•  appropriate calories to achieve and maintain healthy body weight.
• maintain blood glucose in normal range
• achieve optimal blood pressure 
• achieve optimal lipid levels.
• prevent  acute and long term complications of diabetes.
• adjust personal and cultural preferences.

• Nutritional content rationalisation.
• Consistent portion size.
• Consistent meal timing.
• Increasing fiber intake.
• smart snacking ( protein/ fibre)
• Post meal walks for 10 minutes.

1. Restrict calories-30 calories per kg  ideal body weight ( IBW*)( and not as per your current weight)
Or
2. Calculate your calories required per day by using  ‘Calorie calculator’  at ‘Calculator.net ‘
Or
3. Rough estimate of daily calorie need –

• men & active women – 30 kcal per kg IBW.
• sedentary men, women & adults over 55 years – 25 kcal per kg IBW.
• adults with obesity- 10 kcal per kg IBW.

• Choose “healthy” fats – These are also called “monounsaturated” or “polyunsaturated” fats. Healthy fats are found in things like olive oil, canola oil, and sesame oil. They are also found in nuts, seeds, avocados, and nut butters.
• Choose lean meats, poultry, seafood, and proteins – fish ( salmon, mackerel,tuna, sardines),chicken,Egg white,seeds,nuts( walnuts, pistachios, almonds),soy products ,peas,beans.
• Vegetables-non-starchy, colorful vegetables- lettuce,spinach,broccolis,cauliflower,zucchini,cabbage,avocados,jack fruit.
• Fruits-cherries,berries,guava.
• Oils – olive oil, rice bran oil

• Grains to limit or avoid-Grains made with refined flour. Examples include breads, chips, cookies, cakes, pastries,candy, doughnuts, granola, baked goods, muffins, pizza dough, and pie crusts etc.
• Fruits to limit or avoid –banana,custard,apple,mangoes,grapes,chickoo,figs,plums,watermelon,dried fruits,fruit juices,processed fruit products, sweetened beverages
• Vegetables to limit or avoid– Starchy vegetables(white potatoes, sweet potatoes, yam, arbi,beet root, pumpkin,corn, and turnips)

• sugar rich foods- sugar, jaggery, honey,sugar syrups, jams,jelly, marmalades, chocolates, ice cream.
• Trans fat / saturated fats – margarines,fast food,deep fried foods, baked goods,palm oil, coconut oil,meats egg yolk, butter,cheese, full fat milk.
• Crabs,prawns,shellfish.
• Artificial sweeteners
• Alcohol

Easy method of diet planning-

•  5 bowl method ( 3’’bowl)
  1. Veg
  2. Non -veg
  3. Sprout
  4. Salad
  5. Curd
  6. 1 chapati

• Plate method( 9’’ plate)-
  1. Half plate – non starchy veg
  2. 1/4 plate – lean meat
  3. 1/4 plate – low glycemic index carbs.
  4. Side dish – curd

• Male= 50 kg+2.3kg for each inch over 5 feet.
• Female = 45.5 kg+ 2.3kg for each inch over 5 feet.

** Calories Guide ( this is not an exhaustive list)

• Aloo paratha  300 cal
• Chole Bhature (1 serving) -450-500 cal
• Dosa (1 medium) – 168 cal
• Idali (1 piece) —  40 cal
• Misal Pav (1 plate) — 400 cal
• Paratha(1piece,plain)-260 cal
• Poha (1 cup) — 250 cal
• Samosa 1 piece – 200 cal
• Upma (1 cup) — 220 cal

• Biryani (1 plate, chicken/veg) -500-700 cal
• Dal (1 cup cooked) -150 cal
• Khichri (1 cup, moong dal + rice)250 cal
• Mutton curry – 1 bowel – 240 cal
• Poori – 1 peice-240 cal
• Rajma (1 cup)-250 cal
• Roti (1 piece, whole wheat) – 120 cal
• Rice (1 cup cooked) – 200 cal
• Sabzi (1 cup,cooked with light oil) – 120-180 cal
• Sambar (1 cup) —150 cal

