🍳 Nutrition

What diet goes with what disorder — and what food fights what drug

Built from your ATI Nutrition in Nursing unit on alterations in nutrition, plus the drug–food interactions that show up on every exam. Sorted by body system, so you can find a diet by where the problem is.

⭐The six that decide most questions3-second recall

If you read nothing else on this page, read these.

HypertensionDASH Low sodium, high potassium, high calcium. Start <2,300 mg → goal 1,500 mg.

Kidney, pre-dialysisLess protein 0.8–1.0 g/kg. Protein goes down until dialysis starts.

Kidney, on dialysisMore protein 1.0–1.2 g/kg. Dialysis removes protein, so it goes back up.

Low blood sugarRule of 15 15 g fast carb → recheck in 15 min → repeat if still <70.

CeliacGluten-free for life Wheat, barley, rye. Not a preference — an autoimmune injury.

Dumping syndromeFluids between meals Never with food. Small, frequent, high protein and fat, low sugar.

🧂Sodium: one number per conditionmost-confused

Every one of these is a “low sodium diet.” They are not the same number.

The trap: heart failure gets looser when it is mild (3,000 mg) and tighter when it is severe (2,000 mg). Read the severity before you pick the number.

🧡Heart & blood5 conditions

Cardiovascular and hematologic disorders — ATI ch. 13.

🧡 Coronary heart disease — the TLC diet

Cholesterol <200 mg/day. Saturated fat <7% of daily calories.

Soluble fiber is what actually lowers LDL — oats, beans, barley, flaxseed, fruit.

✅ Do

Trim fat, remove skin
Broil, bake, grill, steam
Olive or canola oil
Oily fish — tuna, salmon, herring
Season with spices, not butter or salt

❌ Avoid

Trans fat — anything “partially hydrogenated”
Frying
Lard, butter
Red and fatty meats

Low folate, B6 or B12 raises homocysteine — and homocysteine raises CHD risk.

💉 Hypertension — DASH

Low sodium, high potassium, high calcium. Defined as sustained ≥130/80.

Sodium: start <2,300 mg, work down to 1,500 mg
Potassium foods: apricots, bananas, tomatoes, potatoes
Low-fat dairy for the calcium

DASH is the one diet that lowers both blood pressure and cholesterol.

💔 Heart failure

Mild–moderate: sodium <3,000 mg
Severe: sodium <2,000 mg
Fluid often restricted to 2 L/day
Protein up to 1.12 g/kg

The problem is retained sodium and water, so the diet targets the retention, not the heart itself.

🚨 Myocardial infarction

Liquid diet for the first 24 hours
No caffeine — it raises heart rate and oxygen demand
Small, frequent meals
Then transition to the heart-healthy diet above

Everything here exists to cut the myocardium’s oxygen demand while it heals.

🩸 The three anemias — three different foods

Red cells need iron, B12 and folic acid. Which one is missing changes the plate.

Deficiency	Give	Tell them apart
Iron most common in the world	Red meat, fish, poultry, tofu, dried beans, whole grains, dried fruit, fortified cereal	Pallor of nail beds, cold intolerance, tachycardia
Vitamin B12 macrocytic; pernicious = no intrinsic factor	Fish, meat, poultry, eggs, milk	The only one with neuro signs — paresthesia, poor proprioception, delirium
Folic acid	Green leafy vegetables, dried peas and beans, seeds, orange juice, fortified cereal and bread	Glossitis, diarrhea, irritability — no neuro signs

B12 vs folate: both cause glossitis and fatigue. Only B12 numbs the hands and feet.

🥐Gut14 conditions

Gastrointestinal disorders — ATI ch. 14. This is the longest section, so it is collapsed by symptom.

The classic swap: diverticulosis gets high fiber; diverticulitis gets clear liquids first, then high fiber once the inflammation settles. One letter changes the whole answer.

🥛 Symptoms — nausea, anorexia, constipation, diarrhea, dysphagia

🤮 Nausea & vomiting

Once it settles: clear liquids → full liquids → advance as tolerated.

Easy, low-fat carbs: crackers, toast, oatmeal, pretzels, plain bread
Serve food room temperature or chilled — hot food smells stronger
Elevate the head of the bed
Ginger as a complementary therapy
No liquids with meals — they fill her up

Coffee-ground emesis means blood. Pale green means bile.

😭 Anorexia (no appetite)

Not anorexia nervosa — this is loss of appetite from illness or medication.

Small, frequent meals; largest meal early in the day
Hold drinks 30 min before and after meals
Liquid supplements between meals, not with them
Remove odors, bedpans, soiled linen, clutter
Tart or strongly seasoned food if taste is dulled

💩 Constipation

Fiber first: 25 g/day female · 38 g/day male. Fluid 64 oz/day unless restricted.

