Therapeutic and clinical nutrition

‫اﻟﺘﻐﺬﻳﺔ اﻟﻌﻼﺟﻴﺔ واﻟﺴﺮﻳﺮﻳﺔ‬

Introduction

Clinical nutrition, as a study focuses on the nutritional

management of individuals or group of individuals with
established disease condition. Clinical nutrition deals with issues
such as altered nutritional requirements associated with the
disease, disease severity and malnutrition and many such issues
about which we will learn in this unit.

‫ ﻛﺪراﺳﺔ ﺗﺮﻛﺰ ﻋﻠﻰ اﻹدارة اﻟﻐﺬاﺋﻴﺔ ﻟﻸﻓﺮاد أو ﻣﺠﻤﻮﻋﺔ اﻷﻓﺮاد‬، ‫اﻟﺘﻐﺬﻳﺔ اﻟﺴﺮﻳﺮﻳﺔ‬
‫ ﺗﺘﻌﺎﻣﻞ اﻟﺘﻐﺬﻳﺔ اﻟﺴﺮﻳﺮﻳﺔ ﻣﻊ ﻗﻀﺎﻳﺎ ﻣﺜﻞ اﻟﻤﺘﻄﻠﺒﺎت‬.‫اﻟﻤﺼﺎﺑﻴﻦ ﺑﺤﺎﻟﺔ ﻣﺮﺿﻴﺔ راﺳﺨﺔ‬
‫اﻟﻐﺬاﺋﻴﺔ اﻟﻤﺘﻐﻴﺮة اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻤﺮض وﺷﺪة اﻟﻤﺮض وﺳﻮء اﻟﺘﻐﺬﻳﺔ واﻟﻌﺪﻳﺪ ﻣﻦ ﻫﺬه‬
.‫اﻟﻘﻀﺎﻳﺎ اﻟﺘﻲ ﺳﻨﺘﻌﻠﻢ ﻋﻨﻬﺎ ﻓﻲ ﻫﺬه اﻟﻮﺣﺪة‬

Dietetics and role of dietitian in health care

‫ﻋﻠﻢ اﻟﺘﻐﺬﻳﺔ ودور اﺧﺘﺼﺎﺻﻲ اﻟﺘﻐﺬﻳﺔ ﻓﻲ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‬

Eating a healthy balanced diet improves the quality of our life,

whereas a poor diet may lead to morbidity and disease.

‫ ﻓﻲ ﺣﻴﻦ أن اﻟﻨﻈﺎم‬، ‫إن اﺗﺒﺎع ﻧﻈﺎم ﻏﺬاﺋﻲ ﺻﺤﻲ ﻣﺘﻮازن ﻳﺤﺴﻦ ﻧﻮﻋﻴﺔ ﺣﻴﺎﺗﻨﺎ‬
.‫اﻟﻐﺬاﺋﻲ اﻟﺴﻴﺊ ﻗﺪ ﻳﺆدي إﻟﻰ اﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮاض واﻷﻣﺮاض‬

The branch of medicine concerned with how food and nutrition

affects human health comprising the rules to be followed for
preventing, relieving or curing disease by diet is called Dietetics.
 ، ‫ﻳُﻄﻠﻖ ﻋﻠﻰ ﻓﺮع اﻟﻄﺐ اﻟﻤﻌﻨﻲ ﺑﻜﻴﻔﻴﺔ ﺗﺄﺛﻴﺮ اﻟﻐﺬاء واﻟﺘﻐﺬﻳﺔ ﻋﻠﻰ ﺻﺤﺔ اﻹﻧﺴﺎن‬
‫واﻟﺬي ﻳﺸﻤﻞ اﻟﻘﻮاﻋﺪ اﻟﻮاﺟﺐ اﺗﺒﺎﻋﻬﺎ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ اﻷﻣﺮاض أو ﺗﺨﻔﻴﻔﻬﺎ أو ﻋﻼﺟﻬﺎ ﻋﻦ‬
.‫ ﻋﻠﻢ اﻟﺘﻐﺬﻳﺔ‬، ‫ﻃﺮﻳﻖ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ‬

Clinical Dietetics is the application of dietetics in a hospital or

health care institutional setting. Clinical dietetics focuses on
individual nutrition support and symptom management.

‫ﻋﻠﻢ اﻟﺘﻐﺬﻳﺔ اﻟﺴﺮﻳﺮﻳﺔ ﻫﻮ ﺗﻄﺒﻴﻖ ﻋﻠﻢ اﻟﺘﻐﺬﻳﺔ ﻓﻲ اﻟﻤﺴﺘﺸﻔﻰ أو ﻣﺆﺳﺴﺔ اﻟﺮﻋﺎﻳﺔ‬

.‫ ﻳﺮﻛﺰ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﺴﺮﻳﺮي ﻋﻠﻰ دﻋﻢ اﻟﺘﻐﺬﻳﺔ اﻟﻔﺮدﻳﺔ وإدارة اﻷﻋﺮاض‬.‫اﻟﺼﺤﻴﺔ‬

Diet therapy is a branch of dietetics concerned with the use of food

for therapeutic purpose.

