Diet in fevers

Diet in Fevers : Diet in Fevers Diet in Typhoid fever

FEVER : FEVER Fever is an elevation in body temperature above the normal which may occur due to infection, inflammation or unknown cause. Normal Body temperature =37 Degree Celsius = 98.4-- 98.6 Fahrenheit

Slide 3 : Infection & fevers can be classified into two categories Acute or Chronic Acute fevers are of short duration with acute symptoms like the increase in body temperature to 104 degree F. Examples are-chicken- pox, influenza, typhoid ,malaria or tonsillitis. Chronic fevers are of long duration & may be characterized by low grade fever which may continue for many months. Examples are tuberculosis, HIV infections & AIDS.

Slide 4 : Basal metabolic rate increases in severe infection. There is a 7% increase in BMR with every 1degree Fahrenheit increase in body temperature or 13% increase in BMR with every 1degree Celsius rise in body temperature. Decrease glycogen stores, adipose tissue. Increased catabolism of proteins increase nitrogen wastes place an additional burden upon the kidneys.

Slide 5 : Accelerated loss of body water by sweat & excessive urination. Increased excretion of fluids &,electrolytes that is sodium ,potassium & chlorides. Anorexia (lack of appetite) leading to loss of weight. Absorption of nutrients is reduced especially in intestinal infections

General Dietary Considerations : General Dietary Considerations Diet depends upon the nature and severity of the pathologic conditions and length of convalescence. Energy - In high temp. patient may be able to ingest only 600 – 1200cal. But should be increased as the requirement is high. Protein 100 gm -protein prescribed for an adult when a fever is prolonged (chronic) high protein beverages.

Slide 7 : Carbohydrates : Glycogen stores are replenished by a liberal intake of CHO.Simple sugars absorbed into blood stream easily. Lactose , in some individuals may increase fermentation resulting in diarrhea. Fats – judicious use of fats may increase energy intake but fried foods and rich pastries may retard digestion.

Slide 8 : Minerals : use salty broths and soups for sodium chloride ,fruit juices and milk replenish potassium loss. Calcium requirements are increased Vitamins : requirement of vit A, ascorbic acid, B complex requirements are increased.

Slide 9 : Oral therapy and antibiotics interfere with synthesis of B-Complex vitamins by intestinal bacteria necessitating vitamin supplements. Fluid – The fluid intake to be liberal to compensate for the loss of 2500 ml to 5000 ml. daily (beverages soups, fruit juices, water). Bland Diet readily digested foods will facilitate digestion & rapid absorption in regular or soft consistency.

Disadvantages of fluid diets in fevers : Disadvantages of fluid diets in fevers More bulky in proportion to energy they provide. Increases abdominal distention. May induce anorexia nausea, vomiting

TYPHOID FEVER : TYPHOID FEVER Is called Enteric fever because the infection or bacteria is found in intestines damaging the epithelium. Caused by bacteria Salmonella typhosa. The source of infection is the drinking water, milk & is transmitted through fecal-oral route. Extremely catabolic in nature

Slide 12 : Body stores of glycogen is quickly depleted. GIT tract is highly inflamed & irritable. Excessive diarrhoea ,vomiting & perspiration can cause loss of fluid & electrolytes. Inflammation of GI tract can lead to intestinal ulceration & bleeding. Weakness & loss of weight

Slide 13 : CLINICAL SYMPTOMS Graded fever Abdominal pain Anorexia Internal hemorrhage & malena (bleeding tarry stools)

MODIFICATION OF DIET : MODIFICATION OF DIET ENERGY-Increase in 10%-20% of calories recommended. CARBOHYDRATES- Liberal amounts in easily assimilated CHO form like variety of beverages/light desserts, starches, honey, jam, glucose, . DIETARY FIBER- Typhoid patient has an inflamed intestinal mucosa which can be easily perforated & ulcerated leading to internal hemorrhage Foods high in fiber must be avoided. Green leafy vegetables, whole pulses, thick skin fruits, or vegetables should be avoided.

Slide 15 : PROTEINS-- 1.5 -2G/Kg./day proteins of high biological value FATS--Used in moderation. Increased quantity will lead to diarrhoea as the ability to assimilate is reduced. One can use dairy fats,cream,butter,egg yolk . MINERALS—Loss of minerals is observed due to diarrhoea .Salty soups for sodium, fruit juices for potassium. Iron supplements may be given when hemorrhage occurs.

Slide 16 : VITAMINS Vitamin A &C required to improve the integrity & maintenance of epithelial membrane which may improve the immunity & favor wound healing. B Complex vitamin to improve the assimilation of the nutrients. FLUIDS 2.5-3.5 LITRES FREQUENCY- Since the appetite is poor during acute fever, small feedings of soft or liquid foods are acceptable

FOODS PERMITTED : FOODS PERMITTED Soups, Pulse soup (dal water), Rice starch soup, broths. Refined cereals (maida) , pulses without skin, pureed vegetables, stewed fruits. Eggs, cottage cheese, tender steamed or baked chicken/ fish. Fruit juices, gelatin, honey, sugar and milk products (Yogurt).

FOODS TO BE AVOIDED : FOODS TO BE AVOIDED High fiber foods like whole grain, cereals ,pulses. Raw vegetables and fruits. Fried fatty foods. Spices, pickles, ketchups etc.