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Clear Liquid Diet Purpose

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The diet is generally used as transition diet for patients requiring nourishment that is easily digested

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Patients using Clear liquid diet

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Usually placed on this diet to either prepare them for surgery or as part of the transition back to a general diet following surgery. Although, there is very little scientific evidence supporting the use of clear liquid diets as transition after surgery

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Clear liquid diet in different situations

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In gastrointestinal illness, including abdominal distention, nausea, vomiting, and diarrhea. In preparing the bowel for surgery or a gastrointestinal procedure. To reintroduce foods following a period with no oral intake when poor tolerance, aspiration, or anastomotic leak is anticipated

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Clear liquid diet Description

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The diet is comprised of foods that are liquid at room temperature and are transparent. Clear liquids such as tea, coffee, gelatin, ice water, popsicles, ice chips, stained fruit juice, nutritional supplements, meat and vegetable broth

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Foods Omitted

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Milk and liquids containing milk, fruit juices containing pulp, and solid foods

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Nutritional Adequacy: clear liquid diet

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A clear liquid diet is deficient in calories along with most nutrients and is not intended for long term use

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Average clear liquid diet

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Calories: 500-600, Protein: 5-10g, Fat: minimal, Carbohydrate: 120-130g. A patient should only be placed on a clear liquid diet for about 3-5 days

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Full liquid diet purpose

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Short term use as a transition step between the clear liquid diet and solid foods following gastrointestinal surgery

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Full liquid diet description

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The full liquid diet included the foods allowed on the clear liquid diet with the addition of milk and small amounts of fiber

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Additional foods during full liquid diet

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Juices with pulp, plain ice cream, frozen yogurt and sherbet, popsicles, gelatin, and nutritional supplements

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Nutrition Adequacy: full liquid diet

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Adequate in energy, protein, fat, minerals, and vitamins. May be inadequate in fiber

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Dysphagia Diets defined

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Defined as difficulty in swallowing. Is an impairment in one or all stages of swallowing, resulting in the reduced ability to obtain adequate nutrition by mouth and/or reduced safety during oral feeding

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Dysphagia Diets without effective treatment

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Malnutrition, aspiration pneumonia, dehydration, unintended weight loss

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Who Dysphagia Affects

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Can be a medical and feeding issue at any age; however, it is more likely seen in older individuals. May result from neurological disorders, degenerative diseases, cancers, or post intubation trauma

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Nutrition Intervention

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Provide appropriate nutritional intake and fluids to maintain weight or produce weight gain if losses have occurred. Progress the meal plan to include a wider variety of foods as the patient's swallowing function improves. Provide foods that stimulate the swallow reflex. Support eating independence. Improve any nutrient deficits. Diet is comprised of food that is thick, soft, pureed, etc. and beverages that prevent chocking and aspiration

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Liquids and their consistency

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A speech therapist can preform a swallow study to determine appropriate texture and liquid consistency. The 4 liquid consistency is as followed: thin, nectar-like, honey-like, spoon-thick/pudding thick

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Levels of Dysphagia Diet

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Level 1: pureed foods, Level 2: Mechanically Altered Foods, Level 3: Advanced

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Dysphagia level 1 purpose

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Provide foods that can be tolerated and safely swallowed

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Dysphagia level 1

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Foods should be blended, whipped, and/or mashed until they reach a "pudding-like" texture. All foods should be smooth and free of lumps. Liquids should be thickened to pudding consistency or to recommended consistency per speech therapy speech or medical provider. Soups should be pureed and then strained to remove chunks or lumps. Then the soup should be thickened to recommend consistency using thickener, flour, or cornstarch

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Cooking tips for Dysphagia

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Add small amounts of gravy, sauce, water, milk, vegetables or fruit juice to food items before you puree them. This will allow you to reach that pudding consistency faster but remember to add a small amount

