NutritionNutritionChapter 11Chapter 11

Cooking CompanionDietary Considerations

and Modifications

IntroductionIntroductionDiets may need to be modified to suit

the needs of our clients. Modification of diet may be needed

because of injury , disease, illness or dementia and may be temporary or permanent.

The whole client, his medications and culture should always be taken into consideration.

Dietary FiberDietary FiberThe part of the plant fiber

that is eaten is called dietary fiber.

Remember the following when adding fiber to the diet:

Add small increments to the diet

Drink at least 8 glasses of water

Discuss how addition of fiber may affect absorption of vitamins.

Monitor the affect of BM’s, gas and reaction to medication.

Dietary Fiber UseDietary Fiber UseHigh fiber diet will increase the

amount of residue and fiber in the colon and stimulate peristalsis.

Used for constipation and other gastrointestinal disorders.

Low-residue or Low-fiber Low-residue or Low-fiber dietdiet

Sometimes we need to restrict fiber.Diseases that require this diet may

include; acute diverticulitis, Crohn’s, ulcerative colitis, diarrhea and following bowel surgery.

May need to monitor the intake of fruits, veggies and calcium. A multivitamin may be needed.

Low Residue DietGrain Products:

•enriched refined white bread, buns, bagels, English muffins •plain cereals e.g. Cheerios, Cornflakes, Cream of Wheat, Rice Krispies, Special K •arrowroot cookies, tea biscuits, soda crackers, plain melba toast •white rice, refined pasta and noodles •avoid whole grains

Fruits:•fruit juices except prune juice •applesauce, apricots, banana (1/2), cantaloupe, canned fruit cocktail, grapes, honeydew melon, peaches, watermelon •avoid raw and dried fruits, raisins and berries.

Vegetables:•vegetable juices •potatoes (no skin) •well-cooked and tender vegetables including alfalfa sprouts, beets, green/yellow beans, carrots, celery, cucumber, eggplant, lettuce, mushrooms, green/red peppers, squash, zucchini •cabbage, kale, Swiss avoid vegetables from the cruciferous family such as broccoli, cauliflower, Brussels sprouts, chard etc

Meat and Protein Choice:•well-cooked, tender meat, fish and eggs •avoid beans and lentils

Nuts and Seeds:•Avoid all nuts and seeds, as well as foods that may contain seeds (such as yogurt)

Dairy:•as directed by your healthcare providers

Clear Liquid DietClear Liquid Diet Includes beverages that

are both clear and liquid at room temperature.

Relives thirst, maintains fluid balance, electrolyte balance and stimulates peristalsis after surgery.

No milk or milk products. Tea, coffee, fat free

broth, ginger ale, clear fruit juices and gelatins.

Also used for acute illness, infection, nausea and vomiting and in prep for gastrointestinal exams.

Full Liquid DietFull Liquid Diet Includes foods that liquid at room

temperature.Advance from clear liquid diet.Used for stomach irritation, fever, nausea

and vomiting or for people unable to chew, swallow or digest solid foods.

It is high in fat, calcium and low in fiber.Protein can be addedUsually high in lactose.Foods include ; milk and milk products,

cooked thin cereal, soups and all juices, all foods not allowed on clear liquid diet, and fiber (may have to be added as a supplement)

Soft Diet/ Bland DietSoft Diet/ Bland DietA soft diet consists of foods that are

easily digestible, low in fiber, soft in consistency and bland in flavor.

Can be used as a transition meal before a regular meal plan is followed.

No spiceThe consistency of the food does not

have to be altered.Soft refers to soft to the digestive

tract.

Low-residue or Low-fiber diet Low-residue or Low-fiber diet UsesUses

UlcersGallbladder disordersIntestinal disordersAfter abdominal surgery

Mechanical Soft DietMechanical Soft DietFor clients who have difficulty chewing.Problems may be with teeth or from

stroke, neck or head surgery.The only change in the diet is texture.Common modifications include; veggies

well cooked, soft fruits mashed, meats ground or minced, breads soft, desserts such as puddings, custards cake and some pies.

Mechanical SoftMechanical SoftMay also be advanced from a full

liquid dietUsed for gastrointestinal

disorders and infections

Pureed DietPureed DietFoods are soft and

smoothEasy to swallow

with little or no chewing

Liquids may need to be added when blending for desired consistency

No baby foodsPuree each item

separately for attractiveness.

Dysphagia DietDysphagia Diet A swallowing evaluation will

be preformed Foods may be thick, thin,

smooth or textured, light or heavy.

Commercial thickeners may sometimes may be used.

Do not leave clients alone when they are eating.

May sure temperature is appropriate.

Notice and report any changes in the clients ability to swallow

Sit upright for meals Feed slowly.

Lactose Free DietLactose Free DietLactose is sugar

found in dairy products

Some people do not have the enzyme to digest this.

Eating milk products may lead to cramping, bloating and diarrhea.

Your Role as a Your Role as a HomemakerHomemaker

You will help the family adjust to changes

Incorporate foods while maintaining client satisfaction

Be aware of facial expressions when feeding clients

Present meals in a pleasant atmosphere.

Only changes diets upon the advise of a health care professional.