Disease Sheet of Meal Management and Meal Planning

Deficient Dietary
Disease Name Intro Diagnostic Test
Nutrient Recommendations

GASTROINTESTINAL DISORDERS
Puree/ Thin Liquid / Soft
Anatomic or physiological swallowing problems of Barium X-ray Diet
dysphagia create a disturbance in the normal transfer Dynamic swallowing ↑ Kcal (30 – 35 kcal/kg)
of food from the oral cavity to the stomach. study ↔ CHO
Swallowing requires 5 to 10 seconds and three phases Endoscopy ↑ Protein (1 – 1.5g/kg/d)
Manifestation of
for completion—oral phase, pharyngeal phase, and Fiber-optic endoscopic ↑ Fats (MCTs and Omega 3)
Dysphagia vitamin B12
esophageal phase Some people with dysphagia have evaluation of
deficiency
problems swallowing certain foods or liquids, while swallowing (FEES) With decreased saliva
others can't swallow at all. Other signs of dysphagia Esophageal muscle test production, moisten foods
include: coughing or choking when eating or drinking. (manometry) with small amounts of liquid
bringing food back up, sometimes through the nose Imaging scans. and use extra fats, mild
Upper GI Disorders

sauces, and gravies

Thin Liquid Diet

Barium swallow study
High Caloric and Protein Diet
Esophageal cancer usually begins in the cells that line Using a scope to
↑ Kcal
the inside of the esophagus. Esophageal cancer can Deficiency of examine your
(30 – 35 Kcal/kg/d)
Esophageal occur anywhere along the esophagus. Vitamin D, B12 and esophagus (endoscopy)
↔ CHO
Esophageal cancer is the sixth most common cause of Calcium Collecting a sample of
↑ Protein
cancer deaths worldwide tissue for testing
(1.0 – 1.5 g/kg/d)
(biopsy)
↔ Fats (MCTs)

Reduced energy diet

Deficiency of
Gastroesophageal reflux disease (GERD) occurs when Upper GI X- Ray Small Frequent Meals
vitamin B12
stomach acid repeatedly flows back into the tube Esophageal ↔ to ↓ Kcal
(cobalamin),
connecting your mouth and stomach (esophagus). This Manometry ↔ CHO
GERD Vitamin C
backwash (acid reflux) can irritate the lining of your Upper Endoscopy ↑ Protein
(ascorbate),
esophagus. Many people experience acid reflux from Ambulatory acid (pH) ↔ Fats
Calcium, Iron
time to time probe test ↔ Dietary Fiber
Magnesium
14g/1000Kcal
 Reduced energy diet
A hiatal hernia occurs when the upper part of stomach Small Frequent Meals
bulges through the large muscle separating your Upper GI X- Ray ↔ to ↓ Kcal
abdomen and chest (diaphragm). Diaphragm has a Iron Deficiency Esophageal ↔ CHO
Hiatal Hernia
small opening (hiatus) through which your food tube Anemia Manometry ↑ Protein
(esophagus) passes before connecting to your Upper Endoscopy ↔ Fats
stomach ↔ Dietary Fiber
14g/1000Kcal
NPO Required in Acute
Phase
Small Frequent Feeds
Gastritis involves inflammation of the stomach. Types
Required in Chronic Phase
of gastritis include bacterial (from H. pylori),
autoimmune gastritis with pernicious anemia, erosive
H. pylori Test Small Frequent Meals
gastritis (from aspirin or NSAID use), alcohol-induced Deficiency of
Gastritis Endoscopy ↔ Kcal
Upper GI Disorders

gastritis, bile reflux gastritis, or atrophic gastritis. Th e Vitamin B12

Upper GI X- Ray ↔ CHO
treatment of gastritis will depend on its cause;
↔ Protein
reduction of stomach acid by medication is often most
↔ Fats
helpful
↑ Fiber
Calcium and Riboflavin
incorporate if milk omit

Balanced Diet
A disease in which malignant (cancer) cells form in the Blood Test – LFTS
↔ Kcal
lining of the stomach. Age, diet, and stomach disease Stomach Ultrasound
Deficiency of ↔ CHO
Gastric Cancer can affect the risk of developing gastric cancer. PET
Vitamin A ↔ Protein
Symptoms of gastric cancer include indigestion and CT Scan
↔ Fats (Omega 3, MCTS)
stomach discomfort or pain Surgery
↑ Fluid Intake (35ml/kg)

