Highlighted Changes for the new Great Living Menu

·  Regular/2gm Sodium/Cardiac/Consistent Carb – all get the same foods with minor modifications for the diabetics. We are trying to improve the overall health of our menu. Regulars have additional selections offered to them to ensure satisfaction (i.e. garden burgers, quesadillas, hamburgers, chef salad)

·  Consistent Carb – Don’t get juice unless they specifically request it as one of their CHO choices. They get normal desserts just in small portions so the carbohydrates can be accounted for.( i.e. one chocolate chip cookie is 1 CHO, sweet cinnamon apples is 1 CHO, carrot bundt cake is 2 CHO) Occasionally the menu will state ‘milk or rice’, ‘milk or bread stick’ so the Pt can choose which CHO they prefer but are not allowed both. We try to offer choices as much as possible.

·  Unspecified Consistent Carb – If the order does not clarify low/moderate/high, moderate is automatically sent which is 4-4.5 CHO per meal. Low is 3-3.5 CHO per meal and high is 5 CHO per meal.

·  Gestational Diabetes– Separate menus for our GDM pts which further limits CHO. We follow the Sweet Success Program guidelines: 2 CHO Breakfast, 3 CHO Lunch, 3 CHO Dinner, plus snacks: AM 1 CHO, PM 2 CHO, HS 2 CHO. Juice & muffins are strongly discouraged, fruit & ½ English muffin are offered instead.

·  Extra Kcal/Protein for Pregnancy & Lactation – It is similar to the regular diet but does offer a few extra items to increase overall kcal and protein to help support the additional needs for this population.

·  Dysphagia Diet Levels – There are three different levels of our dysphagia diets which follow the National Dysphagia Diet guidelines.

o  Level 1 is Puree – all items are thick and smooth and have a pudding-like consistency. No sticky or coarse objects allowed. We use food molds to help improve the eye appeal of these trays. They provide the look of the real food item but the appropriate consistency.

o  Level 2 is Ground/Mechanically Altered – all food is moist, soft and simple to chew. All meats are cut to ¼ inch cubes and vegetables must be fork mashable. Canned fruits only plus bananas are allowed.

o  Level 3 is Mechanical Soft/Advanced – all food is moist, soft and bite-size pieces. No hard, sticky or crunchy foods allowed.

·  Renal Diet – Our renal diet provides ~ 80g Protein, 2g Na, 2g K, 1g Phos in an effort to ensure adequate nutrition during an acute care stay. We no longer offer a low protein diet as research does not support this practice and in fact has poor patient outcomes. We do allow some tomato products and dairy but keep them very limited. We use this as a teaching tool, moderation is extremely important in keeping lab values in acceptable ranges.

·  GI Soft/Bland Diet – This is our low fiber diet, it only offers ~15g of fiber. We avoid greasy and spicy foods. A good transitional diet.

·  Pediatric Diet – We offer a few extra kid friendly items but encourage healthy eating. Some portions are modified based on patient age.

·  Clear and Full Liquid Diet – We do not allow carbonated beverages on either diet. The full liquid diet is heavy on dairy therefore it is not a good choice for lactose intolerant patients. We can modify the diet to avoid dairy but it ends up being very similar to the clear liquid diet. Coffee is allowed on both diets.

For any additional information or if you have questions, feel free to call (805)652-4639 or email - Heidi Fernandez MSRD, Assistant Director of Food & Nutrition Services.