NUTRITION & DIET THERAPY
DIET DURING PREGNANCY
AND LACTATION
ROLE OF WELLNESS
O The goal of health promotion is
to prepare a woman for these
changes by helping her become
knowledgeable and responsible
for her own health and the well-
being of her infant.
O Few experience this alone. A
spouse, significant other, and
family members can be sources
of support to further the goals
of health promotion.
O A father-to-be often needs
guidance as he grapples with
his own expectations of his
future responsibilities.
O Health professionals can use
this opportunity to assist
individuals to establish
healthful habits, such as eating
well, being physically active,
and avoiding alcohol and drug
use.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
O Hormones of Pregnancy
✔ There are numerous steroid
hormones, peptide hormones,
and prostaglandins influencing
the course of pregnancy.
✔ Some of them, such as the
placental hormones human
placental lactogen and human
growth hormone, are produced
only during pregnancy.
✔ Others, including insulin,
glucagon, and thyroxine, are
present in altered amounts
compared with the nonpregnant
state and have profound
influences on metabolism
throughout gestation.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
✔ Progesterone and estrogen
have a particularly strong
influence on pregnancy.
✔ The action of progesterone
promotes development of
the endometrium (mucous
membrane of the uterus) and
relaxes the smooth muscle cells
of the uterus.
✔ This relaxation serves to both
help the uterus expand as the
fetus grows and prevent any
premature contractions of the
uterus.
✔ The same effect also influences
other smooth muscle cells, such
as the gastrointestinal (GI)
tract.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
✔ The resulting slowing of the GI
tract during pregnancy may
increase the absorption of
several nutrients, most notably
iron and calcium.
✔ One perhaps annoying
consequence of this decreased
gut motility is the promotion
of constipation.
✔ Progesterone causes increased
renal sodium excretion during
pregnancy.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
✔ The body compensates for this
sodium-losing mechanism by
increasing aldosterone secretion
from the adrenal gland and
renin from the kidney.
✔ Sodium restriction during
pregnancy, once thought to
 NUTRITION & DIET THERAPY
prevent hypertensive disorders
of pregnancy.
✔ Estrogen promotes the growth
of the uterus and breasts during
pregnancy and renders the
connective tissues in the pelvic
region more flexible in
preparation for birth.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
O Metabolic Changes
✔ Profound changes in maternal
metabolism occur during
pregnancy, and successful
adaptation to these changes is
necessary for a favorable
pregnancy outcome.
✔ The basal metabolic rate
(BMR) rises during pregnancy
by as much as 15% to 20% by
term.
✔ This increase is caused by the
increased oxygen needs of the
fetus and the maternal support
tissues.
✔ There are alterations in
maternal metabolism of protein,
carbohydrate, and fat.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
O Metabolic Changes
✔ The fetus prefers to use glucose
as its primary energy source.
✔ Changes occur in maternal
metabolism to accommodate
this need of the fetus.
✔ The adaptation allows the
mother to use fat as the primary
fuel source, thus permitting
glucose to be available to the
fetus.
✔  Increased macronutrient and
micronutrient intake by the
mother during pregnancy
ensures that these increased
metabolic needs are met.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
O Anatomic and Physiologic
Changes
✔ Plasma volume doubles during
pregnancy, beginning in the
second trimester.
✔ Failure to achieve this plasma
expansion may result in a
spontaneous abortion, a
stillbirth, or a low birth weight
infant.
✔ One of the results of this
increase in plasma volume is
a hemodilution effect, or
dilution of the blood.
✔ In other words, measured
components in the plasma such
as hemoglobin, serum proteins,
and vitamins will appear to be
at lower levels during
pregnancy because there is a
greater volume of solvent (the
plasma) relative to
concentrations of solute (the
components).
✔ Cardiac hypertrophy occurs to
accommodate this increased
blood volume, accompanied by
an increased ventilatory rate.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
O Anatomic and Physiologic
Changes
✔ In the kidneys, the glomerular
filtration rate (GFR) increases
to accommodate the expanded
maternal blood volume being
filtered and to carry away fetal
waste products.
✔ As a result of this increase in
GFR, small quantities of
 NUTRITION & DIET THERAPY
glucose, amino acids, and
water-soluble vitamins may
appear in the urine.
✔ Although minor losses may be
acceptable, a woman who
excretes large amounts of
protein may experience a more
serious problem
called preeclampsia, or
pregnancy-induced
hypertension, which needs
strict medical monitoring.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
O Anatomic and Physiologic
Changes
✔ As mentioned, progesterone
may slow GI motility during
pregnancy, leading to
constipation, heartburn, and
delayed gastric emptying.
✔ In late pregnancy, these
problems may be exacerbated
by the weight of the uterus and
fetus as they compress the
abdominal cavity.
BODY COMPOSITION
CHANGES DURING
PREGNANCY
O Weight Gain in Pregnancy
✔ There are three components to
maternal weight gain:
(1) maternal body composition
changes, including increased
blood and extracellular fluid
volume;
(2) the maternal support tissues,
such as the increased size of the
uterus and breasts;
(3) the products of conception,
including the fetus and the
placenta.
✔ Inadequate weight gain by the
mother during pregnancy
suggests she may not have
received the proper nutrients
during pregnancy.
✔ Poor weight gain may then lead
to intrauterine growth
retardation in the infant.
✔ Infants born small for
gestational age (SGA) or low
birth weight are more likely to
require prolonged
hospitalization after birth or be
ill or die during the first year of
life.
✔ SGA is when an infant is born
at a lower birth weight than
expected for the length of
gestation, while low birth
weight is a weight less than 5.5
pounds (2500 g) at birth.
Energy and Nutrients needs
during Pregnancy
O Good nutrition during 38-40
weeks of a normal pregnancy is
essential for both mother and
child.
O Pregnant woman must provide
nutrients and calories for the
fetus, amniotic fluid,
placenta, and the increased
blood volume and breast,
uterine and fat tissue.
Energy and Nutrients needs
during Pregnancy
O mother who consumed a
nutritious diet before pregnancy
is more apt to bear a healthy
infant.
O Malnutrition of mother
believed to cause growth and
mental retardation in the
fetus.
O Weight gain during pregnancy
is natural and necessary for the
infant to develop normally and
the mother to retain her health.
 NUTRITION & DIET THERAPY
Energy and Nutrients needs
during Pregnancy
O Overweight women can afford
to gain less than the average
woman, but less than 15
pounds.
O No one should lose weight
during pregnancy, it can cause
nutrient deficiencies for both
mother and infants.
O The average weight gain during
pregnancy is 25 to 35 pounds.
Energy and Nutrients needs
during Pregnancy
O During first trimester of
pregnancy the average weight
gain of only 2-4 pounds. And 1
pound per week on the second
trimester and fetus grows a
great deal during the third
trimester.
O If the woman is pregnant with
twins, then the recommended
weight gain is 35—45 pounds.
Energy and Nutrients needs
during Pregnancy
O A woman should take a
FOLIC ACID supplement at
least one month prior to
conception and during first
trimester to develop the brain
and spinal cord.
O Protein requirements is
increased by 20% for pregnant
woman over 25 yr old and 25%
for the pregnant adolescent.
O Protein are essential for tissue
building and protein rich foods
are excellent sources of many
other essential nutrients
especially iron, copper, zinc
and vit B.
Energy and Nutrients needs
during Pregnancy
O Vit C is needed to develop
collagen and to increase the
absorption of iron.
O Vit B is needed in greater
amount to develop the role of
metabolism and red blood cells.
O Calcium is essential for the
development of the infants
bones and teeth as well as for
blood clotting and muscle
action.
O IRON is needed to increase
blood volume during pregnancy
Components Weight Gain During
Pregnancy with approximate
amounts of Gain.
COMPONENTS
AMOUNT GAIN
O FETUS
O PLACENTA
O AMNIOTIC FLUID
O UTERUS
O BREASTS
O BLOOD VOLUME
O MATERNAL FAT
O 7.5 POUNDS
O 1 POUND
O 2 POUNDS
O 2 POUNDS
O 1-3 POUNDS
O 4 POUNDS
O 4+ POUNDS
PREGNANCY DURING
ADOLESCENCE
O The nutrient requirements that
have special significance to the
pregnant teenager include
proteins, minerals, and
vitamins.
O Protein is especially important
in the diet of pregnant
adolescents because cellular
growth, function, and structure
require the turnover and
 NUTRITION & DIET THERAPY
metabolism of the component
amino acids.
O Calorie Intake - The first
trimester does not require any
extra calories.
O During the second trimester,
an additional 340 calories a
day are recommended.
O For the third trimester, the
recommendation is 450
calories more a day than
when not pregnant.
PREGNANCY DURING
ADOLESCENCE
O How to have a healthy
pregnancy
1. A healthier body = A healthier
baby. Take a prenatal or one-a-
day vitamin with folate each
day. ...
2. Get regular exercise. ...
3. Don't drink alcohol,
4. Don't smoke. ...
5. No drugs
6. Stay out of hot tubs and saunas.
PREGNANCY DURING
ADOLESCENCE
O Underweight women should
gain 28 to 40 pounds. And
overweight women may need to
gain only 15 to 25 pounds
during pregnancy. In general,
you should gain about 2 to 4
pounds during the first three
months you're pregnant and 1
pound a week during the rest
of your pregnancy.
O According to the National
Institutes of Health, there's a
higher risk of the following in
teenage pregnancy:
• preeclampsia.
• anemia.
• contracting STDs (sexually
transmitted diseases)
• premature delivery.
• delivering at low birth weight.
Concerns During Pregnancy
A. Nausea
= occurs during 1st tri of
pregnancy.
Known as morning sickness.
The following suggestion to relieve
morning sickness:
1. eat dry cracker or dry toast
before rising
2. 2. eat small, frequent meals
3. 3. avoid foods with offensive
odors.
4. 4. avoid liquids at mealtime.
HYPEREMESIS GRAVIDARUM=
when nausea persist and become
severe.
Needs hospitalization and give
PARENTERAL NUTRITION
B. Constipation
⮚ can result from relaxation of
the cardiac sphincter and
smooth muscles related to
progesterone.
⮚ constipation and
hemorrhoids can be relieved
by eating :
1. high fiber food,
2. getting daily exercise,
3. drinking at least 13 glasses of
liquid each day
C. HEARTBURN
⮚ Is common complaint during
pregnancy.
