Therapeutic nutrition

Diet plays a major role in curing diseases or restoring the health by supplying the needed nutrients. Diets are composed of nutrients: macronutrients (proteins, fats and carbohydrates) and the micronutrients (vitamins, minerals and trace elements). Special dietary measures may be required to maintain lives of patients, who have chronic heart, kidney, liver and gastrointestinal diseases. These diets must also consider and supplement the effects of medications on nutrients. The regular diet is a normal unrestricted diet and is the food a person eats every day. The regular diet is well balanced and has a variety of foods from the food pyramid. A therapeutic diet is usually a modification of a regular diet. Therapeutic diet is formulated to optimize the nutritional needs of a particular patient. Therapeutic diet differs from a regular diet in the amount of one or more nutrients or food components for the purpose of treating or healing a disease or illness. The therapeutic diet is also called ‘special diet’ or ‘modified diet.’ A therapeutic diet is made under a physician’s guidance.

Therapeutic diet have modified for nutrients, calorific contribution, texture or consistency and /or food allergies or food intolerances.  For example, a cardiac diet is low in fat or cholesterol. A diabetic diet is low in sugar and fat. A clear liquid diet may be used to maintain hydration during gastro-intestinal illness such as nausea, vomiting and diarrhoea. Calorie – controlled diet is served to residents who are overweight. Sodium – restricted diet is served to residents with heart or kidney disease. High fiber diets (30g or more) are believed to help prevent diverticulosis, constipation, haemorrhoids and colon cancer.

Definition of diet therapy

Diet therapy is the use of any diet for restoring or maintaining optimal nutritional status and body homeostasis. The purpose of diet therapy is to restore or maintain an acceptable nutritional status of a patient.

Therapeutic nutrition

Therapeutic nutrition is broadly defined as the use of nutrients such as vitamins, minerals, amino acids, essential fatty acids, co-factors, enzymes, antioxidants and phytonutrients to support the body’s immune and healing systems, thereby altering the course and outcome of a disease process. It can be used as a preventive or can be used as a therapy. The goals of therapeutic nutrition include the supply of appropriate, bioavailable nutrients, the reduction of inflammation and the enhancement of elimination of toxins. Therapeutic nutrition is concerned with the treatment of patients by prescribing the right type of diets in order to meet their nutritional requirements.

The role of therapeutic diet

1.       To correct dietary deficiencies

2.       To maintain the patient in good nutrition state

3.       To formulate diet to meet the need of the patient.

4.       To educate the patient and family.

Types of therapeutic diets

Simplest therapeutic diets – are mechanically altered diets.  Mechanically altered diets contain foods that are pureed, chopped/ ground or soft for patients who have difficulty in chewing or swallowing. Mechanical soft diet is produced by simply grounding or chopping the food so it requires minimum chewing. For a pureed diet, the regular food is pulverized to a pureed consistency using a food processor.

Liquid diets – the diet is liquid at body temperature. Liquid diets may clear liquid or full liquid. The diet includes fruit juices, water gruels (strained and liquefied cooked cereals). This diet may be used after surgery. This diet can replace fluid lost from vomiting or diarrhea.

Soft or bland diet – it consists of easily digested foods that do not irritate digestive tract.

Restricted residue diet or low residue diet – it eliminates or limits foods that are high in bulk or fibre. It is used for patients with digestive and rectal diseases.

Hippocrates diet – is a natural diet of unprocessed and unchanged food as it is found in nature. It consists of fruits, vegetables and greens; fresh fruit and chlorophyll juices, sprouted seeds, grains and legumes; nuts and seeds; fermented foods and small amounts of raw honey.

Palaeolithic diet – it is also called caveman diet or stone age diet or hunter- gatherer diet. It is basically a high protein, high fibre eating plan. The diet includes a lot fresh lean meats and fish and vegetables and healthier fats.

Vegetarian or  neutral  diet – the vegetarian diet is sourced from plant products, plus dairy products and egg.The neutral diet is diet that contains the least amount of contaminants, pollutants or allergens. A vegetarian diet is the healthiest diet. A vegetarian diet reduces the risk for obesity, coronary artery disease, high blood pressure, diabetes and certain types of cancers. A diet rich in animal fats is the least healthy.

