|
"Dietary
Modification - its neglect means
poor recovery"
By
Shrabani Bhattacharya, Dietician, MRC
The
nutritional requirement of an individual depends on many factors like age,
sex, physical work and physiological stress.
We
are delighted that the modern days cholesterol consciousness has
progressed us to some
extent, but it is nothing if one looks at the rehabilitation ward of
Medical Rehabilitation Centre!
Here
most of the patients happens to be victimised by stroke, either ischaemic
or haemmorhagic. Actually that are the depot of either sugar or lipid
inevitably stored in lumen vessels.
I
remember, a few days back 50% of male ward patients were on insulin and our
diabetologist frequently visited the patients, recommending strict diet
modification. Indeed, diet therapy is a part and parcel of our
rehabilitation units and and by proper modification of diet, lipid and
sugar is seen to be controlled significantly.
Apart
from the diabetes and hyperlipidemic patients, stroke patients always
require proper scientific dietary modification for a better rehabilitation
outcome. Even in spinal injury patients, specialized diet with
supplementation of adequate protein, vitamin, minerals and calcium claims
to be one of the better results by rehabilitation.
It
is very important to determine the exact requirement of calories first.
Secondly, the content of the food which would be suitable for particular
patient to supply the calories. It may be low fat (Saturated/Unsaturated
), low cholesterol, high in PUFA, low carbohydrate, high fibre, low
protein or high protein, even the supplementation of electrolytes like
Na+, K+, Ca2, is to be determined very
scientifically in some patient (as with renal problems).
For
cardiac patients, low calories, low fat particularly low saturated fat, low
cholesterol high in PUFA, low carbohydrate, high fibre and normal protein,
minerals and vitamins are suggested.
For
diabetic patients, low calorie, low carbohydrate, high protein, low fat, and
high fibre diet is suggested. A diabetic patient with insulin and on
exercise programs must get very scientifically calculated calorie,
otherwise a very low calorie supplementation on a patient with insulin if
exercises vigorously, may sink into hypoglycemic coma. Here the exact
energy expenditure in any particular exercise program should be properly
calculated physiatrist. In this respect Medical Rehabilitation Centre's
approach of team discussion is a perfect approach. We are surprised how
this is performed in common practice of home physio in Kolkata!!
|
|
