DIET (NUTRITION) FOR SICK PATIENTS (Diet in Sickness, Therapeutic Diet and Hospital Diet)
NUTRITION
Nutrition is all of the process of activities by which the human body receives and uses all the food necessary for its growth, development, regulation and repair.
TERMS
- Anorexia: loss of appetite
- Dyspepsia: indigestion, a feeling of fullness, discomfort, nausea and anorexia
- Dysphagia: difficulty in swallowing
- Nausea: a sensation of sickness with inclination to vomit
- Nutrients: constituents of food, e.g. carbohydrate, protein, fat, minerals, vitamins and water
- Regurgitation: back flow, e.g., back flow of partly digested food into the mouth from the stomach
- Vomiting: expulsion of stomach contents via the esophagus and the mouth
FUNCTIONS OF FOOD
- To supply heat and energy for work and play
- For growth and repair of the body
- For regulation or control of body process
- For protection of body from diseases
BASIC FOOD KINDS
A well balanced diet contains food from the basic food groups:
- Milk and milk products
- Meat, fish and poultry
- Bread and cereals
- Fruits and vegetables
PURPOSE
- Food gives nourishment to body
- It gives a feeling a security
- It is used to promote a feeling of social acceptance
- It is vitally important for our physical well-being
- Food is the fuel with which we run our bodies
ESSENTIAL NUTRIENTS
- Carbohydrates: these are used as a source of energy. All cereals and root vegetables contain carbohydrate
- Fats: they are also a source of energy. They are found in animals and plant seeds also in egg and milk
- Proteins: the function of proteins in human body is the release of energy and building and repair of body tissues
DIET IN SICKNESS
Diet is an important as medicine in the treatment of diseases. A modification in the diet or in the nutrients can cure certain diseases.
Nutrition during illness should be adequate to prevent weight loss and weakness. An acutely ill or injured patient is in danger of malnutrition
Purpose
- To meet the metabolic needs of human body
- To prevent dehydration
- To improve the appetite
- To provide adequate nutrition
- It is necessary for the growth and maintenances of bones and other tissues
General Rules of Treatment
- The diet must be planned in relation to changes in metabolism occurring as a result of the disease
- The diet must be planned to agree as nearly as possible with the patients food habits his likes and dislikes and the amount of exercise he takes
- Changes should be made gradually adequate explanation must be when it is necessary to make dietary changes gradually
- There should be plenty or variety in the diet hot food should be served hot and cold foods cold
Problems During Sickness
- There will be disturbance of gastrointestinal function
- Anorexia (loss of appetite)
- Defective digestion and absorption
- Lack of exercise decreases need for energy
- The process of anabolism and catabolism are not normal in sickness
- Vomiting and diarrhea are problems in which intravenous fluid administration is required
- In some kinds of illness, protein requirements are more while in some others, both protein and carbohydrate are needed in large amounts
Modifications of Nutrients in Therapeutic Diet
- Carbohydrates are usually well-tolerated and are necessary to maintain the stores of liver glycogen. Adequate intake of carbohydrates can prevent ketosis.
- During sickness demand of protein is increased due to waist. So, easily digestible protein should be given.
- The requirements of calcium and iron must be maintained during illness sodium and potassium may sometimes need to be restricted especially if there is edema, ascites and hypertension
- Fat soluble vitamin, e.g. vitamin A and D need to be added if the patient is on fat-restricted diet for a long time
- Vitamin B complex may not be adequately absorbed in pathological conditions of the gastrointestinal tract
- Requirement of vitamin C is greatly increased in fevers and is especially necessary for the healing of wounds after surgery
- Fluids are very important to prevent dehydration especially in conditions like high fevers, diarrhea and vomiting in such conditions the fluid intake within 24 hours should be 2,500 ml to 3000 ml
- If adequate fluids cannot be given by mouth, they must be given intravenous maintain fluid balance by maintaining accurate intake output chart
- Infants requires a higher amount of fluid compared to adult requirements they need 150 ml of fluid per kg of body weight
THERAPEUTIC DIET
Diet in disease must be planned as part of the complete care of the patient. Many modifications may have to be made according to the disease and the condition of the patient
Objective
- To improve the general health
- To meet the metabolic needs
- To promote healing
- To prevent dehydration
- To facilitate tissue repair and growth
Principle Involved in Diet Therapy
- The diet must be planned in relation to changes in metabolism occurring as a result of disease
- The diet must be planned according to the habits of the patient based on culture, religion, socioeconomic status, personal preferences, physiological and psychological conditions
- As far as possible, changes in the diet should be brought gradually and adequate explanations are given with the changes made, if any
