poverty.
– Homelessness.
– Community violence.
• Medical conditions.
– Hypothyroidism.
– Hormonal changes.
– Some medications.
– Long term illness.
– Cancer.
– Stroke.
– Heart attack.
– Parkinson's disease.
• Person's reaction to events.
– Learning disabilities.
– Change in life style.
– Mental and emotional stress.
– Difficult relationship.
• Life events.
– Financial losses.
– Pregnancy.
– Miscarriage.
– Postpartum.
– Menstrual cycle changes.
– Pre-menopause, Menopause.
– After birth of a child.
– Single parenthood.
– Aging.
– Responsibilities.
• Thinking pattern:
– Low self-esteem.
– Pessimism.
• Sleep disturbances.
• Nutritional causes:
– Frequent and excessive consumption of caffeine and sugar.
– Deficiency of vitamin C.
– Deficiency of vitamin B complex.
– Mineral deficiency of iron, magnesium, selenium, calcium, copper and potassium.
– Excess of copper, magnesium and vanadium.
– Food allergies.
– Consumption of lots of food additives and food preservatives.
SIGN AND SYMPTOMS:

If a person has five or more of the following symptoms lasting for at least 2 weeks, he is in depression.
• Constant feeling of sadness and hopelessness.
• Feeling of worthless and helpless.
• Pessimistic.
• Guilty feeling.
• Desire to cry without reason.
• Anxiety and irritability.
• Continuous desire to cry.
• Loss of interest in daily activities.
• Staying aloof, indifference to friends and family.
• Poor memory and concentration.
• Increase or decrease in appetite and weight.
• Gets easily tired, lack of energy.
• Feeling of anger, frustration.
• Difficulty in concentrating.
• Indecisiveness.
• Sexual problems.
• Sleepless or very sleepy, early morning awakening or oversleeping, inability to fall a sleep, or stay asleep.
• Physical symptoms, pains, headaches, abdominal colic, do not respond to treatment.
• Indulgence in alcohol or drugs.
• Working long hours to keep self busy.
• Thoughts of death or suicide, suicidal attempts.
Mania in case of bipolar disorder:
• Abnormal or excessive excitement.
• Overactive and restlessness.
• Feels wonderful.
• Unusually increased irritability.
• Strikingly increased energy.
• Reduced hours of sleep.
• Spends money and travel.
• Loquacity.
• Increased sexual desire.
• Grandiose ideas.
• Gets many creative ideas.
• Continuous thoughts.
• Lack of judgment.
• Inappropriate social behavior.
• Becomes egocentric.
• Can be hostile and violent.
• May get hallucinations and delusions.
• Feeling of being god.
DIETARY MANAGEMENT:
Do's:
• Practice yoga, do meditations, will effectively reduce symptoms of depression.
• Do regular exercise, and eat a healthy well balanced diet.
• Try to relax and enjoy your favorite recreation as you used to do before.
• Give a surprise visit to your friend.
DON'TS:
• Do not believe in your negative thoughts.
• Avoid making major decisions during the episode of depression.
• Avoid food you are allergic too.
• Avoid alcohol and drugs.
• Avoid refined sugar, white sugar, honey, fructose, maple syrup etc. they deplete your body vitamins and
reduces the sugar levels in our body.
• Avoid caffeine, caffeinated drinks and nicotine completely or if you are drinking more then 4 cups of coffee
in a day, then have decaffeinated coffee and soft drinks.
• Avoid preservatives, dyes, additives, processed foods artificial colors and canned food they hinder in the
process of metabolism.
• Avoid smoking, dairy products, meat and eggs.
• Avoid simple sugar, Nutrasweet, Aspartame and all artificial sweeteners.
CONSUME:
• Eat food in a relaxed atmosphere, as stress decreases the ability of our body to metabolize food.
• Take enough time for lunch.
• Sometimes it is difficult to eat when you are depressed, eat small snacks several times a day.
• Drink plenty of water, at least 8 – 10 full glasses of water. Water is required for energy and for proper
functioning of brain and body.
• Keep a record of every thing you eat and observe how you feel after eating. If you feel tired, weak,
confused or low after eating, you may have a food allergy. Keep a track of it and avoid food you are allergic
too.
• Reduce intake of simple carbohydrates like breads, pastas, sugar, honey, candy, table sugar, syrups, and
carbonated drinks should be avoided.
• Fruits, vegetables, milk and milk products are also simple carbohydrates, but they also are best sources of
vitamins and minerals hence are essential. Should consume every day.
• Limit intake of saturated fats. Not more then 30% of total calories should come from fats.
• Consume foods that have quality fats i.e. foods high in essential fatty acids (EFA).
• Limit intake of foods high in cholesterol (not more then 300 mg a day).
• Protein intake should not exceed more then 60-65 gm / day for males and 50-55 gm / day for female. Note:
protein intake should not be lower then 55-60 gm for males and 45-50 gm per day. Choose proteins which
are high in essential amino acids.
• Increase intake of vitamin B complex. They are needed for energy production, nerve cell functioning and
metabolism of carbohydrates.
• Consume foods high in vitamin C, it increases immunity and is essential for neurotransmitter production.
Consume at least 100 mg / day of vitamin C.
• Increase intake of food high in vitamin E, increases blood circulation and protects the brain cells. Consume
at least 22.5 IU of vitamin E.
• Consume food high in choline or lecithin. Choline acts as a neurotransmitter and is very important for brain
function.
– Milk, eggs, liver, wheat germ and peanuts are rich in choline.
– Other sources are beef, shrimp, salmon, Atlantic cod, Brussels sprouts, broccoli and milk chocolate.
• Include garlic in your regular diet.
• Other foods like beans, pods, tofu, raw fresh fruits and fresh vegetables are good to alleviate depression.
• Include foods high in calcium and foods high in magnesium in your diet, as deficiency of calcium and
magnesium can be one of the cause for depression, as they are needed for energy production and proper
functioning of the nervous system.
• Iron deficiency will lead to fatigue, irritability, weakness and this inefficiency to work can cause depression.
Thus consume food high in iron to avoid iron deficiency.
• Increase intake of minerals like copper, potassium and selenium, are essential for mental alertness and
proper functioning of our body.
Consult your physician:

• Do not start antidepressants on your own, consult your physician instead.
• Talk therapy and short-term psychotherapies are effective seek help of your psychiatrist.
• Your psychiatrist will also help you to find the cause of depression and help you over come it.
• Certain medications like oral contraceptives, steroids and other drugs can cause depression, consult your
physician before discontinuing the medicines.
DIABETES OR JUVENILE DIABETES [DIABETES]
DIABETES / DIABETES INSIPIDUS / JUVENILE DIABETES

It is a metabolic disorder in which utilization of blood glucose by the cells of the body is impaired, leading to
high levels of glucose in blood and excessive excretion of glucose in the urine.
The main cause of high blood glucose levels in the body is decreased production of insulin (hormone
produced by pancreas) or the body does not properly utilize insulin.
Normal glucose levels:
Fasting: 80 – 110 mg/dl.
Post meals up to 140 mg/dl.
Bed time glucose levels should be between 100 and 160 mg/dl.
TYPES OF DIABETES:
• Type I diabetes:
Also known as insulin dependent diabetes and is usually diagnosed in children and young adults. It is an
autoimmune disease. An autoimmune disease results when the body's immune system attacks the body
part. Immune system is the system that protects our body from infections and diseases (resistance power). In
type I diabetes, the immune system (that protects our body) attacks the insulin producing beta cells in the
pancreas, thus pancreas produce little or no insulin (it is an enzyme which helps in glucose ). Type I diabetes
present in some people since birth is termed as Juvenile diabetes.
• Type II diabetes:
It is also known as non-insulin dependent diabetes and is usually present in adults. It is the most common
type of diabetes, about 90-95% of people with diabetes have type II diabetes. In this type of diabetes the
body cells are incapable to process insulin, condition called insulin resistance.
- Pre-diabetes: is a condition in which a person's blood glucose levels are higher than the normal but not high
enough to diagnose type II diabetes.
• Gestational diabetes (diabetes during pregnancy):
Gestational diabetes appears in about 2-5% of all pregnant women who never had diabetes. It is temporary
and fully treatable. About 20-50% of these women develop type II diabetes within 5 - 10 years.
Other types of diabetes - there are several types of diabetes which do not fit in to gestational, type I and type
II diabetes.
• Genetic defect in beta cells.
• Genetically related insulin resistance.
• Disease of pancreas.
• Caused by hormonal defects.
• Caused by chemicals or drugs.
• Malnutrition-related diabetes mellitus (MRDM)
CAUSES:
• Family history of diabetes.
• Genetic.
• Pregnancy.
• Severe illness.
• Severe infection.
• Virus.
• Chronic Pancreatitis.
• Stress.
• Dietary factors – too much of fats, little or no fruits, very little vegetables and minimum fibers.
• Sedentary life.
• Obesity.
• Ethnic groups :
• Whites have greater chances of getting type I diabetes.
• Native Americans, Hispanic Americans, American Indians, American Asians, African Americans, Pacific
Islander Americans, Alaska Natives, Native Hawaiians have greater chances of getting type II diabetes.
SIGN AND SYMPTOMS:

• Polyuria -Increase in frequency of urination.
• Polydipsia - Increased thirst.
• Dry mouth
• Dehydration
• Increased appetite
• Weight loss
• Irritability
• Fatigue
• Pain in calf muscles
• Nausea
• Vomiting
• Abdominal pain
• Headaches
• Blurring of vision
• Frequent infections
• Non healing wounds
• Impotency in males
• Frequent vaginal infections in females
• Ketoacidosis (acidic blood)
• Diabetic coma
COMPLICATIONS OF DIABETES:
• Hypoglycemia – due to improper management of the disease, over exertion or over medication.
• Gestational diabetes: macrosomia (high birth weight) and birth defects.
- Develop type II diabetes.
• Blindness – diabetic retinopathy, macular edema.
• Heart – hypertension, heart attack, ischemic heart disease.
• Blood vessel disease - arteriosclerosis
• Stroke,
• Kidney failure – diabetic nephropathy
• Necrosis, gangrene - amputations,
• Nerve damage – diabetic neuropathy.
• Diabetic coma.
• Liver failure.
• Secondary infections – tuberculosis.
DIETARY MANAGEMENT:
Your blood sugar level in your blood is closely connected to what you eat, so good and balanced nutrition is
most important for living a healthy life with diabetes. Correct choice of food and in appropriate amount will
help you to control your blood sugar levels, thus further preventing or delaying the complications. There is
no particular diet that will suit everyone; it depends on the treatment, individual sensitivity and on the
complication of the disease. So consult your physician before implementing any diet plans.
DO'S:
• Follow your doctor's instructions.
• Do not stop or take any medications on your own.
• Monitor your blood glucose by regular blood Glucose checking.
• Do regular exercise and practice yoga.
• Walk for at least 45 minutes regularly (follow advice of your physician).
• Take extra care for your foot if you get a cut or a bruise, blister or swelling, see your doctor immediately.
• Maintain your optimum weight.
• Always carry a packet of biscuits, candy, juice or sugar along, if you feel giddy have one or two biscuits or
one sweet. You may be hypoglycemic, see your physician Immediately.
• Loose weight if obese as with diabetes the risk of developing heart disease increases. Loose weight
gradually, one or two pounds a week.
AVOID:
• Do not undertake strict diet to loose weight without consulting your physician or a registered dietician.
• Avoid sugars and any thing, which is high in sugar content.
• Avoid artificial sweeteners.
• Avoid canned fruits.
• Avoid alcohol, smoking.
• Avoid high calorie diet – fried, oily or buttered food.
• Do not take appetite suppressants to control weight, they increase blood sugar levels.
• Avoid chocolate, pastries, jams, honey and sweets.
• Avoid potatoes, sweet potato, yam and other "underground vegetables".
• Avoid fruit like chickoo, mango and bananas, or just consume a single slice a day.
• Avoid sleeping in the day time.
CONSUME:
• consume frequent small meals at regular intervals through out the day, instead of eating heavy meals once
or twice a day. This will help to avoid extremes of high or low blood glucose levels.
• Consume snacks high in protein before sleeping, prevents hypoglycemia at night.
• Consume about 2000 calories a day of which 50-60% calories coming from carbohydrates, 20% from
proteins and less then 30% from fats.
• Pregnant woman needs 300 calories more from second trimester and extra 10-12 gm of protein for the
growth of the baby.
• Have plenty of salads before you start your meal.
• Carbohydrates:
- Consume complex carbohydrates (high fiber foods) then the simple carbohydrate diet, both will provide
similar amount of calories, but complex carbohydrates are high in fiber which helps in lowering the blood
glucose levels.
- Avoid sugar as every food contains little sugar, and they are of no nutritive value and considered as empty
calories.
- Consume bitter gourd (karela), string beans (Chaulee), cucumber (kakadi), onions and garlic which are very
beneficial for diabetics.
- Consume lots of green leafy vegetables, beans and legumes.
- As much as possible eat raw fruits and vegetables then cooked ones, cooked food increases blood glucose
levels as compared to raw food.
• Fiber:
- Consume high fiber diet (between 30 to 50 gm a day), it helps lowering the blood glucose levels - fruits,
vegetables, peas, beans and whole- wheat breads, bran, brown rice, oats, seeds, nuts, barley are good
sources of fiber.
- Note: do not exceed more then 60 gm of fiber a day it can lead to nutrition deficiencies.
• Proteins:
- Patients with diabetic kidney need to consume less protein.
- Consume protein more from plant sources then animal sources.
- Prefer fresh fish or soy protein to poultry or meat; consume fish not more then 2 servings per week.
• Fats:
- Consume low fat diet – avoid fried food or mayonnaise based food except if non-fat mayonnaise is used,
avoid egg yolk, bacon, butter etc.,
- Cholesterol intake should not exceed 200 mg per day.
- Consume Polyunsaturated fats (PUFA), and monounsaturated fats instead of saturated fats and cholesterol.
- Monounsaturated fats are mostly present in olive, canola, and peanut oils and in most nuts.
- Consume not more then 5gm of fats, as PUFA, monounsaturated fats or saturated fats they all provide
same amount of calories, though they are different in kind.
• Consume 3-4 nuts regularly as they are high in proteins, fibers and also PUFA
• Consume bitter gourd (karela) or have ½ cup or more of bitter gourd juice every day.
• Before buying any products from the market check its label for amount of fats, carbohydrates and proteins.
• Consume less of salt, not more then 2gm (2,000 mg sodium intake) a day.
• Add garlic, onions and herbs to your food.
• Also add turmeric to food, it lowers the glucose levels.
• Vitamins:
• Include foods that are rich in vitamin A, C, E as they have antioxidant property and thus protect from heart
diseases.
• Include adequate amount of B vitamins in your diet, certain B vitamins like folate, Vitamin B6 and Vitamin
B12 lowers the levels of homocysteine.
• Magnesium deficiency is usually seen in diabetics. The best sources of
magnesium are dark green vegetables, legumes,cereals, wheat bread, fish, and nuts.
• Chromium deficiency is observed to be a risk factor for diabetes type II. Shellfish, fish, eggs, wholegrain
cereals, nuts are good sources of chromium.
• Zinc deficiency is also observed in patients with diabetes Type II. Zinc is abundant in certain seafood, and
whole grains.
• Moderate alcohol intake is beneficial, especially red wine. One should limit to 1 drink per day for women
and 2 drinks per day for men. Pregnant women and people at the risk of alcoholism should not consume
alcohol.
• Tea has proved to have beneficial effects on the heart, as it is rich in flavanoids and thus protects from
damage from LDL, green tea as well as black tea are beneficial for arteries.
NOTE:
• Diet low in protein and salt along with high intakes of fluids can lead to hyponitremia, which can cause
fatigue, confusion and can be life threatening.
• One gram of carbohydrates equals four calories.
• One gram of fat is equal to 9 calories, whether it's saturated or unsaturated.
• One gram of protein contains four calories.
DIARRHEA OR DYSENTRY [DIARRHEA]
DIARRHEA/ DYSENTRY
Diarrhea is frequent passage of loose or watery unformed stools, commonly known as loose motions.
Large number of loose motions containing blood and mucus is called dysentery.
CAUSES:
• Infection, viral, bacterial or parasitic.
• Consumption of contaminated or stale food.
• Low socioeconomic status – because of the bad hygienic conditions.
DIARRHEA:
• Certain drugs – antibiotics, etc.
• Food allergy.
• Chronic, over consumption of alcohol.
• Over eating especially a rich fatty food.
• Malabsorption of various foodstuffs like – milk, coffee, wheat etc.
• Ulcerative colitis
• Irritable bowel syndrome
• AIDS
• Emotional disturbances.
• Stress induced diarrhea, nervous diarrhea.
• Cancer.
DYSENTERY:
• Infestation with bacteria – bacillary dysentery.
• Infestation with amoeba – amoebic dysentery.
• Person to person contact – if you share a towel/ food with the infected person.
• Crowded places are source of infection.
SIGN AND SYMPTOMS:

Diarrhea:
• Frequent passage of loose voluminous, watery stool.
• Abdominal pain and flatulence.
• Occasionally associated with vomiting and low-grade fever.
• Later will have symptoms of dehydration - muscle cramps, decreased urination fatigue, disorientation, and
fast pulse.
• Dehydration in children occurs much faster.
Dysentery:
• Can start with mild loose motions to about 20 stools per day.
• Gripping pain in abdomen.
• Blood and mucus in stools.
• Fever.
• Vomiting.
• Weakness.
• Other symptoms depend on the organs involved e.g. liver – jaundice; lungs –breathlessness, cough; etc.
DIETARY MANAGEMENT:
• Drink plenty of fluids every 15-30 minutes.
– Boiled water with sugar and salt.
– Lemon water with sugar and salt,
– Butter milk, coconut water, barley water.
• Foods high in potassium are important to restore the body's essential stores depleted during diarrhoea.
Such foods include lentils, bananas, mangoes, pineapples, pawpaw, coconut milk and citrus fruits.
• Take oral electrolyte solutions – dioralyte.
• In case of infants start oral rehydration (the above measures) as soon as diarrhea begins.
• Continue breast-feeding and extra food supplement to the infant (if the child is being weaned), breast-
feeding provides the immunity to the infant.
• Avoid solid foods for at least 24 hrs. You can start with - light, bland food
– Porridge, boiled rice, boiled vegetables, dry toast.
– Stewed apple, boiled potatoes.
– Consume plenty of vegetable soups and juices - as they are rich in minerals and salts and help to replace
lost body fluids.
– Curds, kanji (starch prepared from boiled rice)
– Pomegranate.
• Avoid raw food, non-vegetarian, spicy and seasoned food.
• Avoid milk and milk products.
NOTE:
• Avoid eating stale food.
• Wash and cook food properly, make sure food is not half cooked.
• Maintain personal hygiene.
• Do not eat from the roadside vendors.
• Do not self medicate with drugs.
• Treat the cause – in case of bacterial, viral or parasitic infestation.
DYSPEPSIA AND INDIGESTION [DYSPEPSIA]
Improper function of digestion is known as dyspepsia / indigestion.
CAUSES:
• Over eating.
• Eating too quickly and not chewing food properly.
• Eating diet rich in fats.
• Eating indigestible things – chalk.
• Smoking, alcohol, drinking too much of caffeine.
• Increase in acid secretion due to intestinal disease.
• Stress.
• Antibiotics and other drugs (prolong use)
• Liver and pancreatic disease.
• Intestinal tuberculosis.
SIGN AND SYMPTOMS:

• Pain in the center or left upper abdomen, which increases after meals.
• Chest pain on bending / lying down after meal.
• Nausea and vomiting.
• Tongue coated, salty, sour fluid regurgitates.
• Sometimes diarrhea or constipation.
• Belching or gas formation.
• Abdominal bloating.
DIETARY MANAGEMENT:
• Avoid stress.
• Take a light diet consisting of porridge, rice, lentils or have boiled green grams.
• Add a pinch of asafetida in your food – it helps in proper digestion of the food.
• Take plenty of fluids.
• Eat fresh fruits and salad.
• Add curd or butter milk to your meals, helps in digestion.
• Avoid hot, spicy food. Eat blend and boiled food that is easy to digest.
• Eat slowly and chew food properly.
• Avoid alcohol, smoking.
• Avoid fatty food.
• Avoid dairy products and meat food.
• Avoid over eating, take small meals instead of one large meal.
• Avoid drugs that causes stomach upset.
• Do not exercise, bend, stoop / sleep immediately after meals.
DYSPHAGIA [DYSPHAGIA]
Difficulty in swallowing solids or liquids is called dysphagia.
CAUSES:
• Enlarged tonsils.
• Cancer of the oral cavity.
• Fungal infection of the mouth.
• Cerebro-vascular accidents.
• Motor neuron disease [a nerve disorder].
• Myasthenia gravis [fatigue and exhaustion of the muscular system with progressive muscular paralysis].
• Parkinsonism [a group of neurological disorder marked by diminished motor activity, tremor and muscular
rigidity].
• Pharyngo-esophageal diverticulum [pouch/sac].
• Pharyngeal pouch.
• Post-cricoid web.
• Achalasia [failure of the sphincter at the junction of the esophagus and the stomach, to relax].
• Diffuse esophageal spasm.
• Abnormal course of subclavian artery.
• Oesophagitis.
• Peptic stricture.
• External compression from mediastinal masses.
• Dilated left atrium [chamber of heart] in mitral stenosis.
SIGN AND SYMPTOMS:

• Difficulty in swallowing solids or liquids or both.
• Nasal regurgitation or cough, while swallowing.
• Difficulty in swallowing when watched by others [in Parkinsonism].
• Sensation of fullness in the middle of the chest with a feeling as if the food had stopped somewhere along
the esophagus.
• Regurgitation relieves pain and fullness in the centre of the chest.
• Cough.
• Need to drink water while eating.
• Can lead to malnutrition.
DIETARY MANAGEMENT:
• Eat soft, semisolid or mashed food, which is easy to swallow.
• Consume soups – vegetable, tomatoes, and green leafy vegetables etc.
• Have fruits juices, sugarcane juice, buttermilk, and milk.
• Make different porridge- wheat porridge, rice porridge or lentil porridge etc.
• Boil food properly and then mash it so it's easy to swallow.
• Try to make different varieties so all nutrients are consumed to prevent malnutrition.
• Eat small quantities of food at regular intervals.
• In severe cases where food is supplied to the body through food pipe,feed different varieties of soups,
porridge and juices.
NOTE:
• Do not speak while eating.
• Eat your food very slowly.
• Chew the food well.
ECZEMA OR DERMATITIS [ECZEMA]
It is a chronic inflammatory condition of the skin causing a distinctive pattern of symptoms such as itching,
scaling, thickening of skin and discoloration of skin.
CAUSES:
• Heredity.
• Can be associated with asthma.
• Allergic – dust mites, detergents, rubber, nickel plated jewellery.
• Stress – physical or emotional.
• In babies diaper rash or napkin eczema is possible.
SIGN AND SYMPTOMS:

• Intense itching.
• Dry thickened skin usually on wrists, face, knees, and elbows.
• Small eruptions and blisters that may ooze fluid.
• Occasional redness and scaling.
• Rash.
• Dry leathery skin areas.
• Skin is abnormally dark or light in color than the normal skin.
• Raw areas of the skin from scratching.
DIETARY MANAGEMENT:
• Do not scratch especially with long nails. It may lead to secondary infection.
• Avoid foods you are allergic to.
• Avoid nickel plated jewellery, cosmetics, and other articles that give you skin complaints.
DO:
• You can apply non-medicated ointments like petroleum jelly to soothe the irritation.
• Yoga will help to relax and de-stress yourself.
• When washing or bathing, use less soap than usual. After bathing, apply lubricating cream on the skin while
it is damp.
• Avoid eggs, fish, peanuts and soy.
• Avoid dairy products, sugar, white flour, fried foods and processed foods.
• Avoid the excess fat from meat – buy lean and preferably organic.
• Avoid sugar, gluten (wheat, barley, rye and oats) and raw eggs.
• Avoid soft drinks and oranges (if allergic to oranges).
CONSUME:
• Consume lots of fresh and raw fruits and vegetables.
• Eat healthy diet, including five portions of vegetables per day, brown rice, millet, oily fish and a little fruit
(no oranges).
• Consume diet rich in vitamin A and zinc, helps in regeneration of the skin.
• Diet rich in vitamin A:
– Liver oils of fish, egg, milk and milk products,
– Yellow orange colored fruits and vegetables; green leafy vegetables are good source of - carotene.
• Foods rich in zinc:
– Shellfish, beef and other red meats, eggs and seafood, nuts, sea plants especially Japanese sea plants.
• Increase intake of vitamin C, it helps maintain healthy skin:
– Milk and milk products, citrus fruits, green vegetables
– Fruits and vegetables when fresh have maximum of vitamin C.
• Have coriander leaves frequently, its high in vitamin C and helps to maintain healthy skin.
• You can have 3-4 strands of saffron in milk, it is beneficial for skin.
• Basil leaves (tulsi) are said to be helpful in skin ailments, eat 3-4 fresh leaves daily.
• Breast feed your child; breast milk increases the immunity of your child and helps preventing eczema in
future.
CONSULT PHYSICIAN:
• In case of prolonged duration or change in rash pattern take physicians opinion immediately.
• If symptoms get worse or if you see any Signs of infection (fever, redness of the affected area, pain) occur,
see your physician immediately.
FLATULENCE [FLATULENCE]
It is gas formation in stomach and intestine.
CAUSES:
• High fiber diet – beans, vegetables, fruits and grains.
• Partially digested food on which bacteria can grow and produce gas.
• Constipation.
• Ingestion of air in the digestive tract while eating / drinking – when eating too quickly, while drinking
through straw, smoking, and while eating chewing gums.
• Infection of digestive tract may increase the gas production.
• Obesity.
SIGN AND SYMPTOMS:

• Bloating of abdomen.
• Pain in abdomen.
• Audible passage of air – as belching from mouth or as flatus from rectum.
• Gas can be offensive.
DIETARY MANAGEMENT:
• Go for a walk after meals, but not do brisk walking.
• Eat slowly and chew food properly.
• If gas is offensive, limit intake of proteins like- meat, eggs.
• Limit intake of high carbohydrates – rice, potatoes, sweet potatoes etc.
• Avoid pulses and fibrous vegetables like cabbage and cauliflower.
• Avoid cheese, beans, alcohol, soy sauce, carbonated drinks – coke etc.
• Avoid fried and spicy food.
• Add little garlic and asafetida in your diet – helps in digestion and prevents gas formation.
• Take plenty of fluids.
• Avoid over eating, frequent small meals are advisable.
• Curd and butter milk may help to change the intestinal flora.
• If over weight reduce weight.
FLUOROSIS [FLUOROSIS]
Fluorosis is toxic effect of excess of fluoride intake.
CAUSES:
• Drinking water is the main source of high fluoride: drinking water containing more then 1.5 mg/liter of
water (the WHO guideline value for fluoride in water).
• Agriculture contamination – food.
• Use of coal as an indoor fuel source.
• Excess use of toothpaste.
• Water derived from borewells, dug deep down into the earth.
SIGN AND SYMPTOMS:

The dental fluorosis develops before the skeletal fluorosis in people exposed to high fluoride intake.
• Dental fluorosis:
– Teeth loose their shine.
– White chalky patch appear on them.
– Mottling of the teeth enamel.
– Yellow staining and pitting of the teeth.
• Skeletal fluorosis:
– Stiffness and pain in joints especially back and neck.
– Difficulty in movement.
– Ligaments may calcify with impairments of muscles and pain.
– Thickening of bone.
– Marked periosteal proliferation.
• Acute exposure to high level of fluoride:
– Abdominal pain.
– Excessive salivation.
– Nausea and vomiting.
– Seizures and muscle spasms may also occur.
DIETARY MANAGEMENT:
• Fluorosis can be prevented but cannot be cured.
Avoid:
• In affected areas food containing fluoride should be avoided:
– Sea food – fish, shellfish, crab etc.
– Cheese, tea and gelatin.
• Toothpaste containing fluoride should not be used.
DO:
• Drinking water should be analyzed for the fluoride levels in water. Fluoride levels of drinking water should
not be more then 1.5 mg/liter. In endemic areas where fluoride content of water is high, de-fluoridation
(removal of excess of fluorine) is the only solution.
• Mothers in affected areas should breastfeed their infants as breast milk is low in fluoride.
CONSULT PHYSICIAN:
• If any of the above symptoms appear see your physician, as fluorosis can be prevented but not cured.
GASTRITIS [GASTRITIS]
Inflammation of the mucosa of the stomach.
CAUSES:
• Stress – mental or emotional.
• Increased acid secretion in stomach.
• Taking drugs empty stomach – aspirin, antibiotics, steroids or any drug that acts on the mucous membrane.
• Smoking and alcohol.
• Infection- viral or bacterial.
• Over eating, eating indigestible food and eating contaminated food.
• Highly hot and spicy food.
• Allergic to certain food.
• Consumption of chemicals and food additives.
• From radiations.
SIGN AND SYMPTOMS:

• Coated tongue.
• Bad taste in mouth.
• Headache.
• Fever.
• Occasionally diarrhea.
DIETARY MANAGEMENT:
• Eat bland light diet – porridge, soups, boiled green grams.
• Avoid spicy food.
• Eat slowly and chew properly.
• Have fruit juices, lentils and rice.
• Increase intake of vitamin A and zinc will help in healing the stomach mucosa
- Fruits like papaya, melons, apricots, peaches, etc.
- Vegetables like - cantaloupes, pumpkins, carrots, sweet potatoes, broccoli, green leafy vegetables –spinach,
mustard leaves, fenugreek leaves etc.
- Have porridge of whole wheat.
• Do not drink milk, have plenty of fluids.
• Avoid food that is allergic to you.
• Avoid tea, caffeinated drinks and carbonated drinks.
• Eat regularly and at regular times. Do not eat between the meals.
• Avoid alcohol and smoking.
• Try to have stress free life.
• Slow walking after meals.
• Avoid drugs like- aspirin, antibiotics etc.
• Can take fish liver oil supplements.
GASTROENTRITIS OR ENTERITIS [GASTROENTRITIS]
GASTROENTRITIS/ ENTERITIS
Inflammation of the stomach and intestine is known as gastroenteritis / enteritis
CAUSES:
• Acute infection mainly due to bacteria- [Salmonella, Staphylococcus, Listeria (from soft cheese),
Campylobacter (from contaminated poultry, fish or unpasteurised milk), Spigellia, E. coli, Vibrio cholerae,
clostridium difficile.
• Viral – rotavirus, which spreads by direct contact with either vomiting or diarrhea.
• Food poisoning toxins.
• Spreads from person to person, close contact with infected pets.
• Uncooked meat.
• Ingestion of contaminated food, stale food.
• Infected cattle- through unpasteurised milk.
• Poor hygiene, low socioeconomic conditions.
SIGN AND SYMPTOMS:
• Sudden development of symptoms after eating contaminated food.
• Watery diarrhea, dysentery – may contain blood, mucous.
• Stools first yellow then becomes colorless, watery & copious with flakes of the mucus (rice water).
• Pain at anus while passing stool.
• Nausea and retching followed by vomiting, copious and incessant watery vomit.
• Stomach pain – cramps in stomach.
• Abdominal cramps.
• Fever – 100 -102ºFahrenheit.
• Headache
• Anorexia
• Malaise
• Dehydration after diarrhea and vomiting – muscle cramps, headache, fatigue, disorientation, decreased
urination and fast pulse.
• Collapse – subnormal temperature.
DIETARY MANAGEMENT:
• Drink plenty of fluids every 15-30 minutes.
– Boil one glass of water (250 ml) with 2 tbsp sugar and one pinch of salt. You can also add 1/2 a lemon juice
and glucose.
– Lemon water with sugar and salt,
– 2 teaspoonfuls of apple/ carrot juice in boiled water.
– Butter milk, coconut water, barley water with skimmed milk in 1:1 ratio.
– Watermelon juice, sugarcane juice.
• Take oral electrolyte solutions – dioralyte.
• In case of infants start oral rehydration (the above measures) as soon as diarrhea begins, infants get
dehydrated very fast.
• Continue breast-feeding and extra food supplement to the infant (if the child is being weaned), breast-
feeding provides the immunity to the infant.
• Avoid solid foods for at least 24 hrs. You can start with - light, bland food
– Porridge, boiled rice, boiled vegetables, dry toast.
– Stewed apple, boiled potatoes, china grass, and ripe banana.
– Consume plenty of vegetable soups and juices - as they are rich in minerals and salts and help to replace
lost body fluids.
– Curds, kanji (starch prepared from boiled rice)
• Avoid other milk products, raw food, non-vegetarian, spicy and seasoned food till complete recovery.
NOTE:
• Avoid spicy and seasoned food.
• Milk and water should be boiled before drinking.
• Avoid eating uncovered and stale food.
• Maintain personal hygiene.
• Avoid eating food in restaurants where sanitation and hygiene is doubtful.
• Do not consume anything from roadside vendors.
GINGIVITIS [GINGITIVIS]
Gingivitis is inflammation of gums.

