Nutrition (midterms)

IBW, TER AND BMI Therapeutic Diet

 Basal Metabolism  meal plan that controls intake of
certain foods or nutrients
 amount of energy required by
 part of treatment of medical
an individual in resting state
condition
for diff. functions

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o prescribed-physician
o e.g. breathing ,

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circulation of blood o plan-dietician

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 Basal Metabolic Rate

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 modification of regular diet

 modified or tailored to fit the

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 minimum caloric requirement
needed to sustain life in resting nutrition needs of a person

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individual modified for:
 amount of energy ( measured

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1. nutrients
in calories) expended by body

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2. texture
to remain in bed asleep all day
3. food allergies / intolerance
Factors that affect BMR

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1.Genetics 6.Body fat percentage Types of Therapeutic Diet
Reasons therapeutic diets are ordered:
2.Gender 7.Diet
 maintain, restore and collect
3.Age 8.Sleep
nutritional status
4.Weight 9.Endocrine glands
 decrease cal. for wt control
5.Body surface area 10.Fever
 provide extra cal. for wt gain

 balance amount of cho, fat and

pro for diabetes control

 provide greater amount of

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nutrients (protein)  Tube feedings

 decrease amount of nutrients (Na)  liquid tube feedings in addition to

meals
 exclude foods due to allergies or
food intolerance Clear Liquid Diet
 provide texture modifications due
 include minimun residue fluid that
to prob. w/ chewing/ swallowing
can be seen through
Common Therapeutic Diet

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o juices w/o pulp, broth, jell-o

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 often used as first step to

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 Nutrition Modification restarting oral feeding

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 no concentrated sweets diet o after surgery / abdominal

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procedure
 diabetic diet
 used for fluid and electrolyte

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 no added salt diet
replacement in people w/ severe
 low Na diet diarrhea

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 low fat/ cholesterol diet  shouldn`t be used for long period

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 high fiber diet o doesn`t provide enough cal

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and nutrients
 renal diet
FullLiquid Diet
 Texture modification
 fluid that are cream
 mechanical soft diet
o ice cream, pudding, thinned
 puree diet
hot cereal, custard, strained
 Food allergy/ intolerance cream soup, juice w/ pulp
modification
 2nd step - restarting oral feeding
 food allergy
o once clear liquid are
 food intolerance tolerated

