Q: My 5 year old son was attacked by Nephrotic syndrome when he was 1 year of age. Thrice the same problem relapsed. He is fine since November 2000. But due to the steroid medicines, his chest bones are visible. What diet or type of diet is advised for him?

A:Your son has a condition referred to as relapsing nephrotic syndrome. It is characterized by loss of protein in the urine, low levels of blood proteins, high cholesterol levels, edema, and disordered fluid and electrolyte metabolism. Dietary intervention includes restriction of sodium, fat cholesterol. Calorie requirements should be adjusted to allow for normal growth. However the exact needs are variable depend upon the dose of cortico-steroids and the nutritional status of the child. Protein intake should be according to the normal RDA (recommended dietary allowance) for protein for age. This is usually 1.5 Kcal/kg ideal body weight for age. The ideal body weight of a boy of 5 years of age is 19 kg. Therefore, 19 x 1.5 = 28.5 i.e. about 30 gms protein/day. Extra salt on the table should be discouraged. However, normal salt in home cooked food can be taken. Very oily food and fried food should be minimized. Low fat dairy (milk, curd, paneer) should be taken. Butter and desi ghee should be taken in limited quantities. If you are non-vegetarian, lean meats should be preferred. Care should be taken to avoid an over restrictive diet that could lead to an inadequate intake resulting in growth retardation. If the child has many food dislikes or intolerances that greatly limit the variety of foods eaten, a multi-vitamin supplement is recommended. You may find it useful to consult a registered dietician to draw up a specific diet plan for your son.