Three Day Menu

Allison Kliewer

Baptist Health System Dietetic Internship

With

Texas Center for Infectious Disease

March 6, 2013

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Three Day Menu

According to the State Operations Manual for Long Term Care Facilities, a facility must

provide a qualified dietitian to provide each resident with a nourishing, palatable, well-balanced

diet that meets the daily nutritional and special dietary needs of each resident (2013). A

dietitian is qualified based on education, training, and experience with identification of dietary

needs, planning and implementing of dietary programs and much more (2013). Specific training

experience includes developing therapeutic diets and developing regular diets to meet the

specialized needs of geriatric and physically impaired persons (2013). The Texas Center for

Infectious Disease (TCID) operates as a state long term care facility. The following house menu

was designed to meet specialized dietary needs of the TCID patients.

The house menu was to closely resemble that of the State Hospital’s Acceptable

Macronutrient Distribution Ranges (AMDR), while following the “Dietary Guidelines for

Americans” 2010, and offering a culturally healthy and flavorful menu. The AMDR guidelines

can be seen in Appendix III. The Texas Center of Infectious Disease has a specific population of

patients who suffer from tuberculosis among many other clinical diagnoses. Many of the

patients have multiple diseases, are often are substance users and abusers, and are admitted

with malnourishment. The patient population is multi-cultural and while most of the patients

are from Mexico, others are from other nations, such as, Nepal, Iraq, and Russia. The clinical

diagnoses, nutrition status, and unique culture of the patients, were considered in the meal

planning.

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The cardiac menu was modeled to closely follow the American Heart Association

guidelines for a healthy diet; 4.5 cups of fruits and vegetables each day, two servings of fish per

week, at least three servings of fiber rich whole grains per day, less than 1,500 mg of sodium

each day, no more than 450 calories of sugar-sweetened beverages per week, four servings of

nuts, legumes, and seeds per week, no more than two servings of processed meats per week,

and less than seven percent of total energy intake from saturated fat. Guidelines also follow the

“Dietary Approaches to Stop Hypertension” (DASH) diet that is encouraged by the National

Heart, Lung, and Blood Institute, the U. S. Department of Health and Human Services, and the

National Institutes of Health.

The 200 gram carbohydrate restricted diet also followed the cardiac or heart healthy

diet plan, while limiting the carbohydrates at each meal. The purpose of a carbohydrate limited

diet is to better control blood glucose, therefore helping to control diabetes. According to the

National Heart, Lung, and Blood Institute, those who have diabetes are at higher risk for heart

disease, have additional causes of heart disease, may develop heart disease at a younger age,

and may develop a more severe form of heart disease. That is why it is important to follow

heart healthy eating patterns while controlling carbohydrate intake.

The renal diet was restricted following the Nutrition Care Manual (NCM) guidelines for

chronic kidney disease (2012). Nutrients were limited to 2.4 g sodium, 2.4 g potassium, and

800 to 1,000 mg phosphorus (NCM, 2012).

The mechanical soft or dental soft diet is modified from a regular diet for patients with

difficulty chewing or swallowing. Foods included in the diet are to be easily masticated. The

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mechanical soft food items were based on the Manual of Clinical Nutrition Management

(2011).

Analysis

The house menu was adjusted to meet the nutrition standards of a cardiac, 200 gram

carbohydrate, renal, and mechanical soft diet. Data was analyzed using the Nutrition Calc Plus

software (2009). The three day house menu and the nutrient analysis can be viewed in

Appendix I and Appendix II.

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References

Academy of Nutrition and Dietetics Quality Management Committee. (2013). Academy of

Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and

Standards of Professional Performance for Registered Dietitians. Journal of the Academy

of Nutrition and Dietetics. In press.

Silver Oaks Communications. (2009). Nutrition Calc Plus 3.2. The McGraw Hill Companies.

University of Virginia Health System: Manual of Clinical Nutrition Management. (2011).

Morrison Management Specialists, Inc.

Appendix I

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Appendix I (Continued)

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Appendix I (Continued)

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Appendix II

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Appendix II (Continued)

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Appendix III