UNIT 3-DIET THERAPY
RASHMI S SHENOY
INTRODUCTION
A therapeutic diet is a qualitative/quantitative modification of a normal regular diet that has been tailored to
suit the changing nutritional needs of patient/individual. It is used to improve specific health/disease
conditions. It is a planned diet to supplement the medical or surgical treatment.
Balanced diet contains a variety of foods in such quantities and proportions that the need for energy,
proteins, vitamins, minerals, fats and other nutrients is adequately met for maintaining health and well
being
PRINCIPLES OF DIET THERAPY The principles of diet therapy are to: maintain good nutritional status,
correct deficiencies or disease, if any, provide rest to the body, help metabolize the nutrients, and make
changes in body weight, when necessary
FEVERS (ACUTE & CHRONIC) (TYPES, CAUSES, CLINICAL SYMPTOMS AND DIETARY
MANAGEMENT
Fever: Definition, Causes & Symptoms
• Fever is classically described as the abnormal condition of the body, characterized by an
excessive rise in body temperature, quickening of the pulse, and disturbance of various body
functions. Surely, you must be aware of the normal body temperature.
• The normal human body temperature may range from 36°C to 37°C (98.6F). So, technically any
body temperature above the normal temperature may be considered fever. What do you think?
Well, in practice an individual is usually not considered to have a significant fever until the
temperature is above 100.4 (38°C).
Metabolic Changes during Fever
Usually, fever is characterized by certain metabolic changes. Higher the temperature, longer the duration of
the fever, more is the ill effect. The common effects include:
• Increase in the basal metabolic rate (BMR). Note, there is a 13% increase in BMR with every 1°C rise in body
temperature. (or 7% increase with every 1°C increase in temperature).
Decreased stores of adipose (fat) tissue and decreased glycogen stores.
• Increased catabolism (breakdown) of proteins, especially in case of malaria, typhoid, tuberculosis fevers.
This leads to the production of an excess amount of nitrogenous wastes, which lays additional stress on the
kidneys.
• Increased excretion of potassium, sodium, chloride etc. through sweat, urine, vomiting leads to electrolyte
imbalance.
• Accelerated loss of fluid from the body in the form of excessive sweat and urine formation.
• Loss of appetite limits the food intake thus leading to weight loss.
• Decrease in the absorption of nutrients like vitamins, minerals, proteins.
Dietary Considerations and Nutritional Needs During
Sub-acute Fever
2. Infections
Increased metabolic demands: Fever raises basal metabolic rate, increasing energy and protein needs.
•Immune support: Nutrients like vitamin C, D, zinc, selenium, and protein are crucial for immune
function.
•Hydration: Essential to combat fluid loss from fever.
•Nutritional therapy: Aids in faster recovery and prevents complications like malnutrition.
3. Lung Diseases (e.g., COPD, Asthma, Tuberculosis)
•Energy-dense nutrition: Patients often have increased energy requirements.
•Antioxidants: Vitamin E, C, flavonoids help reduce oxidative stress.
•Omega-3 fatty acids: Possess anti-inflammatory properties beneficial in chronic lung conditions.
•Protein: Supports respiratory muscle function and tissue repair.
a) . Chronic Obstructive Pulmonary Disease (COPD)
Nutritional Goals:
•Prevent muscle wasting
•Reduce inflammation
•Maintain immune competence
Nutritional Strategies:
•High-calorie, high-protein diet: To meet increased energy demands and counter muscle loss.
•Antioxidants: Vitamins C, E, A, and selenium protect lungs from oxidative stress.
•Omega-3 fatty acids: Reduce airway inflammation.
•Vitamin D: Modulates immune response and improves lung function.
•Magnesium: Involved in bronchodilation and smooth muscle function.
•Small frequent meals: Prevents shortness of breath during eating.
•Fluid balance: Adequate hydration to thin mucus.
b) Asthma
Nutritional Goals:
•Control inflammation
•Support immune function
•Avoid triggers
Beneficial Nutrients:
•Antioxidants: Vitamins C, E, β-carotene reduce oxidative lung damage.
•Magnesium: Acts as a bronchodilator; found in green leafy vegetables, nuts.
•Vitamin D: Deficiency linked to increased asthma severity.
•Omega-3 fatty acids (EPA/DHA): Found in fatty fish; anti-inflammatory effects.
•Flavonoids: Found in apples, berries, onions; may reduce asthma symptoms.
Foods to Avoid:
•Sulfite-containing foods (wine, dried fruits): May trigger asthma.
•Food allergens: Milk, eggs, nuts, shellfish in sensitive individuals.
4) DIABETES MELLITUS
• Diabetes Mellitus (DM) is a condition when the blood glucose or so called “blood sugar” is too high.
Diabetes is a disease that affects body’s ability to produce or respond to insulin.
• Insulin, is a hormone that is releases in response to food we eat. In a normal healthy person, the
pancreas releases insulin to help the body store and use the sugar from the food they eat.
• Foods, particularly carbohydrate rich foods in our diet namely, rice, wheat, potatoes etc. are digested
and broken down into a simple sugar called glucose.
• Glucose is vital for our health because it is an important source of energy for our body. Insulin helps
to utilize this glucose to produce energy by the body for our daily activities.
• Insulin also stimulates the cells to assimilate glucose, thus preventing a rise in blood glucose and
maintaining its level within certain normal limits.