A peptic ulcer promotes imbalance between digestive Small Frequent Meals

fluids in the stomach and duodenum, with erosion by ↔ to Kcal
gastric acid and pepsin and exposed nerves. Most H. pylori Test ↔ CHO
Decrease in
Peptic Ulcer ulcers are duodenal, within the first 25 to 30 cm. There Endoscopy ↑ Protein
Vitamin C levels
are four major complications of peptic ulcer disease Upper GI X- Ray ↔ Fats
(PUD): bleeding, perforation, penetration, and Vitamin C rich diet
obstruction Avoid citrus and acidic juices
 It is a serious autoimmune disorder of gastrointestinal A gluten-free diet excludes
Positive tissue
tract Genetically leads to ingestion of gluten which wheat, rye, and barley
transglutaminase
damage lining of small intestine. Moreover, it is a A Mediterranean Diet
serologic testing
permanent intolerance of gluten occurs. High Caloric and Protein Diet
Tissue
It is a chronic inflammation in intestinal mucosa which Deficiency of ↑ Kcal
Celiac Disease Transglutaminase
leads toward the atrophy of intestinal villi and Vitamin B12 (35 – 40 Kcal/kg/d)
Antibodies (tTG-IgA)
subsequently manifestation called “Gluten ↔ CHO
Small bowel biopsy
Enteropathy” ↑ Protein
Leukocyte error Dq2,
Gluten is the storge protein that found in wheat, (1 – 2 g/kg/d)
Dq8 or both
barley, and rye ↔ Fats (MCTs)

Thick Liquid / Pureed / Soft

Diarrhea is a condition in which faces are release Diet
frequently or the passage of three or more loose or ↑ Kcal
liquid stools per day. It occurs when accelerated Blood test (CBC) ↔ CHO
Deficiency of
transit of intestinal content through small intestine, Stool test ↑ Protein
Lower GI Disorders

Diarrhea Vitamin B3 or
decreases enzymatic digestion of food, decrease Flexible Sigmoidoscopy ↔ Fats (MCTs)
Nicotinamide
absorption of nutrients and fluids, and increase or Colonoscopy ↑ Fluid (30 – 35 ml/kg)
secretion of fluids into gastrointestinal tract (GIT) or Homemade ORS
exudative losses recommended
Limit Fruit Juices to 6 oz
Pureed / Soft Diet
Constipation occurs when the fecal mass remains in
Blood test – Low High Fiber Diet
the colon longer than the normal 24 to 72 hours after
thyroid ↔ Kcal
meal ingestion or when the patient strains to defecate.
Deficiency of Stool test ↔ CHO
Constipation Stool type and frequency could be used to determine
Vitamin D Sigmoidoscopy ↔ Protein
another problem, such as IBS. Constipation is noted as
X – ray ↔ Fats (MCTs)
normal transit, slow transit constipation (STC), or
Balloon Expulsion Test ↑ Fiber (20 – 35 g/ d)
outlet obstruction
↑ Fluid (30 – 35 ml/kg)
Thin Liquid / Pureed Diet
Inflammatory bowel disease (IBD) is long chronic
CBC ↔ Kcal
inflammation of tissues in digestive tract.
X ray, CT scan ↔ CHO
Ulcerative colitis: Inflammation and sores (ulcers)
Inflammatory Bowel Endoscopy ↑ Protein (1 – 1.5g/kg)
along the lining of large intestine (colon) and rectum. Deficiency of
Disease (Crohn’s Sigmoidoscopy ↔ Fats (MCTs)
Crohn's disease: inflammation of the lining of Vitamin D, B12,
Disease & Ulcerative Upper endoscopy ↔ Dietary Fiber
digestive tract, which often can involve the deeper Iron and Zinc
Colitis) Capsule endoscopy ↑ Fluid (30 – 35 ml/kg)
layers of the digestive tract. Crohn's disease most
Balloon assisted Multi Vitamin mineral
commonly affects the small intestine but also affect
endoscopy supplementation
the large intestine
Lactose free diet If needed
 Physical Examination
Medical and Diet
Irritable bowel syndrome (IBS) is a functional GI Low FODMAP Diet
history
disorder involving disturbances of the brain–gut axis. ↔ Kcal
Endoscopy
Stimulated serotonin (5-HT3) receptors promote ↔ CHO
Celiac test
excessive intestinal motility, secretion, and sensation. Deficiency of ↔ Protein (1 – 1.5g/kg)
Irritable Bowel Roam criteria
Group of symptoms that effect digestion, most Vitamin D, B2, Iron ↔ Fats (MCTs)
Syndrome X-ray, CT scan
commonly affected small and large intestinal colon. and Calcium ↔ Soluble Fiber
Upper endoscopy
Chronic diarrhea & constipation and on &off ↓ Fiber in acute phase
Lactose intolerance
symptoms that cause disorder of Gut-Brain (GB) ↑ Fluid (30 – 35 ml/kg)
test
interactions Lactose free diet If needed
Breath test
Stool test
Lower GI Disorders

Small Frequent Meals

↔ Kcal
Lactose is a disaccharide (glucose-1 galactose) found
↔ CHO
in milk. If lactase enzyme is missing, lactose passes into
↔ Protein
the colon, where it is fermented to gases and organic
↔ Fats (MCTs)
acids by colonic bacteria, resulting in bloating, Deficiency of Hydrogen breath test
Lactose Maldigestion ↔ Dietary Fiber
cramping, nausea, or diarrhea. A limited proportion of Lactase enzyme Lactose tolerance test
the human adult population retains intestinal lactase-
Tolerate up to 6 g of lactose,
phlorizin
½ cup (4 oz) of fluid milk
hydrolase (LPH) activity during adulthood
Lactase Enzyme supplement
before 30 minutes
After surgery Low Fiber &
Soft Diet
Hemorrhoids, also called piles, are swollen veins in ↔ Kcal
your anus and lower rectum, similar to varicose veins. ↔ CHO
Rectal examination
Hemorrhoids can develop inside the rectum (internal Deficiency of ↔ Protein (1 – 1.5g/kg)
Hemorrhoids Proctoscopy
hemorrhoids) or under the skin around the anus Vitamin D and C ↔ Fats (MCTs)
Colonoscopy
(external hemorrhoids). Chronic constipation is ↑ Fiber (25 – 35 g)
believed to be the main cause of hemorrhoids ↓ Fiber in pain
↑ Fluid (30 – 35 ml/kg)
Lactose free diet
Small Frequent Meals
Ascites results from high blood pressure in the liver ↑ Kcal
Pancreatic

