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Diet Therapy and Diet Modifications
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BS Nursing (BSN)
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Diet Therapy and Diet Modifications
Diet modification involves adjustment of the regular diet. It is much like tailoring a suit. A
tailored suit is the same suit after the necessary changes has been made.
Modifying a regular diet may entail one or more of the following;
1 in food consistency.
2. Adjusting the amount of one or more nutrients, or fluids
3. Increasing, reducing or eliminating certain foods; or
4. Altering the number of meals
Purpose of Diet Modification:
To maintain or restore good nutritional status
To correct nutritional deficiency that may have occurred
To afford rest to a particular part of the body that may have been affected by illness or surgery;
To adjust the diet based on the digestive capability of the client
To adjust the diet based on the ability of the client to metabolize nutrients
To treat or prevent edema; and
To eliminate offending food substances
Principles of Disease Management through Diet
Liberalization
The diet should meet the body’s requirement for essential nutrients as generously as the disease
condition permits. This can be achieved by providing a varied diet
Individualization
The diet regimen should take into account the patient’s food habits, preferences, socioeconomic
status, cultural practices and other environmental factors that have bearing on the diet. People
are different and so are the diets they need.
Simplification
The therapeutic diet should vary from the adequate, normal diet as little as possible. Modified
diets should consists of foods that are similar as possible to those of the general, adequate diet.
Ordering of Diets
Diet per se refers to the food and drink regularly consumed based on the individual food habits
and/or as dictated by the needs of treatment when an illness is present. When the diet includes
all the variety of food with no certain restrictions, it is referred to as the regular or house diet. If
the diet needs to be adjusted to meet specific health and medical condition, they are called
modified diets (also therapeutic diets). However, diets given to a person in preparation to or as
part of diagnostic procedure are preferably called test diets.
A diet order or diet prescription is the doctor’s written statement in the medical record and it is
in regard of what diet the patient should receive. The diet prescription designates the type,
amount and frequency of feeding on the patient’s disease and management goals.
Diet prescription should be described in qualitative and quantitative terms that leave no room
for misinterpretation.
Qualitatively, the diet may specify the type of nutrient, such as carbohydrate, protein, fat,
vitamins or minerals, fiber or water.
Quantitatively, the diet may limit or increase various nutrients
1.“high” – the amount of a nutrient is increased above the normal diet by 50- 100%.
2. “low” – the provision of diet with 50% less that those on the normal diet.
3. “restricted” – limiting the amount and/or type of nutrients to a specific level.
4. “controlled” – implies careful or adjustment of levels of one or more nutrients from day-to-day
as needed according to current biochemical changes.
STANDARD HOSPITAL DIETS
Regular Diet
Regular diet allows all types of foods which will promote health and lower the risk of developing
major, chronic, or diet-related diseases.
The diet is a well-balanced diet created to provide 100% of the recommended nutrient intakes;
alternatively, it can be planned consistent with the Food Guide Pyramid or the Nutritional
Guidelines. This ensures a nutritionally adequate meals that are either selected by or planned
for the patient according to food preferences.
There are two(2) general viewpoints guiding the composition of a regular diet:
1. To educate the client in the principles of a good nutrition by example
2. To provide food the client is willing to consume
Alternate names: normal diet, standard diet, general hospital diet, full diet, or house diet.
When is it used?
The diet is served when a person’s health and medical condition does not require any food
restriction.
How adequate is the diet?
1. The diet is satisfactory in all nutrients when planned according to daily food guides. The
easiest way to plan for nutritionally sufficient meals is by using the recommended amount for
specific food groups based on age and sex
2. Growing children and women of childbearing stage need to include a major source of iron
daily.
3. Some hospitals have a selective menu that allows the patient certain choices, yet control the
nutritional balance of the diet.
Suggested Meal Plan: ( regular diet)
Breakfast
Fruit Meat/Fish (or substitute)
Rice/Bread (or substitute)
Beverage
Snack (as desired)
Sandwich/Pasta/Noodle
Hot or cold beverage
Lunch/Supper
Meat/Fish (or substitute)
Vegetable
Rice(or substitute)
Fruit
Clear Liquid Diet
Clear liquid diet is a temporary diet containing foods and fluids that are clear and liquid at room
temperature and is served at frequent intervals (1-2 hour interval). A good rule-of-thumb is
any transparent drinkable liquid or any drinks with color but you can still see through it like tea,
apple juice, etc.
