1.  Nutrition: It is defined as the science of food
and its relationship to health.
 Dietetics: It is the practical application of the
principles of nutritions ,it includes the planning
of meals for the well and the sick.

2. What are nutrients?
 Essential substances that your body needs in
order to grow and stay healthy.

3.  Macronutrients
 Water
 Amino Acids and Proteins
 Lipids
 Carbohydrates
 Micronutrients
 Vitamins (B, C, A, D, E, K)
 Minerals (Fe, Ca, P, Na, K)

4.  A balanced diet is one which contains different types of
foods in such quantities and proportions, so that the
for calories , proteins ,minerals and vitamins and other
nutrients is adequately met and a small provision is
made for nutrients to withstand short duration of
leanness.

5.  Reach and maintain ideal body weight
 Be careful of serving sizes
 Avoid skipping meals
 Increase your daily activity
 Preserve lean body mass

6.  Infective hepatitis:
 A high protein ,high carbohydrate,moderate fat
is recommended.
 Small attractive meals regular intervals are
better.
 Overfeeding should be avoided.

7.  Proteins :1.5 – 2g/kg bw.
 High carbohydrate diet (appox 300-
400g/day).
 Moderate amount of fat in the diet to make
food palatable,no need to totally avoid
dietary fat.
 Vitamins to regenerate liver cells,500 mg of
vit c,10 mg of vit k,and supplements of b
complex for daily needs.
 No alcohol intake.

8.  Energy:35-40 kcals/kg IBW.
 Carbohydrates:65-70% more of simple
carbohydrates,complex sugar to be avoided.
 Proteins:1.2-1.5 gm/kg IBW.
 Fats:mild to moderate fats are given.
 Fibre:avoid roughage,give soft cooked
vegetables and non citrus fruits.
 No restriction of salt

9.  Energy of 2000-2500kcals
 Proteins 1.2 g/kg of body weight
 Fat:20g of fat is given,
 Low sodium diet,400-800mg/day
 Carbohydrates should be given liberally so that
liver may store glycogen

10.  RENAL DISEASES

11.  Fluids:during the first stage ot treatment fluid
should be decreased,to allow disperal of
oedema.
 In later stage fluid replacement should be 500
ml plus daily amount excreted in urine.
 Energy: 1800-2000 kcals are given like
sugar,honey,glucose,sago,and starchy foods.

12.  Protein:if the blood urea nitrogen is elevated
and oliguria is present dietary proteins are
restricted.rice is preferable as it have low
amount of protein than wheat.
 Sodium:restrition of sodium varies with the
degree of oliguria and hypertension,if renal
function is impaired ,sodium will be restricted
500-1000 mg/day.

13.  As the patient in nephrotic syndrome are often
malnourised and wasted, have poor appetite.
 Calorie is high 2000kcals
 Protein is 0.8g/kg of high biological value.and
1 gm of protein per gram of protein loss is
advocated.
 Salt intake should be restricted to 500-750 mg
per 24 hours.
 Restriction of fluid is necessary if oliguria is
present.

14.  Potassium supplements is essential with
vitamin c supplements


16.  Energy:minimum of 600-1000kcal is necessary.
 Protein :all foods containing protein are
stopped if the patient is under conservative
treatment and blood urea nitrogen is rising.
 Carbohydrates: minimum of 100g/day is
essential to minimise tissue breakdown.,if
patient is not fed by mouth,a nasogastric tube
feeding is done 700ml of 15 % glucose.

17.  Potassium : its intoxication occurs with a daily
rise of 0.7 mEq serum potassium.potassium
rich sources like tomato juice,coffee,tea,cocoa
are avoided.

18.  Energy:it is important to provide calories to
enhance positive protein metabolism,in adults
35-50 kcal/kg is given.
 Protein:falling kidneys need to be given rest
protein intake is reduced to 0.5g/kg body
weight per day.
 Fluids:volume of daily urine plus 500ml.
 Potassium:has to be restricted to 1mmol/kg of
body weight.

19.  Adequate fluid intake to ensure urine output of
2 litre or more per day
 Restrict foods rich in calcium and oxaltes
 Calcium rich foods
are:beans,caulliflower,milk,and milk products.
 Oxalates:chickoo,spinach,tea,tomato,beef,choco
lates,cashew nut

21.  proteins- normal diet
 Fats :dietary cholesterol needs to be reduced in
the presence of hypercholesterolemia ,the total
allowance of dietary fat remains unchanged.
 It should between saturated ,polyunsatrated
and monounsaturated fatty acids(30,40,30%)

22.  Rich dietary sources of saturated fat,high in
cholesterol: animal fats:beef,meat,pork organ
meat fats milk,cream ,butter,ghee,egg yolk.
 Hydrogenated vegetable oil eg: margarine and
vegetable ghee.
 Diets containing unsaturated fats(low
cholestrol diet are not restricted,vegetable oils
high in polysaturated faaty acids are
safflower,sunflower,groundnut,cottonseed oils.

23.  Calories –about 20 kcal/kg of ideal body
weight for sedentary worker,and 25 kcal/kg
moderately worker.
 Protein:normal protein 50-60g are required for
a person with optimum weight and mild
hypertension,in severe hypertension with renal
insufficiency protein should be restricted to
20g.
 Fats:high intake of animal and hydrogenated
oils are discouraged.about 20 g of vegetables
oil is permitted.

24.  Carbohydrates should constitute the major
bulk of calories.
 Vitamins in normal amount.
 Minerals sodium is restricted to 4 to 6 / day.

