(Solved): NUTRITION AND DIET THERAPY LESSON 3: DIETS MODIFIED IN COMPOSITION         ...

NUTRITION AND DIET THERAPY

LESSON 3: DIETS MODIFIED IN COMPOSITION

 

 

 

 

 

 

 

LESSON 3 ACTIVITY:
1. NAME THE DIFFERENT DIETS MODIFIED IN COMPOSITION AND DIFFERENTIATE IT FROM EACH OTHER.
2.MAKE A LIST OF FOODS EATEN YESTERDAY. CIRCLE THE FOODS THAT WOULD BE ALLOWED ON A HIGH PROTEIN DIET.

LET'S TALK ABOUT IT Modified diets are used when regular/standard diets fail to meet the specific needs of clients. Modifying the standard diet is much like tailoring a suit. A tailored suit is the same suit after alterations- only it feels better. In the case of a modified diet, the tailoring may involve changing the composition; adjusting the amounts of energy, individual nutrients, or fluid; altering the number of meals; or including or eliminating certain foods. The following concepts are the types of diets modified in composition: 1. Low Calorie Diet Calorie restriction or caloric restriction \( (\mathrm{CR}) \) is a dietary regimen that restricts calorie intake, where the baseline for the restriction varies. People who are interested in going on a very low-calorie diet (VLCD) should first consult a physician. A very lowcalorie diet is any diet plan that allows 800 calories or less in a day; and the diet is overseen by a physician. The length of such a diet is relatively short, usually between 3 and 6 months. Any longer and serious health complications may arise. 2. High Calorie Diet One furnishing more calories than needed to maintain weight, often more than 3500-4000 calories per day. Some medical conditions require a high-calorie diet to help maintain or promote weight gain. People with liver disease are at risk of malnutrition due to poor intake and altered nutrient metabolism. To meet their needs, most people with liver disease should increase the amount of calories they eat each day. People with Huntington's disease have higher calorie needs because of their constant fidgeting which increases their metabolic rate. Cancer patients tend to have higher calorie needs because of a poor appetite related to treatment. Eating more calorie-dense foods, such as whole milk, cheese and nuts, can help you increase your calorie intake when you have a poor appetite. 3. 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. High-protein diets provide \( 25 \% \) to \( 30 \% \) of calories from protein without defined proportions of carbohydrate and fat. For weight loss, high-protein diets must also restrict calories. Weight loss resulting from high-protein diets ( \( 25 \% \) of calories) is the same as that from a typical protein diet ( \( 15 \% \) of calories) when the diets provide the same number of total calories. High-protein weight loss diets do not result in better cardiometabolic outcomes than normal protein weight loss diets. 4. Low Protein Diet Any diet in which the protein intake is reduced. Anyone diagnosed with kidney or liver disease may be prescribed a low-protein diet. In any case, a diet which is especially low in protein should only be under medical direction. Reduce amount of protein Some of each type of protein should still be consumed each day from the two main sources: Animal products (fish, poultry, eggs, meat, dairy products)considered high quality or complete protein. Vegetable products (breads, cereals, rice, pasta, dried beans)considered low quality or incomplete protein. 5. Low fat diet 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. It is important to know that dietary fat is needed for good health, as fats supply energy and fatty acids, in addition to supplying fat-soluble vitamins like A, D, E, and K. Table 4.15 Sample Menu for a Low-Fat Diet containing 30gms Fat, \( 365 \mathrm{gms} \) CHO, 68gms Pro and 2002 Kcals: A.M Snack diet and TLC diet are examples: DASH Diet Dietary Approaches to Stop Hypertension (DASH) was a multicenter feeding study funded by the National Heart, Lung and Blood Institute that set out to test whether eating whole "real" foods rather than individual nutrients would lower blood pressure as a result of some combination of nutrients, interactions among individual nutrients, or other food factors. The results clearly showed that eating a diet high in fruit, vegetables, and low-fat dairy products; moderate in whole