DIETS MODIFIED IN COMPOSITION

Low calorie High calorie High protein Low protein Low fat Low cholesterol Low carbohydrate Low salt/Sodium restricted Low potassium Low purine/Purine restricted LOW CALORIE - is a diet with low calorie consumption per day. - contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids and protein. - Carbohydrate may be entirely absent, or substituted for a portion of the protein; this choice has important metabolic effects - is prescribed on a case to case basis for weight loss (eg. 3 to 5 pounds per week) in patients with Body Mass Index of 30 and above. The health care provider can recommend the diet to a patient with BMI between 27 and 30 if the medical complications the patient has due to overweight present serious health risk. HIGH CALORIE & HIGH PROTEIN A high protein and high calorie diet is made up of foods that are high in both protein and calories. Some of these health conditions include cancer, HIV, and AIDS. Other conditions that increase calorie and protein needs include wounds (such as ulcers), trauma, burns, weight loss, and malnutrition. You may also need to follow this diet to gain weight and get stronger after a surgery or illness. Adding the following to food or drinks will increase the amount of calories in the diet: One tablespoon of butter or margarine (adds 100 calories). One tablespoon of mayonnaise (adds 100 calories). One tablespoon of heavy cream or whipping cream (adds 55 calories). One tablespoon of cream cheese (adds 50 calories). One tablespoon of brown sugar, maple syrup, or honey (adds 45 calories). One tablespoon of sour cream (adds 30 calories). One tablespoon of half-and-half cream (10 to 18 percent fat) or evaporated milk (adds 20 calories). High-protein diet - Examples of high-protein foods are tofu, dairy products, fish, and meat. A high-protein diet is often recommended by bodybuilders and nutritionists to help efforts to build muscle and lose fat. High-protein foods High-protein foods are: Food Amount of protein Soy protein isolate 80g per 100g Boiled soybeans 12g per 100g Whey protein isolate 78g per 100g (Average, Varies between brands Peanuts 24g per 100g Hamburger patty 26g per 100g Steak 27 to 34g per 100g Chicken breast 31g per 100g Tuna fillet 30g per 100g Tuna, canned 26g per 100g

LOW PROTEIN - A low protein diet, a diet in which people are required to reduce their intake of protein, is used by persons with abnormal kidney or liver function to prevent worsening of their disease. - The low protein diet focuses on obtaining most of a persons daily calories from complex carbohydrates rather than from proteins. There are two main sources of protein in the diet: higher levels are found in animal products, including fish, poultry, eggs, meat, and dairy products), while lower levels are found in vegetable products (breads, cereals, rice, pasta, and dried beans). - Protein should never be completely eliminated from the diet. The amount of protein that can be - The purpose of a low protein diet is to prevent worsening of kidney or liver disease. The diet is effective because it decreases the stress on the kidney or liver. - Protein restriction lessens the protein load on the kidney or liver, which slows down the continued development of disease. Sample menu: Breakfast: 1 orange, 1 egg or egg substitute, 1/2 cup rice or creamed cereal, 1 slice whole wheat bread (toasted), 1/2 tablespoon margarine or butter, 1/2 cup whole milk, hot, non-caloric beverage, 1 tablespoon sugar (optional). Lunch: 1 ounce sliced turkey breast, 1/2 cup steamed broccoli, 1 slice whole wheat bread, 1/2 tablespoon margarine or butter, 1 apple, 1/2 cup gelatin dessert, 1 cup grape juice, hot, non-caloric beverage, 1 tablespoon sugar (optional). Mid-Afternoon Snack: 6 squares salt-free soda crackers, 1/2 tablespoon margarine or butter, 1 to 2 tablespoons jelly, 1/2 cup apple juice. Dinner: 1/2 cup tomato juice, 1 ounce beef, 1 baked potato, 1 teaspoon margarine or butter (optional), 1/2 cup steamed spinach, 1 slice whole wheat bread, 1/3 cup sherbet, 4 apricot halves, hot, non-caloric beverage. Evening Snack: 1 banana. This sample menu contains about 1850 calories, with a protein content of 8%. LOW FAT DIET - According to the USDA, a low-fat diet as the name implies is a diet that consists of little fat, especially saturated fat and cholesterol, which is thought to lead to increased blood cholesterol levels and heart attack. - It is important to know that dietary fat is needed for good health, as fats supply energy and fatty acids, in addition to supplying fat-soluble vitamins like A, D, E, and K.[ - Better for Low Cholesterol and Your Heart, says the American Heart Association - Better for Prevention of Cancers, says the World Cancer Research Fund - Better for Your Health and Weight, says the American Dietetic Association and the FDA. Saturated fats are found in high quantities in foods of animal origin. These are converted to cholesterol by the liver, and should not be over-indulged in. These fats are solid at room temperature. "Polyunsaturated" fats are generally from non-meat sources, and are better for you. However, while they do lower the bad cholesterol, they also tend to lower the good cholesterol. These fats are liquid at room temperature.

