Saturday, January 5, 2008

Therapeutic Diets

COMMON THERAPEUTIC DIETS
1. CLEAR-LIQUID DIET
Purpose:
 relieve thirst and help maintain fluid balance.
Use:
 post-surgically and following acute vomiting or diarrhea.
Foods Allowed:
 carbonated beverages; coffee (caffeinated and decaff.); tea; fruit-flavored drinks; strained fruit juices; clear, flavored gelatins; broth, consomme; sugar; popsicles; commercially prepared clear liquids; and hard candy.
Foods Avoided:
 milk and milk products, fruit juices with pulp, and fruit.
2. FULL-LIQUID DIET
Purpose:
 provide an adequately nutritious diet for patients who cannot chew or who are too ill to do so.
 Use:
 acute infection with fever, GI upsets, after surgery as a progression from clear liquids.
Foods Allowed:
 clear liquids, milk drinks, cooked cereals, custards, ice cream, sherbets, eggnog, all strained fruit juices, creamed vegetable soups, puddings, mashed potatoes, instant breakfast drinks, yogurt, mild cheese sauce or pureed meat, and seasoning.
Foods Avoided:
 nuts, seeds, coconut, fruit, jam, and marmalade
SOFT DIET
Purpose:
 provide adequate nutrition for those who have troubled chewing.
Use:
 patient with no teeth or ill-fitting dentures; transition from full-liquid to general diet; and for those
who cannot tolerate highly seasoned, fried or raw foods following acute infections or gastrointestinal
disturbances such as gastric ulcer or cholelithiasis.
Foods Allowed:
 very tender minced, ground, baked broiled, roasted, stewed, or creamed beef, lamb, veal, liver,
poultry, or fish; crisp bacon or sweet bread; cooked vegetables; pasta; all fruit juices; soft raw fruits;
soft bread and cereals; all desserts that are soft; and cheeses.
Foods Avoided:
 coarse whole-grain cereals and bread; nuts; raisins; coconut; fruits with small seeds; fried foods; high
fat gravies or sauces; spicy salad dressings; pickled meat, fish, or poultry; strong cheeses; brown or
wild rice; raw vegetables, as well as lima beans and corn; spices such as horseradish, mustard, and
catsup; and popcorn.
SODIUM-RESTRICTED DIET
Purpose:
 reduce sodium content in the tissue and promote excretion of water.
Use:
 heart failure, hypertension, renal disease, cirrhosis, toxemia of pregnancy, and cortisone therapy.
Modifications:
 mildly restrictive 2 g sodium diet to extremely restricted 200 mg sodium diet.
Foods Avoided:
 table salt; all commercial soups, including bouillon; gravy, catsup, mustard, meat sauces, and soy
sauce; buttermilk, ice cream, and sherbet; sodas; beet greens, carrots, celery, chard, sauerkraut, and
spinach; all canned vegetables; frozen peas;
 all baked products containing salt, baking powder, or baking soda; potato chips and popcorn; fresh or
canned shellfish; all cheeses; smoked or commercially prepared meats; salted butter or margarine;
bacon, olives; and commercially prepared salad dressings.
RENAL DIET
Purpose:
 control protein, potassium, sodium, and fluid levels in the body.
Use:
 acute and chronic renal failure, hemodialysis.
Foods Allowed:
 high-biological proteins such as meat, fowl, fish, cheese, and dairy products- range between 20 and
60 mg/day.
 Potassium is usually limited to 1500 mg/day.
 Vegetables such as cabbage, cucumber, and peas are lowest in potassium.
 Sodium is restricted to 500 mg/day.
 Fluid intake is restricted to the daily volume plus 500 mL, which represents insensible water loss.
 Fluid intake measures water in fruit, vegetables, milk and meat.
Foods Avoided:
 Cereals, bread, macaroni, noodles, spaghetti, avocados, kidney beans, potato chips, raw fruit, yams, soybeans, nuts, gingerbread, apricots, bananas, figs, grapefruit, oranges, percolated coffee, Coca-Cola, orange crush, sport drinks, and breakfast drinks such as Tang or Awake