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Nutrition (midterms)
 used for pips who can`t tolerate
mechanical soft diet
o shouldn`t be used for
extended period
Diabetic / Calorie Contolled Diet
(ADA)
 diets control cal, carbs, pro, and
fat intake in balanced amounts
o to meet nutritional needs,
control blood sugar levels,
control wt
 Portion control - used at
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mealtimes as outlined in the ADA
"Exchange List for Me Planning."
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 Most commonly used cal. levels:
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o 1. 200, 1,500, 1,800 and
2,000.
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No Concentrated Sweets Diet
(NCS)
 liberalized diet for diabetics
o wt and blood sugar level
are undercontrolled
 include regular food w/o additon
of sugar
o cal. not counted (part of
ADA)
No Added Salt (NAS) Diet
 regular diet w/ no salt packet on
the tray.
 Food is seasoned as regular food
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Low Na Diet
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 2 gram Na Diet.
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 Limits salt and salty foods
o bacon, sausage, cured
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meats, canned soups, salty
seasonings, pickled foods,
salted crackers, etc.
 used for people who have:
o "holding water" (edema),
hypertension, heart disease,
liver disease, 1st stages of
kidney disease.
High Fiber Diet
 prescribed in the prevention or
treatment of a number of:
o gastrointestinal,
cardiovascular, and
metabolic disease.
 Fiber Food sources of fiber
o whole wheat, bran, fresh or
dried fruits, and vegetables
 Increased fiber (source):
o fruit, legume, vegetable,
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Nutrition (midterms)
whole bread and cereal
Low Fat/ Cholesterol Diet
 used to reduce fat levels / treat
medical conditions that interfere
with how the body uses fat
o diseases of the liver,
gallbladder, or pancreas.
 Limits fat to 50 grams or no more
than 30% calories derived from
fat.
 low in total fat and saturated fats
and contains approximately 250-
300 mg cholesterol
Mechanically Altered/ Soft
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Diet
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 used when there are problems
chewing and swallowing
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 Changes the consistency of the
regular diet to a softer texture.
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o chopped / ground meats,
chopped / ground raw
fruits and vegetables.
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 for people with poor dental
conditions
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o missing teeth, no teeth-
dysphacia
 Pureed Diet
 Changes regular diet by pureeing
it to a smooth liquid consistency.
 Indicated for those with:
o wired Jaw, extremely poor
dentition (chewing is
inadequate.)
 Often thinned down to pass
through a straw.
o for people with
chewing/swallowing
difficulties, dysphada
 Food: pureed separately.
o Avoid nuts, seeds, raw
vegetables, and raw fruits.
 nutritionally adequate when
offering all food groups.
Food Allergy modification
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 Food allergies an abnormal
immune response to a harmless
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food
 Foods implicated with allergies are
strictly eliminated from the diet.
 Appropriate substitutions are made
to ensure the meal is adequate.
 most common food allergens
o milk, egg, soy, wheat,
peanuts, tree nuts fish, and
shellfish.
 gluten free diet
o elimination -wheat, rye,
and barley
o Replaced with- potato, corn,
and rice products.
Food Intolerance modification
 most common food intolerance-
lactose intolerance (milk sugar)
 because of decreased amount of
an enzyme in the body.
 Other common types of food
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intolerance = adverse reactions to move blood through arteries and

certain products provide oxygen to the tissues of the
body
 added to food
 diastolic pressure = 100 or more
o enhance taste, color /
protect against bacterial o therapy should be initiated
growth. through drugs as well as
diet

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 Common symptoms
 High blood pressure, or
hypertension = no symptoms,

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o vomiting. diarrhea,

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abdominal pain, and o "silent killer" because it
can go undetected for

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headaches years until a fatal heart
attack or stroke occurs.
Tube feedings

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lead to other health complications

 used for people who cannot take o stroke, kidney failure,

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adequate food or fluid (by mouth.) impaired vision, heart
attack, or heart failure.
 All or parts of nutritional need =

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met (through tube feedings). Dietary Management

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 Some people receive food by
Principles of Diet
mouth if they can:

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o swallow safely and working
to be weaned off the tube
feeding.
Dietary Management Hypertension
Hypertension
 condition which systolic pressure
exceeds 120mm Hg and diastolic
pressure exceeds 95 mm Hg
 High blood pressure causes 1/8
deaths worldwide
o third leading cause of
death worldwide.
 Blood pressure - necessary to
 Low calorie, low fat, low sodium
diet with normal protein intake
 Kempner`s rice fruit diet ,
suggested
 This diet is very restrictive and
deficient in many nutrients
1. Energy
 An obese patient is reduced to
normal body weight with low
calorie diet
o 20 Kcal/Kg-sedentary
worker
o 25 Kcal/kg-moderately
active worker
 Alcohol consumption should be
reduced
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Nutrition (midterms)
2) Protein
 A diet of 60g protein is necessary
to maintain proper nutrition
 In severe hypertension protein
restriction to 20g is required as a
temporary measure since protein
foods are rich in sodium
3) Fats
 prone to atherosclerosis - avoid
high intake of animal or
hydrogenated fat.
 About 20g vegetable oil is
permitted
 Omega 3 fatty acids has a role in
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regulation of blood pressure
 DHA is more potent than EPA
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4) CARBOHYDRATE
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 Easily available carbohydrate is of
great help in management of
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hypertension
5) SODIUM
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 Increased sodium intake =
increased intravascular volume =
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increases cardiac output
(elevating blood pressure)
o Restricted sodium and
decrease in
sodium/potassium ratio in
diet
o Moderate sodium restriction
2-3 g/day reduces diastolic
pressure 6-10mm HG
 Sodium restriction accompanied
by weight reduction effectively
control mild/moderate arterial
blood pressure
6) POTASSIUM
 Potassium works with Na to
regulate the body's water balance.
 Low level of potassium cause the
body to retain sodium and water
o this can elevate blood
pressure
 Research shows that a high
potassium-to-sodium ratio is
associated with a greater likelihood
that normal blood pressure will be
maintained.
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o recommended intake of K
is 3500mg/day
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 potassium rich foods
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o leafy green vegetables, root
vegetables like potatoes and
carrots, and fruit, (should
be eaten everyday to meet
potassium requirement)
7) CALCIUM
 Intake of calcium has blood
pressure lowering effects
o involved in the control of
strength which blood is
pumped by the heart and
 the flow of blood in the veins and
capillaries
o both h contribute the blood
pressure
DASH Dietary aproach (stop HPN)
 DASH diet is rich in fruits,
vegetables, whole grains, and low-
fat dairy foods
o meat, fish, poultry, nuts and
beans; and is limited in
sugar-sweetened foods and
beverages, red meat, and
added fats.
> It is a dietary pattern promoted by the U.S.-
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Nutrition (midterms)

