Disease

Diet Therapy

Remarks

Hyperlipidemia

Low fat, High fibre

• Calories should be sufficient to maintain appropriate body weight for a given height.
• Carbohydrate should constitute 55-75% of calories.
• Proteins around
• 10-15% of the total calories (min. 1 gm per kg of ideal body weight)
• Total fat intake between 15-35% of total calories.
• Cholesterol should not exceed 300mg/day in the diet.
• Saturated fat should be less than 10% of the total calories

• Polyunsaturated fat should not exceed 8% of the total calories
• MUFA (10 – 15 % of total calories)
• P/S ratio between 0.8-1.0
• Trans Fatty acids should be avoided
• Linoleic acid(n₆) between 3-7% of the calories
• Alpha-Linoleic acid(n₃) not less than 1% of calories.
• LA/ALNA ratio between 5-10

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