• Bhel Puri (1 serving) —250 cal
• Pakoras (100g, mixed vegetables)-300 cal
• Pav Bhaji (1 plate with buttered pav) – 450 cal
• Pani Puri (6 pieces with stuffing and water) – 180-220 cal
• Samosa (1 piece, medium) – 150-200 cal
• Vada Pav (1 piece) — 280 cal

• Gulab Jamun (1 piece)-150 cal
• Halwa (1 serving, gajar/sooji) – 300-400 cal
• Jalebi (1 piece, medium) -150-200 cal
• Kheer (1 cup) —300 cal
• Ladoo (1 piece, besan/motichoor) 180-250 cal
• Rasgulla (1 piece, medium) – 120 cal

• Buttermilk (1 cup, unsweetened) – 50 cal
• Chai (with milk and sugar, 1 cup) 100 cal
• Coconut Water (1 cup) — 45 cal
• Lassi (sweet, 1 cup) -220 cal
• Sugarcane Juice (1 glass,250 ml) – approx 180 cal

• Watermelon 26
• Papaya 32
• Grapes Black 45
• Kiwi Fruit 45
• Pineapple 46
• Peach 50
• Pears 51
• Orange 53
• Plums 56
• Apple 56
• Lychee 61
• Guava 66
• Cherries 70
• Mangoes 70
• Strawberries 77
• Pomegranate 77
• Chickoo 94
• Banana 95
• Dates 281

• Butter – 750 cal
• Cheese – 315 cal
• Cream – 210 cal
• Ghee – 910 cal
• Ice cream – 170 cal
• Margarine-740 cal
• Pork-340 cal
• Chicken-150 cal
• Peanuts-570 cal
• Bread-230 cal
• Cornflakes with milk- 200 cal
• Chocolate biscuit- 520 cal

• Less than 70 mg/dL: Treat with 15 grams of carbohydrate*
• Less than 50 mg/dL: Treat with 30 grams of carbohydrate.

• Call Emergency Ambulance.
• Do not try to give the person anything by mouth.
• If you have a glucagon injection kit and know how to use it, you may give the person glucagon injection.

1. Glucose Tablets:
   • 1 tablet = about 4 gm carb=15 kcal
   • 4 tablets =16 gm carb = 60 kcal.
2. Fruit Juice :
   • 1 cup = 30 gm carb = 120 kcal.
3. Sugar:
   • 1 tsp = 4 gm carb= 16 kcal.
   • 1 Tbsp=15 gm carb = 45 kcal
4. Honey:
   • 1 Tbsp =15 gm carb = 90 kcal.
5. Milk:
   • 1 cup =12 gm carb = 100 kcal.

1.Restrict calories -30 calories per kg  ideal body weight (IBW*)(and not as per your current weight)

•  men & active women – 30 kcal per kg IBW.
• sedentary men, women & adults over 55 years – 25 kcal per kg IBW.
• adults with obesity- 10 kcal per kg IBW.

1. Vegetables- all
2. Multi grain,jowar, Bajra, nachni,  brown rice.
3. Nuts and seeds, pulses, sprouts, soya.
4. Oil – olive oil,ricebran oil,safflower oil.
5. Skimmed milk, curd ,Chaach.
6. Non veg – egg white, skinned chicken, fatty fish.
7. Dry fruits- pista , Badam, walnut.
8. Fruits – berries, cherries.

