Definition of Diet – This book covers the entire syllabus of “Nutrition and Dietetics” prescribed by BNMC-for all Diploma in Nursing Science and Midwifery students. We tried to accommodate latest information and topics. This book is examination friendly setup according to the teachers’ lectures and examination’s questions.

At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourished. The unique way of presentation may make your reading of the book a pleasurable experience.

Table of Contents

Definition of Diet

In nutrition, diet is the sum of food consumed by a person or other organism. The word diet often implies the use of specific intake of nutrition for health or weight-management reasons (with the two often being related).

Or,

Diet is the sum of food consumed by a person or other organism.

Purposes of Normal Diet:

To maintain adequate nutrition of the individual.
To promote optimal nutrition.
To restore the individual to a satisfactory nutritional status, if his nutritional balance has been disturbed.

(Ref by-Annamma Jacob/2nd/172)

Types of Diet:

A. Normal food:	An average patient whose appetite is normal is given normal food. Fried and highly seasoned foods are not given to patients.
B. High diet:	It is cooked simply, without fat; gas forming foods are also avoided.
C. Soft diet:	It contains food which requires little che wing and contains no fibre or no seasoning. These foods are given to people with gastro intestinal disorders.
D. Liquid diet:	Full liquid diet: Soups, puddings, custards, cooked cereals, milk. Clear diet: Water, tea, lemon, coffee, juice and beverage. Bland diet: Full liquid diet excepting coffee, tea, colas and soups.
E. Therapeutic diet:	Diabetic diet. Sippe’s diet. Fat free diet. High caloric diet. Low caloric diet.

What kinds of diet will you provide for a heart disease patient

1. Diet for peptic ulcer patient:	Peptic ulcer diet: Characteristics of peptic ulcer diet: It should be frequently fed to neutralize acid. It should be soft, smooth or bland. It should be free from irritants like spices, excess salt and acidic or tinned food. The following foods are avoided in peptic ulcer: Such as raw, leafy, uncooked vegetables, spices, meat soup, tea, coffee, alcohol and tobacco etc.
2. Diet for liver disease patient:	a) Diets in liver disease: (With jaundice): Restricted or reduction in protein and fat. Increase inn carbohydrate quantity by glucose IV or drink. No restriction for vitamins and minerals. b) Diets in liver disease: (Without jaundice): High protein, high caloric diet is prescribed. No restriction for fat (1 gm per kg of body wt, given). No restriction of minerals and vitamins. Complete restriction for alcohol.
3. Diet in gallbladder disease:	Normal intake of protein (60-80gm). Fat is restricted if fat intolerance persists. Otherwise fat can be given in form of olive oil or ground nut oil. Restriction on carbohydrate diet, to be avoided like pastries, apples, melons, fatty meat, fried eggs, cheese fried potato chips, peas and beans, cabbage cauliflower, cucumber, radish, turnips, nuts, popcorn, dried fruits, pickles, chutney, pepper condiments, spices-are also avoided.
4. Diet for constipating patient:	Normal protein. Normal or increased fat. Carbohydrate containing more cellulose like salads, brinjal, green vegetable puree, fruits etc.
5. Diet in diarrhoea and dysentery:	If tolerated highly assimilable protein rich substance like skimmed milk, white of egg, minced meat. Fats are avoided due to its hard digestibility. Easily assimilable carbohydrate like kanji from rice or sago, vegetable puree, fruit juice.
6. Diet in kidney disease:	a) Acute glomerulonephritis. Protein restriction if urine output is reduced. Fats are not restricted. No restriction on carbohydrates. Sodium chloride (Common salt) is restricted. b) Nephrotic syndrome. High protein diet. Normal fat intake. Normal carbohydrate intake. Restricted common salt. c) Acute renal failure. Protein restricted. Fats in normal quantity. Increased carbohydrate food as protein is restricted. Sodium chloride (common salt) is restricted. d) Chronic renal failure. Drastic restriction of protein. Normal fat intake. Increase in protein-free carbohydrate. In case of oedema and hypertension salt is restricted.
7. Diet for diabetes patient:	a) Diet in diabetes mellitus: Proteins are given normally. Fats should be moderate. Excess may result in weight gain. Vitamins and minerals adequately. b) Diet/ food to be avoided: Sweets are completely avoided. Sweet drinks, carbonated drinks, cakes, pastries, creams, beer and wines, dried and canned fruits, sweet pickles, jaggery, sweet meat, and all root vegetables.
8. Diet in ischaemic heart disease	Protein normal quantity. Carbohydrates are restricted. Fats are restricted.
9. Diet for hypertension Patient:	Diet in hypertension: Proteins are restricted in severe high blood pressure. Fats and oils are restricted. Carbohydrates should constitute major portion of diet. Salt is restricted in all hypertensive cases.
10. Diet for congestive heart failure patient:	Diet in CHF: Normal protein diet Restricted fatty diets Increased carbohydrate diet, Complete sodium chloride (common salt) restricted.
11. Diet for anaemic patient:	The diet should contain more of iron, calcium and protein for synthesis of haemoglobin in blood. The diet for anaemia patient should contain- Liver, meat, eggs, spinach, potatoes, mustard leaves, wheat, fruit juice. Excess milk may aggravate anaemia further as milk is lacking in iron and vitamin ‘C.

