A therapeutic diet is a meal plan prescribed to treat a medical condition. It modifies a patient's normal diet based on their altered nutritional needs due to disease. The objectives of a therapeutic diet are to maintain good nutrition, correct deficiencies, rest affected organs, and adjust intake based on a patient's ability to metabolize nutrients while sick. Diet therapy works with medication to cure disorders and restore health. Therapeutic diets are altered in nutrient content, consistency, and amount. A dietitian assesses patients, develops nutrition care plans, and provides counseling using tools like WAVE and REAP to effectively motivate dietary changes. Different diets like high fiber, DASH, low calorie, and bland diets treat specific conditions.

1. BY
ALIYU ADAM
THERAPEUTIC DIET AND
EFFECTIVE NUTRITIONAL
COUNSELLING

2. DEFINITION
 A therapeutic diet 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.

3. OBJECTIVE OF THERAPEUTIC DIET
 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.

4. Importance of diet therapy
 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.

5. cont.
 The use of 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.

6. Cases where therapeutic diet 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.

7. Potential drug/ nutrient interaction 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

8. Therapeutic diet are altered in three ways;
namely
 The nutrient content of the diet.
 The consistency of the diet.
 The amount or quantity of the diet.

9. Drug and diet interaction
 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.

10. Therapeutic diet in a 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).

11. 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 .

12. Tools for effective nutritional 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

17. TYPES OF THERAPEUTIC DIET 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.

18. HIGH FIBRE DIET in 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.

19. 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.

20. Cont.
 Low calorie diet: 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.

21. 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.