⮚ As fetus grow pushes on the
mothers stomach which may
cause stomach acid to move
into the lower esophagus and
create a burning sensation.
⮚ Heartburn may relieved by :
1. eating small,
2. frequent meals,
3. avoiding spicy or greasy foods.
4. Avoiding liquids with meals,
 NUTRITION & DIET THERAPY
5. waiting at least one hour after
eating before lying down and
waiting at least hours before
exercising.
D. EXCESSIVE WEIGHT GAIN
⮚ Drink fat-free milk to reduce
her calories intake not her
intake of proteins, vitamins and
minerals.
⮚ A bowl of crispy raw
vegetables such as broccoli or
cauliflower tips, carrots, celery,
cucumber and radish.
⮚ Fruit and custards made with
fat free milk make nutritious.
⮚ Boiling food instead of frying
can further reduce the caloric
intake.
E. PREGNANCY – INDUCED
HYPERTENSION (PIH)
⮚ Called Toxemia or
Preeclampsia
⮚ it is a condition that sometimes
occurs during the third
trimester.
⮚ It is characterize by high blood
pressure, the presence of
albumin in the urine called
proteinuria and edema
⮚ This is due to inadequate diet
especially on protein-deficiency
diets.
F. PICA
⮚ An abnormal graving for
nonfood substance such as
starch, clay or ice.
G. ANEMIA
O Is a condition caused by an
insufficiency of red blood cells,
hemoglobin or blood volume.
O Iron deficiency is the most
common form, patient look
pale, feels weak and tired.
O Needs additional iron
supplement.
O Folate deficiency result in a
form of megaloblastic anemia
can occur during pregnancy.
O Needs increase folate
supplement of 400-6000mg a
day during pregnancy.
Nutrition-related Concerns During
Pregnancy
A. ALCOHOL
1. FETAL
ALLCOHOLSYNDROME (FAS) it
is an Alcohol consumption
associated with subnormal
physical mental development of
the fetus.
⮚ Many infants with FAS are
premature and have a low birth
weight.
⮚ Physical characteristic may
include :
1. small head ( microcephaly),
2. short eye slits= that make eyes
appear to be set far apart,
3. flat midface,
4. thin upper lip,
5. growth deficiency = like the
abnormal height and weight,
6. hyperactivity,
7. seizures,
8. attention deficits,
2. Fetal alcohol effect (FAE)
⮚ Cause by ingesting alcohol
while pregnant.
⮚ Born with less dramatic or no
physical defects, but with many
behavioral and psychosocial
problems.
⮚ Not able to lead normal lives
due to deficits in intelligence
 NUTRITION & DIET THERAPY
and behavioral and social
abilities.
❖ When the mother drink alcohol,
it enters into the fetal blood
stream in the same
concentration, the fetus does
not have the capacity to
metabolize it as quickly as the
mother so its stays longer in the
fetal blood than in the
maternals blood.
Recommended would
ABSTINENCE ON
DRINKING ALCOHOL.
B. CAFFEINE
✔ Is known to cross the placenta
and enter the fetal bloodstream.
✔ Birth defects in new born if the
mother will drink a high doses
of caffeine.
✔ Woman should limit caffeine
intake to 2 cups beverages each
day or less than 300mg/day.
C. DRUGS
✔ Self – prescribed drugs
including vitamins and mineral
supplements and dangerous
illegal drugs can damage the
fetus.
✔ Drugs derive from vitamin A
can cause FETAL
MALFORMATION AND
SPONTANEOUS
ABORTION.
✔ Illegal drugs can cause the
infant to be born addicted to
whatever substance the mother
used and possibly to be born
with the HUMAN
IMMUNODEFICIENCY
VIRUS. (HIV)
D. TOBACCO
⮚ Pregnant woman who smoke
has some time been associated
with babies of reduced birth
weight.
⮚ The more the pregnant woman
smoke the smaller her baby.
⮚ SIDS ( sudden infant death
syndrome) another risk
associated with smoking that
reduces the oxygen and
nutrients carried by the blood.
It causes fetal death,
spontaneous abortion and
complication at birth.
⮚ Smoking during pregnancy
may also affect the intellectual
and behavioral developme nt
of the baby as it grows up.
Nutrition-related Concerns During
Pregnancy
O Exercise
✔ Women with normal
pregnancies should stay active
during pregnancy.
✔ Strenuous exercise was thought
to divert blood to the exercising
muscles and thus reduce the
blood supply to the fetus.
✔ If woman chooses to exercise
during pregnancy she must
remember to drink fluids
before, after and if necessary
and choose nutritious snacks
before and after exercise
O Exercise
✔ Limit workout to 15 minutes.
✔ Keep pulse rate below 140
beats per minute
✔ Do not exercise lying on your
back after the fourth month.
✔ Avoid exercising in hot, humid
weather.
✔ Consume enough calories to
meet the extra needs of
pregnancy plus the exercise
performed.
 NUTRITION & DIET THERAPY
Nutrition-related Concerns During
Pregnancy
O Maternal age
✔ Adolescent and women older
than 35 yrs of age at higher risk
for poor pregnancy outcome.
✔ Several factors for nutritional
status of pregnant teen.
1. Growth pattern of the mother.
2. Maturity of the mother.
3. Lack of economic resources to
provide for the infants
4. Delay seeking medical care
Goal :
To assess the poor dietary habits of
the teens
To evaluate the preoccupation weight
gain during pregnancy.
Nutrition-related Concerns During
Pregnancy
O Maternal age
✔ Several nutritional status of
pregnant after 35 years
1. Reflecting their longer medical
history
2. Potential long –term use of oral
contraceptives ( which may
affect folate level)
3. The possibility of longer
history of poor eating habits.
4. In additional: older women are
risk for nutrition- related
complications such as
Gestational Diabetes.
GOAL:
Careful nutrition evaluation of these
patients can be useful in providing
guidance to reduce the risk of
nutritional imbalances that cause
pregnancy complication.
Pregnancy Meal Plan First
trimester
Trimester One:
=In the first trimester, your diet needs
to include food with higher folate,
Vitamin B6 and iron content.
=These are good for your baby’s
developing nervous system and
helps to ease nausea.
Pregnancy Meal Plan Second
trimester
TrimesterTwo:
=In the second trimester, you must
consume food that is a good source of
calcium and Vitamin D. This will help
you baby grown stronger bones and
teeth.
= It is also important to eat food that
is rich in magnesium and omega 3
which is essential for baby’s brain
development.
Pregnancy Meal Plan third
trimester
Trimester Three:
=The food that you consume in the
third trimester needs to boost your
energy levels.
=It must also be rich in Vitamin K,
which is necessary to helping your
body to heal well after the birth.
=The iron content in the food helps
preventing premature delivery and
low birth weight.
Diet for pregnant woman with
Diabetes
O Group of diseases in which one
cannot use or store glucose
normally because of inadequate
production or use of insulin.
O This impaired metabolism
causes glucose accumulate in
the blood, where it causes
numerous problems if not
controlled.
O Some women have diabetes
when they become pregnant.
O Other may develop
GESTATIONAL DIABETES
 NUTRITION & DIET THERAPY
during pregnancy. And
disappears after the infants is
born.
Diet for pregnant woman with
Diabetes
O Risk of physical and mental
defects in the infants will
develop.
1. Stillbirth
2. Macrosomia – birth weight over 9
pounds.
O Every pregnant woman should
be tested for diabetes between
16 and 28 weeks of gestation.
O Nutrient requirement of
pregnant woman with diabetes
are the same s for the normal
pregnant woman.
LACTATION
LACTATION
O Is the production and secretion
of breast milk for the purpose
of nourishing an infant.
O How long the mother can
lactate? - be very harmful and can cause
The vast majority of mothers
can produce enough milk to
fully meet the nutritional needs
of their baby for six months.
O Try adding these lactation-
boosting foods to your diet:
O Oats contain lots of iron. A
warm bowl of oatmeal can also
help with relaxation. ...
O Garlic has many health
benefits, including boosting
your milk production. ...
O Eat plenty of vegetables like
carrots, yams, and dark leafy
greens. ...
O Look for sesame seeds.
NUTRIENTS REQUIREMENTS
DURING LACTATION
O Protein- is particularly
importance because it is
estimated that 10 grams of
protein are secreted in the milk
each day.
O Fruits and vegetables-
specially those with Vit C
O Extra Fat Free milk- will
provide many of the additional
nutrients and calories.
O iron,, zinc, copper, protein,
calcium and vitamin D
O Vitamin B12 supplement –
can be prescribed
O More Fluids – to replace those
lost in the infants milk like
water and fruit juice.
AVOID DURING LACTATION
OR BREASTFEEDING
O Medicine or nutritional
supplements
O Caffeine –can cause the infant
to be irritable.
O Alcohol (1)
O Tobacco (2)
O Illegal drugs (3) this three can
the baby to be excessively
drowsy and to feed poorly.
LACTATION
HOW DO WOMEN PRODUCE
BREST MILK?
⮚ Pregnancy hormones cause the
milk ducts to grow in number
and size. ...
⮚ -Prompted by the hormone
prolactin, the alveoli take
proteins, sugars, and fat from
your blood supply and make
breast milk.
⮚ -A network of cells surrounding
the alveoli squeeze the glands
and push the milk out into the
ductules, which lead to the
ducts.
 NUTRITION & DIET THERAPY
BENEFITS OF LACTATION
O Breast milk contains
antibodies that help your baby
fight off viruses and bacteria.
O Breastfeeding lowers your
baby's risk of having asthma or
allergies.
O Plus, babies who are breastfed
exclusively for the first 6
months, without any formula,
have no:
⮚ ear infections
⮚ respiratory illnesses
⮚ bouts of diarrhea.
THANK YOU
DIFFERENT HOSPITAL DIET
DIFFERENT HOSPITAL DIET
❑ Regular Diet. The regular diet
can also be referred to as a
general or normal diet or
balance diet
❑ Mechanical Soft Diet. ...
❑ Clear Liquid Diet. ...
❑ Full Liquid Diet. ...
❑ GI Soft Diet. ...
❑ Low Residue/Low Fiber
Diet. ...
❑ Salt-restricted (Low Sodium)
Diet. ...
❑ Fat-Restricted Diet.
HELPFUL AND COMPLETE DIET
PLAN FOR A BREASTFEEDING
MOM
DIFFERENT HOSPITAL DIET
⦿ Mechanical soft diet or
edentulous diet
is a diet that involves only foods that
are physically soft, with the goal of
reducing or eliminating the need to
chew the food.
