dieteducation1- fd service

8/14/2019 DietEducation1- Fd Service

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Diet Education forFood Service Employees

Dietetic Services


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Objectives

To know and understand

Who receives a special diet?

What are the diet guidelines for each diet?

Why is tray accuracy important?

Why is proper customer service important?


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Clear Liquid Diet

Who: Patients who are pre or post-surgeryor need to rest their digestive system

Why: Gives patients calories with minimal

amount of work for digestion

Milk based fluids are not allowed

Serve only pulp free juices

Additional foods may be added if physician ordered
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Clear Liquid Diet

Diet Guidelines:

Consists of clear fluids

Other beverages may be

foods that are liquid atroom temperature

(e.g. Jell-O or popsicles)


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Clear Liquid Foods

Apple Juice

Cranberry Juice

Grape Juice Jell-O

Broth

PopsiclesCoffee or Tea


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Diabetic Clear Liquid Diet

Who: Patients who have diabetes and need aclear liquid diet

Why: A regular clear liquid diet is used to provideenough calories and CHOs to avoid low

blood sugars

Give patient sugar substitutesinstead of regular

sugar packets
http://images.google.com/imgres?imgurl=http://www.whatdaphuk.com/img/splenda.jpg&imgrefurl=http://www.whatdaphuk.com/&h=200&w=194&sz=23&tbnid=kGHuMAW-0juq1M:&tbnh=99&tbnw=96&hl=en&start=7&prev=/images%3Fq%3Dsplenda%26svnum%3D10%26hl%3Den%26lr%3D


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Full Liquid Diet

Who: Patients advancing from clear liquids

to solid foods

Why: Provides more calories and protein than

clear liquids

Prepares digestive system for solid foods

Margarine is allowed

Avoid foods that contain fruit, coconut, seeds or nuts

Avoid solid foods unless special ordered by physician


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Full Liquid Diet

Diet Guidelines:

Given to patients who cannot tolerate solid

foods

Consists of foods and liquids that become

(or remain) liquid at room temperature


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Full Liquid Foods

Juices

Health shakes

Pudding

Yogurt (no fruit) Strained soups

Milk

Grits Cream of Wheat

Hard candy


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Pureed Diet Who: Patients who are unable to chew or swallow

Can be used after certain surgeries

(e.g. Wired Jaw, Gastric ByPass, etc)

Why: To make chewing and swallowing easier

To prevent choking

For easier digestion

Blended food must be consistently smooth

Garnishes must be pureed too!


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Pureed Diet

Diet Guidelines:

Foods have been changed in texture to be

soft, moist, and easy to swallow

Add gravies and sauces to garnish the food

and to help moisten the food.


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Pureed Diet

Most foods can be pureed

Meat, eggs, vegetables, fruits, grits,beans

Exceptions: Breads

Cakes

Cookies

Nuts

Most raw fruits and vegetables


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Mechanical Soft Diet

Who: For patients with chewing problems

Why:All foods must be soft for easy

chewing and swallowing

AVOIDCrunchy or hard-to-chew foods such as:

Raw fruits and vegetables (salads) Nuts

Seeds

Dried fruits
http://images.google.com/imgres?imgurl=http://www.pccnaturalmarkets.com/health/Food_Guide/Nuts_And_Seeds.jpg&imgrefurl=http://www.pccnaturalmarkets.com/health/Food_Guide/Nuts_And_Seeds.htm&h=200&w=200&sz=24&tbnid=7Tu7yOJl8Y9GGM:&tbnh=99&tbnw=99&hl=en&start=2&prev=/images%3Fq%3Dnuts%2Band%2Bseeds%26svnum%3D10%26hl%3Den%26lr%3D


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Mechanical Soft Diet

Diet Guidelines:

Foods that are soft

Meats are chopped or ground

Add gravy and/ or sauces to moisten foods

Waffles, pancakes, and other bread products are

served with syrup

Canned fruits

Serve cooked vegetables (no lettuce)

Garnishes must comply with guidelines
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Modified Dysphagia Diet

Diet Guidelines

Foods are ground, pureed or naturally soft

Liquids can be thickened:

Pudding consistency (thickest) *Honey consistency

Nectar consistency

* If consistency level is not ordered, then defaultto Honey Cons istency


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Post-Gastric ByPass Diet

Who: Obese patients who have Gastric ByPass

(GBP) surgery

Why: The patients stomach is reduced to the

size of an egg, so they need: Smaller Portions

Nutrient Dense Food - PROTEIN!