"Monounsaturated" fats not only lower the bad cholesterol, but tend to increase the good cholesterol. The U.S. Departments of Agriculture, as well as Health and Human Services has recommended the following for healthy Americans (Step 1 diet): Total fats: less than 30% of total calories -Saturated fats: less than 10% of total calories -Monounsaturated: less than 15% of total calories -Polyunsaturated: less than 10% of total calories Cholesterol: less than 300 mg daily For patients with problems with their cholesterol or who have manifest arteriosclerosis, these recommendations (Step 2 diet) become: Total fats: 25-30% of total calories -Saturated fats: less than 7% of total calories -Monounsaturated: less than 10% of total calories -Polyunsaturated: less than 10% of total calories Cholesterol: less than 200 mg daily You have to figure your calories to figure your fat intake. Your daily caloric intake to maintain your weight, depending on your activity, is: Sedentary or inactive: Your current weight in pounds multiplied by 12. Moderately active. Weight in pounds multiplied by 14. Very active: Weight in pounds multiplied by 16 to 18 Lets say you weigh 150 pounds, are moderately active, and are on a Step 1 diet. Your calorie intake should be 150 X 12 = 1800 calories. You can have 30% of your calories as fat, or about 540 calories a day. Each gram of fat contains 9 calories, so 540 divided by 9 = 60 grams of fat. Foods high in fat: Dairy foods (whole milk, ice cream, creams) Fatty red meats Butter is not only high in fat, but saturated fat as well Oils are fat, although some may have lower saturated fat. Egg yolks, which are particularly high in cholesterol. Cheese (sorry, there are some that are better than others, though) Processed meats (sausage, salami, hot dogs, bologna) Foods low in fat: Fruits Vegetables Fish and shellfish Cereals, rice Pasta Nuts and seeds Vegetable oils are preferable to butter (see below) LOW CHOLESTEROL Cholesterol in the Diet Cholesterol in the body comes from two sources. Most cholesterol is made by the liver from various nutrients and especially from ingested fats. The liver makes just about all the cholesterol the body will ever need. Since all animals can make their own cholesterol, some cholesterol in the human body comes directly from eating animal foods. These foods include meats, poultry, egg yolks, organ

meats, whole milk and milk products. This cholesterol is absorbed through the intestines and added to what the liver makes. It is also known that a diet high in saturated fat increases cholesterol production in the body. Therefore, reducing dietary cholesterol and fats helps to keep blood cholesterol levels within a healthy range. Most important of all is to significantly reduce the amount of animal meat, meat products and trans fat in the diet. Food Groups Meat, Poultry, Fish, Other Protein Choose Lean Meats: Select meats with minimal marbling. Trim away excess fat. Generally, a serving size is about the size of a deck of cards. Broil or grill to allow excess fat to drip away. Poultry: Chicken and turkey with skin removed. Avoid Fatty Meats: Corned beef, mutton, ham, bacon, luncheon meat, short ribs, spare ribs, sausage, hot dogs, scrapple, sandwich spreads, all organ meats Self basted poultry; processed poultry products such as turkey franks or bacon; chicken frankfurters, or scrapple Check with your physician or nutritionist regarding how many whole eggs per week. Any seafood that is sauteed or deep fried

Eggs: Egg whites and low cholesterol egg substitutes. Whole eggs as recommended by a physician or nutritionist. Seafood: Fish oils are particularly heart healthy. Those with the highest fish oil include swordfish, mackerel, albacore tuna, salmon, walleye, Pollack, and blue fish. Fish should be eaten at least 3 times per week. Cheese: Select low fat cheese such as cottage cheese, pot cheese, mozzarella, ricotta and Swiss. Wild Game: Elk, deer (venison), Bison, pheasant, rabbit, wild duck and squirrel Beans: Beans of almost any type, peas, lentils; tofu; peanut butter Milk: Skim, non-fat (fluid, powdered, evaporated, condensed), buttermilk, lactose-reduced and sweet Acidophilus made from skim milk Yogurt: Made from skim or non-fat milk Creamers: Only those containing polyunsaturated oils Cereals, Grains, Complex Carbohydrates Choose Cereals, Dry or Cooked: Oat cereals are particularly heart healthy. Check labels on all cereals for total calories, sugar and sodium. Cereal grains are low in saturated fat. Pasta & Rice: Noodles, spaghetti, macaroni, brown rice (preferred), wild rice