CAUSES:
• Plaque formation- a layer of bacteria and other organic matter on the surface of tooth.
• From diet in refined sugars
• Vitamin C deficiency
• Poor dental hygiene.
SYMPTOMS:
• Red angry appearance of gums
• Bleeding on touch
• Bleeds on eating, chewing and swallowing
• Bad breath
• Salivation increased.
• In extreme conditions - Difficulty in speech.
DIETARY MANAGEMENT:
• Eat bland and soft food.
• In case of severe pain consume liquid or semi solid food.
• Consume lots of vitamin C-
- Fruit juice – citrus fruits like- orange, lime, strawberries, grape fruits, mango, amla (Indian Gooseberry) etc.
- Vegetable soups –tomatoes, green leafy vegetables- spinach, tangerines etc.
- Eat boiled vegetables- cabbage, broccoli, tubers- potatoes and sweet potatoes.
• Avoid solid food that has to be chewed.
• Avoid too much intake of sugar.
• Drink lots of water.
• Avoid smoking.
• Take warm food, avoid too hot or too cold food / drink.
• Clean your mouth with water every time you eat.
• Massage gums with vegetable oil, a pinch of salt and turmeric (turmeric has antiseptic property).
GLUTEN INTOLERANCE [GLUTEN]
GLUTEN INTOLERANCE (CELIAC DISEASE)

Gluten intolerance is a celiac disease, which is due to allergic reaction to gluten, a protein found in wheat,
barley, rye and oats.
Incidences:
• Ethnics – northwestern European are more prone to suffer.
• Females are more prone to suffer than males.
• Children are more affected than adults.
CAUSES:
• Inability to absorb gluten
• Hereditary.
• After bowel infection.
• It can be triggered by over exposure to –
– wheat
– severe stress
– emotional or physical trauma
– surgery
– Viral infections.
SYMPTOMS:
• Abdominal bloating.
• Abdominal pain.
• Diarrhea.
• Light colored stools.
• Foul smelling stools.
• Weight loss.
• Malnutrition.
• Urticaria.
• Angioedema.
• Emotional disturbances.
• Irritability.
• Depression.
• Muscle cramps.
• Joint pains.
• Fatigue.
• Menstrual irregularities.
COMPLICATIONS:
• Cancer.
• Irritable bowel syndrome.
• Osteoporosis.
• Anemia.
• Seizures.
• Vitamin mineral deficiency.
DIETARY MANAGEMENT:
• Strictly follow gluten free diet.
• Avoid foods containing gluten - wheat, rye, barley, oat in your diet.
• Avoid breads, cakes, biscuits, tinned and frozen foods, they contain gluten as thickeners.
• Check labels for words like – farina (semolina, rava), flour, enriched flour, malt flavoring or extracts,
caramel coloring, cereals, monosodium glutamate (MSG), modified food starch, stabilizers, distilled vinegar,
emulsifiers, semolina, durum and triticale, avoid these products as they all contain gluten.
• Note: - products labeled as wheat free are not necessarily free of gluten.
• Check labels on canned soups, Ketchup, mustards, soy sauce and other sauces as gluten is used as
thickener.
• Consume fresh vegetables, root vegetables like potato, yam, sweet potato etc.
• Consume fresh fruits, beans, rice, millets, maize, nuts and seeds, eggs, cheese, butter, honey, jam etc.
• You can eat meats, fish and poultry.
• You can consume gluten free sausages and biscuits available in the market.
• You can eat buckwheat and quinoa as they are gluten free cereals, but avoid wild rice and spelt as they
contain gluten.
• Here is a list of foods that are gluten free:
-rice,cassava
-corn (maize)
-soy
-potato
-tapioca
-beans
-sorghum
-quinoa
-millet
-buckwheat groats (also known as kasha)
-arrowroot
-amaranth
-flax
-chia
-yucca
-gluten-free oats
-nut flours
GUM BLEEDING [GUMBLEEDING]
Bleeding from gums.
CAUSES:
• Inflammation of gums (gingivitis).
• Inflammation of oral cavity.
• Bleeding disorders-
– Thrombocytopenia
– Haemophilia
– Leukemia
– Absence of anticoagulants
• Abnormalities of vessel walls-
– Scurvy
– Purpura
• Disease of connective tissue
– Pseudo-xanthoma
SIGN AND SYMPTOMS:

• Bleeding from gums.
• Swelling of gums.
• Burning in oral cavity.
• Pain while chewing.
• Occasionally ulcer on the gums.
DIETARY MANAGEMENT:
• Treat the causes.
• In case of continue bleeding apply ice to stop bleeding.
• Massage gums with vegetable oil, a pinch of salt and turmeric (turmeric has antiseptic property).
• Avoid solid food that has to be chewed.
• Eat bland and soft food.
• Consume lots of vitamin C, vitamin B12 and folic acid -
– Fruit juice – citrus fruits like- orange, lime, strawberries, grape fruits, mango, amla (Indian Gooseberry) etc.
– Vegetable soups –tomatoes, green leafy vegetables- spinach, tangerines etc.
– Eat boiled vegetables- cabbage, broccoli, tubers- potatoes and sweet potatoes.
– Milk and milk products.
– Boiled or scrambled egg.
– Wheat porridge.
– If pain is not too much you can have well-cooked (soft) meat, kidney, liver, pork, sea food- shellfish,
shrimps, crabs, lobsters.
• In case of pseudo-xanthoma avoid food rich in fats - you can include sesame oil, mustard oil, oily fish,
linseed oil, skimmed milk and low fat milk products in your diet in small quantities.
• Take warm food, avoid too hot or too cold food / drink
• Avoid sweets and carbohydrates.
HEART ATTACK [HEARTATTACK]
A heart attack happens when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes
blocked and the heart can't get oxygen.
CAUSES:
• Inadequate supply of blood and oxygen to the heart is the main reason.
• Sedentary life.
• Obesity.
• Chronic consumption of alcohol.
• Hypertension.
• Family history.
SIGN AND SYMPTOMS:

• Severe pain in chest – crushing, constricting, sharp, burning pain with feeling of strangling and suffocation.
• Pain may radiate to both arms or mostly along the left arm to the little finger and the jaw, teeth, neck
throat, epigastric region and between the shoulder blades.
• Breathlessness.
• Dizziness.
• Sweating.
• Irregular heart beats.
• Pale bluish lips or fingernails.
• Clammy skin.
• anxiety and fear.
DIETARY MANAGEMENT:
Patients with history of heart attack or family history should take following dietary measures to prevent the
heart attack again.
• A healthy diet is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugars.
meat), tallow (fats derived from goat or sheep mutton) – all non-vegetarian food contain cholesterol in
varied amount.
source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, sesame oil, olive oil. As all oils
are high in fats, its consumption should be limited. The intake of oils should not exceed 20gms a day.
• Take high fiber diet - whole grains, bran, oat, green leafy vegetables etc.
• Consume food rich in magnesium.
– Nuts and sea food, green leafy vegetables, sea plants like Japanese sea plants, whole grains, peas, lotus
stem, pulses, legumes and oil seeds.
– Citrus fruits, green leafy vegetables, vegetables- cabbage, broccoli, tubers- potatoes and sweet potatoes.
– milk and sea food, nuts- ground nuts, walnut, almond and cashew nuts; green leafy vegetables, whole
grains, fruits like - custard apple and banana.
– Peas, lotus stem, pulses, legumes and oil seeds.
NOTE:
• See you doctor for regular heart checkups.
• Do regular exercise or brisk walking for at least 40 minutes.
HYPERCHOLESTEROLEMIA [HYPERCHOLESTROL]
It is an excess of cholesterol in the blood. It is an important risk factor for atherosclerosis.
CAUSES:
• Inherited, as an autosomal dominant trait called familial hypercholesterolemia.
• Family history of hyperlipidemia or xanthomas indicates a genetic cause.
• Age - men and women below age 50.
• Drugs-oral contraceptives, antihypertensive, glucocorticoids.
• Diet rich in fatty food e.g.: cheese, butter, oil etc.
• Physical inactivity.
• Emotional stress.
• Alcohol intake.
• Disorders to which hypercholesterolemia are secondary-
– Hypothyroidism
– Uncontrolled diabetes [insulin deficiency]
– Uremia
– Nephrotic Syndrome
– Obstructive liver disease
– Dysproteinemia [multiple myeloma, lupus erythromatosus]
SIGN AND SYMPTOMS:

• Increased blood pressure.
• Xanthomas- eruptive, palmer or plantar, tendon xanthomas, pseudo xanthomas.
• Lipaemia (presence of abnormally large amount of fat in the blood) retinalis.
• Acute inflammation of the pancreas.
DIETARY MANAGEMENT:
• Eat plenty of vegetables and fruits - 7 servings or more each day
• Eat whole grain foods rich in soluble fibre – oats, psyllium and barley
• Include 2 Omega 3 rich fish meals per week – salmon, trout, sardines
• Include 2 bean based meals per week – kidney beans, chickpeas, lentils
• Eat nuts such as almonds and walnuts – small portions 5 times a week
• Improve the quantity and quality of fats you eat. A diet rich in saturated fat increases the LDL level.
Saturated fats are found in sausages, butter, meat pies, ghee or clarified butter, lard, cream, cheese, cakes,
and coconut or palm oil.
• Saturated fats should be replaced by unsaturated fats, which increase the level of high-density lipoproteins
(HDLs) or "good" cholesterol. HDLs carry cholesterol away from cells to the liver, where it can be broken
down and processed as waste.
• Foods that are high in unsaturated fats include avocados, nuts, seeds, oily fish, sunflower oil, rapeseed oil
and olive oil.
• Oils are best for added fat – use small amounts, avoid frying
• If your triglycerides are high, limit sugars and alcohol.
• Fibre is found in plant based foods. Vegetables, fruit, whole grains, nuts, seeds, beans, peas and lentils are
all great fibre sources.Functional or "soluble" fibre helps to reduce cholesterol by binding with cholesterol in
your stomach and bowel.
• Eat more barley, oatmeal, sunflower seeds, almonds, soy, tofu,chickpeas, black beans, kidney beans, lentils,
Brussels sprouts, carrots, apples, bananas, pears, oranges, grapefruit, prunes, blackberries.
Note[Note]
• Be active – move your body 30 minutes each day
• If you are overweight, work to reduce your weight by 10%
HYPERTENSION [HYPERTENSION]
Blood pressure which remains consistently high and not just once / twice is termed hypertension.
Blood pressure is measured in two parameters. One is systolic (upper) and second is diastolic (lower), 120/80
mm of mercury, is the normal reading. But a lot of doctors consider 140/90 mm of mercury within the
normal range in young adults.
CAUSES:
• In most cases the cause for high blood pressure is not known.
• Familial heredity.
• Stress.
• Kidney pathology
• Hormonal imbalance.
• More than 80% of hypertension is "Essential hypertension" for which no cause can be found.
COMPLICATIONS:
• Stroke
• Heart attack.
• Damage to kidney.
SIGN AND SYMPTOMS:

• Majority cases of hypertension are detected accidentally as many are asymptomatic.
• Headaches on exertion or from sun.
• Chest pain or tightness.
• Palpitations.
• Tingling and numbness
• Muscle cramps.
• Nosebleeds and profuse perspiration are rare symptoms.
DIETARY MANAGEMENT:
DASH (Dietary Approaches to Stop Hypertension) diet is common diet recommended in hypertensive
patients.
• Cut down salt (common table salt) intake in your diet; do not exceed more then 2 to 2.5 gm a day.
• In case of severe hypertension do not consume salt at all till the blood pressure lowers down. Later you can
start with balanced diet with low salt and fats in your diet.
• Add very little salt to food; do not add salt to cooked food.
• Avoid other sources of salts like- baking powder and baking soda (sodium bicarbonate), monosodium
glutamate and sodium benzoate. These are commonly known as Worcestershire sauce, soy sauce, onion salt,
garlic salt and buillon salt.
• Avoid salt-preserved foods like ketchups, sauces, pickles, canned and processed foods.
– Sea food, nuts, green leafy vegetables, sea plants like Japanese sea plants, whole, peas, lotus stem, pulses,
legumes and oil seeds.
– Milk, nuts and sea food, green leafy vegetables, whole grains, peas, lotus stem, pulses, legumes and oil
seeds.
– Certain fruits like - custard apple and banana are high in calcium.
• Reduce intake of diet rich in saturated fats e.g. meat, eggs, milk products, cheese, butter etc.
• Avoid foods rich in cholesterol: ground nut oil, ghee, butter, , lard (fats derived from pig meat), tallow (fats
derived from goat or sheep mutton), oily fish and red meat – all non-vegetarian food contain cholesterol in
varied amount.
source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, sesame oil, mustard oil and
olive oil. As all oils are high in fats, its consumption should be limited. The intake of oils should not exceed
20gms a day.
• Avoid coffee and caffeinated drinks.
HYPERTHYROIDISM [HYPERTHYROIDISM]
Hyperthyroidism / thyrotoxicosis is a clinical condition, resulting from excess of circulating thyroid hormones
T4 (normal range 5.5-12.5 µgm/dL) and / or T3 (normal range 80-200 mg/dL).
CAUSES:
• More common between the age of 20 and 40.
• It often starts after times of extreme stress or during pregnancy.
• Diffuse Toxic Goiter (enlargement of the thyroid gland)- Grave's disease.
• Nodular goiter
• Hashimoto's thyroiditis.
• Iodine induced thyrotoxicosis.
• Cancer of thyroid (secondary).
• Ovarian struma.
• Hydatidiform mole.
• Thyroid stimulating Hormone (TSH) pituitary tumor.
• Ingestion of excess quantities of thyroid hormone, termed thyrotoxicosis factitia.
• High-dose radiation therapy.
SIGN AND SYMPTOMS:

• Trembling hands.
• Increased appetite.
• Weight loss in spite of eating well.
• Sometimes may have weight gain due to increased appetite.
• Heat intolerance.
• Nervousness.
• Insomnia.
• Breathlessness.
• Palpitations.
• Chest pain.
• High blood pressure.
• Increased bowel movements.
• Light or absent menstrual periods.
• Muscle weakness.
• Fatigue
• Warm moist skin.
• Hair loss.
• Irritability.
• Mood swings.
• Restlessness
• Hyperactivity.
• Non- infective diarrhea.
• Occasionally double vision, undue prominence of eyes, irritation, photophobia, excessive lachrymation.
• Staring gaze, lid lag, lid retraction, and mild degrees of conjunctival injection.
• Visible swelling in the middle of neck goiter.
• Vitiligo (white discoloration of skin).
• Infiltrative ophthalmopathy (common) and dermopathy (uncommon), which are autoimmune
manifestations of Graves' disease and are not seen in other cause.
• Occasionally, raised, thickened skin over the shins, back of feet, back, hands, or even face.
• In crisis: fever, very rapid pulse, agitation, and possibly delirium.
DIETARY MANAGEMENT:
Avoid:
• Avoid smoking, alcohol.
• Avoid tea, cola and chocolates.
• Avoid refined foods, dairy products and wheat.
CONSUME:
• Consume vitamins and minerals, high protein and high calorie diet.
• Vitamin C increases the levels of antioxidants and helps to regulate the thyroid gland. B complex vitamins
are another example of vitamins that can help hyperthyroid patients. They help to build the immune system
and stabilize the digestive process, which goes off track due to increased metabolism in hyperthyroid
patients.
• Consume food that depresses the thyroid - broccoli, cabbage, Brussels sprouts, cauliflower, kale, spinach,
turnips, soy, beans, and mustard greens.
• Increase consumption of Omega-3 fatty acids, Vitamin D, Calcium, Vitamin E, magnesium and Phosphorous.
• Omega-3 fatty acids are anti-inflammatory and help immune system function properly.
• Sources of Omega-3 fatty acids: Fish and fish oils provide excellent forms of omega-3s. Flax / linseed oil is
the richest source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, cottonseed oil,
maize oil, sesame oil, rich bran oil, ground nut oil, mustard oil and olive oil.
• Add little Turmeric to food as it has an anti-inflammatory property.
CONSULT PHYSICIAN:
• Consult your physician immediately in case of thyroid crisis - high temperature with flushing and sweating,
extreme tachycardia (fast pulse rate), restlessness and agitation, frequent diarrhea with dehydration.
• Consult your physician prior to taking any supplementations.
HYPERVITAMINOSIS A [HYPERVITAMINOSIS A]
Toxicity from high doses of vitamin A. 25,000IU per day is considered to be high and toxic. The upper limit of
vitamin A is 10,000IU per day.
CAUSES:
• Chronically high consumption of vitamin A especially of retinol (a form of vitamin A found in foods of
animal origin) rich food.
• High doses of vitamin A or cod liver oil supplements.
• Patients with renal failure (4,000 IU per day can be toxic.)
SIGN AND SYMPTOMS:

High doses of retinol:
• Fatigue.
• Headaches.
• Muscles, joint and bone pains.
• Gastrointestinal problems.
• Anorexia.
• Weight loss.
• Sleep disorders.
• Skin desquamation (dry flaky skin).
• Alopecia.
• Amenorrhea.
• Liver enlargement.
• Liver damage.
• Spleen enlargement.
• Papillar edema.
• Pseudotumor cerebri.
• Birth defect.
High doses of carotene:
• Yellow / orange color of the skin.
• Yellow color of the plasma.
• Decreases level of vitamin E.
• Birth defect.
DIETARY MANAGEMENT:
• Do not take vitamin supplements without consulting your physician.
• Avoid consumption of vitamin A rich food:
– Animal sources: egg, milk, fortified skimmed milk, butter, ghee, margarines, cheese, cream, meat, fish,
kidney and liver.
– Liver oils of fish like cod, shark, and halibut are richest source of vitamin A. This source of vitamin A is rich
in fat and cholesterol.
• You can consume plant sources as they provide vitamin A in the form of beta carotene which is converted
to retinol in our intestine according to the need of our body hence excess will be excreted.
– Plant sources: yellow orange colored fruits and vegetables are good source of - carotene.
– Ripe fruits like mango, papaya, melons, apricots, peaches, pink grapefruit and vegetables like pumpkin,
carrots, sweet potatoes, winter squashes, cantaloupe, peas, red pepper, tomatoes, and broccoli are rich in -
carotene.
– Green leafy vegetables (most dark green leafy vegetables) like, spinach, mustard leaves, fenugreek leaves
etc are rich source of - carotene, and here the yellow color of - carotene is masked by chlorophyll present in
the plants. These vegetables are free of fat and cholesterol.
• Avoid fat as liver is damaged and also vitamin A is a fat soluble vitamin, usually associated with fat rich
food.
• Avoid alcohol as liver is damaged from high doses of vitamin A.
• Avoid food rich in zinc, zinc aids in metabolism of vitamin A:
– Seafood (especially oysters), beef, oatmeal, chicken, liver, milk, spinach, sea plants, nuts and seeds.
– Plant foods are low in zinc, Whole wheat grains provide good amount of zinc.
CONSULT PHYSICIAN:
• High doses of vitamin A can damage liver so consult your physician as soon as you have any of the above
symptoms.
• You can take vitamin C supplements (1,500 mg per day) under the guidance of your physician.
HYPOTHYROIDISM OR MYXOEDEMA [HYPOTHYROID]
HYPOTHYROIDISM / MYXOEDEMA
Hypothyroidism is a clinical condition, which results from deficiency of thyroid hormones.
Hypothyroidism with deposition of mucinous substance in subcutaneous tissues is known as ‘myxoedema'.
CAUSES:
• Primary thyroid gland involvement.
• Lack of pituitary TSH (thyroid stimulating hormone).
• Hypothalamic deficiency of TRH (thyrotropin-releasing hormone).
• Autoimmune thyroiditis.
• Severe iodine deficiency.
SIGN AND SYMPTOMS:

• Slowing down of mental and physical functions of the body.
• Easy fatigability and tiredness.
• Sleepiness.
• Body ache.
• Puffiness of face.
• Edema feet.
• Weight gain.
• Increased sensitivity to cold.
• Dryness of skin.
• Brittle nails.
• Constipation.
• Hair fall.
• Hoarseness of voice.
• Hearing loss.
• Tendency for repeated infections.
• Muscle cramps.
• Shortness of breath.
• Anemia.
• Mood swings.
• Forgetfulness.
• Slow speech.
• Infertility.
• Menorrhagia (profuse menses).
• Occasionally rise in blood pressure.
DIETARY MANAGEMENT:
Avoid:
• Avoid goitrogens (food that blocks the utilization of iodine): turnips, cabbage, mustard, cassava root,
soybeans, peanuts, pine nuts and millets. Cooking usually inactivates goitrogens.
CONSUME:
• Increase consumption of iodine, it is an important building block of thyroid hormone:
– Sea food, meat, milk and milk, sea plants- kelp, dulse (vegetable sea food) and Japanese sea vegetables.
Plants grown in iodine rich soils are also good source of iodine.
– Iodized salt is a primary source of iodine.
• Increase consumption of copper, selenium and zinc as these minerals are essential for normal thyroid
hormone production and metabolism.
• Foods rich in copper:
– Meat gelatin, eggs, yeast, lamb; pork; pheasant quail; duck; goose; squid; salmon; organ meats.
– Soy and soy products, nuts and seeds, beans, legumes; almonds, broccoli, garlic; bran breads and cereals;
sea plants and mushrooms.
– Dried beans - soy beans, lima beans, baked beans, dried peas; lentils; barley.
– Dried fruits including raisins, dates, prunes, avocado, Chocolate.
– Some amount of cooper is obtained from cooking in copper vessels.
• Foods rich in selenium:
– Grains, Brazil nuts, garlic, wheat germ and brewer's yeast, fish, shellfish, eggs, red meat, chicken and liver.
• Food rich in zinc: Good dietary sources of zinc include seafood (especially oysters), beef, oatmeal, chicken,
liver, spinach, nuts and seeds.
– Meat, poultry and milk, shell fish, crab, shrimp and sea plants etc.
• Increase consumption of proteins - tyrosine, an amino acid is a precursor for making thyroid hormone :
– Milk and milk products, eggs (is the richest source), Flesh food: meat, fish, and poultry.
– Nuts and oilseeds, pulses, cereals.
Note[Note]
• Mild to moderate exercise is advisable, exercise stimulates thyroid gland function.
• Practise yoga.
CONSULT PHYSICIAN:
• If myxoedema presents with complications like cardiac failure or coma consult your physician immediately.
Immediate medical attention is necessary.
IRRITABLE BOWEL SYNDROME [IBS]
Irritable bowel syndrome is more common in the age of 20-45 years.
CAUSES:
• Psychological factors – stress, anxiety.
• Specific food intolerance – wheat (gluten), lactose etc.
• Abuse of laxatives.
• Post gastroenteritis.
SIGN AND SYMPTOMS:

• Abdominal pain.
• Spasmodic, explosive watery diarrhea.
• Frequent urge to defecate.
• Worse in morning and after breakfast.
• Incomplete defecation with mucus in stools.
• Feeling of bloatedness.
• Inability to finish meals.
• Slight weight loss.
• Occasionally backache, frequent urination and urgency in males.
DIETARY MANAGEMENT:
• In acute phase of disease rest and take only liquids- water with salt and sugar, fruit juices- water melon,
etc, start dioralyte in case of severe diarrhea.
• Later start with semi solid, light and bland diet – porridge, soups, fruit juices etc.
• Add a pinch of turmeric to food, it has anti inflammatory properties and its action is seen more in the
colon.
• Try to consume more of antioxidants (vitamin A, E, C, Selenium etc.)– Most fruits and vegetables contain
bioflavanoids, which is a good antioxidant.
• Eating too much insoluble fiber in the form of grains can increase diarrhea.Focus on soluble fiber which is
present in vegetables and fruit.
• Avoid intake of milk and milk products.
• Increase intake of iron – boiled eggs, jaggery, beet roots, green leafy vegetables, and nuts – Brazil nuts and
almonds, dried fruits, dates etc.
• Avoid eating beans.
• Limit fried, fatty and non - vegetarian food.
• Avoid refined sugars, tea, coffee and aerated drinks.
ISCHEMIC HEART DISEASE [IHD]
ISCHEMIC HEART DISEASE (IHD):

IHD is atherosclerosis of the coronary arteries (arteries that supply blood to the heart).
It is most important cause of death in the world.
CAUSES:
• Elderly are at high risk of IHD.
• Males are more prone to IHD.
• Women after menopause are also at risk of IHD.
• Hypertension.
• High intake of dietary fats.
• People with low HDL (high density lipoproteins) and high total cholesterol are at risk.
• Obesity.
• Family history Of IHD.
• Stress.
SIGN AND SYMPTOMS:

• Breathlessness on exertion.
• Chronic or episodic fatigue from reduced cardiac output.
• Angina – pain in the chest region on left side may or may not radiate to the left hand up to the fingers.
• Sometimes pains may radiate to the shoulder or back.
• Angina can be associated with fainting.
• Episodes of sweating.
• Palpitations.
• Atrial fibrillation.
DIETARY MANAGEMENT:
• Cut down sodium chloride (common table salt) intake in your diet to avoid hypertension. Intake should not
exceed more then 2 to 2.5 gm a day.
source of PUFA's. Other oils that contain PUFA's are safflower oil, soybean oil, maize oil, sesame oil, rich bran
oil, ground nut oil, mustard oil and olive oil. As all oils are high in fats, its consumption should be limited. The
intake of oils should not exceed 20gms a day.
• Flaxseeds are small brown seeds that are high in fiber and omega-3 fatty acids.
• Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and
heart health.
• Eat more vegetables and fruits.
body):-
seeds.
NOTE:
• Do regular exercise or brisk walking for at least 40 minutes.
KIDNEY STONES OR URINARY CALCULI [URICACIDSTONE]
KIDNEY STONES / URINARY CALCULI (URIC ACID STONES):

Uric acid – a waste product that normally passes out of the body in urine. About 10% of kidney stones are
made of uric acid.
CAUSES:
• Hot climate and dehydration.
• Working in hot environment.
• Uric acid stones: more common in men then in women.
• Low urine output.
• Blockage of the urinary tract.
• Diet high in animal protein, such as red meat.
• High intake of alcohol.
• Results from a problem in metabolizing purines.
• Gout.
• Inflammatory bowel disease.
• Excess intake of vitamin D
• Urinary tract infection.
• Chemotherapy.
SIGN AND SYMPTOMS:

• When kidney stones are small they are passed unnoticed with the urine.
• Large stones cannot easily pass through urinary tract and are painful.
• Hard Abdomen
• Increased pulse
• Red urine
• Pus in urine
• In case of an infection along with the above mentioned symptoms there may be
-Fever with Chills.
-Frequent urge to pass urine.
DIETARY MANAGEMENT:
• Fluid intake:
water.
– You can drink barley water and coconut water daily, it helps in removing stones.
stones.
• Foods that have been shown to increase the amount of oxalate in urine include
-spinach
-rhubarb
-nuts
-wheat bran
-Avoiding these foods may help reduce the amount of oxalate in the urine.
• Increase intake of fiber – bran, whole grains, oat, green leafy vegetables, peas, beans, potatoes, raw
• Avoid high purine foods. They lead to high production of uric acid.
• Stop eating MEAT, be a vegetarian as meats are major sources of purine.
• The following foods are very high in purine and should be avoided completely:
– Anchovies, herring, mackerel, roe, sardines, scallops, shrimp, mussels, partridge, meat and meat extracts
(oxo, bovril), red meat, mincemeat, goose, bouillon / broth / consommé of brains, kidney liver and heart.
– Dried legumes, sweetbreads, yeast (baker's and brewer's), yeast extracts (marmite, vegemite).
• If possible avoid alcohol or limit alcohol consumption to 1 drink three times a week. Completely avoid beer.
• Consume moderate amount of protein. Instead of animal proteins consume plant sources of proteins.
• Limit fat intake, foods high in fats are listed above.
• Consume lots of vitamin C; avoid crystallization of uric acid and helps in urinary excretion of uric acid.
Consume buffered form of vitamin C, ascorbate.

immediately.
LACTOSE INTOLERANCE [LACTOSE]
Lactose intolerance is an inability to digest significant amount of lactose / milk sugar, so is also termed as
milk intolerance.
Mostly lactose intolerance is seen in babies, in 1st six months of their life.
CAUSES:
This inability occurs due to lack or shortage of enzyme lactase, is produced in the linings of the intestine, it
aids in digestion of lactose.
• Digestive disease or injuries to the small intestine.
• Inborn inability to produce lactate.
• Premature births at 28-32 weeks gestation, have low levels of lactase, as lactase levels increase in fetus in
the last weeks of third trimester.
• Lactase activity is reduced in patients with Crohn's disease, ulcerative colitis, celiac disease, intestinal
tuberculosis and intestinal cancer.
• Lactase production can be low in alcoholics.
INCIDENCES:
• Ethnics – more seen in African Americans, American Indians, Asian Americans, Jews, Native Americans and
Mexicans.
• It is least common in northern Europeans.
SYMPTOMS:
• Diarrhea, which doesn't respond to usual medicines.
• Vomiting.
• Irritability.
• Dehydration.
• Nausea.
• Cramps.
• Bloating, gas.
DIETARY MANAGEMENT:
• In case of infants, Mothers should stop feeding the infant as mother's milk is high in lactose. Lactose-free
milk is also a great way to get calcium.
• In case of severe diarrhea, give rehydration solutions – water with salt and sugar after every stool.
• If your child is dehydrated (Signs - weak cry, low activity, dry tongue) do not treat at home, rush to your
physician.
• Start milk again only after consulting your physician.
• Do not start prepared baby formulas without consulting your physician.
• Adults should avoid sweets, bakery or dairy products, they contain lactose.
• It is not necessary for older children and adults to avoid foods containing lactose completely; lactose
intolerance differs from individual to individual for different food and in different quantities. For e.g. some
individuals can tolerate one glass of milk and not more then that, where as others may not be able to
tolerate even ½ a glass of milk, some can eat cheddar cheese with out distress where as others get severe
aggravation from cheese.
• So Dietary management for lactose intolerance depends on how much lactose they can tolerate.
• You can consume yogurt, though it is high in lactose, studies have shown that bacterial cultures in the
yogurt, produces some lactase enzyme which helps in proper digestion of yogurt. But initially consume only
3-4 tablespoons of yogurt and if you have no symptoms you can freely consume it. It is essential as yogurt
contains all the nutrients found in milk, thus prevents deficiencies that may occur due to avoiding lactose
containing food (all dairy products).
• Do not consume frozen yogurt, they do not have live bacteria's.
• Check food labels for – whey, curds, casein, malted milks, butter milk, dry milk solids, milk by-products,
nonfat dry milk powder, lactose (lactate, lactalbumin, lactylate and caseinate do not contain lactose.), on
processed meats check for – cold cuts, sausages etc. for presence of milk solids.
• Check labels of drugs before consuming as 20% of drugs contain lactose, e.g. many types of birth control
pills, antacids, neomycin and colchicines.
• You can consume, home made breads and pastas or pastas which do not contain milk solids, rice, barley,
dried legumes and fresh potatoes, not commercially prepared ready to eat potatoes.
• You can use soy milk, goat's milk, rice milk. But check labels before use.
• You can use lactase enzymes available in the form of tablets and liquids, along with milk and milk products.
They are available as lactaid, lacterase and dairy ease enzyme products.
• If you are completely avoiding milk and milk products you can face deficiency of the nutrients available
from milk – calcium, vitamin A, Vitamin D, riboflavin and phosphorus. Vitamin A, riboflavin and phosphorus
can be easily obtained from other food sources; where as vitamin D is easily produced by our body on
exposure to sun. But milk is main source of calcium, so avoiding dairy products will lead to calcium
deficiency. Hence one should always watch their calcium intake from other food sources and increase other
foods that are high in calcium.
LATEX ALLERGY [LATEX]
Latex allergy is an allergic reaction that develops on contact with latex, rubber.
Latex / rubber / natural latex, is obtained from the milky sap of the rubber tree (Hevea brasiliensis).
Types of latex allergies:
Contact dermatitis:
A poison ivy like rash / hives develops 24-48 hrs after coming in contact with latex.
SYSTEMIC ALLERGY:
The latex allergy affects the whole body. The symptoms appear immediately after inhaling latex allergens,
which are bound to corn-starch powder, used to lubricate some gloves. The symptoms appear in the form of
hives or may develop symptoms of hay fever and asthma. Rarely severe systemic reaction may cause low
blood pressure, low pulse, rapid heart beat leading to shock and death (anaphylactic shock).
CAUSES AND INCIDENCES:

The exact cause for latex allergy is not known but it is seen that repeated exposure to latex and rubber can
increase the sensitivity for latex.
RISK FACTORS -
• Occupational – working in factories that uses latex to make products
• Rubber industry workers
• Health care professionals, as they have to use gloves most of the time.
• Working in food packaging factories.
• Spina bifida patients.
• Patients with congenital urologic abnormalities.
• History of several surgeries.
• Myelodysplasia (irregular bone marrow cells).
• Family history of allergies – asthma, eczema, food allergies.
• History of allergies like – asthma, eczema, certain food allergies specifically of – banana, kiwi, avocado or
chestnuts.
SIGN AND SYMPTOMS:

Contact dermatitis:
• Hives
• Rashes
• Dry skin
• Severe itching
• Burning
• Scaling of white flakes
• Lesions on scratching
SYSTEMIC ALLERGIES:
Mild -
• Conjunctivitis
• Cramps
• Hives with severe itching
Moderate -
• Rhinitis
• Asthma
• Breathlessness.
Severe -
• Rarely – anaphylactic shock
- Low blood pressure
- Low pulse
- Rapid heart beat
- Slurred speech
- Tremors
- Chest pain
- Difficulty breathing
- Loss of consciousness
- Death.
Some of the Latex Products that you can avoid:
• Rubber gloves, instead you can use synthetic gloves.
• Rubber bands
• Erasers
• Chewing gums
• Rubber grip utensils
• Tooth brush with rubber handle
• Bath mats and door mats that have rubber backing
• Rubber toys
• Balloons
• Condoms
• Adhesives – glue, paste, glue pens etc.
• Adhesive tape and bandages
• Medical and dental supplies contain latex: urinary catheters, dental dams and material used to fill root
canals, tourniquets and resuscitation equipments.
• Diapers that contain rubber and sanitary pads
• Garments that have elastic rubber
• Feeding nipples and pacifiers
• Water proof bed pads that have rubber
• Bathing caps made of rubber.
• Pens with rubber grip or rubber coating
• Computer – mouse pads or wrist pads that are made of rubber.
DIETARY MANAGEMENT:
Do:
• You should wear a medic alert bracelet that clearly states about your allergy.
• Always carry an emergency autoinjectable epinephrine (Epi-Pen), as an emergency in case of severe
reactions, it is a life saver until you reach to the hospital. Note: this injection will be effective for only 20
minutes.
• Carry non-latex gloves and other latex alternatives for use in case of emergency.
• Inform you physician, employer and school professional about your allergy.
AVOID:
• Avoid contact with all products made of latex.
• Avoid going in places where powdered gloves are used.
• Avoid going to restaurants which uses latex gloves for food preparation.
• People with latex allergy usually have cross reactions to certain foods, these foods have proteins similar to
that in latex and thus the immune system reacts to them as if they are latex. This is known as cross reactive
foods and people with latex allergy should avoid them.
• The foods are listed in the order of their reactivity in latex allergic individuals –
A. High level of reactivity:
a. Banana
b. Avocado
c. Chestnuts
d. Kiwi.
B. Moderate level of reactivity:
a. Apple
b. Carrot
c. Celery
d. Melon
e. Papaya
f. Raw potato
g. Tomatoes.
C. Low level of reactivity:
a. Apricot
b. Cherry
c. Fig
d. Grapes
e. Hazelnuts
f. Mango
g. Nectarine
h. Passion fruit
i. Peach
j. Milk
k. Pears
l. Pineapples
m. Plum
n. Peanut
o. Rye
p. Strawberry
q. Soybeans
r. Walnut
s. Mugwort (Artemisia vulgaris)
t. Wheat Grass
u. Ragweed
v. Coconut
w. Paprika.
• Avoid diet soda as they contain NutraSweet, which is made from bananas.
CONSULT PHYSICIAN:
• If you see any Sign of anaphylaxis (rapid heart beat, slurred speech, tremors, difficulty in breathing) call for
your doctor immediately.
LATHYRISM [LATHYRISM]
Lathyrism is a morbid condition from eating leguminous plant especially peas of species Lathyrus sativus.
CAUSES:
• Ingestion of beta-aminopropionitrile.
• Consumption of peas of species Lathyrus sativus, it has a neurotoxin called beta oxalyl amino alanine
(BOAA).
SIGN AND SYMPTOMS:

• Onset with lameness in the extremities.
• Progressive spastic paraplegia.
• Pain.
• Hyperesthesia.
• Paresthesia.
• Angiolathyrism – causes sudden death.
• Aneurysms.
• Osteolathyrism – affects skeletal development, cartilages and bones grow abnormally – deformity of the
body.
• Development of brain stops.
DIETARY MANAGEMENT:
• Lathyrism cannot be cured but can be prevented.
• Avoid consumption of pulses of species Lathyrus sativus (Peas).
• Before consumption of pulses, toxins should be washed out, as toxins are water-soluble -
– Parboil pulses with the water and drain that water.
– Soak pulses in hot water for 10 minutes and drain away the water.
MALNUTRITION [MALNUTRITION]
Inadequate supply of nutrients for body to function properly.
CAUSES:
• Lack of a single vitamin in the diet or a combination of vitamins.
• Digestion and absorption is not proper.
SIGN AND SYMPTOMS:

• Specific malnutrition related disorders depending on which nutrient is deficient.
• General symptoms - fatigue, drowsiness, weight loss, decreased immune response.
DIETARY MANAGEMENT:
Avoid:
• Avoid mental stress.
• Avoid crowded and unhygienic places.
CONSUME:
• Increase intake of the nutrient you are deficient in.
• Take high energy and high protein diet.
• Fluid intake should be adequate.
• Increase intake of antioxidants like vitamin A, Vitamin C, vitamin E, selenium.
• Vitamin A rich foods: sweet potatoes, carrots, dark leafy greens, winter squashes, lettuce, dried apricots,
cantaloupe, bell peppers, fish, liver, and tropical fruits.
twice a day. It helps you to develop immunity and is highly nutritious.
• Drink boiled mixture of water, mint and basil leaves.
• Increase consumption of zinc, decreases diarrhea episodes:
• Add a pinch of turmeric to food; it will boost up your immunity.
• Consumption of roots of winter cherry (ashwagandha) is advisable as it is an immuno-modulator.
• You can consume eggs, milk, fish, and little amount of meat and poultry.
• Vegetarians should increase their consumption of pulses and legumes (peas and beans).
• Milk and milk products should be avoided to those patients with intestinal damage who are also lactose
intolerant or those who cannot tolerate, digest or absorb a normal diet in such case liquid supplement
formula can be used.
CONSULT PHYSICIAN:
• If it is complicated with infectious diseases consult your physician immediately.
• If you have persistent diarrhea vomiting see your physician at once.
• Multivitamin supplements can be taken as indicated by your physician.
MARASMUS OR KAWSHIORKOR [KWASHIORKAR]
PEM (PROTEIN ENERGY MALNUTRITION) IN INFANTS AND CHILDREN / MARASMUS / KWASHIORKOR /

STUNTING / WASTING
Protein Energy Malnutrition as the name suggests is lack of protein and energy resulting from poor nutrition.
Kwashiorkor is the edematous form of protein- energy malnutrition; it is due to total deprivation of protein.
Marasmus is a form of PEM which is characterized by muscle wasting and shrunken appearance of the child.
Stunting is low height for their respective age.
Wasting is low weight for their respective age.
CAUSES:
• Inappropriate weaning by a young mother. Occurs in second year of life when the child is weaned from the
breast on to a diet low in protein.
• Poor maternal nutrition.
• Diet limited in protein and calories.
• Malabsorption –intestinal diseases.
• Gastroenteritis.
• Measles.
• Malaria.
• Infections: most commonly gastro intestinal, respiratory, measles etc.
• Under nutrition.
• Breast-feeding, when amount of milk is markedly reduced.
• More frequent in infants who are artificially fed.
• Famines associated with climatic disasters.
• Poor socioeconomic state.
• Chronic infectious disease – diarrhoea or respiratory disease.
SIGN AND SYMPTOMS:

Kwashiorkor:
• Muscle wasting hidden by oedema.
• Fat is present but is not firm.
• Oedema in lower limbs, face and lower arms.
• Low weight but masked by oedema.
• Low height for age.
• Irritable, moaning and apathetic.
• Appetite is poor.
• Diarrhoea.
• Diffuse pigmentation.
• Flaky paint dermatosis.
• Hair – alter in colour from black to blond, reddish or grey; it becomes thin and sparse, silky, easily pulled
out.
• Liver enlargement due to fat deposits.
• Hypothermia.
• Immunodeficiency – susceptibility to infections.
• Angular stomatitis (inflammation of the mucous lining of the mouth) may be seen.
MARASMUS:
• Shrunken wasted appearance.
• Muscle wasting.
• Severe loss of subcutaneous fat.
• Weight and height low for age.
• Apathy and irritability.
• Diarrhoea.
DIETARY MANAGEMENT:
Avoid:
CONSUME:
• The child should be given a diet providing sufficient quantities of calories and proteins, with an increase in
amounts gradually without provoking vomiting or diarrhoea.
• It is suitable to initiate the feeding with a liquid formula gradually changing the consistency.
– Give water drained from boiled green grams, Sugar cane juice, Fruit juices, Vegetables soups, Porridge of
lentil and rice, Porridge of pulses and cereals, Milk, milk shakes.
– Make sure food is cooked properly.
• Sugar and vegetable oil should be added to increase the energy
content.
• Continue breastfeeding if possible.
• Along with breast feeding give appropriate and adequate complementary feeding, in weaning stage –
– Give boiled and mashed vegetables and fruits, porridge of pulses and cereals, water drained from boiled
green grams, Sugar cane juice Fruit juices.
• a dose of 2 lakh IU of vitamin A should be provided to the child. Daily supplement of 60 mg/day of iron and
100
microgram/day of folic acid should be introduced in the diet.
• vitamin A: all yellow fruits and vegetables contain Vitamin A. Meat, eggs, fish, kidney and liver, liver oils of
fish like cod, shark, and halibut are richest source of vitamin A.
• Include Vitamin C, antioxidant:
– Citrus fruits vegetable soups and vegetables- cabbage, broccoli, tubers- potatoes and sweet potatoes
• Increase intake of vitamin E: foods of animal origin are low in vitamin E.
– Oilseeds and vegetable oils like soy, cotton-seed and safflower oil.
– Wheat germ, whole grain, corns, cereals, pulses, nuts, dark green leafy vegetables, olives.
• Another very good antioxidant selenium should be included in the diet: animal foods like - fish, shellfish,
eggs, red meat, chicken and liver.
– Grains, Brazil nuts, garlic, wheat germ and brewer's yeast are good source of selenium.
CONSULT PHYSICIAN:
• If you do not have complete knowledge of what to feed your infant during the weaning stage consult your
physician.
• If your child has persistent diarrhea vomiting see your physician at once.
MIGRAINE [MIGRANE]
Migraines are vascular headaches with reoccurring throbbing pain usually affecting one side of the head.
Classification of migraine:
CLASSICAL MIGRAINE:
About 20% of all the cases have classical migraine. Classical migraine are preceded by an aura –
lightheadedness, sparkles or flash lights, super sensitivity to noise etc. this aura lasts for 15-45 minutes and is
followed by pounding, throbbing headache.
COMMON MIGRAINE:
Common migraines usually lack the aura, the warning symptoms. In common migraine the pain involves the
whole head instead of just temples or one side of the head.
CAUSES:
• Family history.
• It is more common in young females in their reproductive age. Women are affected 3 times more than
man.
• Between the age of 15 to 55 years.
• History of motion sickness.
• Stress – examination, important interview, etc.
• Depression.
• Poor diet.
• Missing meals.
• During menses.
• Drugs – birth control pills.
• Overexertion or fatigue after exercise or sexual activity.
• Exposure to sun.
• Excessive flickering light, bright light, fluorescent lights.
• Excessive noise.
• Watching television or a movie.
• Loss of sleep or excessive sleep.
• Iron deficiency.
• Low blood sugar.
• Vitamin B deficiency.
• On withdrawal from caffeine.
• Specific food allergies:
– Ice-creams, cold food.
– Chocolates.
– Cheese.
– Bread.
– Wine, alcohol.
– Food additives.
– Monosodium glutamate (used in cooking Chinese food).
– Aspartame (nutrasweet).
– Chicken liver.
– Pickled herring, pickles.
– Canned figs, canned food.
– Nitrates (used in curded meats like sausages, salami, hot dogs).
– Sour cream.
– Shellfish.
– Fatty fried food.
– Lactose (milk and milk products).
These are the common food allergens but one can be allergic to other food items not listed.
SIGN AND SYMPTOMS:

• The aura / the preceding symptoms 15-45 minutes before the migraine:
– Visual disturbances – wavy lines, dots or flashing lights, blind spots.
– Intolerance to light.
– Ringing in ears.
– Dizziness.
– Increased thirst.
– Excessive drowsiness.
– Feeling of excess of energy.
– Craving for sweet or any particular food like banana, chocolate etc.
– Tingling in arms or face.
– Slurred speech.
• During the attack:
– Headache usually one sided.
– Pains are throbbing pulsating type.
– Pains in temples or face, sinus, jaw or neck area.
– Headache increased by movements.
– Head is sensitive to touch; even combing the hair is painful.
– Nausea.
– Vomiting.
– Diarrhea.
– Light headedness.
– Giddiness.
– Intolerance of light, noise.
– Increased irritation.
– Pale face.
– Tenderness of scalp.
– Decreased sensation around the mouth.
– Mood changes.
– Anxiety.
– Sudden head movement can increase the pain.
– Pains last for hours or for days.
– Moderate to intense pains affecting the daily activity, at times pains are so ever that the person has to lie in
a dark room till the episode subsides.
– Reoccurring once a month, in some people, it is often once or twice a week.
COMPLICATIONS OF MIGRAINE:
– Paralysis of eye movement.
– Weakness or paralysis of arms and legs.
– Vertigo.
– Tingling.
– Blindness.
– Loss of consciousness.
DIETARY MANAGEMENT:
Avoid:
• Avoid stress and learn to cope with it. Practice yoga will help to deal with stress.
• Avoid smoking or even being around a cigar or a cigarette smoke.
• Avoid alcohol, red wine champagne.
• Avoid coffee and caffeinated drinks. The more caffeine you consume more chances of having headaches.
• Sources of caffeine: coffee, tea, soft drinks, chocolate.
• Do not suddenly stop caffeine intake, you may get withdrawal symptoms. Reduce caffeine intake gradually.
• Do not drink or eat anything that has artificial sweeteners.
• Avoid canned foods and food with preservatives, foods with artificial colors.
• Avoid food you are allergic to. If you don't know what food triggers the migraine, avoid foods listed above.
• Avoid monosodium glutamate, used in Chinese cooking.
• Avoid missing meals or fasting.
• Do not over eat.
• Avoid overexertion. Do regular moderate exercise.
• Avoid going out in sun; carry an umbrella or dark glasses when out in sun.
• Avoid taking pain killers and oral contraceptives.
• Avoid all perfumes, scented laundry detergents, deodorants, air fresheners, candles, shampoo etc.
DO'S:
• Keep a diary to record when your headache occurs, symptoms, what you had eaten before the headache
started, your food craving that that period, your sleep patterns, menstrual cycle and other factors. This will
help you to find out what triggers your migraine, so that you can avoid that factor and prevent migraine.
• Consume plenty of water.
• During the attack a cold compressant may help you if your migraine is not caused by cold. Lie in a dark
quite room without a pillow. Take complete bed rest with minimal light, noise and odors.
• Do regular exercise, it prevents migraine attacks.
• Get a regular massage around the neck and shoulders to relieve the tension in the muscles.
• Proper rest and sleep is needed for prevention of migraine attacks.
• Eat proper balanced diet.
• Eat at regular time.
• Eat frequent small meals and snacks through out the day, to maintain blood sugar levels.
– Eat high protein meals regularly.
– Avoid eating sweets.
• Eat organic food, fresh fruits and vegetables.
• Limit intake of fats. It should be below 30% of your total calorie intake.
• Increase intake of omega 3 fatty acids. Omega 3 has tremendous effects on migraine. Especially the EPA
(eicosapentaenoic acid), it helps in production of thromboxane A3, which plays important role in controlling
migraine, it makes the blood less sticky and thus blood flows with out resistance and it produces
prostaglandins (a hormone like substance) that reduces inflammation of the blood vessels.
• Increase intake of omega 3 fatty acids and reduce intake of omega 6 fatty acids (ratio of 2:1), omega 3 fatty
acid has anti-inflammatory properties.
• Consume lots of vitamin B complex, helps to control blood sugars. They also help in release of energy which
boosts up the immune system.
• Increase intake of iron, iron deficiency cause headaches.
• Calcium and vitamin D are helpful in reducing headaches especially headaches after menses.
• Increase intake of magnesium, magnesium deficiency causes spasms of muscles also of the smooth muscles
in the lining of the blood vessels. Thus magnesium will relax the vessels in the blood vessels and allow the
blood to flow freely.
• Sources of Vitamin A: all yellow fruits and vegetables contain Vitamin A. Meat, fish, kidney and liver, liver
oils of fish like cod, shark are richest source of vitamin A
• Eat food rich in zinc:
• Consume carbohydrates with proteins.
• Limit intake of simple carbohydrates: sugar, all sugary foods, alcohol, soda etc.
• Take high fiber diet, take 12-20 gm of fiber - whole grains, bran, oat, green leafy vegetables, peas, beans,
potatoes, raw vegetables, salads, dried fruits and fresh fruits.
• Include food rich in Vitamin E:
• You can consume feverfew, an herb that is said to alleviate migraine pains, it gives temporary relief but will
not cure migraine.

• Consult your physician or professional dietician before making any dietary changes.
• Take vitamin supplements under the guidance of your physician.
• If your headache is accompanied with severe vomiting, weakness, visual problems then see your physician
immediately.
• If you get too frequent attacks of migraine consult your physician.
• If your headache is with vomiting, fever and intolerance to light it can be meningitis consult physician as
soon as possible.
• If you develop weakness or paralysis of one side or any part of the body, following a headache consult your
physician.
MYOCARDIAL INFARCTION [MYOCARDIAL]
Myocardial infarction is death of small portion of myocardium (muscle of the heart) due to improper /
obstructed blood supply to the area.
CAUSES:
• Blood clot that lodges in the coronary artery and obstructs the blood supply to the heart muscle.
• Sedentary life.
• Obesity.
• Chronic consumption of alcohol (alcoholism).
• Hypertension.
• Family history of atherosclerosis or coronary heart disease.
SIGN AND SYMPTOMS:

• Severe chest pain - crushing, squeezing or heavy feeling in the chest.
• Pain remains for 30-60 minutes or more.
• Pain radiates to arms, neck and back.
• Sweating.
• Nausea.
• Rapid heart beat.
• Reduced B.P.
• A minority of patients does not experience any pain and are diagnosed by routine electrocardiogram (ECG).
DIETARY MANAGEMENT:
more than 2 to 2.5 gm a day.
source of PUFA's. Other oils that contain PUFA's are soybean oil, mustard oil and olive oil. As all oils are high
in fats, its consumption should be limited. The intake of oils should not exceed 20gms a day.
• Take high fiber diet - whole grains, bran, oat, green leafy vegetables etc.
• Avoid fat-rich desserts and fried snacks like cakes, pastries, puddings etc.
• Avoid eating junk food – pizza, burgers etc.
body):-
seeds
– Should avoid custard apple.
NOTE:
• Do some relaxation techniques like yoga, meditation etc to relieve the stress. Change your lifestyle to
MYOCARDITIS [MYOCARDITIS]
Inflammation of heart muscle is known as myocarditis.
CAUSES:
• Viral infection.
• May also occur during or after viral, bacterial or parasitic infections.
• Exposure to chemicals.
• Allergic reactions to certain medications.
SIGN AND SYMPTOMS:

• History of preceding viral illness.
• Fever.
• Chest pain that resembles a heart attack.
• Joint pain/swelling.
• Abnormal heart beats.
• Leg edema.
• Total absence of symptoms is common.
DIETARY MANAGEMENT:
• Cut down salt (common table salt) intake in your diet. Intake should not exceed more then 2 to 2.5 gm a
day.
• The diet should be light, digestible, small meals often, eat more fresh vegetables and fruit.
• Bananas are rich in potassium ions, sodium ions inhibited the pressor and damage blood vessels.
• No smoking, less alcohol, drink less coffee or tea.
• Red berries, cherries, pineapple and other red and yellow fruits rich in carotene; fresh fruit and dried fruit
are also calcium, phosphorus, copper, iron, manganese and other minerals, a good source.
• Apple potassium and vitamin C can protect the heart.
• Add a pinch of turmeric powder to your food; it has anti-inflammatory and antiseptic properties.
• Avoid refined sugars.
NARCOLEPSY [NARCOLEPSY]
NARCOLEPSY (DAYTIME SLEEP DISORDER)

Narcolepsy is defined as excessive uncontrollable daytime sleepiness and frequent sleep attacks.
CAUSES:
• The exact cause of narcolepsy is not known.
Probable Cause:
• Genetic disorder.
• Insomnia.
• Disruption of work schedules – night shifts.
• Excessive alcohol intake.
SIGN AND SYMPTOMS:

• Excessive daytime sleepiness of sudden onset.
• Sleep may last for 15 minutes to an hour.
• Reoccurrence of sleep attacks within one to several hours. Patient wakes up refreshed and get tired in
several hrs and get another sleep attack.
• Increased amount of arousals in the night.
• Cataplexy (temporary intermittent muscle weakness), about 70% of patients have this symptom.
• Weakness of muscles during the attack is so much that the person has to struggle to keep their head from
dropping.
• Hallucinations while falling asleep or on waking (hypnogogic and hypnopomphic hallucinations), this is
symptom is very uncommon and is seen in almost 25% of patients.
• Sleep paralysis (paralysis while falling asleep or waking), about 30% of these patients suffer this symptom.
• Usually occur in teenage or in early twenties.
DIETARY MANAGEMENT:
Avoid:
• Avoid alcohol and sugar.
• Avoid stimulants like coffee, caffeinated drinks, tea or drugs.
DO:
• Make a schedule and maintain time of sleep.
• Avoid shift work or maintain timing of the shift.
• Take short naps during the day.
• Schedule naps, like 15 minute nap after lunch then 15 minutes nap at 5:30 pm. This will provide temporary
alertness and reduce the intensity of daytime sleepiness.
CONSUME:
• Reduce intake of fats.
• a diet rich in whole grains, vegetables, fruits, low fat dairy and lean sources of protein.
• limit alcohol, chocolate and caffeine intake and should avoid consuming any of them several hours before
bed.
• Increase intake of calcium and magnesium, needed for energy production and proper functioning of
nervous system.
• Consume food high in protein diet during the day, protein foods increases alertness.
• Food high in proteins contains L – Glutamine (amino acid), it promotes mental ability and is a brain fuel as it
passes the brain barrier freely.
• You can take L – Glutamine supplements, empty stomach with water or juice. Do not drink milk with it, as it
hinders the absorption. You can have vitamin C and vitamin B6 supplements along with it for better
absorption.
• Consume proteins high in L – Tyrosine; it is needed for production of norepinephrine and dopamine which
are important for mental alertness and long term memory.
• Consume food high in L - tryptophan in the evening meals with carbohydrates as they slow mental function
and cause sleepiness.
– Milk, tuna fish, turkey and eggs, Almonds, cabbage, kidney beans, oats, pistachios, bananas, poppy seeds,
pumpkin seeds, spinach, wheat, sunflower seeds and evening primrose seeds.
• Consume complex carbohydrates for evening meals as they have calming effect and may endorse
sleepiness. Even though carbohydrate calms brain but is necessary for adequate mental performance as
glucose is main fuel source for brain.
• Consume food high in choline or lecithin. Choline acts as a neurotransmitter and is very important for brain
function.
– Milk, eggs, liver, wheat germ and peanuts are rich in choline.
– Other sources are beef, shrimp, salmon, Atlantic cod, Brussels sprouts, broccoli and milk chocolate.
• Consume food high in chromium; it promotes energy and regulates sugar metabolism.
• Consume coenzyme Q10, it increases circulation to the brain.
• Food sources:
– Meat poultry, fish, soybean, canola oil and nuts, fruits vegetables, eggs, dairy products are also good
sources.
• You can take supplements of coenzyme Q10 – 100-300 mg per day.
• Consume Octocosanol supplements. It is a naturally occurring substance found in sugar cane, wheat germ
oil, spinach and other natural food sources. It increases the oxygen utilization by the body.
• Consume B vitamins especially niacin and pyridoxine, B vitamins boost metabolism and increase the energy
levels and normal brain functions.
• Consume food high in pyridoxine.
• Consume food high in niacin.
• Consume lots of vitamin C and bioflavanoids, increases energy and has antioxidant properties.
CONSULT PHYSICIAN:
• Before making any changes in your diet and medicine please consult you physician or qualified dietician.
• Before taking any supplements consult your physician.
NEPHROTIC SYNDROME [NEPHROTIC SYNDROME]
Oedema, proteinuria and hypoproteinaemia collectively is termed as nephrotic syndrome, irrespective of the
causes.
CAUSES:
• Glomerular causes:
Minimal change nephropathy.
Proliferative glomerulonephritis.
Membranous nephropathy.
Focal & segmental glomerulosclerosis.
Cresentric glomeruloneprhitis.
INFECTIONS:
Malaria.
Hepatitis B.
Herpes zoster infections.
Streptococcal infection.
Staphylococcus infection.
Syphilis.
Leprosy.
Schistosomiasis.
FOOD ALLERGIES:
Gluten intolerance.
Allergy to milk proteins.
Contaminated foods.
High intake of meat proteins.
DRUG INDUCED:
Heavy metal like gold therapy.
Anticonvulsant drugs.
• Malignancy:
Lymphomas & Hodgkin's disease.
• Systemic diseases:
Diabetes mellitus.
SLE.
Amyloidosis.
Polyarteritis nodusa.
Cryoglobulinemia.
• Familial disorders:
Congenital nephrotic syndrome.
Fabry's disease.
• Miscellaneous:
Reflux nephropathy.
Renal vein thrombosis.
Toxaemia of pregnancy.
Allergic reactions to insect bites, pollens, vaccines.
Renal artery stenosis.
SIGN AND SYMPTOMS:

• Oedema is peripheral to lower limbs.
• In children oedema on the face & abdomen.
• Scrotal oedema/ Vulva oedema.
• Bilateral hydrothorax.
• Generalized anasarca.
• Loss of weight.
• Diarrhoea.
• Vomiting.
• Lethargy, tiredness.
• Frequent infections.
• Muscular wasting.
• Dyspnoea.
• Increased blood pressure.
• In later stages hypertension becomes permanent.
DIETARY MANAGEMENT:
• To prevent massive oedema, sodium levels in the diet must be low. Usually 500mg sodium diet is
satisfactory.
• Lots of fresh fruit and vegetables – fiber such as whole grains, fruits and vegetables can help lower total
and LDL cholesterol.
• A balanced diet adequate in both energy and protein (1-2gm per kilogram body weight) should be
adequate for most children.
• A very high protein diet may cause tubular damage to the kidneys as the kidneys will have to filter more of
the proteins.
• Lean cuts of meat, less red meat, more chicken and fish
• Use healthy oils such as olive, canola, coconut, or sunflower
• If you are allergic to gluten avoid: wheat, rye, barley, oats etc.
• Avoid milk and milk products if you are allergic to milk proteins.
• Avoid proteins like – albumins from eggs and milk, globulin and casein from milk, muscle proteins from
meat and soy proteins.
• Avoid artificial body building powders.
• Limit saturated fats (dairy, animal fat) and eliminate trans fat (partially hydrogenated oils found in
processed and fast food)
• Avoid animal proteins instead consume plant source of proteins. Limit intake of protein to 40 – 50 gm per
day.
• Consume fresh flaxseed oil as they protect kidney from further deterioration and progression to renal
failure.
• Reduce intake of fats.
• Increase magnesium intake (300 – 350 mg / day).
CONSULT PHYSICIAN:
• Do not make dietary changes without consulting your physician or dietician.
OSTEOMALACIA [OSTEOMALACIA]
Osteomalacia is softening of bones to excess accumulation of organic bone due to vitamin D deficiency.
Vitamin D is needed for the absorption of calcium. Thus a deficiency in vitamin D results in calcium
deficiency.
CAUSES:
• Less exposure to sunlight.
• Poor nutrition – food deficient in vitamin D.
• Malabsorption.
• Certain diseases – chronic renal failure.
• Certain drugs – anti-epileptics, anti-convulsants.
• Continuous dialysis – rarely.
• Poverty.
• Multiple pregnancies.
• Common in women of reproductive age.
SIGN AND SYMPTOMS:

• Dull bone pains – ribs, upper thigh, lower back and legs.
• Muscle pains.
• Muscle weakness – difficulty in climbing stairs.
• Pain on pressure on the bones.
• Fractures.
• Deformities of the back bone.
• Weight loss.
• In young children – poor sleep, restlessness, headache, nausea, dizziness, nervousness, diarrhea. Later may
develop "Bow legs" and or change of curvature of spine (kyphoscoliosis).
DIETARY MANAGEMENT:
Avoid:
• Avoid bony injuries, to prevent fractures.
CONSUME:
• Get your daily dose of sunlight. Spending 5 to 10 minutes in the sun is sufficient for proper Vitamin D
synthesis in the body.
• Consume foods rich in vitamin D:
– egg yolk and fish liver oils are riches source.
– Liver, veal, beef, oyster, salt water fish – mackerel, kipper, herrings, salmon, sardines and tuna.
– Dairy products like – cream, butter, cheese, fortified milk and margarines, yogurt.
– Plant foods are low in vitamin D.
• Breast milk and formula, milk and dairy, eggs, green leafy vegetables, sesame seeds and tofu are rich in
calcium.
• You can take vitamin D supplements – cod liver oil, fortified milk.
• Vitamin D injections into the muscles can be taken under your physician's guidance.
CONSULT PHYSICIAN:
• consult your physician immediately if any of the above signs and symptoms are observed as deformities
once formed cannot be corrected.
• In case of malabsorption consult your physician immediately.
• If you develop any complications such as fractures see your physician immediately.
PELLAGRA [PELLARGA]
Pellagra is disease caused by deficiency of nicotinic acid / niacin (B vitamin).
CAUSES:
• Poor consumption of niacin or amino acid, tryptophan from which niacin can be synthesized.
• Vitamin and protein deficiency.
• Diets of chronic alcoholics.
• Occasionally seen in patients suffering from cirrhosis, chronic diarrhea, diabetes and cancerous growth.
SIGN AND SYMPTOMS:

• Dermatitis – bilaterally symmetrical seen on parts exposed to sunlight such as back of hands and forearms,
face and neck etc.
• Itching and burning on the affected parts.
• In chronic case patches turn reddish brown, rough, scaly and pigmented.
• There is a dull- red erythema (flushing of skin) on bridge of nose and around the cheeks with powdery
scaling (butterfly erythema and pigmentation).
• Diarrhea with nausea, vomiting, abdominal pain.
• Dementia (memory disorder, confusion, disorientation etc).
• Hallucination.
• Fatigue, dizziness.
• Insomnia (loss of sleep).
• Glossitis (inflammation of tongue).
• Stomatitis (inflammation of mucous lining of the mouth).
• Vaginitis (inflammation of mucous lining of the vagina) in females.
• Anemia.
DIETARY MANAGEMENT:
Avoid:
• Avoid alcohol consumption.
• Avoid excess consumption of maize (corn) and sorghum (jowar), they hinder in absorption of niacin.
CONSUME:
• The recommend daily allowance (RDA) for niacin is 16 milligrams per day for men and 14 milligrams per
day for women.
• Take diet rich in niacin (vitamin B3) -
– Meat, fish liver, lean meat, rabbit and poultry.
– Cereals, pulses, whole grains, brown rice, legumes are rich source, nuts, peanuts, yeast and seeds, green
leafy vegetables,
– Certain fruits like pomegranates are also good source of niacin.
• Consume diet rich in tryptophan: eggs and milk.
• Increase intake of vitamin C, helps in better absorption of niacin.
– Citrus fruits, green vegetables.
CONSULT PHYSICIAN:
• People with diabetes, glaucoma, any liver disease or peptic ulcers should consult physician before taking
niacin supplements.
PICA [PICA]
Pica is a craving or a habit of eating non-edible and unsuitable substances which haveno nutritional value.
Recent evidences suggest that some patients may have particular mineral deficiencies like iron etc. It is
common in early childhood but is also seen in mentally handicapped and psychotic patients.
CAUSES:
• Parental neglect
• Lack of affection
• Emotional deprivation
• Malnutrition
• Iron deficiency
• Calcium deficiency
• Poor economic status
• Mental retardation
SIGN AND SYMPTOMS:

It is indiscriminate eating of non-nutritious and harmful substances such as:
• Earth or mud
• Grass
• Leaves
• Stones
• Chalk
• Pencil
• Lead
• Wall plaster
• Clay
• Ash
• Paint
• Soap
• Cigarette buts
DIETARY MANAGEMENT:
• Give diet rich in iron –
– Milk and dairy products, eggs, lean (without fat) red meat.
– Organ meats, poultry, sea food - tuna fish, salmon, oysters
– Green leafy vegetables, Beet roots, cereals, pulses, lentils, whole grains and millets, nuts – Brazil nuts and
almonds.
– Jaggery, dried fruits, dates, prunes, raisins apricots
• Give diet rich in calcium –
– Milk and milk products, sea foods like – crab, shrimp, sardines
– Green vegetables – broccoli, collards, bok choy (Chinese cabbage).
– Some fruits – banana, custard apple etc.
– Nuts and oilseeds – sesame, coconut, almond, walnuts, Brazil nuts
– Cereals and pulses – finger millet, Bengal gram, kidney beans
Note[Note]
• You can take homeopathic Biochemic medicines – they can facilitate absorption in a natural way and
decrease the deficiency, but should not self medicate, consult a professional homeopath.
PILES OR FISSURES OR FISTULA [PILES]
PILES / FISSURES / FISTULA

Piles are caused by swollen veins inside or outside the anus.
Anal fissure is an elongated ulcer in the long axis of the lower anal canal.
Anal fistula is an abnormal passage formed rectum to the vagina.
CAUSES:
• Straining to evacuate stool in constipation.
• Over purgation – Diarrhea of colitis, dysentery etc.
• Low roughage diet.
• Pregnancy.
• Cancer of rectum.
PILES:
• Straining to urinate – in case of stricture of urethra or enlarged prostate (piles).
• Hereditary tendency.
• Sedentary life.
• Obesity.
Fistula/ fissure:
• Granulomatous infection e.g. Crohn's disease or Syphilis
SIGN AND SYMPTOMS:

• Bleeding from anus along with defecation.
• Bleeding of bright red blood.
• Blood and pain while defecating.
• Blood streaked stools (fissures).
• Drops of bright red blood after stools (piles).
• Mucus discharge and itching.
• Prolapse of piles – either it go back them selves or need to be replaced manually.
• Sensation of incomplete evacuation of rectum.
• Stools being evacuated from vagina (in case of anal fistula).
DIETARY MANAGEMENT:
• Avoid hot spicy and highly seasoned food.
• Consume more apples, pears, watermelons, papaya, grapes, strawberries, pomegranates, rose petals,
kiwis, pineapples, and Coconut water.
• Have high fiber diet – whole grains, bran, oat, green leafy vegetables, peas, beans, potatoes, raw
• If possible stick to vegetarian diet.
• Eat bitter gourd, black musale (Kali musli), Kareer (ker) are said to be beneficial.
• Drink sufficient water to avoid constipation.
• If over-weight reduce weight.
PNEUMONIA [PNEUMONIA]
An acute inflammation of the lung lining (parenchyma) is known as pneumonia.
CAUSES:
- Infection:- viral, bacterial or fungal, bacterial pneumonia are more common than viral.
- Aspiration of food / drink into respiratory passage.
- It is common complication of respiratory disorders.
- Risk factors:
– Hospitalization or stay in camps and military bases.
– Alcoholism.
– Extremes of age.
– Tobacco smoking.
– Cardiac disease.
– Diabetes.
– Malnutrition (poor nutrition).
– HIV status.
– Low immunity.
– Environmental pollution.
SIGN AND SYMPTOMS:

• Fever with chills.
• Cough.
• Breathlessness.
• Bacterial pneumonia:
– Sudden onset.
– Chest pain with Breathlessness.
– Dark thick or bloody sputum.
– Loss of appetite.
– Weakness.
– Increased pulse.
– Increased respiratory rate.
– Restlessness.
• Viral pneumonia
– Cough with yellowish greenish sputum.
– Headache.
• Fungal pneumonia
– Weakness
– Fatigue
– Cough-scanty white or no expectoration.
DIETARY MANAGEMENT:
• Fruits and vegetables are top suppliers of antioxidants, which help your body resist and heal from
infections and disease.
• Whole grains provide valuable amounts of carbohydrates, your body's main fuel source, as well as a host of
vitamins, minerals and antioxidants.
• nutritious whole grains include oats, brown rice, quinoa, air-popped popcorn and barley.
• Choose sources low in saturated fats, such as beans, lentils, skinless white-meat poultry and fish.
• Avoid saturated fat sources, such as red and processed meats, that can increase inflammation.
• Olive oil, fatty fish, avocados, soy milk, nuts, olives, peanut butter, sunflower seeds and tofu are all foods
that are rich in healthy fats.
• Consume lots of vitamin A, maintains the integrity of the respiratory mucosa: Liver oils of fish like cod,
shark, and halibut are richest source of vitamin A.
– Egg, milk and milk products, meat, fish, kidney and liver.
– Yellow orange colored fruits and vegetables, dark green leafy vegetables.
• Increase intake of vitamin C, it has antioxidant property: foods of animal origin are poor in vitamin C.
• Include zinc in your diet, it boosts up your immunity:
– Meat, poultry and milk, sea food - shell fish, crab, shrimp, and sea plants etc.
NOTE:
• Take bed rest or reduce activity during infection.
• Yoga will help by breathing exercises. Breathing exercise will help better utilization of available lung space.
• Avoid sharing things such as towels, beverages with infected people.
• Avoid contact with infected people.
• Avoid crowded places.
PROTEIN ENERGY MALNUTRITION IN ADULTS [PEMA]
PEM (PROTEIN ENERGY MALNUTRITION) IN ADULTS

Protein Energy Malnutrition as the name suggests is lack of protein and energy resulting from poor nutrition.
CAUSES:
• Insufficient food intake.
• Anorexia.
• Persistent regurgitation or vomiting.
• Depletion of electrolytes – sodium, potassium and magnesium from diarrhea.
• Malabsorption – small intestinal disease.
• Increased BMR e.g. thyrotoxicosis, prolonged infections.
• Glycosuria in diabetes mellitus.
• Cachexia (condition of abnormally low weight, and general bodily decline in some cases of cancer.)
SIGN AND SYMPTOMS:

• Weight loss.
• Craving for food.
• Thirst.
• Weakness.
• Feeling cold.
• Nocturia (passage of urine at night).
• Amenorrhoea (absence of menses).
• Impotence.
• The face first looks younger but later becomes old, withered and expressionless.
• The skin is lax, pale, and dry and may show pigmented patches.
• Hair becomes thinned or lost except in adolescents.
• The extremities are cold and cyanosed (blue).
• Subcutaneous fat disappears.
• Skin turgor is lost.
• Muscle wasting.
• Oedema may be present.
• Psychologically, starving people loose initiative; they are apathetic, depressed and introverted but become
aggressive if food is nearby.
• Hypothermia.
• The pulse is slow, low blood pressure.
• The abdomen is distended and diarrhoea is common.
DIETARY MANAGEMENT:
Avoid:
• Avoid mental stress.
CONSUME:
• Give high energy and high protein diet.
• Start with light food which is high in protein and energy:
– Give water drained from boiled green grams, Sugar cane juice, Fruit juices, Vegetables soups, Porridge of
lentil and rice, Porridge of pulses and cereals, Milk, milk shakes.
• Make sure food is cooked properly.
• Fluid intake should be adequate.
• Increase intake of antioxidants like vitamin A: all yellow fruits and vegetables contain Vitamin A. Meat,
eggs, fish, kidney and liver, liver oils of fish like cod, shark, and halibut are richest source of vitamin A.
• Consume:-
seeds
• Increase intake of vitamin E: foods of animal origin are low in vitamin E.
– Oilseeds and vegetable oils like, coconut oil, groundnut oil, soy, cotton-seed and safflower oil.
– Wheat germ, whole grain, corns, cereals, pulses, nuts, dark green leafy vegetables, olives, spinach,
asparagus.
• Another very good antioxidant selenium should be included in the diet: animal foods like - fish, shellfish,
eggs, red meat, chicken and liver.
– Grains, Brazil nuts, garlic, wheat germ and brewer's yeast are good source of selenium.
• Include Japanese sea vegetables (arame, hijiki, kombu, nori) in diet if available, they are remarkably
nutritious.
twice a day. It helps you to develop immunity and is highly nutritious.
• Increase consumption of zinc, decreases diarrhea episodes:
– Whole wheat grains provide good amount of zinc.
CONSULT PHYSICIAN:
• If you have persistent diarrhea vomiting see your physician at once.
• Multivitamin supplements can be taken as indicated by your physician.
PSORIASIS [PSORIASIS]
Psoriasis is red scaly (silvery white) patches which can appear any where on the skin.
CAUSES:
• Unknown.
• Possibly genetically determined.
• Common between 15-30 years.
• Precipitating factors are:
– emotional stress.
– Cold weather.
– Injury.
– Septic focus.
– Drugs like Steroids, Brufen, Lithium, Anti-malarials and Beta - adrenergic blockers.
SIGN AND SYMPTOMS:

• Usually affects both sides of body symmetrically.
• Well circumscribed red, dry plaques (flat areas on the skin) of various sizes, covered with scales.
• Removal of scales gives rise to pin-point bleeding points.
• Sites can be anywhere on the body especially on e.g. elbow, knees, sacrum and occiput.
• Lesions are coin shaped or circular with central clearing.
• Joints can get affected especially finger joints.
• Nails frequently become pitted and thick with brownish black discoloration.
DIETARY MANAGEMENT:
Avoid:
• Avoid precipitating or trigger factors.
• Avoid food you are allergic to.
• Avoid foods high in fat or sugar.
• Avoid non-vegetarian food – meat, poultry.
DO:
• Warmth may help to control relapses.
• Do regular exercise helps by improving blood circulation.
• Practicing yoga will help in reducing stress.
CONSUME:
• Eat fresh and raw fruits and vegetables as they provide antioxidants and flavanoids which help in reducing
inflammation and boosting up immunity.
• Consume figs and fish oil might help you feel better.
• Eat a well-balanced diet - Proper nutrition will improve general health and reduce the severity of the
disease. Do not over eat even healthy foods.
• Limit intake of red meat and dairy products.
• Eat foods that contain psoralen before you walk out in sun - Celery, carrots, citrus, figs, fennel, and
parsnips. It makes the skin more sun-sensitive to the positive effects of UV light. But do not over expose to
sun.
• Consume oily fish, may help reduce the inflammation associated with psoriasis - mackerel, salmon, black
cod, albacore tuna, herring and sardines.
• Have a low-calorie diet if you are over weight - about 1,200 calories per day. Some researches have shown
relations between psoriasis and obesity.
• Consume gluten free diet, it benefits individuals with psoriasis (Gluten is a mixture of proteins found in
some cereals, particularly wheat) – avoid wheat, rye, barley and oats they contain gluten.
• Increase intake of vitamin D.
• Increase intake of omega 3 fatty acids and reduce intake of omega 6 fatty acids (ratio of 2:1), omega 3 fatty
acid has anti-inflammatory properties.
• Food rich in omega 3:
– Canola oil, flaxseed, flax seed oil, walnuts and green leafy vegetables.
• Reduce (do not completely avoid) intake of food rich in omega 6:
– Cereals, vegetable oils, whole-grain breads, baked goods and margarines, eggs and poultry.
• Consume diet rich in vitamin A and zinc, helps in regeneration of the skin.
• Increase intake of vitamin C, it helps maintain healthy skin.
• Have coriander leaves frequently, its high in vitamin C and helps to maintain healthy skin.
• You can have 3-4 strands of saffron in milk, it is beneficial for skin.
• Basil leaves (tulsi) are said to be helpful in skin ailments, eat 3-4 fresh leaves daily.
CONSULT PHYSICIAN:
• You can take vitamin and cod liver oil supplements under guidance of your physician.
• In case of prolonged duration or change in rash pattern take physicians opinion immediately.
• If symptoms get worse or if you see any Signs of infection (fever, redness of the affected area, pain) occur,
see your physician immediately.
RENAL COLIC [RENALCOLIC]
Renal colic is pain in right or left lower abdomen or low back pain due to disease in the kidney, ureter or
bladder.
CAUSES:
• Renal stones are main reason for renal colic.
• Disease of kidney – hydronephrosis, polycystic kidney, tuberculosis.
• Blood clot in kidney or bladder.
• Inflammation of ureter.
• Inflammation of bladder.
• Foreign body in bladder.
• Infection of kidney, ureter or bladder.
• Cancer.
• Other disease that give similar pains that of renal colic:
– Inflammation of pancreas.
– Inflammation of gall bladder.
– Appendicitis (right side pain).
SIGN AND SYMPTOMS:

• Pain in abdomen, either right or left lower abdomen.
• Pain may radiate to groins or thigh.
• Gripping type of pain.
• Restlessness.
• Fever.
• Vomiting
• Increase in frequency of micturation.
• Painful urination.
• Red urine.
DIETARY MANAGEMENT:
• Drink enough water and other fluids to produce at least 2 liters of urine a day.
• Foods that have been shown to increase the amount of oxalate in urine include
-spinach
-rhubarb
-nuts
-wheat bran
• People who form uric acid stones should limit their meat consumption to 6 ounces each day.
• Avoid drugs like antacids which contain calcium.
• People who form calcium oxalate stones should include 800 mg of calcium in their diet every day, not only
for kidney stone prevention but also to maintain bone density.
• Consume vitamin C and zinc improves immunity.
• Consume lots of Vitamin A: all yellow fruits and vegetables contain Vitamin A. Meat, fish, kidney and liver,
liver oils of fish like cod, shark, and halibut are richest source of vitamin A.
• Avoid alcohol, chocolate, tea, tomatoes,vinegar etc as they may irritate the urinary tract.

• Do not self medicate, consult your physician.
• Do not take any vitamin supplements without consulting your physician.
• See your physician immediately if you have pus or blood in urine.
• If you have frequent attacks of renal colic consult your physician.
RICKETS [RICKETS]
It is the characteristic result of vitamin D deficiency in children.
CAUSES:
• It is less common in breastfed infants.
• Less exposure to sunlight.
• Dark skinned infants.
• Dietary deficiency of vitamin D.
• Malabsorption.
• Chronic liver disease.
• Renal osteodystrophy.
• Calcium wasting.
• Hereditary.
SIGN AND SYMPTOMS:

• Head:
– Prominent forehead.
– Delayed closing of anterior fontanels (normally closes by 6 months of age).
– Frequent rocking movement of the head.
– Temporary teeth usually appear late.
– Excessive sweating over the forehead.
• Thorax:
– Beading of ribs (rachitic rosary), at the junction of the ribs and cartilages.
– Prominent sternum (Pigeon's Breast).
• Spinal column:
– Patient has hump in the back (Kyphosis).
• Extremities:
– Bow legs.
– Knock knees.
– Outwards curving of bones of forearm.
– Dwarfism in severe cases.
– Green stick fractures can occur in severe cases.
• Ligaments and muscles:
– Weakness of legs.
– Delayed walking and standing.
– Over extension of knee joints.
– Pot belly due to weakness of abdominal muscles.
• Digestive system:
– Indigestion due to liver and spleen affection.
• Nervous system:
– Restless at night.
– Rocking of head on the pillow.
• Respiratory system:
– Adenoid and tonsillar hypertrophy.
– Rhinitis.
– Pharyngitis (inflammation of mucous lining of the pharynx).
– Bronchitis.
– Bronchopneumonia.
• Spasmophilia:
– Triad of tetany.
– Laryngismus stridulus.
– Convulsion may be expected in low calcium type of rickets.
DIETARY MANAGEMENT:
Avoid:
• Avoid bony injuries, to prevent fractures.
CONSUME:
• Consume foods rich in vitamin D:
– Animal food: egg yolk and fish liver oils are riches source.
– Liver, veal, beef, oyster, salt water fish – mackerel, kipper, herrings, salmon, sardines and tuna.
– Dairy products like – cream, butter, cheese, fortified milk and margarines.
– Plant foods are low in vitamin D – vegetable oils, fruits, nuts and green leafy vegetables.
• Egg yolks are also a great source of nourishment.
• Calcium rich foods like green vegetables and milk are very important.
• Breast feeding should be continued.
• You can take vitamin D supplements – cod liver oil, fortified milk.
CONSULT PHYSICIAN:
• Consult physician if you have any of the above signs and symptoms.
• Associated illness should be treated.
• Vitamin D injections can be injected under the guidance of your physician.
SCURVY [SCURVY]
Scurvy is due to vitamin C deficiency.
CAUSES:
• Poor consumption of vitamin C.
SIGN AND SYMPTOMS:

• Fatigue.
• Easy bruising.
• Pigmentation on calf & legs.
• Spongy gums.
• Anemia.
• Irritability.
• Swelling on the ribs which looks likes beads.
• Recurrent infections of gums.
• Patches on skin.
• Pain & swelling of large joints.
DIETARY MANAGEMENT:
• Dietary sources of vitamin C include:
-fruits such as oranges, lemons, limes, grapefruits, blackcurrants, mangoes, kiwifruits, tomatoes and
strawberries
-vegetables, particularly green vegetables such as cabbage, capsicum, spinach and broccoli
kidney and liver.
• Avoid alcohol.
• You can take vitamin C supplements as directed by your physician. But it is always best to consume vitamin
C in its natural form from food.
CONSULT PHYSICIAN:
• Never take more than the recommended dose of a vitamin C supplement without your doctor's knowledge
and approval.
• If the bleeding is too profuse and does not stop.
• If you are taking aspirin, estrogen, anticoagulant medicine and antacids then consult your doctor as they
lower the level of vitamin C in our body and may cause bleeding.
SPINA BIFIDA Or NEURAL TUBE DEFECT [NTD]
SPINA BIFIDA / NEURAL TUBE DEFECT (NTD)

Note: spina bifida cannot be corrected as the nerve tissues cannot be reproduced or replaced once formed.
But it can be prevented by Dietary management before conception and during pregnancy.
The term Spina bifida implies a failure of the fetus's spine to close properly during the early development of
the embryo (first month of pregnancy).
TYPES:
There are three types of spina bifida:
• Spina bifida occulta: It is a bony defect in which there is failure of fusion of the vertebral arches posteriorly.
It is the mildest form and is common in the lumbo-sacral region.
– Overlaying skin may have a dimple, a tuft of hair, a lipomatous mass or a dermal sinus.
– When there is neurological deficit there is always an overlying skin defect.
• Meningocele: It is more severe form of spina bifida. In this spinal cord develops normally but the meninges
(the protective covering around the spinal cord) protrude from the opening in the spinal column. The sac
containing this protruded part of the spinal cord is termed meningocele.
• Myelomeningocele / spina bifida aperta: It is the severest form of spina bifida, mostly found in the thoraco-
lumbar region. The meninges and the spinal cord containing the deeper nerves of the spinal column protrude
from the opening in the spine.
– The bulging sac may contain only the meninges and fluid only and the nerves are in place.
– Cerebrospinal may be leaking through the site.
– The spinal cord and the nerve roots are enclosed in a sac and are outside the line of the vertebra.
– The lesion may be closed or open.
CAUSES:
• Congenital defect.
• Abnormally high levels of Alpha-Fetoprotein (AFP) in the amniotic fluid that surrounds the embryo.
• Folic acid deficiency during pregnancy.
• Vitamin B12 deficiency
• High homocysteine levels.
• Family history of neural tube defect.
• A women who has given birth to an NTD baby before are at more risk to have another NTD baby.
• Pregnant women with diabetes.
• Hyperinsulinemia.
• Pregnant women taking certain seizure medications.
• Prepregnancy obesity.
SIGN AND SYMPTOMS:

The sign and symptoms depend on where the defect in the spinal cord is located.
• Some people may have very mild or no symptom.
• Hydrocephalus.
• Club foot.
• Physical and mobility difficulties.
• Learning disabilities.
• Weakness or paralysis below the level of the defect in the parts where the affected nerves reach.
• Infection in the exposed part of the spinal cord.
• In severe cases baby is stillborn or dies soon after birth.
• Spina bifida occulta:
– In neural involvement there is muscle imbalance of the lower limbs, often with selective muscle wasting
and foot deformity (equino-varus or cavus foot).
• Myelomeningocele / spina bifida aperta:
– Motor paralysis of the lower limbs and to some extend of the trunk, the motor paralysis is often uneven
and may some time lead to hip dislocation.
– Sensory paralysis of the lower limb.
– Incontinence of bladder and bowel is also present.
– Associated hydrocephalus may be present.
MANAGEMENT:
Child born with NTD:
• Consult your physician immediately.
• Seek advice of a neurosurgeon.
• Take aid of physiotherapy helps in faster rehabilitation.
• Avoid exposure to latex and latex containing products.
DIETARY MANAGEMENT:
• Eat a well balanced diet; to give birth to a healthy baby, it is essential that you are healthy too.
• Consume enough folic acid, folate (vitamin B9). Researches have shown that folic acid deficiency during
pregnancy is strongly associated with NTD.
• Folic acid is essential for the development of DNA, hence is important for cell growth and development,
and tissue formation. Hence it is essential for proper growth and development of the fetus.
• Since spina bifida occurs in first month of pregnancy, it is essential that the pregnant women should have
Significant amount of folic acid in her body before conception.
• As most of the pregnancies are not planned it is essential for all women of childbearing age to have at least
400 µgm of folic acid daily.
• Consume 600 µgm of folic acid daily if you are pregnant and 500 µgm of folic acid daily if you are breast
feeding.
• In case you had a previous NTD baby, it is advised to undergo at least 4.0 mg folic acid supplementation
daily.
• Foods that are naturally high in folic acid include dark green vegetables such as broccoli and spinach, egg
yolks and citrus fruits.
• If you cannot obtain enough folic acid from diet you can take folic acid supplements.
• Increase intake of foods rich in Methionine, essential amino acid it helps to prevent NTD.
• Increase the dietary intake of choline and inositol, reduces the risk of NTDs. Increase the intake of choline
and inositol in the periconceptional period.
• Consume at least 425 mg/day before conception, rather every women in their reproductive age should
consume this amount of choline, and 550 mg/day for the lactating females.
• Vitamin B12 consumed in early months of pregnancy, reduces the risk of NTDs.
• Consume at least, 2 µg/day for women in their fertile period and 3 µg/day for lactating women.
• Limit intake of sucrose (table sugar) and foods with high glycemic index (mostly simple carbohydrates);
they increase the risk of NTDs. In a research done it was proved that high intakes of glucose and fructose did
not risk the fetus, but sucrose and foods with high glycemic index were a risk factor for NTDs.
STRUVITE STONES [STRUCTIVESTONE]
KIDNEY STONES / URINARY CALCULI (STRUVITE STONES):

Struvite stones are also known as magnesium ammonium phosphate stones, triple phosphate or "infection
stones". About 10% of kidney stones are struvite stones.
CAUSES:
• Struvite stones: usually seen in women.
• Usually occur after or with kidney or urinary tract infections.
SIGN AND SYMPTOMS:

• Hard Abdomen
• Increased pulse
• Red urine
• Pus in urine
• In case of an infection along with the above mentioned symptoms there may be
-Fever with Chills.
-Frequent urge to pass urine.
DIETARY MANAGEMENT:
• Fluid intake:
water.
stones.
• The main cause of struvite stone is infection so 1st treat the infection.
• Struvite stones are dissolved in acidic urine. Hence consume foods high in citrates.
• Consume lots of vitamin C especially orange juice should be consumed in large quantities. Vitamin C makes
urine acidic and there by aids in eliminating infection and dissolves the stone.
• Urinary infection and stones can be prevented by daily consumption of much greater amounts of ascorbic
acid (vitamin C).