.‫اﻟﻌﻼج اﻟﻐﺬاﺋﻲ ﻫﻮ ﻓﺮع ﻣﻦ ﻋﻠﻢ اﻟﺘﻐﺬﻳﺔ ﻳﻬﺘﻢ ﺑﺎﺳﺘﺨﺪام اﻟﻄﻌﺎم ﻟﻐﺮض ﻋﻼﺟﻲ‬

The principles of diet therapy are to: ‫ﻣﺒﺎدئ اﻟﻌﻼج اﻟﻐﺬاﺋﻲ ﻫﻲ‬

• maintain good nutritional status ‫اﻟﺤﻔﺎظ ﻋﻠﻰ ﺣﺎﻟﺔ ﻏﺬاﺋﻴﺔ ﺟﻴﺪة‬

• correct deficiencies or disease.‫ﺗﺼﺤﻴﺢ اﻟﻨﻮاﻗﺺ أو اﻟﻤﺮض‬

• provide rest to the body ‫ﺗﻮﻓﻴﺮ اﻟﺮاﺣﺔ ﻟﻠﺠﺴﻢ‬

• help metabolize the nutrients ‫ﺗﺴﺎﻋﺪ ﻋﻠﻰ أﻳﺾ اﻟﻌﻨﺎﺻﺮ اﻟﻐﺬاﺋﻴﺔ‬

• make changes in body weight, when necessary.

.‫إﺟﺮاء ﺗﻐﻴﻴﺮات ﻓﻲ وزن اﻟﺠﺴﻢ ﻋﻨﺪ اﻟﻀﺮورة‬

Therapeutic diet refers to a meal plan that controls the intake of

certain foods or nutrients. They are adaptation of the normal,
regular diet.
 ‫ﻳﺸﻴﺮ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﻌﻼﺟﻲ إﻟﻰ ﺧﻄﺔ وﺟﺒﺎت ﺗﺘﺤﻜﻢ ﻓﻲ ﺗﻨﺎول ﺑﻌﺾ اﻷﻃﻌﻤﺔ أو‬
.‫ إﻧﻪ ﺗﻜﻴﻒ ﻣﻊ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﻌﺎدي واﻟﻤﻨﺘﻈﻢ‬.‫اﻟﻌﻨﺎﺻﺮ اﻟﻐﺬاﺋﻴﺔ‬

Depending on the nature of the problem, a health care team might

include physician/doctor, nurses, nutritionists, dietitians, counselors
etc. But dietitian/nutritionists are at the forefront of nutritional care.

، ‫ ﻃﺒﻴﺒًﺎ‬/ ‫ ﻗﺪ ﻳﻀﻢ ﻓﺮﻳﻖ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﻃﺒﻴﺒًﺎ‬، ‫اﻋﺘﻤﺎدًا ﻋﻠﻰ ﻃﺒﻴﻌﺔ اﻟﻤﺸﻜﻠﺔ‬
‫ ﻟﻜﻦ اﺧﺘﺼﺎﺻﻲ‬.‫ إﻟﺦ‬، ‫ وﻣﺴﺘﺸﺎرﻳﻦ‬، ‫ وأﺧﺼﺎﺋﻴﻲ ﺗﻐﺬﻳﺔ‬، ‫ وﺧﺒﺮاء ﺗﻐﺬﻳﺔ‬، ‫وﻣﻤﺮﺿﺎت‬
.‫ ﺧﺒﺮاء اﻟﺘﻐﺬﻳﺔ ﻫﻢ ﻓﻲ ﻃﻠﻴﻌﺔ اﻟﺮﻋﺎﻳﺔ اﻟﻐﺬاﺋﻴﺔ‬/ ‫اﻟﺘﻐﺬﻳﺔ‬

Role of dietitian in nutrition care

‫دور اﺧﺘﺼﺎﺻﻲ اﻟﺘﻐﺬﻳﺔ ﻓﻲ رﻋﺎﻳﺔ اﻟﺘﻐﺬﻳﺔ‬

Dietitian you know is an expert in dietetics, dealing with human

nutritional care. A dietitian apply the science and principals of
human nutrition to help people understand the relationship between
food and health and make appropriate dietary choices to attain and
maintain health and to prevent and treat illness and disease.