The diet is designed to provide adequate amounts of fluid and electrolytes and modest, Rapidly
absorbs calories so as to promote a return to normal diets; it provides some energy for energy
for clients when normal food intake must be withheld
Foods included are those that are easily absorbed and leave minimal residue in the GIT
The diet also minimizes stimulation of the GIT, i., non-distending, non-irritating, and non-
stimulating to peristaltic action.
Clear Liquid diet: Special Considerations:
Restrictions: The type of food items given may vary according to the client’s acceptance
and/or as dictated by his medical condition, the diagnostic test, or specific surgery a patient is
undergoing. Individual instructions should be strictly followed.
Number of food exchange list unit is not applicable in this diet
When persistent abdominal discomfort is experienced even on a clear liquid diet: the patient
should notify the health care professional at once.
Preparing for a medical test: it is essential that the diet be allowed exactly; the value of the test
depends on getting a thoroughly clean digestive tract.
When is it used?
As an initial feeding progression between IVF and a full liquid diet or a solid
diet following surgery.
As a dietary preparation for medical tests like bowel examination
As pre-diet for surgery to reduce fecal matter.
As a diet when there is acute disturbance of GI function like diarrhea
As an initial feeding for a severely debilitated (weak) patient including
severely malnourished patient and those with fever.
How adequate is the diet?
The diet cannot meet all the calories and essential nutrients needed by the body. It mainly
provides fluids (water), some electrolytes, and small amounts of energy from simple
carbohydrates (sugar).
The average clear liquid diet contains 400-800 calories per day
Because of inadequacy, its use must be limited to 1 or 2 days; extended use should be
combined with high-protein gelatin or low-residue liquid supplements.
In severe vomiting and diarrheal conditions, electrolytes through parenteral fluids may be
needed.
Suggested Meal Plan: (clear liquid diet)
AM,PM, Midnight snacks (clear liquids)
Strained fruit juice or soft drink
Gelatin dessert
Full Liquid diet
Full liquid diet provides both clear and opaque liquid foods and some semiliquid at body
temperature
The foods allowed may vary according to tolerance of the client and his disease condition,e.,
diabetes, renal disease, etc.
Many foods provided on full liquid diets contain lactose; in case of lactose intolerance, lactose-
free formula may be given
When used for prolonged periods, clients may find the diet unappetizing and boring
Other name: general liquid diet
When it is used?
As a step between clear liquid and soft diet
For person who has difficulty in chewing including dental wiring and jaw wiring or swallowing
For individuals who have problems digesting solid foods
In conjunction with parenteral nutrition
For persons w/ moderate GI inflammations and mouth lesions
For patients who are too ill to eat such as during fevers and infections
FULL LIQUID DIET: CONTRAINDICATIONS
Post-surgical patients with secondary or temporary lactose intolerance
Hypercholesterolemic patients using the diet for an extended period;
appropriate modification should be instituted
How adequate is the diet?
With careful planning, the diet is adequate in protein, calcium, phosphorous,
riboflavin and ascorbic acid.
The diet is particularly lacking in fiber, low in iron, Vit, Vit, niacin, folacin
and thiamin
The average caloric composition is approximately 1300 to 1500 kcal unless
provided with a nutritionally complete formula.
If given for more than 2 to 3 days, liquid nutritional supplements or blenderized
foods should be used to improve nutritional composition
Suggested Meal Plan:Modifications of Full Liquid:
1. Cold liquid diet – food items are served chilled or iced. Check tolerance of
patient for citrus juices
Indication for use: tonsillectomy,adenoidectomy, dental extraction, and minor
operation of the mouth and throat.
2. High calorie, high protein liquids – especially recommended for surgical patients
who must be maintained on a full liquid diet for longer than 48 hours. Use straw
whenever necessary
How to increase the protein and calorie content of the liquid diet:
Add nonfat, dry milk to beverage and soups
Add instant breakfast powder to milk, puddings, custards and milkshakes
Add butter to hot soups and cereals
Add strain meats (such as those in baby food) to broths
Use sugar or syrup in beverages
Use smooth ice cream in desserts and beverage
SOFT DIET
Soft diet is a modification of the regular diet to provide a selection of foods that
are soft in texture and consistency, easily digested, and simply prepared.
