Allergens, Intolerances, and Hospital Diets

• This text discusses allergens, intolerances, illnesses linked to food consumption, and various hospital diets.

Allergens, Intolerances, and Food-Related Diseases

• Food allergy is an inappropriate immune response to a food component, usually a protein; it can endanger a person's life.
• Food intolerance is an adverse reaction to food that doesn't involve the immune system, though it can chronically affect someone's health.
• Food allergies cause rapid and clear reactions, while food intolerances manifest more slowly.
• Allergy symptoms can range from mild, like hives and dermatitis, to severe, affecting multiple organ systems.
• Intolerance symptoms include nausea, diarrhea, and abdominal pain.

Regulations

• Spanish Royal Decree 126/2015 sets standards for food information on unpackaged foods sold to consumers.
• The decree mandates informing consumers about ingredients causing allergies or intolerances, even if modified in the final product.
• The Food Information Law requires informing consumers about the composition of dishes and any allergens they contain.
• Requirements apply to businesses offering meals, unpackaged foods, or those packaging food for immediate sale.

Obligatory Allergen Declarations

• There are 14 allergens that must be declared including:
  • Cereals containing gluten (e.g., wheat, rye, barley, oats)
  • Crustaceans
  • Eggs
  • Fish.
  • Peanuts.
  • Soybeans.
  • Milk (including lactose)
  • Nuts (e.g., almonds, hazelnuts, walnuts)
  • Celery.
  • Mustard.
  • Sesame seeds.
  • Sulfur dioxide and sulfites
  • Lupin
  • Mollusks.

Eating Disorders

• Eating disorders are used as an escape from difficult situations.
• Sufferers deal with their unease via food, body image and weight control in order to find alleviation and control.

Anorexia Nervosa

• Anorexia is characterized by restricting food intake, a fear of gaining weight, and a distorted perception of body weight.
• Anorexia often involves persistent behaviors that prevent weight gain and a failure to recognize the seriousness of having a low body weight.
• Restrictive type anorexia involves no recurrent episodes of binge eating or purging in the last three months
• Binge-eating/purging anorexia involves recurrent episodes of binge eating or purging in the last three months.
• Symptoms include severely restricted eating, excessive exercise, and extreme thinness.

Bulimia Nervosa

• Bulimia is characterized by eating large amounts of food in a short period.
• Bulimia is characterized by a sense of lack of control, and compensatory behaviors to prevent weight gain.
• Compensatory behaviours include self-induced vomiting, laxative use, fasting, and excessive exercise.

Diabulimia

• Diabulimia is where diabetic bulimia patients manipulate insulin dosages for weight loss.

Binge Eating Disorder

• Binge Eating Disorder is characterised by recurrent episodes of binge eating, and distress over the behaviour.
• There is an absence of compensatory behaviors seen in bulimia nervosa.
• Symptoms include eating large amounts of food quickly, when not hungry, and feeling uncomfortably full.
• Further symptoms include eating alone due to embarrassment, feelings of guilt, and frequent dieting.

Other Specified Feeding or Eating Disorders

• These diagnoses are for presentations with feeding that cause significant distress but do not meet the full criteria for other disorders.

Examples of Atypical Anorexia Nervosa

• Diagnostic criteria for anorexia nervosa are met with the exception of the individual’s weight

Purging Disorder

• Purging after eating normal amounts of foot to influence weight/shape.
• Is characterized by recurrent purging behaviors to influence weight or shape in the absence of binge eating.

Night Eating Syndrome

• Is characterized by recurring episodes of night eating, with excessive food consumption after dinner, or waking regularly to consume food.

Vigorexia

• Vigorexia is characterised by a distorted body image.
• Sufferers see themselves as lacking muscle and will compulsively exercise and eat a diet high in protein.

Fatorexia

• Fatorexia is a condition characterized by obese individuals looking in the mirror and not perceiving.
• They eat lots of junk food so can develop malnutrition.
• View excess weight is synonymous with strength and vitality.

Permarexia

• Permarexia is associated with people being obsessed with being overweight.
• Sufferers will be on permanent diets and are fixated on calories.
• Sufferers do not go without food or induce vomiting, or use diuretics or laxatives.