⦿ LClear liquid diet 
✔ consists of  clear liquids —
such as water, broth and plain
gelatin — that are easily
digested and leave no
undigested residue in your
intestinal tract. Your doctor
may prescribe a clear liquid
diet before certain medical
procedures or if you have
certain digestive problems. Diet
⦿ Full Liquid Diet
⮚ is made up only of fluids and
foods that are normally liquid
and foods that turn to liquid
when they are at room
temperature, like ice cream. It
also includes: Strained creamy
soups. Tea
⦿ GI Soft Diet
⮚ is soft in texture, low in fiber,
and easy to digest. The goal is
to decrease nausea, diarrhea,
and gas in the bowel that may
cause abdominal pain and
discomfort.
⦿ Low Residue/Low Fiber Diet
is a diet whose goal is fewer
and smaller bowel movements
each day. The diet may be used
as part of the bowel preparation
before a diagnostic procedure
such as colonoscopy
⦿ Salt-restricted (Low
Sodium/SALT) Diet
- limits high-sodium foods and
beverages.
- Although there are variations,
sodium intake is generally
kept to less than 2–3 grams
(2,000–3,000 mg) per day
- -For reference, one teaspoon of
salt contains about 2,300 mg
of sodium
⦿ Fat-Restricted Diet
 NUTRITION & DIET THERAPY
limits the amount of fat you can
consume each day.
Why Should I Follow a Fat-Restricted
Diet? This diet may be prescribed for
certain conditions that make it
difficult for the body to digest fat,
such as chronic pancreatitis and
gallbladder disease.
LIFE SPAN HEALTH
PROMOTION: CHILHOOD
AND ADOLESCENCE
The life span stages reflect
psychological and physiologic
maturation. Approaches to health
promotion take into account the
impact on nutrients requirements,
eating style and food choices.
CHILDHOOD ( 1 TO 12 YRS)
Normal growth pattern are
affected by genetics and
environmental influence should
be assisted by the families to
understand the growth curves
of their children.
This stage where the
development of psychosocial
and physiological
requirements are combined.
The dietary reference intake
will be highlights the nutrients
like, protein, iron, calcium and
zinc.
Children will depend on adults
for the provision of food.
Adults control all the quantity
and quality of foods prepared
and the environment within
which foods are presented for
consumption.
While the children themselves
however will control all the
actual amount to consumed of
food.
STAGES OF CHILDHOOD
STAGES 1:
CHILDREN 1 TO
3 YEARS OLD
STAGES II:
CHILDREN 4 TO
6 YEARS OLD
STAGES III:
CHILDREN 7 TO
12 YEARS OLD
Stage 1: Children 1 to 3 years old
Referred as TODDLERHOOD,
it is a busy time for young
children. They are dealing time
with autonomy.
Meals are best accepted when
hunger, tiredness and emotions
are still controllable, but an
over tired child just cannot eat.
Adult should be fostering self-
reliance by allowing young
children to feed themselves in a
manner most appropriate for
their psychomotor activities.
Regardless of the messy result,
child should allow to attempts
to self-feed to provide a self –
empowerment to develop
her/his physical and
psychological development.
Meals and snacks are design by
adult based on food selection
and acceptable to their age.
Nutritional Requirements for
Children 1 to 3 years old
ENERGY:
1,300kcal/day
PROTEIN:
16 gms to meet demands
of
growing
muscles
 NUTRITION & DIET THERAPY
FRUITS AND VEGETABLES:
1 tablespoon per year of
age.
MILK :
2 to 3 cups /day or 16 to
24oz/day
MEAT:
should offer at least
twice a day
FAT:
low-fat version
IRON:
12mg/kg
CALCIUM:
400mg
Stage 11: Children 4 to 6 years old
Characterized by independent
eating styles, although
modelling of adult still occur.
Can understand the time frame
of meals and can save their
appetite for meals.
Snacks are still and integral
nutrients intake on this stage.
New foods can continue to be
introduced.
At this stage children can
develop a sense of
responsibility for healthy food
selections.
Stage 11: Children 4 to 6 years old
Caloric requirements should be
reduced to 9 percent by
replacing higher fat food with
lower.
Should increased their intake of
fruits and vegetables, and very-
low-fat desserts.
3 meals + healthy snacks to
consume enough calories, and
physical activity is important
like low fat yogurt, raw
veggies, fresh fruits, low fat
milk, graham crackers, low fat
cheese
Limit concentration of sweets.
Nutritional Requirements for
Children 4to 6 years old
ENERGY: 1800kcal/day
PROTEIN: 24grms
Stage 111: Children 7 to 12 years
old
With slow and irregular
growth with average of 7lbper
year, may be all at once.
Body changes are gradual.
Girls development occurs
sooner
Breakfast is important with
snacks to consume enough
calories
Physical activity is also
important
Nutritional Requirements for
Children 7to 12 years old
ENERGY: 200 to 2200kcal/day
PROTEIN : 28grms to 46 gms
per day depending on sexual
maturity.
Sexual maturity leads to an
increase of lean body mass,
particularly for boys.
Lean body mass requires more
dietary protein for the growth
and development maintenance.
Adolescence 13 to 19 years old
Nutritional Requirements for
Adolescence
FEMALES
ENERGY: 2200kcal/day
PROTEIN: 45grams per day
MALES
ENERGY: 2500 to 2900
kcal/day
 NUTRITION & DIET THERAPY
PROTEIN: 45 to 49 grams per
day
CALCIUM: 1300mg/day both
male and female
Childhood and Adolescence
Nutritional Problems
Failure to Thrive: infant and
children do not grow and
develop normally, and may be
hospitalized, can be due to
medical illness or psychosocial
problems.
Anemia : common problems
with formula feed children or
those who drink excessive
amount of milk with poor iron
source.
Childhood and Adolescence
Nutritional Problems
Obesity : coz of eating high-
fat foods, overeating, low
physical activity, and eat
supersized meals.
Lead poisoning: found in old
paint dust or chips. Soil, air
from industrial and
transportation pollution,
excessive amounts of lead can
be absorbed into the body.
Childhood and Adolescence
Nutritional Problems
Food allergy : peanuts, milk,
eggs, seafood's
Eating disorder: anorexia
nervosa, bulimia nervosa or
binge eating.
Anorexia nervosa is a mental
disorder characterized by self-
imposed starvation.
Bulimia nervosa is a mental
disorder characterized as binge
and purge syndrome.
THANK YOU…..
AGING AND NUTRITION
AGING
• Is a gradual process that reflects
the influence of genetics,
lifestyles, and environment
over the course of the life span
• Other organ may altered
include taste and smell, saliva
secretion, swallowing
difficulties, liver function, and
intestinal function.
• Nutrients intake and dietary
patterns directly influence the
risk of developing the chronic
disorders osteoporosis,
coronary artery disease,
diabetes, hypertension, and
obesity
• If nutrient intake is adequate
and the exercise is weight
bearing, she may reduce her
risk of osteoporosis as well as
the risk of the other chronic
disorder.
FACTORS FOR HEALTHY
AGING
A. MEANINGFUL
INVOLVEMENT
1. Keep active
2. Functioning as a productive
citizen
3. Remaining involved in the
community
4. Volunteering
5. Continuing to learn
6. Continuing to travel
7. Experiencing new things
8. Having meaningful work
FACTORS FOR HEALTHY
AGING
B. POSITIVE MENTAL
OUTLOOK
1. Developing good mental
outlook
2. Feeling optimistic and hopeful
 NUTRITION & DIET THERAPY
3. Maintaining mental and
physical health
4. Being happy
5. Being joyful
6. Keeping an active mind
7. Exercising self- discipline
8. Being glad for everyday
FACTORS FOR HEALTHY
AGING
C. RELATIOSHIP WITH
OTHERS
1. Giving to others
2. Having friends
3. Expressing an interest in others
4. Displaying kindness towards
others
5. Spending time with family
6. Showing concern for those with
less
7. Helping make the world a
better place
Special Nutrient Needs of Older
Adults
✔ Eating right and staying fit are
important no matter what your
age.
✔ As we get older our bodies
have different needs, so certain
nutrients become especially
important for good health.
A. Calcium and Vitamin D
• Older adults need more calcium
and vitamin D to help maintain
bone health.
• Have three servings of calcium-
rich foods and beverages each
day.
• This includes: fortified cereals
and fruit juices, dark green
leafy vegetables, canned fish
with soft bones, milk and
fortified plant beverages.
• If you take a calcium
supplement or multivitamin,
choose one that contains
vitamin D.
Special Nutrient Needs of Older
Adults
B. Vitamin B12
• Many people older than 50 do
not get enough vitamin B12.
Fortified cereal, lean meat and
some fish and seafood are
sources of vitamin B12.
C. Fiber
• Eat more fiber-rich foods to
stay regular.
• Fiber also can help lower your
risk for heart disease and
prevent Type 2 diabetes.
• Eat whole-grain breads and
cereals, and more beans and
peas — along with fruits and
vegetables which also provide
fiber.
D. Potassium
• Increasing potassium along
with reducing sodium (salt)
may lower your risk of high
blood pressure.
• Fruits, vegetables and beans are
good sources of potassium.
• Also, select and prepare foods
with little or no added salt.
• Add flavor to food with herbs
and spices.
Special Nutrient Needs of Older
Adults
E. Know Your Fats
• Foods that are low in saturated
fats and trans fat help reduce
your risk of heart disease.
• Most of the fats you eat should
be polyunsaturated and
monounsaturated fats, which
are primary found in nuts,
seeds, avocados, olive oil and
fish.
• little or no added salt. Add
flavor to food with herbs and
spices.
Add Physical Activity
• Balancing physical activity and
a healthful diet is the best
recipe for health and fitness.
• Set a goal to be physically
active at least 30 minutes every
day — this even can be broken
 NUTRITION & DIET THERAPY
into three 10-minute sessions
throughout the day.
• For someone who is currently
inactive, it's a good idea to start
with a few minutes of activity,
such as walking, and gradually
increase this time as they
become stronger.
• And always check with a
health-care provider before
beginning a new physical
activity program.
Healthy foods include:
• Fat-free and low-fat dairy
products, such as low-fat
yoghurt, cheese, and milk.
• Protein foods, such as lean
meat, fish, poultry without skin,
beans, and peas.