‫ وﻳﺘﻌﺎﻣﻞ ﻣﻊ اﻟﺮﻋﺎﻳﺔ‬، ‫اﺧﺘﺼﺎﺻﻲ اﻟﺘﻐﺬﻳﺔ اﻟﺬي ﺗﻌﺮﻓﻪ ﻫﻮ ﺧﺒﻴﺮ ﻓﻲ ﻋﻠﻢ اﻟﺘﻐﺬﻳﺔ‬

‫ ﻳﻘﻮم اﺧﺘﺼﺎﺻﻲ اﻟﺘﻐﺬﻳﺔ ﺑﺘﻄﺒﻴﻖ ﻋﻠﻮم وﻣﺒﺎدئ اﻟﺘﻐﺬﻳﺔ اﻟﺒﺸﺮﻳﺔ‬.‫اﻟﺘﻐﺬوﻳﺔ ﻟﻺﻧﺴﺎن‬
‫ﻟﻤﺴﺎﻋﺪة اﻟﻨﺎس ﻋﻠﻰ ﻓﻬﻢ اﻟﻌﻼﻗﺔ ﺑﻴﻦ اﻟﻐﺬاء واﻟﺼﺤﺔ واﺗﺨﺎذ اﻟﺨﻴﺎرات اﻟﻐﺬاﺋﻴﺔ‬
.‫اﻟﻤﻨﺎﺳﺒﺔ ﻟﺒﻠﻮغ اﻟﺼﺤﺔ واﻟﺤﻔﺎظ ﻋﻠﻴﻬﺎ واﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻷﻣﺮاض واﻷﻣﺮاض وﻋﻼﺟﻬﺎ‬

The activities most likely to be undertaken by the clinical

dietitians would include:

:‫ﺗﺸﻤﻞ اﻷﻧﺸﻄﺔ اﻟﺘﻲ ﻳﺮﺟﺢ أن ﻳﻘﻮم ﺑﻬﺎ اﺧﺘﺼﺎﺻﻴﻮ اﻟﺘﻐﺬﻳﺔ اﻟﺴﺮﻳﺮﻳﺔ ﻣﺎ ﻳﻠﻲ‬

• Collecting, organizing and assessing data relating to health and

nutritional status of individuals, groups and communities

‫ﺟﻤﻊ وﺗﻨﻈﻴﻢ وﺗﻘﻴﻴﻢ اﻟﺒﻴﺎﻧﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﺤﺎﻟﺔ اﻟﺼﺤﻴﺔ واﻟﺘﻐﺬوﻳﺔ ﻟﻸﻓﺮاد واﻟﺠﻤﺎﻋﺎت‬
‫واﻟﻤﺠﺘﻤﻌﺎت‬

• Review and analyze patients nutritional needs and goals to make

appropriate dietary recommendations.

‫ﻣﺮاﺟﻌﺔ وﺗﺤﻠﻴﻞ اﺣﺘﻴﺎﺟﺎت اﻟﻤﺮﺿﻰ اﻟﻐﺬاﺋﻴﺔ وأﻫﺪاﻓﻬﻢ ﻟﺘﻘﺪﻳﻢ اﻟﺘﻮﺻﻴﺎت اﻟﻐﺬاﺋﻴﺔ‬

.‫اﻟﻤﻨﺎﺳﺒﺔ‬

• Develop and implement nutrition care plans and monitor, follow up

and evaluate these plans and take corrective measures wherever
required

‫وﺿﻊ وﺗﻨﻔﻴﺬ ﺧﻄﻂ اﻟﺮﻋﺎﻳﺔ اﻟﺘﻐﺬوﻳﺔ ورﺻﺪ وﻣﺘﺎﺑﻌﺔ وﺗﻘﻴﻴﻢ ﻫﺬه اﻟﺨﻄﻂ واﺗﺨﺎذ‬
‫اﻹﺟﺮاءات اﻟﺘﺼﺤﻴﺤﻴﺔ ﺣﻴﺜﻤﺎ ﻟﺰم اﻷﻣﺮ‬

• Çalculate nutritional value of food/meals planned

‫ اﻟﻮﺟﺒﺎت اﻟﻤﺨﻄﻂ ﻟﻬﺎ‬/ ‫ﺣﺴﺎب اﻟﻘﻴﻤﺔ اﻟﻐﺬاﺋﻴﺔ ﻟﻸﻏﺬﻳﺔ‬

• Prescribe therapeutic diets and special nutrition support and

feeding regimens

‫وﺻﻒ اﻟﺘﻐﺬﻳﺔ اﻟﻌﻼﺟﻴﺔ وأﻧﻈﻤﺔ اﻟﺘﻐﺬﻳﺔ واﻟﺪﻋﻢ اﻟﺘﻐﺬوي اﻟﺨﺎﺻﺔ‬

• Oversee the preparation of special diets, special nutrition formulas

for patients who are critically or terminally and require special
feeding through oral, enteral or parenteral routes.