Nowadays, soft diet is used when a “bland diet” or low-residue diet is ordered.
It limits food items that are hard to chew and swallow; it is moderately low in
indigestible carbohydrates (cellulose) and connective tissues.
Strongly flavored vegetables and fried foods are also restricted. These make the
diet bland and lower in fat content
Foods to include will greatly depend upon the clients acceptance; thus, a
selective menu should be used whenever possible
Food tolerances vary with individualsGuidelines for the soft diet are more liberal today that they
were in the past,
especially concerning high-fiber foods like whole grains and vegetables
When it is used?
As a transition diet from liquids to a regular diet, i., the patient is ready for solid
foods but unable to handle a regular solid diet
For conditions in which ease of chewing, swallowing and digestion are desired –Extreme
weakness, chemotherapy and radiation therapy, fever and mild
infections, GI discomfort and convalescence.
For patients recovering from trauma or debilitating disease who have impaired
ability or appetite to ingest a completely regular diet.
Suggested Meal Plan:
Breakfast AM Snack
Juice or fruit Sandwich
Juice or fruit Fruit shake
Egg dish
Coffee or tea
Cream and sugar
Lunch/Supper PM Snack
Soup Pasta or porridge
Meat dish Fruit juice
Well cooked vegs
Soft-cooked rice or soft bread
Canned fruit or juice
Custard or gelatin
THERAPEUTIC DIETS
High Fiber Diet
This diet emphasizes the use of foods high in fiber such as whole-grain breads and
cereals, fruits, vegetables, and legumes.
Essentially a regular diet, the high fiber regimen contains about 20 to 35 grams of dietary fiber
(DF) per day. Consumption of higher than 50 g has no additional benefit and may cause
undesirable GI upsets
The purpose of the diet is to increase the weight of the residue reaching the colon; to increase
intestinal peristalsis, and decrease colonic Pressure.
When introducing the diet, the different sources of the DF should be considered.
1 is an effective laxative to relieve constipation; and
2. Pectin has significant effect on serum lipids, blood sugar absorption and diarrhea.
When it is used?
Cancer prevention; colon, rectum, breast, bladder, prostate, lining of the uterus
Constipation
Coronary heart disease
Diabetes mellitus
Diarrhea (high in soluble fiber)
Diverticulosis
Suggested Meal Plan
Same as the regular diet but with additional servings of fruits, veg's, and substitution of
refined carbohydrates with whole grains
Fiber-restricted Diet
Fiber-restricted diet limits the consumption of fiber-rich foods by avoiding whole grain
bread and cereal products, nuts seeds, legumes and certain fruits and veg’s.
The extent of fiber restriction will depend on the client’s condition and the goals
of the management.
Low fiber diet serves mainly to reduce the total fecal size by limiting the sources
of fiber and connective tissues
When it is used?
After surgery
Diverticulitis
Inflammatory bowel diseases (during active episode)
Intestinal gas reduction
Narrowing of the intestinal as in the case of obstruction and stricture
Progressive diet
Radiation enteritis
Suggested Meal Plan:
Same as the regular diet but using only allowed foods
Low-Residue Diet
The low –residue diet provides food and drinks that are easily digested and almost
completely absorbed to produce only a moderate amount of stool.
A lactose restricted diet is a highly individualized regular diet that often limit, but do not exclude
milk and milk products.
The diet is intended to reduce any adverse reaction due to lactose ingestion
Many people can tolerate ten grams lactose per day with no occurrence of symptoms. A cup of
whole milk has approximately 10 grams of lactose.
When is it used?
Lactose deficiency
Malabsorption syndrome associated with lactose intolerance
How adequate is the diet?
The diet is generally a regular diet and thus adequate in all nutrients except calcium,vitamin D,
riboflavin and other B vitamins.
