Diets & Nutrition

MACRONUTRIENTS

  • Carbohydrates

  • Ex: Grains, Pastas, Breads

    • Gives energy really fast

    • Complex carbohydrates: darker in color, insoluble fibers, and takes the body longer to break down: BETTER FOR BODY, not turned into simple sugars

  • Fruits, eggs, meats, veggies: low carbs

Diabetes Mellitus

  • On average they consume 60carbs per meal

  • Should eat: complex carbs

    • High proteins

    • Fruits

    • Veggies

    • Eat before exercising- when BG is highest

  • Count carbs

  • Take insulin with meals

Proteins

  • Amino acids are building blocks of our cells

  • Amino acids come from protein

  • Lower in protein: fruits and veggies

  • High protein diet when the body needs to heal

    • Cystic fibrosis

  • Low protein diet for kidney disease

    • EXCEPT for nephrotic syndrome

Fats

  • Good and bad fats

  • Unsaturated fats = GOOD: olive oil nuts

  • Saturated fats = BAD: butter, red meat, vegetable oil

VITAMINS & KEY MINERALS

Vitamins

  • Vitamin C: Ex, Citrus fruits, strawberries Use: Healing

  • Vitamin D Ex, Fortified milk and cereal, Use: Absorption of calcium

  • Vitamin K Ex, Leafy Greens Use: Warfarin antidote

  • Vitamin B12 Ex. Protein, dairy, eggs Use: Prevents B12 deficiency anemia

  • Folic acid Ex, Dark green veggies, legumes, nuts Use: Prevents neural tube defects, Prevents deficiency anemia

  • Iron Ex, Meat, eggs, leafy greens Use: Prevent iron deficiency anemia

High Potassium Diet

  • Low potassium levels

    • K<3.5

    • EKG Changes

  • K wasting diuretic

    • Loop furosemide

    • Thiazide

  • Cushings disease

  • Vomiting, Diarrhea, NGT to suction

  • Hyperinsulinsim

Low Potassium Diet

  • High Potassium

    • K>5

    • EKG changes

  • K sparing diuretic

    • Spironolactone

  • Addison’s disease

  • Renal Failure

  • DKA

CALCIUM FOODS

  • Cheese, Leafy green veggies, soy milk, tofu , almonds

High Calcium diet

  • Ca<9

  • Renal failure

  • Malnutrition

    • Alcoholism

    • Bulimia nervosa

    • Vitamin D deficiency

  • Malabsorption

  • Hypoparathyroidism

  • Hyperphatemia

Low Calcium diet

  • Ca>10.5

  • Cancer of bones

  • Steroids

  • Immboility

  • Hyperparathyrodism

  • Hypophosatemia

Phosphorus

  • Chocolate. Cola, Dairy, Nuts, Beans, Meat, Grains seeds

High Phosphorus diet

  • Low phosphorus lvls

    • phos <2

  • Starvation

  • Malnutrition

  • Re-feeding syndrome

  • Tpn

  • Hyperparathyroidism

Low Phosphorus diet

  • High phsophorus levels

    • Phos>4.5

  • Renal failure

  • Tumor lysis syndrome - tumor releases its content

  • hypoparathyroidism

Foods high in sodium

  • Soy sauce, Table salt, condiments, canned food, processed meat, popcorn

High sodium diet

  • Addison’s disease/Crisis

  • Hyponatremia

Low sodium diet

  • Heart failure

  • High blood pressure

  • Cirrhosis

  • Edema

  • Glomerulonephrisits

  • Nephrotic syndrome

THERAPEUTIC & SPECIALITY DIETS

DASH - Dietary Approaches to Stop Hypertension

  • Low: SODIUM & FAT

  • High: CALCIUM - relaxes peripheral vasculature, Potassium, Fiber

Heart Healthy Diet

  • Goal: Redice caloric intake to achieve/maintain ideal body weight

  • Used in

    • Heat disease

    • MI

    • High cholesterol

    • High BMI

    • Metabolic syndrome

    • CAD

  • LOW: FAT AND SODIUM

  • HIGH: non starchy veggies, complex carbs, and high lean protein diet (chicken and fish)

Renal Diet

  • Body is unable to regulate fluids and electrolytes

  • Fluid restriction

  • low electrolytes

  • low protein

    • Body can no longer clear urea

  • Specifics may depend on their treatment

BROW

  • Barley, rye, oats, and wheat

  • Foods with gluten

  • For patients with celiacs, can cause gi distress

Ketogenic diet

  • Control of epilepsy

  • High fat, adequate protein

  • Low carbohydrate diet

  • The body has so few carbs to use for energy, it burns fat, and develops ketones.

DIETARY RX & PROGRESSION

Diet Orders

  • NPO; nothing by mouth

    • Pre-op

    • Postop before bowel sounds return

  • After NPO, they get advanced to Clear liquids

  • Clear Liquids: diets consist of foods and liquids that are transparent to light and are liquid when at body temperature

    • Best for clients who have not had oral intake for some time, and for the first time, a client eats after complete bowel rest

  • Should be able to see through it. no chunks

    • Water, juice w/o pulp, geltain, tea, or coffee

  • Clear to FULL LIQUIDs

  • Full Liquids;

    • Ice cream, strained soups, sherbert, jello, milk, pudding, custards, refiined cooked cereals