Abdominal Ultrasound
Liver and

(portal hypertension) and low serum albumin. A ↔ CHO

Cell count & culture
distended abdomen results from excess fluid in the Deficiency of ↑ Protein (1.5 g/kg/d)
Ascites test
peritoneal cavity. Th e development of ascites vitamin B12 ↔ Fats (MCTs)
Albumin & Protein
indicates a pathological imbalance between the
LFTs Fluid Restriction (1 – 1.5 l/d)
production and resorption of intraperitoneal fluid
Sodium restriction (2g/d)
 Mediterranean diet
NAFLD is common disorder
Controlled Calories and
It is a spectrum of liver disease ranging from steatosis
Protein Diet
to steatohepatitis and cirrhosis. It involves the Blood Test – LFTs
Non Alcoholic Fatty Insufficiency of ↔ Kcal
accumulation of fat droplets in the hepatocytes and MRI CT Scan
Liver Vitamin D ↔ CHO (50 – 55% TE)
can lead to fibrosis, cirrhosis, and even hepatocellular Needle Biopsy
↔ to ↓ Protein
carcinoma. Most common NAFLD is a non-serious
↔ Fats (MCTs, Omega 3)
condition called fatty liver
↓ Fluid intake
Small Frequent Meals
liver inflammation resulting from alcohol use, toxic
↑ Kcal (30 – 35 kcal/day)
materials (carbon tetrachloride), or viral infection
Blood Test – LFTS ↔ CHO (50 – 55% TE)
(transmitted in food, liquids, or blood transfusions). Th Deficiency of
Hepatitis Liver Ultrasound ↑ Protein (1 – 1.2 g/kg/d)
ere is also an autoimmune form. Acute viral hepatitis vitamin D
Liver Biopsy ↔ to ↓ Fats (MCTs)
is a widespread inflammation of the liver and is caused
(Low if malabsorption Show)
by hepatitis viruses A, B, C, D, or E.
↑ Fluid intake in case HCV

Cirrhosis (hepatic fibrosis) is caused by chronic

degeneration of the parenchymal liver cells and Small Frequent Meals
thickening of the surrounding tissue. The liver slowly ↑ Kcal
Complete Blood Count
deteriorates and malfunctions due to chronic injury. (Low if malabsorption or
(CBC)
Alcoholism and hepatitis C are the most common Repletion Show)
International
causes. Alcoholic cirrhosis is also called Laennec ↔ CHO (complex)
Deficiency of Normalized Ratio (INR)
Hepatic Cirrhosis cirrhosis. Cirrhosis may result from biliary stenosis, ↑ Protein (1 – 1.5 g/kg/d)
Vitamin B Liver Enzyme
hepatitis B to D, obesity with nonalcoholic fatty liver ↔ to ↓ Fats (MCTs &
Liver Function Test
disease (NAFLD), autoimmune hepatitis, prolonged omega 3)
Electrolyte Test
exposure to toxic chemicals, and inherited diseases (Low if malabsorption Show)
Liver Biopsy
such as glycogen storage disease, cystic fibrosis, alpha- ↓ Fluid intake in
1 antitrypsin deficiency, hemochromatosis, Wilson Hyponatremia
disease, or galactosemia
Pancreatitis is an inflammatory, clinical syndrome
defined by a discrete episode of abdominal pain and Blood Test – Pancreatic Mostly Tube Feed (6-8)
Hepatic and
Pancreatic

Low Antioxidant
elevations in serum enzyme levels. The exocrine Enzyme Test ↑ Kcal
levels (Low level of
pancreas secretes proteolytic, lipolytic, and amylolytic CT Scan, MRI ↔ CHO
Pancreatitis Vitamin A, C, E,
enzymes for nutrient digestion in the intestines. AP is Abdominal Ultrasound ↔ Protein
B12, Selenium, and
initiated inside acinar cells by premature activation of Endoscopic Ultrasound ↔ Fats (Omega 3 & MCTS)
Carotenoid
digestive enzymes in the pancreas instead of the Stool Test Antioxidant rich diet
duodenum.
 Small Frequent Meals (6-8)
Pancreatic cancer is a disease in which malignant Ultrasound
↑ Kcal
(cancer) cells form in the tissues of the pancreas. CT scans
↔ CHO
Smoking and health history can affect the risk of Deficiency of MRI
Pancreatic Cancer ↑ Protein
pancreatic cancer. Signs and symptoms of pancreatic Vitamin D Positron Emission
↑ Fats (MCTS)
cancer include jaundice, pain, and weight loss. Tomography (PET)
↑ Fluid Intake
Pancreatic cancer is difficult to diagnose early scans
Avoid tomato & citrus
↑ Kcal
Cholestasis involves reduced bile fl ow in any liver
↔ CHO
disease with bilirubin over 2.0 mg/dL. Disturbance of
Deficiency of ↑ Protein
the fl ow of bile leads to intracellular retention of
Fat soluble Physical and Medical Acute:
biliary constituents. Th e bile salt export pump (BSEP,
vitamins History Examination Children 1 – 1.5g/kg
Cholestasis ABCB11) is the primary transporter of bile acids from
Vitamin A, D, E and Blood Test Adults 0.5 – 1.2g/kg
the hepatocyte to the biliary system; it is a rate-
K Ultrasound Chronic
limiting step in bile formation for the enterohepatic
Impairment of Fats Children 3g/kg
circulation of bile acids and the digestion of dietary
Adults 1 – 1.5g/kg
fats
↔ Fats (MCTS)

