NUTRITION AND DIET some chores requiring daily physical

Chapter 17: THERAPEUTIC DIETS activity.

Nutrition Therapy for Obesity and Weight Control 3. Pre-school children should not be bribed or
rewarded with food. They should have a
 Obesity variety of activities so they take their minds
- a condition in which the natural energy off the excessive pleasure of eating
reserve is increased, is a hazard to health. It is
not suprising that obese people are prone to
heart disease, gallbladder disease, diabetes, or
other chronic diseases.
 The degree of obesity is often judged
by comparing what one weighs with
the height-weight table. If one weights Planning for Weight Loss
10%-19% more than the average for 1. Planning for weight loss should be
his or her height and body frae, he/she directed by a physician
is overweight.
 Losing weight simply means balancing food 2. It should set a reasonable goal
calorie intake with the body’s needs for
calories. If one has 500 calories less everyday, 3. It must keep a weekly weight chart
he/she will lose 1lb/week.
 The state of being overweight and obese is a 4. It must include an exercise regimen
condition in which the body stores of fat are
enlarged. Underweight or undernutrition
results when intake does not meet the energy
requirement.
Low calorie diet
Some Reasons for Excessive Calorie Intake
 Women usually lose weight satisfactorily on
● Family patterns of rich, high-calorie foods, the diets restricted to 1000-1500 calories whereas
mother or any household member being a men lose weight satisfactorily on diets
good cook furnishing 1200-1800 calories. Bed patients,
● Good appetite; likes to eat; likes any rich such as those with heart diseases, are often
foods, may dislike fruits and vegetables placed on diets restricted to 800-1000 calories
● Ignorance of calorie value foods and sometimes less.
● Skips breakfast; is a frequent nibbler;  The daily food allowances for the 1000-1,200
takescoffee break with high calorie snacks and 1,500-calorie diets are somewhat higher
● Pattern of living than in protein than normal. Usually, the food
allowances are divided into 3 approximately
 Sedentary occupation. Idleness equal meals. Skipping breakfast is not a
 Riding to work or school good idea. Meals with a low-calorie diet
 Little exercise during leisure time should be attractive and palatable.
 Often sleeps more as person becomes  Low-calorie diet should not include alcoholic
older beverages, sweetened carbonated beverages,
 Emotional outlet; eats to overcome worries cakes, canies, cookies, cream, fried foods,
and problems, boredom, loneliness or grief sweetened fruits, pastries, pies, potato chips,
pretzels, puddings and others.
 Many social events serving rich foods;
frequent eating at restaurants
Nutrition Therapy for Diabetes Mellitus
 Lower metabolism with increasing age, but
failure to reduce intake
 Influenced by advertising of many high-calorie  Diabetes mellitus is a metabolic disease that
foods affects the endocrine system of the body and
use of carbohydrates and fats. Specifically,
there is not enough insulin available for the
Prevention of Obesity
body’s needs.
1. There should be a change in eating patterns
 Two types of diabetes are recognized.
of families so that the recommended calorie
1. Juvenile diabetes occurs at any age from
intake for members is followed.
birth through adolescence. It is severe,
2. Children should be encouraged to get more requires insulin for treatment, and is
exercise and should be assigned to perform difficult to manage.
 2. Adult-type diabetes occurs primarily chemical, or thermal irritation
among obese people who become diabetic
in middle age. The disease is usually
middle, stable, and well-regulated by diet  Bland Diet is a nutritionally adequate diet that
alone or by diet and oral compounds. includes food that has bland flavor and soft
consistency, and mechanically and chemically
Characteristics of Diet non-stimulating.
The diet is essentially normal except that the  The most important therapeutic quality of a
amounts of food and their distribution in meals are peptic ulcer is that it assists in diluting,
controlled from day to day neutralizing the stomach acid. Foods rich in
Energy Overweight diabetics are initially protein have somewhat greater ability to
placed on low-calorie diet neutralize acid than low-protein foods. Fats
