BACHELOR OF SCIENCE IN NURSING:
NUTRITION AND DIET THERAPY
COURSE MODULE COURSE UNIT WEEK
2 8 9
DIETARY MODIFICATIONS AND THERAPHY
Read course and unit objectives
Read study guide prior to class attendance
Read required learning resources; refer to unit
terminologies for jargons
Proactively participate in classroom discussions
Participate in weekly discussion board (Canvas)
Answer and submit course unit tasks
At the end of the unit, the students are expected to:
1. The students should be able to discuss the significance and purpose of therapeutic diet.
2. The students should be able to discuss the different types of general diets.
Dietary Modification and Dietary
Therapy
Therapeutic diet – is a meal plan that controls the intake of certain foods or nutrients. It is part
of the treatment of a medical condition and are normally prescribed by a physician and
planned by a dietician. A therapeutic diet is usually a modification of a regular diet.
Therapeutic diets are formulated by doctors and dietetians.
A. General Diets
Standard Hospital Diets
Liquid Diets
1. Clear Liquid Diet - consists of liquids without residue or fibers
- used to relieve thirst and maintain water balance
- diet used for 24-48 hours following acute vomiting, diarrhea or surgery
- allowance of tea, coffee, fat-free broth, ginger ale, fruit juices in sachet, gelatin, fruit ices,
hard candy and water
2. Full Liquid Diet - nutritionally adequate diet consisting of fluids and foods that liquefy at body
temperature
- diet used for acute infections and fever of short duration and for patients who are ill to chew
- milk, cream soups, cereal, soft custard, strained meat in broth, strained citrus fruits, tomato
juice, vegetable puree, eggnog, yogurt
3. Cold Liquid (Yin diet) - diet for patient undergone tonsillectomy and adenoidectomy
- allowance for ice chips, ice cream, sherbet, ice drop, popsicles
4. Soft Diet - nutritionally adequate diet differs from the normal diet in having reduce the fiber
content, soft consistency and bland flavor
- used immediately between the full fluid diet and regular diet following surgery, acute
infections, fever, and GI disturbances
- patient with no teeth or ill-fitting dentures;
- those who cannot tolerate highly seasoned, fried or raw foods
- the normal diet is modified in the following ways:
- meat and poultry are minced and ground
- vegetables are cooked – little longer than usual
- soft raw fruits may be used
- soft rolls, bread or biscuits are used instead of crisp rolls, crust breads and toast
- all desserts on a normal diet may be used
5. Mechanical Soft Diet - dental soft or mechanically altered diet
- foods should be well cooked, easy to chew, chopped ground or minced
- foods are best served moist or with gravy and sauce
6. Regular Diet - most frequently ordered among the house diets
- also called general, house, full hospital diet, diet as tolerated
7. Light Diet - a transition between the soft and regular diets
- for elders who cannot tolerate rich and heavy foods
8. Vegetarian Diet - usually low in saturated fatty acid, cholesterol, and high fiber
- with disadvantage is inadequate or low level of Vit B12, Iodine, Calcium, Zinc, Vit. B2 and Vit.
D.
a. Vegan diet - total vegetarian, or strict vegetarian diet or plant in origin
b. Lacto-vegetarian - milk and milk products + items of plant origin
c. Ovo-vegetarian – eggs and eggs products + items of plant origin
d. Lacto-ovo-vegetarian – eggs + milk + plant origin
e. Semi-vegetarian – lacto-ovo- vegetarian foods + fish + chicken + plant
f. Pesco-vegetarian – fish and fish products + items of plant origin
9. Restricted Diet - a diet limited in a specified amount or type of nutrient
- cholesterol restricted diet, salt restricted diet
10. Controlled Diet - implies careful adjustment of levels of nutrients from day to day as
needed; controlled CHON, K, Na.
