CHAPTER 3: DIETS IN MODIFIED

COMPOSITION
 A. HIGH CALORIE DIET  B. LOW CALORIE DIET
 Indications: Underweight, PEM, Indications: Obesity, diabetes, renal
fevers, infections, hyper catabolic failure, gout, gallbladder, overweight,
conditions like hyperthyroidism, cardiac, hypertensive, arthritic or
injury, burns, growth, pregnancy, diabetic individuals; hypothyroidism;
lactation. prolonged bed rest or in elderly persons;
preceding surgery.
 Food Selections: normal diet,
increase amount of cereals, breads, Food Selections: emphasize in bulk low
butter, cream, fats and sugar in calorie for satisfied feeling. Calories
increase snacks. are reduced by limiting carbohydrates
and fats while keeping protein at the
 Avoided: Excessive amount in bulky normal level of 1.1 gm or more per kg
low-calorie foods. body weight per day. However, very low
calorie diets, 1200 kcal or less, require
vitamin and mineral supplementation.

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  C. HIGH PROTEIN DIET  Foods Allowed: With emphasis on
meat, milk, eggs, cheese, poultry,
Purpose: To correct large protein losses
general diet with added protein;
and raises the level of blood albumin.
soybean or lactose milk, cooked
Maybe modified to include low-fat, low
sweet beans, tofu, nuts, peanut
sodium, and low-cholesterol diets.
butter, fish, eggs, ice cream, cake,
Indications: Growth, pregnancy, custard cookies.
malnutrition, lactation, burns, surgery,
 Foods avoided: restrictions depend
fractures, anemia, hepatitis, cirrhosis,
on modifications
hyperinsulinism; before and after
surgery, hypercatabolic conditions,
hepatitis, portal cirrhosis( no impending
hepatic coma), nephrosis, liver and
gallbladder disorder.

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  D. LOW PROTEIN DIET  E. HIGH CARBOHYDRATE DIET
 Indications: Acute glomerulonephritis with  Indications: renal and liver disturbances,
impaired renal function, CRF with toxemia of pregnancy. Addisons disease
impaired renal function without
hypertension, advanced liver disease with  Food Selections – Emphasize on rice and
hepatic insufficiency or encephalopathy, other cereals, root crops, noodles, sugar,
uremia, hepatic coma. native cakes

 Food Selections: Check your handouts  F. LOW CARBOHYDRATE DIET

 Food Avoided: Protein foods in excess  Indications: COPD, hyperinsulinism,

amounts, limit the intake of legumes, dumping syndrome, obesity, epilepsy,
nuts. celiac disease.
 Food Selections: Foods high in protein,
adequate to high fat foods in certain
conditions. Provide no more than 50% of
total calories, diet is higher in fat and
protein than the normal diet.

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  G. LOW-FAT, CHOLESTEROL-RESTRICTED DIET  Low Cholesterol – Hypercholesterolemia,
CAD, adults with history of heart disease
 Purpose: reduce hyperlipidemia, provide
dietary treatment for malabsorption  Use: Hyperlipidemia, atherosclerosis,
syndromes and patients having acute pancreatitis, cystic fibrosis, sprue ( disease
intolerance for fats. of intestinal tract characterized by
malabsorption), gastrectomy, massive
 Low-fat – weight reduction, cholecystitis, resection of small intestine, and
cholelithiasis, atherosclerosis, portal cholecystitis.
cirrhosis, hepatitis, pancreatitis, fat
malabsorption  Foods allowed: not-fat milk; low-
carbohydrate, low fat vegetables; most
fruits; breads; pastas; cornmeal; lean meats;
non saturated fats
 Food Avoided: Avoid the five C’s of
cholesterol- cookies, cream, cake, coconut,
chocolate; whole milk and whole- milk or
cream products, avocados, olives,
commercially prepared baked goods such as
donuts and muffins, poultry skin, butter, etc.