(Ref by-LC Gupta/3/232-7)

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Special Considerations of Serving a Normal Diet

Note any food preferences, allergies or restrictions of diet.
Note the diet the patient is on and indicate any special preparation or utensils the patient needs while eating.
Note any eating difficulties or how well the patient tolerated the meal.
Check for medications to be administered before, after and along with the meal, e.g. insulin.

(Ref by-Annamma Jacob/2nd/173)

Some Dietary Problems during Sickness:

During sickness, there will be disturbance of gastro intestinal function.
Anorexia (loss of appetite).
Dyspepsia.
Defective digestion and absorption.
Lack of exercise decreases need for energy.
Tissue building foods are needed more.
The process of anabolism and catabolism are not normal in sickness.
In some kinds of illness, protein requirements are more while in some others, both protein
and carbohydrates are needed in larger amounts.
Vomiting and diarrhea are problems in which intravenous fluid administration is required.

Factors Influence Food Habits of a Person:

A. Physical:	State of mouth and teeth. Intact digestive system. Physical proficiency in shopping for/preparing food. Physical proficiency in taking food and drink. Appetite/thirst regulation.
B. Psychological;	Intellectual capacity to procure and prepare food and drink. Knowledge about diet and health. Weight control. Alcoholism. Food hygiene. Disposal of food waste. Attitude to eating and drinking. Emotional status. Likes and dislikes.
C. Sociocultural:	Family traditions. Cultural idiosyncrasies Religious commendations / Restrictions.
D. Environmental:	Climate and geographical position. Facilities for procuring/growing food. Distance from home to the shopping area. Availability of transport. Means of cooking. Means of storage.
E. Economic:	Finances available. Choice of food and drink. Quantity and quality of food and drink.

(Ref by- SN. Nanjunde Gowda/2/430)

Procedure of Feeding a Helpless Patient:

A. Articles:

Tray containing prepared diet.
Face towel and water.
Kidney tray.
Backrest and cardiac table.
Fork and spoon.
Feeding cup with water.

B. Procedure:

Explain procedure to the patient and assess how he can participate.
Position the patient comfortably, preferably in Fowler’s position.
Assist the patient to wash his hands and face.
Place towel over chest and around the neck.
Make sure that therapeutic restrictions are considered. Check the diet and ensure that is the one was ordered.
Create a pleasant environment.
Wash hands.
Sit or stand at the side of patient.
Consider the patient’ preferences while feeding and encourage his participation to the extent possible.
Feed the patient in small spoonful’s waiting for him to chew and swallow one mouthful before next.
Encourage the patient to take all the food several to him, but not force,
Give water in between if patient prefers water.
When the patient has eaten food and he feels satisfied, stop feeding and give him a glass of water if he prefers.
Provide articles for rinsing mouth and encourage patient to do so.
Dry lips and face with towel.
Replace articles and wash hands.
Record in nurse’s record the type of diet, time of feeding, amount taken and tolerance.
Record fluid taken, in intake output record.