Protein About ½ g per kg body weight is has some ability to inhibit the secretion of
usually allowed acid. It also delays the emptying time of the
stomach.
Carbohydrate The number of grams of fat is  Diverticular diseases are often consequences
and Fat ordinally about the same as the of long-term, low-fiber eating practices and
number of protein; the amount of frequent constipation
carbohydrate is roughly twice the  A well-balanced diet with variety of foods
number of grams of protein. and adequate protein is recommended.
 Acute episodes may require liquids and
low-residue foods, excluding roughage.
 As swelling abates, a high-fiber diet is
recommended to lessen straining
FOOD PREPARATION and SERVICE
 Malabsorption syndrome (celiac spruce) is a
condition in which mucosa of the small
 All food items in the diet are measured intestine is damaged by gluten which results in
according to the amounts in the food exchange the malabsorption of nutrients.
lists. Level measures with standard measuring  Non-tropical spruce is a diarrheal condition
cups and spoons are used. in which excessive fat is excreted in the stool.
 Foods are prepared using only those allowed  Many of these patients have
on the meal patterns. No extra flour, bread intolerance for gluten. The
crumbs, butter, or other foods may be used. characteristic of the diet are as
 Meats are broiled, baked,reasted, or stewed. If follows:
they are fried, some of the fat allowance may 1. A high-protein diet is usually
be used. necessary.
 Frozen or canned fruit packed with sugar must 2. Cereals and breads containing
be avoided. wheat, rye, or oats must be
 Concentrated sweets and desserts are avoided. omitted.
3. Corn and rice cereals can be
NUTRITION THERAPY FOR DISEASES OF substituted.
THE GASTROINTESTINAL TRACT 4. A low-fat fiber diet may be better
tolerated during the initial stages.
Peptic Ulcer Is an ulceration in the  Ulcerative Colitis is an inflammatory bowel
protective inside layer disease of the large intestine limited to the
of the lower esophagus, rectum and the colon which causes profuse
stomach, or duodenum and bloody diarrhea. It is characterized by
severe diarrhea, rectal bleeding, cramping,
The dietary treatment for peptic ulcer requires the abdominal pain, anorexia, and weight loss.
preparation of a bland diet. Particular emphasis is Treatment: Rest, nutritional therapy,
placed on: sulfonamides
 Lactose Intolerance is caused by a deficiency
of lactase, the enzyme which hydrolyzes
1. Nutritive adequacy
lactose, the sugar in milk. This disorder may
either be congenital or may arise from other
2. Ability if the diet to dilute, neutralize, or disease like Celiac Spruce, where the intestinal
reduce the secretion of acid by the stomach mucosa is affected, or can occur after gastric
surgery.
3. Ability of the diet to avoid mechanical, Treatment: Nutritional management
  Diarrhea refers to the frequent loose or liquid o High-fat foods
bowel movement that prevents complete  Foods that Do Not Affect the Lower
digestion. Esophageal Sphincter
Types of diarrhea: o Protein foods with low-fat
 Acute, which is diarrhea of less than 2 content
weeks caused by viral, bacterial, or o Carbohydrate foods with low-
protozoan infections, medication side fat content
effect or altered dietary intake.  Foods that Can Irritate Damaged
 Chronic, occurs more than 2 weeks Esophageal Mucosa
resulting from disorders. o Soft drinks
Treatment: Nutritional Management o Citrus fruits and juices
 Constipation is a condition in which a person o Coffee
experiences hard feces that are difficult to o Herbs
egest. Its symptoms are lack of appetite, o Spices
lethargy, bad breath, distended stomach, and o Tomato products
caked tongue.
o Very hot or cold foods
Types of Constipation:
 Atonic Constipation- experienced by  Short Bowel Syndrome is a malabsorption
older people, obese individuals, before disorder caused by resection of portions of the
surgery, and during pregnancy small intestine due to an illness or injury
 Spastic Constipation- caused by over Treatment: Nutritional Management
stimulation of the intestinal nerve
endings resulting in asymmetrical NUTRITION THERAPY FOR DISEASES OF
contractions of the bowel. THE LIVER, GALLBLADDER, AND PANCREAS
 Obstructive Constipation- a
condition in which the passage of LIVER
feces is impeded or a compression by
surrounding tissues happens causing
the drying and enlargement of fecal
mass

