Health diet

Hepatitis is a common medical problem, especially in the developing countries. Hepatitis can be of many types namely infective hepatitis (hepatitis A), hepatitis B, hepatitis C, hepatitis D, hepatitis E and some more, which are very rare. The commonest is hepatitis A or commonly known as infective hepatitis, which is transmitted by feco-oral route i.e. from unsafe drinking water. This disease is common in developing countries due to unavailability of safe drinking water for large number of people in developing countries.

The objectives of dietary advice in hepatitis:

1. To provide optimal nutrition.

2. To help in the regeneration of live tissue/liver cells (hepatocytes).

3. To prevent further damage to liver cells.

4. To provide symptomatic relief.

Dietary modifications during hepatitis:

Energy requirements: During hepatitis a high energy diet is advised, to maintain health and to ensure maximum protein utilization. As loss of appetite is a symptom of hepatitis, initially patient may not be able to consume enough food to maintain health. But patient should be encouraged to take more energy dense foods which he/she will be able to take gradually in increasing amount.

Proteins: Protein intake should be high in hepatitis as protein is required for regeneration of liver cells. But in case of severe hepatitis the protein intake should not be very high as the liver may not be able to handle or tolerate the high protein in food. If the liver damage is extensive the protein intake should be lower, sometimes less than normal protein intake.

Carbohydrates: High carbohydrate diet is recommended during hepatitis, as there is increased need of energy. Any source of carbohydrate can be used to provide high energy need.

Fats: The fat consumption should be less in case of hepatitis, as the digestion and absorption of fat is impaired. Fat intake should be reduced and easily digestible fats such as fat from milk, butter, cream, and eggs should be taken more in compared to fats which are difficult to digest like animal fats. But some amount of fat is required to increase the palatability of the food.

Vitamins: The requirement of all vitamins is increased in hepatitis, especially vitamin A, B, C and K. So the diet should be balanced for vitamins and if required vitamin supplementation can be given.

Minerals: The diet of hepatitis should have all the minerals required by us, especially calcium and iron. If diet can not meet the demand of minerals, they can be supplemented.

Diarrhea is a common medical problem, especially in the developing countries. One should be careful in selecting diet for diarrhea for speedy recovery. In general during severe diarrhea foods with high fiber content should be avoided, as they increase the bulk of the stool, which can affect patients’ health by increasing purging. Diet with low fiber content should be selected during diarrhea to reduce purging. Diarrhea diet also should be balanced in protein, carbohydrate, fats, vitamins and mineral.

Foods to be ideally avoided during severe diarrhea:

Whole cereals (such as whole wheat flour, but well cooked rice can be taken) and whole cereal based products, pulses, raw vegetables (especially salads) and fruits, fried foods (with high content of fats and fats are not completely digested during diarrhea), nuts, spicy foods (like pickles), milk and milk products including milk based beverages etc. should be avoided during severe diarrhea.

Vegetables to be avoided during diarrhea are peas, beans, raw vegetables such as used in salads (cabbage, cucumber, carrot etc.) etc. Fruits to be avoided during severe diarrhea are apple, cherries, pears, peaches, plums, guava etc.

Food to be taken in liberal amount during severe diarrhea:

Cereals and vegetables- Refined cereals like rice, bread, noodles, and macaroni. Vegetables like potato, eggplant etc.

Animal products- Eggs (properly boiled egg is easy to digest, but raw or improperly boiled egg is difficult to digest), chicken, fish in liberal amounts.

Fruits-Fruit juices and fruits like banana and papaya should be taken in large amounts during severe diarrhea.

Other foods to be consumed during severe diarrhea- any soup, curd (but not milk) and custard with banana should be consumed during diarrhea.

Important note:

If you are suffering from severe diarrhea drink plenty of fluid (preferably WHO or world health organization ORS available in the nearest medical store) and take blend diet frequently (at least every few hours).

A good healthy diet is essential in case of diarrhea. A proper diet and fluid replenishment will reduce severity and suffering in case of diarrhea. Diet and fluid replenishment plan will also reduce hospitalization rate as well as the cost of treatment. During diarrhea food should be taken in small quantity but more frequently, which affect patients’ health positively by maintaining adequate nutrition.