Increase fiber gradually
Exercise
Avoid chronic laxative use

Of peanut butter, peeled apple, hardboiled egg and a baked potato — the baked potato has the most fiber. Peeling the apple throws the fiber away.

💧 Diarrhea

Loses potassium, sodium and fluid — that is what makes it dangerous.

Liberal fluid to replace losses
Low fiber, short term, to calm bowel stimulation

🍽 Dysphagia

Aspiration is the risk. Upright or high-Fowler’s to eat — every time.

Thicken liquids, modify texture
Refer to speech therapy
Oral care before eating improves taste
Small bites, thorough chewing, no rush
Pills with 8 oz fluid so they don’t lodge in the esophagus
Avoid thin liquids and sticky foods

🪨 Stomach — dumping, GERD, gastritis, ulcers

⏳ Dumping syndrome

After gastric surgery, stomach contents rush into the small intestine.

Early, 10–20 min: fullness, cramping, nausea, diarrhea, faintness, syncope, diaphoresis, tachycardia, hypotension, flushing.
Late, 1–3 hr: diaphoresis, weakness, tremors, anxiety, hunger — this is rebound hypoglycemia.

Small, frequent meals
Protein and fat at every meal
No concentrated sugars; restrict lactose
Fluids 1 hr after meals — never with them
Lie down after eating to slow gastric emptying
Watch for iron and B12 deficits

Note the exam trap: dumping causes tachycardia and hypotension, not bradycardia, and not dry skin — they sweat.

🔥 GERD

Everything here either lowers abdominal pressure or protects the lower esophageal sphincter.

No eating 3 hr before lying down
Elevate on pillows; no large meals or bedtime snacks
No tight clothing
Weight loss if overweight

❌ Drops the sphincter

Fatty foods
Caffeine, chocolate
Alcohol, nicotine
Peppermint and spearmint

❌ Irritates directly

Citrus fruit and juice
Spicy food
Carbonated drinks

🪨 Gastritis & peptic ulcer disease

Nearly the same food list for both.

Avoid: alcohol, smoking, aspirin and NSAIDs, coffee, caffeine, black pepper, spicy food
Gastritis: avoid frequent meals and snacks — they drive acid secretion
Bland diet once food is tolerated
Monitor for B12 deficiency

PUD findings: dull gnawing or burning epigastric pain, tarry stools, anemia, sour taste, bloating. Eating temporarily relieves it. Steatorrhea and swollen nodes are not PUD.

🦬 Bowel & accessory organs — lactose, ostomy, IBD, gallbladder, pancreas, liver, celiac

🥛 Lactose intolerance

Not enough lactase. Distention, cramps, flatus, osmotic diarrhea.

4–6 oz of milk with a meal is often tolerated
Yogurt and aged cheese are lower in lactose
Limit: milk, soft cheese, ice cream, cream soup, sour cream, pudding, coffee creamer
Watch calcium and vitamin D; ask about a lactase enzyme

🧿 Ileostomy & colostomy

Fluid and electrolytes are the whole concern — the colon is what normally absorbs them.

Fluids 1.9–2.4 L (64–80 oz) daily, plus soluble fiber
More calories and protein to heal the stoma
Gas: beans, eggs, carbonated drinks
Blockage: nuts, raw carrots, popcorn
Odor: eggs, fish, garlic

Start with liquids after surgery and advance on tolerance.

🦠 Diverticulosis vs diverticulitis

✅ -osis (quiet)

High fiber
Softer stool, less pressure in the colon

🚨 -itis (inflamed)

Clear liquids until inflammation drops
Then high fiber, low fat

🔥 Inflammatory bowel disease

Crohn’s and ulcerative colitis — flares and remissions.

Exacerbation: low residue, high protein, high calorie, plus vitamins and minerals
Enteral feeding preferred over parenteral — similar benefit, lower cost
In remission, broaden the diet to her own triggers
Avoid nicotine

🥒 Gallbladder & pancreas

Cholecystitis: limit fat — fat is what makes the gallbladder contract.

Acute pancreatitis: NPO, NG tube to suction, TPN if needed. Rest the pancreas completely.

Chronic pancreatitis: low fat, high protein, high carbohydrate, plus vitamin C and B-complex.

Of a ribeye, oatmeal, ice cream and pretzels — ribeye and ice cream are the ones to cut.

🥪 Liver disease

Protein increased for positive nitrogen balance
Carbohydrates not restricted — they are the calorie source
Multivitamins, especially B, C and K
Eliminate alcohol, nicotine and caffeine

Malnutrition is the norm in liver disease, not the exception.

🌾 Celiac disease

Strict gluten-free for life. Autoimmune, inherited — not a sensitivity or a preference.