‫ وﺻﻴﻎ اﻟﺘﻐﺬﻳﺔ اﻟﺨﺎﺻﺔ ﻟﻠﻤﺮﺿﻰ‬، ‫اﻹﺷﺮاف ﻋﻠﻰ إﻋﺪاد اﻷﻧﻈﻤﺔ اﻟﻐﺬاﺋﻴﺔ اﻟﺨﺎﺻﺔ‬
‫اﻟﺬﻳﻦ ﻫﻢ ﻓﻲ ﺣﺎﻟﺔ ﺣﺮﺟﺔ أو ﻧﻬﺎﺋﻴﺔ وﻳﺘﻄﻠﺒﻮن ﺗﻐﺬﻳﺔ ﺧﺎﺻﺔ ﻣﻦ ﺧﻼل ﻃﺮق اﻟﻔﻢ أو‬
 .‫اﻟﻤﻌﻮﻳﺔ أو ﺑﺎﻟﺤﻘﻦ‬

• Plan and prepare basic menus and assist in supervising food

service 3 personnel in preparing menus and serving of meals

3 ‫ﺗﺨﻄﻴﻂ وإﻋﺪاد اﻟﻘﻮاﺋﻢ اﻷﺳﺎﺳﻴﺔ واﻟﻤﺴﺎﻋﺪة ﻓﻲ اﻹﺷﺮاف ﻋﻠﻰ ﺧﺪﻣﺔ اﻟﻄﻌﺎم‬

‫ﻣﻮﻇﻔﻴﻦ ﻓﻲ إﻋﺪاد اﻟﻘﻮاﺋﻢ وﺗﻘﺪﻳﻢ اﻟﻮﺟﺒﺎت‬

• Schedule work assignments in the dietary unit to facilitate the

effective operation of the kitchen and other food preparation or
dining areas

‫ﺟﺪوﻟﺔ ﻣﻬﺎم اﻟﻌﻤﻞ ﻓﻲ اﻟﻮﺣﺪة اﻟﻐﺬاﺋﻴﺔ ﻟﺘﺴﻬﻴﻞ اﻟﺘﺸﻐﻴﻞ اﻟﻔﻌﺎل ﻟﻠﻤﻄﺒﺦ وأﻣﺎﻛﻦ‬
‫إﻋﺪاد اﻟﻄﻌﺎم أو ﺗﻨﺎول اﻟﻄﻌﺎم اﻷﺧﺮى‬

Therapeutic Diets: ‫اﻷﻧﻈﻤﺔ اﻟﻌﻼﺟﻴﺔ‬

Balanced diet is defined as one which contains a variety of foods

in such quantities and proportions that the need for energy,
proteins, vitamins, minerals, fats and other nutrients is adequately
met for maintaining health and well-being.

‫ﻳُﻌﺮف اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﻤﺘﻮازن ﺑﺄﻧﻪ اﻟﻨﻈﺎم اﻟﺬي ﻳﺤﺘﻮي ﻋﻠﻰ ﻣﺠﻤﻮﻋﺔ ﻣﺘﻨﻮﻋﺔ ﻣﻦ‬
‫اﻷﻃﻌﻤﺔ ﺑﻜﻤﻴﺎت وﻧﺴﺐ ﺗُﻠﺒﻰ ﺑﺸﻜﻞ ﻛﺎفٍ اﻟﺤﺎﺟﺔ إﻟﻰ اﻟﻄﺎﻗﺔ واﻟﺒﺮوﺗﻴﻨﺎت‬
‫واﻟﻔﻴﺘﺎﻣﻴﻨﺎت واﻟﻤﻌﺎدن واﻟﺪﻫﻮن واﻟﻌﻨﺎﺻﺮ اﻟﻐﺬاﺋﻴﺔ اﻷﺧﺮى ﻟﻠﺤﻔﺎظ ﻋﻠﻰ اﻟﺼﺤﺔ‬
.‫واﻟﺮﻓﺎﻫﻴﺔ‬
The reasons for modifying the diets may include:

:‫ﻗﺪ ﺗﺘﻀﻤﻦ أﺳﺒﺎب ﺗﻌﺪﻳﻞ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻣﺎ ﻳﻠﻲ‬

• For essential or lifesaving treatment: For example in celiac

disease, providing gluten free diet

‫ ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ﻓﻲ ﻣﺮض اﻻﺿﻄﺮاﺑﺎت اﻟﻬﻀﻤﻴﺔ‬:‫ﻟﻠﻌﻼج اﻷﺳﺎﺳﻲ أو اﻟﻤﻨﻘﺬ ﻟﻠﺤﻴﺎة‬

‫ ﺗﻮﻓﻴﺮ ﻧﻈﺎم ﻏﺬاﺋﻲ ﺧﺎل ﻣﻦ اﻟﺠﻠﻮﺗﻴﻦ‬،

• To replete patients who are malnourished because of disease

such as cancer and intestinal diseases by providing a greater
amount of a nutrient such as protein