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  Low fat provides no more than 15% of total  Use: Heart failure, hypertension, renal
calories or about 1800kcal and 30 gms fat. disease, CHF with edema, liver disease with
Since absorption of fat soluble vitamins is ascites, glomerulonephritis, nephritic
impaired when fat intake is low, syndrome, ARF and CRF; cirrhosis, toxaemia
supplementation of the diet with these of pregnancy and cortisone therapy.
vitamins, especially vitamin A is desirable.
 Modifications: Mildly restrictive 2g sodium
 H. LOW SALT/SODIUM RESTRICTED DIET diet to extremely restricted 200mg sodium
diet.
 Purpose: Reduce sodium content in the tissue
and promote excretion of water.  Food Avoided: table salt, all commercial
soups, catsup, gravy, mustard, meat sauces,
and soy sauce, buttermilk, ice cream, and
sherbet; sodas; beet greens carrots, celery,
chard, sauerkraut, and spinach; all canned
vegetables; frozen peas; all baked products
containing salt, baking powder, or baking
soda; potato chips etc.
 -Regular diet of 2800 to 6000 mg sodium or 7-
15 grams of table salt. No salt is used in the
preparation and service of meals.

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  I. LOW PURINE DIET/ PURINE RESTRICTED  Low purine is about 120-15omg/day whereas
DIET regular diet contains as much as 600-
1000mg/day. Diet should be relatively high in
 Purpose: designed to reduce intake of uric carbohydrate and low in fat since
acid-producing foods. carbohydrate have been shown to favour uric
 Indication: Hyperuricemia, gout acid excretion while fats tend to favour
retention. A liberal intake of fluid is helpful
 Use: High uric acid retention, uric acid renal in eliminating excess uric acid and in
stones, and gout. maintaining calculi formation.
 Food Allowed: general diet plus 2-3 quarts of  J. LOW POTASSIUM DIET
liquid daily.  Indication: Hyperkalemia, acute and chronic
 Foods Avoided: Cheese containing spices or renal disease. This is a diet in which the
nuts, fried eggs, meat, liver, seafood, lentils, potassium content is reduced to about 1.0 to
dried peas and beans, broth, bouillon, 1.8 grams ( 25-46meq) per day. The usual
gravies, oatmeal and whole wheat, pasta, diet contains about 2 to6 grams (51.3 to
noodles, and alcoholic beverages, limited 153.6 meq) daily, coming mainly from
quantities of meat, fish and seafood allowed. vegetables, cereals, fruits, meat, fish and
poultry. Vitamins A and C likely to be low and
must be provided in the form of
supplements.

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  J. ACID AND ALKALINE DIET: b.Alkaline Ash: milk, vegetables, fruits
( except cranberries, prunes, and
Purpose: Furnish a well diet in which
plums)
the total acid ash is greater than the
total alkaline ash each day. c. Neutral: sugar, fats, beverages (
Use: Retard the formation of renal coffee, tea)
calculi. The type of diet chosen
Foods Allowed:
depends on laboratory analysis of the
stone. Breads- preferably whole grain;
crackers; rolls
Acid and Alkaline ash food groups:
Cereals: preferably whole grains
a. Acid ash: meat, whole grains, eggs,
cheese, cranberries, prunes, plums Desserts: angel food or sunshine cake;
cookies made without baking powder
or baking soda, cornstarch.

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  Fats: any, such as butter,  Soup: broth as desired; other soups
margarine, salad dressings, Crisco, from food allowed.
spry, lard, salad oil, olive, etc.  Sweets: cranberry and plum jelly;
plain sugar candy.
 Fruits: cranberry, plums, prunes
 Miscellaneous: cream sauce, gravy,
 Meat: eggs, cheese, any meat, fish peanut butter, peanuts, popcorn,
or fowl, two serving daily; at least salt, spices, vinegar, walnuts.
one egg daily.  Restricted Foods: no more than the
 Potato Substitutes: Corn, lentils, amount allowed each day
macaroni, noodles, rice, spaghetti,  1. milk: 1 pint daily ( may be used in
vermicelli other ways than as beverage)

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 2. Cream: 1/3 cup or less daily
3. Fruits: one serving of fruits daily (
in addition to the prunes, plums and
cranberries)
4. Vegetable: including potatoes: two
serving daily
5. Sweets: chocolate or candies,
syrups
6. Miscellaneous: other nuts, olives,
pickles.

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