grains, poultry, fish, and nuts; and low in fat, red meat, sweets, and sugar-sweetened beverages substantially lowers both systolic and diastolic blood pressures as well as low-density lipoprotein cholesterol. The DASH diet is a healthy eating pattern appropriate for all people, unless contraindicated. For most people, following the DASH diet translates into major changes in the foods they eat. The diet may be easier to adopt if changes are made gradually. These suggestions may help clients adapt: Gradually increase servings of fruits, vegetables, and grains to reduce gas and bloating that may accompany a higher-than-normal fiber intake. Remember to drink plenty of water as well. For those who eat only one or two servings of fruits or vegetables a day, start by including at least two servings of fruits and/or vegetables at each meal ( 6 servings). Then add one fruit and one vegetable as a snack (total 8 servings). TLC Diet Therapeutic Lifestyle diet recommends that you: Choose healthier fats. You should limit both total fat and saturated fat. No more than 25 to 35 percent of your daily calories should come from dietary fats, and less than \( 7 \% \) of your daily calories should come from saturated fat. Depending upon how many calories you eat per day, here are the maximum amounts of fats that you should eat: Saturated fat is a bad fat because it raises your LDL (Dad cnoiesueroy level more than anything else in your diet. It is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods. Trans fat is another bad fat; it can raise your LDL and lower your HDL (good cholesterol). Trans fat is mostly in foods made with hydrogenated oils and fats such as margarine, crackers, and French fries. Instead of these bad fats, try healthier fats, such as lean meat, nuts, and unsaturated oils like canola, olive and safflower oils. Limit foods with cholesterol. You should have less than \( 200 \mathrm{mg} \) a day of cholesterol. Cholesterol is in foods of animal origin, such as liver and other organ meats, egg yolks, shrimp, and whole milk dairy products. Eat plenty of soluble fiber. Foods high in soluble fiber help prevent your digestive tract from absorbing cholesterol. These foods include whole-grain cereals (oatmeal and oat bran), fruits such as apples, bananas, oranges, and pears; legumes such as kidney beans, lentils and black-eyed peas. Eat lots of fruits and vegetables. A diet rich in fruits and vegetables can increase important cholesterol-lowering compounds in your diet. These compounds, called plant stanols or sterols, work like soluble fiber. Eat fish that are high in omega-3 fatty acids. These acids won't lower your LDL level, but they may help raise your HDL level. They may also protect your heart from blood clots and inflammation and reduce your risk of heart attack. Fish that are good source of omega-3 fatty acids include salmon, tuna and mackerel. Limit salt. You should try to limit the amount of sodium (salt) that you eat no more than about a teaspoon of salt a day. You can reduce your sodium by choosing low-salt and "no added salt" foods and seasonings at the table or while cooking. Limit alcohol. Alcohol adds extra calories, which can lead to weight gain. Too much alcohol can increase your risk of heart diseases because it can raise your blood pressure and triglyceride level. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. 7. Low Carbohydrates Dietary programs that restrict carbohydrates consumption usually for weight control or for the treatment of obesity. Foods high in digestible CHO (bread and pasta) are limited or replaced with foods containing higher percentage of proteins and fats (meat, poultry, fish, shellish, eggs, cheese, nuts) and other foods low in carbohydrates (most salad vegetables) although other vegetables and fruits (berries) are often allowed. Apart from obesity, low-carbohydrate diets are often used as treatments for some other conditions, most notably diabetes and epilepsy, but also for chronic fatigue syndrome and PCOS. 8. Low Sodium Diet A diet that includes no more than 1,500 to \( 2,400 \mathrm{mgs} \) of sodium per day. (one teaspoon of salt has about \( 2,300 \mathrm{mg} \) sodium.) People who follow a vigorous or moderate exercise schedule are usually advised to limit their sodium intake to \( 3,000 \mathrm{mg} \) per day and those with