Most cheeses are high in saturated fat. Avoid cream cheese, processed cheese and cheese spreads. Domestic duck or goose Canned baked beans (sugar and extra calories added). Check labels. Any milk product made with whole or 2% milk, chocolate milk, milkshakes, eggnog, coconut milk Made from whole milk or custard style Any containing coconut or palm oils; whipped, sour, light, heavy, half & half creams Avoid Coconut containing cereals, instant hot cereals, granola

Prepared with whole eggs, cream and cheese sauces; canned or boxed noodle and macaroni dishes; canned spaghetti dishes

Baked Goods: Whole grain breads and rolls; low fat or homemade muffins, pancakes, waffles and biscuits using polyunsaturated spread or oil and non-fat milk Tortillas: Corn, soft flour made with unsaturated oils Crackers/Snacks: Unsalted crackers, pretzels, popcorn prepared with air popper or mono/polyunsaturated oil

Butter or cheese rolls and breads; croutons; commercial biscuits, muffins, pancakes, pastries, sweet rolls, donuts, croissants, popovers Soft flour tortillas made with lard, shortening, hydrogenated fats, coconut and palm oils Salted crackers or snacks; fried snack foods; any snacks or crackers containing saturated fats, coconut or palm oils, hydrogenated or partially hydrogenated fats; cheese crackers or snacks; potato chips; corn chips; tortilla chips; chow mein noodles; commercial buttered popcorn

Fruits and Vegetables Choose Avoid Vegetables: Fresh, frozen or low sodium canned; Spaghetti sauce; creamed, breaded or deep-fat low sodium tomato and vegetable juices fried vegetables; vegetables in sauces Fruit: Fresh, unsweetened dried fruits; canned or Canned or frozen packed in syrup, sweetened frozen packed in water, own juice or light syrup dried fruits, coconut, fried snack chips preferred; all fruit juices (unsweetened preferred) Fats Fats in nuts, seeds and avocado are mostly unsaturated and healthy. They are high in vitamins and minerals, but they also contain high calories and should be limited. Choose Polyunsaturated Fats: Sunflower, safflower, corn, soybean, cottonseed, sesame oils Monosaturated Fats: Canola, olive, peanut oils Spreads: Tub type vegetable spreads made with canola or other mono- or poly- unsaturated fats Salad Dressings: Olive oil and balsamic vinaigrette. Check labels for saturated or trans fats. Seeds and Nuts: Unsalted, pumpkin, sesame, sunflower and others not on avoid list Miscellaneous Choose Desserts: Homemade baked goods made with unsaturated oils or spreads, skim or 1% milk and egg substitute or egg whites; gelatin; angel food cake; ginger snaps; fruit ice, fruit whips, sorbet, sherbet; low-fat frozen desserts; puddings, custards or junkets made with non-fat milk and egg allowances Beverages: Sparkling or mineral water, seltzer, club soda - unsweetened preferred; coffee; tea; Postum Soups & Sauces: Fat-free, low-salt broth, consomme and bouillon; homemade soup Avoid Butter, lard, beef tallow, salt pork, bacon, bacon drippings, ham hock, animal fat, shortening, suet, chocolate, cocoa butter, coconut, coconut oil, palm and palm kernel oil, hydrogenated fat Hardened stick margarine or butter, any spread made with saturated or trans fat Made with saturated or trans fats, egg yolks Cashews, macadamia, pistachio, Brazil

Avoid Made with whole milk, cream, butter, chocolate and egg yolk; commercially prepared cakes, pies, cookies, pastries; ice cream; chocolate desserts; frozen cream pies; commercial dessert mixes such as cake and brownie mixes; chocolate; candies made with cream fillings Tonic, commercially or home softened water, instant cocoa mixes, Dutch processed cocoa Soup made with whole milk or cream; broth containing fat; canned soups; dehydrated soup

skimmed of fat; cream soup and sauces made with non-fat milk and fat allowance Other: Spices, herbs, pepper, lemon juice, garlic and onion powder, Tobasco, catsup, mustard, vinegar, relishes, jam, jelly, marmalade (unsweetened preferred)

mixes; bouillon not labeled low-sodium; gravy and sauces made with butter, other animal fat and whole milk Commercially fried foods, pickles, any foods containing items not allowed

