Lesson Note

Subject: Food And Nutrition
Topic: Special Diets
Lesson Objectives: by the end of the lesson, the learners should be able to:
1. Define the term “Special Diet”;
2. Identify the Diets for certain individuals with health conditions;
3. Prepare special diets for family member who may be under health condition discussed in this lesson.
Instructional Materials: for easy understanding, teachers should take different food items under the various categories of special diet. If possible, show pictures of these foods in the case of classroom learning.

Lesson Summary

What are special diets?
Special diets are meals prepare for certain individuals with one health challenge or the other. Some individuals without health conditions may decide to go for special diets strictly to improve health or prevent certain health problems from occuring. There are different categories of special diets based on individuals and health conditions. They are discussed as follows:

1. Vegetarian Diets

Vegetarians are those people who neither eat animal flesh nor fish. There are three types of vegetarian. They are:

  • Lacto-ovo-Vegetarians: These are people who do not eat the flesh of animals, fish or poultry but take milk and milk products and eggs in addition to vegetables which they consume in generous amounts.
  • Lacto Vegetarians: These people do not eat the flesh of animals, fish, poultry or eggs. However, they take milk and milk products together with vegetables.
  • Strict Vegetarians: These people are also known as vegans. They do not eat the flesh of animals, poultry and fish as well as all the animal or diary products. They eat only vegetables i.e. plant foods.

While it is easy to plan a balanced diet for the lacto-ovo and lacto-vegetarians because of the inclusion of eggs, milk, and milk products respectively in their diets, it is not easy to plan a balanced diet for a vegan. Since vegans depend solely on plant foods, their diet may lack some of the essential amino acids and vitamins which can only be obtained from animal foods. However, through a careful planning and judicious combination of different plant foods, a fairly balanced diet can be prepared. For example, combination ot cereals,legumes and leafy vegetables will produce a balanced diet. Vegetarians should also consume adequate fresh fruits. For the lacto and lacto-ovo vegetarians the consumption of milk and milk products plus eggS respectively will make their diets balanced.

Sources of protein can be:
Pulses e.g. peas, bEans, soya beans etc.
Cereals e.g. rice, maize, millet etc
Nuts e.B groundnuts, walnuts, chestnut etc.
Sources of Fats can be:
Nuts eg. groundnuts, coconut, palm kernel.
Sources of Vitamins and minerals can be:
Legumes or pulses
Fresh fruits and vegetables e.g cabbage, spinach, waterleaf, okro, citrus, etc.

Sources of Carbohydrates can be:
Tubers e g. yams, cocoyam, potatoes, etc
Cereal e.g. rice, maize, sorghum, millet, etc.
Additional proteins, vitamins and minerals can be obtained from milk, milk products and eggs for the lacto and lacto-ovo vegetarians respcclively.

Menu for the Different Types of Vegetarians

Rice
Green beans
Egg stew
Fruit salad and custard sauce
Boiled yam or plantain
Vegetables stew with or without eggs
Rice pudding
Fried plantain
Beans
Vegetable stew

2. Invalid and Convalescent Diets

An invalid is a sick person that is confined to bed while a convalescent is someone recovering or has just recovered from an illness. In both cases, they have very weak intestines. Therefore their diets must be easily digestible. They need plenty of protein, vitamins and minerals as well as energy foods. Though fat is a highly concentrated form of energy, it is easily digested and therefore should not be given to the invalid or to the convalescent.
Appropriate methods of cooking such as stewing, boiling and steaming that will make the food easily digestible must be used.

Some Suggested Meals For Invalids And Convalescents.

1. Milk flavoured with ovaltine or any beverage.
2. Egg lightly boiled.
3. Moinmoin (bean pudding) with pap.
4. Soups e.g. meat, fish or vegetable.
5. Mashedyam/potato/cocoyam cassava
6. Milk pudding including custards.
7. Fresh fruits or fruit juice.