Fluid replenishment in diarrhea:

The ideal way of replenishing lost fluid in case of diarrhea is with WHO-ORS (world health organization- oral re-hydration salt/solution). This is available in all medical stores and should be taken orally after every stool or as required or it can be taken as much as you can drink (there is no problem of over hydration as seen in intravenous fluids).

Early morning breakfast:

Breakfast should consist of boiled egg, bread and butter.

Mid morning:

The mid morning food should be fresh fruit juice like orange juice.

Lunch:

The lunch during diarrhea should be with well cooked staple food (depending on the region and habit, it will vary). Lunch should consist of less fats and moderate amount of protein.

Evening snacks/tea:

It should be with lemon juice, bread etc. and coffee/tea.

Dinner:

Dinner should be with well cooked staple food, soup (tomato soup, chicken soup etc. as per the liking), boiled or grilled potato, bread etc.

Bed time:

It should be with lemon juice or orange juice.

Important points to remember during diarrhea:

1. Diet during diarrhea should be bland, soft (well cooked), less of fats and low in fiber.
2. During diarrhea frequent food in small quantity and lots of oral fluid should be taken to replace fluid loss.

Diarrhea is a common health problem, especially in the developing countries. Diarrhea along with constipation makes an enormous burden in terms of mortality, morbidity, social inconvenience, loss of work productivity, and consumption of medical resources. Worldwide more than a billion individuals suffer one or more episodes of acute diarrhea every year (including approximately 100 million in USA). Acute infectious diarrhea is still one of the most common causes of mortality (accounting for 2 to 3 million deaths per year) in developing countries, particularly among children.

Diarrhea can be defined as passage of abnormally liquid or unformed stools at an increased frequency. If stool weight is more than 200 gram per day with a typical Western diet, it also can be considered as diarrheal stool.

The objectives of diarrhea diet:

1. The main objective of diarreal diet is to maintain patients’ health and to meet nutritional requirements as well as to provide some extra nutrition that is lost due to diarrhea.
2. To replenish the water and electrolyte that is lost due to diarrhea and affect patients’ health positively.

Advice on dietary modification in diarrhea:

Energy: During diarrhea the energy requirement is increased by 10 to 20%. This is to meet the losses, to provide some extra nutrition and for overcoming weakness.

Protein: The protein requirement in diarrhea may be increased by as high as 50%. This increased requirement has to be supplied in the diet.

Carbohydrates: The carbohydrate requirement is increased in diarrhea for increasing energy need.

Fats: Fats are not completely digested during diarrhea and fat intake should be restricted. But fats in the form of butter can be taken as they are easily digested even during diarrhea.

Minerals: Foods high in iron and calcium should be taken during diarrhea, as the absorption of theses mineral is lowered during diarrhea. Other minerals salts such as sodium and potassium are lost in high amounts. To replenish this loss, oral re-hydration salt (ORS) is a simple, inexpensive and very effective treatment.

Fibers: The intake of fibers should be restricted (by avoiding high fiber diets) during diarrhea.

If a person is taking energy dense food or diet with high calorie per unit volume of food, may increase the risk of developing type-2 diabetes (which is independent of baseline obesity). Energy dense foods contain very high amount of carbohydrate and fats per volume of food, like highly processed and refined foods, fatty foods, meats, and calorie-laden fruit juices or soft drinks. High energy-dense foods contain more energy (calories) and they are also associated with weight gain and high blood sugar levels. Low energy-dense foods are fresh whole grains or cereals, fruits and vegetables, water and calorie-free drinks etc.

In Britain a study was conducted to see if high energy-dose foods increase the chances of developing diabetes. In the study researches included 21,919 men and women (who were free of diabetes, cancer, or cardiovascular disease at the beginning of the study), aged between 40 and 79 years of age. They ere divided into 2 groups, one with energy-dense diets averaged approximately 2,600 daily calories with 35-40 percent from fat (this group consumed greater amounts of meat, especially processed meat, and soft drinks, and lower quantity of fresh vegetables and fruit, and water or other calorie-free beverages) and the other group with low energy-dense diets averaged approximately 1,600 calories per day with less than 30 percent from fat (this group consumed more fresh vegetables, fruit, and calorie-free drinks, and less meats and soft drinks). Data about food habits were collected at the beginning of the study.

They were followed up for 12 years and out of 21,919 persons 725 people developed type-2 diabetes. The incidence of diabetes was 60 percent higher among high energy-dense diets in compare to low energy-dense diets.

Although there is need for more study and research, the above study clearly indicates that adoption of healthier food habit with less energy-dense diets in combination with physical activity could help prevent diabetes (especially Type-2 diabetes).

Constipation is a common and chronic problem. It is very difficult to clearly define (because of the wide range of normal bowel habits) and differentiate normal bowel habit with that of constipation. Constipation usually refers to persistent, difficult, infrequent, or seemingly incomplete defecation. Most persons have at least three bowel movements per week in Western countries and more than 5 bowel movements per week in the developing countries. But, low stool frequency alone is not the sole criterion for the diagnosis of constipation as many constipated patients have a normal frequency of defecation but complain of excessive straining, hard stools, lower abdominal fullness, or a sense of incomplete evacuation.

Advice on dietary modification in constipation:

Fibers: If you are suffering from constipation you should consume liberal amount of fibers. Fibers help the stool to be formed properly and make it easier to pass. The foods rich in fiber contents are green leafy vegetables, fruits, all types of vegetables, whole grain cereals etc. You should consume large quantities of these foods.

Fluid intake: Drinking plenty of water and other fluids is advised in constipation. It helps to soften the stool and help in defecation. 8-10 glasses of water (about 3 liters) should be taken everyday and is highly recommended. A glass of lukewarm water with lemon juice in the morning also helps.

Fatty foods: For some persons suffering from constipation, fatty foods help to relieve constipation, due to the lubricating effects of fats and also due to the stimulating effect on mucosal lining of the gastrointestinal tract.

Important points to remember in constipation:

-Consume foods with high fiber content in large quantities (this is the reason constipation is less common in developing countries as they eat non refined natural foods with high fibers).

-Take plenty of water and other fluids (preferably 3-4 liters of water daily).

-Regular moderate aerobic exercise is important in non drug management of constipation.

-Use laxatives only if absolutely necessary and do not develop habit of laxatives.

-Try to avoid refined foods as they contain very less fibers and very high calorie.

-Try to avoid strain during passing stool as it may increase the incidences of piles or hemorrhoids.

Diabetes is a disorder of carbohydrate metabolism. Two types of diabetes is generally recognized (although there are a few more uncommon types of diabetes), type I diabetes or insulin dependence diabetes mellitus (IDDM) and type II diabetes or non-insulin dependence diabetes mellitus (NIDDM). Dietary advice for both the types of diabetes is essentially the same. Diet has a very important role in treatment of diabetes and it can be used alone for management of mild cases of diabetes or diet can be used along with medications (insulin or oral hypoglycemic agents).

The objectives of diabetic diet:

• To maintain adequate nutrition and optimal patients’ health for diabetics.
• To maintain blood sugar level within normal limits.
• To bring body weight to normal (if obese) and maintain it.
• To prevent, delay or minimize the onset of chronic systemic complications of diabetes, which ultimately cause the death of the diabetic patient.

Foods to be avoided by diabetics:

Ideally a diabetic patient should avoid glucose, sugar, all types of sweets, candies, chocolates etc. and it is important for maintaining patients’ health of diabetic patient.

Foods to be restricted by diabetics:

Potatoes, sweet potatoes, yam, bananas, alcoholic drinks (especially in excess than 2 drinks per day), grapes, mangoes, fried foods (especially deep fried foods), cakes, pastries, dry fruits etc. should be taken in limited quantities.

Foods to be consumed liberally by diabetics:

Foods to be taken in large quantities by diabetics are green leafy vegetables, cucumber, radish, tomatoes, bitter gourd, buttermilk, tea and coffee (without sugar), different types of vegetables etc.

Important points to remember:

-It is very important for a diabetic to remember that he/she should control the quantity of food and time of food intake (ideally small quantity of food more frequently).

-Meals should not be missed as well as large meals should be avoided.

-Substitute craving for sweet by some fruits (preferably low carbohydrate fruits).

-Select foods of your liking and within the acceptable list of foods for diabetics.