nutri power point

8/2/2019 NUTRI Power Point

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Diets Modified in

ConsistencyPart 2Ombrete, Ramon Timothy G.


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DIETS Mechanical Soft Bland Residue Restricted Low Fiber


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Mechanical Soft Diet Mechanical Soft Diet provides foods which can be ingested

with a minimum of chewing but provides more calories andbulk than the Full Liquid Diet.

The mechanical soft diet is adequate in all nutrients asspecified by the RDAs. The consistency of the diet can beadjusted by the nutritionist according to the needs of thepatient. This is low in calories and may result in weight loss if the calorie content is not adjusted to the level of need.


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It is for patients who are recovering from head, neck, or mouth

surgery, who have dysphagia (difficulty swallowing), narrowingof the esophagus (food tube), or who are too ill or weak tochew. The diet also benefits those who have poorly fitting

dentures, no teeth, or other dental problems.


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General Guidelines Ease of chewing may be increased by mashing, chopping, or blenderizing. The following guidelines will help you prepare foods with a blender:

1. Scrub all equipment with hot soapy water and rinse well.

2. To prepare food for cooking, remove skin, pits, or seeds. Remove bone,gristle, and fat from meat. Bring to a full boil and cook until tender.Vegetables do not need to be overcooked to blend well.

3. Add 1 cupful of food at a time to the blender with cup liquid. Moreliquid may be needed for meat to allow blades to operate: care should betaken, however, to use as little water as possible so product is not toodiluted.


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General Guidelines cont.4. Force food through a strainer to remove large particles that couldclog your syringe.

5. Save time! Prepare several days feedings at once and freeze.


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Preparing the food Use a food processor to grind or puree foods to make them

easier to chew and swallow. Chicken broth, beef broth, gravy, or sauces may be used to

moisten and blend meats and vegetables. Fruit juice may be used to blend fruit. Do not eat the same thing every day. Prepare a variety of

foods to make sure you get all the nutrients you need.


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Food Group Foods Allowed Foods to Avoid

Milk and milk products Milk; all typesYogurtCustardIce creamCottage cheeseCheeseEggnog

none

Protein Foods Tender meats and poultry,ground or choppedEggs, egg saladTuna saladMeatloaf, meatballsSoft fishCasserolesSmooth peanut butter

Tough meats

Fruits All juicesAll canned fruitsFresh fruits:

ApplesauceBananaCantaloupeMelon (seeded)Grapefruit sections

(without membranes)BerriesAvocadoApple (peeled)Pear (peeled)

Fresh fruit with membranes ortough skinsDried fruit


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Food Group Foods Allowed Foods to AvoidVegetables Well cooked soft or pureed

vegetablesTomato pasteTomato catsupTomato puree

Raw vegetableVegetables with tough skinsor membranes

Grains Soft bread including:ToastRollsBiscuitsMuffinsCornbread

Cooked cereals

Dry cereals with milkCooked noodlesRiceCrackers with beverageWafflesPancakes

Hard rollsBread sticksBagelsPopcorn

Fats ButterMargarine

MayonnaiseSalad dressingsCream:

SourWhippingCoffee

Cream cheeseGravyOlives

BaconNuts

Deep-fried; crispy food


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Food Group Foods Allowed Foods to Avoid

Desserts SherbetGelatinPuddingsCakesPiesCookies with beverage

Desserts containing nuts ordried fruits

Miscellaneous SaucesSoupsSeasonings

Potato chipsSnack chips


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Special Consideration If constipation is a problem while you are on this diet, you may wish

to try: adding bran to milkshakes, cream soups, yogurt. including a whole grain cereal in your breakfast such as cream of

wheat or oatmeal OR eating a whole grain cold cereal soaked in milk. prune juice.

Since it is now more difficult for you to eat, you may find it easier tohave six small meals each day instead of three larger ones.Remember, when snacking, choose snacks which provide protein,

vitamins, and minerals rather than empty calories. Try adding dry milk to mashed potatoes to help increase the protein

content. Add grated cheese to mashed potatoes or vegetables.