Diet in Fever and Infection

A fever is a condition in which the body temperature rises above normal. It is usually a symptom of other diseases which can even be due to infection. During a fever or an infection, the appetite is usually depressed and there is the possibility of the body becoming dehydrated. Therefore at the onset of a fever or an infection, a clear fluid diet should be served. This can be tea, coffee, and fat-free broth, or ginger ale (infusion), fruit juices, and water gruels could be given. Small amounts of fluid should be offered every hour or two to the patient so as to relieve thirst and maintain the water balance. Broth provides some sodium, and fruit juices supply potassium.
Sugar, fruit juice, carbonated beverages can be given so as to supply a small amount of carbohydrate for energy. Full-fluid diet which consists of liquids and foods that liquify at body temperature can be given next.. The food can be in puree or mashed form to ease the rate of digestion. At this stage, energy foods in the form of carbohydrates should be given So as to supply the needed energy.
Vegetables and fruits should be consumed in high quantity to facilitate the needed vitamins and mineral elements. Also meat and fish cooked by the appropriate method should be given. As the situation improves however, the normal diet can be served.

Home Management of Diarrhoea

By home management, we mean first aid for diarrhoea. That is, what you can do to save the patient before taking him to the hospital for proper treatment.
Diarrhoea is the frequent passing of watery stool with very offensive odour. It has been identified as one of the major killer diseases in children especially in the under-developed and developing countries where the level of personal and community hygiene is very low. The occurrence of the disease increases rapidly when mothers begin to introduce complementary foods to their children as they attain certain stage of growth which usually commences in the second year of life. Diarrhoea is more common in under-nourished than healthy children. The more severe the under nutrition the more frequent and severe the diarrhoea.

A child that is suffering from diarrhoea has lost a lot of body fluid and therefore the major Consequence of diarrhoea is dehydration (loss of fluid from the body). The first attempt at the treatment of diarrhoea therefore is ‘rehydration (replacement of lost fluids by intake of water and fluids)’. The best solution for this rehydration is oral rehydration salt (ORS), one litre of boiled, cool water.
Alternatively, the ORS can be prepared locally at home with the following ingredients and measurements:
Salt – 4g or one level teaspoonful
Sugar – 40g or eight level teaspoonfuls
Water – 1 litre or five cupfuls or 1 empty beer bottle.

Dietary Management of Diarrhoea

Since diarrhoea leads to serious losses of fluids, electrolytes, protein, fats, carbohydrates and vitamins, any child affected also lose a lot of energy. This makes the child to become very weak. These losses must be corrected by an adequate fluid intake, mineral and vitamin supplements, and a high-calorie and high-protein diet. Vegetable soups, fish, meat or poultry soups must be given in reasonable quantity.
Once the rehydration has been accomplished, high energy and high-protein foods must be given. If the child is still being spoon fed, maize gruel, some palm-oil, powdered milk or milled dried fish should be added to the gruel and fed to the child. Alternatively, multimixes based on the local foodstuffs available can be prepared with which the child can be fed.
Examples of some multimixes

A.

Rice – 70g

Fish – 30g

Oil – 5g

Procedure

Boil the rice till it becomes soft. Chop the fish, wash and add to the rice. Also add the oil and continue to boil until the fish is cooked. The fish should be boneless.
Then mash the mixture very well and feed it to the child.

B.

Peeled potato – 150g
Dark green leaves (e.g. amarranthus) – 40g
Chick pea flour – 20g
oil – 5g
Procedure
Mix the chickpea flour with water, add the oil and boil gently together. Chop the potato into pieces and add the washed dark green leaves and boil until the potatoes become soft. Mash the potatoes and dark green leaves and add to the chickpea mixture. Add a little more water it necessary and mix thoroughly while simmering until a smooth paste is obtained. This can be fed to the child.

3. Diet for Overweight

An overweight person is one whose body size or weight rises above normal. The extra weight makes demands upon the heart, blood circulation, back, and the whole of the body skeleton. It is not surprising therefore that overweight people often have heart disease and hypertension, diabetes and other chronic diseases. The need for the overweight individual to shed the extra weight can be due to increased muscular development or it could be due to excessive tat accumulation in the adipose tissue.
Gaining or losing weight is simply a question of balancing food calories with the body’s need for calories. Therefore, the diet for overweight people should be low in calories. Food items like fat and carbohydrates should be reduced drastically, while a higher protein should be consumed. This is desirable because it helps to correct the greater losses of muscle tissue that occur during reducing. Generous amounts of fresh vegetables and fruits should also be consumed to supply the needed vitamins and minerals. Meals of a low calorie diet should be attractive and palatable. Meats, fish and poultry should be free from fat and should be prepared by boiling, roasting or stewing.
The low calorie diet should be accompanied with regular exercise for it to be very effective.

