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27 June 2019

ICDS Supervisor Exam Kerala PSC |Diet in Different Diseases Part 1|ICDS Supervisor Study Materials

ICDS Supervisor Exam Kerala PSC |Diet in Different Diseases|ICDS Supervisor Study Materials

Diet in Different Diseases part 1

1. Fever

Fever is an elevation in body temperature above the normal.

Fever are of three types:
i. Short duration fever (eg) typhoid, influenza,
ii. Chronic fever (eg) tuberculosis
iii. Intermittent fever (eg) malaria.

General Dietary Considerations

Energy: A high calorie diet is prescribed because there is increase
in the metabolic rate. Around 2500 - 3000 calories is prescribed.

Protein: About 80 – 100g of protein is prescribed. 
High protein beverages may be used as supplements to the regular meals.

Fats: Fried foods and highly concentrated foods are avoided because it cannot be digested easily.

Vitamins: Fevers apparently increase the requirement for Vitamin
A, B Complex vitamins and Vitamin C.

Fluid: The fluid intake must be liberal to compensate for the losses
from the sweat. 2500 - 5000ml is necessary, including soups, fruit
juices and water.

Bland, readily digested food and soft foods should be given to
facilitate digestion and rapid absorption.

 Small quantities of food at regular intervals of 2 - 3 hours will permit adequate nutrition without overtaxing the digestive system at any time.

 Foods to be Included: Fruit juices with glucose, coconut water, barley water, custards and cereal gruels.

Foods to be Avoided: Oily foods, ghee, spices, fried foods and rich

2. Peptic Ulcer

The term peptic ulcer is used to describe any localized erosion of
the mucosal lining of those portions of the alimentary tract that come in contact with gastric juice.

 The symptoms of peptic ulcer are epigastric pain, discomfort and gas formation in the upper part of abdomen, weight loss and iron deficiency anaemia.

Dietary Guidelines

1. Bland diet, which consists of mechanically, chemically and thermally non-irritating foods should be given.

2. Moderate use of seasonings is permitted.

3. Regularity of meal times is essential. Small frequent meals are given.

4. In between meals, protein rich snacks should be taken.

5. Meals should be eaten in a relaxed atmosphere and the person
should forget personal or family problems while eating.

6. Foods should be eaten slowly and chewed well.

7. Milk and cream can be included because it helps in healing of
the ulcer.

8. High protein foods should be included because it helps in healing
of the ulcer.

Foods to be Included: Milk, cream, butter, custards and well cooked cereals.

Foods to be Avoided: Strong tea, coffee, alcohols, pickles, spices
and condiments and fried foods.

3. Diarrhoea

Diarrhoea is the passage of stools with increased frequency, fluidity or volume compared to the usual for a given individual.

Nutritional care includes the replacement of lost fluids and electrolytes by increasing the oral intake of fluids, particularly those high in sodium and potassium such as soups and juices.

Oral Rehydration Solution (ORS) is given which is made by mixing one glass of boiled cooled water with one pinch of salt and one teaspoon of sugar. 

When the diarrhoea stops, starchy foods like rice, potato and plain cereals can be given followed by protein foods. 

Fat need not be limited if the individual is otherwise healthy.

4. Liver Diseases

Liver is a vital organ, which secretes bile and takes part in the metabolism of carbohydrates, fats and proteins and in many other vital metabolic processes. 

The diseases of the liver include:

i. Infective Hepatitis
This is otherwise called as viral hepatitis. The symptoms include
anorexia, fever, headache, rapid weight loss, abdominal discomfort
and jaundice, (ie) yellow discolouration of the skin and body tissues.

ii. Cirrhosis of Liver

Cirrhosis is a condition in which there is destruction of the liver cell due to viral infection, alcohol and toxins


anorexia, nausea, vomiting, pain, muscle cramps, weight loss, fever, jaundice and ascites. i.e. accumulation of fluid in the

iii. Hepatic Coma

This results from entrance of certain nitrogen containing substances
such as ammonia into the cerebral circulation without being metabolized by the liver. 

The precipitating factors are gastro intestinal bleeding, severe
infections, surgical procedures and excessive dietary protein. 

The symptoms include confusion, restlessness, irritability, inappropriate behaviour and drowsiness. 

Treatment consists of dietary protein restriction and increased calorie intake.

Dietary management of hepatitis and cirrhosis

Energy: A high calorie diet is prescribed. The calorie requirement is between 2000 - 2500 calories.

Proteins: Protein requirement varies according to the severity of the disesase. 

In severe jaundice 40g is given while in mild jaundice 60 - 80g of protein is permitted.

Fats: About 20g of fat is given. Coconut oil, which contains medium chain fatty acids are given because it does not require bile acids for digestion.

Carbohydrates: High Carbohydrate content in the diet is essential to supply enough calories so that tissue proteins are not broken down for energy purposes.

Vitamins: They are essential to regenerate liver cells. Vitamin
supplementation is essential for patients with liver diseases.

Foods Included: Cereal porridge, bread, rice, skimmed milk, fruit
juices, biscuits and non stimulant beverages.

Foods Avided: Pulses, bakery products, concentrated sweets, fried
foods, whole milk and cream

5. Heart Diseases

Heart disease affects people of all ages, but is most often caused
by atherosclerosis. 

 atherosclerosis :condition in which lipids are deposited in the intima of blood vessels.

The important contributory causes for the development of
atherosclerosis are
  • High calorie intake
  •  High saturated fat and cholesterol intake.
  •  Increased level of cholesterol in blood.
  •  Sedentary life.
  •  Stress and strain.

Dietary Management

The objective are maximum rest for the heart and maintenance of
good nutrition.

Principles of Diet

Energy : The calorie intake should be just adequate to meet the

For obese patients, it may be necessary to reduce
calorie intake.

Fats :
Fats should be restricted to not more than 20% of the total calories

The diet should consists of polyunsaturated fatty acids, (eg)sunflower oil.

The diet should contain adequate amount of proteins and vitamins.
Fishes are a good source of n-3 fatty acids. 

Consumption of 100 - 200g of fish 2-3 times a week helps to prevent heart disease.

Three or four smaller meals are suggested instead of two big meals.

Regular exercise and relaxed mental attitude help to reduce blood
pressure. Smoking and drinking of alcohol should be stopped.

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