amounts of these nutrients and cause hypervitaminosis; death may result in extreme cases. Water-soluble vitamins, such as B complex and ascorbic acid, are not stored to any great extent.
Vitamin supplements are usually not necessary if the diet includes a wide variety of foods. Exceptions may occur in prenatal diets in which iron is low and in patients proven to be deficient in a specific vitamin. Vitamin supplements should be taken only on a physicians or dietitians recommendation.
The body can survive weeks without food, but only days without water. It makes up 70 percent of the body weight and is found in every cell in the body. Water is the medium through which nutrients are transported from the digestive tract to the cells where they are needed. It is also the medium through which the by-products of cell metabolism are removed. Water also serves as the medium in which the chemical processes of life take place. Fluid needs are increased with sweating, vomiting, diarrhea, high protein diets, and hot environments. Water is normally taken into the body in beverages, soups, and in the form of solid foods. An insufficient intake may cause constipation, loss of weight, abnormal body temperature, and dehydration leading to ketosis.
Calculating therapeutic diets can be complicated and is best left to dietitians. For daily living, there is a simple, practical plan, based upon the classification of foods into groups according to the nutrient content.
It is now common practice for dietitians or dietary kitchens to select foods for diets on the basis of food groups. See figure 3-1 for the Guide to Good Eating food groups. They are classified according to their nutritional value and the number of servings that should be eaten each day. This figure can serve as a simple and effective guide in planning or evaluating diets.
The appetite of the patient requires catering to, as patients tend to be more fastidious when sick. In some disease states, such as cancer, patients experience marked taste changes. Because of the importance of the nutritional elements in feeding the sick, try to carry out the patients wishes whenever possible. A tactful and observant hospital corpsman will be most helpful to the physician and dietitian in carrying out the dietary regimen, You must be aware of what comprises a well-balanced diet and should be able to recognize when dietary adjustments need to be made in special situations. This is important to meet the changing needs of the diseased bodys ability to make use of foods.
The patient should be made to feel that the utmost cleanliness and care have been observed. The patients face and hands should be cleaned before food is served, and the lips and teeth cleaned before and after the meal. If the mouth is dry, it should be moistened periodically.
When special or modified diets are ordered, check the contents of the tray with the written orders. An error in serving a special diet may cause discomfort, serious illness, or even death.
The dietary objectives are:
Diets used in the treatment of disease are often spoken of by names that show a special composition and often indicate the purpose for which the diet is intended.