The gallbladder, located under the liver, collects and

stores bile, which is made up of bile salts, electrolytes, Acute Cholecystitis:
bilirubin, cholesterol, and other fats. Bile contains 85% NPO or Low-Fat Diet
to 95% water; electrolytes (sodium, potassium, Chronic Cholecystitis:
chloride, bicarbonate, calcium, magnesium). Loss of Fat/Calorie-Controlled Diet
bile can cause malabsorption and maldigestion of fat, Abdominal Cholelithiasis:
electrolyte imbalances, and poor excretion of drugs or Deficiency of ultrasound High-Fiber, Low in Calories
Gallbladder Disease
heavy metals. Vitamin D Endoscopy Diet
Cholelithiasis is defined as the presence of gallstones CT scan After stones removal
Cholecystitis is inflammation of the gallbladder with ↔ Kcal
different causes, degrees of severity. ↔ CHO (complex)
Gallbladder cancer gallstones change into cancer. ↔ Protein
Jaundice, pain above the stomach, lumps in the ↔ Fats (Omega 3 & MCTS)
abdomen, and fever should be addressed.

ENDOCRINE DISORDERS
 HBA1c 5.7 – 6.4 % Small Frequent Meals
Fasting Blood Sugar ↔ Kcal
Prediabetes distinguishes those people who are at Level 100 – 125mg/dl ↔ CHO (45 – 50%)
increased risk of developing diabetes. Prediabetes ↑ PRO (20%)
implies impaired fasting glucose (IFG; 100 to 125 Deficiency of ↔ Fats (MCTs & Omega 3)
Prediabetes Oral Glucose Tolerance
mg/dL), impaired glucose tolerance (IGT; 2-hour post Vitamin D ↔ Fibers (20 – 30 g/d)
Test
glucose load of 140 to 199 mg/dL), or both. A normal Lose weight 5 – 10lbs
blood glucose level is 100 mg/dL; < 140mg/dl Normal Cinnamon may improve
140 – 199 mg/dl blood sugar and lipid levels
Prediabetics (1/2 teaspoon daily).

CHO Counting with

Random Blood Sugar
Type 1 diabetes mellitus (DM or T1D) is an Small Frequent Meals
Test
Diabetes Mellitus

autoimmune disease characterized by destruction of ↔ Kcal

(≥200mg/dL or ≥ 11.1
the pancreatic beta-cells (the islets of Langerhans). It ↔ CHO (Complex)
mmol/L)
usually starts in children or young adults but ↑ PRO (20%)
Glycate Hemoglobin
Diabetes Mellitus represents only 10% of total cases of diabetes. Signs ↔ Fats (MCTs & Omega 3)
Deficiency of Zinc (A1C) Test
Type 1 and symptoms include polyuria (frequent urination, ↑ Fibers
≥ 6.5%
including frequent bedwetting in otherwise trained Discourage Skipping Meals
Fasting Blood Sugar
children), polydipsia (excessive thirst), polyphagia Heart Healthy Foods
Test
(extreme hunger), weakness, fatigue, irritability, and 5 Serving Fruits & Vegs
≥ 126 mg/dl
sudden weight loss. 6 Servings Whole Grains
(7.0 mmol/L)
2 servings low fat dairy

Type 2 diabetes (T2D) arises because of insulin HBA1c 5.7 – 6.4 % Small Frequent Meals
resistance, when there is failure to use insulin properly Fasting Blood Sugar ↔ Kcal
combined with relative insulin deficiency and ≥ 126 mg/dl ↔ CHO (Complex)
hyperglycemia. Chronic, low-grade adipose tissue (7.0 mmol/L) ↑ PRO (20%) in weight loss
Diabetes Mellitus Deficiency of
inflammation is a key mechanism linking type 2 Oral Glucose Tolerance ↔ Fats (MCTs & Omega 3)
Type 2 Vitamin D
diabetes (T2D) and obesity. Previous names for T2D Test ↑ Fibers
include non–insulin-dependent diabetes (NIDDM), ≥ to 200mg/dl DASH diet (prevent
adult-onset, type II, maturity-onset, and ketosis- (11.1mmol/L) for hypertension)
resistant diabetes Diabetics type 2 Lose weight 5 – 10lbs
 Small Frequent Meals
Hypoglycemia is low blood sugar (70 mg/100 dL or Every 3hrs
lower) that occurs primarily in patients with T1D. Fasting Blood Sugar ↔ Kcal
Except in diabetic patients receiving insulin or Level ↔ CHO (complex)
Deficiency of
Hypoglycemia sulfonylureas, hypoglycemia is a rare disorder. Low < 70 mg/dL ↔ PRO
Vitamin B12
blood glucose levels release hormones such as CBC ↔ Fats
catecholamines, which produce hunger, trembling, Ketone Bodies Test Give Bedtime snacks like
headache, dizziness, weakness, and palpitations. Milk, Fruits, and Crackers
(Table 9-16)