Vegan diet – consists of fruits, vegetables, legumes, grains, nuts and seeds. No eggs, cheese, yogurt, ice cream, butter or other milk products are eaten.

Raw food diet – consists 70% of raw fruits and vegetables and 30% of grains, nuts, dairy products and meat. Eating fresh, organic raw fruits and vegetables will increase the vitamins and micronutrients in your diet.  The raw foods have high levels of antioxidants with health promoting and disease preventing compounds.

Gluten free diet – Gluten is a protein found in wheat, rye, barley, triticale and oats. People with celiac disease (a digestive disorder) are sensitive to the presence of gluten in the diet. Gluten free foods include meat products, fish, dairy products, fruits and vegetables, pasta and noodles, rice and potatoes.

Calcium rich diet – calcium is absolutely critical nutrient in regulating acid/alkaline balance in the blood. Calcium plays another critical role in maintaining structural integrity of our skeleton. Excess calcium can deposit in blood vessels and kidneys. The diet includes dairy foods, sardines, collards, greens, spinach, sesame seeds and scallops.

Iron rich diet – Iron is an essential nutrient required for the synthesis of haemoglobin which carries oxygen in the blood. Iron deficiency anaemia is a worldwide health problem in young women and in children. Iron rich diet consists of broccoli, soybeans, bok choy, lentils, dark green vegetables, meat, poultry and fish.

Protein restricted diet – The average person needs between 40 to 65 grams of protein each day. People with chronic liver or kidney disease should limit protein intake. Proteins contain 16% nitrogen, which the body eliminates in the urine as urea. In cases where liver or kidney function is impaired, urea, ammonia or other toxic nitrogen metabolites may build up in the blood. To control protein intake, foods such as starches, sugars, grains, fruits, vegetables, fats and oils should be eaten at levels sufficient to meet daily energy needs. The purpose of a low protein diet is to prevent worsening of kidney or liver disease.

Mediterranean diet – consists of food mainly plant sources such as vegetables, fruits, cereals, legumes, garlic, nuts, olive oil, moderate amounts of fish, chicken, yogurt, red wine; low in cheese, eggs, saturated fats, sugar and red meat. A study has reported that this diet lowers the incidence of secondary heart attacks by 70% - a 70% reduction in deaths from all causes.

Detoxification diet – a diet of fruits, raw vegetables, water and yogurt to eliminate toxins absorbed from the environment or caused by poor digestion or poor excretion waste products.

The Atkins diet – It is a high-protein, low carbohydrate diet developed by Robert Atkins during 1960s. It is the most famous weight loss diet. It is based on the simple premise of a diet high in sugar and refined carbohydrates causes weight gain and ultimately leads to obesity. There are four phases to the Atkins diet: induction phase, ongoing weight loss, pre- maintenance and lifetime maintenance phase.

The macrobiotic diet – was developed in the 1920s by George Ohsawa. It consists of a simple diet of brown rice, miso soup and sea vegetables. Whole grains such as brown rice, barley, millet, oats, corn and rye makeup the bulk of the macrobiotic diet. This diet encourages the consumption of vegetables such as cabbage, broccoli, cauliflower, kale, bok choy, collards and mustard greens. Beans, tofu and sea vegetables should be eaten on a daily basis.

Zone diet – was developed by Barry Sears. The zone diet proposes a dietary ratio of 40% carbohydrate, 30% protein and 30% fat.

Benefits of therapeutic diets

It is essential or life saving treatment in the case of coeliac disease, phenylketonuria and galactosemia. Therapeutic diets are used to replenish patients who are malnourished in the case of cancer or intestinal diseases. Therapeutic diets are used to produce a negative nitrogen balance in obese people. Therapeutic diets are used as an alternative or complementary treatment in the case of diabetes or hypertension. Therapeutic diets are used to provide standard condition for diagnostic tests in the diagnosis of food sensitivity.

     Diet therapy restores or maintains an optimal nutritional status of a patient.