‫ﻹﻣﺪاد اﻟﻤﺮﺿﻰ اﻟﺬﻳﻦ ﻳﻌﺎﻧﻮن ﻣﻦ ﺳﻮء اﻟﺘﻐﺬﻳﺔ ﺑﺴﺒﺐ أﻣﺮاض ﻣﺜﻞ اﻟﺴﺮﻃﺎن وأﻣﺮاض‬
‫اﻷﻣﻌﺎء ﻣﻦ ﺧﻼل ﺗﻮﻓﻴﺮ ﻛﻤﻴﺔ أﻛﺒﺮ ﻣﻦ اﻟﻌﻨﺎﺻﺮ اﻟﻐﺬاﺋﻴﺔ ﻣﺜﻞ اﻟﺒﺮوﺗﻴﻦ‬

• To correct deficiencies and maintain or restore optimum

nutritional status
 ‫ﺗﺼﺤﻴﺢ اﻟﻨﻘﺺ واﻟﺤﻔﺎظ ﻋﻠﻰ اﻟﺤﺎﻟﺔ اﻟﺘﻐﺬوﻳﺔ اﻟﻤﺜﻠﻰ أو اﺳﺘﻌﺎدﺗﻬﺎ‬

‫‪• To provide rest or relieve an affected organ such as in gastritis‬‬

‫ﻟﺘﻮﻓﻴﺮ اﻟﺮاﺣﺔ أو ﺗﺨﻔﻴﻒ اﻟﻌﻀﻮ اﻟﻤﺼﺎب ﻣﺜﻞ اﻟﺘﻬﺎب اﻟﻤﻌﺪة‬

‫‪• To adjust to the body's ability to digest, absorb, metabolize or‬‬

‫‪excrete: For example a low fat diet provided in fat malabsorption,‬‬

‫ﻟﻠﺘﻜﻴﻒ ﻣﻊ ﻗﺪرة اﻟﺠﺴﻢ ﻋﻠﻰ اﻟﻬﻀﻢ أو اﻻﻣﺘﺼﺎص أو اﻟﺘﻤﺜﻴﻞ اﻟﻐﺬاﺋﻲ أو اﻹﺧﺮاج‪:‬‬

‫ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل اﺗﺒﺎع ﻧﻈﺎم ﻏﺬاﺋﻲ ﻗﻠﻴﻞ اﻟﺪﺳﻢ ﻓﻲ ﺣﺎﻟﺔ ﺳﻮء اﻣﺘﺼﺎص اﻟﺪﻫﻮن‬

‫‪• To adjust to tolerance of food intake. For example in case of‬‬

‫‪patients with cancer of esophagus tube feeding is recommended‬‬
‫‪when patients cannot tolerate food by mouth,‬‬

‫ﻟﻠﺘﻜﻴﻒ ﻣﻊ ﺗﺤﻤﻞ اﻟﻤﺪﺧﻮل اﻟﻐﺬاﺋﻲ‪ .‬ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ﻓﻲ ﺣﺎﻟﺔ اﻟﻤﺮﺿﻰ اﻟﺬﻳﻦ‬
‫ﻳﻌﺎﻧﻮن ﻣﻦ ﺳﺮﻃﺎن اﻟﻤﺮيء ﻳﻮﺻﻰ ﺑﺎﻟﺘﻐﺬﻳﺔ ﺑﺄﻧﺒﻮب اﻟﻤﺮيء ﻋﻨﺪﻣﺎ ﻻ ﻳﺴﺘﻄﻴﻊ اﻟﻤﺮﺿﻰ‬
‫ﺗﺤﻤﻞ اﻟﻄﻌﺎم ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﻢ‬

‫‪• To exclude foods due to food allergies or food intolerance,‬‬

‫ﻻﺳﺘﺒﻌﺎد اﻷﻃﻌﻤﺔ ﺑﺴﺒﺐ اﻟﺤﺴﺎﺳﻴﺔ اﻟﻐﺬاﺋﻴﺔ أو ﻋﺪم ﺗﺤﻤﻞ اﻟﻄﻌﺎم‬

‫‪• To adjust to mechanical difficulties, for example for elderly‬‬

‫‪patients with denture problems, changing the texture/consistency‬‬
‫‪of food recommended due to problems with chewing and/or‬‬
‫‪swallowing,‬‬

‫ﻟﻠﺘﻜﻴﻒ ﻣﻊ اﻟﺼﻌﻮﺑﺎت اﻟﻤﻴﻜﺎﻧﻴﻜﻴﺔ ‪ ،‬ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ﻟﻠﻤﺮﺿﻰ اﻟﻤﺴﻨﻴﻦ اﻟﺬﻳﻦ ﻳﻌﺎﻧﻮن‬
‫ﻣﻦ ﻣﺸﺎﻛﻞ ﻓﻲ أﻃﻘﻢ اﻷﺳﻨﺎن ‪ ،‬وﺗﻐﻴﻴﺮ ﻧﺴﻴﺞ ‪ /‬ﺗﻨﺎﺳﻖ اﻟﻄﻌﺎم اﻟﻤﻮﺻﻰ ﺑﻪ ﺑﺴﺒﺐ‬
‫ﻣﺸﺎﻛﻞ اﻟﻤﻀﻎ و ‪ /‬أو اﻟﺒﻠﻊ ‪،‬‬
• To increase or decrease body weight/body composition when
required, for example as in the case of obesity or underweight,