Small Frequent Meals

Diabetes Mellitus

Initial Glucose Test CHO Controlled Diet

Gestational diabetes is a type of diabetes that can
190 mg/dL or 10.6 ↑ Kcal (30 – 35kcal/d)
develop during pregnancy in women who don't
Deficiency of mmol/L ↔ CHO (Complex)
Gestational Diabetes already have diabetes. Managing gestational diabetes
Vitamin D ↑ PRO (20%)
will help make sure you have a healthy pregnancy and
Follow up Glucose ↔ Fats (MCTs & Omega 3)
a healthy baby
Tolerance Test ↑ Fibers
Limit Juices, Sakes & Sweets

First Fluid replacement

Diabetic ketoacidosis (DKA) occurs most often in Blood Test:
therapy
patients with T1D, but patients with T2D are also Blood Sugar Test
Small Frequent Meals
susceptible to DKA under stressful conditions. Ketone Level
↔ Kcal
Infection is the leading cause of DKA. Other factors Blood Acidity
Deficiency of ↔ CHO (complex)
Diabetic Ketoacidosis include not getting enough insulin from missed
Vitamin D ↔ PRO
injections and alkaline reserves depleted by too little Blood Electrolytes Test
↔ Fats
insulin, fl u or colds, fever, and pneumonia. DKA in T2D Urinalysis
Give Bedtime snacks and
is usually from urinary tract infections, trauma, stress, Chest X rays
monitor Blood Glucose Level
pregnancy, surgery, or myocardial infarction ECG
like Milk, Fruits
Endocrine Glands

Hypopituitarism is an underactive pituitary gland. A

Small Frequent Meals
deficiency in production of pituitary hormones may be Blood Test – for
Disorders

↔ to ↓ Kcal
caused by tumor, trauma, radiation to the brain, Deficiency of hormone measure
↔ CHO
Hypopituitarism stroke or aneurysm, or surgery. In hypopituitarism, Vitamin D, C, E, B1, Vision Test
↔ PRO
there is a lack of hormones and loss of function in the B12 and Omega 3 Brain Imaging – CT &
↔ Fats
affected gland or organ. It may take years for an MRI
Rich in Calcium & Vitamin D
accurate diagnosis to be made
 Addison disease is a strict insufficiency state of adrenal High Protein & Moderate
hormones, including cortisol and aldosterone. CHO Diet
Blood Electrolytes Test
Autoimmune Addison disease is caused by ↔ Kcal
ACTH Stimulation
autoreactivity toward the adrenal cortex; T cells seem ↔ CHO (Complex)
Hormone
to be involved. An Addisonian crisis can be Deficiency of ↑ PRO (1 – 1.75g/kg)
Addison Disease Insulin Induced
precipitated by acute infection, trauma, surgery, or Vitamin D ↔ Fats
Hypoglycemia Test
excessive body salt loss. Patients with Addison disease ↑ Fluid (2 – 3L/d)
Imaging Test – Pituitary
often suffer from fatigue, faintness, lack of Adequate intake of Sodium
Gland MRI
concentration, and memory deficits; high-calorie food with medication. Monitor
reduces symptoms of this neuroglycopenia Potassium levels

High Energy Diet

Hyperthyroidism results from over secretion of the ↑ Kcal (start with 40kcal/d)
thyroid hormones triiodothyronine (T3) or thyroxine Medical and Physical ↔ CHO
Endocrine Glands Disorders

(T4). These hormones affect every cell through Examination ↑ PRO (1 – 1.75g/kg)
Hyperthyroidism
controlling body temperature, heart rate, metabolism, Low level of Iron Blood Test – T3, T4 and ↔ Fats
and production of calcitonin. When the hypothalamus TSH ↑ Fluid (3 – 4L/d)
signals the pituitary gland to produce TSH, normally Thyroid Ultrasound Avoid Raw natural
this is regulated to be just enough. goitrogens with anti-thyroid
medication

Hypothyroidism is caused by the under functioning of

the thyroid gland. It can be classified as primary Energy Controlled Diet
(thyroid failure), secondary (from pituitary TSH ↔ Kcal
deficit), or tertiary (from hypothalamic deficiency of Deficiency of ↔ CHO
Blood Test – T3, T4 and
thyrotropin-releasing hormone) or result from Iodine, Vitamin ↔ PRO
Hypothyroidism TSH
peripheral resistance to the action of thyroid B12, Zinc, and ↔ Fats
Thyroid Ultrasound
hormones. Achieving optimal thyroid hormone Copper Optimal iodine intakes from
replacement is more difficult in TSH deficiency iodized salt (150 to 250 g/d
compared to primary hypothyroidism because of the for adults)
inability to be guided by serum TSH levels