B. Dietary Modification with
Consistency
The modified consistency diet includes all the foods you are allowed to eat in your regular diet
based on your tolerance, This diet may also meet all your nutrition needs if you make healthy
food choices. Cut starches into small pieces, mash or puree. Cook fruits: cook or steam
vegetable
MODIFIED CONSISTENCY DIET
PUREED DIET
MECHANICAL SOFT DIET
MODIFIED REGULAR DIET
LIQUID DIET
THICKENED LIQUIDS
Therapeutic Diet for specific disease condition
Acute Glumerulonephritis - Low Na, Low CHON
Acute Renal Failure – Oliguric Phase - Low Na, Low CHON, High CHO
Addison’s Disease - High Na, Low K
Attention deficit hyperactivity disorder - Finger foods
Bipolar Disorder - Finger foods
Cerebrovascular Accident - Osterized Feeding with Low Na, Low cholesterol, High fiber
Cholecystitis - Low fat, High CHO, High CHON
Chronic Renal Failure - Low CHON, Low Na, Low K
Congestive Heart Failure - Low Na, Low Cholesterol
Cushing Disease - High K, Low Na
Decubitus Ulcer - High CHON, High Vitamin C
Dengue Fever - Diet as tolerated except dark-colored food
Diabetes Melitus - Well-balanced diet
Diverticulitis - Low fiber
Dumping Syndrome - High fat, High protein
Hepatic Encephalopathy - Low CHON, High calorie
Hirschsprung’s disease - High calorie, Low residue, High CHON
C. Dietary Modification with
Composition
LOW CALORIE DIET
Calorie restriction, o rcaloric restriction(CR)
that restricts calorie intake, where the baseline for the restriction varies
low-calorie diet (VLCD) should first consult a
physician.
-calorie diet is any diet plan that allows 800 calories or less in a day; and the diet is
overseen by a physician.
6 months. Any longer and
serious health complications may arise.
LOW-CALORIE DIETS AND VERY LOW-CALORIE DIETS
-calorie
diet," which would commonly consist of 1500 to 1800 calories per day.
for more moderate calorie restriction.
HIGH CALORIE DIET
–4000
calories per day.
-calorie diet to help maintain or promote weight gain.
nutrient
metabolism.
they eat each day.
fidgeting which increases their metabolic rate.
treatment.
-dense foods, such as whole milk, cheese and nuts, can help you
increase your calorie intake when you have a poor appetite.
Severe Burns
Underweight
Competitive Athletics
HIGH-PROTEIN DIET
a diet that contains large amounts of protein, consisting largely of meats, fish, milk, legumes,
and nuts.
It may be indicated in protein depletion that results from any cause, as a preoperative
preparation, or for patients with severe burns and sepsis.
It may be contraindicated in liver failure or when kidney function is so impaired that added
protein could result in azotemia and acidosis.
LOW-PROTEIN DIET
disease may be prescribed a low-protein diet.
e undertaken under
medical direction .
Reduce amount of protein
–considered high quality or
complete protein.
–considered low quality or
incomplete protein.
LOW FAT DIET
According to the USDA, a low-fat diet–as the name implies–is a diet that consists of little fat,
especially saturated fat and cholesterol, which is thought to lead to increased blood cholesterol
levels and heart attack.
fatty acids, in addition to supplying fat-soluble vitamins like A, D, E, and K
LOW CARBOHYDRATES
carbohydrate consumption usually for weight control or for the
treatment of obesity.
bread, pasta) are limited or replaced with foods
containing a higher percentage of proteins and fats(e.g., meat, poultry, fish, shellfish, eggs,
cheese, nuts, seeds, peanuts, and soy products) and other foods low in carbohydrates (e.g.,
most salad vegetables) although other vegetables and fruits(especially berries) are often
allowed.
-carbohydrate diets.
ketogenic (i.e. they restrict carbohydrate intake sufficiently to
cause ketosis) for example, the induction phase of the Atkins diet.
low-carbohydrate as well.
-carbohydrate diets are often used as treatments for some other
conditions, most notably diabetes and epilepsy, but also for chronic fatigue syndrome(see
ketosis) and polycystic ovarian syndrome
ALOW SODIUM DIET
sodium per day.(One teaspoon of
salt has about 2,300mg sodium.)
te exercise schedule are usually advised to limit their
sodium intake to 3,000mg per day and those with moderate to severe heart failure are usually
advised to limit their sodium intake to 2,000mg per day.
LOW POTASSIUM DIET
ssists in maintaining normal blood pressure and proper
contraction of the heart.