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Dysphagia Level 2 purpose

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Provide foods that can be tolerated and safely swallowed. Foods should be blended, chopped, grinding and or mashed until the food is easy to chew and swallow. All foods in large chunks or hard to chew or that are sticky should be avoided. Liquids should be thickened to pudding consistency or to recommended consistency per speech therapy speech or medical provider recommendations. Soups should be pureed and then strained to remove chunks or lumps. Then soup should be thickened to the recommended consistency using thickener, flour, or cornstarch

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Dysphagia Level 2 Cooking tips

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Equipment that could be used to prepare a dysphagia level 2 is blender, food processor, food chopper, grinder, and/or potato masher. Add gravies or sauces to moisten foods and to add flavor. Cooked vegetables should be tender enough to be easily mashed with a fork

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Dysphagia Level 3 Purpose

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Provide foods that are nearly regular textures and safely swallowed. Very hard, sticky, and crunchy foods should be avoided. Should be moist and bite size. Dysphagia level 3 is a transition to a regular diet

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Blenderized Diet

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Has foods and liquids that have been thinned in a blender or food processor and strainer. These foods and liquids can be eaten using a cup, straw, syringe or spoon

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Blenderized Diet uses

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Used for both chewing and swallowing difficulties

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Foods and beverages on the blenderized diet

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All liquids can be used to blenderize or thin foods. The best liquids to use are those that add flavor and have added vitamins and minerals

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Basic guidelines for the blenderized diet

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Cut foods into smaller pieces before placing them into the blender. After blenderizing, the foods should be strained to remove chunks of food, seeds or fibers. Blend equal amounts of solid and liquid foods together. Blending fruits or vegetables may require less liquids. The right thickness and temperature of blended foods may be different for each person on this diet. Try to use blenderized foods right away so they will not spoil. Possibly try a meal pattern that follows eating a small, frequent meal to prevent fatigue from eating large quantities at one time.

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General recommendations fro the blenderized diet

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Breads, cereal, rice, pasta. Meat and meat substitutes. Desserts such as smoothies or pudding. Fats like melted butter or cream cheese. Other liquids such as tomato paste or smooth yogurt

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Fiber restricted diet purpose

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To address acute gastrointestinal issues by reducing the frequency and volume of stools. This will lessen gastrointestinal tract irritation and helps it heal

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Fiber restricted diet description

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Conditions that may require a low fiber nutrition therapy includes: Crohn's disease, Diverticulitis, Ulcerative colitis, and radiation therapy to the pelvis and lower bowel

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Modification to the fiber restricted diet

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Limit fiber intake per day and to select foods low in fiber. Contains less than 13g of fiber/day. Well cooked vegetables and canned fruits. Legumes, beans, seeds, nuts, raw fruit/vegetables, whole grains, and other high fiber foods should be eliminated

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Nutritional Adequacy for fiber restricted diet

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Adequate in all nutrients

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Related Physiology

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Diverticulosis and Diverticulitis, inflammatory bowel disease (IBD), Crohn's disease

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Diverticulosis

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Diverticulosis is the presence of sac like pouches involving the mucosal layer of the colon due to excessive muscular contractions related to attempts to pass small and hard stools

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Inflammatory Bowel Disease (IBD)

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An autoimmune, chronic inflammatory condition of the gastrointestinal tract. Ulcerative colitis - inflammatory disease affects the innermost lining of the large intestine and rectum. Symptoms include abdominal pain/cramping.

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Crohn's Disease and Ulcerative Colitis Medical Nutrition Therapy Physiology

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May not digest food and absorb foods consumed. May need more or some vitamin and minerals due to decreased absorption

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Crohn's Disease and Ulcerative Colitis Medical Nutrition Therapy Guidelines

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Eat small meals or snacks every 3-4 hours. When there are symptoms, stick to a fiber restricted diet. When diarrhea decreases start adding small amounts of whole grain foods and high fiber fruits and vegetables. Incorporate high fiber foods one at a time. Drink enough fluids to prevent dehydration. Take a multivitamin

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Diverticulitis

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Occurs when the sac like pouches become inflamed or infected. Part of treatment includes nutrition therapy focused on fiber intake and probiotic/ prebiotic supplementation

