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Therapeutic diets - AIC Learning diets portion... · PDF fileIncrease fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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  • Therapeutic diets

  • Content

    Therapeutic diets

    Types of diets (modifications)

    Management strategies


    Portion control

    What is it

    Why use it

    Recipe modification

    Recipe fortification

    Recipe reduction

    Standard recipes

  • Therapeutic diets

    Therapeutic diets are meals plans which are

    designed to assist a resident who may have a

    nutritional issue requiring modification to the

    foods which are provided to them.

    Modification to the texture of food or

    removing or adding foods.

  • Types of therapeutic diets

    Diabetic carbohydrates modified

    Heart diets low fat low salt

    Renal low potassium

    Bowel health high fibre

    Food intolerance gluten, dairy

    Food allergy peanut, soy, fish

    Malnutrition high energy/high protein

    Wound management high protein/energy

  • Example of therapeutic diets

  • Diabetes CHO modified

    Deficiency or diminished effectiveness of

    insulin to maintain blood glucose in the

    normal range.

    Examine the unrefined carbohydrates eaten

    Limited carbohydrate foods

    Use low fat food if resident is over weight and

    also use foods which have a low to moderate

    glycemic index (GI)

  • Glycemic index

  • Heart low fat/low cholesterol

    Diets high in fat can cause blockages in


    Excessive weight

    Reduce saturated fats

    Limit excessive sugar

  • High fibre - constipation

    Increase fibre in the diet

    Ensure fluids are being


  • Gluten free (wheat)

  • Lactose free (avoid milk)

  • Malnutrition

    Failure to thrive in older adults

    Biological syndrome of decreased reserve

    and resistance to stressors, resulting from

    cumulative declines across multiple

    physiological systems, and causing

    vulnerability to adverse outcomes

    Ref : Rose Ann DiMaria Ghalili & Elaine Amella Nutrition in Older Adults

    AJN March 2005 Vol 105 No 3 page43

  • Malnutrition

    Associated with reduction of intake

    Elderly people may not need as much energy

    as they once did

    But do need the same amounts of vitamins,

    minerals and trace elements

    Poor appetite

    Reduce food intake

    Flavour reduce taste

  • Therapeutic diet for


    High energy and high protein

    Energy and nutrient dense foods

    Pick foods from the menu which can be


    Use of supplements

    Recipe fortification

    Examine what a resident like to eat and

    encourage those types of foods

  • Menu integration

    Placing as many diets on the menu

    Trying to get the menu to cater for as many

    of these as possible with high fibre choices,

    gluten free options and high energy and high

    protein snacks.

    Ways to incorporate foods so that everyone

    eats the same thing which is good quality


  • Menu integration

  • Example of an Australian


  • Nutrition vs Flavour




    The great debate in aged care

  • Portion control

    Ensures that food quantities are standard.

    Pre-set recipes so that optimal nutrients can be

    obtained per serve

    Important for vitamised

    e.g. scoop of meat = 15g protein

    vitamised pudding = 8g fibre

  • Example of portion sizes

    Food group Minimum number of serves per


    Minimum serving size Comments






    1 fresh piece

    120g canned fruit

    100ml fruit juice

    One piece of fresh fruit per day



    Dark green/leafy








    Bread and cereals 4 1 slice of bread

    180g hot cereal

    30g cold cereal

    70g rice or pasta

    Wholegrain, wholemeal

    Meat, poultry, fish, eggs,

    legumes, nuts and seeds

    2 75g meat, fish, poultry

    1-2 eggs

    1 cup cooked legumes

    100g nuts and seeds

    Lean meats are preferred

    Milk, cheese and yogurt 3 200ml milk

    40g cheese

    200g yogurt

    Offer milk based desserts.

    Have milk alternatives like soy


    Fats and spread 4 serves 1 tsp butter

    1 tsp margarine

    1 tablespoon oil

    Unsaturated margarine should be


  • Recipe modification

    Is when recipes are taken and changed to

    make them adaptable for a menu

    Recipe modification can work in two way Recipe fortification

    Recipe reduction

    Recipe fortification increase nutrients and


    Recipe reduction reduces nutrients and


  • Recipe fortification

    Adding a




  • Recipe reduction

  • Example of a recipe

  • Time consuming task

    Promotes uniform quality of menu

    Special dietary needs can be controlled

    Level of nutrition set for each recipe so

    that certain proportion of nutrients can be


    Foodservice tools

    Standardised Recipes

  • Examples

    of standard


  • Standard recipe examples

  • Standard recipe process

  • Conclusion

    Therapeutic diets to be used when necessary

    Ensure that residents with malnutrition are eating

    foods which taste good and full of flavour

    Menu design should aim for diet integration so that

    everyone eats the same types of foods

    Portion control is an essential tool in menu planning

    Standard recipes help with the delivery of nutritional


  • Questions

    Karen Abbey

    Aged care and foodservice specialist dietitian

    [email protected]

    mailto:[email protected]

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