Nutri

An individual’s diet is the sum of food and drink that he or she habitually consumes.
Dieting
is the practice of attempting to achieve or maintain a certain weight through diet. People’s
dietary choices are often affected by a variety of factors, including ethical and religious beliefs,
clinical need, or a desire to control weight.
Not all diets are considered healthy. Some people follow unhealthy diets through habit,
rather than through a conscious choice to eat unhealthily. Terms applied to such eating habits
include “junk food diet” and “Western diet”. Many diets are considered by clinicians to pose
significant health risks and minimal long-term benefit. This is particularly true of “crash” or “fad”
diets – short-term weight-loss plans that involve drastic changes to a person’s normal eating
habits.
Regular Diet
The regular diet can also be referred to as a general or normal diet. Its purpose is to provide a
well-balanced diet and ensure that individuals who do not require dietary modifications receive
adequate nutrition. Based on the Dietary Guidelines and the Food Guide Pyramid, it
incorporates a wide variety of foods and adequate caloric intake.
Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.
Includes a variety of protein foods such as seafood, lean meats and poultry, eggs, legumes
(beans and peas), soy products, nuts, and seeds. Is low in added sugars, sodium, saturated
fats, trans fats, and cholesterol.
urbanization and changing lifestyles have led to a shift in dietary patterns. People are now
consuming more foods high in energy, fats, free sugars and salt/sodium, and many people do
not eat enough fruit, vegetables and other dietary fibre such as whole grains.
The exact make-up of a diversified, balanced and healthy diet will vary depending on individual
characteristics (e.g. age, gender, lifestyle and degree of physical activity), cultural context,
locally available foods and dietary customs. However, the basic principles of what constitutes a
healthy diet remain the same.
For adults
A healthy diet includes the following:
Fruit, vegetables, legumes (e.g. lentils and beans), nuts and whole grains (e.g. unprocessed
maize, millet, oats, wheat and brown rice).
At least 400 g (i.e. five portions) of fruit and vegetables per day (2), excluding potatoes, sweet
potatoes, cassava and other starchy roots.
Less than 10% of total energy intake from free sugars (2, 7), which is equivalent to 50 g (or
about 12 level teaspoons) for a person of healthy body weight consuming about 2000 calories
per day, but ideally is less than 5% of total energy intake for additional health benefits (7). Free
sugars are all sugars added to foods or drinks by the manufacturer, cook or consumer, as well
as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
Less than 30% of total energy intake from fats (1, 2, 3). Unsaturated fats (found in fish, avocado
and nuts, and in sunflower, soybean, canola and olive oils) are preferable to saturated fats
(found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard) and trans-fats
of all kinds, including both industrially-produced trans-fats (found in baked and fried foods, and
pre-packaged snacks and foods, such as frozen pizza, pies, cookies, biscuits, wafers, and
cooking oils and spreads) and ruminant trans-fats (found in meat and dairy foods from ruminant
animals, such as cows, sheep, goats and camels). It is suggested that the intake of saturated
fats be reduced to less than 10% of total energy intake and trans-fats to less than 1% of total
energy intake (5). In particular, industrially-produced trans-fats are not part of a healthy diet and
should be avoided (4, 6).
Less than 5 g of salt (equivalent to about one teaspoon) per day (8). Salt should be iodized.
For infants and young children
In the first 2 years of a child’s life, optimal nutrition fosters healthy growth and improves
cognitive development. It also reduces the risk of becoming overweight or obese and
developing NCDs later in life.
Advice on a healthy diet for infants and children is similar to that for adults, but the following
elements are also important:
Infants should be breastfed exclusively during the first 6 months of life.

Infants should be breastfed continuously until 2 years of age and beyond.
From 6 months of age, breast milk should be complemented with a variety of adequate, safe
and nutrient-dense foods. Salt and sugars should not be added to complementary foods.
Types of Therapeutic Diets

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. It is modified
or tailored to fit the nutrition needs of a particular person.
Therapeutic diets are modified for (1) nutrients, (2) texture, and/or (3) food allergies or food
intolerances.
Common reasons therapeutic diets may be ordered:

To maintain nutritional status.
To restore nutritional status.
To correct nutritional status.
To decrease calories for weight control.
To provide extra calories for weight gain.
To balance amounts of carbohydrates, fat and protein for control of diabetes.
To provide a greater amount of a nutrient such as protein.
To decrease the amount of a nutrient such as sodium.
To exclude foods due to allergies or food intolerance.
To provide texture modifications due to problems with chewing and/or swallowing
Common therapeutic diets include:
1. Nutrient modifications.
No concentrated sweets diet;

Diabetic diets;
No added salt diet;
Low sodium diet;
Low fat diet and/or low cholesterol diet;
High fiber diet;
Renal diet.
2. Texture modification.
Mechanical soft diet;

Puree diet.
3. Food allergy or food intolerance modification.
Food allergy;
Food intolerance.
4. Tube feedings.
Liquid tube feedings in place of meals;

Liquid tube feedings in addition to meals.
5. Additional feedings – In addition to meal, extra nutrition may be ordered as:
Supplements – usually ordered as liquid nutritional shakes once, twice or three times per day;
given either with meals or between meals.
Nourishments – ordered as a snack food or beverage items to be given between meals mid-
morning and/or mid-afternoon.
HS snack – ordered as a snack food or beverage items to be given at the hour of sleep.
6. The following list includes brief descriptions of common therapeutic diets:
Clear liquid diet –
Includes minimum residue fluids that can be seen through.

