DIET MODIFICATION 8.

Socioeconomic and other considerations

SEMIFINALS such as religious beliefs, customs.

PRINCIPLES OF DIETARY MANAGEMENT

Purposes of Diet Therapy
1. To maintain or to restore good nutritional
status
2. To correct nutrition deficiencies which may
have occurred.
3. To adjust the diet to digestive capacity of the
patient.
4. To bring about the changes in body weight,
whenever necessary
5. To treat or prevent edema
6. To eliminate offending substances
Factors to consider in the study of the diet
therapy
1. Underlying disease conditions which require
a change in the diet
2. The possible duration of the disease
3. The factors in the dietary which must be
altered to overcome these conditions
4. The patient’s tolerance for food by mouth.
Modification of the Normal Diet
1. Change in consistency
Example: Fluid and soft diets
2. Increase or decreases energy values
Example: High and Low Carbohydrates
3. Include greater or lesser amounts of one
or more nutrients
Example: High Protein and Sodium restricted
Diet
4. Increase or Decrease Bulk
Example: High and Low Fiber Diet
1. Liberazation - the diet should not meet
the body’s requirement for essential
nutrients as generously as the disease
condition permits.
2. Individualization - the diet regimen
should take cognizance of the patient’s
food intake habits, preference, economic
status, religious practices, and any
environmental factor which have bearing on
the diet such as where the meals are eaten
and who prepares them.
3. Simplification - the therapeutic diet
should vary from the adequate normal diet
as little as possible.
HOSPITAL DIETS
a. Routine Diets
 Regular Diet-Designed - for patients
who require no special dietary
modifications or restriction.
 Soft Diet
 Liquid Diets - Clear, Full, Cold,
Blenderized or Tube Feeding.
b. Therapeutic Diets
 Liquid Diets (Clear, Full, Cold, Tube
Feedings aka Blenderized)
c. Test Diets
- these diets are with specified food
requirements and uses diagnostic aids.

5. Provide foods bland in flavor

Example: Bland diet regimen

6. Modify Intervals of feeding

Example: Bland, Diabetic, and Liquid Diets.

