This is a 60-year-old male with a personal history of ischaemic heart disease (he suffered an acute myocardial infarction in 2004) and is a former smoker. The patient had no known drug or food allergies. In July 2008 he was diagnosed with primary amyloidosis and nephrotic syndrome. On discharge from hospital, he received nutritional recommendations from the nephrology department to follow a low-sodium and low-fat diet and to exclude protein foods. To this end, the patient had to cook all food, not use table salt, and could not use any other cooking techniques (frying, grilling, roasting, microwaving, etc.), as well as not eating the second courses (meat, fish and eggs). The pharmacological treatment she is currently receiving is omeprazole, candesartan, enalapril, atorvastatin, acetylsalicylic acid, ezetimibe, furosemide, barnidipine and spironolactone. She attended the diet therapy consultation to establish a diet adjusted to her nutritional needs.
At the initial consultation, a nutritional history was taken, including a complete anthropometric assessment, biochemistry and analysis of intake through a 3-day dietary survey analysed with the Dietsource 3.0 ®Nestlé Healthcare Nutrition software (2005 Edition). The baseline intake characteristics are shown in table I, together with the nutritional recommendations for the patient with nephrotic syndrome: restrictive diet in protein, salt and lipid profile rich in monounsaturated and polyunsaturated fatty acids3 . The following results were obtained in the initial examination:

- Anthropometry: weight 86.7 kg, height 171 cm, BMI 29.65 kg/m2. Body composition was measured by bioelectrical impedance (TANITA TBF 300®): 56.1 litres of water (64.7%), 76.6 kg of lean mass (88.4%) and 10.1 kg of fat mass (11.6%). The patient had oedema with pitting up to the knees.
- CBC: Creatinine: 0.95 (normal values 0.5-1.1) mg/dL, Glomerular Filtration: > 60 ml/min/1.72 m2, P: 3.31 (normal values 2.5-4.5) mg/dL, K: 4.23 (normal values 3.6-5) mmol/L, Total Protein: 3.8 (normal values 6.2 - 8) gr/dL. Albumin: 1.74 (normal values 3.5-5) gr/dL and prealbumin: 20 (normal values 10-40) g/dL. Proteinuria: 14.55 g/24h. Total cholesterol: 180 (normal values 100-200) mg/dL, Triglycerides: 110 (normal values 50-150) mg/dL, HDL: 44 mg/dL (normal values 40-65), LDL: 68.8 mg/dL, Uric acid: 7.23 mg/dL (normal values 2.4-7).
A diet was prepared in accordance with the recommendations3 , according to the patient's characteristics, tastes, habits and schedules. The nutritional characteristics of the diet are shown in table I and the diet calibrated for the patient in table II.

After six months on the diet, the patient presented the following data:
Anthropometry: weight 79.4 kg, BMI 27.15 kg/m2. Body composition measured with the same technique as at the initial visit indicated 46.5 litres of water (58.6%), 63.5 kg of lean mass (80.0%) and 15.9 kg of fat mass (20.0%). Oedema had decreased and was present only in the perimalleolar area.
CBC: Creatinine: 1.58 mg/100, Glomerular filtration rate: 48 ml/min/1.72 m2. P: 4.4 mg/dL and K: 5.37 mmol/L. Total protein: 4.8 g/L, albumin: 3.15 mg/dL and prealbumin: 36.9 mg/dL. Proteinuria: 2.1 g/24h. Total cholesterol: 140 mg/dL, Triglycerides: 88 mg/dL, HDL: 64 mg/dL, LDL: 58.4 mg/dL, Uric acid: 10.75 mg/dL.
Dietary adherence: Dietary intake was collected in a 24-hour recall and analysed with the same software as at the baseline visit. The data are shown in table I.
At present the patient continues with the prescribed diet and continues to attend the diet therapy consultation bimonthly.