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Is it working. Weight is your BEST indicator of your intake of calories.

Daily measuring of weight is important for patients

If you find yourself losing more than five to six pounds, try the

suggestions for increasing calories.

Good sources of protein are meat, eggs, milk, cheese andyogurt.


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Bland Diet A bland diet consists of foods that are generally soft, low in

dietary fiber, cooked rather than raw, and not spicy. Fried andfatty foods, strong cheeses and whole grains.


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It is for Bland diets are often recommended following stomach or

intestinal surgery, or for people with ulcers, heartburn,nausea, vomiting, and gas. A bland diet allows the digestivetract to heal before introducing more difficult to digest foods.


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Allowable foods Milk and other dairy products, low-fat only Cooked, canned, or frozen vegetables Fruit and vegetable juices Cooked or canned fruit with the skin and seeds removed, such as applesauce or

canned peaches

Breads, crackers, and pasta made with refined white flour Refined hot cereals, such as oatmeal and cream of wheat Lean, tender meats, such as poultry, whitefish, and shellfish that are steamed, baked,

or grilled with no added fat Creamy peanut butter Pudding and custard Eggs Tofu Soup, especially broth Weak tea


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Foods to avoid Fatty dairy foods, such as whipped cream or high-fat ice cream Strong cheeses, such as bleu or Roquefort Raw vegetables Vegetables that make you gassy, such as broccoli, cabbage, cauliflower, cucumber,

green peppers, and corn

Fresh berries and other fresh fruit Dried fruit Whole-grain or bran cereals Whole-grain breads, crackers, or pasta Pickles, sauerkraut, and similar foods Spices, such as hot pepper and garlic Foods with a lot of sugar or honey in them Seeds and nuts Highly seasoned cured or smoked meats and fish Fried foods


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Special Considerations When on a Bland Diet.

Eat small meals, and eat more often during the day. Chew your food slowly, and chew it well. Stop cigarette smoking, if you smoke. Do not eat within 2 hours of when you go to bed. Stop eating foods that are NOT on the "do not" list if you dont

feel well after eating them. Drink fluids slowly.


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Residue Restricted Diet The residue restricted diet provides food low in fiber which

will result in a small amount of fecal material in the lowerbowel. This diet is used prior to surgery of the gastrointestinaltract. It may also be used following gastrointestinal

surgery. For a more restricted residue diet, a clear liquid dietcan be served for a short duration. Dietary fibers that arerestricted include hemicellulose, pectin substances, mucilage,lignin, and cellulose.


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Principles1. This diet includes foods which are not stimulating to the lower

gastrointestinal tract, and are almost completely digestible, in order to

reduce (not eliminate) the residue in the colon.

2. Hot and cold foods are eaten slowly.

3. Milk and milk products are limited to 2 cups daily. For a greater

restriction of residue in the colon, milk should be eliminated.

4. Fruits and vegetables that contain 2.0 grams or less of dietary fiber per

100 grams edible food are allowed in controlled amounts.

5. Digestability of fiber is not appreciably altered by reducing particle size

through pureeing or blenderizing.

6. Prune juice may need to be limited due to its laxative effect.


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Food Groups Food Allowed Food Avoid

Cheese American processed, mildcheddar, cottage,cream. Plain yogurt orfruited yogurt withallowed fruits as part of milk allowance. Tofu.

Cheese with herbs, seeds,or spices.

Desserts Cakes, cookies, gelatin,sherbets, fruitwhip. Custard, ice cream,and puddings preparedfrom milkallowance. Whippedtoppings.

Desserts prepared withcoconut, fruits, nuts, orspices.

Eggs Soft scrambled or fried,poached, boiled, souffl,omelet.

None.


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Food Groups Food Allowed Food to Avoid

Fats Butter, cream, creamsubstitutes, margarine,mayonnaise, gravies,vegetable oils, crispbacon, plain saladdressings.

Fried foods.