✅ Safe

Rice, corn, potatoes
Milk, cheese, eggs
Fruit, vegetables
Fresh meat and fish, dried beans

❌ Gluten

Wheat, barley, rye
Graham crackers, gravy mixes
Sauces, cold cuts, soups
Even lipstick, communion wafers, some vitamins

Watch for bleeding (vitamin K), the three anemias, and osteoporosis — damaged villi absorb nothing well.

🥬Kidney5 stages

Renal disorders — ATI ch. 15. The one section where protein moves in both directions.

Why it reverses: before dialysis, protein waste is work the kidney cannot do. On dialysis, protein and amino acids are pulled out into the dialysate, so intake has to rise to replace them.

🥬 CKD stages 1–4 (pre-dialysis)

Goal: slow the progression.

Protein 0.8–1.0 g/kg of ideal body weight
Restrict sodium (blood pressure) and potassium (hyperkalemia)
Limit high-phosphorus foods to one serving a day or less
Control glucose and blood pressure

High phosphorus deposits calcium and phosphorus in the kidney — restricting it is what slows the disease.

High phosphorus: peanut butter, dried peas and beans, bran, cola, chocolate, beer, some whole grains.

💧 End-stage kidney disease (stage 5)

GFR <15 mL/min. Low protein until dialysis, then higher.

Calories 35 kcal/kg
Protein 1.0–1.2 g/kg once dialysis begins — half from biologic sources
Sodium 2–3 g/day
Phosphorus 700–1,200 mg/day; phosphate binders with every meal and snack
Calcium supplements — the high-phosphorus foods she must avoid were also her calcium
Vitamin D supplement — failing kidneys can’t activate it

⚡ Acute kidney injury

Usually reversible. Diet depends on the phase and whether she is on dialysis.

Calories 20–30 kcal/kg/day in every phase
Protein 0.6 g/kg without dialysis → 1.0–1.2 with it
Potassium 60–70 mEq/day on dialysis
Sodium 1–2 g without dialysis · 2–4 g with it
Oliguric phase fluid = urine output + 500 mL

💦 Nephrotic syndrome

Protein pours out in the urine → hypoalbuminemia, edema, hyperlipidemia, hypercoagulability.

Protein 0.7–1.0 g/kg — enough to stop muscle catabolism
Sodium 2,000 mg for the edema and pressure
Soy protein lowers both protein loss and lipids
Carbohydrates carry most of the calories
Multivitamin, plus vitamin D — both leave with the protein

🪨 Kidney stones

Fluid is the whole treatment. Enough to make 2 L of urine a day, including some before bed.

Calcium oxalate — the most common:

Limit animal protein, excess sodium, alcohol, caffeine
Limit oxalates: spinach, rhubarb, beets, nuts, chocolate, tea, wheat bran, strawberries
No megadoses of vitamin C — it turns into oxalate
Low potassium encourages stones

Uric acid stones: limit purines — lean and organ meats, whole grains, legumes.

Oxalate matters more than calcium. Do not slash dietary calcium to prevent calcium stones.

🍬DiabetesATI ch. 16

Two emergencies and one counting system.

Notice the same number does three jobs: 15 grams, 15 minutes, 15 grams per carbohydrate serving. That is why carb counting and hypoglycemia treatment use the same unit.

🌱 The everyday diabetic plate

Carbs from grains, fruit, legumes, milk. Limit refined grains and sugars.
Fat: less saturated and trans. Fish 2+ servings a week.
Fiber at least 14 g per 1,000 calories — improves carb metabolism and lowers cholesterol.
Protein 15–20% of calories. Cut it if there is kidney failure too.
Sodium <2,300 mg.

Coronary heart disease is a leading cause of death in diabetes, which is why this looks like a cardiac diet.

🍸 Alcohol

Allowed in moderation — 1 drink female, 2 male.

Always with or right after a meal — alcohol on an empty stomach causes hypoglycemia
Alcohol never replaces food intake

🧊 Sweeteners

Artificial sweeteners are fine: sucralose, aspartame, saccharin, acesulfame potassium.

Sugar alcohols (xylitol, mannitol, sorbitol) still contain some sugar.

Table sugar is allowed — it just has to be counted in the day’s carbohydrates so the medication covers it.

🌿Cancer & immunosuppressionATI ch. 17

Here the goal flips: not restriction, but getting calories and protein in.

📈 What cancer does to nutrition

Causes anorexia, raises metabolism, drives a negative nitrogen balance.

Calories 25–35 cal/kg
Protein 1–2.5 g/kg
Vitamin and mineral supplementation

🥛 Getting calories in

Eat more on the good days, and in the morning when appetite is best
High-protein, high-calorie supplements between meals — or as a meal
Whole milk instead of water in recipes
Add milk, cheese, yogurt or ice cream to dishes
Peanut butter on fruit; yogurt as a topping
Don’t fill up on low-calorie foods — broth, water, high-roughage food

👅 Mouth ulcers & stomatitis

Soft toothbrush after eating and at bedtime
No alcohol-based mouthwash
Omit acidic, spicy, dry or coarse food — so no citrus, no toast
Cold or room-temperature food, cooked tender
Small bites, straws, gravies and mild sauces

The right answer to “I understand my stomatitis care” is “I will avoid toasting my bread” — not larger bites, not more citrus.