Use of a milk substitute (e. soya milk) is necessary to satisfy the calcium requirement
Suggested Meal Plan
Follow the same pattern as the regular diet but limit lactose-containing foods
according to tolerance
High Protein Diet
A high protein diet provides a protein level substantially above the normal amount required. It
supplies a minimum of 1 gram per kilo or 100 to 200 gram protein daily for adults and is also
basically high in kilocalories to spare protein from being used as energy.
When is it used?
Hypermetabolic or catabolic states
In preparing the nutritionally wasted patient for surgery
Primary and secondary PEM (Protein energy malnutrition)
How adequate is the diet?
The diet is generally a regular diet and, thus, nutritionally adequate
Suggested Meal Plan
Same as the regular diet. Snacks must be given as frequent as possible
Low Protein Diet
A low protein diet regulates the dietary intake of protein to a prescribed level.
Protein allowance is computed at 0 to 0 grams per kilo body weight in the absence of edema
or alternatively using DBW. However, the diet must have at least 40 grams protein per day.
Below this level, the diet is combined with keto acid or amino acid supplements.
High biologic value protein sources are emphasized, at least 2/3 of the protein intake, such as
those found in meats, fish, seafood and poultry.
When is it used?
Acute renal failure
Acute glumerulonephritis
Chronic renal failure without dialysis
Liver failure with impending coma
How adequate is the diet?
A low protein diet is adequate in all nutrients except for vitamin B12 and iron.
Low-Purine Diet
A low –purine diet limits the amount of purines to 120 to 150 mg/day as
compared to the usual intake of 600 to 1000 mg per day.
The diet is relatively high in carbohydrate (at least 50 percent of calories) content
and low in fat (should not exceed 30% of calories) with fluid intake of at least 2
quarts per day or more.
When is it used?
Low purine diet is suggested when the uric acid level in the body is high, unless the patient is on
medication that helps eliminate excess uric acid.
Gout
Hyperuricemia
Uric acid stones
PURINE
-a compound that is mainly found in animal
protein and is metabolized to uric acid in the body
How adequate is the diet?
The diet provides all the essential nutrients when planned based on the principle of balanced
diet
Suggested Meal Plan
Same as the regular diet but choose only from those foods that are permit
Gluten-Restricted Diet
A gluten-restricted diet (also gliadin-free diet) eliminates all food sources of gluten.
When is it used?
Dermatitis herpetiformis
Gluten-sensitive enteropathies
How adequate is the diet?
A gluten-restricted is not nutritionally inadequate; however, when malabsorption
is present, appropriate vitamin and/or mineral supplements should be prescribed.
Suggested Meal Plan
Same as the regular diet but use only those foods that are permitted.
Low-Fat Diet
A low-fat diet is a modification in fat content. It is designed to limit the total amount of fat in the
diet to less than 10-15% of total calories intake or about 30 to 50 grams per day
When is it used?
Cardiovascular disorders such as atherosclerosis and congestive heart failure
Chronic renal disease
Chronic pancreatitis
Disorder in the digestion, absorption, and transport of fat including steatorrhea ( absorption of
fat by the intestines )
and fat malabsorption, gallbladder disease.
How adequate is the diet?
Dietary fat serves as a carrier for fat soluble vitamins and provides essential fatty acids. These
functions can be met by a diet containing 15-25 grams fat daily. A variety of food intake ensures
that the diet will provide all the essential nutrients.
Suggested Meal Plan
Breakfast
Fruit or fruit juice
Meat/fish (or substitute)
Rice/plain bread (or substitute)
Coffee or fat-free milk
Lunch/supper
Lean meat/fish, seafood/poultry without skin
Stir fry vegetable or salad with vinegar dressing
Plain rice
Fruit juice or fresh fruit slices
Snack
Fruit juice
Low-fat sandwiches
Fat-controlled Diet
Fat-controlled diet regulates both the amount and type of fat, especially saturated fat and
cholesterol.
The diet is generally planned to provide:
-30% of the total calories from fat
-less than 10% of total calories from saturated fatty acids
-10-15% of total calories from monounsaturated fatty acids; and
-up to 10% of total calories from polyunsaturated fatty acids
The basic changes made in the diet include the removal of foods that are high in
saturated fats, cholesterol and total fat.