Examples are juices without pulp, broth, and Jell-O.
Is often used as the first step to restarting oral feeding after surgery or an abdominal procedure.
Can also be used for fluid and electrolyte replacement in people with severe diarrhea.
Should not be used for an extended period as it does not provide enough calories and nutrients.
7. Full liquid diet.
Includes fluids that are creamy.

Some examples of food allowed are ice cream, pudding, thinned hot cereal, custard, strained
cream soups, and juices with pulp.
Used as the second step to restarting oral feeding once clear liquids are tolerated.
Used for people who cannot tolerate a mechanical soft diet.
Should not be used for extended periods.
No Concentrated Sweets (NCS) diet.
Is considered a liberalized diet for diabetics when their weight and blood sugar levels are under
control.
It includes regular foods without the addition of sugar.
Calories are not counted as in ADA calorie controlled diets.
Diabetic or calorie controlled diet (ADA).
These diets control calories, carbohydrates, protein, and fat intake in balanced amounts to meet
nutritional needs, control blood sugar levels, and control weight.
Portion control is used at mealtimes as outlined in the ADA “Exchange List for Meal Planning.”
Most commonly used calorie levels are: 1,200, 1,500, 1,800 and 2,000.
No Added Salt (NAS) diet.
Is a regular diet with no salt packet on the tray.
Food is seasoned as regular food.
Low Sodium (LS) diet.
May also be called a 2 gram Sodium Diet.
Limits salt and salty foods such as bacon, sausage, cured meats, canned soups, salty
seasonings, pickled foods, salted crackers, etc.
Is used for people who may be “holding water” (edema) or who have high blood pressure, heart
disease, liver disease, or first stages of kidney disease.
Low fat/low cholesterol diet –
Is used to reduce fat levels and/or treat medical conditions that interfere with how the body uses
fat such as diseases of the liver, gallbladder, or pancreas.
Limits fat to 50 grams or no more than 30% calories derived from fat.
Is low in total fat and saturated fats and contains approximately 250-300 mg cholesterol.
High fiber diet.
Is prescribed in the prevention or treatment of a number of gastrointestinal, cardiovascular, and
metabolic diseases.
Increased fiber should come from a variety of sources including fruits, legumes, vegetables,
whole breads, and cereals.
Renal diet.
Is for renal/kidney people.
The diet plan is individualized depending on if the person is on dialysis.
The diet restricts sodium, potassium, fluid, and protein specified levels.
Lab work is followed closely.
Mechanically altered or soft diet.
Is used when there are problems with chewing and swallowing.
Changes the consistency of the regular diet to a softer texture.
Includes chopped or ground meats as well as chopped or ground raw fruits and vegetables.
Is for people with poor dental conditions, missing teeth, no teeth, or a condition known as
dysphasia.
Pureed diet.
Changes the regular diet by pureeing it to a smooth liquid consistency.
Indicated for those with wired jaws extremely poor dentition in which chewing is inadequate.
Often thinned down so it can pass through a straw.
Is for people with chewing or swallowing difficulties or with the condition of dysphasia.
Foods should be pureed separately.
Avoid nuts, seeds, raw vegetables, and raw fruits.
Is nutritionally adequate when offering all food groups.
Food allergy modification.
Food allergies are due to an abnormal immune response to an otherwise harmless food.
Foods implicated with allergies are strictly eliminated from the diet.
Appropriate substitutions are made to ensure the meal is adequate.
The most common food allergens are milk, egg, soy, wheat, peanuts, tree nuts, fish, and
shellfish.
A gluten free diet would include the elimination of wheat, rye, and barley. Replaced with potato,
corn, and rice products.
Food intolerance modification.
The most common food intolerance is intolerance to lactose (milk sugar) because of a
decreased amount of an enzyme in the body.
Other common types of food intolerance include adverse reactions to certain products added to
food to enhance taste, color, or protect against bacterial growth.
Common symptoms involving food intolerances are vomiting, diarrhea, abdominal pain, and
headaches.
Tube feedings –
Tube feedings are used for people who cannot take adequate food or fluids by mouth.
All or parts of nutritional needs are met through tube feedings.
Some people may receive food by mouth if they can swallow safely and are working to be
weaned off the tube feeding.
Bland Diet
At times, due to gastro-intestinal or esophageal problems, clients need to follow a bland
diet.
Ideas: Applesauce, toast, French to as cream of wheat or rice, oatmeal, simple muffins,
cinnamon bread, pasta dishes such as macaroni and cheese, egg noodles with herbs or
cheese, potatoes of all kinds – baked, mashed, scalloped, eggs: omelets, soft-boiled, egg salad,
rice dishes, rice pudding, custards, puddings.
Special Diets:
If the physician recommends a special diet, the physician or nurse usually provides guidelines
and sample menus.

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An individual’s diet is the sum of food and drink that he or she habitually consumes.

Infants should be breastfed exclusively during the first 6 months of life.

Types of Therapeutic Diets

Common reasons therapeutic diets may be ordered:

No concentrated sweets diet;

Mechanical soft diet;

Liquid tube feedings in place of meals;

Clear liquid diet –

Includes minimum residue fluids that can be seen through.

Includes fluids that are creamy.

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