There are many types of therapeutic diets, they are specialized diets designed to address specific medical conditions and improve health outcomes. From heart-healthy diets aiding in cardiovascular disease management to diabetic diets for blood sugar control.
These diets play a vital role in patient care and chronic disease management. While advocating for diet liberalization is important in malnutrition prevention, there are certain people that need a therapeutic diet.
Here’s the top therapeutic diets currently used, and when you should be using them
Types of Therapeutic Diets
|Diet Name||Why Someone Needs It||Foods Allowed||Foods Not Encouraged|
|Heart-Healthy Diet||Heart disease, hypertension, high cholesterol, post-cardiac surgery||Oats, brown rice, skinless poultry, fish (especially omega-3-rich like salmon), nuts, seeds, olive oil, plenty of fruits (like berries, apples) and vegetables (like spinach, carrots)||Trans fats (found in some processed foods), high-sodium foods (like canned soups), red meats, sugary treats, full-fat dairy|
|Diabetic Diet||Diabetes (Type 1 and 2), prediabetes, insulin resistance||Fiber-rich whole grains (quinoa, barley), lean proteins (chicken, fish), non-starchy vegetables (broccoli, cucumbers), low-glycemic fruits (berries, apples), legumes||Sugary desserts, white bread, pasta made with white flour, sugary cereals, fruit juices|
|Renal Diet||Chronic kidney disease, kidney stones||Cauliflower, blueberries, garlic, buckwheat, olive oil, egg whites||High potassium foods (bananas, oranges), high phosphorus foods (dairy, whole grains), processed foods with added salts, certain dark-colored sodas|
|Low Sodium Diet||Hypertension, heart failure, kidney disease, liver cirrhosis||Fresh vegetables and fruits, unsalted nuts, grains like rice and pasta, fresh meats, herbs and spices for flavor||Deli meats, canned soups and vegetables, salted snacks, pre-packaged meals, condiments like soy sauce and ketchup|
|Gluten-Free Diet||Celiac disease, non-celiac gluten sensitivity, wheat allergy||Gluten-free grains (rice, quinoa, corn), most dairy products, fresh meats and fish, fruits and vegetables, nuts and seeds||Anything containing wheat, barley, rye, and their derivatives; certain processed foods, beers, and malt beverages|
|Low Residue Diet||Inflammatory bowel disease, Crohn’s disease, ulcerative colitis, diverticulitis||White bread and pasta, white rice, well-cooked vegetables without skin or seeds, canned fruits.||Whole grains, raw fruits and vegetables, nuts, seeds, popcorn, dried fruits|
|High Fiber Diet||Constipation, irritable bowel syndrome, diverticulosis||Whole grains (whole wheat bread, brown rice), legumes (beans, lentils), fruits (apples, pears), vegetables (carrots, broccoli), nuts, and seeds||Processed foods low in fiber, white bread, non-whole grain cereals, canned fruits and vegetables|
|High Calorie, High Protein Diet||Malnutrition, cancer, certain infections, wound healing, muscle wasting||Lean meats, dairy products (milk, cheese), nuts and nut butters, seeds, legumes, whole grains, avocado||Low-calorie foods, diet beverages, foods low in protein such as rice cakes, plain salads without protein|
|Lactose-Free Diet||Lactose intolerance, certain digestive disorders||Lactose-free milk and dairy products, non-dairy milks (almond, soy, rice), lactose-free yogurts and cheeses, meats, grains, fruits and vegetables||Regular milk, standard dairy products like cheese and yogurt, anything containing lactose or milk derivatives|
Types of Altered Texture Diets
|Level Number||Name||Why Someone Needs This Diet||Foods Allowed|
|7||Regular||No dysphagia or mild dysphagia||Standard diet with no modification|
|6||Soft and Bite-Sized||Moderate dysphagia, difficulty chewing||Soft, moist foods easily formed into a bolus|
|5||Minced and Moist||More pronounced chewing difficulties||Small, minced, moist foods like ground meats, soft-cooked vegetables|
|4||Pureed||Severe dysphagia, poor oral phase abilities||Smooth, homogeneous foods like pureed fruits, vegetables, and meats|
|3||Liquidized||Difficulty managing semi-solid foods||Foods pureed and thinned to a liquid consistency|
|2||Mildly Thick||Need for slightly slower-moving liquids||Liquids thickened to a mildly thick consistency|
|1||Slightly Thick||Mild difficulty with thin liquids||Liquids thickened to a slightly thick consistency|
|0||Thin Liquids||No difficulty with swallowing thin liquids||Regular liquids like water, tea, coffee|
Ways to Liberalize Diets
|Diet Name||Standard Restrictions||Ways to Liberalize|
|Heart-Healthy Diet||Low in saturated fats, trans fats, cholesterol, sodium||Introduce occasional meals with lean cuts of red meat, use moderate amounts of healthy fats like olive oil, allow controlled portions of dark chocolate for heart health|
|Diabetic Diet||Controlled carbohydrates, low sugar, balanced meals||Incorporate more variety of fruits (even those with medium glycemic index), allow occasional treats with a focus on portion control, and balance with other meal components|
|Renal Diet||Low potassium, low phosphorus, controlled protein||Increase the variety of fruits and vegetables with careful monitoring of potassium levels, add small amounts of whole grains, introduce more proteins|
|Low Sodium Diet||Very low salt, avoidance of processed foods||Use of herbs and spices to enhance flavor without adding salt, occasional inclusion of low-sodium processed foods, slight increase in salt in cooking|
|Gluten-Free Diet||No gluten (found in wheat, barley, rye)||For non-celiac gluten sensitivity (not for celiac disease), trial inclusion of low-gluten grains like oats, explore more gluten-free processed foods for variety|
|Low Residue Diet||Limited fiber, low residue foods||Gradually introduce more cooked fruits and vegetables, incorporate low-fiber whole grains, allow for more variety in protein sources|
|High Fiber Diet||High in fiber-rich foods, whole grains, fruits, and vegetables||Include occasional refined grains for variety, introduce more processed foods that are still high in fiber, allow for some lower-fiber fruits and vegetables|
|High Calorie, High Protein Diet||High in calories and protein, often with nutrient-dense foods||Introduce more variety in high-calorie foods including healthy desserts, use of protein supplements in creative ways (like smoothies), add more diverse fat sources like nuts and avocados|
|Lactose-Free Diet||No lactose-containing foods (found in many dairy products)||For those with lactose intolerance, trial small amounts of lactose-containing foods, introduce lactose-reduced dairy products, explore a wider range of lactose-free alternatives|
The Importance of Therapeutic Diets
So there you have it, but let’s remember that when it comes to therapeutic diets, especially for our older adult and elderly patients, it’s not just about the strict guidelines. As dietitians, our role extends to making these diets not only nutritionally adequate but also appealing and improving quality of life.
Liberalizing these diets, while maintaining their effectiveness, is key in this demographic. They need diets that are manageable, enjoyable, and respectful of their long-held eating habits and preferences. After all, we’re aiming for them to enjoy food and prevent malnutrition.
By combining our nutritional expertise with a genuine understanding of the unique challenges and preferences of the elderly, we can tailor these diets to be a positive, sustainable part of their daily routine.
Here’s to creating therapeutic diets that are not just medically beneficial but also a source of comfort and enjoyment in their golden years!
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Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.