Hypoparathyroidism results from a deficiency of PTH High Calcium & Phosphorus

from biologically ineffective hormones, damage to or Blood Test – Calcium, Diet
accidental removal of the glands, or impaired skeletal Parathyroid Hormone ↔ Kcal
Hypoparathyroidism or renal response. The most common cause of (PTH), Blood ↔ CHO
Deficiency of
Hypocalcemia hypoparathyroidism is iatrogenic after anterior neck Phosphorus Level ↔ PRO
Vitamin D
surgery. Hypoparathyroidism with hypocalcemia is ↔ Fats
one of the most common results of damage to Urine Test Intake of dairy products,
parathyroid glands during surgery; in fact, it may be ECG nuts, salmon, peanut butter,
diagnosed during a workup for hypocalcemia and green leafy vegetables
 Low Calcium & Phosphorus
Blood Test – Calcium
Diet
Endocrine Glands Related Disorders
Level
Hyperparathyroidism is a condition in which one or ↔ Kcal
more of your parathyroid glands become overactive ↔ CHO
Hyperparathyroidism Deficiency of Urine Test
and release (secrete) too much parathyroid hormone ↔ PRO
Hypercalcemia Vitamin D X ray for Kidney
(PTH). This causes the levels of calcium in your blood ↔ Fats
Bone Mineral Density
to rise, a condition known as hypercalcemia Fewer dairy products, nuts,
(DEXA)
salmon, peanut butter, and
Ultrasound
green leafy vegetables

Small Frequent Meals

Pelvic Exam
Polycystic ovarian syndrome (PCOS) is an endocrine ↔ Kcal
Deficiency of Blood Test – Hormone
disorder characterized by hyperandrogenism, ↔ CHO (45 – 50%)
Calcium, Level, fasting
bilaterally enlarged polycystic ovaries, and insulin ↔ PRO (15 – 20%)
Magnesium Cholesterol,
Polycystic Ovary resistance. During developmental sensitive periods, ↔ Fats (25 – 30%)
Potassium Triglycerides, Glucose
Syndrome (PCOS) excesses of gonadal steroid hormones cause ↔ Fibers (20 – 30 g/d)
Insufficiency of Tolerance Test
permanent tissue-specific alterations in the ovary, DASH Diet
Vitamin C, B12 and Ultrasound
epigenetic changes that alter the expression of critical Weight Loss Diet (5 – 10lbs)
Folic Acid Screening Obstructive
hormone receptor genes Use Low GI Fruits and Low
Sleep Apnea
fat dairy

RENAL DISORDERS

Abrupt decline in renal function with waste retention Adequate Calories Diet
RENAL DISORDERS

because of a circulatory, glomerular, or tubular ↔ Kcal

deficiency. ARF is caused by diabetes or hypertension Urine Output ↔ CHO
in most cases. Other causes include Low level of Measurement ↓ Protein (0.5 – 0.6g/kg/d)
glomerulonephritis (GN), polycystic kidney disease Vitamin D Urine Test ↔ Fats (Omega 3, MCTS)
Acute Renal Failure
(PKD), burns, severe crush injuries, transfusions, Sometime Vitamin Blood Test ↓ Fluid Intake
antibiotics, nephrotoxicity from drugs, surgery or D toxicity Imaging Test (Urine output + 500ml)
anesthesia, cardiac transplantation, shock, or sepsis. Biopsy ↓ Sodium
In children, ARF has been caused by hemolytic uremic ↓ Potassium
syndrome. ARF is often reversible. ↓ Phosphorus
 Adequate Calories Diet
↔ Kcal
↔ CHO
↓ Protein (HBV)
Chronic kidney disease (CKD), or chronic renal failure Stage 1. 2
(CRF), is characterized by the slow, gradual loss of (0.8 – 0.6g/kg/d)
kidney function. Excess urea and nitrogenous wastes Stage 3, 4
Blood Test
accumulate in the bloodstream (azotemia). People at (0.6 – 0.5g/kg/d)
Chronic Kidney Urine Test
highest risk from progressive CKD are defined by a ↔ Fats (Omega 3, MCTS)
Disease Ultrasound
sustained decline in eGFR and/or the presence of ↓ Fluid Intake
CT Scan
significant albuminuria/proteinuria or more advanced (Urine output + 500ml)
Biopsy
CKD. Causes of CKD include lupus, chronic ↓ Sodium (3g/d)
hypertension, prolonged urinary obstruction, ↓ Potassium
nephrotic syndrome, PKD, cystinosis, or diabetes Stage 1, 2 (1.7g/d)
Stage 3, 4 (0.8 – 1g/d)
↓ Phosphorus
Stage 1, 2 (<4g/d)
RENAL DISORDERS

Stage 3, 4 (2.4 g/d)

