Beyond the Bedside: Dietary Modifications

Beyond the Bedside: Dietary Modifications

Whether you’re a patient or a loved one of a patient, I cannot stress the importance of  proper patient education. Once the patient leaves the hospital or clinic, it is up to that patient or their caretakers to ensure that they are compliant and adherent to their appropriate regimens. As nurses, we are responsible for educating our patients and their families upon discharge. Not only must their discharge education be thorough, but must also be taught at a level that they deem easy to understand and follow once they go home.

Certain foods that we would normally eat on an everyday basis can actually interfere with medications that we start to take–either negatively or positively–or can even make the diseases that we have worse. For instance, in iron-deficiany anemia, consuming foods with vitamin C can actually help absorb iron better because when iron and vitamin C bind, the absorption rate is much quicker, meaning the medication will take effect much faster. Oppositely, if you take lithium for bipolar disorder, for example, extreme fluctuations in sodium intake can cause sub-therapeutic blood levels or contrarily, an overdose.

Below are 2 lists that I have compiled that pertain primarily to dietary modifications for common diseases, as well as dietary modifications when taking certain medications. Remember, patient care goes beyond the bedside and is an interdisciplinary effort. With the assistance of both healthcare professionals and familial support, we can ensure better outcomes for our patients.


Suggested Dietary Changes Related to Diseases

Celiac disease   Avoid gluten-containing foods

Cholelithiasis   Avoid fatty foods

Cirrhosis   Limit sodium; limit protein intake; avoid alcohol

Congestive heart failure   Limit sodium

Diabetes mellitus   Amercian Diabetic Association diet; limit calories; exercise

Diverticulosis   Low-residue diet

Esophagitis   Avoid alcohol, NSAIDs, tobacco; consume thick liquids

Gastroesophageal reflux   Avoid caffeine, chocolates, mints, or late meals

Gout   Limit alcohol, purine, and citric acid intake

Hyperlipidemia   National Cholesterol Education Program diet with limited fat and cholesterol and increase fiber

Iron-deficiency anemia   Iron supplements with vitamin C

Irritable bowel syndrome   Limit sodium intake

Osteoporosis   Supplement calcium and vitamin D; limit alcohol and tobacco

Renal failure   Limit sodium, potassium, protein, and fluids

Foods to Avoid with Certain Drugs

ACE Inhibitors   Potassium-containing salt substitute

Aspirin   Feverfew, ginkgo, green tea

Calcium-channel blockers   Grapefruit juice

Cyclosporine   Grapefruit juice, potassium-containing salt substitute

Digoxin  High-fiber foods and meals

Enteric-coated pills   Excess milk, hot beverages, alcohol

Fluoroquinolones (e.g. Cipro, Levaquin)   Foods high in calcium, iron, zinc (dairy and red meats)

Lithium   Significant increase or decrease in sodium intake

NSAIDS   Asian ginseng, gingko

Penicillin G   Carbonated beverages, acidic juices

Phenytoin   Excess protein

Potassium-sparing diuretics   Potassium-containing salt substitues

“Statin” drugs   Grapefruit and grapefruit juice

Tetracycline   Iron-rich food or supplements, calcium

Warfarin   Vitamin K foods and supplements, Asian ginseng, feverfew, garlic, ginger, gingko, St. John’s wort, green tea