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Crohn's Disease

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May affect any portion of the gastrointestinal tract, from mouth to anus, but typically affects the ileum which is part of the small intestine. Recommend avoiding foods that aggravate bowl problems

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High fiber diet purpose

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Aid in gastric motility reduce cholesterol and blood glucose levels. Fiber and fluid may help a person feel less bloated and prevent/alleviate constipation or diarrhea. The diet is used for the prevention and treatment of a variety of conditions including diverticular disease, Crohn's, irritable bowel syndrome, hypercholesterolemia, diabetes, cancer, constipation and obesity

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High fiber diet description

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Increases fiber slowly over the course of a few days to weeks. When fiber is first introduced into an individuals diet some individuals may experience bloating, cramping, or gas. In order to help combat these symptoms it is recommended to increase your intake of no or low calorie beverages. Slowly increase the amount of fiber to 25 to 38g per day

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Soluble fiber

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Attracts water to form a gel like material which slow down digestion. Aids in lowering blood cholesterol and glucose levels

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Insoluble fiber

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Promotes the movement of material through the digestive systems and increases stool bulk. Aids individuals with constipation and/or irregular bowel movements

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Foods to include in the high fiber diet

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Whole grain breads and cereals. Look for choices with 100% whole grain, rye, oats, or bran as the first or second ingredient. Brown or wild rice. Variety of grains including barley, oats, faro, kamut, and guinoa.

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Lactose intolerance diet

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A condition in which an individual is unable to fully digest lactose. This occurs due to the small intestine not producing enough lactase, an enzyme that breaks down lactose into glucose and galactose. Without the enzyme lactase, lactose wouldn't be broken down and absorbed

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Nutrition Prescription for lactose intolerance

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Restrict or eliminate lactose containing foods or beverages. Diet modification varies due to individual tolerance. Most individuals with lactose intolerance can consume some lactose, about 12g or 1 cup. It is important to know the sources of lactose and individual tolerance levels to avoid symptoms for occurring. Lactose enzymes are available in drop or pill form. Individuals that completely eliminate dairy products may need to take calcium and vitamin d

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Sources of lactose

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Mainly found in dairy food. May be present in other foods or medication as an ingredient. Hidden sources of lactose can be breads, some creamed vegetables, canned or packaged mixes, processed meats, mixed drinks and some dessert items

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Fat restricticed diet purpose

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Utilized to relieve fat digestion or absorption issues associated with a disease process

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Fat restricted diet description

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A fat restricted diet is often limited to 30-45g of fat per day but varies depending on the severity of the specific disease.

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Pancreatitis

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The inflammation of the pancreas due to digestive enzymes being activated while inside the pancreas.

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Pancreatitis causes

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Hyperteiglycerdemia (elevated levels of triglycerides in the blood), chronic alcohol abuse, gallstones, cystic fibrosis

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Nutritional Deficiencies of pancreatitis

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Increased malabsorption risk of fat, which can lead to vitamin A, D, E and K deficiencies

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Treatments for pancreatitis

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Initiate a low fat diet I'm order to minimize pancreas enzymes production. Pancreatic enzymes may be prescribed to ensure fat digestion and absorption. Eliminate alcohol

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Celiac disease

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Small intestine inflammatory disorder that results from an autoimmune response to ingested gluten. This is a sensitivity to the protein Gluten found in wheat, barley, and rye. When these grains are consumed, they trigger an inflammatory response against the small intestine mucosa which ultimately flattens the villi and inhibit absorption of nutrients and water

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Untreated Celiac disease

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The inflammatory response can cause scar tissue and render sections of the GI Tract / gut with minimal to no absorptive function. Ultimately a person with celiac disease can suffer long term consequences from malabsorption of nutrients

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High calorie/ protein diet purpose and guidelines

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Recommended for individuals that have recently lost weight or have an increase calories and protein requirements. Used for patients under high physical and/or metabolic stresses

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Benefits of consuming a high calorie/high protein diet

