personnel knowledgeable in proper eating habits. The dietitian conducts patient interviews to learn the patient’s eating behaviors, usual portions, preparation of foods, meal patterns, nutritional adequacy, exercise, and so forth. Individual programs should then be recommended to assist patients to attain and maintain their ideal weight. The Handbook of Clinical Dietetics, published by the American Dietetic Association, lists the following formula for determining ideal body weight. For females, the basic weight for 5 feet is 100 pounds. Add 5 pounds for every inch over 5 feet. For males, the basic weight for 5 feet is 106 pounds, with 6 pounds added for every inch over 5 feet. Adjustments must be made for body build. Reduce desired weight by 10 percent for a small frame; increase it by 10 percent for a large frame. Total caloric requirements are based on ideal body weight plus activity. Many patients on low-calorie diets experience hunger. To satisfy this hunger or appetite, low-calorie foods such as raw vegetables, broth, black coffee or tea, and other unsweetened or diet beverages should be provided. Water and sodium need not be restricted unless there are cardiac complications or edema, and the restrictions are ordered by the physician. LOW-PROTEIN DIET.—As the name implies, the low-protein diet is made up of foods that furnish only small amounts of protein and consist largely of carbohydrates and fats (e.g., foods such as marshmallows, hard candy, and butter). This diet is used in renal diseases associated with nitrogen retention or liver disorders. Limited amounts of protein are sometimes advocated in certain kidney diseases (such as chronic nephrotic edema). Low-protein diets for renal failure are usually restricted in sodium and potassium, because these two elements are not excreted properly during this condition. In some cases of chronic renal insufficiency, the protein content of the diet is varied, usually between 40 and 60 g per day, so that there will be sufficient complete protein to maintain nitrogen equilibrium. In some metabolic disturbances, such as amino acids in the urine, protein restriction may be of therapeutic value. HIGH-RESIDUE DIET.—The high-residue (high-bulk, high-fiber, high-roughage) diet is indicated in atonic constipation, spastic colon, irritable bowel syndrome, and diverticulosis. This diet encourages regular elimination by stimulating muscle tone, creating softer and larger stools that are more easily propelled through the colon, thereby reducing the pain and cramping that accompany spastic colon or irritable bowel syndrome. The patient is given a regular diet, with the inclusion of high-residue foods. The main sources of fiber are whole-grain breads and cereals, bran cereals, fresh fruits, and vegetables that are raw or cooked until tender. Whole grain breads and cereals that contain wheat bran have a greater laxative effect than fruits and vegetables, because the bran acts to absorb water within the colon, creating a bulk effect. Fiber intake should be increased gradually to minimize potential side effects of bloating, cramps, and diarrhea. At least one serving of 100 percent wheat bran cereal is recommended daily. Cereals such as raisin bran, Bran Flakes®, Shredded Wheat®, and oatmeal may be used occasionally, but they contain less than half the amount of fiber found in All-Bran® or Bran Buds®. Fresh fruits and vegetables with edible skins, such as apples and grapes, are higher in fiber content than canned fruits or vegetables and their juices. Dietary intake of refined sugars and starches should be decreased because they are poor sources of fiber. Also, limit white flour products, refined cereals, pies, cakes, and cookies. Too little fluid in the high-residue diet may cause dehydration and lead to constipation. The patient must drink at least eight 8-ounce glasses of water or other fluids daily, particularly when consuming the recommended amount of bran. Drinking too much alcohol, beverages containing caffeine (such as coffee, cola, tea, and soft drinks), however, can irritate a sensitive colon and can cause dehydration. When possible, use decaffeinated coffee. One or two glasses of water in the morning help to stimulate peristalsis. Excessive intake of foods like dried beans, fruits with seeds and skins, nuts, popcorn, and strong spices may cause irritability, especially during the inflammation period of colon disease states. These foods should be individualized to the patient. When one is progressing from a low-residue diet after an acute infection or diverticulitis, increase fiber in the diet gradually. Start by adding one serving of 100 percent bran cereal and three servings of whole-grain bread to the low-residue menu pattern. Gradually increase the amount of raw vegetables and fresh fruits to at least four servings per day. LOW-RESIDUE DIET.—The low-residue diet is indicated in ulceration, inflammation, and other 9-9