Need of a low potassium diet If an individual has kidney problems, excess potassium can
accumulate up to dangerous levels in the blood. This causes irregular heartbeats, confusion or
a heart attack. In this case, a low potassium diet is recommended. If the diet contains less than
2000 mg of potassium per day, then it is called as a "low potassium diet".
Low potassium foods1 serving of the following can be considered to be low potassium
food. 1 serving implies ½ cup. More than 1 serving of the following can make it high potassium
food.
General foods Bread (bread products)
–angel, yellow
-potassium foods)
LOW PURINEDIET
low-purine diet is an eating plan that limits foods that contain purine. Purines are a natural
substance found in some foods.
-ick) acid is produced.
up of uric acid crystals in the joints can cause a type of arthritis known as gout.
Purines are found in many healthy foods. The purpose of a low-purine diet is not to
completely avoid purines.
is in the food you eat, and to
learn how your body responds when you eat different foods that contain purine.
BRAT diet
– banana, rice, apple, toast – indicated patients with diarrhea
Butterball diet
- spare protein but high in CHO indicated with liver disorders
Giordano diet
– spare protein, indicated for patients with CRF
Giordano-Giovannetti diet
- a low-protein, low-fat, high- carbohydrates diet with controlled potassium and sodium intake,
used in chronic renal insufficiency and liver failure
Kosher diet
– meat and milk cannot be served simultaneously diet for Orthodox Jews
Tyramine rich diet
– use to prevent hypertensive crisis for patients who are taking in MAOI anti-depressant
No to ABC – avocado, banana, canned, processed, smoked, aging and fermented foods
South Beach Diet - diet developed by the Miami-based cardiologist Arthur Agatston, M.D.,
who says that the key to losing weight quickly and getting healthy isn’t cutting all
carbohydrates and fats from your diet, but choosing the right carbs and the right fats.
Monothropic Diet - A diet that involves eating only one food item, or one type of food, for a
period of time to achieve a desired weight reduction.
DASH diet - (Dietary Approaches to Stop Hypertension). A recommendation that those
with high blood pressure consume large quantities of fruits, vegetables, whole-grains and low
fat dairy foods as part of their diet, and avoid sugar sweetened foods, red meat and fats.
Elemental diet - A medical, liquid-only diet, in which liquid nutrients are consumed for ease of
ingestion.
Ketogenic diet - A high-fat, low-carb diet, in which dietary and body fat is converted into
energy. It is used as a medical treatment for epilepsy.
Paleo diet - foods include meat, fish, eggs, seeds, nuts, fruits and veggies, along with healthy
fats and oils. Avoid processed foods, grains and sugar.
Pureed Diet – you may need to follow a pureed diet if you have trouble chewing , swallowing, or fully
breaking down (“digesting”) solid foods. Pureed means that all food has been ground, pressed, and or
strained to a soft , smooth consistency like pudding.
https://www.google.com/search?q=pureed+diet+meaning&oq=pureed+diet+meaning&aqs=chrome
..69i57.13994j1j4&client=ms-android-samsung-gj-rev1&sourceid=chrome-mobilw&ie=UTF-8
1. Discuss a nursing care plan that deals with the responsibility for feeding clients with
dysphagia.
Include safe procedures and features of foods to be considered.
2. List at leasts four dietary treatment guidelines for peptic ulcer disease. Include the rationale
for each
Luu, J. (2012 December 8). Understanding Modified Consistency Diets. Retrieved from
https://www.youtube.com/watch?v=6TB4Zk6OCMg&feature=share&fbclid=IwAR3PtsQPVVhdxgS1Vs4
7-lD1ii1LTIVSORddpanS4EsLxGjlaYQmfblReqs
Imam, P. (2015 April 27). Diet Modified In Composition. Retrieved from
https://vdocuments.site/amp/diet-modified-in-composition.html?fbclid=IwAR0Tvq9l4JEGAXwwO8sW-
nEcPa45FSYZ7jWsGkviGRcnxNWATw8yfPo6wHc.
Caudal, Maria Lourdes C. (2019). Basic nutrition and diet therapy : textbook for nursing
students 2nd Edition. QC: C&E. F 613.2 C31 2019
Caudal, Maria Lourdes C. (2019). Basic nutrition and diet therapy : laboratory manual for
nursing students. QC: C&E. F 613.2078 C31 2019
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