• Whole-grain foods, such as
whole-wheat bread, oatmeal,
and brown rice. ...
• Fresh fruits, canned, frozen, or
dried.
3 Stages of Adulthood & Nutrition
• After age 18, your dietary
needs change as your body
ages.
• Early adulthood, Middle age
and Late Adulthood.
• Each of these stages carries
slightly different requirements
when it comes to nutrition,
although some needs may stay
the same.
Early Adulthood ( 20-30 years old)
• Spans from ages 20 to 30. If
you fall into this age range, you
should get plenty of calories to
fuel your active lifestyle.
• Recommended RI for women
is 2,000 calories per day and
that men eat between 2,600 to
3,000 calories per day for
optimum health.
• Keep in mind that the more
active you are, the more
calories you should take in to
stay healthy.
• Young adults need plenty of
calories because this is
traditionally when you're most
active and burning the most
calories each day.
• You'll also need to include
plenty of fiber in your diet,
about 28 grams per day for
women and 33.6 grams for
men.
NUTRITIONAL
REQUIREMENTS for Early
Adulthood
• ENERGY: 2200KCAL/DAY
FOR WOMEN
2900KCAL/ DAY FOR
MEN
5000 -6000 KCAL/DAY
FOR ATHLETIC
WITH SERIOUS TRAINING.
• PROTEIN: 46-50GMS
WOMEN AND 58 -63
GMS MEN
• CALIUM: 1300MG –
DROPPING 1000MG
Middle Age
• From age 31 to 50. During this
time, the body starts to slow
down just a bit, so you'll want
to compensate for that in your
diet.
• Recommends RI for women in
this age range get around 1,800
calories per day and men
around 2,200 to maintain their
health.
• Eating fewer calories helps you
maintain your ideal weight as
your metabolism slows and you
burn about 100 fewer calories
per day for every decade you
age.
• Middle age also means a little
less fiber in the diet.
• Women should get around 25.2
grams of fiber per day and men
around 30.8 grams.
Late Adulthood
 NUTRITION & DIET THERAPY
• As you enter your golden years,
your body and metabolism
slows down even further, so
you require fewer calories to
stay healthy.
• From age 51 on, you'll have to
make some dietary adjustments.
• recommends RI for women in
this age group eat around 1,600
calories per day and men eat
around 2,000 per day.
• In terms of fiber, women need
only around 22.4 grams per day
and men around 28 grams per
day, although eating a high-
fiber diet is healthy for all
adults. .
Late Adulthood
• Eating a high-fiber diet is
healthy for all adults.
• Older adults do need more of
some nutrients like vitamin B-6
in their diets – around 1.5 mg
for women and 1.7 mg for men
per day.
• It's important for older women
to get more calcium to prevent
conditions like osteoporosis as
they enter menopause and
experience hormonal changes.
• Although all adults need around
1,000 mg of calcium per day,
women over 51 require 1,200
mg per day.
• Rich in vitamin C aid in the
absorption of the iron.
Adult Dietary Requirements
• Many dietary requirements
don't change throughout
adulthood, including your
protein and carbohydrate
requirements.
• To stay healthy, all adults
should aim to eat a low-sodium
and low-fat diet rich in fruits
and vegetables.
• Fruits and vegetables are rich in
healthy antioxidants and wise
choices at any age.
• During all stages of adulthood,
look for foods rich in whole
grains, stick to eating lean
meats and don't forget to
include fatty fish like salmon
and sardines that are rich in
omega-3 fatty acids.
WAYS TO PROMOTE
SUCCESSFUL AGING
SUGGESTION FROM OLDER
ADULTS
• Simplify your life, identify
priorities and set limits
• Pay attention to yourself; your
body, mind and spirit
• Continue to teach, to learn ;
teach a class, take a class
• Plan some serious leisure
activities, painting, woodwork
• Let yourself laugh and let your
self cry- both are important
• Be flexible; learn to navigate
change
• Be charitable, make it practice
to give wisdom, experience,
money, time and yourself
WAYS TO PROMOTE
SUCCESSFUL AGING
SUGGESTION FROM OLDER
ADULTS
• Be financially assure; invest
early for retirement
• Get a life; you’ll live better in
retirement if you do
• Practice good nutrition and
exercise
• Think your past and future
• Be involved; discover what has
meaning for you.
• Be positive, have hope and
believe there is a tomorrow
• Link with others-relationship
are important
• Become mortal and deal with
your morality
COMMON DISORDER DURING
ADULTHOOD
• FOOD ASPHYXIATION
 NUTRITION & DIET THERAPY
✔ This is due of reduced chewing
ability from loss of teeth or
poorly fitting dentures.
✔ Condition like Parkinson’s
disease and effects of stroke
may also result in chewing and
swallowing difficulties that
may cause asphyxiation.
COMMON DISORDER DURING
ADULTHOOD
• STRESS
✔ Affects all aspects of well-
being, but not be related to
dietary intake and meal pattern,
it may be altered by nutrient
intake.
✔ Condition may be lead to
gastrointestinal tract disorder.
✔ Emotional stress can increase
the release of some hormone
such as adrenaline.
WOMEN’S HEALTH ISSUES
DURING ADULTHOOD
▪ BREAST CANCER
✔ Dietary intake high in animal
fats and low in dietary fiber
may increase the risk for
cancer.
✔ Consumption of high fat diet
may develop breast tumor
▪ MENOPAUSE
✔ Recommendation to increase
fruits, vegetables and grain.
✔ Consumed calcium containing
food accompanied by decreased
intake of dietary fats especially
animal derived fats.
MEN’S HEALTH ISSUES
DURING ADULTHOOD
▪ ALCOHOL
✔ Chronic consumption of large
alcohol affects nutritional
status.
✔ Appetite is diminished and
associated with limited
nutrients absorption,
metabolism, excretion and
further increases the effects of
aging.
✔ May develop cirrhosis of the
liver and cancer of the liver.
✔ Affect social problems like
driving a car, ability to parent
and function in the work
setting.
▪ PROSTATE CANCER
✔ Known as having diet intake of
high fat particularly saturated
fat.
✔ Increase consumption of fruits,
vegetables and whole grain and
lower intake of saturated fat
may reduce the risk for cancer,
have healthy heart and reduce
blood pressure and decrease the
risk of type 2 DM.
THANK YOU …..
GOD BLESS US ALL
DIET DURING INFANCY
1.1 YEAR IN LIFE
NUTRITIONAL DURING
INFANCY
ENERGY
⦿ Birth weight doubles by 6
months and
⦿ triples within first year
⦿ During the first year
approximately 98 to 108
calories per kilogram of body
weight each day
⦿ Infants should not have a
restricted fat intake. Human
milk has a high in cholesterol
and fat content.
NUTRITIONAL DURING
INFANCY
PROTEIN
⦿ Protein requirements is highest
during the first 4 months of life.
⦿ Recommended intake of 2.2
g/kg/day from birth to 6 months
of age and 1.6 g/kg/day for the
second half of 1 year.
 NUTRITION & DIET THERAPY
⦿ Protein has a significant
influence on renal solute load.
⦿ The infant kidney is immature
and unable to handle the large
renal solute of an adult.
⦿ Therefore increasing a normal
infants protein intake above
recommended amount should
be avoided.
NUTRITIONAL DURING
INFANCY
VITAMINS AND MINERALS
SUPPLEMENTATION
⦿ Nutritional needs depend on
child’s growth rate
⦿ The basis of the infant’s diet is
breast milk or formula.
⦿ Essential vitamins and minerals
can be supplied in breast milk,
and formula.
⦿ Vitamin D supplement given in
breastfed infants not in exposed
to sunlight
⦿ When reaching 6 months of
age, the infant given iron-
fortified cereal .
⦿ Flouride is not recommended
on infants less than 6 months of
age.
⦿ Vit K injection of .5mg to .
10mg is given after birth to
prevent hemorrhage.
NUTRITIONAL DURING
INFANCY
FOODS FOR INFANTS
⦿ The ideal food for the first 4 to
6 months is breast milk.
⦿ Breast milk has the correct
balance of all essential nutrients
to protect the infants from acute
and chronic disease.
⦿ The breast should be offered at
least 10 to 12 times per 24
hours in the first several
weeks.at least 10 to 15 mins per
breast ( offer both breast per
session) is good
recommendation
⦿ If mother has medical condition
and breast feeding is
contraindication, a variety of
formula milk will be given
either cow’s milk or soy milk.
BENEFITS FOR THE INFANT
A. Breast feeding :Has perfect
composition for baby’s needs
Breast milk provides antibodies
⦿ Lower incidence of ear
infections, diarrhea, allergies.
⦿ Promotion of good jaw
development
⦿ Decreased risk of obesity later
in life
⦿ Facilitation of bonding between
mother and child
⦿ Helps lose weight gained
during pregnancy
⦿ Stimulates uterus to contract
back to original size
⦿ Is economical Provides
opportunity for resting Is
always right temperature and
⦿ readily available
BENEFITS FOR THE INFANT
⦿ Also beneficial to mothers Less
risk of breast cancer and
osteoporosis
⦿ Indications of adequate
nutrition of the infant include:
a. Infant has six or more wet
diapers per day
b. Infant has normal growth
c. Infant has one to two bowel
movements per day
d. Breast becomes less full during
nursing
 NUTRITION & DIET THERAPY
BENEFITS FOR THE INFANT
B. Bottle Feeding Infant should
be cuddled and held in semi-
upright position
Planning and Intervention for
Bottle feeding:
⦿ During and after the feeding,
the infant should be burped to
release gas in the stomach and
prevent regurgitation
(vomiting).
⦿ Formulas made from modified
cow’s milk to resemble breast
milk in nutritional value
⦿ Formulas has more protein and
mineral salts and less lactose
than human milk
⦿ Synthetic formula may be used
for infants who are sensitive or
allergic
BENEFITS FOR THE INFANT
⦿ Bottle Feeding Formula must
be prepared with correct
amount of water to prevent
health complications
⦿ Too little water will create too
heavy a protein and mineral
load for the infant’s kidneys.
⦿ Too much water will dilute the
nutrient and calorie value so
that the infant will not thrive
⦿ Infants under the age of 1 year
should not be given regular
cow’s milk , it can cause
gastrointestinal blood loss in
infants
⦿ Infants should not be put to bed
with a bottle
⦿ The milk then bathes the upper
front teeth, causing tooth decay.