BASES OF MODIFICATION
1. Normal Requirement (RENI, Nutritional
Guidelines, Individual Diet)
2. Previous Nutritional Status of the Individual
3. Pathophysiology of diseases
4. Anticipated duration of disease and injury
5. Dietary Factors to be Altered
6. Amount and Character of the Nutrient which
is being lost from the body
7. Patient’s tolerance for food
 CHARACTERISTICS AND INDICATIONS
FOR USE OF DIFFERENT
THERAPEUTIC DIETS
Types of Diet
A. Liquid Diet Tube Feedings (Blenderized)
Indication: Surgery of the mouth, Gastric
surgery, Severe Burns, Coma, Acute and
Chronic Infections
Characteristics: Composed of foods included
in the soft diet and liquid diet, blended and
liquified to enable the mixture to pass through
a polyvinyl tube.
Food Selection: All foods included in the soft
and liquid diets which are easily blended.
B. Cold Liquid Diet
Indication: Dental Extraction, Sometimes
referred to as diet for Tonsillectomy and
Adenoctomy. Used for minor throat and mouth
operation
Characteristics: given to prevent bleeding of
the operated area.
Food Selection: Ice cream, cold milk, iced
tea, soft drinks.
C. Soft Diet
Indication: Patients who are unable to chew,
swallow, or digests foods, included in full diet,
mild to moderate infection, simple GI
disturbances and convalescence.
Characteristics: Serves as transition from full
liquid to the regular diet.
Food Selection: low in cellulose content, low
in fiber, simple and easily digested.
D. Minimum Residue Diet
Indication: Diseases and conditions involving
the bowel like, dysentery, diarrhea, pre- and
post -op periods when it is desired to reduce
fecal residue, as colostomy, ileostomy, and
bowel resection.
Characteristics - made up of foods which
form the least amount of fecal matter.
Food Selection - Plain and Strained soups,
tender beef, liver, chicken (no skin) fish and
other sea foods.
Foods Avoided: Cheese, raw eggs,
vegetables, cereals, fried foods.
E. Bland Diet
Indication: Gastric and Duodenal Ulcers,
Gastritis, Ulcerative Colitis, In some cardiac
cases in order to provide rest to the heart.
Characteristics: an allowance of food and
drink which is chemically, mechanically, and
thermally non-irritating.
Foods Selection: foods that are mild on flavor
no coarse fiber, any food tolerated by the
patient
Foods Avoided: Black pepper, chili powder,
strong coffee and alcohol.
F. Mechanical Soft Diet
Indication: Poor dentures, lack of teeth,
presence of sores and lesions in the mouth
Characteristics: food given requires little
chewing.
Food Selection: those included in the full diet
may be given but reduced to small pieces by
grinding, chopping, and mincing.
G. Low Fiber Diet
Indication: spastic constipation, other
gastrointestinal disturbance
Characteristics:
- contains a minimum of indigestible
carbohydrates and tough connective tissue.
- normal diet with fiber increased to more than
10 gms daily.
Food Selection:
- avoid tough connective tissues in meats,
seeds, skins of fruits and vegetabes, and
whole grains of cereals.
H. High Fiber Diet
Indication: atonic constipation, diabetes
mellitus
Characteristics: normal diet with fiber
increased to more than 10 grams daily.
Food Selection: Full diet emphasis on long-
fibered vegetables like raw fruits and
vegetables, whole grain cereals, and coarse
bread.
I. Calorie
A. High Calorie
Indication: underweight, protein energy
malnutrition, fevers and infection, growth,
pregnancy and lactation.
Characteristics: contains greater amount of
total energy to effect a positive energy,
balance, minerals and vitamins remain at or
above recommended levels.
Food Selection: All foods in diet with
increased amounts of cereals, breads, butter,
cream, and other fats and sugars
Food Avoided: Low calorie foods, fried foods
B. Low Calorie
Indication: Obesity and those cases where
excess weight is complicating factor like
diabetes mellitus, CVD, renal disease, gout,
preceding surgery.
Characteristics: Contain a reduced amount of
total energy to effect a negative energy
balance, proteins, minerals and vitamins
remain at above or recommended levels.
Food Selection: Protective foods that are
emphasized sufficient bulk
Foods Avoided: High fats food, High
Carbohydrates food.
J. Carbohydrates
A. High CHO
Indication: Renal and Liver Disturbances,
Toxemia of Pregnancy, Preparation for
Surgery
Characteristics: Increased by the 50% above
the normal
Food Selected: Emphasis on rice and other
cereals, breads and bakery products, noodles,
sugars, native cakes.
B. Low CHO
Indication: Hyperinsulinism, Dumpling
Syndrome, Obesity, epilepsy, celiac disease
Characteristics: Diets are reduced by 50%
proteins and or fats are increased
Food Selected: foods high in protein
K. Protein
A. High Protein
Indication: Growth, Pregnancy, Lactation,
Protein Energy Malnutrition, Burns, Surgery,
Fractures, Fever, Pernicious Anemia,
Hepatitis, Celiac Disease
Characteristics:
- A regular diet with proteins increased by 50-
100% above the normal allowance; about 1/3 -
1/2 and 1/2 to 2/3 of the total protein in diets of
adults and children
Foods Selected: All foods in the regular diet
with emphasis on milk, eggs, cheese, meat,
poultry and fish.
B. Low Protein
Indication: acute glomerulonephritis, uremia,
hepatic coma, chronic glomerulonephritis with
nitrogen retention
Characteristics:
- Protein restricted to 50% below the normal
allowance or about 20-30 grams per day;
about 2/3 of the total protein prescribed should
come from HBV proteins; sodium and
potassium may be restricted.
Foods Avoided: Protein foods in excess of
prescribed amount
Limited: Legumes, Nuts, Cereals and
Vegetables
C. Protein-free or Zero Protein
Indication: hepatic coma,and acute anuria
Characteristics: Use only as an emergency
measure, High CHO, and fats to prevent tissue
breakdown
Foods Selected: Fruit Juices if potaasium is
not restricted, sugar, butter, sugar-mixtures,
butter soup, etc.