Complications of Diabetes
The symptoms of diabetes are very typical, but sometimes they are so mild that we don’t even notice
them. But in cases of Type 1 diabetes, the symptoms usually happen quickly and are much more severe
as compared to type 2 diabetes. However, you would notice that both types of diabetes have some
warning symptoms which include:
• Frequent and increased/excessive urinary output (Polyuria);
• Feeling of thirst (Polydipsia) and dry mouth;
• Hunger increased appetite (Polyphagia) even though the individual is eating;
• Extreme fatigue, lack of energy, easy tiredness and irritability;
• Unexplained Weight loss;
• Blurry vision;
• Frequent infections such as skin, vaginal infections;
• Cuts, bruises, sores which are slow to heal; and
• Tingling sensation, pain or numbness in the hands and feet.
Dietary Management of Diabetes Diet plays a crucial role in the management of diabetes. The main
objectives of dietary management of diabetes are to:
• Attain and maintain ideal/desirable body weight;
•achieve and maintain normal blood glucose levels;
• provide adequate nutrition to maintain optimal nutritional status;
• treat the symptoms;
• prevent/avoid the acute complications;
• achieve optimum blood lipid levels
Physical Activity Guidelines for Indian Population
The health benefits of physical activity are well established. Lifestyle intervention studies have
shown that Type 2 diabetes and Coronary Heart Disease (CHD) can be prevented with
appropriate physical activity and diet. What is appropriate physical activity for the Indian
population? The guidelines for adults and children are highlighted herewith:
1. A total of 60min of physical activity is recommended every day for healthy Asian Indians in
view of the high predisposition to develop T2DM and CHD. This should include at least 30 min
of moderate-intensity aerobic activity (e.g., brisk walking, jogging, hiking, gardening, bicycling
etc.), 15 min of work-related activity (e.g., carrying heavy loads, climbing stairs etc.), and
15min of muscle-strengthening exercises (such as playing with playground equipment,
climbing trees, playing tug-of- war, lifting weights etc.).
2. For children, moderate-intensity physical activity for 60 min daily should be in the form of
sports and physical activity. Educate the diabetic patients to follow an appropriate physical
activity schedule
5. Gastrointestinal diseases
Issue Natural Support
Acidity Jeera water, cold milk, banana
IBS (diarrhea type) Psyllium husk (isabgol), sabudana
Constipation Warm lemon water, soaked raisins, prunes
Ulcers Slippery elm, licorice root (under supervision)
General Therapeutic Diet Guidelines for GI Health
Include Avoid
- Soft-cooked vegetables (carrot, pumpkin,
- Fried, spicy, oily foods
spinach)
- Probiotics (curd, buttermilk, kefir) - Carbonated drinks, alcohol
- Whole grains (if tolerated) - Excessive caffeine, tea, coffee
- Lean protein (egg white, chicken, fish) - Raw onions, garlic in excess
- Fluids: Jeera water, coconut water, herbal teas - Pickles, chutneys, processed foods
Therapeutic Diet Must Be:
•Customized: Based on the phase (acute/chronic), age, and nutritional status
•Nutrient-dense: Especially in chronic GI conditions like IBD
•Anti-inflammatory: Use turmeric, omega-3s, and gut-friendly herbs
•Easily digestible: During flare-ups or infections
5. Cancer
•Malnutrition risk: Due to tumor metabolism, anorexia, chemotherapy side effects.
•High-protein, high-calorie diet: To prevent cachexia.
•Antioxidants (e.g., carotenoids, selenium): May offer protective effects, though timing with
therapy is critical.
•Nutrition therapy: Plays a key role in improving tolerance to treatment and quality of life.
6. Stress and Mental Health
•Micronutrients:
• B-complex vitamins, magnesium, zinc, omega-3s: Important in neurotransmitter function.
•Gut-brain axis: Gut health (via fiber, fermented foods) linked to mood regulation.
•Complex carbs: Promote serotonin production.
•Protein: Provides precursors (e.g., tryptophan) for neurotransmitters.
🥗 Therapeutic Diet Guidelines for Stress & Mental Health
Nutrient Foods Benefits
✅ Foods to Include:
Fatty fish (sardines, mackerel, Reduce inflammation, support brain
Omega-3 Fatty Acids
salmon), walnuts, flaxseeds function
Tryptophan (precursor to Milk, curd, banana, eggs, oats,
Boosts serotonin levels
serotonin) pumpkin seeds
Green leafy vegetables, almonds, Calms nervous system, reduces
Magnesium
sesame, ragi anxiety
Eggs, fish, spinach, legumes, Needed for neurotransmitter
B-vitamins (esp. B6, B9, B12)
fermented foods synthesis
Pumpkin seeds, whole grains, meat,
Zinc Supports memory and learning
lentils
Curd, buttermilk, kefir, kanji, Improve gut microbiome and reduce
Probiotics / Fermented foods
homemade pickles anxiety
Berries, amla, turmeric, dark Protect brain cells from oxidative
Antioxidants
chocolate (70%+), citrus fruits stress
Whole grains (millets, oats, brown Help in slow glucose release and
Complex Carbohydrates
rice), sweet potato mood stability
Provides amino acids for
Protein Eggs, chicken, paneer, tofu, dals
neurotransmitters
❌ Foods to Avoid / Limit:
•Refined sugar and flour (blood sugar spikes worsen anxiety)
•Processed and packaged foods (contain preservatives, excess sodium)
•Excess caffeine (coffee, tea, cola – increases cortisol)
•Alcohol (disrupts sleep, depletes nutrients)
•Artificial sweeteners (can affect gut bacteria and mood)