1. Salt.
2. Sugar.
3. Maida and its products.
4. White rice.

1. All bakery products
2. All confectionery,ice cream,desserts.
3. All soft drinks,fruit juice,canned fruits,sweetened  beverages.
4. Farsan,sweets( all halwai product)
5. All fast food.
6. All processed/ultra processed food.
7. Red meat, prawns, crabs, oysters,lobsters, organ meat( liver, kidney, brain)   egg  yolk.
8. Vegetables-Potatoes,corn, turnip
9. Dry fruits- Kaju, kismis, peanuts, macadamia nuts, pinenuts,dates, coconut.
10. Ghee,butter,cheese, palm oil, coconut oil, groundnut oil, margarine,full fat milk products,
11. Alcohol.
12. Tobacco.

•  5 bowl method ( 3’’bowl)
  • Veg
  • Non -veg
  • Sprout
  • Salad
  • Curd
  • 1 chapati

•  Plate method( 9’’ plate)-
  • Half plate – non starchy veg
  • 1/4 plate – lean meat
  • 1/4 plate – low glycemic index carbs.
  • Side dish – curd

• Male= 50 kg+2.3kg for each inch over 5 feet.
• Female = 45.5 kg+ 2.3kg for each inch over 5 feet.

• Aloo paratha  300 cal
• Chole Bhature (1 serving) -450-500 cal
• Dosa (1 medium) – 168 cal
• Idali (1 piece) —  40 cal
• Misal Pav (1 plate) — 400 cal
• Paratha(1piece,plain)-260 cal
• Poha (1 cup) — 250 cal
• Samosa 1 piece – 200 cal
• Upma (1 cup) — 220 cal

• Biryani (1 plate, chicken/veg) -500-700 cal
• Dal (1 cup cooked) -150 cal
• Khichri (1 cup, moong dal + rice)250 cal
• Mutton curry – 1 bowel – 240 cal
• Poori – 1 peice-240 cal
• Rajma (1 cup)-250 cal
• Roti (1 piece, whole wheat) – 120 cal
• Rice (1 cup cooked) – 200 cal
• Sabzi (1 cup,cooked with light oil) – 120-180 cal
• Sambar (1 cup) —150 cal

• Bhel Puri (1 serving) —250 cal
• Pakoras (100g, mixed vegetables)-300 cal
• Pav Bhaji (1 plate with buttered pav) – 450 cal
• Pani Puri (6 pieces with stuffing and water) – 180-220 cal
• Samosa (1 piece, medium) – 150-200 cal
• Vada Pav (1 piece) — 280 cal

1. Gulab Jamun (1 piece)-150 cal
2. Halwa (1 serving, gajar/sooji) – 300-400 cal
3. Jalebi (1 piece, medium) -150-200 cal
4. Kheer (1 cup) —300 cal
5. Ladoo (1 piece, besan/motichoor) 180-250 cal
6. Rasgulla (1 piece, medium) – 120 cal

1. Buttermilk (1 cup, unsweetened) – 50 cal
2. Chai (with milk and sugar, 1 cup) 100 cal
3. Coconut Water (1 cup) — 45 cal
4. Lassi (sweet, 1 cup) -220 cal
5. Sugarcane Juice (1 glass,250 ml) – approx 180 cal

• Watermelon 26
• Papaya 32
• Grapes Black 45
• Kiwi Fruit 45
• Pineapple 46
• Peach 50
• Pears 51
• Orange 53
• Plums 56
• Apple 56
• Lychee 61
• Guava 66
• Cherries 70
• Mangoes 70
• Strawberries 77
• Pomegranate 77
• Chickoo 94
• Banana 95
• Dates 281

• Butter – 750 cal
• Cheese – 315 cal
• Cream – 210 cal
• Ghee – 910 cal
• Ice cream – 170 cal
• Margarine-740 cal
• Pork-340 cal
• Chicken-150 cal
• Peanuts-570 cal
• Bread-230 cal
• Cornflakes with milk- 200 cal
• Chocolate biscuit- 520 cal

• Milk(Buffalo)-115 cal
• Milk(Cow)-100 cal
• Milk(Skimmed)-45 cal
• Buttermilk -20 cal

• Sugar 1 tbsp -45 cal
• Honey 1 tbsp -90 cal

• Monounsaturated fats & polyunsaturated fats- nuts, seeds, avocado, olive oil, canola oil,sesame oil.