‫ ﻛﻤﺎ ﻓﻲ ﺣﺎﻟﺔ اﻟﺴﻤﻨﺔ أو‬، ‫ ﺗﻜﻮﻳﻦ اﻟﺠﺴﻢ ﻋﻨﺪ اﻟﺤﺎﺟﺔ‬/ ‫ﻟﺰﻳﺎدة أو إﻧﻘﺎص وزن اﻟﺠﺴﻢ‬
‫ﻧﻘﺺ اﻟﻮزن‬

• As helpful treatment, alternative or complementary to drugs, as in

diabetes or in hypertension

‫ ﻛﻤﺎ ﻫﻮ اﻟﺤﺎل ﻓﻲ ﻣﺮض اﻟﺴﻜﺮي أو ارﺗﻔﺎع‬، ‫ ﺑﺪﻳﻞ أو ﻣﻜﻤﻞ ﻟﻸدوﻳﺔ‬، ‫ﻛﻌﻼج ﻣﻔﻴﺪ‬
‫ﺿﻐﻂ اﻟﺪم‬

The significance of modified or therapeutic diet is that:

:‫أﻫﻤﻴﺔ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﻤﻌﺪل أو اﻟﻌﻼﺟﻲ ﻫﻮ‬

• it is useful in managing the disease condition;

.‫ﻣﻔﻴﺪ ﻓﻲ إدارة ﺣﺎﻟﺔ اﻟﻤﺮض‬

• it promotes resistance to disease condition ‫ﻳﻌﺰز ﻣﻘﺎوﻣﺔ اﻷﻣﺮاض‬

• is preventive or supplemental treatment. ‫ﻫﻮ ﻋﻼج وﻗﺎﺋﻲ أو ﺗﻜﻤﻴﻠﻲ‬

Types of dietary adaptations for therapeutic needs

‫أﻧﻮاع اﻟﺘﻜﻴﻔﺎت اﻟﻐﺬاﺋﻴﺔ ﻟﻼﺣﺘﻴﺎﺟﺎت اﻟﻌﻼﺟﻴﺔ‬

A diet may need to be altered and adjusted in many ways before it

meets the therapcutic needs of an individual patient. These
adaptations may include:

‫ﻗﺪ ﻳﺤﺘﺎج اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ إﻟﻰ اﻟﺘﻐﻴﻴﺮ واﻟﺘﻌﺪﻳﻞ ﺑﻌﺪة ﻃﺮق ﻗﺒﻞ أن ﻳﻠﺒﻲ اﻻﺣﺘﻴﺎﺟﺎت‬
:‫ ﻗﺪ ﺗﺸﻤﻞ ﻫﺬه اﻟﺘﻌﺪﻳﻼت‬.‫اﻟﻌﻼﺟﻴﺔ ﻟﻠﻤﺮﻳﺾ‬
• Change in consistency of foods, such as liquid diet, soft diet, low
fiber diet, high fiber diet.

، ‫ واﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﻨﺎﻋﻢ‬، ‫ ﻣﺜﻞ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﺴﺎﺋﻞ‬، ‫ﺗﻐﻴﻴﺮ ﻓﻲ ﺗﻨﺎﺳﻖ اﻷﻃﻌﻤﺔ‬
.‫ واﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﻐﻨﻲ ﺑﺎﻷﻟﻴﺎف‬، ‫واﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻣﻨﺨﻔﺾ اﻷﻟﻴﺎف‬

• Increase or decrease in energy value of the diet such as low

calorie diet for weight reduction, high calorie diet for burns.

‫زﻳﺎدة أو ﻧﻘﺼﺎن ﻗﻴﻤﺔ اﻟﻄﺎﻗﺔ ﻓﻲ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻣﺜﻞ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻣﻨﺨﻔﺾ‬
.‫ واﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻋﺎﻟﻲ اﻟﺴﻌﺮات اﻟﺤﺮارﻳﺔ ﻟﻠﺤﺮوق‬، ‫اﻟﺴﻌﺮات اﻟﺤﺮارﻳﺔ ﻹﻧﻘﺎص اﻟﻮزن‬

• Increase or decrease in specific nutrients or type of food

consumed, such as sodium restricted diet, lactose restricted diet,
high fibre diet, high potassium diet.

