Therapeutic diet and effective nutritional counselling

Therapeutic diet and effective nutritional counselling

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  BY ALIYU ADAM THERAPEUTIC DIETAND EFFECTIVE NUTRITIONAL COUNSELLING
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  DEFINITION  A therapeuticdiet is a meal plan that controls the intake of certain food nutrients. It is a part of the treatment of a medical condition and are normally prescribed by a physician and planned by a dietician. It is simply a modification of regular diet  Diet therapy is the use of food in the treatment of diseases. This is accomplished by changing the patients normal diet in order to meet the altered requirement resulting from diseases or injuries.
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  OBJECTIVE OF THERAPEUTICDIET  To maintain good nutritional status.  To correct nutrition deficiency.  To afford rest to the whole body or specific organ affected by disease.  To adjust the food intake to the body ability to metabolize the nutrient during the disease.  To bring about changes in the body weight whenever necessary.
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  Importance of diettherapy  The need of every person at any stage of life are to be modified and deviated from the normal diet when attacked by illness. Diet therapy can be considered as a shield which if effectively used can protect from further attack and help restore normal health. Thus an understanding of nutrition is the basis of diet therapy.
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  cont.  The useof medication alone is not always sufficient to cure any health disorder unless there is a proper nutritional management. on the other hand, in the absence of good and proper nutrition the drug therapy, even though at its best may become a total failure.
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  Cases where therapeuticdiet may be required.  When food consumption is interfered with, as an impaired appetite, GIT disease, traumatic neurological disorders interfering with self feeding, neuropsychiatric disorder, food allergy, diseases of soft or hard oral tissue.  When there is an increase in excretion or loss of nutrient from the body as in lactation, burns, glycosuria and albuminuria, acute or chronic blood loss.  When there is increase in the nutrient requirement as when physical activity is increased or in a period of rapid growth, pregnancy & lactation, hyperthyroidism and drug therapy.  When the function is impaired or tissues are destroyed as in achlorhydria in the GIT, heavy metal & other metabolic antagonist.  When utilization or storage is interfered with as in impaired liver function, hypothyroidism neoplasm of GIT drug or radiation therapy.
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  Potential drug/ nutrientinteraction for some commonly used drugs. Drug nutrient Potential side effect antacids Thiamine, Iron and calcium Decreased absorption due to altered GIT pH Penicillamine Zinc, vit B6, sodium Altered nutrient excretion Chloramphenicol, tetracy cline Protein, iron, folate. Impaired metabolism and utilization. Phenytoin, phenobarbital, primidone, or phenothiazines Folate , vit D In most patients, cause folate (folic acid) deficiency*, probably because hepatic microsomal drug- metabolizing enzymes are affected cimetidine Vit B12 Deficiency. Euressemide Calcium, potassium, sodium Diuretic effect depletion
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  Therapeutic diet arealtered in three ways; namely  The nutrient content of the diet.  The consistency of the diet.  The amount or quantity of the diet.
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  Drug and dietinteraction  Knowledge of drug and diet interaction is very essential for the physician and dietitian.  These interaction falls under four different categories: 1. The dietary factors help promote drug action and thus faster recovery. 2. The dietary factors may reduce the potential of the drug to deliver the expected result. 3. The dietary factor and drug may interact to produce harmful or a times toxic effect resulting in an unexpected complication. 4. The drug in certain cases influences the metabolic processes in such a way that the availability of certain nutrient to the body is adversely affected.
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  Therapeutic diet ina hospital may be classified as follows:  Liquid diet(clear and full liquid). Usually prescribed for patient in pre or post operative stage for 1 or 2 days.  Soft diet. For patients who are acutely ill or unable to chew or swallow solid food.  Light /soft diet. It is prescribed for patient convalescing from surgery, GI disturbances and acute infections.(adequate nut soft in texture and consistency).
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  Role of dietitian To assess the nutritional status of the patient In health and disease.  To device and coordinate all aspect of nutrition care plan, which include long term and short term plans.  To communicate with doctors and monitor.  implementation of nutrition care plan.  To document all aspect of nutrition care.  To arrange patient follow up as needed.  To communicate effectively and share knowledge with other health care providers .
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  Tools for effectivenutritional counseling  Behavioral and dietary changes can be helpful in preventing or treating a variety of prevalent health problems. Dietitian can be helpful in motivating patient to make positive dietary changes, be physically active and all this can be a very great extent with effective nutrition counseling.  The nutrition academy award has develop two new tools that can help health care provider conduct NUT assessment and counseling with there patient in a practical and effective manner.  WAVE  REAP
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  TYPES OF THERAPEUTICDIET IN VARIOUS DISORDERS. Diet in fever The nutritional requirement will depend on the nature, severity and duration of the fever. • During this phase, calorie requirement is increase • Frequent feeding must be given to the client and fat must be restricted. • Fluid intake must be from 3000- 5000ml in form of glucose, fruit juices. • A readily digestible food must be given.
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  HIGH FIBRE DIETin constipation  Constipation is decreased frequency of passing stool or complete retention of faces.  The diet should include foods rich in fiber content like whole cereals, whole legume, vegetables.  Fruit rich in fiber like apple, banana, guava etc.  More fluid in form coffee, tea, fruit juices, and warm water.
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  Cont.  DASH diet:In addition to being a low salt (or low sodium) plan, the DASH diet provides additional benefits to reduce blood pressure. It is based on an eating plan rich in fruits and vegetables, and low-fat or non-fat dairy, with whole grains. It is a high fiber, low to moderate fat diet, rich in potassium, calcium, and magnesium.
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  Cont.  Low caloriediet: prescribed in other to achieve weight loss especially for those suffering from CV and renal disease.  Calorie dense : use in weight increase regimes.  Bland diet : use in ulcerative colitis, gastritis, or diarrhea.
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  MODIFICATION IN VITAMINS. High vitamin diet – vitamin A content of the diet may be increased to combat night blindness.  increased Vitamin D content to combat ricket and osteomalacia.  Increased vitamin k content to combat liver and gall bladder disease.  Increased thiamine to prevent beri-beri and polyneuritis.  Increased niacin to prevent pellagra.  Increased ascorbic acid to prevent scurvy, improve wound healing and overall defence mechanism of the body.