Limit fluid volume at one time

Limit high fat foods
http://images.google.com/imgres?imgurl=http://www.medscape.com/content/2004/00/47/19/471952/art-mgm471952.fig3.gif&imgrefurl=http://www.medscape.com/viewarticle/471952_3&h=369&w=400&sz=22&tbnid=aK-_eGgGefHFIM:&tbnh=110&tbnw=120&hl=en&start=16&prev=/images%3Fq%3Dgastric%2Bbypass%26svnum%3D10%26hl%3Den%26lr%3D


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Post-Gastric ByPass Diet

Diet Guidelines

Progressive Diet

Day 1: Clear Liquids (limited amount)

Day 2: Full Liquids

Day 3: Pureed Foods

No sugar!

Sugar substitutes are allowed 6 Small meals per day

No Garnishes allowed on trays


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Bland Diet

Who: Patients with ulcers or stomach irritation

(can cause heartburn after meals)

Why: Eating these foods can cause further painand discomfort

Black pepper packets

Caffeine containing: Coffee / Tea / Soda

Chocolate: Pudding / Cake/ Frosting / Ice

Cream
http://images.google.com/imgres?imgurl=http://www.sciencebob.com/lab/bodyzone/stomach.gif&imgrefurl=http://www.sciencebob.com/lab/bodyzone/digestion.html&h=251&w=301&sz=27&tbnid=NlsB0oiXIvCe7M:&tbnh=93&tbnw=112&hl=en&start=20&prev=/images%3Fq%3Dstomach%26svnum%3D10%26hl%3Den%26lr%3D


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Bland Diet

Diet Guidelines:

Foods that are NOT ALLOWED: Caffeine drinks

Coffee Tea

Sodas

Chocolate

Spicy foods

Black pepper

Alcohol

Chili Powder


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Low Fat Diet

Who: Patients with digestive disorders (e.g. pancreatitis) Why: Some patients cannot properly break down fats

Too much fat in the diet can cause diarrhea, gas or other

unpleasant side effects

High fat desserts/pastries (e.g. doughnuts, muffins, sweetrolls)

Butter, margarine, cooking oils, salad dressing Whole milk

Fried foods

Some cheeses
http://images.google.com/imgres?imgurl=http://www.lutzcafe.com/images/tbd/minipa~1.jpg&imgrefurl=http://www.lutzcafe.com/pastry/main/pastries.html&h=454&w=532&sz=59&tbnid=d_frELUuVn58tM:&tbnh=110&tbnw=129&hl=en&start=5&prev=/images%3Fq%3Dpastries%26svnum%3D10%26hl%3Den%26lr%3D


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Low Fat Diet

Diet Guidelines:

NO fried foods

Use LOW FAT gravy ONLY

Select FAT free dairy products Serve *FYH (For Your Health) vegetables

AVOID Red Meat, fried and fatty meats

NO margarine added to trays

*FYH foods are limited in fat, cholesterol, and sodium
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Low Sodium (Na+) Diet

Who: Patients with high blood pressure, and

heart, kidney, or liver disease

Why: Large amounts of salt in the diet maycause the body to retain fluid, which makesthe heart, kidneys, and liver work harder

Serve For Your Health (FYH) foods ONLY

DO NOT add salt packets to trays

Extra herb seasoning packets may be added
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Low Sodium (Na+) Diet

Diet Guidelines:

AVOID processed foods like

Deli meats, canned soups, frozen

meals

Limit canned and instant

products like

Canned vegetables, and meats

Instant grits, instant potatoes
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Cardiac Fitness Diet Who: For patients with heart problems

Why: Too much sodium causes the heart to work harder

Too much fat can clog arteries and cause heart

attacks or strokes

AVOID: Fried foods

Salad dressings

Cooking oils

Eggs

High fat meat and dairy products

Foods high in sodium such as cheeses and soups
http://images.google.com/imgres?imgurl=http://www.aic.cuhk.edu.hk/web8/Hi%2520res/Heart.jpg&imgrefurl=http://www.aic.cuhk.edu.hk/web8/Heart%2520diagrams.htm&h=1418&w=1464&sz=682&tbnid=ZerKP5i_iC28RM:&tbnh=145&tbnw=150&hl=en&start=7&prev=/images%3Fq%3Dheart%26svnum%3D10%26hl%3Den%26lr%3D


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Cardiac Fitness

Diet Guidelines:

Foods that are low in sodium and fat

Eat chicken, fish, or fresh pork instead of red meat

Use herbs instead of salt

Limit margarine (only 1 pat of margarine at Breakfast)

Select low fat dairy products (e.g. skim milk)

Avoid high fat desserts


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Carbohydrate Counting (CHO)

Who: Patients with diabetes or require

weight control

Why: - Diabetes is a disease which affectsblood sugar control

- Carbohydrate (CHO) foods turn into

sugar when eaten- Too little or too much CHO can

result in coma or death
http://images.google.com/imgres?imgurl=http://www.nelh.nhs.uk/dlnet/pod/Diabetes%2520mag.jpg&imgrefurl=http://www.nelh.nhs.uk/dlnet/pod.asp&h=2487&w=2362&sz=344&tbnid=wG7yveKD23IIIM:&tbnh=150&tbnw=142&hl=en&start=4&prev=/images%3Fq%3Ddiabetes%26svnum%3D10%26hl%3Den%26lr%3D


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Carbohydrate (CHO) Counting diet

Diet Guidelines: The amount of CHOs per day are

restricted

CHO foods include: Breads & Cereals

Dairy products

Starchy vegetables (beans, corn,potatoes)

Fruit and fruit juices Sweets

Portion sizes are very importantand need to be accurate
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CHO Counting Cont.

Portion size: Correct portions are essential!

Substitutions: If a patient asks to substitute a menuitems, check with a dietitian first

Free Foods: The patient can have unlimitedamounts of:

Coffee

Diet Soda

Diet Jell-O

Broth

Lettuce

Sugar substitutes (Sweet n Low)
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Renal Diet

Who: Patients with kidney disease

Why: The kidneys can not get rid of excess potassium

(K+), sodium (Na), and phosphorus

DO NOT serve foods high in potassium, sodium, orphosphorus

Portions!

Soaking (potatoes, French Fries)!

Limit FLUIDS as ordered


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Renal Diet

Diet Guidelines:

ALLOWED Foods

Low in Sodium

Fresh and frozen foods

Low in Phosphorus White bread, lettuce, green beans,

corn

Low in potassium Pears, pineapple, applesauce
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HIGH Phosphorus

AVOIDHIGHphosphorus foods: Beverages: Chocolate drinks, canned iced teas,

dark colas

Dairy Products:Limit to 1/2c serving: milk, ice cream,pudding, cream soup, yogurt;

cheese, cottage cheese

Protein: Liver, oysters, sardines

Vegetables: Beans- (Baked, black, garbanzo,kidney, porkn beans, soy)

chick peas, lentils, lima beans,

split peas
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High Potassium (K+)AVOID: Foods HIGHin Potassium

Apricots

Avocado

Banana

Cantaloupe

Honeydew

Kiwi Lima beans

Milk

Oranges and orange juice

Potatoes (unless soaked overnight)

Prunes Spinach

Tomatoes

Vegetable juice

Winter squash
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Fluid Restriction

Limit the drinks as written on menu

Remember that some foods count asfluids:

Jell-O ( c) = 120 cc fluid

Ice Cream ( c) = 120 cc fluid

1 Popsicle = 120 cc fluid


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Gluten-Free Diet

What is gluten?

Gluten is a general name for certain proteins

in different types of grains

Wheat, rye, and barley products containgluten!


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Gluten-Free Diet

Who: Patients with gluten-sensitivedisorders (e.g. Celiac Disease)

Why: Food containing Gluten may damage the

small bowel, which can become lifethreatening

DO NOT serve items containing wheat,rye, or barley

DO NOT let gluten foods touch gluten-free foods (evenpots, pans or griddles)


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Gluten-Free Diet

Diet Guidelines

DO NOT serve ANY items containing:

WHEAT RYE

BARLEY

Most breads and pastas contain Gluten

Fillers and thickeners contain Gluten

(e.g. hotdogs, soups, desserts)


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Gluten-Free Diet

Common Gluten containing foods to AVOID:

Barley Bran

Bread Flour Blue Cheese

Club Wheat Coloring

Common Wheat Couscous

Food Starch Germ

Gum Base Hard Wheat

Kamut Malt

Matzo Oats

Pasta Rice Malt

Soy Sauce Teriyaki Sauce


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Isolation Diet

Who: Patients with infections that couldpass to other people

Why: Patients are placed in isolation

rooms to prevent the spread of infections

You MUST wear gloves when entering thesepatient rooms, remove gloves when leaving

AND wash and/or sanitize your hands


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Isolation Diet

Diet Guidelines Follow guidelines posted on the patients door

Use regular China (except for Iodine treatment)

Dietary may enter contact isolation rooms wearing

gloves BEFORE leaving room: remove gloves, wash or

sanitize hands

Patients w ith C-dif f must wash AND sani t ize

hands BEFORE leaving the room

Patients receiving Iodine (I 131) treatment Use isolation trays for these patients ONLY

Rooms are draped in plastic


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Reverse Isolation

(Neutropenic) Diet

Who: Patients unable to fight off infections

(e.g. chemotherapy)

Why: Serving uncooked fruits and vegetables

can introduce bacteria into their body

- Avoid fresh fruits and vegetables that

cannot be peeled!

- Pepper packets are not allowed


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Reverse Isolation

(Neutropenic) Diet

Diet Guidelines:

Avoid * Fresh fruits (grapes, blueberries,

strawberries, etc) Avoid * Fresh vegetables (lettuce, cabbage,

broccoli, peas, etc)

Avoid pepper (unless cooked in food) No yogurt (or soft served dairy products)

* That can not be peeled .


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Toddler Diet

Who: Toddlers (1-3 years old)Preschool (4-5 years old)

Why: Because Toddlers have small stomachs,

frequent small feedings are providedFinger foods promote self feeding

Choking Risks: Nuts, hotdogs, popcorn, grapes,

peanut butter, jelly, beans, and hard candy


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Toddler Diet

Diet Guidelines:

Finger foods (e.g. chicken fingers)

Include a variety of colors, textures, and

shapes

Limit sweet foods and drinks

Include milk at every meal

6 Small meals provided Avoid foods that may cause choking

YOUTH DIET
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YOUTH DIET Who: Children 618 years old

Why: Providing adequate nutrition for growing

children is importantHonor food preference whenever

possible!

A sick child is at greater nutrition risk.


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YOUTH DIET

Diet Guidelines:

Comply with food preferences

Milk is served at every meal

Provide a variety of foods

Snacks are provided as needed

AGE SPECIFIC


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AGE SPECIFIC

COMPETENCIESGrowth and development specific to each

stage of life

Important to appropriately care for patients

Major areas: physical, cognitive, social,

and emotional


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Potentially hazardous

articles out of reach

Parent is primary care

provider

Neonate (028 days)


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Infant (29 days12 months)

Fears unfamiliar situations

and people

Supervision and safety

precautions

Choking risk - Avoid popcorn, nuts, grapes,

peanut butter, hot dog

Avoid hot foods

Foods and texture based on age/motor skills

Parent is primary care provider


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Pediatric (13 months-12 years)

Learning manners

Asserts self

Desires to be involved in care

Involved in decision-making

Avoid hot foods, use with caution as

child grows older and more mature


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Adolescent (13-18 years)

Privacy required

Interested and confused in bodily

changes

Involved in decision-making


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Adult (19-60 years)

Achievement oriented Increased responsibility/stress

Balance of career, family, and social life

Personal set of values Cope with change

Involve in own plan of care


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Geriatric ( 61+ years)

Altered texture due to tooth loss

Decreased ability to self feed

Decreased taste and smell

Slower GI tract Early satiety

Speak with family as well as the patient


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Customer Service

Tray Preparation Wash hands

Food Safety

Tray Passing Get trays to patients on time

Identify yourself and patient

Place tray within reach Ask Have you received the menu?

Ask Is there anything else I can do?


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Customer Service

NPO (nothing by mouth)

Check with diet office and nursing station

Look for NPO sign on door

Patient not in room

Check with nursing station

Know patients location

Know how long before patient

will return


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Diet Education Quiz

1. True/False - Popsicles count as a clearliquid.

TruePopsicles become liquid at room temperature so they are

considered a liquid and may be placed on a clear liquid tray.

2. True/FalseOn a pureed diet tray, alettuce leaf can be used as a garnish.

FalseAll garnishes used for the pureed diet must also bepureed. Gravies and sauces are good garnishes to usebecause they add color and moisture to pureed food.


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Diet Education Quiz

3. For a modified dysphagia diet, if noconsistency is ordered, what is thedefault consistency?

Honey is the default consistency for all modified dysphagia diets.

4. True/FalseExtra herb seasoningpackets (e.g. Mrs. Dash) may be added

to low sodium diet trays.TrueExtra herb seasoning packets may be added, but

no salt packets should be added to low sodium diet trays.
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Diet Education Quiz

5. Why are portion sizes so important for thecarbohydrate counting diet?

Using the correct portion sizes is important because the purpose of thethis diet is to make it easier for a patient to control his/her bloodsugar. If serving sizes are too large, the patients blood sugar could

go very high.

6. True/FalseBananas and orange juice are

high in potassium.TrueBoth of these foods are high in potassium

and should not be served to a patient on arenal diet.


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Diet Education Quiz

7.True/FalseBlue Cheese, some food coloringsand soy sauce could all contain gluten andshould not be served for a Gluten-free diet.

TrueGluten may be found in all three of these commonly usedfoods or food ingredients

8. True/FalseGloves must be changed betweenevery patient visit.

TrueGloves should ONLY be worn in one room. Put on thegloves when you enter the room, then remove the gloves andwash and/or sanitize your hands before you leave.


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Diet Education Quiz

9. Name three foods that can cause a child tochoke and should not be included on a toddlertray.

Nuts, hotdogs, popcorn, grapes, peanut butter, jelly beans,

and hard candy are all foods that could cause a youngchild to choke.

10. Why is hand washing an important part ofcustomer service?

Hand washing and sanitizing are both important parts of avoiding food borneillnesses and preventing the spread of infection. This simple task can makea big difference.


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Acknowledgements:


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Acknowledgements:

Developed by:

Mary Basel, MNS, RD

2006 MUSC Dietetic Interns

Denise Boutwell Jill DeJulio

Anna Grusin Leanne Kaye

Elissa Murphy Erika Murtaugh

Narrated by:Elissa Murphy, MUSC Dietetic Intern

Resource:American Dietetic Association Manual of Clinical Dietetics, Sixth

Edition
http://www.sodexhousa.com/index.html

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