• Saturated fats -beef, bacon, sausage, hotdogs, palm oil, coconut oil, cotton seed oil, full fat dairy, palm kernel.
• Transfat – deep fried foods, commercial bakery products, frozen dinners, margarine, butter, cheese, egg yolk.

The dietary advice depends on a number of factors including-

• stage of renal disease.
• type of ongoing treatment.
• current blood results.
• presence of other medical conditions e.g.diabetes,hyper-lipidemia,HT, heart disease etc.

In general, the diet controls the amount of protein, sodium, potassium water,calcium and phosphorus in addition to calories.

• Calorie intake should be optimum to maintain ideal Body Weight.
• Proteins- In kidney diseases,you will need to reduce the amount of protein you eat to avoid buildup of urea in your body.
  Recommend protein intake is 0.8 gm/ kg body weight for non dialysis patients and 1 gm / kg for patients on dialysis.
  Some sources of protein produce less urea than others. They are known as High Biological Value proteins. Eat 50% of your proteins from High Biological Value sources.

High Biological Value Proteins-

1. Soybeans
2. peas
3. beans
4. Milk & Milk products
5. Meat
6. fish
7. poultry
8. Egg

Low Biological Value proteins-

1. Cereal & its products
2. Dals & Pulses
3. Nuts & Oilseeds
4. Vegetables

• Sodium Restriction
  1. Limit the amount of salt in your diet. Consume 2 to 3 gm/d.
  2. Avoid papad, chutney, pickle, chips, masala, sauces, bread, and baked items.
  3. Prepare meals without using aji-no-motto, baking soda, and eno powder.
  4. Make use of flavors as – fresh limejuice, onions flakes, mango powder (amchur),vinegar, tamarind pulp, and kokum and garlic-ginger-green chillies.
  5. Salt substitutes usually contain KCL (Potassium Chloride). They may contribute to a significant amount of potassium so, should be checked with the doctor before using it.
  6. Do not consume organ meats.
  7. Fresh river water fish are preferred to seafood.
• Potassium Restriction-
  • Restrict the consumption of High potassium foods.
  • High Potassium Foods:
    • Coconut Water
    • Apricots
    • Kiwi fruit
    • Bananas
    • Melons
    • Sweet lime
    • Beets
    • Avocados
    • Spinach
    • Tomato
    • Potatoes
    • Lima beans
    • Brussels sprouts
    • Clams
    • Sardines
    • Peanuts
    • Dates
    • Prunes
    • Figs
    • Raisins
  • Vegetables and dals can be leached to reduce their potassium content (peel, soak in large amount of luke warm water, drain the water & rinse before cooking)
  • Fruits like apple, papaya, pineapple, guava, and pear are comparatively low in potassium. These fruits can be taken in prescribed amount.
•  Fluid Intake-
  • Do not exceed the fluid restriction recommended by the doctor.
  • Fluids include not only water but milk, fruit juices, non-alcoholic beverages, buttermilk, jelly, ice, ice-creams, soups, dals, gravies, hot drinks, milk-shakes etc.
  • Keep a record of what you are drinking.
  • Drink from a small cup or a glass.
  • Avoid salty, dried and fried foods as they increase thirst.
  • Include the fluids taken with medicines.
• Calcium and Phosphorous-
  • With kidney functioning being impaired, calcium is re-absorbed from bones with decreased excretion of Phosphorus.This could lead to weaker bones and may cause itching. To prevent this increase dietary calcium & restrict Phosphorus.
  • Foods like milk & cheese, dried beans, peas, colas, nuts and peanut butter are high in phosphorus. However, incorporate milk & its products in the prescribed amounts as it provides good quality proteins & Calcium.
  • Restrict intake of leafy veg. (Phytates & oxalic acid present in these prevent Ca absorption)
  • Use of Phosphate binders as prescribed by the doctor.

