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Modified Diets
FNU-422
During many illness a person can meet
energy and nutrients needs by :
1. Standards/ regular diet
2. Modified diet
FNU-422
Standard or regular diet : diet that includes
all foods and meets the nutrient needs of
healthy people.
Modified diet :diet that is adjusted to meet
medical needs and may be adjusted in:
1. Consistency.
2. Level of energy or nutrients.
3. Inclusion or elimination of certain foods.
FNU-422
1- Mechanically altered diets:
–
Are usually prescribed for patients with difficulty
chewing or swallowing
1. Patients with dysphagia
2. Patients with limited chewing abilities or dental
problems
–
The most restrictive diet may contain pureed
foods, The less restrictive diet may include moist
,soft textured foods.
Diets for people with chewing problems include
foods that are ground/minced and easy-to-chew.
–
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2- Blenderized liquid diets:
Are often prescribed after oral or facial
surgeries and for patients with chewing
problems( Jaw fraction).
– Include fluids and foods that have been
blenderized to a liquid form (often with
added liquid).
• Cereals and breads; cooked vegetables; fresh or
cooked fruits without skins or seeds; cooked,
tender meats and fish; potatoes, rice, and pasta.
FNU-422
Blenderized liquid diets (cont’d):
– Exclude foods that do not blend well:
• Nuts and seeds; dried fruits; hard cheeses; raw
vegetables and corn.
– Should be consumed immediately after
preparation or can be refrigerated for up to 48
hours, to prevent bacterial growth.
FNU-422
3- Clear liquid diets:
– Require minimal digestion.
– Often are the first foods offered after acute
gastrointestinal (GI) disturbances or IV
feeding.
– Are used prior to bowel surgeries and
colonoscopy (examination of the colon).
FNU-422
Clear liquid diets (cont’d):
– Include clear fluids and foods that are:
1. liquid at room temperature
2. leave little residue (undigested material) in
the intestine.
Include :clear or pulp-free fruit juices, clear
broths, fruit-flavored or unflavored gelatin,
fruit ices made from clear juices.
FNU-422
Clear liquid diets (cont’d):
• Although it provides fluid and electrolytes,
its nutrient and calorie content are
extremely limited.
– If used for greater than 1-2 days, should be
supplemented with commercially prepared
low-residue formulas that provide required
nutrients.
FNU-422
4-Full liquid diets:
– Not limited to clear liquids
– Transitional diet between liquids and solid
foods
– May include milk, yogurt, cream soups and
thin cooked cereals
– Because the diet contain milk products , it
may be inappropriate for individuals with
significant lactose intolerance.
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5- Fat-restricted diets:
– May be recommended for reducing
symptoms of fat malabsorption, heartburn.
– Restricts fat to low as little as 50
grams/day or very low as limited to as little
as 25 grams/day.
– Shouldn’t restrict fat more than necessary
it is an important source of calories.
– Include foods that have less than 1 gram of
fat per serving.
FNU-422
Fat-restricted diets (cont’d):
– Include nonfat milk products, most fruits,
most breads, fat free broths, vegetables
prepared without fat and nonfat candies and
sweets.
– Permit lean meat and meat substitutes –
restricted to 4-6 oz. per day depending on the
degree of restriction.
– Sometimes limit lactose or dietary fiber in
patients who can not tolerate.
FNU-422
6- Fiber-restricted diets:
– Are recommended during acute phases of
intestinal disorders when the presence of fiber
may increase intestinal discomfort or cause
diarrhea or blockages.
– Used before surgery to minimize fecal
volume, and after surgery during transition to
a regular diet.
– Shouldn’t be used on a long-term basis –
associated with constipation, diverticulosis,
etc.
FNU-422
Fiber-restricted diets (cont’d):
– Often eliminate whole-grain breads and
cereals, nuts and seeds, raw and dried
fruits, berries, dried beans and peas,
chunky peanut butter, winter squash,
and most raw vegetables.
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7- Low-residue diets:
– Differs from low-fiber diet by further
restricting most fruits and milk products ; for
greater reductions in colonic residue.
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8-Sodium-restricted diets:
– Are used to prevent or correct fluid retention
and is often recommended for the treatment of
hypertension, heart failure, kidney and liver
diseases.
– The degree of restriction depends on the
degree of illness
– Restrict sodium in most cases to 2000-3000
mg/day & may be further restricted in hospital
setting
– Are difficult to adhere to because most patients
find them unpalatable
FNU-422
Sodium-restricted diets (cont’d):
May require :
– omitting salt in cooking and at the table
– eliminating most prepared foods and
condiments,
– limiting consumption of milk and milk
products.
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9- High-kcalorie, high-protein diets:
– Are used for patients who have unusually
high requirements or who are eating poorly.
– High-fat foods are added - diet may exceed
35% of calories from fat.
– Consist of small, frequent meals and
commercial liquid supplements (Boost or
Ensure).
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The diet order
• Nothing by mouth (NPO) :
• An order to not give a patient anything at all
(food, beverages, or medications).
• NPO is an abbreviation for non per os Which
means nothing by mouth
– Maybe for 24 hours (NPO for 24 hours)
– until after X-ray( NPO until after X-ray)
– Commonly used during certain acute illnesses
or diagnostic tests involving the GI tract.
FNU-422