Diet Clinic
THERAPEUTIC DIET
A therapeutic diet is an adaptation of the normal or regular diet. The diet may have to be
modified depending upon the disease, the severity of the problem, the nutritional status of
the patient as well as the metabolic changes involved. Therefore, the diet used for feeding a
normal, healthy individual needs to be altered in certain respects so as to make it suitable to
meet the modified nutritional needs of an individual suffering from a specific disease. In
some disease conditions, the dietary modifications involved may be few but in others,
several alterations and adjustments may have to be made. It is imperative that the basis for
planning of such modified diets, i.e. therapeutic diets should be the normal diet. Therapeutic
diets are planned to maintain or restore good nutrition in the patient. In most cases, the
therapeutic diet is used to supplement the medical or surgical treatment of the patient, while
in some instances, like noninsulin dependent diabetes mellitus, a therapeutic diet is the most
important aspect of the patient's treatment, rather than medical therapy. A sick like a healthy
person should be maintained in nutritional homeostasis. A well-planned diet providing all the
specific nutrients to the body helps achieve nutritional homeostasis in a normal, healthy
individual. However, in disease conditions, the body tissues either do not receive proper
nutrients in sufficient amounts or cannot utilize the available nutrients owing to faulty
digestion, absorption or transportation of food elements, thus affecting the nutritional
homeostasis of the sick person. The diet, therefore, needs to be suitably modified.
The objectives of therapeutic modifications may thus be stated as:
• To maintain a good nutritional status
• To correct nutrient deficiencies which may have occurred due to the disease
• To afford rest to the whole body or to specific organs affected by disease
• To adjust the food intake to the body's ability to digest, absorb and disease metabolize
nutrients during the disease .
• To bring about changes in body weight and composition, whenever necessary.
THERAPEUTIC ADAPTATIONS OF THE NORMAL DIET
A normal diet may be modified according to disease, symptoms, metabolic changes and
condition of the patient. Therapeutic modifications which ass commonly done are:
• Change in consistency so as to provide a normal, soft or a liquid diet. In conditions like
diarrhoea, fevers, post surgery, the digestive system may be affected and a liquid or soft diet
is recommended. The presence of ulcers in the mouth may hinder the intake of solid food.
On the other hand, in diseases like diabetes and hypertension, a normal consistency diet
may be recommended.
• Modifications in energy intake, for example, high or low energy diets. Depending upon the
metabolic changes, modification in activity patterns and the weight of a patient, suitable
alterations in the energy intake are done. An obese diabetic would thus be recommended a
low energy diet while an underweight tuberculosis patient would be advised a high energy
intake.
• Modification in the content of one or more nutrients, for example, high or low protein diets,
low sodium diets, moderate fat diets or high carbohydrate diets. It is imperative to increase
the nutrient intake in certain diseases where the loss of nutrients is enhanced or the body's
needs are increased.
• Modification in the fibre content, such as high and low fibre diets. Diseases affecting the
functioning of the gastro-intestinal system generally require modifications in the fibre content
of the diet. Patients of diarrhoea are advised to decrease their fibre intake, while patients
suffering from constipation are asked to increase the intake of fibrerich foods. High fibre
diets, especially soluble fibre, are also beneficial in the management of chronic non-
communicable diseases (NCD) like diabetes, coronary heart disease, hypertension and
some cancers.
• Bland diets are prescribed to avoid irritation of any kind to the alimentary tract as in case of
peptic ulcers, inflammatory and bowel disease. Such diets are chemically, mechanically and
thermally bland. Strong spices, stimulants and strongly flavoured vegetables and fruits as
irritants are avoided. The foods served should be at room temperature and very hot or very
cold foods are avoided.
• Exclusion of certain foods. In allergic conditions, certain specific foods to which the
individual is allergic are entirely excluded from the diet. Generally protein rich foods like milk,
egg and seafood's produce allergic reactions and so these foods may have to be eliminated
in the diet of the affected individuals. In case of malabsorption syndrome like celiac the
gastro-intestinal mucosa being sensitive to the wheat protein gluten, wheat and its products
have to be completely excluded from the diet.
• Rearrangement in the frequency of feeding. In some disease conditions, the patient may
not be able to eat large amounts of foods at one time. It may thus become essential to give
smaller meals at frequent intervals as in fevers and diarrhoea. Rearrangement in the number
and frequency of meals may also be required for diabetics and peptic ulcer patients.
• Modify the mode of feeding. In patients who are not able to take foods orally, special
feeding methods like tube or intravenous feeding may have to be adopted to meet the
nutritional needs
