Nutrition and Fever

FEVER
DEFINITION
An increase in the body temperature above normal (36.5–37.5 °C) is generally referred to as fever. There is an increase in the rate of metabolic activities during fever. Fever is generally the result of an imbalance between the heat produced and the heat eliminated in the body. It is not a disease in itself but an indication of some disease. Infections and malnutrition are the main causes of fever.
FACTORS AFFECTING NUTRITION
Factors affecting nutrition during fever are as follows:
*Increase in temperature during fever increases the rate of metabolism in the body.
* Energy is stored as glycogen in the body. Amount of glycogen is gradually depleted in fever.
*Loss of tissues in fever leads to increased demand of proteins.
* Acute deficiency of water & minerals is caused in fever due to excessive sweating and urination.
* Digestion is disturbed in fever. It leads to less absorption of nutrients in the body from food.
TYPES OF FEVER
Continuous/short duration fever: Such fever is acute but short in duration. Temperature remains above normal throughout the day and does not fluctuate more than 1 °C in 24 hours, e.g. lobar pneumonia, typhoid, urinary tract infection.
Intermittent fever: Such fever occurs only in intervals. The temperature elevation is present only for a certain period, later cycling back to normal. e.g. malaria, kala-azar,pyaemia, or septicemia.
Remittent / long duration fever: Such fever lasts for a longer duration with low temperature. Temperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours, e.g., infective endocarditis.
DIET IN FEVER OF SHORT DURATION
Energy: Calorie rich foods must be given. E.g., fruit juices, glucose water, honey water, etc.
Carbohydrates: To meet the increased demand of energy and to restore glycogen in the body, increased amount of carbohydrates should be given to the patient. For this, glucose, honey, sugar, etc, can be added to the diet.
Fats: Fried and fat rich foods should be avoided in fever. But to meet the body requirements, easily digestible simple fats like butter, cream, etc should be given to the patient.
Proteins: Breakage of tissues in fever leads to high requirement of protein. 100 gms or more of proteins should be given to the patient to make up this loss.
Liquids: Two and a half to 5 liters of liquids per day should be given to the person suffering from fever. For this, plain water, soup, fruit juice, coffee, tea, milk etc should be given to the patient.
Minerals: In fever, considerable amount of salt like sodium and potassium are lost in the body due to excretion of water. Loss of sodium is made up by adding salt to soups, vegetables, etc.
Vitamins: Increased amount of vitamin A, ascorbic acid (vitamin C) and vitamin B complex should be added to the diet because of decreased vitamin synthesis due to antibiotics in the body.
MEAL PLANNING
-Small Amount of food should be given to the patient suffering from fever at short intervals.
- High calorie and high protein diet should be given to the patient.
-The patient should be given liquid, semi-liquid or soft food according to his condition.
- Food should be easily digestible.
- Sometimes excessive use of liquid may lead to nausea and aversion in the patient.
- Soft foods are easily digestible by such patient.
- Low fiber diet without spices should be given to the patient.
DIET IN FEVER OF LONG DURATION
Energy: Weight loss can be prevented by intake of 2500-3000 calories per day.
Protein: Amount of albumin and serum is reduced drastically. Hence more amount of protein is required. It is important to replace worn out cells by new cells and tissues.
Minerals: Calcium is very important for healing wounds. Its demand can be met by taking one liter of milk daily.
Vitamins: The requirement for vitamins A, B complex, C and D is increased.
MEAL PLANNING
- Liquid diet rich in protein and calorie should be given to the patient.
- Food should be given 5-6 times per day regardless of loss in appetite.
- Food should be simple, digestible and fat free.
- With fall in temperature gradually give soft, semisolid and normal food to the patient.
- Food should be given in small proportions, a number of times in a day.