End-stage renal failure, also known as end-stage renal High Calories Diet
disease (ESRD), permanent stage of chronic kidney ↑ Kcal
disease, where kidney function has declined to the Deficiency of ↔ CHO
point that the kidneys can no longer function on their Vitamin D ↑ Protein (HBV)
Blood Test (1.2 – 1.5 or 1.6 g/kg/d)
End Stage Renal own.
Urine Test ↔ Fats (Omega 3, MCTS)
Disease (ESRD) – Patients may experience a wide variety of symptoms
X – rays
Dialysis as kidney failure progresses. These include fatigue, ↓ Fluid Intake
CT Scan, MRI
drowsiness, decrease in urination or inability to (Urine output + 500ml)
Kidney Biopsy
urinate, dry skin, itchy skin, headache, weight loss, ↓ Sodium (3g/d)
nausea, bone pain, skin and nail changes and easy ↓ Potassium
bruising Dialysis specifically involves artificial filtering ↓ Phosphorus
of blood by a machine. (800 – 1200 mg/d)
DASH Diet
↑ Kcal
Kidney stones develop when salt and minerals in urine
↔ CHO
form crystals that coalesce and grow in size. The Blood Test
↔ Protein (↓ Animal
process is officially known as nephrolithiasis. Stones Urine Test
Protein & only ↓ plant
are formed by progressive deposition of crystalline X – rays
Kidney Stones protein in Uric acid stones)
material around an organic nidus. When they move CT Scan
(1.2 – 1.5 or 1.6 g/kg/d)
down through the ureters, they cause severe pain. Analysis of Passes
↔ Fats (Omega 3, MCTS)
Types of Stones are Idiopathic Hypercalciuria, Calcium Stones
↑ Fluid Intake (2 – 3.5L/d)
Oxalate, Cystine Stones, Struvite, Uric acid Stones.
↔ Calcium
(800 – 1200 mg/d)
 ↔ Kcal
↔ CHO
UTI is the bacterial infection which occur in any part of Urinalysis ↔ Protein (↓ Protein if
urinary system, Infection mostly includes in lower Urine culture Test renal function decrease)
Urinary Tract
urinary tract, bladder, and urethra. It could be painful Ultrasound ↔ Fats (Omega 3, MCTS)
RENAL DISORDERS

Infection
when infection limit bladder Effected parts due to Cystoscopy ↑ Fluid Intake
infections are Kidney, bladder, ureter and urethra CT Scan Antioxidant and Anti-
inflammatory Diet
Deficiency of
Use acidified food
Vitamin D

Tumors of the renal calyces, renal pelvis and ureters Mediterranean Diet or DASH
start in the layer of tissue that lines the bladder and Cystoscopy ↔ Kcal
Bladder, and Urinary the upper urinary tract, called the urothelium. Cancer Biopsy ↔ CHO
Tract Cancers that starts in the urothelium is called urothelial (or Urine Cytology ↔ Protein
transitional cell) cancer. This is the most common type CT Scan ↔ Fats (Omega 3, MCTS)
of cancer found in the bladder, as well ↑ Fluid Intake (35ml/kg)

BONE HEALTH DISORDERS

Joint fluid test Antioxidant Diet
Blood test - uric acid ↔ Kcal
Rheumatological Disorders

A common form of inflammatory arthritis that is very

levels ↑ CHO (50 – 60%)
painful. It usually affects one joint at a time (often the
Deficiency of X-ray imaging ↔ Protein (↓Purine Diet)
Gout big toe joint). There are times when symptoms get
Vitamin B 12 Ultrasound ↓ Fats rich in Omega 3 and
worse, known as flares, and times when there are no
Dual-energy MCTS (20 – 30%)
symptoms, known as remission
computerized ↑ Fiber
tomography (DECT) ↑ Fluid (35 – 40 ml/kg)

Caloric Control Diet

The most common form of arthritis. Some people call
↔ Kcal
it degenerative joint disease or “wear and tear”
↔ CHO (complex)
arthritis. It occurs most frequently in the hands, hips, Deficiency of X- Rays
Osteoarthritis ↔ Protein
and knees. With OA, the cartilage within a joint begins Vitamin D MRI
↔Fats (Omega 3, MCTS)
to break down and the underlying bone begins to
Vitamin C and Calcium Rich
change
Diet
 Caloric Control Diet
Weakens bones to the point that they can break easily. X- Rays ↔ Kcal
It is called a “silent disease” because people who MRI ↔ CHO (complex)
Deficiency of
Osteoporosis develop it may not notice any changes until a bone Bone Density test ↔ Protein
Copper
breaks — usually a bone in the hip, spine, or wrist. Dual - Energy X-ray ↔Fats (Omega 3 & MCTS)
Bones are made of living tissue Absorptiometry (DEXA) Vitamin D and Calcium Rich
Diet
Rheumatological Disorders

Mediterranean Diet
High Energy & High Protein
An autoimmune and inflammatory disease, which Diet
X-ray imaging
means that your immune system attacks healthy cells ↑ Kcal
Deficiency of Ultrasound
Rheumatoid Arthritis in your body by mistake, causing inflammation (painful ↔ CHO
Vitamin D MRI
swelling) in the affected parts of the body. RA mainly ↑ Protein
CT Scan
attacks the joints, usually many joints at once ↔ Fats (Omega 3 & MCTS)
Vitamin C, D & Calcium Rich
Diet