SUPPLEMENTARY FOODS
⦿ The introduction of solid foods
before the age of 4 to 6 months
is recommended.
⦿ Solid foods must be introduced
gradually and individually
⦿ Solids should be started with
iron-fortified rice
⦿ Followed with cooked
vegetables, then cooked fruits,
egg yolk, and finely meats
⦿ Honey should never be given to
an infant because it could be
contaminated with Clostridium
botulinum bacteria.
SUPPLEMENTARY FOODS
⦿ When the infant learns to drink
from a cup, juice can be
introduced from a cup better
than a bottle
⦿ Never be given from a bottle
because babies will fill up on it
and not get enough calories
from other sources.
⦿ Use only 100 percent juice
products because they are
nutrient-dense.
⦿ Breast milk or formula
continues to be the main source
of calories at this age.
SUPPLEMENTARY FOODS
⦿ Solid foods must be introduced
gradually and individually
⦿ Solids food should be started
with
A. iron-fortified rice cereal
B. cooked vegetables,
C. cooked fruits,
D. egg yolk,
SPECIAL CONSIDERATION
FOR INFANTS WITH ALTERED
NUTRITIONAL NEEDS
A. Premature infants- sucking
reflex not develop until 34 wks
gestation.
✔ Must need total parenteral
nutrition,
✔ tube feeding
 NUTRITION & DIET THERAPY
✔ bolus feeding
✔ Infants have increased needs
for protein, calories, calcium,
phosphorus, sodium, iron, zinc,
vitamin E, and fluids.
✔ The best feeding choice is
mother’s milk.
Concern for premature infants;
⮚ Low birth weight
⮚ Unlack of fat reserves
⮚ Mental delays
⮚ Growth retardation
Breast milk is best nutrition for
baby and mother encourage to
pump their milk until the infants is
able to nurse.
SPECIAL CONSIDERATION
FOR INFANTS WITH ALTERED
NUTRITIONAL NEEDS
B. Cystic Fibrosis –
⮚ is an inherited disease that
affects the respiratory and
digestive systems.
⮚ CF makes children sick by
disrupting the normal function
of epithelial cells — cells that
make up the sweat glands in the
skin and that also line
passageways in the lungs, liver,
pancreas, and digestive and
reproductive systems.
Your Child's Nutritional Needs
⮚ In general, kids with CF need’s
more calories than other kids in
their age group.
⮚ The amount of additional
calories they need will vary
according to each child's lung
function, activity level, and
illness.
SPECIFIC NUTRITIONAL
NEEDS WITH CF:
1. Calcium. Patients with pancreatic
insufficiency have difficulty
absorbing calcium and are
especially at risk for developing
osteoporosis (weak, brittle
bones), as are all kids with CF.
a. Dairy products are good
sources of calcium (and the
full-fat varieties also are good
sources of fat and calories).
b. Many juices also are fortified
with calcium.
2. Essential fatty acids.
a. Found in plant oils, safflower
oil, and soybean oils, they help
in the building of cell
membranes and may play a role
in lung function.
b. Salmon, flax seeds, and
walnuts are excellent food
sources of omega 3 fatty acids.
C. Failure to Thrive ( FTT)
⮚ Can be determined by plotting
the infants growth on standard
charts.
⮚ Weight for height is the
parameter affected when
determining FTT.
⮚ Slow development or lack of
physical skills such rolling
over, sitting, standing and
walking
⮚ Mental and social skill delayed
Causes:
⮚ Watered down formula
⮚ Congenital abnormalities
⮚ AIDS
⮚ Lack of bonding
⮚ Child abuse or neglection
SPECIFIC CONSIDERATION
FOR INFANTS WITH
METABOLIC DISORDER
 NUTRITION & DIET THERAPY
1. GALACTOSEMIA is a condition
affecting 1 in 30,000 live birth in
which there is lack of the liver
enzyme transferase.
Diet therapy:
a. Feed baby with lactose free
milk formula
b. Provide supplemental minerals
and vitamins like calcium, and
vit D and riboflovin or vit B
2. PHENYLKETONURIE (PKU)
lack of liver enzyme called
phenylalanine hydroxylase which is
necessary for the metabolism of the
amino acid.
▪ Most of them are hyperactive,
suffer seizures between 6 and
18th months and become
retarded.
▪ Newborn screening is
recommended
▪ PKU babies typically have light
– colored hair.
DIET THERAPY:
a. Phenyle-free milk formula
b. PKU–1, 2 or 3 milk formula.
3. MAPLE SYRUP URINE
DISEASE ( MSUD)
is a congenital defect in the
inability to mobilize three amino acid
like: leucine, isoleucine and valine. It
is name for the odor of the urine of
infants.
Diet therapy:
a. Provide sufficient calories and
nutrients
b. Give a special milk formula
and low – protein foods.
NUTRITION AND PATIENT
CARE
NUTRITION
⮚ is about eating a healthy and
balanced diet. Food and drink
provide the energy
and nutrients you need to be
healthy.
⮚ the process of providing or
obtaining the food necessary
for health and growth.
⮚ is the science that interprets the
nutrients and other substances
in food in relation to
maintenance, growth,
reproduction, health and
disease of an organism. It
includes ingestion, absorption,
assimilation, biosynthesis,
catabolism and excretion.
NUTRITION INTERVENTION
⚫ NUTRITIONAL CARE
PROCESS
✔ Identify the nutritional needs
depending on his or her injury
or illness.
✔ Use the 5 steps procedure of
nursing process to identify and
solve nutrition-related
problems.
Step 1: Assessment of patient’s
nutritional status and needs
Step 2: Analysis of assessment date to
determine nutritional requirements.
Step 3: Planning intervention to meet
nutritional needs
Step 4: Implementation of the plan
( step 1 to 3)
Step 5: Evaluation of intervention by
ongoing assessment (step 1) and
making appropriate changes.
NUTRITION MANAGEMENT
CHECKLIST
⚫ UNIT ASSESSMENT
 NUTRITION & DIET THERAPY
1. Checked appropriate dietary
order.
2. Assessed nutritional needs of
patient.
3. Determined sociocultural
orientation of patient.
4. Obtained diet history and
determined eating habits and
food preference of patient.
5. Assessed ability of patient to
comply with diet regimen.
6. Assessed patient’s fluid intake
needs.
7. Checked recommended daily
dietary allowance and essential
body nutrients.
8. Evaluate results of appropriate
data.
SERVING A FOOD TRAY
⚫ PROCEDURE
1. Washed hands.
2. Raised bed to high position and
lowered side rails.
3. Assisted patient to sitting
position if possible
4. Placed protective covering over
goer if desired.
5. Place tray at table, position
table so patient could see food.
6. Assisted patient as needed. Eg.
Cut meat, sliced fruit
7. Checked in patient during meal
to determine if assistance was
necessary.
8. Repositioned tray table at
bedside when completed.
9. Provide hand cleaning an oral care
if desired.
10. Offered bedpan or assistance to
commode to
bathroom
11. Raised side rail
12. Positioned bed for comfort
13. Noted amount of food eaten
14. Removed tray from room
15. Washed hand
16. Charted amount eaten. If
necessary recorded it in Intake and
Output sheet.
FEEDING A PATIENT
⚫ PROCEDURE
1. Checked Patient Care Plan for
current changes in
diet.
2. Washed hands.
3. Raised bed to high and lower side
rails.
4. Assorted patient to wash hands and
face, if
desired.
5. Placed patient sitting position if
possible.
6. Placed protective covering over
gown if desired
7. Placed tray on table. Positional
table also patient
could see food.
8. Stood or sat facing patient
9. Asked patient the order in which
he/she would like
to be fed.
10. Encouraged the patient to hold
his/her glass,
breed, finger foods.
11. Allowed him/her time to chew and
swallow.
12. Provided fluids throughout meal.
13. Alternated foods.
14. Allowed patient to rest at intervals
during the
feeding.
15. Talked with patient during meal.
16. Repositioned tray table at beside
when complicated.
17. Provide hand cleaning and oral
care desired.
18. Raised side rail.
19. Position bed for comfort. Lowered
bed if it was
raised
20. Noted amount of food eaten.
21. Removed food tray from room.
 NUTRITION & DIET THERAPY
22. Washed hands.
23. Charted amount eaten. If
necessary, recorded
I&O
NUTRITION INTERVENTION
⚫ NUTRITIONAL RISK
✔ Assessing patients nutritional
status, estimating nutritional
needs and planning for
intervention.
✔ Areas to consider regarding
nutritional risk are age, weight,
laboratory test result, body
system, and feeding modalities.
Therapeutic diet checklist
⚫ Unit of assessment
1. Assessed total condition of
patient-physical, emotional and
mental state.
2. Determined appropriateness of
prescribed therapeutic diet as
related to altered of health
3. Evaluated ability if patient to
tolerate diet.
4. Assessed mental state of patient
in regard to compliances with
diet regimen.
5. Referred to general assessment
steps in maintaining normal
nutritional status.
Providing Therapeutic Diet
⚫ Procedure
1. Become familiar with
therapeutic diets.
2. Learned the specific diets
appropriate for certain
disorders.
3. Identified patient through ID
band.
4. Washed hands.
5. Informed patient of the diet
served. Reminded patient about
specific diet restrictions and
provided health teachings
regarding therapeutic diet.
6. Donned gloves as necessary
7. If SO is present, demonstrate how
to provide diet therapy if needed (for
special feeding techniques).
8. Provided assistance to patient if
necessary. Positioned patient
appropriately.
9. Provided oral care when feeding is
done.
MEDICAL NUTRTION
THERAPY
⚫ FOOD SERVICE
DELIVERY SYSTEM
✔ It is beneficial for the nurses to
familiarized the food service
system staff like:
1. Procedure and telephone
numbers to request a physician-
ordered diet, make diet changes
or report problems with a
patient’s tray.
2. Procedure and telephone
number of the dietician to
request nutrition assessment or
education.
3. Time schedule of meal service
so request or charges can be
made before meals are
delivered to patients.
4. Location of the diet manual on
the nursing unit.