HIGH-PROTEIN, HIGH CARBOHYDRATE DIET
Purpose:
 to correct large protein losses and raises the level of blood albumin. May be modified to include low-
fat, low-sodium, and low-cholesterol diets.
Use:
 burns, hepatitis, cirrhosis, pregnancy, hyperthyroidism, mononucleosis, protein deficiency due to poor
eating habits, geriatric patient with poor intake; nephritis, nephrosis, and liver and gall bladder
disorder.
Foods Allowed:
 general diet with added protein.
Foods Avoided:
 restrictions depend on modifications added to the diet. The modifications are determined by the patient’s condition.
PURINE-RESTRICTED DIET
Purpose:
 designed to reduce intake of uric acid-producing foods.
Use:
 high uric acid retention, uric acid renal stones, and gout.
Foods Allowed:
 general diet plus 2-3 quarts of liquid daily.
Foods Avoided:
 cheese containing spices or nuts, fried eggs, meat, liver, seafood, lentils, dried peas and beans, broth,
bouillon, gravies, oatmeal and whole wheat, pasta, noodles, and alcoholic beverages. Limited
quantities of meat, fish, and seafood allowed.
BLAND DIET
Purpose:
 provision of a diet low in fiber, roughage, mechanical irritants, and chemical stimulants.
Use:
 Gastritis, hyperchlorhydria (excess hydrochloric acid), functional GI disorders, gastric atony, diarhhea, spastic constipation, biliary indigestion, and hiatus hernia.
Foods Allowed:
 varied to meet individual needs and food tolerances.
Foods Avoided:
 fried foods, including eggs, meat, fish, and sea food; cheese with added nuts or spices; commercially
prepared luncheon meats; cured meats such as ham; gravies and sauces; raw vegetables;
 potato skins; fruit juices with pulp; figs; raisins; fresh fruits; whole wheats; rye bread; bran cereals;
rich pastries; pies; chocolate; jams with seeds; nuts; seasoned dressings; caffeinated coffee; strong tea;
cocoa; alcoholic and carbonated beverages; and pepper.
LOW-FAT, CHOLESTEROL-RESTRICTED DIET
Purpose:
 reduce hyperlipedimia, provide dietary treatment for malabsorption syndromes and patients having
acute intolerance for fats.
Use:
 hyperlipedimia, atherosclerosis, pancreatitis, cystic fibrosis, sprue (disease of intestinal tract
characterized by malabsorption), gastrectomy, massive resection of small intestine, and cholecystitis.
Foods Allowed:
 nonfat milk; low-carbohydrate, low-fat vegetables; most fruits; breads; pastas; cornmeal; lean meats;
nsaturated fats
Foods Avoided:
 remember to avoid the five C’s of cholesterol- cookies, cream, cake, coconut, chocolate; whole milk
and whole-milk or cream products, avocados, olives, commercially prepared baked goods such as
donuts and muffins, poultry skin, highly marbled meats

 butter, ordinary margarines, olive oil, lard, pudding made with whole milk, ice cream, candies with
chocolate, cream, sauces, gravies and commercially fried foods.
DIABETIC DIET
Purpose:
 maintain blood glucose as near as normal as possible; prevent or delay onset of diabetic complications.
Use:
 diabetes mellitus
Foods Allowed:
 choose foods with low glycemic index compose of:
a. 45-55% carbohydrates
b. 30-35% fats
c. 10-25% protein
 coffee, tea, broth, spices and flavoring can be used as desired.
 exchange groups include: milk, vegetable, fruits, starch/bread, meat (divided in lean, medium fat, and
high fat), and fat exchanges.
 the number of exchanges allowed from each group is dependent on the total number of calories
allowed.
 non-nutritive sweeteners (sorbitol) in moderation with controlled, normal weight diabetics.
Foods Avoided:
 concentrated sweets or regular soft drinks.
ACID AND ALKALINE DIET
Purpose:
 Furnish a well balance diet in which the total acid ash is greater than the total alkaline ash each day.
Use:
 Retard the formation of renal calculi. The type of diet chosen depends on laboratory analysis of the stone.
Acid and alkaline ash food groups:
a. Acid ash: meat, whole grains, eggs, cheese, cranberries, prunes, plums
b. Alkaline ash: milk, vegetables, fruits (except cranberries, prunes and plums.)
c. Neutral: sugar, fats, beverages (coffee, tea)
Foods allowed:
 Breads: any, preferably whole grain; crackers; rolls
 Cereals: any, preferable whole grains
 Desserts: angel food or sunshine cake; cookies made without baking powder or soda; cornstarch,
 pudding, cranberry desserts, ice cream, sherbet, plum or prune desserts; rice or tapioca pudding.
 Fats: any, such as butter, margarine, salad dressings, Crisco, Spry, lard, salad oil, olive oil, ect.
 fruits: cranberry, plums, prunes
 Meat, eggs, cheese: any meat, fish or fowl, two serving daily; at least one egg daily
 Potato substitutes: corn, hominy, lentils, macaroni, noodles, rice, spaghetti, vermicelli.
 Soup: broth as desired; other soups from food allowed
 Sweets: cranberry and plum jelly; plain sugar candy
 Miscellaneous: cream sauce, gravy, peanut butter, peanuts, popcorn, salt, spices, vinegar, walnuts.
Restricted foods:
 no more than the amount allowed each day
1. Milk: 1 pint daily (may be used in other ways than as beverage)
2. Cream: 1/3 cup or less daily
3. Fruits: one serving of fruits daily( in addition to the prunes, plums and cranberries)
4. Vegetable: including potatoes: two servings daily
5. Sweets: Chocolate or candies, syrups.
6. Miscellaneous: other nuts, olives, pickles.
HIGH-FIBER DIET
Purpose:
 Soften the stool
 exercise digestive tract muscles
 speed passage of food through digestive tract to prevent exposure to cancer-causing agents in food
 lower blood lipids
 prevent sharp rise in glucose after eating.
Use: diabetes, hyperlipedemia, constipation, diverticulitis, anticarcinogenics (colon)
Foods Allowed:
 recommended intake about 6 g crude fiber daily
 All bran cereal
 Watermelon, prunes, dried peaches, apple with skin; parsnip, peas, brussels sprout, sunflower seeds.
LOW RESIDUE DIET
Purpose:
 Reduce stool bulk and slow transit time
Use:
 Bowel inflammation during acute diverticulitis, or ulcerative colitis, preparation for bowel surgery,
esophageal and intestinal stenosis.
Food Allowed:
 eggs; ground or well-cooked tender meat, fish, poultry; milk, cheeses; strained fruit juice (except
prune): cooked or canned apples, apricots, peaches, pears; ripe banana; strained vegetable juice:
canned, cooked, or strained asparagus, beets, green beans, pumpkin, squash, spinach; white bread;
refined cereals (Cream of Wheat)

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