|
The alteration of the normal diet requires an appreciation of
- The underlying disease conditions which require a change in the diet;
- The possible duration of the disease;
- The factors in the diet which must be altered to overcome these conditions; and
- The patient’s tolerance for food by mouth. In planning meals for a patient his economic status, his food preferences, his occupation and time of meals should also be considered.
The normal diet may be modified
- To provide change in consistency as in fluid and soft diets;
- To increase or decrease the energy value;
- To include greater or lesser amounts of one or more nutrients, for example, high protein, low sodium, etc;
- To increase or decrease bulk-high and low fibre diets; and
- To provide foods bland in flavour.
The planning of a therapeutic diet implies the ability to adopt the principles of normal nutrition to the various regimens for adequacy, correctness, economy and palatability. It requires recognition of the need for dietary supplements such as vitamin and mineral concentrates when the nature of the diet itself imposes severe restrictions, the patient’s appetite is poor, absorption and utilization are impaired so and the diet cannot meet the needs of optimum nutrition.
Dietary history should help in planning each diet. The dietary history reveals the patient’s past habits of eating with respect to dietary adequacy, likes and dislikes, meal hours, where meals are eaten, budgetary problems, ability to obtain and prepare foods. The likes and dislikes of patients are respected because food habits are deep-seated and it is not possible to change them overnight. It requires considerable encouragement and understanding on the part of the doctor-nurse-dietician team to bring about important changes in the diet. Intelligent planning of therapeutic diets necessitates consideration of food costs, the avoidance of waste, and retention of nutrients so that the diet is economically practicable.
|
Participants