MEDICAL NUTRTION
THERAPY
⚫ FOOD SERVICE
DELIVERY SYSTEM
✔ Identify the Basic Hospital
Diets such as;
1. Clear liquid diet
 NUTRITION & DIET THERAPY
2. Full liquid diet ⚫ PREVENTION OF
3. Mechanical diet ASPIRATION
4. Soft diet ⚫ PATENCY OF TUBING
5. Regular or General diet ⚫ Check tube placement before
6. Diet as tolerated administration
⚫ Tube placed into small bowel
MEDICAL NUTRTION are associated with decreased
THERAPY risk for aspiration
⚫ Irrigate tubes every 6-8 hours
⚫ FOOD SERVICE with 40-50ml of warm water
DELIVERY SYSTEM ⚫ Flush tube with 40-50ml of
✔ Enteral Nutrition such as; warm water each time feeding
1. GI tract is used to provide is stopped
nourishment ⚫ If tubing clogs, flush with 30-
2. May administered orally or via 50 ml of warm water
tubes.
3. Most often referring to CRITERIA FOR SAFE
specialized formula feeding ADMINISTRATION OF
ENTERAL TUBE FEEDING
CRITERIA FOR SAFE
ADMINISTRATION OF CRITERIA CONSIDERATION
ENTERAL TUBE FEEDING ⚫ MEDICATION
⚫ PATENCY OF TUBING
CRITERIA CONSIDERATION
⚫ MONITORING
⚫ TEMPERATURE
⚫ Administered through tubing in
⚫ PREVENTION OF
liquid form
BACTERIAL
⚫ Flush tubing before and after
CONTAMINATION
giving the medication with 20
⚫ Administer solution infused by
cc of water to prevent clogging
continuous drip chilled
⚫ Crushing medication when not
⚫ Administer intermittent and
in liquid form before feeding
bolus feeding at room
through the tube
temperature to decrease
⚫ Do not mix together multiple
incidence of GI side effects.
medication and deliver
⚫ Use closed feeding containers
simultaneously unless the
⚫ Prefilled, ready to feed, closed
compatibility of the medication
system are available for some is known
products never add new monitor patient response to
formula to old formula medications given through the
⚫ Do not hang feeding for longer feeding tube and make changes
than 4-8 hours. needed
⚫ Confirm tube placement before
CRITERIA FOR SAFE initiation of feeding and before
ADMINISTRATION OF each intermittent feeding
ENTERAL TUBE FEEDING
⚫ Record urine glucose every
shift until final feeding rate and
CRITERIA CONSIDERATION
concentration are established
 NUTRITION & DIET THERAPY
⚫ Record gastric residual every 4
hours
⚫ Record bowel movements and
consistency
⚫ Record daily weight, intake and
output,
⚫ Reassess nutrition indexes
weekly, adjusting energy aand
protein as needed
Nutrients Via Tube Feeding
Checklist
⚫ Unit assessment
1. Assessed overall patient status.
2. Evaluated oral intake.
3. Assessed nutritional intake.
4. Assessed status of GI tract.
5. Assessed capacity to chew and
swallow.
6. Checked for presence of Gag
reflux.
7. Evaluated respiratory or
thoracic condition.
8. Checked for renal
complications.
9. Checked for vomiting and/or
diarrhea.
10.With hi-protein diets, assessed
for fluid and electrolyte
imbalance.
GIVING OF NASOGASTRIC
TUBE FEEDING
⚫ PROCEDURE
1. Explained procedure to the patient
and assessed
privacy.
2. Placed patient on the right side in
high-fowler’s
position.
3. Aspirate stomach contents to
determine amount of
residual.
4. Returned aspirated contents to
stomach to prevent
electrolyte imbalance.
5. Pinched the tubing.
6. Remove plunger from barrel of
syringe and
attached barrel to NGT.
7. Filled syringe with formula.
8. Held container no more than 18
inches above the
patient.
9. Allowed formula to infuse slowly
(between 20 to 35
minutes) through the tubing. Did
not allow syringe
to run dry.
10. Followed tube feeding with water
in amount
ordered.
11. Clamped end of the tube.
12. Washed tray and returned it to
patient’s bedside.
13. Gave water in between feeding if
tube feeding
was the sole source of nutrition.
14.Washed, rinsed and dried
equipment after each
feeding.
OVERVIEW OF MEDICAL
NUTRITION THERAPY
Nutrition Disorders of the :
1. Gastroesophageal Reflux
Disease ( GERD)
2. Peptic Ulcer
3. Dumping Syndrome
4. Celiac Disease ( Gluten-
Sensitive Enteropathy)
5. Lactose Intolerance
6. Inflammatory Bowel Disease
7. Ileostomies and Colostomies
Disease
8. Diverticular Diseases
9. Intestinal Gas and Flatulence.
10.Dysphagia
 NUTRITION & DIET THERAPY
Gastroesophageal Reflux Disease of your small intestine
(GERD) (duodenum)
▪ is a digestive disorder that
occurs when acidic stomach IN ADDITION TO TAKING THE
juices, or food and fluids back ANTIBIOTICS AND ACID-
up from the stomach into the BLOCKING MEDICATIONS
esophagus. GERD affects RECOMMENDED BY YOUR
people of all ages—from DOCTOR FOR YOUR ULCER
infants to older adults. TREATMENT, EATING THESE
▪ occurs when there is acid FOOD MAY ALSO BE HELPFUL
backflow from the stomach into AGAINST THE ULCER-CAUSING
the esophagus. This happens BACTERIA:
commonly but can cause
complications or troublesome • cauliflower
symptoms, such as heartburn. • cabbage
• radishes
Foods that may help reduce the • apples
symptoms • blueberries
▪ Vegetables • raspberries
▪ Ginger • blackberries
▪ Oatmeal • strawberries
▪ Non-citrus fruits • cherries
▪ Lean meats and seafood ▪ bell peppers
▪ Egg whites • carrots
▪ Healthy fats • broccoli
• leafy greens, such as kale and
Foods that may triggers the spinach
symptoms • probiotic-rich foods, such as
▪ High-fat foods yogurt, kefir, miso, sauerkraut,
▪ Tomatoes and citrus fruit and kombucha.
▪ Chocolate • olive oil and other plant-based
▪ Garlic, onions, and spicy foods oils
▪ Caffeine • honey
▪ Mint • garlic
• decaffeinated green tea
PEPTIC ULCER • licorice
▪ open sores that develop on the • turmeric
inside lining of your stomach
and the upper portion of your WHY THEY HELP
small intestine. The most ▪ stomach ulcer is caused by
common symptom of a peptic an H. pylori infection, so foods
ulcer is stomach pain. that are rich in antioxidants
may be beneficial. They could
PEPTIC ULCERS INCLUDE: help protect and activate your
• Gastric ulcers that occur on immune system and help fight
the inside of the stomach the infection. They may also
• Duodenal ulcers that occur on help protect against stomach
the inside of the upper portion cancer.
 NUTRITION & DIET THERAPY
NUTRITIONAL THERAPY
⚫ AVOID RED AND BLACK
PEPPER,
⚫ CHILI PEPPER
⚫ COFFE
⚫ CAFFEINE
⚫ ALCOHOL
What is Dumping Syndrome?
Is common after gastric surgery.
It is a group of symptoms that may
result from having part of your
stomach removed or from other
surgery involving the stomach.
What are the symptoms?
• EARLY PHASE – may
happen about 30-60 minutes
after eating.
✔ A feeling of fullness,
even after eating just a
small amount
✔ Abdominal cramping or
pain
✔ Nausea or vomiting
✔ Severe diarrhea
✔ Sweating, flushing, or
light-headedness
✔ Rapid heartbeat
CAUSES
• The small intestine stretches.
• Water pulled out of the
bloodstream moves into the
small intestine.
• Hormones released from the
small intestine into the
bloodstream affect blood
pressure.
• LATE PHASE – may happen
about 1-3 minutes after eating.
✔ Fatigue or weakness
✔ Flushing or sweating
✔ Shakiness, dizziness,
fainting, or passing out
✔ Loss of concentration or
mental confusion
✔ Feeling of hunger
✔ Rapid heartbeat
CAUSE: Rapid rise and fall of blood
sugar levels.
When do you get dumping syndrome?
Dumping syndrome usually
occurs when one consumes food or
drinks that are high in sugar (refined
sugar), fatty and fried food.
How to prevent it?
✔ Eating a protein-based diet
✔ Never eat food that is rich in
sugar or fats alone
✔ Chew the food thoroughly and
eat slowly
✔ Avoid drinking and eating at
the same time (give yourself
atleast 20 minutes).
✔ Avoid alcohol
How do you treat Dumping
Syndrome?
It is best to discuss with your
surgeon or dietitian as there are
various treatment depending on what
exactly is causing it. This ranges from
simple diet modifications to different
types of medication.
NUTRITIONAL THERAPY
⚫ ABSTAINING FROM :
✔ Wheat
✔ Oats
✔ Rye
✔ Barley
✔ Limited of wheat-based breads,
ceackers and pasta
FOODS CONTAINS GLUTEN
✔ Meat and meat alternatives
✔ Grains and grain products
✔ Vegetables
✔ Fats and oils
✔ Soup sweets and desserts
✔ Beverages
✔ Soy sauce
✔ Vinegar
Lactose Intolerance
 NUTRITION & DIET THERAPY
• is caused by a defieciency of Why a Ileostomy or an Colostomy is
lactase, the enzyme needed for done
digesting the sugar in milk. • cancer of the colon, rectum or
• undigested lactose remains in anus
the gut and acts osmotically to • an inflammatory bowel disease,
draw water into the intestines such as ulcerative colitis or
• Primary lactose intolerance Crohn’s disease
includes congenital lactase • familial adenomatous polyposis
deficiency and adult lactase (FAP)
deficiency. • a blockage in the intestine
• Secondary lactose intolerance (called a bowel obstruction)
arise from the other disease • an injury that damages the
conditions affecting the intestine
intestinal mucosa and can occur • diverticulitis
after small bowel or gastric • birth defects of the intestines
surgery after periods of disease -A ileostomy or an colostomy is done
of intestinal tract. when part of the intestine needs to be
removed or bypassed. A colostomy or
Diet Therapy an ileostomy may be done as part of
• a lactose-restricted diet is a treatment for:
difficult diet since lactose is a Ileostomy and Colostomy Diet
hidden ingredient in many Therapy
foods and drugs. • Powdered milk
• restriction is also highly • Yogurt
individualized because the • Cheese
amount of lactose allowed • Egg
depends on the person's • Meat (w/o visible fat)
tolerance. • Fish
• Nuts
Foods • Cereals
• Milk • Orange
• Milk solids • Whited bread, Pasta, and Rice
• Lactose • Lettuce
• Whey • Tomatoes
• Casein • Zucchini
• Cream Cheese • Potatoes
• Watermelon
Ileostomy and Colostomy Disease • Honeydew
• A ileostomy is a surgery that • Banana
makes a temporary or
permanent opening called a INTESTINAL GAS AND
stoma. A colostomy creates an FLATULENCE
opening from the colon to the INTESTINAL GAS AND
outside of the body through the FLATULENCE
abdominal wall.