🦠 Taste changes & food aversions

Eat well-liked foods before treatment, not during — otherwise she learns to hate them
Plastic utensils help the metallic taste
Tart flavors wake up a dull palate

🦠 Immunosuppression — food safety

Bacteria come from raw fruit and vegetables and undercooked meat, poultry or eggs.

Wash produce, cook thoroughly
Refrigerate perishables immediately

🩺 HIV / AIDS

Wasting = unintended 10% weight loss plus diarrhea, weakness or fever for 30 days.

Frequent, calorie-dense meals and snacks
High protein
Multivitamin at 100% of daily requirement
Liberal fluids — dehydration is the constant threat
Enteral feeding if she cannot take enough by mouth

🍏 Cancer prevention on a plate

✅ More

Fiber — lowers colon cancer risk
Vitamin A: dark green, red, orange veg
Vitamin C: citrus
Cruciferous: broccoli, cauliflower, cabbage
Whole grains
Poly- and monounsaturated fat — fish, olive oil

❌ Less

Smoked, pickled, charcoal-grilled meat
Nitrate-containing chemicals
Refined grains and sugars
Red and processed meat
Alcohol

💊Drug & food — what fights what22 pairs

The other half of nutrition questions: a food that blocks a drug, or a drug that strips a nutrient.

🚨 The five that are asked most

Warfarin & vitamin K — green leafy vegetables. The rule is consistent intake, not avoidance. A sudden salad binge drops the INR.
MAOIs & tyramine — aged cheese, cured and smoked meat, red wine, tap beer, soy sauce, overripe fruit. Hypertensive crisis.
Grapefruit juice — raises drug levels of statins, calcium channel blockers, cyclosporine and tacrolimus.
Iron & vitamin C — C helps it in; milk, antacids, tea and coffee block it. Give through a straw, expect dark stools.
Digoxin & potassium — low potassium makes digoxin toxic at a normal dose.

Drug	Food / nutrient	What happens
Warfarin	Vitamin K — kale, spinach, broccoli	Antidote and antagonist. Keep intake steady, don't ban it.
MAOI antidepressants	Tyramine — aged cheese, cured meat, red wine, soy sauce	Hypertensive crisis
Statins, calcium channel blockers	Grapefruit juice	Blocks metabolism → drug level climbs
Cyclosporine, tacrolimus	Grapefruit juice	Toxic levels after transplant
Oral iron	Vitamin C (helps) · milk, antacids, tea, coffee (block)	Absorption swings either way
Levothyroxine	Any food; calcium and iron especially	Empty stomach, same time daily, alone
Alendronate and bisphosphonates	All food and drink except plain water	Empty stomach, full glass of water, upright 30 min
Tetracyclines, fluoroquinolones	Dairy, antacids, iron	Chelation — the antibiotic never absorbs
Digoxin	Potassium	Hypokalemia → toxicity at a normal dose
Lithium	Sodium and fluid	Low sodium → lithium retained → toxicity
ACE inhibitors, ARBs, spironolactone	Salt substitutes, high-potassium foods	Hyperkalemia — salt substitutes are potassium chloride
Furosemide, thiazides	Potassium	Wasted — eat potassium foods
Corticosteroids (prednisone)	Glucose, sodium, calcium	Raises glucose, holds sodium, thins bone. Take with food.
Metformin	Vitamin B12	Long-term use lowers B12
Proton pump inhibitors	B12, magnesium, calcium	Less stomach acid → less absorption
Isoniazid	Vitamin B6 (pyridoxine)	Depletes it → peripheral neuritis. B6 is given alongside.
Phenytoin	Folic acid	Depleted; also causes gum overgrowth
Methotrexate	Folic acid	Folate antagonist — supplement is prescribed
Carbidopa-levodopa	High-protein meals	Protein competes for absorption → less effect
Theophylline	Caffeine — coffee, cola, chocolate	Additive stimulation
Cholestyramine	Fat-soluble vitamins A, D, E, K	Binds them — supplement, and keep fiber up
Nicotinic acid (niacin)	—	Flushing. Ibuprofen 30 min before reduces it.

📚Already on the hubdon't rebuild

These two cover the basics and the diet-order types, so this page doesn't repeat them.

🍳 NG-005 · Basic Nutrition Macronutrients, vitamins, minerals — the foundation layer. 🍴 NG-084 · Diet Types Clear liquid, full liquid, mechanical soft, bland, low residue — what each order actually means.