25.  Morning 1 cup tea with 1 tea spoon sugar and 2
table spoon milk
 Breakfast:4 slices bread ,1 cup milk,no sugar,1
glass buttermilk.
 Lunch:2 medium size chapatis,or 1 medium
katori rice ,1 medium katori dal ,1 medium
katori vegetables

26.  16.00 hours 1 cup tea with 1 teaspoon sugar,2
toasts.
 Dinner:2 medium size chapatis,1 medium
katori vegetables,1 medium katori dal.
 Bedtime 1 cup skimmed milk ,no sugar .
 Allowance of fats and oils per day:20 g this diet
provides 1320 calories , carbohydrates 198 g
protein,protein 51g fats 40 g.

27.  Energy:adult with a good nutritional status
needs about 2000kcal,a malnourised patient
may require 3000-4000 kcal depending on
degree of malnutrition.
 Protein: A protein amount of 80-100 g to meet
maintenance needs to ensure anabolism.
 Vitamins:vit A, vit C and vit E,
 Fibre diet should be increased
 Fats :less than 30% of total calories,avoid
saturated fats.

28. A low calories and fat,high in fibre is recommended.
Some guidelines for obese patients :
1)Set realistic short term and long term goals.
2)Avoid fasting or feasting/skipping of meals.
3)Always eat breakast with good choice of cereals.

29.  Do not sleep,immediately after eating.
 Thoroughly chew each and every morsel of
food.
 Avoid alcohol and follow dietary
recommendations.
 Physical exercise is a must to burn away
excessive fat.

30.  Energy:a low calorie diet of atleast 1,200
kcal/day is considered safest and most
effective.
 Proteins:intake of 1g/kg of ideal body weight.
 Fats:a minimum level of 15-20g visible fat
should be maintained in diet to provide
palatability and essetial fatty acid requirement.

31.  Carbohydrates:high carbohydrates foods contents like
potatos , rice are restricted. fruits rich in carbohydrates
are avoided.
 Vitamins:with prolonged restriction of fats,there is
restricted fat soluble vitamin A and vitamin D which
may be supplemented.
 Minerls:restriction of sodium as comman salt is
helpful.
 High fibre diet: high fibre low calorie foods like green
leafy vegetables,fruits,vegetable salads,whole grains
cereals and pulses can be included in the diet.

33.  Diet to restrict foods,beverages that may cause gastric
irritation or stimulate excesssive gastric acid secretion.
 Energy:35 to 40 kcal/kg is given.
 Proteins :it have buffering effect.milk proteins
considered better and do not irriatate gastric
mucosa.1.2gm/kg IBW is provided.
 Fats:it delays gastric emptying and help in meeting the
caloric requirement.avoid fried snacks.

34.  Vitamins and minerals:adequate vitamin c and iron is
necessary for proper healing.
 Fibres:raw vegetables,leafy vegetables,fruits(peel)
irritates mucosal lining.
 Foods to
avoid:alcohol,coffee,spies,caffeine,spies,pickles,vinegar
,garlic,onions.

35.  A low in fat and purine,high carbohydrate diet is
advised to decrease elevated blood uric acid level.
 Energy:ajusted to 500kcal
 Carbohydrates:liberal use of fruits and vegetables and
soluble fibre is helpful.
 Protein:skimmed milk and its products should be
used.
 Fats :a low fat diet will promote weight reduction

36.  Fluids:liberal intake in the form of thin
buttermilk,vegetable soup, will facilitate urinary
excretion of accumulated uric acid and prevent
formation of calculi.
 Foods to avoid:alcohol,sweet
breads,sardines,liver,chicken,ham,musroom.meat,custa
rd apple.

37.  The diet is designed to improve blood glucose and
lipid levels,to encourage healthy eating
pattens,promote consistent food intake and avoid
undue starvation or overeating.Out of the total calroies
provided 60% from carbohydrate,20% proteins,20%fats
 Energy:calories by IBW ideal body weight,and waist-
hip ratio.
 For overweight 20kcal/kg/day IBW
 For underweight 40kcal/kg/day IBW
 For ideal weight: 25kcal/kg/day IBW

38.  For pregnant diabetic woman:30-35 kcal/kg/day IBW.
 Small , frequent meals, avoiding load to the pancreas.
 Carbohydrates:the daily intake of carbohydrates
should range from 100g to 240-260g.Avoidence of
simple cabohydrates like sugar,jaggery,honey.
 And complex carbohydrates can be given as they do
not raise sugar quickly.

39.  Proteins:1 gm/kg is the recommended dietary
allowance,skimmed milk amd milk products except
(cream,butter),dals,pulses,nuts,fish, are good sources of
proteins.
 Fats:A diet of 15-20 gms of visible fats in limited
quantities are given.vegetables fats such as sunflower
oil,safflower oil, corn oil,contains a high proportion of
polyunsaturated fatty acids which are helpful in
controling cholestrol levels.

40. Fibre: dietary fibre is beneficial in type 1 and type 2 DM.
fibre present in vegetables,certain
fruits,legumes,fenugreek seeds are effective in
controlling blood sugar and serum lipid levels.
Patients with insulin dependent diabetes must eat
multiple meals to avoid hypoglycemia.

41.  Frequent, Small Meals are given.
 A high energy, high protein and low
carbohydrate is given in COPD.
 vitamins : vitamin A and vitamin E are
recommended as they are good source of
antioxidants.