• A colostomy or an ileostomy • What is flatulence?
can be temporary or Commonly known as farting, passing
permanent.  wind, or having gas, flatulence is a
medical term for releasing gas from
 NUTRITION & DIET THERAPY
the digestive system through the anus.
It occurs when gas collects inside the
digestive system, and is a normal
process.
Gas collects in two main ways.
Swallowing air while you eat or drink
can cause oxygen and nitrogen to
collect in the digestive tract. Second,
as you digest food, digestive gases
such as hydrogen, methane, and
carbon dioxide collect. Either method
can cause flatulence.
INTESTINAL GAS AND
FLATULANCE
FOODS TO LIMIT TO REDUCE
FLATULENCE
DIET THERAPY FOR
INGESTINAL GAS AND
FLATULENCE
DYSPHAGIA
•  is the medical term for
swallowing difficulties.
• Some people
with dysphagia have problems
swallowing certain foods or
liquids, while others can't
swallow at all.
• Other signs
of dysphagia include:
coughing or choking when
eating or drinking. bringing
food back up, sometimes
through the nose.
NUTRITIONAL THERAPY
•  A dysphagia diet features
different textures of foods and
liquids that can make it easier
and safer for patients to
swallow.
• These textures make it easier
to chew and move food in the
mouth and reduce the risk of
food or liquid going into the
windpipe or trachea, which
leads to the lungs.
FOODS ARE GOOD FOR
DYSPHAGIA
•  Pureed breads (also called
“pre-gelled” breads)
• Smooth puddings, custards,
yogurts, and pureed desserts.
• Pureed fruits and well-mashed
bananas.
• Pureed meats.
• Souffles.
• Well-moistened mashed
potatoes.
• Pureed soups.
• Pureed vegetables without
lumps, chunks, or seeds.
OVERVIEW OF MEDICAL
NUTRITION -II
⚫ Constipation
⚫ Diarrhea
⚫ Fatty liver Disorder
⚫ Viral Hepatitis
⚫ Cirrhosis of the Liver
⚫ Gallbladder Disorder
⚫ Pancreatitis
⚫ Diabetes Mellitus Type 1 and
2
⚫ Coronary Artery Disease
CONSTIPATION
WHAT IS CONSTIPATION?
• Chronic constipation is
infrequent bowel movements or
difficult passage of stools that
persists for several weeks or
longer.
• Constipation is generally
described as having fewer than
 NUTRITION & DIET THERAPY
three bowel movements a
week.
• It most commonly occurs when
waste or stool moves too
slowly through the digestive
tract or cannot be eliminated
effectively from the rectum,
which may cause the stool to
become hard and dry.
NUTRITIONAL THERAPY
• Consume adequate fluids
• Consume variety of foods
which contain ample amount of
fiber.
• Have a adequate balance diet
What should I avoid eating or
drinking if I’m constipated?
• To help prevent or relieve
constipation, avoid foods with
little to no fiber, such as
1.)chips
2.)fast food
3.)meat
4.)prepared foods, such as some
frozen meals and snack foods
5.) hot dogs or some microwavable
dinners
6.)Alcohol. Alcohol is frequently
mentioned as a likely cause of
constipation
7.)Milk and dairy products
Foods best for constipation
1. Foods that contain Soluble Fiber
( bran, barley, nuts, seeds, beans,
lentils, peas)
2.Apples
3.Pears
4.Kiwifruit
5..Citrus Fruits
6. Sweet Potato
7. Spinach and Other Greens
8. Prunes. Dried plums, known as
prunes, are widely used as a natural
remedy for constipation
DIARRHEA
Diarrhea
• In diarrhea, fluids are not
absorbed as the intestinal
contents move quickly through
the GI tract and this is added to
the food residue preventing
complete digestion and
absorption
• Diarrhea is not a disease itself
but a symptom of variety of
diseases or infection
• Anorexia, vomiting,
restlessness, muscle weakness
Diet Therapy
• Oral fluids (provides
electrolytes)
• NPO for 12 hrs
• Potassium
• Avoid harsh fibers
Fatty Liver Disorder
Fatty Liver Disorder
• Fatty liver disease is a
condition in which fat builds up
in your liver. There are two
main types: Nonalcoholic fatty
liver disease (NAFLD)
Alcoholic fatty liver disease,
also called alcoholic
steatohepatitis.
• Nonalcoholic fatty liver
disease is a type of fatty liver
disease that is not related to
heavy alcohol use.
• Alcoholic fatty liver disease is
due to heavy alcohol use.
Fatty liver develops when your
body produces too much fat or
doesn’t metabolize fat efficiently
enough. The excess fat is stored in
liver cells, where it accumulates and
causes fatty liver disease. Lifestyle
changes can help reverse fatty liver
disease like limit or avoid alcohol,
take steps to lose weight, and make
changes to your diet. Physical activity
can also be an effective way to
decrease liver fat.
Foods to keep your Liver healthy:
 NUTRITION & DIET THERAPY
• Coffee
• Green leafy vegatables
(cauliflower,cabbage,spinach)
• Oatmeal
• Avocado
• Olive oil
• Green tea
• Fish
Avoid
• Alcohol is the major cause of
fatty liver disease as well as
other liver diseases.
• Sugary foods such as candy,
cookies, sodas, and fruit juices.
High blood sugar increases the
amount of fat buildup in the
liver.
• Fried foods which are high in
fat and calories.
• White bread, rice, and pasta.
White usually means the flour
is highly processed, which can
raise your blood sugar more
than whole grains due to a lack
of fiber.
• Red meat are high in saturated
fat.
What is viral hepatitis?
Viral hepatitis is an infection that
causes liver inflammation and
damage. Inflammation is swelling that
occurs when tissues of the body
become injured or infected.
Inflammation can damage organs.
Researchers have discovered several
different viruses link that
cause hepatitis, including hepatitis A,
B, C, D, and E.
Hepatitis A and hand hepatitis
E typically spread through contact
with food or water that has been
contaminated by an infected
person’s stool. People may also get
hepatitis E by eating undercooked
pork, deer, or shellfish.
Hepatitis B, hepatitis C, and hepatitis
D spread through contact with an
infected person’s blood. Hepatitis B
and D may also spread through
contact with other body fluids. This
contact can occur in many ways,
including sharing drug needles or
having unprotected sex.
The hepatitis A and E viruses
typically cause only acute, or short-
term, infections. In an acute infection,
your body is able to fight off the
infection and the virus goes away.
Diet and nutrition of a patient who
has a hepatitis?
• A bad diet sometimes can lead
to liver problems. If your diet
provides too many calories, you
will gain weight. Being
overweight is linked to the
buildup of fat in the liver,
called "fatty liver." 
Eating tips.
People with hepatitis don't need to
follow a special "hepatitis diet." The
advice that an average, healthy person
gets will work just as well for people
with hepatitis ,unless those people
also have cirrhosis or another
condition, such as diabetes, HIV, or
kidney disease.
• General dietary advice:
• Eat regular, balanced meals
• Maintain healthy calorie intake
• Eat whole-grain cereals, breads,
and grains
• Eat lots of fruits and vegetables
• Get adequate protein
• Go easy on fatty, salty, and
sugary foods
• Drink enough fluids
• Reach and maintain a healthy
weight
• Cautions:
• Avoid alcohol
• Be careful with dietary
supplements
CIRRHOSIS OF THE LIVER
Cirrhosis of the liver
 NUTRITION & DIET THERAPY
■ Is a complication of liver
disease that involves loss of
liver cells and irreversible
scarring of the liver.
■ Alcohol & Viral hepatitis B &
C are common cause of
cirrhosis, although there are
many other causes.
■ Diagnosis of cirrhosis can be
suggested by history, physical
examination & blood tests, and
can be confirmed by liver
biopsy.
■ Treatment of cirrhosis is
designed to prevent further
damage to the liver, treat
complications of cirrhosis, and
preventing or detecting liver
cancer early.
Sign & Symptoms
Cirrhosis often has no signs or
symptoms until liver damage is
extensive. When signs and
symptoms do occur, they may
include:
■ Fatigue
■ Easily bleeding or bruising
■ Loss of appetite
■ Nausea
■ Swelling in your legs, feet or
ankles (edema)
■ Weight loss
■ Itchy skin
■ Yellow discoloration in the skin
and eyes (jaundice)
■ Fluid accumulation in your
abdomen (ascites)
■ Spiderlike blood vessels on
your skin
What to eat & to avoid:
Advise
⮚ Coconut Water
⮚ Radishes
⮚ Fresh vegetable soup, salad,
juices
⮚ Sugarcane juices
⮚ is inflammation of the pancreas
⮚ It happens when digestive
enzymes start digesting the
pancreas itself. Pancreatitis can
be acute or chronic.
⮚ The most common cause is
heavy alcohol use. Other causes
include cystic fibrosis and other
inherited disorders, high levels
of calcium or fats in the blood,
some medicines, and
autoimmune conditions.
What not to eat if you have
pancreatitis
Foods to limit include:
• red meat
• organ meats
• fried foods
• fries and potato chips
• mayonnaise
• margarine and butter
• full-fat dairy
• pastries and desserts with added
sugars
• beverages with added sugars
The best food choices!
• fruits
• vegetables
• whole grains
• legumes
• nonfat/low fat dairy
• lean cuts of meat
• avocado
• olive oil
• fatty fish
• nuts
DIABETES MELLITUS
TYPE 1
• Type 1 diabetes occurs because
the insulin-producing cells of
the pancreas (beta cells) are
damaged.
• In Type 1 diabetes, the
pancreas makes little or no
insulin, so sugar can;t get into
the body's cells for use as
energy.
 NUTRITION & DIET THERAPY
• People with Type 1 diabetes
must use insulin injections to
control their blood glucose.
• Type 1 is the most common
form of diabetes in people who
are under age 30, but it can
occur at any age.
• Ten percent of people with
diabetes are diagnosed with
Type 1.
• In Type 2 diabetes (adult onset
diabetes), the pancreas makes
insulin, but it either doesn't
produce enough, or the insulin
doesn't work properly.
