Types of Therapeutic Diets

Therapeutic diets are meal plans that are designed to manage or treat specific medical conditions. These diets are usually prescribed by a physician and are planned by a dietician. The aim of therapeutic diets is to modify the regular diet to meet the nutritional needs of a particular person. They can be modified for specific nutrients, texture, and/or food allergies or intolerances. Some common reasons for ordering therapeutic diets are to maintain, restore, or correct nutritional status, decrease or provide extra calories for weight control, balance amounts of carbohydrates, fat, and protein for control of diabetes, or exclude foods due to allergies or food intolerance.

There are several types of therapeutic diets, including nutrient modifications, texture modifications, food allergy or intolerance modifications, tube feedings, and additional feedings. Nutrient modifications are designed to modify the intake of specific nutrients. They include diets such as the no concentrated sweets diet, diabetic diets, no added salt diet, low sodium diet, low-fat diet and/or low-cholesterol diet, high fiber diet, and renal diet. Texture modification diets are designed for people with chewing or swallowing problems, and they include the mechanical soft diet and puree diet. Food allergy or intolerance modification diets are designed to exclude specific foods due to allergies or intolerances. Tube feeding diets are liquid feedings in place of meals or in addition to meals. Additional feedings are ordered as supplements, nourishments, or HS snack and are given between meals.

The clear liquid diet is a therapeutic diet that includes fluids that are minimum residue and can be seen through. Examples of foods allowed on this diet include juices without pulp, broth, and Jell-O. This diet is often used as the first step to restarting oral feeding after surgery or an abdominal procedure and can also be used for fluid and electrolyte replacement in people with severe diarrhea. However, it should not be used for an extended period as it does not provide enough calories and nutrients. The full liquid diet is the second step to restarting oral feeding once clear liquids are tolerated. It includes creamy fluids, such as ice cream, pudding, thinned hot cereal, custard, strained cream soups, and juices with pulp. It is used for people who cannot tolerate a mechanical soft diet, but it should not be used for extended periods.

The no concentrated sweets (NCS) diet is considered a liberalized diet for diabetics when their weight and blood sugar levels are under control. It includes regular foods without the addition of sugar, and calories are not counted as in ADA calorie-controlled diets. The diabetic or calorie-controlled diet is designed to control calories, carbohydrates, protein, and fat intake in balanced amounts to meet nutritional needs, control blood sugar levels, and control weight. Portion control is used at mealtimes as outlined in the ADA “Exchange List for Meal Planning.” Most commonly used calorie levels are 1,200, 1,500, 1,800, and 2,000. The no added salt (NAS) diet is a regular diet with no salt packet on the tray. Food is seasoned as regular food. The low sodium (LS) diet may also be called a 2 gram Sodium Diet. It limits salt and salty foods such as bacon, sausage, cured meats, canned soups, salty seasonings, pickled foods, salted crackers, etc. It is used for people who may be “holding water” (edema) or who have high blood pressure, heart disease, liver disease, or first stages of kidney disease. The low fat/low cholesterol diet is used to reduce fat levels and/or treat medical conditions that interfere with how the body uses fat such as diseases of the liver, gallbladder, or pancreas. It limits fat to 50 grams or no more than 30% calories derived.

Renal diet –

• Is designed for people with kidney disease.

• Limits protein, sodium, and potassium intake to help decrease the workload on the kidneys.

• May also limit fluid intake to help control swelling and high blood pressure.

• Is based on individual needs and is planned by a registered dietitian.

Mechanical soft diet –

• Is used for people who have difficulty chewing or swallowing food due to dental problems, mouth sores, or a recent surgery.

• Foods are cooked and softened or ground to make them easier to chew and swallow.

• Includes foods such as ground meat, soft-cooked vegetables, and soft fruits.

Puree diet –

• Is used for people who have difficulty chewing and swallowing food.

• Foods are pureed or blended to a smooth consistency.

• Includes foods such as pureed meats, vegetables, and fruits.

Food allergy –

• Eliminates certain foods from the diet due to an allergy.

• Examples of food allergies include milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat.

• Requires careful reading of food labels to avoid hidden allergens.

Food intolerance – • Eliminates certain foods from the diet due to an intolerance.

• Examples of food intolerances include lactose intolerance, gluten intolerance, and fructose intolerance.

• May require supplementation with vitamins and minerals to make up for nutrients lost from the eliminated foods.

Tube feedings –

• Are used for people who cannot eat or swallow food orally.

• Nutrients are delivered through a tube that goes directly into the stomach or small intestine.

• Liquid tube feedings can be used as a supplement or as a complete replacement for meals.

• May be used short-term or long-term, depending on the individual’s needs.

Additional feedings –

• Are used to provide extra nutrition in addition to regular meals.

• Supplements may be in the form of liquid nutritional shakes.

• Nourishments may be snack foods or beverages given between meals.

• HS snacks are given as a snack food or beverage at bedtime.

In conclusion, therapeutic diets are tailored meal plans that help manage and treat specific medical conditions. They can be modified based on an individual’s nutrient needs, food allergies or intolerances, and texture preferences. Common therapeutic diets include nutrient modifications, texture modifications, food allergy or intolerance modifications, tube feedings, and additional feedings. It is important to work with a physician and registered dietitian to determine the appropriate therapeutic diet for an individual’s needs. By following a therapeutic diet, individuals can maintain, restore, or correct their nutritional status, manage weight, and control medical conditions.

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