The diet is designed to decrease the concentration of serum cholesterol and
other circulating lipids in order to prevent or reduce the development of atherosclerosis.
When is it used?
Atherosclerosis
Elevated cholesterol levels
Gallbladder stones w/ cholesterol esters
Hyperlipidemia or hyperlipoproteinemia
How adequate is the diet?
The fat-controlled diet can include a wide variety of food products resulting in carrying amounts
of nutrients.
Suggested Meal Plan
Breakfast
Fresh fruit
Lean meat/fish(or substitute)
Plain rice/ bread(or substitute)
Coffee or fat-free milk
Lunch/Supper
Lean meat/ fish, seafood/poultry without skin
Stir fry vegetable or salad w/ vinegar dressing
Plain rice (or substitute)
Fruit juice or fresh fruit juice
Sodium-Restricted Diets
Snack
fruit juice
low-fat sanwiches
Sodium-restricted diets restrict the quantity of sodium to a prescribed level.
These diets are designed to induce a loss of sodium and water from the body or avoid excessive
sodium retention.
Suggested levels of sodium modification include:
Mild sodium restriction 3000mg sodium/day
Moderate sodium restriction 2000mg sodium/day
Strict sodium restriction 1000mg sodium/day
Very strict sodium diet 500mg sodium/day
When is it used?
3000mg Na diet: mild hypertension, mild edema
2000mg Na diet: congestive heart failure, moderate hypertension, pregnancy induced
hypertension, corticosteroid therapy, cirrhosis, and chronic renal disorders
1000mg Na diet: severe hypertension, cirrhosis with ascites, pulmonary edema, congestive
heart failure and eclampsia
500mg Na diet: a diet used on a short-term basis for patients requiring severe
sodium restriction
How adequate is the diet?
The diet provides all the essential nutrients when planned based on the
principles of balanced diet.
Suggested Meal Plan
Same as the regular diet but use only those foods that are permitted.
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Diet Therapy and Diet Modifications
Course: BS Nursing (BSN)
462 Documents
Students shared 462 documents in this course
Was this document helpful?
Diet Therapy and Diet Modifications
Diet modification involves adjustment of the regular diet. It is much like tailoring a suit. A
tailored suit is the same suit after the necessary changes has been made.
Modifying a regular diet may entail one or more of the following;
1.Changes in food consistency.
2. Adjusting the amount of one or more nutrients, or fluids
3. Increasing, reducing or eliminating certain foods; or
4. Altering the number of meals
Purpose of Diet Modification:
To maintain or restore good nutritional status
To correct nutritional deficiency that may have occurred
To afford rest to a particular part of the body that may have been affected by illness or surgery;
To adjust the diet based on the digestive capability of the client
To adjust the diet based on the ability of the client to metabolize nutrients
To treat or prevent edema; and
To eliminate offending food substances
Principles of Disease Management through Diet
Liberalization
The diet should meet the body’s requirement for essential nutrients as generously as the disease
condition permits. This can be achieved by providing a varied diet
Individualization
The diet regimen should take into account the patient’s food habits, preferences, socioeconomic
status, cultural practices and other environmental factors that have bearing on the diet. People
are different and so are the diets they need.
Simplification
The therapeutic diet should vary from the adequate, normal diet as little as possible. Modified
diets should consists of foods that are similar as possible to those of the general, adequate diet.
Ordering of Diets
Diet per se refers to the food and drink regularly consumed based on the individual food habits
and/or as dictated by the needs of treatment when an illness is present. When the diet includes
all the variety of food with no certain restrictions, it is referred to as the regular or house diet. If
the diet needs to be adjusted to meet specific health and medical condition, they are called
modified diets (also therapeutic diets). However, diets given to a person in preparation to or as
part of diagnostic procedure are preferably called test diets.
A diet order or diet prescription is the doctor’s written statement in the medical record and it is
in regard of what diet the patient should receive. The diet prescription designates the type,
amount and frequency of feeding on the patient’s disease and management goals.
Diet prescription should be described in qualitative and quantitative terms that leave no room
for misinterpretation.
Qualitatively, the diet may specify the type of nutrient, such as carbohydrate, protein, fat,
vitamins or minerals, fiber or water.
