2. Objectives
At the end of the session, students will be able to-
Identify the therapeutic diet
Explain about the daily requirements for each food
group
3. What is a therapeutic diet?
A 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.
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4. What is a therapeutic diet?
It involves removing or adding some foods.
Changing nutrients/calorie content and texture
of foods
Increase or decrease the fibre in the diet
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5. Purpose of therapeutic diets
Regulate the amount of food.
Assist body organs to function normally
Aid in digestion
To improve specific health conditions
Increase or decrease body weight
Modify diet patterns
These diets are useful in managing diseases, improves immunity, act
as prevention or supplemental treatment.
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6. Types of therapeutic diets
Clear liquid diet
Liquid diet
Full fluid diet
Soft diet
Pureed diet
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7. Regular diet: Balanced diet usually used for
ambulatory patients with no serious chronic
disorders.
Liquid diet: Nutritionally inadequate. Used for short
period of times after surgeries.
Full fluid diet: Includes liquids along with smooth
textured fluids at room temp such as custards,
eggnog, thick soups, pudding etc. Generally used for
grade 1 dysphagia, dehydration,etc.
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8. Clear liquid diet: water, apple juice, plain gelatine, fat free broth, ginger
ale, tea, coffee, etc.
Soft diet: Similar to regular diet but most foods required little chewing
and be easy to digest. Avoid tough meats, shell fish, raw fruits and
vegetables, nuts, coconuts and spicy foods
Low residue diet: used for patients with digestive diseases and rectal
diseases such as colitis and diarrhoea. Eliminates or limits high bulk
foods such as raw veg, fruits, nuts, coconut, tough meats, fried foods,
beans , seeds, whole grains.
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9. Diabetic diet: Diet for hyperglycaemia. Diet contains
exchange lists to match carbohydrate intake as per
pts. needs
Low calorie diet: Diet for patients with overweight.
Avoids fatty foods, sugars, high fat meats, etc.
High Calorie diet: Diet for patient’s with underweight,
anorexia, hyperthyroidism, cancer etc. Includes
calorie dense foods and avoids high bulk foods which
reduce appetite.
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10. Low Cholesterol diet: Diet for pts. With
atherosclerosis and heart diseases. Diet limits foods
rich in saturated fats.
Low Sodium diet: used for patients with
cardiovascular diseases, hypertension, oedema and
renal diseases. Avoids or limits salt in food along wit
restriction on processed foods, preserved foods, fried
items, pickles and processed cheese.
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11. High protein diet: Regular Diet with added protein rich foods like milk,
eggs, etc. Used for growing age groups, pregnancy and lactation, pre and
post surgery, pts. With burns, infections and fever.
Low Protein diet: Diet for patients with certain kidney diseases, allergies.
Avoids high protein foods.
Bland diet: Diet for patient’s with ulcers and other digestive diseases.
Avoids foods that irritate GI tracts. Avoid coarse foods, highly seasoned
foods, tea, coffee, oily foods, spicy foods, salted meats and fish
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12. ROLE OF NURSE IN NUTRITIONAL
CARE
Coordinator
Communicator
Counselor
Teacher
Motivator
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13. THE ROLE OF THE NURSE IN IMPLEMENTATION OF
THERAPEUTIC NUTRITION
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1. Reinforce the importance of therapeutic
diet.
2. Identify and communicate needed changes
in the patient’s diet.
3. Identify and implement changes in method
of feeding & time of feeding.
4. Reinforce the meal plan with the patient
and the patient's family.
14. The role of the nurse in implementation of
therapeutic nutrition
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5. Encourage the patient to depend on
himself (the restorative approach).
6. Encourage the patient to eat, provide
adaptive equipment, and right
atmosphere.
7. Make sure that all health care
professionals are consulted with respect
to diet plan and implementation.