based National Heart, Fruits and Lung, and Blood

Institute to prevent and control hypertension.
 DASH - flexible and balanced
eating plan.

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o proven to lower blood

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pressure and cholesterol

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 in adition to low salt (or low sodium)
plan, the DASH diet provides

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additional benefits to reduce blood
pressure.

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o high fiber, low to moderate
fat diet, rich in potassium,

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calcium, and magnesium.

Diabetic Diet Plan

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Nutrition (midterms)
Cardiac Diet
 an unofficial term - heart-healthy
diet.
 eating plan - emphasizes foods
that promote heart health
o vegetables and fruits, whole
grains, lean poultry and oily
fish like salmon and tuna
that are high in omega-3
fatty acids.
 The diet also limits processed
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foods
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 high in sugar, salt and unhealthy
fats, because these increase the
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risk of heart disease.
Recommended Cardiac Diet
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 DASH (Dietary Approaches to Stop
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Hypertension) diet
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 Mediterranean diet,
 many vegetarian diets
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WHAT CAN I EAT ON A CARDIAC DIET?
WHOLE GRAINS
 Whole grain bread, bagels, English
muffins, and tortillas
o Whole grain hot or cold
breakfast cereals with no
added sugar, like oatmeal
or shredded wheat
o Whole grain brown or wild
rice, or quinoa
o Whole wheat or whole grain
pasta and couscous
 Choose products with the word
"whole" in the first ingredient
o "whole wheat," "whole
grain" or "whole oats."
MEATS AND OTHER
PROTEIN
 High-fat cuts of beef (regular
ground meat, ribs, T-bone and
ribeye steaks)
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 Processed meats like hot dogs,
sausage, salami, lunch meat,
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bacon
 Organ meats (liver, brains and
sweetbreads)
 Fried chicken or fish
 Poultry with skin
 Whole eggs
MEATS AND OTHER
PROTEIN
 High-fat cuts of beef
(regular ground meat, ribs,
T-bone and ribeye steaks)
 Processed meats like hot
dogs, sausage, salami,
lunch meat, bacon
 Organ meats (liver, brains
and sweetbreads)
 Fried chicken or fish
 Poultry with skin
 Whole eggs
DAIRY
 Full-fat cheese
 Cream cheese
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Nutrition (midterms)

 Whole or 2% milk
 Whole milk yogurt
 Ice cream
 Cream or half-and-half

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FATS AND OILS

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 Butter

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 Stick margarine

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 ShorteningTropical oils like
coconut, palm and palm kernel

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oil
BEVERAGES

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 Drinks with added sugars

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 Alcohol

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R.A 3720 FOOD, DRUG AND
COSMETIC ACT.

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