• Nine out of 10 people with
diabetes have Type 2.
• This type occurs most often in
people who are over 40 years
old but can occur even in
childhood if there are risk
factors present. Type 2 diabetes
may sometimes be controlled
with a combination of diet,
weight management and
exercise.
• However, treatment also may
include oral glucose-lowering
medications (taken by mouth)
or insulin injections (shots)
TYPE 11
DIABETES MELLITUS TYPE 1
DIET
MEAL TIMING IS VERY
IMPORTANT FOR PEOPLE
WITH TYPE 1 DIABETES.
MEALS MUST MATCH INSULIN
DOSES. EATING MEALS WITH A
LOW GLYCEMIC LOAD (INDEX)
MAKES MEAL TIMING EASIER.
• Foods to eat for a type
1 diabetic diet include
complex carbohydrates such as:
• brown rice,
• whole wheat,
• quinoa,
• oatmeal,
• fruits,
• vegetables,
• beans, and
• Lentils.
• Five type 1
diabetes "superfoods" to eat
include fiber, sardines, vinegar,
cinnamon, and berries.
DIABETES MELLITUS TYPE 1I
DIET
MEAL TIMING IS VERY
IMPORTANT FOR PEOPLE
WITH TYPE 1 DIABETES.
MEALS MUST MATCH INSULIN
DOSES. EATING MEALS WITH A
LOW GLYCEMIC LOAD (INDEX)
MAKES MEAL TIMING EASIER.
• Foods to eat for a type
I1 diabetic diet include
complex carbohydrates such as:
• brown rice,
• whole wheat,
• quinoa,
• oatmeal,
• fruits,
• vegetables,
• beans, and
• Lentils.
• Five diabetes "superfoods" to
eat include chia seeds, wild
salmon, white balsamic
vinegar, cinnamon, and lentils.
CORONARY ARTERY DISEASE
CORONARY ARTERY DISEASE
Hypertension
What is hypertension?
• Hypertension is when blood
pressure is too high. Blood
pressure is written as two
numbers. The first (systolic)
number represents the pressure
in blood vessels when the heart
contracts or beats. The second
 NUTRITION & DIET THERAPY
(diastolic) number represents into the shoulder, arm, back,
the pressure in the vessels when neck or jaw.
the heart rests between beats
NUTRITIONAL DIET FOR
What is the main cause of MYOCARDIAL INFARCTION
hypertension? • Eat a Mediterranean‐style diet
• Common factors that can lead • bread,
to high blood pressure include: • fruit,
A diet high in salt, fat, and/or • vegetables and
cholesterol. Chronic conditions • fish
such as kidney and hormone • less meat;
problems, diabetes, and high • butter and cheese
cholesterol. • vegetable and
• plant oils
What are the nutritional therapy FOODS SHOULD AVOID FOR
for hypertension? MYOCARDIAL INFARCTION
• Eat more fruits, vegetables, and • Bacon, sausage and other
low-fat dairy foods processed meats. Hayes, who
• Cut back on foods that are high has a family history of coronary
in saturated fat, cholesterol, and disease, is a vegetarian.
trans fats • Potato chips and other
• Eat more whole-grain foods, processed, packaged snacks.
fish, poultry, and nuts • Dessert.
• Limit sodium, sweets, sugary • Too much protein.
drinks, and red meats • Fast food.
• Energy drinks
Foods that may help prevent • Added salt
Hypertension • Coconut oil
Citrus fruits Salmon Cardiac failure
Tomatoes Recommended foods
Carrots Pumpkin seeds – Person with cardiac failure
Pistachios should focus on plant based
Broccoli Beans . Foods.
Greek yogurt Rich in potassium helps lower bp
and balances effects of sodium
• Foods that can prevent ? . Sweet potatoes
hypertension ? Spinach
MYOCARDIAL INFARCTION ? . Squash
By: Husniah M. Bayabao ? . Banana
MYOCARDIAL ? . Avocado
INFARCTION(MI) Rich in Omega 3 fatty acid which
• also known as a heart attack, decrease inflammation
occurs when blood flow ? Salmon
decreases or stops to a part of ? Sardines
the heart, causing damage to ? Wallnuts
the heart muscle. The most ? Soy beans
common symptom is chest pain ? Flaxs seed
or discomfort which may travel Rich in fiber
? Oatmeal
 NUTRITION & DIET THERAPY
? Lentils
? Raisens
? Fruits and vegetables
Vit.b folic acid- lower levels of
homocysteine in the blood
? broccoli , Kale
? Asparagus , spinach
Foods to avoid
? Foods with high saturated fats
? Processed food
? Sweets such as, cakes ,
doughnuts , cookies
? fastfoods
? Dairy products
? Red meat
ACUTE RENAL FAILURE
MACARAMBON, NIHAYA F.
IMPORTANCE OF A HEALTHY
DIET IN KIDNEY DISEASE:
Chronic Renal Failure
Presented by Aisah Jehanne B.
Pangandaman
Chronic Renal failure
• Also known as Chronic kidney
Disease, describes the gradual
loss of kidney function.
Your kidneys filter wastes and
excess fluids from your blood,
which are then excreted in your
urine.
• The purpose of this diet is to
keep the levels of electrolytes,
minerals, and fluid in your
body balanced when you have
CKD or are on dialysis.
• People on dialysis need this
special diet to limit the buildup
of waste products in the body.
Limiting fluids between
dialysis treatments is very
important because most people
on dialysis urinate very little.
Without urination, fluid will
build up in the body and cause
too much fluid in the heart and
lungs.
Lesser the amount of Sodium
Intake
• Sodium is an essential mineral
needed for the body for water
balance if we consume more
sodium content foods diseased
kidneys can’t filter it out
thereby extra sodium and fluid
buildup inside the body. This
situation leads to swollen
ankles, puffiness, a rise in
blood pressure, etc.
• Avoid high sodium content
canned foods, processed eats,
restauarant and take away
foods. Limit the amount of salt
and salt seasonings like table
salt, garlic salt, meat tenderizer,
and salty sauces and snacks like
barbeque sauce, soy sauce,
crackers, potato chips, nut and
popcorn.
• Always check the nutrition fact
label of food products to know
the amount of sodium. Always
choose sodium free, salt free,
very low sodium, unsalted,
reduced sodium, light sodium
and lightly salted food
products.
Lesser the amount of Potassium in
your diet
• Potassium is a mineral needed
for keeping heartbeat regular
and proper working of muscles.
If kidneys are not healthy the
amount of potassium in blood
increases to dangerous levels.
• Avoid high potassium foods
like dried fruits, grapefruit
juice, orange juice, honeydew,
artichoke, baked beans, carrots,
black beans, lentils, legumes,
pumpkin, tomato, chocolate,
granola, milk, and yogurts
• Safe level of potassium in
blood for adults is 3.5-5.0
mEq/L or 3.5-5.0mmol/L
 NUTRITION & DIET THERAPY
• Eat Low Potassium foods like
apple, blackberries, blueberries,
cherries, grapes, pineapples,
plums, watermelon, asparagus,
cauliflower, celery, cucumber,
kale, lettuce, onions, radish,
and watercress. Eating more of
these foods give the result of
high potassium foods so limit
the amount to ½ cup size.
Choose less Phosphorus Foods
• Phosphorus is needed for bones
to be stronger. In case of
kidney diseases, kidneys cannot
remove phosphorus very well.
Extra phosphorus in your body
pulls calcium out of your bones
and bones became weak.
• Reduce the consumption of
high phosphorus foods like
chocolate drinks, beer, cheese,
milk, ice cream, pudding,
yogurt, oysters, sardines,
lentils, black beans, baked
beans, chick beans, bran
cereals, caramels, seeds nuts,
and wholegrain products.
• Normal level of phosphorus in
blood is 2.5 to 4.5 mg/dL.
Limit the amount of protein in Diet
• Protein is required for growth
and repairing of all cells. When
body breaks down protein from
the foods.
• Eat enough amount of protein
containing foods without
overloading your kidney
functions
HEMODIALYSIS
Eduave, Princess J.
Human Immunodeficiency Virus
(HIV) & Acquired Immune
Deficiency Syndrome (AIDS)
What Is HIV?
HIV stands for Human
Immunodeficiency Virus. HIV
is the virus that causes AIDS.
Your immune system is your
body's defense system. While
the immune system can control
many viruses, HIV targets and
infects the same immune
system cells that protect us
from germs and illnesses.
These cells are a type of white
blood cell called CD4 cells
(sometimes called T cells).
Without medication to control
the virus, HIV usually takes
over CD4 cells and turns them
into factories that produce
millions of copies of the virus.
As the virus makes copies, it
damages or kills the CD4 cells,
weakening the immune system.
This is how HIV causes AIDS.
What Is AIDS?
AIDS stands for Acquired
Immune Deficiency Syndrome.
AIDS is the most advanced
stage of HIV disease.
HIV causes AIDS by attacking
CD4 cells, which the immune
system uses to protect the body
from disease. When the
immune system loses too many
CD4 cells, you are less able to
fight off infections and can
develop serious, often deadly,
infections. These are
called opportunistic
infections (OIs).
What Is the Difference Between
HIV and AIDS?
You do not have AIDS as soon as you
acquire HIV. You can live with HIV
(be HIV+) for many years with no
signs of disease, or only mild-to-
moderate symptoms. People living
with HIV and taking HIV drugs as
prescribed have a very low risk of
 NUTRITION & DIET THERAPY
progressing to AIDS. But without
treatment, HIV will eventually wear
down the immune system in most
people to the point where they have
few CD4 cells and develop
opportunistic infections.

Learn About HIV/AIDS to help

prevent infection.
HIV is spread only in certain
body fluids from a person
infected with HIV. These fluids
are blood, semen, pre-seminal
fluids, rectal fluids, vaginal
fluids, and breast milk.
HIV is spread mainly by having
sex or sharing injection drug
equipment, such as needles,
with someone who has HIV.
To reduce your risk of HIV
infection, use prophylactics
correctly as virus barriers every
time you have vaginal, oral, or
anal sex.
Don’t inject drugs.
If you don’t have HIV but are
at high risk of becoming
infected with HIV, talk to your
health care provider about pre-
exposure prophylaxis (PrEP).
PrEP involves taking a specific
HIV medicine every day to
reduce the risk of HIV
infection.
Avoid promiscuity. Loyal
partners build better, safer
families and communities.