Diet for Underweight

Underweight is direct opposite of overweight. Both are equally not good for individuals. An underweight person is one whose weight falls below the standards for his age or height. What the underweight requires is a diet high in calories. This will enable him or her to gain weight. About 500Kcal daily above the normal calorie requirements are needed in order to gain 0.4kg per week. Weight loss is often accompanied by loss of protein tissue as well as fat tissue. Therefore it is necessary to provide a liberal protein allowance usually 100gm per day. He should consume food high in energy and protein. Such foods include carbohydrates, foods such as tubers and cereals, fat e.g. butter. The following foods rapidly increase the calorie content of the diet, coffee cream or fruit on cereal, ice cream, butter, margarine, mayonnaise, jelly, jam, marmalade, honey, cake, candies, puddings, pies and pastry. Such foods should therefore be included in the diet.

Body Mass Index

Suggested Menu for Low Calorie Diet

People who require this type ot diet are those who are obese or overweight and need therefore to watch their weight. The diet of such people should provide a daily energy of about 1000kcal, 60g of protein and 35g of fat. The diet should however be adequate in other nutrients.

Breakfast

120ml orange juice or 1/2 grapefruit
1 boiled egg
20g bread or 1 slice (it can be toasted)
Coffee or tea (no sugar) with a little milk.
Lunch/Dinner
Boiled beans (about 4 5 serving spoonfuls)
with vegetable stew and fish/meat (2
pieces) or Vegetable stew with meat,
chicken or fish (about 80g).

Suggested Menu for Underweight or

Convalescent

Both the underweight and convalescent need high energy and protein food. Their diet should also be adequate in terms of other nutrients. Such people need about 3000 to 3500kcal energy and 100 120g protein daily.
Their food for the day may be as follows:
Milk 750 100ml
Meat or Fish 3-5 servings
Bread and Cereal/Tubers 8-12 servings
Fruits 2-4 servings
Fat 90g

Deserts. 1-2 servings

Sample Of Daily Menu

Breakfast
1 orange or grapefruit
Cereal porridge with milk and sugar
1 or 2 eggs
2-4 slices of bread with butter and jam or marmalade.
Tea or coffee with sugar and milk.

Lunch/Dinner
Meat or fish vegetable stew or meat or fish
stew with okra or ewedu. (2-3 pieces of meat), pounded yam, amala or eba, dessert or pudding.

Suggested Diets for Some Invalids Diabetic

The aim of a diabetic diet is to restrict the carbohydrates intake while meeting normal needs for protein and providing just sufficient energy to maintain normal weight in adults and to allow for growth in children.
Thus the daily menu for a diabetic patient should provide about
1800kcal energy and 80g protein.

Sample daily menu

120ml of orange juice or 4 grapefruit
2 wraps of moinmoin (about 150g)
Tea or coffee with milk but no sugar

Lunch/Dinner

Fish, meat stew or chicken stew (about
60gm)
Boiled beans
Fruit or vegetable salad.

Hypertensive Patients

This group of people need a balanced diet but should avoid foods rich in sodium and cholesterol or saturated fatty acids. The energy content of the food should also be moderate as they cannot afford to be obese. Such people require about 60 to 90gm protein and 160 to 200kcal energy per day. The sodium consumption should not exceed 40mm per day. These patients should consume the diets of normal healthy human beings; however, they should not take salt and egg because of their high cholesterol content. They should also reduce or stop the consumption of butter or margarine because they contain a high proportion of saturated fatty acids. They should however consume generous amounts of fruits and vegetables.

Lesson Evaluation/Test

  1. What are special diets?
  2. Mention the categories of individuals who need special diets.
  3. Distinguish between the different types of vegetarians you know.
  4. Which type of vegetarian is the most difficult to plan a balanced menu for? Give your reasons.
  5. Discuss the dietary requirement for an overweight individual who wants to lose some weight.

Project: Managing weight has been one of the major reasons people use the gym these days. Prepare a menu from the locally available foodstuff in your area for an individual who wants to lose extra weight.

Questions answered correctly? Bravo!

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