Ebriorexia

• Ebriorexia is characterised by the limiting consumption of alcohol to compensate for calories.
• It usually occurs in younger adults and can be combined with other disordered behaviours like vomiting to control weight.

Orthorexia

• Orthorexia is characterised by an obsession with categorising and consuming healthy food to a personal healthy eating criteria.
• It can affect mental health and cause social anxiety.

Other Feeding and Eating Disorders

• Pica is persistent eating of nonnutritive substances
• Rumination disorder is the regurgitation of food
• Avoidant/restrictive food intake disorder is nutritional deficiency.
• Hyperphagia is defined as excessive hunger combined with overeating

Detecting an Eating Disorder

• To detect an eating disorder:
  • Note any restrictive diets, or negative changes in social behaviour
  • Obsession over appearance and exercise
  • Inconsistencies with food habits

New Diet Trends

• New diet trends include:
  • Healthy and unhealthy diets
  • Omnivore and Mediterranean diets
  • Vegetarian and vegan diets
  • Raw Food diets

Types of Vegetarian

• Vegetarians tend to consume mainly vegetables, and may consume dairy/eggs.
• Vegans consume foods based on plants and omit animal products.
• Ovo-vegetarians consume vegetable based products and eggs.
• Pescetarians consume plants and fish.

Special Diets

• Crudités is a diet based on consuming raw foods that have not been modified by any cooking process.
• Ovolactovegetarian Crudivores include raw eggs, unpasteurized dairy products and bee products in their raw food diet.
• Diets designed at stopping hypertension are rich in fibre, calcium and potassium, as well as protein.

Flexitarian Diet

• A semivegetarian diet consists mainly of plants, but includes meat, dairy, eggs, poultry and fish.
• They will prioritise plant based foods but will include animal protein and fish.

Lacto-vegetarian

• Lacto-vegetarians eat dairy, but avoid consuming animal products.

Combined Diet

• Diets that combine elements of the Mediteranian diet are effective in hypertension, cholesterol and aging.

Weight Loss Diet

• These diets usually decrease the risk of cardiovascular disease, but prioritise fruits and vegetables

Api-Vegetarian Diet

• Includes honey.

Diet Guidelines

• People with Lacto-ovo vegetarian diets can incorporate milk, cheese, yogurt and eggs.
• All meat, fish and seafood is restricted in vegan, and gluten free diets.

Other Weight Loss Diets

• Noom: weight and habit change with a support system.
• Pritikin: low fat, protein, and high cabohydrate diet.
• The Zone: high protein and proportions of carbohydrate protein and fat.
• Nutritarian: plant based, restricted animal proteins
• South Beach: consumption of lean protein, reduced carbohydrates.

Examples of Diets

• Paleo: unprocessed food and simple cooking methods.
• Keto: Low-carb, high fat.
• Atkins: High protein.
• SlimFast: 1200 calorie diet

Types of Hospital Diets

• Hospital diets should meet energy and nutritional needs, factoring in personal circumstances adapting to individual circumstances like, age, weight, likes and dislikes
• Therapeutic diets have changes in composition and number dependant on the activity carried out at the centers of work.
• They aid in treatment and healing, tailored individually and are both preventative and curative in nature.
• The regulation of diet is called dietotherapy.

Hospital Food Service

• Providing patients with a nutritious, balanced diet that is pleasant in taste and presentation.
• Planning of food and liquids based on characteristics.
• Staff includes: Physicians, nurses and nutritional staff.

Responsibilites of Foodservice

• The medical team prescribes the diet
• Nursing team apply for diets and distribute to medical staff
• Nutrition team: Define the specific recipes.
• Planned baseline and adapted diets, to align with different patients as well as menu choices.
• Nutrition education for staff such as appropriate hygiene and sanitisation.
• Food quality management.

Preventative Medicine Services

• The Preventative Medicine service checks the hygiene/food preparation conditions and co-ordinates with other staff to avoid hazards/ accidents:
  • Staff health check.
  • Analysis of sanitation and safety, and training.

Classifying Diets

• Each hospital center classifies and systematizes its own diets according to scientific criteria and maximum applicability
• Classification includes information diets with the purpose of treatment/prevention of the disease.
• Each center should provide dietary codes and well as the rationale diet.
• Balanced diets have necessary calories for bodily functions; also, compensate for activities.
• A balanced diet means 50% carbohydrates, 20% protein and 30% fats.

