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Dietary Management in Specific Diseases
| Disease | Diet Therapy | Remarks |
| Hyperlipidemia | Low fat, High fibre |
|
| Hypercholesterolemia |
Low saturated fat, low cholesterol, high fiber |
|
| Hypertension | Sodium Restriction |
Emphasize fruits and vegetables, low fat dairy products, whole grains, nuts.
Restrict Sodium intake to < 2.4 g ( 6g salt /day) |
| Hypertriglyceridemia | Moderate restriction in total fat; sucrose and alcohol-restricted, calories to achieve or maintain ideal body weight | 30% of calories from fat increase intake of complex carbohydrates Restrict concentrated sweets Restrict alcohol |
| Mycocardial infarction | Restrict sodium and saturated fat | If CHF is present, fluid restriction may be necessary Fat similar to Hypercholesterolemia |
| Congestive Heart Failure (CHF) | Restrict-sodium Low saturated fat | Acute CHF-2-3g sodium/day Severe restriction- 0.5-1.0g/day |
| Diabetes Mellitus, Type-2, non-insulin dependant | Low fat, low cholesterol, high fiber diet Specify the calorie level | Include whole grains, fruits, vegetables & low fat dairy. For glycemic control, total amount of carbohydrate is more important. Low glycemic index diet s may be considered Dietary fiber-12-14g/1000kcal |
| Gout | Purine restricted | Avoid intake of organ meats, liver, kidney & certain sea foods, mushroom, dried fruits & nuts Consume liberal amounts of fluids |
| Obesity | Weight reduction |
Specify calories to achieve 1-2lb of weight loss per week. Less than 1000 kcal for
women & 1200 kcal for men is generally not recommended because of difficulty
in achieving nutritional adequacy. Lifestyle modification & exercise programs are recommended |
| Celiac Disease | Gluten free | Omit foods containing wheat, rye, barley. Substitute with oats,corn, rice, tapioca, soybean, arrowroot & potato flours |
| Constipation, Diverticulosis, hemorrhoids | High fiber (21-38g/day) |
Dietary sources of fiber should be tried before supplements Excessive intake may reduce absorption of calcium, copper, iron, magnesium, selenium & zinc. |
| Ulcerative colitis | Individualised | Avoid highly spiced foods, highly osmotic fruit juices, alcohol & caffeine |
| Lactose intolerance | Lactose restricted/free |
Severe lactase deficiency-avoid all milk containing foods
Moerate lactase deficiency- Curd, butter-milk, cottage cheese, pro-biotic curd often tolerated. Lactase enzymes for pre-treatment of lactose containing foods may be used |
| Acute renal failure (ARF) |
Individualized for the degree of renal failure Consider sodium, potassium, phosphorous and fluid restrictions if necessary |
ARF with dialysis- 0.8g/kg/protein/day |
|
Chronic kidney disease without dialysis |
Consider for protein, sodium, potassium & fluid restrictions |
Energy- 20-35kcal/kg/ ideal body weight/day With hypertension and edema, restrict sodium (1-3g/d) & fluid. Protein-0.8-.1.0g may be helpful |
|
End Stage renal disease (ESRD) with dialysis |
Individualised restriction of
sodium, potassium, phosphorous & fluid restrictions |
Adjust energy for activity level and body weight For weight maintenance- 20-35kcal/kg/ ideal body weight/day For weight reduction- 20-55kcal/kg/ ideal body weight/day Protein- Hemodialysis- 1.1-1.4g/kg/ ideal body weight/day Peritoneal dialysis- 1.2-1.5g/kg/ ideal body weight/day Phosphorous- Hemodialysis & Peritoneal dialysis< 17mg/kg/ ideal body weight/day Potassium- Hemodialysis- About 40-70meq/day Peritoneal dialysis- About >75meq/day Fluid –according to urine output & patient’s condition |
|
Dental impairment |
Ground pureed or full liquid |
Patients with fresh dental sutures should not use straws |
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Dr. Parmeet Kaur