Diet to reduce Uric acid

Avoid

• Grains to avoid or limit – Oatmeal, wheat bran, wheat germ.
• Vegetables to avoid or limit– Asparagus, spinach, cauliflower, green peas, mushrooms.
• Fruits- chickoo,custard apple.
• Meats, poultry, seafood,Red meat,organmeat,fish,seafood,mincemeat, turkey.
• proteins to avoid or limit – dried beans, peas.
• Dairy- whole fat milk/cream
• Pulses- masoor dal.
• Other foods and drinks to avoid or limit – meat sauces, Meat- or fish-based soups, alcohol.
• Avoid starvation.
• Limit high fat cooking.

Have –

• Grains – whole-grain breads, pastas, cereals, rice
• Vegetables – All vegetables, except those that are moderate and high in purines. Vegetables to avoid or limit are listed above.
• Dairy – low-fat or fat-free milk, yogurt, or cheeses.
• Non veg – Egg white.
• Other foods and drinks – Water, tea, coffee, cocoa, condiments like salt, herbs, olives, vinegar, olive oil.
• Consume at least 3 liter water daily.( unless medically contraindicated)

Nonalcoholic Fatty Liver disease diet( NAFLD)

• Keep track of calories intake. Calorie restriction is the pillar for diet in NAFLD.
• Use the glycemic index (GI) to plan your meals.Choose low-GI foods.

What foods to eat?

1. Grains-Whole grains, Quinoa, Brown rice
2. Vegetables-Lettuce. Spinach. Peas. Cauliflower. Cabbage. Broccoli. Carrots. Tomatoes. Squash. Eggplant.Herbs. Peppers. Onions. Cucumbers. Brussels sprouts. Beans. Lentils.
3. Fruits- Apples, Papaya, Kiwi, Cherries
4. Meats and Other Protein- Fish, Lean meats, Poultry, Tofu
5. Dairy- Low-fat or fat-free dairy products.
6. Beverages- Water, Sugar-free drinks,Tea,Coffee,Low-fat or skim milk soy or almond milk
7. Condiments- Mustard,low-sugar ketchup, barbecue sauce
8. Sweets and Desserts-Sugar-free sweets.
9. Fats and Oils- Canola or olive oil.Nuts and Seeds.

What foods to avoid

1. Palm oil.
2. coconut oil.
3. Processed foods.
4. Fried foods.
5. Sweetened drinks.
6. Alcohol.
7. Sweets.
8. All bakery products.
9. All Halwai products.

1. Raw or undercooked foods.
2. Unpasteurised products.
3. Unwashed or contaminated produce( fruits,vegetables etc).
4. Other high-risk foods: Avoid fast food restaurants, salad bars, buffets, ice cream parlors, and street vendors.
5. Food from street vendors.
6. Buffets.
7. Unsafe water for drinking.

1. Cook thoroughly.
2. Wash produce( fruits, vegetables etc)
3. Practice good hygiene during food preparation.
4. Prevent cross contamination-
   • When grocery shopping, keep raw meat, poultry, seafood,and their juices away from other foods. 
   • Keep raw meat, poultry, seafood, and eggs separate from all other foods in the fridge.
   • Use separate cutting boards and plates for raw meat,poultry, and seafood.   

1. Cooked foods should not be left at room temperature for more than 1 hour.
2. Throw away leftovers in refrigerator after 2 days.
3. Avoid  thawing or marinating food on the counter.
4. Thaw frozen food safely in the refrigerator, in cold water, or in the microwave.
5. Always marinate food in the refrigerator.
6. Drink safe water
   1. Bottled or canned beverages.
   2. Disinfected water ( boiled water,chlorinated water)
   3. Filtered water.
7. Dairy products- use only pasteurised or cooked dairy products.