Low Calorie and Special Dietary Foods

B.K. Dwivedi

• Publisher: CRC Press
• Year: 2018
• ISBN:
  9781351091091
• Edition: 1
• Topic: Medicine
• Subtopic: Nutrition, Dietics & Bariatrics

This book is based on the papers presented at the Symposium on Low Calorie and Special Dietary Foods at the annual meeting of the Institute of Food Technologies in Anaheim California on June 8, 1976.

Chapter 1

FOOD PRODUCTS FOR SPECIAL DIETARY NEEDS

B. K. Dwivedi

TABLE OF CONTENTS

I. Introduction

II. Low Sodium Foods

III. Low Gluten Foods

IV. Foods Low in Phenylalanine

V. Foods with Low Calorie Content

VI. Foods with High Calorie Content

VII. Foods with Low Fat Content

VIII. Foods with Modified Carbohydrates

A. Lactose Intolerance

B. Galactosemia

C. Dental Caries

D. Diabetes Mellitus

1. Xylitol

2. Sorbitol

3. Mannitol

4. Maltitol

5. Lycasin

6. Fructose

IX. Foods with Low Protein Content

X. Foods with High Protein Content

Conclusions

References

I. INTRODUCTION

At the recent National Nutritional Policy hearings, Dr. William E. Connor, Co-Chairman of the Select Committee’s Panel on Nutrition and Health, testified:¹

The vast majority of Americans suffer from overabundance of food. The changed ecology of our land... has led to a whole new spectrum of diseases in which nutritional factors either play the prime etiological role or else are highly contributory to the development of the given disease state, that is coronary heart disease, obesity, and so on.

There is general agreement among nutritionists that most of the serious abnormal physiological conditions can by improved by proper diet modifications. The nature and magnitude of these benefits are estimated in Table 1. Besides disease prevention, it should be possible to enjoy good health, a longer active life span, and greater satisfaction in our day-to-day life from improved diets and nutrition.

In recent years, the utilization of formulated and fabricated foods has changed considerably. The traditional nutritional patterns no longer provide adequate nutrition to all segments of the population. Consequently, 1 in 3 men and 1 in 6 women in the U.S. are expected to die of heart disease; 25 million Americans suffer from high blood pressure, and about 5 million are afflicted by diabetes mellitus. Until recently, physicians largely ignored diet therapy as part of the treatment of these illnesses. More and more health professionals are now beginning to appreciate the fact that special diets and specially formulated foods could be effectively used in the management of abnormal physiological conditions.

The U.S. Food and Drug Regulations dealing with special dietary foods³ define the foods for special dietary use as follows:

(a) The term “special dietary use” as applied to food (including dietary supplements) used by man means a particular use for which an article purports or represented to be used, including but not limited to the following: (1) Supply a special dietary need that exists by reason of a physical, physiological, or other condition, including but not limited to the conditions of convalescence, pregnancy, lactation, infancy, allergic hypersensitivity to food, underweight, overweight, diabetes mellitus, or the need to control the intake of sodium ...

It should always be remembered that dietary foods are foods and not medicines; as such, claims about their curative or preventive properties with regard to human health should not be made, as these claims often lead to confusion and misunderstanding in the consumers’ minds. Regulatory agencies in most countries forbid any such claim about the dietary foods.

Two main categories of dietary foods are (1) Foods which meet the special nutritional needs of people suffering from abnormal physiological conditions such as deficiency states and metabolic disorders. Dietary foods in this category include foods with:

Low sodium content

Low gluten content

Low levels of certain amino acids

Low calorie content

High calorie content

Low fat content

Modified carbohydrates

Low protein content

High protein content

(2) Foods which are designed to meet normal physiological conditions such as those for infants and children, for pregnant and breast-feeding women, for the aged, and foods with supplementary nutrients required by intensive physical exertion or special environmental conditions.

In this chapter, only those foods designed for people suffering from abnormal physiological conditions (category 1) are discussed.