‫ ﻣﺜﻞ ﻧﻈﺎم‬، ‫زﻳﺎدة أو ﻧﻘﺼﺎن ﻓﻲ ﻋﻨﺎﺻﺮ ﻏﺬاﺋﻴﺔ ﻣﻌﻴﻨﺔ أو ﻧﻮع ﻣﻦ اﻷﻃﻌﻤﺔ اﻟﻤﺴﺘﻬﻠﻜﺔ‬
، ‫ وﻧﻈﺎم ﻏﺬاﺋﻲ ﻏﻨﻲ ﺑﺎﻷﻟﻴﺎف‬، ‫ وﻧﻈﺎم ﻏﺬاﺋﻲ ﻣﻘﻴﺪ اﻟﻼﻛﺘﻮز‬، ‫ﻏﺬاﺋﻲ ﻣﻘﻴﺪ اﻟﺼﻮدﻳﻮم‬
.‫وﻧﻈﺎم ﻏﺬاﺋﻲ ﻋﺎﻟﻲ اﻟﺒﻮﺗﺎﺳﻴﻮم‬

• Elimination of spices and condiments, such as bland diets.

.‫ ﻣﺜﻞ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﺪﻫﻨﻲ‬، ‫اﻟﺘﺨﻠﺺ ﻣﻦ اﻟﺒﻬﺎرات واﻟﺘﻮاﺑﻞ‬

• Omission of specific foods such as allergy diets, gluten free diet.

‫ واﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﺨﺎﻟﻲ ﻣﻦ‬، ‫إﻏﻔﺎل ﺑﻌﺾ اﻷﻃﻌﻤﺔ ﻣﺜﻞ اﻻﻏﺬﻳﺔ اﻟﻤﺴﺒﺒﺔ ﻟﻠﺤﺴﺎﺳﻴﺔ‬
.‫اﻟﻐﻠﻮﺗﻴﻦ‬

• Adjustment in the ratio and balance of proteins, fats and

carbohydrate such as diabetic diet, renal diet and cholesterol-
lowering diets.
‫ﺗﻌﺪﻳﻞ ﻧﺴﺒﺔ وﺗﻮازن اﻟﺒﺮوﺗﻴﻨﺎت واﻟﺪﻫﻮن واﻟﻜﺮﺑﻮﻫﻴﺪرات ﻣﺜﻞ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻟﻤﺮﺿﻰ‬
‫اﻟﺴﻜﺮي واﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ اﻟﻜﻠﻮي واﻷﻧﻈﻤﺔ اﻟﻐﺬاﺋﻴﺔ اﻟﻤﺨﻔﻀﺔ ﻟﻠﻜﻮﻟﻴﺴﺘﺮول‪.‬‬

‫‪• Test diets: These are single meals or diets lasting one or few days‬‬
‫‪that are given to patients in connection with certain tests e.g. the‬‬
‫‪fat absorption test used to determine if steatorrhea is present.‬‬

‫اﺧﺘﺒﺎر اﻷﻧﻈﻤﺔ اﻟﻐﺬاﺋﻴﺔ‪ :‬وﻫﻲ وﺟﺒﺎت ﻓﺮدﻳﺔ أو وﺟﺒﺎت ﻏﺬاﺋﻴﺔ ﺗﺴﺘﻤﺮ ﻟﻴﻮم واﺣﺪ أو‬
‫ﺑﻀﻌﺔ أﻳﺎم وﺗﻌﻄﻰ ﻟﻠﻤﺮﺿﻰ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﺧﺘﺒﺎرات ﻣﻌﻴﻨﺔ ‪ ،‬ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل‪.‬‬
‫ﻳﺴﺘﺨﺪم اﺧﺘﺒﺎر اﻣﺘﺼﺎص اﻟﺪﻫﻮن ﻟﺘﺤﺪﻳﺪ ﻣﺎ إذا ﻛﺎن اﻹﺳﻬﺎل اﻟﺪﻫﻨﻲ ﻣﻮﺟﻮدًا‪.‬‬

‫‪• Change in frequency of meals, feeding intervals, re- arrangement‬‬

‫‪of the number and frequency of the meals such as diabetic diet,‬‬
‫‪diet for peptic ulcer disease.‬‬

‫اﻟﺘﻐﻴﻴﺮ ﻓﻲ ﺗﻮاﺗﺮ اﻟﻮﺟﺒﺎت ‪ ،‬وﻓﺘﺮات اﻟﺘﻐﺬﻳﺔ ‪ ،‬وإﻋﺎدة ﺗﺮﺗﻴﺐ ﻋﺪد وﺗﻮاﺗﺮ اﻟﻮﺟﺒﺎت‬
‫ﻣﺜﻞ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻟﻤﺮﺿﻰ اﻟﺴﻜﺮي ‪ ،‬واﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻟﻤﺮض اﻟﻘﺮﺣﺔ اﻟﻬﻀﻤﻴﺔ‪.‬‬

‫اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻣﻦ اﻟﺘﻨﺎﺳﻖ اﻟﻤﺘﻐﻴﺮ‪Diets of altered consistency:‬‬