moderate to severe heart failure are usually advised to limit their sodium intake to \( 2,000 \mathrm{mg} \) per day. The human requirement for sodium in the diet is about \( 69 \mathrm{mg} \) per day, which is typically less than one-tenth as much as many diets "seasoned to taste". Patient Teaching in Low Sodium Diet Provide general information: Reducing sodium intake will help the body rid itself of excess fluid and help lower high blood pressure. Sodium appears in the diet in the form of salt and, to some degree, in almost all foods and beverages. Most unprocessed, unsalted foods are low in sodium. The majority of sodium comes from processed foods. Sodium-containing compounds are used extensively as preservatives, leavening agents, and flavor enhancers and are found in foods that may not taste salty. Salt substitutes replace sodium with potassium or other minerals. "low-sodium salt substitutes are not sodium free and may contain half as much sodium as regular table salt. Use neither type without a physician's approval. The reference for salty taste eventually will decrease. When an occasional food containing \( 300 \mathrm{mg} \) or more per serving is eaten, balance it out with low-sodium foods the rest of the day. Try to make low-sodium choices while dining out. Teach the client food preparation techniques to minimize sodium intake: Prepare foods from "scratch" whenever possible. Experiment with sodium-free seasonings, such as herbs, spices, lemon juice, vinegar and wine. Fresh ingredients are more flavorful than dried ones. Try a commercial "salt alternative" for sodium-free flavor enhancement. Teach the client how to read labels: Salt, MSG, baking soda, and baking powder contain significant amounts of sodium. Other sodium compounds such as sodium nitrite, benzoate of soda, sodium saccharin, and sodium propionate add less sodium to the diet. Sodium labeling terms are reliable: "Sodium-free" and "salt-free" foods provide \( <5 \mathrm{mg} \) sodium/serving. "Very low sodium" provides \( <35 \mathrm{mg} \) sodium/serving. "Low sodium" provides \( <140 \mathrm{mg} \) sodium/serving A very of low and reduced-sodium products are available. The difference in flavor between some low-sodium products and their high-sodium counterparts is barely noticeable; others taste flat and may need to have herbs or spices added. 9. Low Potassium Diet Potassium is a mineral that assists in maintaining normal blood pressure and proper contraction of the heart. The nervous system, digestive system, muscles and heart are kept healthy. It is found in whole grains, vegetables, milk, fruits, peas and dried beans. 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 lee than \( 2000 \mathrm{mg} \) of potassium per day, then it is called as a "low potassium diet". Low potassium foods: 1 serving of the following can be considered to be low potassium food. 1 serving implies cup. More than one serving of the following can make it high potassium food: bread (bread products) cake, coffee (maximum 8 ounces), cookies (without nuts or chocolate), noodles, pasta, pies (without chocolate or highpotassium foods), rice, tea (maximum 16 ounces) High potassium foods: avocado, banana, canned apricot and peaches, orange juice, papaya, potatoes, tomato juice, and yogurt. 10. Low Purine Diet A low-purine diet is an eating plan that limits foods that contain purine. Purines are a natural substance found in some foods. When your body digest purine, a waste product called uric acid is produced. A buildup of uric acid crystals in the joints can cause a type of arthritis known as gout. A low-purine diet is prescribed to persons whose systems are unable to handle uric acid in the body efficiently or persons with gout or gouty arthritis Purines are found in many healthy foods. The purpose of a low-purine diet is not to completely avoid purines. Instead, the goals are to limit and monitor how much purine is in the food you eat, and to learn how your body responds when you eat different foods that contain purine. Avoid beer, soft drinks that contain sugar, fatty food, limit chicken, beef, pork and duck crab, lobster, oysters and shrimp. Enjoy at least 12 cups of fluid, such as water or fruit juice, low-fat and fat-free dairy products, such as cheese and yogurt, eggs (in moderation), peanut butter and nuts, rice