Sunday, December 12, 2010

Sodium-Restricted Diets

Sodium-restricted diets restrict the quantity of sodium to a prescribed level. These diets are designed to induce a loss of sodium and water from the body or avoid excessive sodium retention. Suggested levels of sodium modification include:

Mild sodium restriction- 3000mg sodium per day
Moderate sodium restriction- 2000mg sodium per day
Strict sodium restriction- 1000mg sodium per day
Very strict sodium diet- 500mg sodium per day

-The choices of foods depend on the sodium levels. In general, commercially prepared foods with added sodium are limited in amount or excluded altogether while those foods with naturally occurring sodium are only allowed in some degree.

When is it used?
- 3000mg sodium diet: mild hypertension, mild edema
- 2000mg sodium diet: congestive heart failure, moderate hypertension, pregnancy-induced hypertension, corticosteroid therapy, cirrhosis, and chronic renal disorders.
- 1000mg sodium diet: severe hypertension, cirrhosis with ascites, pulmonary edema, congestive heart failure, and eclampsia.
- 500 mg sodium diet: a diet used on a short-term basis for patients requiring severe sodium restriction.

How adequate is the diet?

The diet provides all the essential nutrients when planned based on the principles of balanced diet.

Suggested Meal Plan

Same as the regular diet but use only those foods that are permitted.
Breakfast
Fruit
Meat/fish (or substitute)
Rice/bread (or substitute)
Beverage

Lunch/Supper
Meat/fish (or substitute)
Vegetable
Rice (or substitute)
Fruit

Snacks
(As desired)
Sandwich/pasta/noodles
Hot or cold beverage

Fat-Controlled Diet

Fat-controlled diet regulates both the amount and type of fat, especially saturated fat and cholesterol. The diet is generally planned to provide.
- 30% of the total calorie from fat;
- Less tahn10-15% of total calories from saturated fatty acids;
- Up to 10 of total calories from polyunsaturated fatty acids; and
- No more than 300 mg cholesterol a day.
The basic changes made in the diet include the reduction of foods high in saturated fats, cholesterol, and total fat. The diet is designed to decrease the concentration of serum cholesterol and other circulating lipids in order to prevent or reduce the development of atherosclerosis.

When is it used?
-Atherosclerosis
- Elevated cholesterol stones with cholesterol esters
- Hyperilipidemia or hyperlipoproteinemia

How adequate is the diet?

The fat-controlled diet can include a wide variety of food products resulting in carrying amounts of nutrients.

Suggested Meal Plan
Breakfast
Fresh fruit
Lean meat/fish (or substitute)
Dressing
Plain rice/bread (or substitute)
Coffee or fat-free milk

Lunch/Supper
Lean meat/fish, seafood/poultry without skin
Stir-fry vegetables or salad with vinegar
Plain rice (or substitute)
Fruit juice or fresh fruit slices

Snacks
Fruit juice or cola
Low-fat sandwich/noodles

Low-Fat Diet

A low fat diet is a modification in fat content. It is designed to limit the total amount of fat in the diet to less than 10-15% of total calorie intake or about 30 to 50 grams per day.

When is it used?

This diet may be prescribed for patients with the following conditions:
- Cardiovascular disorders such as atherosclerosis and congestive heart failure
- Chronic renal disease
- Disorder in the digestion, absorption, and transport of fat including steatorrhea and fat malabsorption, gallbladder disease.

How adequate is the diet?

Dietary fat serves as a carrier for fat-soluble vitamins and provides essential fatty acids. These functions can be met by a diet containing 15-25 grams fat daily. A variety of food intake ensures that the diet will provide all the essential nutrients.

Suggested Meal Plan
Breakfast
Fruit or fruit juice
Meat/fish (or substitute)
Rice/plain bread (or substitute)
Coffee or fat-free milk

Lunch/Supper
Lean meat/fish, seafood/poultry without skin
Stir-fry vegetable or salad with vinegar dressing
Plain rice
Fruit juice or fresh slices

Snacks

Fruits juice
Low-fat sandwich

Gluten-Restricted Diet

A gluten-restricted diet, also called gliadin-free diet, eliminates all foods sources of gluten. Gluten is a protein found in grains and contains a specific amino acid peptide sequence. This peptide sequence occurs in the prolamin frcation of wheat (gliadin), rye (secalin), and barley (hordein).

When is it used?
- Dermatitis herpetiformis
- Gluten-sensitive enteropathies such as celiac disease (celiac sprue) and nontropical sprue.

How adequate is the diet?
A gluten-restricted diet is not nutritionally inadequate; however, when malabsorption is present, appropriate vitamin and/or mineral supplements should be prescribed.

Suggested Meal Plan

Same as the regular diet but use only those foods are permitted.

Low-Purine Diet

A low-purine diet limits the amount of purines to 120 to 150 mg/dayas compared to the usual intake of 600 to 1000 mg per day.
-The diet is relatively high in carbohydrate (at least 50 percent of calories) content and low in fat (should not exceed 30% of calories) with fluid intake of at least 2 quarts per day or more.

When is it used?
Low-purine diet is suggested when the uric acid level in the body is high, unless the patient is on medication that helps eliminate excess uric acid.
- Gout
- Hyperurucemia
- Uric acid stones

PURINE- a compound that is mainly found in animal protein and is metabolized to uric acid in the body.

How adequate is the diet?

The diet provides all the essential nutrients when planned based on the principles of balance diet.

Suggested Meal Plan

Same as the regular diet but choose only from those foods that are planned.

Low Protein Diet

A low-protein diet regulates the dietary intake of protein to a prescribed level. It is intended to reduce ammonia or toxic nitrogen metabolites in people with malfunctioning liver and kidney.
- Protein allowances is computed at 0.5 to 0.8 grams per kilo body weight in the absence of edema or alternatively using the DBW. However, the diet must have at least 40 grams protein per day. Below this level, the diet is combined with keto acid or amino acid supplements.
- High biologic value protein sources are emphasized, at least 2/3 of the protein intake, such as those found in meats, fish, seafood, egg, and poultry.

When is it used?

- Acute renal failure
- Acute glomerulonephritis
- Chronic renal failure without dialysis
- Liver failure with impending coma

How adequate is the diet?


A low protein in all nutrients except for vitamin B12 and iron. Unless the diet is well planned, the low-protein diet may also be low in calcium, thiamin, riboflavin, and niacin. A nutrients supplement may be necessary to prevent deficiency.

High Protein Diet

A high protein diet provides a protein level substantially above the normal amount required. It supplies a minimum of 1.5 gram per kilo DBW or 100 to 200 gram protein daily for adults and is also basically high in kilocalories to spare protein from being used as energy.
-It aims to rehabilitate a client who has protein malnutrition characterized by weight loss and tissue wasting.
- The diet easily can be achieved by supplementing the normal diet with high protein foods like milk, meat, and eggs, and special-high-protein, high-calorie proprietary liquid supplements.

When is it used?
- Hypermetabolic or catabolic states
- In preparing the nutritionally wasted patient for surgery
- Primary and secondary protein-energy malnutrition

How adequate is the diet?
-The diet is generally a regular diet and, thus, nutritionally adequate.

Suggested Meal Plan


Same as the regular diet. Snacks must be given as frequent as possible.