A- Modification in Quantity ‫اﻟﺘﻌﺪﻳﻞ ﻓﻲ اﻟﻜﻤﻴﺔ‬

Depending on the clinical condition some individuals may require a

restriction diet such as sodium restricted diet (as in high blood
pressure)

‫ ﻗﺪ ﻳﺤﺘﺎج ﺑﻌﺾ اﻷﻓﺮاد إﻟﻰ ﻧﻈﺎم ﻏﺬاﺋﻲ ﻣﻘﻴﺪ ﻣﺜﻞ‬، ‫اﻋﺘﻤﺎدًا ﻋﻠﻰ اﻟﺤﺎﻟﺔ اﻟﺴﺮﻳﺮﻳﺔ‬
(‫ﻧﻈﺎم ﻏﺬاﺋﻲ ﻣﻘﻴﺪ ﺑﺎﻟﺼﻮدﻳﻮم )ﻛﻤﺎ ﻫﻮ اﻟﺤﺎل ﻓﻲ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم‬

B- Modification in Nutrient (Proteins, Fat, Carbohydrate)

Content

(‫ اﻟﻜﺮﺑﻮﻫﻴﺪرات‬، ‫ اﻟﺪﻫﻮن‬، ‫ﺗﻌﺪﻳﻞ ﻣﺤﺘﻮى اﻟﻌﻨﺎﺻﺮ اﻟﻐﺬاﺋﻴﺔ )اﻟﺒﺮوﺗﻴﻨﺎت‬

The nutrient content of the diet is modified to treat deficiencies,

change body weight or control diseases such as hypertension or
diabetes.

‫ﻳﺘﻢ ﺗﻌﺪﻳﻞ اﻟﻤﺤﺘﻮى اﻟﻐﺬاﺋﻲ ﻓﻲ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ ﻟﻤﻌﺎﻟﺠﺔ أوﺟﻪ اﻟﻘﺼﻮر أو ﺗﻐﻴﻴﺮ وزن‬
.‫اﻟﺠﺴﻢ أو اﻟﺴﻴﻄﺮة ﻋﻠﻰ اﻷﻣﺮاض ﻣﺜﻞ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم أو ﻣﺮض اﻟﺴﻜﺮي‬

C- Changes in Meal Frequency ‫ﺗﻐﻴﻴﺮ وﺗﻴﺮة اﻟﻮﺟﺒﺎت‬

Individuals suffering with gastro-esophageal reflux disease (GERD)

stand to benefit by consuming small but frequent meals.

‫( اﻻﺳﺘﻔﺎدة ﻣﻦ‬GERD) ‫ﻳﻤﻜﻦ ﻟﻸﻓﺮاد اﻟﺬﻳﻦ ﻳﻌﺎﻧﻮن ﻣﻦ ﻣﺮض اﻟﺠﺰر اﻟﻤﻌﺪي اﻟﻤﺮﻳﺌﻲ‬
.‫ﺧﻼل ﺗﻨﺎول وﺟﺒﺎت ﺻﻐﻴﺮة وﻟﻜﻦ ﻣﺘﻜﺮرة‬

D- Changes in Method of Cooking

‫ﺗﻐﻴﻴﺮات ﻓﻲ ﻃﺮﻳﻘﺔ اﻟﻄﻬﻲ‬

Leaching is indicated for cooking vegetables for people with
chronic kidney diseases because the kidney's no longer maintain
the ideal level of potassium necessary for optimum health.

‫ﻳﺸﺎر إﻟﻰ اﻟﺘﺮﺷﻴﺢ ﻟﻄﻬﻲ اﻟﺨﻀﺎر ﻟﻸﺷﺨﺎص اﻟﺬﻳﻦ ﻳﻌﺎﻧﻮن ﻣﻦ أﻣﺮاض اﻟﻜﻠﻰ اﻟﻤﺰﻣﻨﺔ‬
‫ﻷن اﻟﻜﻠﻰ ﻟﻢ ﺗﻌﺪ ﺗﺤﺎﻓﻆ ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻤﺜﺎﻟﻲ ﻣﻦ اﻟﺒﻮﺗﺎﺳﻴﻮم اﻟﻀﺮوري ﻟﻠﺼﺤﺔ‬
.‫اﻟﻤﺜﻠﻰ‬

E- Modification in the Method of Feeding

‫ﺗﻌﺪﻳﻞ ﻃﺮﻳﻘﺔ اﻟﺘﻐﺬﻳﺔ‬

• To provide adequate nutrition, normally oral feeding is

recommended.

.‫ ﻳﻮﺻﻰ ﻋﺎدة ﺑﺎﻟﺘﻐﺬﻳﺔ ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﻢ‬، ‫ﻟﺘﻮﻓﻴﺮ اﻟﺘﻐﺬﻳﺔ اﻟﻜﺎﻓﻴﺔ‬