immediately.
TUBERCULOSIS [TUBERCULOSIS]
Infection caused by ingestion of Tubercullin bacteria is known as Tuberculosis, commonly known as TB.
CAUSES:
• Poor nourishment.
• Poor living standards.
• Overcrowding in urban areas.
• Poor immunity.
• Contact with infected people (in pulmonary tuberculosis only).
• Chronic renal failure.
• AIDS.
• Diabetes.
SIGN AND SYMPTOMS:

• Cough.
• Blood streaked expectoration.
• Low grade fever especially in evening.
• Weight loss, gradual.
• Poor appetite.
• Night sweats.
• Pain in chest.
• Swelling mainly in neck region and armpit.
• Decreased activity & easy fatigue.
DIETARY MANAGEMENT:
• Strawberries are high in potassium, vitamins, and minerals that help boost the immune system and help
fight the disease.
• Blueberries and cherries and dark leafy vegetables along with whole-grain foods, milk, and lean meats and
poultry are also recommended to combat weight loss.
• Consume diet rich in proteins (55 gm of protein daily):
– Milk and milk products, eggs, meat, fish, poultry, nuts and oilseeds, pulses, cereals.
• Diet rich in carbohydrates: (60% of total calories should come from carbohydrates)
– Cereals and millets, roots and tubers, fruits.
• Consume considerable amount of fats: (15 gm of fats daily)
– Oils and fats, food of animal origin, nuts and oil seeds.
• Take lots of vitamin A, helps in maintaining the integrity of the respiratory mucosa: Liver oils of fish like
cod, shark, and halibut are richest source.
– Egg, milk and milk products, meat, fish, kidney and liver, yellow orange colored fruits and vegetables, dark
green leafy vegetables.
• Increase intake of Vitamin C, will strengthen immunity: foods of animal origin are poor in vitamin C.
– Eats fruits and vegetables raw as they provide have maximum of vitamin C when fresh and raw.
• Include Vitamin E in considerable amount: foods of animal origin are low in vitamin E.
– Vegetable oils and oil seeds, Wheat germ, whole grain, corns, cereals, pulses, nuts, dark green leafy
vegetables, olives, spinach and asparagus.
• Consuming Zinc in adequate amount will boost up immunity: plant foods are low in zinc, Whole wheat
grains provide good amount of zinc.
– Animal foods, sea food and sea plants etc.
NOTE:
• Maintain personal hygiene and hygienic environment.
• Avoid eating from roadside vendors and from places where hygiene is doubtful.
• Avoid contact with infected person.
• Vaccinate your child with BCG.
ULCERATIVE COLITIS [ULCERATIVE COLITIS]
Ulcerative colitis is due to inflammation of the rectum and the colon.
CAUSES:
• Females between 20-40 years are affected.
• More commonly seen in females, no cause known for it.
• Genetic- family history of Crohn's disease or ulcerative colitis.
• Immunological.
• Atopy.
• Psychological factors like continued stress and anxiety.
• Smoking aggravates the condition but does not cause it.
SIGN AND SYMPTOMS:

• In acute condition: Frequent small loose stools.
- Cramps in abdomen.
- Rectal pain.
- Fever.
- Bloody diarrhea.
• In chronic condition: Low grade fever
- Anemia
- Malaise
- Appetite low
- Weight loss
- Rectal bleeding
- Passage of blood and mucus in stool and sometimes even pus.
• It can be associated with: joint pains,
- Back stiffness
- Eye complications
- Aphthous stomatitis (mouth ulcer)
DIETARY MANAGEMENT:
• Foods that are recommended are the low-residue diet.
• 2 cups of milk, cottage cheese, pudding, or yogurt per day if your complaints are not aggravated by this
products.
• Refined white breads, pasta, crackers, and dry cereals that have less than half a gram of fiber per serving.
• Reduce the amount of greasy or fried foods in your diet.
• Fruits: raw, ripe bananas, melon, cantaloupe, watermelon, plums, peaches, and apricots
• Avoid dry fruits, berries, figs, prunes, and prune juice.
• Vegetables: raw lettuce, cucumbers, zucchini, and onion, spinach, pumpkin, seedless yellow squash,
carrots, eggplant, potatoes, green and wax beans.
• Avoid eating raw vegetables. ALways cook them.
• Avoid spicy sauces, dressings, pickles.
• Restrict eating high-fiber foods such as nuts, seeds, corn, and popcorn.
• Eat five or six small meals per day rather than two or three larger ones.
• Try to drink plenty of fluids daily especially water.
• Avoid refined sugars.
• Avoid tea, coffee and aerated drinks, alcohol
VITAMIN A DEFICIENCY [BLINDNESS]
VITAMIN A DEFICIENCY / NIGHT BLINDNESS / XEROPTHALMIA

Deficiency of vitamin A.
Inability to see in dim light is known as night blindness (nyctalopia).
Xeropthalmia: dry eyes.
CAUSES:
• Inadequate intake of vitamin A rich food.
• Malabsorption.
• Intestinal diseases.
• Poor socio-economic status.
• Defective metabolism of vitamin A – liver disease, intestinal surgery, malabsorption or alcoholism.
Night blindness:
• Vitamin A deficiency.
• Retinitis pigmentosa.
• Cataract.
• Poor adaptation to darkness, accompanied by myopia.
• Certain drugs.
• Birth defect.
• Genetic condition.
• Caused by injury.
• Defective metabolism of vitamin A – liver disease, intestinal surgery, malabsorption or alcoholism.
SIGN AND SYMPTOMS:

• Deficiency of vitamin A has predominantly ocular manifestations – collectively known as xeropthalmia.
– Night blindness – inability to see in dim light.
– Conjunctival xerosis - conjuctiva becomes dry and non wettable, appears muddy and wrinkled.
– Bitot's spots - are triangular, pearly white or yellowish spots on the bulbar conjunctiva on either side of the
cornea.
– Corneal xerosis – corneal appears dull, dry, non wettable, and opaque. May have corneal ulcer, ulcer heals
with scar formation.
– Keratomalacia - liquefaction of the cornea. Cornea becomes soft and may burst open. If the eye collapses
vision is lost.
• Extra ocular manifestation –
– Hyperkeratosis.
– Anorexia.
– Growth retardation.
• Increased susceptibility to respiratory and intestinal infections.
DIETARY MANAGEMENT:
Avoid:
• Avoid going in crowded places as you are susceptible to get infections easily.
• Avoid contacts with people suffering from respiratory or any infectious disease.
CONSUME:
• Increase intake of vitamin A:
– Animal sources: egg, milk, fortified skimmed milk, butter, ghee, margarines, cheese, cream, meat, fish,
kidney and liver.
– Liver oils of fish like cod, shark, and halibut are richest source of vitamin A. This source of vitamin A is rich
in fat and cholesterol.
– Plant sources: yellow orange colored fruits and vegetables are good source of - carotene.
– Ripe fruits like mango, papaya, melons, apricots, peaches, pink grapefruit and vegetables like pumpkin,
carrots, sweet potatoes, winter squashes, cantaloupe, peas, red pepper, tomatoes, and broccoli are rich in -
carotene.
– Green leafy vegetables (most dark green leafy vegetables) like, spinach, mustard leaves, fenugreek leaves
etc are rich source of - carotene, and here the yellow color of - carotene is masked by chlorophyll present in
the plants. These vegetables are free of fat and cholesterol.
• Increase intake of zinc, zinc aids in metabolism of vitamin A:
– seafood (especially oysters), beef, oatmeal, chicken, liver, milk, spinach, sea plants, nuts and seeds.
• Eat raw leaves of sweet basil (tulsi) and mint leaves, this will boost up you immunity and protect you from
infections.
• Continue breastfeeding, breast milk is a natural source of vitamin A.
• You can consume foods fortified with vitamin A to maintain vitamin A status.
CONSULT PHYSICIAN:
• Consult your physician in case of any eye symptoms, as high doses of vitamin A (200,000 IU / 110 mg of
retinol palmitate orally) need to be administered immediately to prevent eye collapse and blindness.
WERNICKES ENCEPHALOPATHY (KORSAKOFFS PSYCHOSIS) [KS]
WERNICKE'S ENCEPHALOPATHY (KORSAKOFF'S PSYCHOSIS)

It is a disease caused by deficiency of vitamin B1 (thiamine).
CAUSES:
• Poor consumption of vitamin B1.
• Chronic alcoholism.
SIGN AND SYMPTOMS:

• Eye Signs- weakness of muscles of eye resulting in double vision, squint, and sometimes no movement of
eyes.
• Inability to stand or walk without support, and imbalance while walking
• Confusion, inattentiveness, sluggishness, indifference to surroundings.
• Drowsiness.
• Increased heartbeats with palpitations, difficulty in breathing, lowered blood pressure can occur due to
heart involvement.
DIETARY MANAGEMENT:
Avoid:
• Avoid alcohol.
CONSUME:
• Increase consumption of thiamine:
– Thiamine is found in almost all foods of animal and plant origin. Fats oils and sugars do not contain
thiamine.
– Lean meat especially pork, fish, dairy products, poultry, egg yolk.
– Cereals, pasta, whole grains like rice and wheat germ, dried beans, peas and soybeans
• Fruits are poor source of thiamine.
• Thiamin supplements can be taken as prescribed by your physician.
CONSULT PHYSICIAN:
• If any of the above sign and symptoms are noticed consult your physician immediately. Immediate
injectable administration of thiamine is essential.
WILSONS DISEASE [WILSONSDISEASE]
The toxic effects from high level of copper in plasma, liver, brain and other organs is known as Wilson's
disease.
CAUSES:
• It is a genetic disorder in which the liver is unable to excrete the metal copper and thereby it accumulates,
in the system.
SIGN AND SYMPTOMS:

• Liver swelling, with jaundice, albumin in urine, or water accumulation in abdominal cavities (ascites).
• Copper accumulation in the brain cause neurological symptoms like tremors, sudden involuntary
movements of the limbs rigidity and stiffness of joints, drooling.
• Difficulty in swallowing.
• Difficulty in movement of joints.
• Psychological disturbances like manic-depressive psychosis where patient has alternative states of over
excitability and depression.
• Neurosis and anxiety.
• Repeated abortions.
• Absence of menses.
DIETARY MANAGEMENT:
Avoid:
• Avoid foods that are high in copper:
– meat gelatin, lamb; pork; pheasant quail; duck; goose; squid; salmon; organ meats including liver, heart,
kidney and brain.
– Sea food: shellfish including oysters, scallops, shrimp, lobster, clams, and crab.
– soy and soy substitutes, nuts and seeds, beans, legumes; whole grain, wheat germ, almonds, broccoli,
garlic; bran breads and cereals; fresh sweet potatoes and sea plants.
– Dried beans including soy beans, lima beans, baked beans, garbanzo beans, pinto beans; dried peas; lentils;
millet; barley.
– Vegetable juice, cocktail, mushrooms.
– Nectarine, commercially dried fruits including raisins, dates, prunes, avocado.
– Chocolate and some kind of beers are rich in copper.
– The dietary intake of copper should be less than 1.0 mg per day.
• Avoid cooking in copper vessels.
• Avoid drinking alcohol. It can be harmful to the liver, and the liver may already be damaged from Wilson's
disease.
CONSUME:
• Increase intake of vitamin B6: Patients under treatment of D- penicillamine, develops deficiency of vitamin
B-6 (pyridoxine).
– You can take a vitamin B6 supplement of 25 mg daily.
– Brewers yeast is very good source of vitamin B6.
– Meats, live, fish, eggs and milk, beans, nuts, legumes and whole grains, sunflower seeds, eggs, walnuts and
herring.
– Kidney, liver, pork, poultry, salmon, wheat germ and Avocado good source of vitamin b6 but are high in
copper hence should be avoided.
• Read food labels; and check for copper content. Check labels of vitamin/mineral supplements to see if they
contain copper.
• Analyze drinking water for copper content; if it contains more then 100 micrograms per liter, bottled
demineralized water should be used. Water containing not more than 1 microgram of copper per liter can be
consumed.
• Increase intake of zinc, it reduces copper levels:
– Plant foods are low in zinc, whole wheat, meat, poultry and milk, sea food.
CONSULT PHYSICIAN:
• Copper is present in almost all foods, hence only dietary restriction is not enough to control the disease. So
consult your physician for the proper management of the disease.
• Regularly see your physician as regular monitoring of blood count, urine, and body temperature is needed
along with the treatment.
ZINC DEFICEINCY [ZINCDEFICEINCY]
Deficiency of zinc.
CAUSES:
• Diet poor in zinc.
• Strict vegetarians: their main foods are grains and legumes which are high in phytic acid and they hamper
the absorption of zinc from the food.
• Malabsorption syndrome.
• Crohn's disease / ulcerative colitis.
• Chronic liver disease.
• Chronic renal disease.
• Sickle cell disease.
• Diabetes.
• Malignancies.
• Smoking and high alcohol consumption.
• Elderly are more prone to deficiency.
SIGN AND SYMPTOMS:

• Reduced appetite.
• Retarded growth.
• Atrophy (shrinkage) of sexual organs.
• Loss of hair.
• Diarrhea.
• Respiratory tract infection.
• Keratosis (desquamation) of tongue.
• Skin affections.
• Dwarfism.
• Cognitive impairment.
• Infertility- low sperm count.
• Delayed healing of wounds.
• Decreased taste acuity.
• Deficiency during pregnancy can cause abnormal labor and retarded fetal growth.
• Increased risk of infection.
DIETARY MANAGEMENT:
Consume:
• Consume foods rich in zinc: zinc is present in wide variety of foods especially along with proteins.
Vegetarian diet contains less zinc compared to meat based diet. Best sources of zinc are -
– Beef, crabmeat, oysters, lamb, pork, turkey, salmon, shellfish, chicken, clams, lobster, milk, yoghurt and
cheese cheddar.
– Whole wheat bread, oatmeal, brown rice, spinach, lentils, beans, lima beans, rye bread, peas and baked
potatoes. Meat, eggs and seafood.
– Other sources of zinc are – green leafy vegetables, sea plants, Japanese sea plants, yeast, Nuts – cashews,
almonds and peanuts, seeds – sesame and pumpkin seeds. Pumpkin seeds are one of the concentrated
sources of zinc in vegetarian food.
• Only 20% of the zinc present in diet is absorbed by our body, dietary fibers and phytic acid present in food
inhibits absorption of zinc. Phytic acid and fiber are found in foods like – bran, whole grain cereals, pulses
and nuts.
• Cooking process can reduce the effects of phytic acid and fibers on the absorption of zinc.
• Ferment whole grains as enzymatic actions of yeast reduces the levels of phytic acid and thus absorption of
zinc is adequate.
CONSULT PHYSICIAN:
• You can take oral supplements of zinc according to your physician's instruction.

Diabetes or Juvenile Diabetes

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Diabetes or Juvenile Diabetes

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ACIDITY OR HEART BURN [ACIDITY]

ACIDITY, HEART BURN, WATER BRASH, PEPTIC ULCER

WATER BRASH / HEARTBURN:

IN CASE OF HEARTBURN OTHER CAUSES INCLUDE:

SIGN AND SYMPTOMS:

HEARTBURN / WATER BRASH:

SIGN AND SYMPTOMS:

ACUTE RENAL FAILURE [ARF]

SIGN AND SYMPTOMS:

SIGN AND SYMPTOMS:

IMPORTANT NOTES FOR DRINKERS:

CONSULT YOUR PHYSICIAN:

ANGINA PECTORIS [ANGINA]

SIGN AND SYMPTOMS:

APTHOUS ULCER [APTHOUS ULCER]

SIGN AND SYMPTOMS:

ARIBOFLAVINOSIS OR HYPORIBOFLAVINOSIS [ARIBOFLAVINOSIS OR

Ariboflavinosis is due to deficiency of vitamin B2 (riboflavin).

SIGN AND SYMPTOMS:

ALLERGENS CAN BE:

FOOD, WHICH CAN CAUSE ALLERGY ARE:

SIGN AND SYMPTOMS:

BARTTERS SYNDROME [HYPOKALEMIA]

BARTTER'S SYNDROME (HYPOKALEMIA)

SIGN AND SYMPTOMS:

SIGN AND SYMPTOMS:

SIGN AND SYMPTOMS:

SIGN AND SYMPTOMS:

CHRONIC HEART FAILURE [CHF]

CHRONIC HEART FAILURE / RIGHT HEART FAILURE / COR-PULMONALE

SIGN AND SYMPTOMS:

CHRONIC RENAL FAILURE [CRF]

SIGN AND SYMPTOMS:

CROHNS DISEASE [CROHNS DISEASE]

SIGN AND SYMPTOMS:

COMMON COLD OR CORYZA [COMMON COLD OR CORYZA]

COMMON COLD / CORYZA

SIGN AND SYMPTOMS:

SIGN AND SYMPTOMS:

CORONARY HEART DISEASE [CHD]

SIGN AND SYMPTOMS:

It is a violent exhalation to an irritant stimulus.

SIGN AND SYMPTOMS:

CYSTINE STONES [CYSTINE STONES]

KIDNEY STONES / URINARY CALCULI (CYSTINE STONES) :

SIGN AND SYMPTOMS:

CONSULT YOUR PHYSICIAN:

Dry white flakes of skin, on your scalp is known as dandruff.

SIGN AND SYMPTOMS:

SIGN AND SYMPTOMS:

Consult your physician: