ADVISING THE DIET

The most important advice the patient and the relatives seek from the Doctor – next of couse to medicines is the dietary advice. Unfortunately, we doctors usually tell the patients only what not to eat the patiet then goes home and ponders at every fee, as to what is allowed and what is not.

Dietary advice is also about what to eat, and not just what not to eat.

This chapter is written in the format of the doctor advising the patient, and we shall see what one can advise in commonly faced health problems.

These are the gross guidelines. Take into consideration the eating habits of the local people. (advice to eat idli may be right in the southern states, but may not go will in the North). Also consider the eating habits of the person and his family. (don’t tell a poor man to eat pudding & cheese sandwich). And then using the guidelines given below, form your own menu.

For more interested doctors, there is a diet prescription at the end of the hpater, which may be Xeroxed or printed in Local language on your letterhead. For selected patients, like Diabetes, jaundice, ulcer, IHD, typhoid etc, you may tick mark what to eat and what not to eat, and give this prescription.

Fever: viral fevers, Typhoid

“Take soft foods – Ganji (Rice or Sabu), Kheer (payasam), soft irce with milk/ghee/plain daal, Boiled vegetable (cauliflower, beet, cabbage), you may take little limepickle or papad for taste but no chillies. Don’t take any oily or fried foods. Take plenty of water and fluids every 2-3 whrs. Take plain water, limewater, coconut water or Electral water. Take milk with Horlicks or Bournivata. With the meals you may take soups, buttermilk. But avoid cold drinks, cold water, Ice-cream.

For snacks you can take plain idli with butter, Bread butter, Toast-jam, Gujarati Plain Khakra, or cornflakes. Take fruits like apple, bananas, pear, citrus fruits, watermelon. You may also take dry fruits & biscuits.”

Cough:

“Take warn or hot jobs often – like hot tea, coffee, milk or soups 5-6 times a day. Totally avoid fried foods like Wada, Samosa, Dosa Pakodas, Papad, Namkeens & Potato chips. Avoid Hotal food.

Do not take any cold drinks, cold water, ice cream, chilled food from refrigerator.  Avoid sour fruits like citrus fruits, grapes. Take sweet fruits – bananas, Papaya, Mango.

Take mainly soft diet – Rice, chapatti or Phulka, with Non-spicy vegetables, take Boiled vegetables”

Asthma:

“Avoid Deep fried foods like Samosa, Dosa Pakodas, fried Papd, Namkeens & Potato chips, Hamburgers & pizzas.

Avoid too cold foods like Ice-cream, kulfi, cold drinks.

Avoid sour foods like Non-fresh curds, sour Lassi, srikhand, Raw onion.

Avoid sour fruits like citrus fruits (Mosambi, orange, Lemon), sour grapes, important: by trial & error method keen observation, note if any particular food precipitates attak of bronchospasm. Any such food must be totally avoided.

Take a glass of warm water early morning. Take warm drinks of ten like tea, coffee, soups.

For breakfast & snacks, take Bread sandwiches, idli sheera, cornflakes, khakra, biscuits, sweet fruits like apple,papaya, Mango, Dry fuits.

For meals, have Roti, Chapati, Rice, take plenty of leafy vegetables like Palak, Methi, Cabbage, and salads like Beet, carrot, cucumber. Cooking should use minimum oil,Non-vegetarian foods may be taken only if tolerated.

Avoid heavy meals –eat small frequent  meals. and take early dinner. Avoid sleep for at least 2 hrs after meals. Emphysema patients should have early dinner at 6 pm”

Acidity, Peptic Ulcer:

Avoid periods of starvation. Take small meals every 3 hrs. do not keep the stomach empty, also do not take heavy meals. Avoid Tea & Coffee – Never on empty stomach. Milk is good – cold milk is better. Add horlicks, bournvita or kesar for taste.

For breakfast & snacks, bread or toast with jam, cheese or butter, idli sheera, cornflakes, plain Khakra. Avoid deep fried & hot foods like Samosa, Pakoda, Masala Dosa, Hamburger. You may take sweets cakes.

Avoid all chilies. Avoid chaat preparations. For meals, vegetables and other preparations should be non-spicy. Take plenty o raw and boiled vegetables. Take Rice with plain dal or milk or ghee. Take chapati, phulka or Roti. You may take Jelly, pudding or Ice-creams after meals.

Avoid sour fruits like citrus fruits, Imli, Grapes. Take sweet fruits, Dry fruits.”

When there is acute exacerbation of  peptic ulcer, patient should take absolutely bland diet. Take plenty of Cold Milk, chocolate milk shake, ice-cream, and foof without chillies like bread butter, Rice with plain dal, boiled vegetables, sweet biscuits, sweet fruits, plain idli, etc till acute phase is controlled.

Flatulence:

Avoid all oily & fried foods – Like Pakodas, Samosa, Namkeen, Potato chips,  Puri-Bhaji. Avoid tubers like Potato, sweet Potato, avoid flatulent foods like Harbara dal, chana dal, Brinjal.

Take easily digestible foods. Wheat causes flatulence in many. So Roti (Jawar) is preferred to Chapati (wheat). All preparations should be less picy. Vegetables and fruits containe fibre and should be taken in plenty. Avoid aearated drinks. Avoid paan chewing and smoking.

Avoid over eating, do not sleep immediately after food. Have a small walk after each meal.

Chronic constipation:

“Aim should be to provide more roughage in the diet. So take plenty of green vegetable like Cabbage, Cauliflower, Palak, cucumber, Lady’s finger etc.

Et plenty of fruits. Fruits with edible covers like apples, pers, (inner covers of Mosambi or orange), should preferable be eaten with cover. Eat just ripe (slightly raw) Bananas.

Take 2 tsp of ghee with warm water early in the morning.

For breakfast, take bread, toast, cornflakes.

For meals, start with plenty of Salads and Boiled vegetables, have preparations of sprouted cereals, and vegetables, with rice and Roti.

Avoid oily & fried foods. But in general, there is no restriction to taking any particular food.”

Acute diarrhea:

Principle is to take adequate quantities of water and electrolytes

Take plenty of fluids – Orolyte (Electrolyte solutions), Lime water with salt and sugar, coconut water, Black tea, Buttermilk, lsoups, Dall water, Ganji, Fruit juices, Cocum syrup.

But avoid aerated drinks. Avoid milk. Avoid chilies, avoid all deep fried foods. Take over ripe Bananas, Bread, Biscuits. Once the acute phase is controlled start on soft diet like bread, Toast, idli, sheera, cornflakes, soft rice, dry fruits, salads.

Irritable Bowel syndrome:

Eat at a leisurely pace. If in hury, eat less quantity.

Eat less quantity at a time and chew thoroughly.

Take plenty of roughage – Fruits, vegetables, salads, sprouted pulses.

Do not take Ice-cold foods and drinks. Avoid cold water from Refrigerator. Use less amount of oil in the recipes. Avoid yellow of eggs.

Jaundice:

The principle is Fat free diet. No oil, ghee, fried foods. Plenty of sweets. No alcohol. “Take Rice, wheat, Jowar, Daals.

For breakfast, you can take Toast-Jam (no butter), plain idli, Tea with skimmed milk.

For Meals, take Rice, Phulka, Daal, Kadhi, Roti, Tomato/vegetable soup. Take all vegetables but not oil or  Masalas in te preparation. For taste you can add garlic paste, or tomato gravy. Roasted Papad, After meals you can have Jelly, Custard or Fruit salad in Skimmed milk.

You can have all fruits, Fruit Juices, Glucose Biscuits, Plain popcorns, chirmure, amongst dry fruits take Dates & manuka. No eggs, meat and Non-Veg preparations. No oil, Ghee and Butter. No peanuts, Coconut, or any oil seeds.

Take boiled water for all at home, and avoid Hotel/Mess foods”

To prepare skimmed milk for Jaundice patients: Boil milk, cool & keep in fridge for 3-4 hrs, then rome all the cream. Again boil it, cool, keep in fridge, remove the cream. This is skimmed milk with negligible fat content.

IHD:

Principle is to avoid fatty foods. If there is Hypertension, avoid salt.

Avoid- Unskimmed milk, Butter, ghee, cheese.

Absolutely avoid saturated oils – like dalda, coconut oil, vanaspati oil.

Say no to: deep fried foods like puries, Pakodas, Samosa, potato French Fries, hamburger, cakes.

Avoid coconut, oil seed nuts like groundnuts, do not take yellow of egg, Red meat, Beef, Duck, Goose.

You can take limited quantity of skimmed milk. Eat more of vegetables, salads, sprouted pulsles, fruits, soups, chat (Bhel) for meals, take Rote, Phulka without oil or ghee, vegetable preparations should in no oil or minimum oil – and when used the oil should be polyunsaturated oil or unsaturated oil used alternately or in mixture. Onion Garlic are recommended. Nonveg- you can take fish, limited quantities of white of egg, lean meat where all visible fat is trimmed off.

If Hypertension, avoid Salt, Pickles, Papad, Fast Foods, Tomato Sauce, preserved tinned food, Salted Biscuits.

Tuberculosis:

Principle is High protein diet.

Take milk with protein powder added- to 3 times a day.

Have more of roti or parathas, sprouted beans and pulses.

Nonveg- have an extra egg, Meat.

Osteoporosis:

Principle is a diet rich in calcium and vitamin D.

For Calcium- take plenty of milk and milk products – like curds, cheese.

Take plenty of green leafy vegetables, amongst fruits – guava, sitaphal.

Seafood like fish is very rich in calcium.

For natural buildup of calcium it is important to have a daily walk of 15-20 minutes, and weight bearing exercises like low impact aerobic exercises, climbing stairs and running. Do not do muscle Bull-worker, for springs. (not recommended in Osteoporosis)

For Vitamin Done- take eggs, liver, spend 15 minutes in sun 2-3 times a weeks to get natural vitamin D.

Principle is to have more of proteins and calcium, and restrict intake of salt and potassium.

You can have normal quantities of Carbohydrates and Fats. So take your Rice, Roti, Chapaati, Sugar, Jaggery, Potato and vegetables.

You can have oil, ghee, butter milk products, Meat.

Since there is proteinuria, take plenty of Daals, sprouted pulses, beans, soya bean, milk and milk products, meat.

Do not take salt  in the plate as well as in cooking. Do not take salt rich foods like Pickles, Papad, Fast foods, Pizzas, Sauce, Salted Biscuits.

If Serum K+ levels are high, You should also avoid Potassium containing foods like Chocolates, Potato, Tomato, Banana, Papaya, and leafy vegetables. [To remove K+ from leafy vegetables –cut hem into small pieces, and keep in water for 2 hrs. then throw the water, and cook the vegetables.]

For calcium, take plenty of milk, amongst fruits – Guava & Sitaphal, Fish.

if serum creatinine is high, then protein intake has to be restricted.

Renal stones:

The most important thing is to drink plenty of water. Drink 2 to 2.5 liters of water or fluids every day. If you always maintain urine output of 250-300ml every 3hrs, then stone is unlikely to form.

You can have the fluid in the form of Plain water, Lemon water, Black tea, Soups tea.

Avoid excess of Milk and Milk products like Cheese, which are rich in Calcium.

In Oxalate Stones: Oxalate intake must be reduced – so do not take Tomato, and other fruits with tiny seeds like strawberries, Brinjal, (You may have the part without seeds). Avoid Phalak, Chocolates.

In Uric Acid and Cystine stones: Avoid Red Meat, and Fish.

Diet in Pregnancy:

Principle is to have a diet rich in Iron, Calcium, Minerals, and meet the increased requirement of Calories.

For iron, Eat plenty of Green leafy vegetables, Meat,

For Minerals, eat fresh Fruits regularly, For Proteins, take more of Mink with protein powder, Cereals and Legumes, Daal rice, [Nonveg – Egg, Meat]

For Calcium, take plenty of milk and milk products – like curds, cheese. Take plenty of green leafy vegetables, Amongst fruits – Guava, Sitaphal.

Diet for Vomiting of pregnancy:

Principle is to have small quantities at a time, mainly dry foods.

Avoid all fried and oily foods. No spicy and sour foods.

Take small servings of fresh fruit juices, coconut water, cold milk, ice-cream often. Take small quantities of bland dry food every half to one hour. Take Glucose biscuits, Khakra, Bread sandwich, Toast-jam, Idli, Dry fruits. During meals take soft rice or Ganji, Salads, non-spicy vegetables. Roti, Chapati, Fruits, Tea, Coffee may be taken as tolerated. Do not eat heavy meal/ Chew cardamom.

Diet for Growing Children:

Principle is to have a well balanced diet with more proteins and more Calories and good exercise.

Children in their Growing age must try to increase the quantity of food by eating half or one roti extra than their usual quota. Exercise and if needed apetisers will increase the appetite.

For Proteins, take more of Milk with protein powder or Complan, more of cereals and Legumes, Daal rice, (Nonveg – Egg, Meat)

For Minerals, eat fresh Fruits regularly,