LOW-CARB DIET - A low-carb diet limits carbohydrates such as bread, grains, rice, starchy vegetables and fruit and emphasizes sources of protein and fat. Many types of low-carb diets exist, each with varying restrictions on the types and amounts of carbohydrates. Examples of low-carb diets include the Atkins diet and the Zone diet. - A low-carb diet is generally used to lose weight. Typical menu In general, a low-carb diet focuses on meat, poultry, fish, eggs and some nonstarchy vegetables. A lowcarb diet excludes or limits most grains, beans, fruits, breads, sweets, pastas and starchy vegetables. Some low-carb diet plans allow fruits, vegetables and whole grains. A daily limit of 50 to 150 grams of carbohydrates is typical. Results A low-carb diet is likely to promote weight loss, at least at first. Contributing factors may include: Loss of water weight. Low-carb diets often have a diuretic effect. Increased feeling of fullness. A low-carb diet is relatively high in fat and protein. Since fat and protein take longer to digest than do carbs, you may feel fuller longer. Reduced calories. A low-carb diet strictly limits the variety of foods you eat. This generally results in fewer calories overall. A low-carb diet may also help lower your cholesterol level, as long as you choose monounsaturated and polyunsaturated fats. If you eat foods high in saturated fat which technically fit the criteria of a lowcarb diet you may actually increase your cholesterol. LOW SODIUM - A low sodium diet is a diet that includes no more than 1,500 to 2,400 mgs of sodium per day. (One teaspoon of salt has about 2,300 mg sodium.) People who follow a vigorous or moderate exercise schedule are usually advised to limit their sodium intake to 3,000 mg per day and those with moderate to severe heart failure are usually advised to limit their sodium intake to 2,000 mg per day. - The human requirement for sodium in the diet is about 69 mg per day, which is typically less than one-tenth as much as many diets "seasoned to taste". For certain people with salt-sensitive blood pressure, this extra intake may cause a negative effect on health. - A low salt diet (median of approximately 4.5 g/day - approx 1800mg Sodium) in hypertensive people resulted in a decrease in systolic blood pressure High sodium content Sodium occurs naturally in most foods. The most common form of sodium is sodium chloride, which is table salt. Milk, beets, and celery also naturally contain sodium, as does drinking water, although the amount varies depending on the source. Sodium is also added to various food products. Some of these added forms are monosodium glutamate, sodium nitrite, sodium saccharin, baking soda (sodium bicarbonate), and sodium benzoate. These are ingredients in condiments and seasonings such as Worcestershire sauce, soy sauce, onion salt, garlic salt, and bouillon cubes. Processed meats, such as

bacon, sausage, and ham, and canned soups and vegetables are all examples of foods that contain added sodium. Fast foods are generally very high in sodium. Also, processed foods such as potato chips, frozen dinners and cured meats have high sodium content. Other foods that are low in sodium include: Seasonings: Black, cayenne, or lemon pepper, mustard, some chili or hot sauces Herbs: Dried or fresh garlic, garlic/onion powder (no salt), dill, parsley, rosemary, basil, cinnamon, cloves, paprika, oregano, ginger, vinegar, cumin, nutmeg Fresh fruits and vegetables (celery, carrots, beets, spinach) Dried beans, peas, rice, lentils Macaroni, pasta, noodles, rice, barley (cooked in unsalted water) Honey, sugar Unsalted butter Unsalted dry curd cottage cheese Fresh beef, pork, lamb, fish, shrimp, egg Skim milk, yogurt Hot cereals Club soda, coffee, seltzer water, soy milk, tea Sodium Restricted Diet Plan Basic Meal Plan Sample Menu BREAKFAST 1 serving fruit or juiceList I 1/2 grapefruit 40 1 Calories Sodium Cholesterol mg. mg. Special Instructions FOR WEIGHT CONTROL * Follow a regular exercise program as directed by your physician * Avoid the use of wine, beer or other alcoholic beverages * Use only unsweetened or fresh fruits for desserts; avoid sugar, concentrated sweets, regular jelly and jams, regular soft drinks, etc. Artificial sweetener may be used * Limit breads and cereals to 4 servings per day

1 serving cereal-List I

1 cup Puffed rice cereal 1 cup enriched with

60

10

1 serving nonfat milkList II

1 cup Carnation Instant Nonfat Milk

80

115.8

1 serving fruit-List I

1 small banana

120

1 serving salt-free bread-List II

1 slice salt-free whole wheat toast

51

1 serving fat-List I

1 tsp. unsalted margarine

34

1 serving sweets-List I Beverage 2 oz. cooked fresh meat-List II 2 servings salt-free bread-List I 1 serving fat-List I