16. Objectives of dietary management
To relieve strain to the heart
To prevent further damage to the heart
To restore the damaged heart
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17. Recommended foods
Skimmed milk
Cottage cheese
Whole grains
Fruits and vegetables
High fiber and soluble fibers like pectin and gum
Lean meat, egg whites, fish
Honey, jaggery
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18. Foods to be Avoided/ to limit
Cholesterol rich foods
Whole cream, butter, cream cheese
Heavy sweets, bakery products
Organ meat
Fried foods
Alcohol
High sodium processed foods
High fat convenience meals
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19. Prevention and Treatment of CVD
HTN: DASH Diet
Individuals should adopt the Dietary Approaches to Stop
Hypertension (DASH) dietary pattern which is rich in
fruits, vegetables, low-fat dairy, and nuts; low in
sodium, total fat, and saturated fat; and adequate in
calories for weight management. The DASH dietary
pattern reduces systolic blood pressure by 8-14 mmHg.
20. DASH: Major Food Groups
Fruit: Melons, bananas, papaya,
prunes, oranges (Mg, K), fortified
juices (Ca), fiber
4-5 servings per day
Vegetables: broccoli (vit A), Soy
(Ca, K), beets, mushrooms,
potatoes (B6), green
leafy/spinach (vit A, Mg, Ca),
tomatoes, (K, Mg) (fiber)
4-5 Servings per day
22. Objectives of dietary management
To improve glycemic control
To prevent diabetes related complications such as retinopathy,
nephropathy
To improve nutritional quality of life and reduce morbidity and
mortality
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23. Nutrition Intervention options for Diabetes
Reduce energy and fat intake
Carbohydrate counting
Simplified meal plans
Healthy food choices
Individualized meal planning strategies
Exchange lists
Insulin-to-carbohydrate ratios
Physical activity and behavioral strategies
24. Prevention and Treatment of CVD & Diabetes
Recommendations:
Very High Triglycerides (>500)
◦ Very low-fat diet less than or equal to15% fat),
◦ Weight management
◦ Physical activity
◦ Alcohol restriction
Elevated Triglycerides (≥ 150) and Macronutrients
◦ Calorie controlled
◦ Complex Carbohydrates
◦ Limit refined sugar
◦ Limit Alcohol
◦ Weight loss of 7 to 10% of body weight
◦ Physical Activity
25. CHOLESTEROL PROFILE
IMPROVEMENT STRATEGY
Foods to increase
1 bowl of oat bran at breakfast with oatmeal. (Note that Psyllium also
decreases total cholesterol)
Fresh vegetables, avocados (rich in good fat), artichokes, lentils and beans,
chick peas (high in isoflavones), rice bran, citrus fruits, strawberries, apples
(rich in pectin) and apple pulp (rich in soluble fiber)
Mulberries, raspberries (rich in resveratrol)
Almonds, pecans, walnuts, hazelnuts, macadamia, pistachios, peanuts.
Almonds can reduce the ratio LDL to HDL up to 12% after 4 weeks (Journal
of the American Heart Association). Eat them natural or “dry roasted”
without added oils or salts. Most of their fat is polyunsaturated or mono-
unsaturated.
26. Glycemic Index
• A scale that ranks carbohydrates by how much they raise blood
glucose levels compared to a reference food.
1. Low 0 – 55
2. Moderate 56 – 69
3. High 70 or more
29. NUTRITION ACTION PLAN FOR CVD & DM
1. Eat meat sparingly
2. Add fish to your diet
3. Eat fruits and vegetables
4. Go for nuts
5. Increase complex carbohydrates and fiber
6. Opt for low-fat dairy products
7. Cut down on saturated fat in cooking
8. Avoid palm and coconut oils
9. Avoid trans fats
10. Reduce dietary cholesterol
11. Reduce salt and sugar intake
12. Watch the snacks
13. Drink alcohol only in moderation
14. Read labels carefully
30. References
1. Mann J, Truswell S, editors. Essentials of human nutrition.
5th ed. London, England: Oxford University Press; 2017.
Chapter - 43, pp – 670-678
2. Bender DA. Introduction to nutrition and metabolism,
fourth edition. 4th ed. Boca Raton, FL: CRC Press; 2007.
Chapter - 6, pp- 178-186