- In short and acute illness, the food should not be forced because his appetite is very poor but he may soon recover the normal appetite
- Whatever the diet prescribed, there should be variety of for selection
- Small and frequent feeds are preferred to the usual three meals
- Hot foods should be served hot and cold foods should be served cold
Therapeutic Diet contain
Diabetic diet: low GI foods, high fiber
Heart diet: low fat, low cholesterol, low salt
Renal diet: low potassium, low protein
Bowel health: high fiber
Food intolerance: gluten, dairy
Food allergy: peanut, so, fish
Malnutrition: high energy, high protein
Wound management: high protein, energy
HOSPITAL DIET
Regular Diet
- Full diet: it is a regular well-balanced diet. It is vegetarian or non-vegetarian this is for patients who do not need any special modification
- Soft light diet: it is given to provide light and easily digestible food with minimum residue. It contains food which requires little chewing and contains no fiber or no seasoning
- Bland diet: the foods are easily digestible, free from substances which might cause irritation of the gastrointestinal tract and generally or low roughage content, used mainly for patients with gastrointestinal conditions
Liquid Diets
- Liquid Diets: must be used for patients who are unable to take or tolerate solid food. This diet is given usually to patient having hyperpyrexia, postoperative patients and patients having gastrointestinal disturbances
- Clean fluids: used when there is a marked intolerance to food and roughage these include clear tea, weak black coffee, clear soups, whey water, strained fruits juices, clear fluid diet should be used only for a short time
- Full liquid diet: it is given the total nutrition of the patient has to be maintained by fluids for considerable time. This is necessary when the patient is unable to swallow solid food or if the patient is fed by intragastric or gastrostomy tubes
Low Calorie Diet
- The total calorie intake is reduced to less than the body’s requirements so that the remainder of the calories required can be derived from the stored fat
- The aim of this diet is to slow steady loss of weight over a period of several weeks or even months. This diet is advised to obese patients
- The food stuffs are – ghee, butter, sugar, sweet bread, rice and potatoes are omitted from the diet. Use salads, fruits and boiled vegetables. The patient must have plenty of bulk in the diet by using high fiber foods and low calorie beverages
Low Protein Diet
- Low protein diet is advised in kidney diseases such as nephritis, uremia. In these disease, the protein is avoided or given in low moderate type
- This type of diet is given to give the rest to kidneys because excessive protein intake acts as an additional load to kidneys
- The food stuff are – milk, eggs and meat, etc are omitted or restricted according to the prescribed protein intake
Low Fat Diet
- Low fat diet is restricted from the diet patients with liver diseases and gall bladder diseases. Carbohydrate in the diet should be increased to supply the liver with glycogen to prevent the ketosis
- No fried food – ghee or butter or other fat is allowed in the diet, only rice chapattis, bread, fruits, dahi and vegetables
Salt Free Diet
- Sodium is totally or partially restricted the restriction of sodium depends on the severity of the condition of the patient
- The patients with heart diseases hypertension, kidney diseases, etc. are given salt restricted diet or low salt diet. The necessity of the restriction should be carefully explained to the patient and relatives
- The following foods are totally avoided – salt, baking powder pappads, canned foods, cheese, pickles, salted chips and biscuits, etc
High Protein Diet
- High Protein Diet – the protein intake should be average from 75 to 100 g per day for adult. In protein energy malnutrition cases easily digestible and high nutritive value protein, e.g. milk protein should be given
- High protein diet is given to the patients such as operated cases, tuberculosis accident, burns, nephritic syndrome and emacided cases
- The food stuffs contains rich protein are milk and milk proteins, eggs, fish, meat, broth, dhal, dahi, beans, soyabean and groundnut
Diabetic Diet
- Diabetes mellitus – the metabolism carbohydrate, fat and protein are affected. Diabetes is a lifelong disease which can be treated but not cured. The dietary treatment depends upon the severity of the condition
- The purpose of diabetic diet is to keep the patient in good health to keep the blood sugar level within normal level and to keep urine free from sugar
- The diet should be balanced but there should be restriction of carbohydrates, e.g. rice, biscuits, sugars, jams, sweets, honey, carrots, and sweet potatoes. The patient should have egg, milk, raw salads, and all types of green leafy vegetables
- The total calorie required 20-25% should be from protein, 40% from carbohydrate and 40% from fat
Diet in Anemia
- This type of patient requires the diet which is high, in protein, high in iron, and high in vitamins. The diet should provide necessary nutrients for the formation of new red blood cells or hemoglobin
- The main purpose are to provide necessary nutrients for blood cell formation and to remove the cause of anemia
- The food stuffs recommended are liver, meat, eggs, spinach, drumstick leaves, ragi, jaggery, etc