1 tsp. jam coffee or tea NOON MEAL 2 oz. unsalted roasted chicken (light meet) 2 slices salt-free white bread and 1 tsp. salt-free mayonnaise with lettuce (3 small leaves) 1 box (1 1/2 oz.) raisins 1/2 medium apple 1/2 cup Carnation Instant Nonfat Milk EVENING MEAL 1 cup chopped fresh spinach 1/2 medium tomato 2 Tbsp. oil and vinegar dressing 1 slice salt-free whole wheat bread 1 tsp. unsalted margarine 7 oz. wine

18 2 95

0.8 2 36 68 * Limit margarine and other fats to 4 servings per day * Avoid the use of potatoes or other starchy vegetables (including corn, lima beans, sweet potatoes, dried peas and beans)

124

33

1 serving vegetableList I 1 serving fruit-List I 1 serving fruit-List I 1 serving nonfat milkList II

2 124 40 80

1 12 1 115.8

5 SODIUM VARIATIONS * To convert diet to 1,000 mg. sodium, replace the 4 servings of salt-free bread with regular bread

1 serving vegetablesList I 1 serving vegetablesList I 2 servings fat-List II

14 11 166

39 1.5 1

1 serving salt-free bread-List I 1 serving fat-List I 1 serving wine-List I (optional)

61 34 173

5 10.2 * To convert diet to 2,000 mg. sodium, replace salt-free bread with 4 servings of regular bread, replace salt-free margarine with regular margarine, and replace salt-free cereal with regular cereal, 1 cup maximum

4 oz. cooked fresh meat-List II

4 oz. broiled lean steak

234

67.8

103

1 serving vegetableList I 2 servings fat-List I 1 serving vegetableList I

1 baked potato

188

2 Tbsp. sour cream 6 asparagus spears

57 18

12 1

16

1 serving vegetableList I 1 serving dessert-List I Beverage 1 serving fruit-List I

1/2 cup cooked rhubarb with sugar 1/2 cup ice cream Coffee or Tea

191

2.5 42 2 1 487 26

129 2 BEDTIME 1 medium orange 64 Total: 2255

226

LOW POTASSIUM - Potassium is a crucial component in our blood stream, and in order to avoid unwanted sideeffects, a low potassium diet should be eaten when levels need to be specifically regulated because levels are too high, and a diet rich in potassium should be followed when levels are too low. - Potassium is a mineral found in significant levels in the body's blood stream. This mineral helps regulate levels of the mineral sodium which is significant for controlling hydration of the body. Potassium is crucial to cleansing unwanted toxins from the cells of the body. - It is also essential for: Maintaining a correct blood pH Stimulating the production of insulin Maintaining digestive enzyme efficiency Ensuring optimal nerve and muscle functions Foods to Increase or Avoid Below are some common types of foods that contain potassium. If blood levels are too high and a low potassium diet is required, omit them from the diet, and if a high potassium diet is needed simply increase the intake. The first group is vegetables: Asparagus Avocado Broccoli Brussels sprouts Cauliflower Celery Mushrooms Spinach Sweet potatoes The second group is fruits: Bananas Cantaloupe melon Dried apricots Grapefruit Kiwifruit Oranges Strawberries And thirdly non-specific foods which have been identified as rich in potassium: Halibut Cod Pinto beans Soy beans

Kidney beans Natural yogurt

Potassium is a mineral that is found in many foods. It keeps the heart beating regularly, helps to maintain fluid balance, and allows the nerves and muscles to work properly. - The kidneys maintain the correct level of potassium in the blood. People who take certain medicines or who have chronic kidney disease must limit the amount of potassium in their diet to keep their potassium level close to normal. Reducing potassium levels in vegetables It is possible to remove some of the potassium in certain vegetables with high potassium levels. Leaching is a process of soaking raw or frozen vegetables in water for at least two hours before cooking to "pull" some of the potassium out of the food and into the water. You should not eat these vegetables frequently because there is still a lot of potassium in the food after leaching. Wash and then cut the raw vegetable into thin slices. Vegetables with a skin (eg, potatoes, carrots, beets, rutabagas) should be peeled before slicing. Rinse the cut vegetables in warm water. Soak the vegetables for at least two hours or overnight. Use a large amount of unsalted warm water (approximately 10 parts water to 1 part vegetables). If possible, change the water every four hours. Drain the soaking water. Rinse the vegetables again with warm water. Cook vegetables as desired, using a large amount of unsalted water (approximately 5 parts water to 1 part vegetables). Drain the cooking water. -