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More energy, weight gain or prevent weight loss, healing, increase resistance to infections, faster recover from surgery or illness

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Dietary Guidelines for a high calorie/protein diet

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Eat smaller, more frequent meals rather than increasing the size of each meal. Eat on a time schedule. Never skip meals and always plan snacks between meals. Increase intake of foods highly concentrated in calories but which include high percentages of protein, vitamins and minerals

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High protein foods

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Meat, milk, tofu, peanut butter, cheese, eggs, sirloin, tuna, pork tenderloin, nuts and seeds

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High calorie foods

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Dried fruits, juices, sauces, butter, cream cheese, sour cream, mayo, and oils

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Things to avoid on a high calorie/protein diet

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Light (lite) or diet foods and beverages that fill up the stomach but do not have calories or protein such as plain coffee, tea, and diet soda

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Tips to eat more calories and protein

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Aim for at least 6 meals and snacks each day. Extra meals and snacks can help you get enough calories and protein. Nutritional supplement drinks to get more calories each day. Snacks such as milk shakes, smoothies, pudding, ice cream, or custard

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Dietary Fat

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Fats provide a lot of calories in just a few bites. A tablespoon of oil, butter, or margarine has about 100 calories. Add butter, margarine, or oil to bread, potatoes, vegetables, and soups. Use mayonnaise, salad dressing, and peanut butter freely

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High Calorie drinks

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Choose drinks such as whole milk, juice, or soft drinks made with sugar. Plain water, tea, and coffee have no calories and should be chosen less often

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Calorie and protein boosters

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Milk: add powered milk to whole milk, sauces, and gravies. Cook oatmeal in milk instead of water. Use milk fortified with powered milk when making canned soups and puddings. Cheese: add to sauces, casseroles, pastas, vegetables. Meat: add to soups and casseroles. Eggs: Chopped hard boiled eggs can be added to salads. Snacks: ice cream, cheese, cheese, fruited yogurt. Desserts: top puddings, pies, fruits, gelatin

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Sodium Restricted Diets purpose

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To limit the amount of sodium consumed by a sodium sensitive individual to prevent accumulation of fluid an/or promote loss of excess fluid from edema or ascites along with managing hypertension

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Sodium restricted diet used in management with

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Essential hypertension, cardiovascular disease, severe cardiac failure, impaired liver function, renal disease, chronic renal failure

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No added salt (NAS)

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Least restrictive of the sodium restrictions. Table salt should not be used and should be limited in cooking. High sodium foods should be limited. Provides about 4000mg of sodium daily

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3000 mg Sodium

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Restricts foods and beverages that have been highly processed which include but not limited to fast foods, soy sauce, salty snack foods, canned/pickled foods, luncheon meats, smoked, salted, and kosher meats. Up to 1/4 teaspoon of salt can be used for cooking

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2000 mg Sodium

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Eliminates processed and prepared foods and beverages that are high in sodium. Salt should not be used in cooking or at the table. Salt free prepared foods should only be used. Milk and milk products should be limited to 16 ounces per day

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1000 mg Sodium

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Eliminates processed and prepared foods and beverages that are high in sodium. Milk and milk products should be limited to 16 ounces per day. Low sodium or sodium free versions of food items should be selected

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General Guidelines of sodium

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Salt substitute should only be used when prescribed by a physician. Salt substitute is usually potassium chloride, which can be an issue for patients on potassium sparing medications. An individual can use herbs and spices to flavor foods. Examples include but not limited to onions, garlic, salt free seasonings such as Mr. Dash

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Sodium intake recommended from The American Heart Association (AHA)

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Americans should eat less that 1500mg of sodium per day. The American Heart Association selected this recommendation based the US Centers for disease control and prevention data that was released in 2009. The data showed that nearly 70% of Americans are made up of the groups to whom 1500mg a day of sodium is recommended. This is contrasting recommendations for less than 2300mg/day as stated by the dietary guidelines. It would be appropriate to recommend less than 2300mg/day and educate patients about the 1500mg/day recommendations from AHA

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