In hospitals, the formulation of a required special diet for the patient is frequently accomplished by deleting the undesirable foods from his meals. However, if the patient must follow the special diet for a long period of time or if he must change his eating habits for life, it is desirable that he not be denied certain foods or excluded from social meals. Under these conditions, specially formulated foods that fulfill the patient’s nutritional needs and resemble normal food in appearance and flavor are highly desirable. The food industry has come a long way in fulfilling this need. However, the efforts manufacturers put into formulation and production of dietetic foods has been limited, primarily because of the limited market for these foods. Presently, increased consumer awareness of caloric content in the diet, has caused the food industry to take a second look at this market. It appears likely that within a decade, dietetic foods, particularly low calorie foods, will be one major category of processed foods.

TABLE 1

Magnitude of Benefits from Nutrition Research

From Weir, C. E., Nutrition and Health, With An Evaluation of Nutritional Surveillance in the United States, U.S. Government Printing Office, Washington, D.C., 1975.

II. LOW SODIUM FOODS

Sodium is involved in maintenance of body fluid pH, osmolality, and body fluid volume. These functions are accomplished by the unequal distribution of sodium and potassium ions in the plasma membrane. A higher concentration of potassium is found inside the membrane compared to outside, the reverse is true for sodium. The system is commonly known as K⁺/Na⁺ pump. The “pump” is universally found in the plasma membrane of cells where it is localized. Under the following conditions, the sodium concentration in the plasma membranes increases, resulting in fluid retention or edema in the body:⁴

• Nephritis
• Nephrosis
• Cardiac disease
• Cirrhosis of the liver
• Toxemia of pregnancy
• Hypertension
• Adrenocarticotrophin therapy

In these conditions, the most successful treatment for prevention of further edema is restriction of sodium content in the diet.

Daily sodium intake, mostly in the form of sodium chloride, depends on eating habits and varies considerably from person to person. Although only about 0.5 g of sodium per day is required for proper biological functions, the average sodium intake comes to about 3 to 6 g/day. The salt or sodium content in the diet should be restricted as required by the severity of disease and edema, using the following guidelines.

Mild restriction — In the case of mild heart damage, the intake should be restricted to 2 to 3 g/day. Deletion of highly salted foods from the diet is sufficient to achieve this level. Salting cooked foods lightly may be permitted under this condition.

Moderate restriction — If the patient has edema, the sodium intake should be restricted to about 1 g/day. To achieve this level, it is necessary to delete salt (sodium chloride) completely from the diet and permit only the foods which are low or moderate in sodium.

Severe restriction — In the case of congestive heart failure, severe edema, and hypertension, the sodium intake should be restricted to about 0.5 g/day. This level is difficult to achieve, and it is necessary that only foods low in sodium and the specially formulated low sodium foods be permitted.

Commercially, low sodium foods are prepared by using ingredients inherently low in sodium Removal of sodium from ingredients during processing, although feasible, is not practiced, probably because of excessive costs. A recently perfected ultrafiltration process may lend itself to removal of sodium from solutions and colloidal suspensions at a reasonable cost. The prime capability of ultrafiltration lies in the membrane’s ability to pass or reject molecular species on the basis of differences in shape, size, and chemical structure. Since sodium salts comparatively have a much lower molecular weight than carbohydrates and proteins, they are easily removed by ultrafiltration. In preparing low sodium foods, the following substances may be used to replace sodium chloride:

I. Calcium, magnesium,* and potassium salts of these acids

Acetic

Adipic

Carbonic

Citric

Hydrochloric

Glutamic

Tartaric

Succinic

II. Potassium sulfate

III. Choline salts of these acids

Acetic

Carbonic

Citric

Hydrochloric

Lactic

Tartaric

IV. Adipic and glutamic acids

III. LOW GLUTEN FOODS

Low gluten foods are recommended in coeliac disease. This di...

Table of contents

• Cover
• Title Page
• Copyright Page
• Preface
• The Editor
• Contributor
• Table of Contents
• 1 Food Products for Special Dietary Needs
• 2 Dietary Lipids in Health and Disease
• 3 Low Calorie Bulking Agents
• 4 The Practical Requirements for the use of Synthetic Sweeteners
• 5 Application Potential for Aspartame in Low Calorie and Dietetic Foods
• 6 Pure Fructose and Its Applications in Reduced-Calorie Foods
• Index