Basic Hospital Diets

• Divided into adult and pediatric.
• Also dietary fibre.

Other Diets

• Other diets are of modified consistency, such as easy to chew and crushed foods.
• Therapeutic diets are adapted accordingly.

Diets and Modifications

• Diet modifications can affect composition (hypocaloric, reduction to essential principle), and can lead to potential deficiencies.
• To try to avoid deficiencies, some modifications make use of texture and nutritional value.

Diet Classifications

• Therapeutic diets are categorised in hospitals.
• Coded therapeutic diets adhere to hospitals and patient needs.
• Non-coded therapeutic diets are combined, adapted and complex.
• Starting diets are often used post fasting to provide nutrition, and lack protein.

Types of Diets

• A bland diet is digestible and lacks irritation of the gastrointestinal system.
• It is complete in its energy and protein content.
• Low protein diets can be applied to those in renal/hepatic issues.
• Low fat diets are very low In fats
• Low fat/protein is protein and fat restrictive that avoids pancreatitis.

Calorie Restricted Diet

• There a calorie restricted diets that vary by number: 1000, 1500, 2000, 3500.
• They control the level of ingestion and sugars .

Restrictive Diets

• Astringent, high or low in nutrients (sodium), but may have an impact on other conditions.

Texture Modifications

• Texture modifications such as fiber, fats and proteins.

Special Therapeutic Diets

• Control specific nutrients like carbohydrates or manage digestive issues .

Lactose Free Diets

• Lactose free diets are for lactose intolerance and restrict dairy, however requires use of supplements

Gluten Free Diets

• Gluten free diets are for gluten allergies restrictions include wheat, rye and barley

Diets Low in Purines

• Low purine diets are for restricting uric acid to manage red meat, seafood and oily food

Dietary Concerns

• Additional concerns for all diets can help with:
  • Calicum absorption or restrcitions
  • Low in potassium
  • Food allergies
  • Diabetic control
  • Post operative diets
  • Celiac disease
  • Liver disorders
  • Obesity

Other Diets

• Includes light, hypoglycemic, or those with a surgical or exploratory purpose
• They may include a diet that suppresses all food and drink

Therapeutic Diets

• Diets needs for necessary treatment of disease, such as: diet, gluten free, malabsorption.
• Profilactic concerns must provide weight loss of the patient and treatment.
• Diets with special features such as the ability to lower blood sugar, and may include some foods and supplements as part of the treatment of the .

Additional Dietary Concerns

• Dietary concerns may include:
  • Ulcers
  • Allergies
  • Burns
  • Liver failure
  • May also need:
    • Specific fluid intake
    • Bland texture

Modified Texture Diet

• Include a clear liquid, semiliquid , soft with no lactose that is easily chewable.
• Recommended if the patient has gastrointestinal or swallowing issues
• High intensity of fibre, and provides vitamins A, D, and E
• Is provided in easy to consume forms, such as soup, purees, and cooked meats

Common Characteristics of Diets

• Diets are restricted in different substances and should vary depending on the personal and cultural habits of the individual.
• Should be rich in plant and fibre content and low in processed foods and fats.

Role of Nutrition

• Adopting healthy eating habits is beneficial and can help control or manage serious conditions
• Essential for overall health to provide energy and regulate components of our bodies.
• Following a therapeutic diet will have specific health benefits depending on how to improve intake of different parts of our body.

Additional Considerations

• Increase of fruit and vegetables while limiting fast food and saturated fat.
• Water intake.

Food Components

• Fruits provide sugar, fibre and antioxidants.
• Vegetables are another great source of fiber, minerals and antioxidants
• A variety of fats are helpful like olive oil for antioxidant properties
• Dairy with less fat
• Pulses add vital nutrients.

The Mediterranean Diet

• The Mediterranean diet emphasizes an abundance of vegetables and a selection of wholegrains.
• High levels and low saturated fate and animal proteins is beneficial.

Explore allergens, intolerances, and food-related illnesses. Understand the differences between allergies and intolerances, their symptoms, and relevant regulations like the Spanish Royal Decree 126/2015. Learn about hospital diets.