Therapeutic Diet Manual

Diet Order / Possible Indication / Specifics
1000ml Fluid Restriction / Fluid Restriction / Divided between 3 meals
1200ml Fluid Restriction / Fluid Restriction / Divided between 3 meals
1500ml Fluid Restriction / Fluid Restriction / Divided between 3 meals
800ml Fluid Restriction / Fluid Restriction / Divided between 3 meals
Bariatric Stage 1 (CLD) / Post-CABG patients (SCIP BS control) and post-bariatric surgery / 3 oz total per meal, no straws; NO carbonated or caffeinated beverages, or dairy products
Bariatric Stage 2 (FLD) / Post-bariatric surgery / Same as above, includes Boost Glucose Control
Bariatric Stage 3 (Puree) / Post-bariatric surgery / Pureed diet with following changes: No beverages, half portions, no desserts or rolls.
Bariatric Stage 4 (Reg) / Post-bariatric surgery / Regular diet with following changes: No beverages, half portions, no desserts or rolls
Carbohydrate Controlled (CCD) / Diabetes, calorie and glycemic control / 4-5 carbohydrate servings (60-75 grams) per meal. Carbohydrates include fruit, milk, starches, and sweets.
Cardiac (2gm Na, Low fat/chol) / Heart failure, HLD
HTN, CVD / <2g sodium, <200mg cholesterol, <7% total calories from saturated fats, 25-35% total calories from fat, 20-30g dietary fiber
Clear Liquid / Often used as a transition diet after a procedure such as a colostomy; temporary diet / Includes broths, juices, gelatin, Italian ice, clear sodas
Dysphagia 1 (Puree) / To provide foods that can be successfully and safely swallowed / Includes blended, whipped, or mashed foods that are smooth and free of lumps, a "pudding-like" texture. Excludes raw fruits/vegetables and nuts. Some foods may require thickening to achieve pudding consistency (through use of flour, cornstarch, potato flakes, or other commercial thickeners).
Dysphagia 2 (Mech Altered) / To provide foods that can be successfully and safely swallowed / Includes ground or chopped meats; requires extra gravy or sauces to moisten foods. Vegetables should be cooked tender enough to be mashed with fork. Excludes sticky foods like peanut butter, chewy foods like dried fruit, or crunchy foods like cookies.
Dysphagia 3 (Soft) / Transition to a regular diet. Adequate dentition and mastication are required. Appropriate for patients with mild oral and/or pharyngeal phase dysphagia. May also be used in patients with IBD, IBS, or patients recovering from GI surgery. / Consists of nearly regular textures that are easy to chew, excludes very hard, sticky or crunchy foods. Foods should still be moist and "bite-size." This is a low-fiber (or low-residue) diet, containing <13g fiber daily; it limits the amount of indigestible foods such as seeds, skins, raw vegetables, and whole nuts in order to decrease the volume and bulk of stool and slow movement through the intestines.
Full Liquid / Poor or missing dentition; pain with chewing / Includes all clear liquids as well as milk, yogurt, pudding, cream soups, and oral supplements.
Gestational CCD / For patients with gestational diabetes / The breakfast meal excludes all juices and includes only 2 carbs (CHO) as blood glucose levels tend to be higher in the morning. Lunch and dinner meals include 4-5 CHO choices. Due to food safety measures, excludes deli meat, soft cheeses such as brie, blue cheese, raw sprouts, and herbal teas. 3 snacks daily
Gluten Free / For patients with gluten-sensitivity or Celiac disease / Excludes all sources of gluten: barley, rye, oats, wheat (including kamut, spelt, emmer, einkorn), and malt. Proper food preparation techniques are important to prevent cross-contact.
High Calorie High Protein / For specific populations (such as CF, oncology, malnutrition) as well as recovery from surgery or illness / Includes double portions for all meals and 3 snacks daily. Oral supplements may also be added to further increase calories and protein.
Honey Thick Liquid / Beverage Consistency restriction
Ketogenic Diet / Used in the management of seizures / Modified Atkins: limits carbohydrates to 15-20g daily
Low-Glycemic Index: limits carbohydrates to 40-60g daily and allows only CHO foods with a GI <50 (such as brown rice, whole wheat pasta, and split peas
Kosher / Jewish religious dietary guidelines
Attention needs to be paid to the ingredients of the entire meal, not just the main dish / All food prepackaged and classified “KOSHER”. No dairy (milk, cheese, yogurt, butter) and meat/poultry at the same meal; the time to wait between these two foods varies depending on beliefs (typically 3-6 hours). Margarine or non-dairy butter substitute can replace butter.
Lactose-Restricted / For lactose-intolerance or other GI conditions requiring this diet / Lactaid milk; limited dairy products. Low-lactose dairy foods include aged cheese (Swiss, cheddar, parmesan), cream cheese, cottage cheese, and ricotta cheese (<1g lactose per serving).
Low Microbial / For patients with weakened immune systems / No deli meat. No melon fruits. Well washed raw fruits and vegetables.
Low Phosphorous / Phosphorous electrolyte restriction / Renal diet: Contains <2.4g sodium, <2.4 g potassium, 800-1000mg/d of phosphorus, <2g/day calcium, 80g protein
Low Potassium / Potassium electrolyte restriction / Renal diet: Contains <2.4g sodium, <2.4 g potassium, 800-1000mg/d of phosphorus, <2g/day calcium, 80g protein
Low Sodium / Salt or sodium restriction / Cardiac diet: <2g sodium, <200mg cholesterol, <7% total calories from saturated fats, 25-35% total calories from fat, 20-30g dietary fiber
Nectar Thick Liquid / Beverage consistency restriction
NPO / ***** / No food or liquids; may or may not include ice chips.
Pediatric / General, healthful diet for pediatric population / Based off Pediatric Nutrition Care Manual, this diet adheres to principles of MyPlate. Includes whole grains choices for at least half of daily grains, 2-3 servings of calcium rich foods, lean meats/poultry, fruits, and vegetables.
Pediatric Low Sodium / Salt or sodium restricted / Pediatric diet with restriction of 2300mg sodium.
Regular / General, healthful diet / Based on the 2010 Dietary Guidelines for Americans. Overall high in fiber with focus on whole grains, fruits, and vegetables. Limited amounts of lean meat with more protein coming from fish, poultry, and vegetables sources as well as low-fat/fat-free dairy products. Limits saturated/trans fats as much as possible.
Renal (2g Na, 2g K, 80P) / Chronic kidney disease or other renal failure / Contains <2.4g sodium, <2.4 g potassium, 800-1000mg/d of phosphorus, <2g/day calcium, 80g protein
SHINE CCD / Stroke SHINE participants / 60 gms CHO/meal; Shine Protocol Approved snacks only
Tube Feeding / ***** / Enteral nutrition feeds
Vegetarian / Can vary based on preferences. / Default to lacto-ovo, which excludes all meat/poultry/seafood as well as products made from these foods (broths, gravy, gelatin); includes dairy and eggs.
Lacto: excludes eggs also; milk still included
Vegan: also excludes milk and dairy products, whey, casein, and honey

Therapeutic Diet Manual extrapolated from the Academy of Nutrition and Dietetics’ Nutrition Care Manual – which is approved by the Clinical Nutrition Manager and the Medical Executive Committee.

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12/20/2016