CBC
It is a chronic autoimmune and inflammatory disease ↔ Kcal
Kidney & Liver
which occurs when immune system that affects any ↔ CHO
Assessment
part of body like joints, skin and kidney in which ↔ Protein
Deficiency of Urinalysis
Systematic Lupus widespread, inflammation and tissue damage occur. Protein varies with kidney
Vitamin D Antinuclear antibody
SLE signs are: Joint pain and swelling, Headache, Hair issues
(ANA) Test
loss, Fingers turning white or blue and tingling when ↔ Fats (Omega 3 & MCTS)
Chest X- rays
cold, Anemia, Sever fatigue Vitamin A, E, D, B Rich Diet
Echocardiograms

CARDIAC VASCULAR DISEASE/ DISORDERS

Energy Controlled Diet
Ambulatory Monitoring
CARDIAC VASCULAR

High blood pressure, also called hypertension, is blood ↔ Kcal

– 6 to 24hrs
pressure that is higher than normal (140 and 90 Deficiency of ↔ CHO
Blood Test –
DISEASE

mmHg). Your blood pressure changes throughout the Vitamin D, & K ↔ Protein
Hypertension Cholesterol level
day based on your activities. Having blood pressure Excess Intake of ↔ Fats (Omega 3 & MCTS)
Urine Test
measures consistently above normal may result in a Sodium ↑ Fiber
ECG
diagnosis of high blood pressure ↑ Fluid
ECO
DASH Diet
 Angina pectoris involves retrosternal chest pain or Electrocardiogram
↔ Kcal
discomfort from decreased blood fl ow to the (ECG)
↔ CHO
myocardium from decreased oxygen supply (often Chest X- rays
↔ Protein
during exertion). Chronic stable angina is the most Blood Test
Deficiency of ↓ to ↔ Fats (Omega 3 &
Angina common manifestation of ischemic heart disease and Echocardiogram
Vitamin D MCTS)
is associated with impaired quality of life and CT Scan
↑ Fiber
increased mortality. Angina has 4 types: Stable MRI
DASH Diet, Anti-oxidant
(classic) Angina, Unstable Angina, Variant (Prinzmetal) Coronary Angiography
Diet, Anti-inflammatory Diet
Angina and Microvascular Angina Nuclear Stress Test
Atherosclerotic cardiovascular disease (ASCVD) Low to moderate Fat Diet
Blood Test – CRP
involves progressive narrowing of the arterial tree, Small Frequent Meals
Electrocardiogram
giving rise to collateral vessels. Th e heart, brain, and ↔ Kcal
(ECG)
leg arteries are most often affected. ASCVD ↔ CHO
Chest X- rays
CARDIAC VASCULAR DISEASE

characterized as Coronary Artery Disease (CAD), Insufficiency of ↔ Protein

Atherosclerotic Echocardiogram
Dyslipidemia and Ischemic Heart Disease (IHD). Vitamin D ↓ to ↔ Fats (Omega 3 &
Exercise Stress Test
Urbanization and a westernized lifestyle are thought MCTS)
CT Scan, MRI, PET
to play a major role. Genetic factors interact with ↑ Fiber (17 – 30g/d)
Coronary Angiography
environmental factors, including diet, nutritional DASH Diet, Anti-oxidant
Doppler ultrasound
status, and physiological parameters. Diet, Anti-inflammatory Diet
Energy Controlled Diet
Heart failure sometimes called congestive heart Blood Test – CRP Soft Diet with Small
failure. It occurs when heart muscles are unable to Deficiency of ECG Frequent Meals
pump blood around the body properly. It usually Vitamin A, D, Chest X- rays ↔ Kcal
happens because the heart has become too weak or Calcium, Echocardiogram ↔ CHO
Heart Failure
stiff. Heart failure does not mean your heart has Magnesium, Stress Test ↑ Protein
stopped working. There are 4 types of Heart Failure: Selenium and CT Scan, MRI ↔ Fats (Omega 3 & MCTS)
Left-sided heart failure, Right-sided heart failure, Iodine Coronary Angiography ↑ Fiber
Diastolic heart failure, and Systolic heart failure Myocardial Biopsy DASH Diet
Avoid Gas forming foods
Liquide or Soft Diet & DASH
Diet
Myocardial infarction (MI) is necrosis in the heart
Blood Test – CRP Small Frequent Meals
muscle caused by prolonged inadequate blood supply
ECG ↔ Kcal
or oxygen defi cit. A coronary occlusion (heart attack)
Deficiency of Chest X- rays ↔ CHO
Myocardial Infarction is the closing of a coronary artery feeding heart muscle
Vitamin D and Iron Echocardiogram ↔ Protein
by fatty deposits or a blood clot; it manifests with
CT Scan, MRI ↔ Fats (Omega 3 & MCTS)
heavy squeezing pain radiating to the jaw or back,
Coronary Angiography ↑ Fiber & ↑ Fluid
nausea, vomiting, diaphoresis, anxiety, and weakness.
Avoid Saturated and Gas
forming foods