Quantitatively, the diet may limit or increase various nutrients
1.“high” – the amount of a nutrient is increased above the normal diet by 50- 100%.
2. “low” – the provision of diet with 50% less that those on the normal diet.
3. “restricted” – limiting the amount and/or type of nutrients to a specific level.
4. “controlled” – implies careful or adjustment of levels of one or more nutrients from day-to-day
as needed according to current biochemical changes.
STANDARD HOSPITAL DIETS
Regular Diet
Regular diet allows all types of foods which will promote health and lower the risk of developing
major, chronic, or diet-related diseases.
The diet is a well-balanced diet created to provide 100% of the recommended nutrient intakes;
alternatively, it can be planned consistent with the Food Guide Pyramid or the Nutritional
Guidelines. This ensures a nutritionally adequate meals that are either selected by or planned
for the patient according to food preferences.
There are two(2) general viewpoints guiding the composition of a regular diet:
1. To educate the client in the principles of a good nutrition by example
2. To provide food the client is willing to consume
Alternate names: normal diet, standard diet, general hospital diet, full diet, or house diet.
When is it used ?
The diet is served when a person’s health and medical condition does not require any food
restriction.
How adequate is the diet?
1. The diet is satisfactory in all nutrients when planned according to daily food guides. The
easiest way to plan for nutritionally sufficient meals is by using the recommended amount for
specific food groups based on age and sex
2. Growing children and women of childbearing stage need to include a major source of iron
daily.
3. Some hospitals have a selective menu that allows the patient certain choices, yet control the
nutritional balance of the diet.
Suggested Meal Plan: ( regular diet)
Breakfast
Fruit Meat/Fish (or substitute)
Rice/Bread (or substitute)
Beverage
Snack (as desired)
Sandwich/Pasta/Noodle
Hot or cold beverage
Lunch/Supper
Meat/Fish (or substitute)
Vegetable
Rice(or substitute)
Fruit
Clear Liquid Diet
Clear liquid diet is a temporary diet containing foods and fluids that are clear and liquid at room
temperature and is served at frequent intervals (1-2 hour interval). A good rule-of-thumb is
any transparent drinkable liquid or any drinks with color but you can still see through it like tea,
apple juice, etc.
The diet is designed to provide adequate amounts of fluid and electrolytes and modest, Rapidly
absorbs calories so as to promote a return to normal diets; it provides some energy for energy
for clients when normal food intake must be withheld
Foods included are those that are easily absorbed and leave minimal residue in the GIT
The diet also minimizes stimulation of the GIT, i.e., non-distending, non-irritating, and non-
stimulating to peristaltic action.
Clear Liquid diet: Special Considerations:
Restrictions: The type of food items given may vary according to the client’s acceptance
and/or as dictated by his medical condition, the diagnostic test, or specific surgery a patient is
undergoing . Individual instructions should be strictly followed.
Number of food exchange list unit is not applicable in this diet
When persistent abdominal discomfort is experienced even on a clear liquid diet: the patient
should notify the health care professional at once.
Preparing for a medical test: it is essential that the diet be allowed exactly; the value of the test
depends on getting a thoroughly clean digestive tract.
When is it used?
As an initial feeding progression between IVF and a full liquid diet or a solid
diet following surgery.
As a dietary preparation for medical tests like bowel examination
As pre-diet for surgery to reduce fecal matter.
As a diet when there is acute disturbance of GI function like diarrhea
As an initial feeding for a severely debilitated (weak) patient including
severely malnourished patient and those with fever.
How adequate is the diet?
The diet cannot meet all the calories and essential nutrients needed by the body. It mainly
provides fluids (water), some electrolytes, and small amounts of energy from simple
carbohydrates (sugar).
The average clear liquid diet contains 400-800 calories per day
Because of inadequacy, its use must be limited to 1 or 2 days; extended use should be
combined with high-protein gelatin or low-residue liquid supplements.
In severe vomiting and diarrheal conditions, electrolytes through parenteral fluids may be
needed.
Suggested Meal Plan: (clear liquid diet)
AM,PM, Midnight snacks (clear liquids)
Strained fruit juice or soft drink
Gelatin dessert
