The many physiologic, cultural, economic, and emotional factors affecting food acceptance have been discussed. The person who is ill must face added problems related to his meals. Diet is related to both the comfort and the treatment of the patient, but sometimes it is necessary to take therapeutic measures that may distress rather than provide immediate comfort. The nurse plays an essential role in helping to bridge this gap.

Illness itself often reduces interest in food because of anorexia, gastrointestinal distention, or discomfort following meals. Inactivity and some drugs also reduce the desire for food.

The patient in a hospital may be away from home for the first time. He probably misses his family and the sociability of family meals. He finds that the food pattern in the hospital and the time for meals differ, more or less, from his usual pattern. He finds it difficult to manage a tray in bed. His food intake is affected by his worries about mounting hospital bills, about return to work, or about the extent of his return to full health.

If the diet is modified, the patient may be getting less or more food than he normally eats. The change in flavor or texture of some diets is not appealing. Often he is unwilling to accept any change, worried about how he will get the new foods for his diet at home, or bothered about the inconvenience of sticking to a diet that is different from that of his family or friends. Some modified diets make him feel that he is deprived and punished.

In his illness the patient becomes more self-centered, and he reacts by being irritable or even angry. He complains incessantly about his food in order to get more attention, or he is quite indifferent to his diet, eats poorly, and ignores the suggestions made by doctors, nurses, or dietitians.

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