Treatment: Nutritional Management, regular exercise

 Intestinal Gas may be referred to as increased

occurrence of passage of gas or cramping pain
associated with the buildup of gas in the GIT,
gas swallowed, or gas exchanged in the GIT
and blood or produced during digestion.
Treatment: Nutritional Management
 Hemorrhoids are enlarged veins which occur
in the lower part of the rectum at the anal GALLBLADDER
opening. External hemorrhoids crop up when
the rectum meets the skin while Internal
hemorrhoids form completely within the
rectum.
Treatment: Nutritional management
 Gastroesophageal reflux disease, hiatal
hernia and esophagitis or heart burn take
place 1 to 4 hours after meal when a decrease PANCREAS
in sphincter pressure happens. Often caused by
decreased levels of progesterone brought by
pregnancy; oral contraceptives; smoking; and
certain foods.
Treatment: reducing intra-abdominal pressure
and gastric production
 Foods that relax the lower
Esophageal Sphincter
o Alcohol
o Mint
o Chocolate
  During our lifetimes, optimal oral health
depends on adequate quantities of vitamin A,
NUTRITION THERAPY FOR B-complex, C,D, and E; proteins; calcium,
CARDIOVASCULAR DISEASES phosphorus and magnesium; iron; zinc; copper
and some lipids, such as omega-3 fatty acids.
1. Lipids perform a key role in the general
health (energy, obesity, diabetes and
hypertension) and have slight implications
for the control of oral health status. Fat
provides a protective layer on teeth and
prevents biofilm adherence.
2. Protein is responsible for repair and
maintenance. Amino acids repair tissues
and form antibodies to help resist
infection.
3. Vitamin A in adequate amounts helps
sustain immune function and the integrity
of sulcular epithelium, assists with bone
remodeling and keeps the salivary glands
working efficiently.
4. Vitamin D in constant amounts is
important throughout life since calcified
tissues remodel. Vitamin D is vital to
general health because it controls the
presence of calcium, magnesium, and
phosphorus in blood plasma.
5. Vitamin E is a group of 10 lipid-soluble
compounds that include tocopherols and
NUTRITION THERAPY FOR DISEASES OF tocotrienols. Vitamin E functions as an
THE KIDNEYS antioxidant and protects red blood cells.
6. Vitamin K functions as a cofactor (enzyme
partner) for the synthesis of prothrombin.
7. Vitamin B-complex is a group of
coenzymes. These coenzymes work
together to sustain healthy oral tissues by
forming a new cells and preserving the
immune system.
8. Vitamin C assists with collagen and
connective tissue formation; aids with
blood vessel integrity, phagocytosis, and
wound healing; is a strong antioxidant;
facilitates calcium and iron absorption;
and protects Vitamin A and E.
9. Calcium, magnesium, and phosphorus in
minute amounts in the diet can affect
absorption and create aggressive bone
resorption, increased tooth mobility,
premature tooth loss, and increased risk of
hemorrhage.
10. Iron deficiency can lead to angular
cheilosis, pallor, burning tongue, glossitis,
and atrophy or denudation of the filiform
papillae, and candidiasis, as a result of
Maintenance of Healthy Periodontal Tissues lowered immune function.
11. Zinc is an essential mineral needed for
 When the host is weak, bacteria attack wound healing and new tissue formation,
periodontal tissues. Healthy oral tissue is the Zinc works along with iron and copper for
best protection against microbe invasion. wound resolution.
Some nutrients influence the process of
maintaining and repairing periodontal
structures more than others.
 12. Copper is an important mineral, involved c. Sharing Contaminated Needles
in both collagen and elastin formation and d. Mother to Child during pregnancy,
regeneration. childbirth, breastfeeding
 It cannot spread by mere kissing, coughing,
NUTRITION THERAPY FOR CANCERS sneezing, touching and sharing of utensils.

TYPES OF CANCER NUTRITIONAL MANAGEMENT

1. Carcinoma - is a malignant cancer that arises 1. Dietary Management

from the cells of the skin, glandular organs,
and inner linings of internal organs. a. Energy - 35 to 45 kcal/kg BW
2. Sarcoma - is a cancer that develops in the b. Protein - 2 to 2.5 g/kg BW
muscles, cartilages, connective tissues, and c. Fats - increase omega-3 sources and decrease
bones saturated fats in the diet
3. Glioma - originates in the central nervous d. Vitamins and minerals - an increase to be
system and supporting connective tissues in recommended in case of altered metabolism
the brain
4. Lymphoma - is a cancerous growth in the NUTRITIONAL MANAGEMENT
lymph nodes and other tissues of the lymphatic
system. a. Common in patients with chronic or terminal
illness
NUTRITIONAL MANAGEMENT b. May range from vitamin and mineral
supplementations
1. Oral Nutrition
a. High Calorie, high-protein beverages may
be offered.
b. In case of lactose deficiency, Lactaid may
be given.
2. Tube Feedings
a. Complete Products : meal replacements
that require digestion and absorption
b. Chemically-defined Products: minimal or
no digestion; for pancreatic cancer patients
c. Modular Products : used in combination
with other tube feeding products to
enhance calorie or protein intake
d. Specialty Products: vary in terms of
specific amino acid, carbohydrate, and fat
content; for patients with hepatic or renal
failure
3. Total Parenteral Nutrition
a. Used when the digestive tract is not
functioning
b. Nutrients administered intravascularly

c. NUTRITION THERAPY FOR

ACQUIRED
d. IMMUNE DEFICIENCY SYNDROME
(AIDS)

NUTRITION THERAPY FOR ACQUIRED

IMMUNE DEFICIENCY SYNDROME (AIDS)

 Acquired immune deficiency syndrome

(AIDS) is caused by human
immunodeficiency virus or HIV. An infected
person can transmit the virus through/from:
a. Sexual Intercourse
b. Blood Transfusion