Fruits Ripe bananas,grapefruit; baked apple(without skin); cooked orcanned fruits withoutseeds: white grapes,cherries, pineapple,

plums, applesauce,peaches, apricots,mandarin oranges;

jellied cranberry sauce;all fruit juices.

All other fruits.


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Meats, Fish, and Poultry Baked, broiled, creamed, orstewed: very tender beef,chicken, lamb, liver, fish,sweetbreads, tuna, turkey,salmon, veal, lean pork, crispbacon, canned ham, shellfish.

Tough meats with gristle,smoked meats or fish, cornedbeef, frankfurters, luncheonmeats, sausage.

Potatoes and Substitutes White potatoes: boiled,baked, creamed, scalloped,

mashed; grits, macaroni,noodles, rice, spaghetti;strained sweet potatoes, i.e.commercial baby food.

Potato skins, sweet potatounless strained. Brown or

whole grain rice, wild rice.

Salads Gelatin: fruits and vegetablesprepared from allowed foods.

All others.

Soups Broth, bouillon soups, creamsoups prepared from milk andvegetable allowance.

Highly seasoned soups.


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Sweets Sugar. Clear jelly, honey,syrup, hard candies, milk

chocolate, gumdrops,marshmallows.

Candies made withcoconut, dried fruit, or

nuts.

Vegetables Fresh, cooked, canned,or frozen vegetables:cauliflower, lettuce,celery, beets, asparagus

tips, wax or green beans,acorn squash, tomatoes,vegetable juices.

All other vegetables,dried beans, peas, andlegumes.

Miscellaneous Salt, cream sauce,catsup, flavoring extracts,lemon juice, paprika,

vinegar. Smooth peanutbutter, chocolate,cocoa. Mild herbs andspices.

Pepper, mustard, nuts,olives, pickles, popcorn,raisins, spices, and other

herbs, seeds; i.e. sesame,caraway, celery, poppy.


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Low Fiber Diet The Low Fiber Diet is composed of foods that are low in

residue content. This diet therefore reduces fecal mass andavoids intestinal pressure. This diet is sometimes used in thetreatment of chronic diarrhea, colitis and other

gastrointestinal disorders, although more recently, higher fiberdiets have been employed for these purposes. This diet is veryuseful for pre- and post-operative abdominal surgery.


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It is for 1ST & 2nd stages of labor

Pre- and post- abdominal or intestinal surgery

Bowel Inflammation

Crohns disease

Diverticulitis

Ulcerative colitis

Radiation Therapy to the pelvis and lower bowel Chemotherapy patients

Preparation for a colonoscopy


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Foods Allowed

Enriched white bread or rolls without seeds White rice, plain white pasta, noodles and macaroni Crackers Refined cereals such as Cream of Wheat Pancakes or waffles made from white refined flour Most canned or cooked fruits without skins, seeds or membranes Fruit and vegetable juice with little or no pulp, fruit-flavored drinks and flavored

waters Canned or well-cooked vegetables without seeds, hulls or skins, such as carrots,

potatoes and tomatoes Tender meat, poultry and fish Eggs Tofu Creamy peanut butter up to 2 tablespoons a day Milk and foods made from milk, such as yogurt, pudding, ice cream, cheeses and sour

cream up to 2 cups a day, including any used in cooking Butter, margarine, oils and salad dressings without seeds

Desserts with no whole grains, seeds, nuts, raisins or coconut


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Foods to Avoid Whole-wheat or whole-grain breads, cereals and pasta

Brown or wild rice and other whole grains such as oats, kasha, barley, quinoa

Dried fruits and prune juice

Raw fruit, including those with seeds, skin or membranes, such as berries

Raw or undercooked vegetables, including corn

Dried beans, peas and lentils

Seeds and nuts, and foods containing them

Coconut

Popcorn


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Risks Because a low-fiber diet restricts what you can eat, it can be

difficult to meet your nutritional needs. Therefore you shoulduse a low-fiber diet only as long as directed by your doctor. If you must stay on this diet for a longer time, consult a

registered dietitian to make sure your nutritional needs arebeing met.


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THANK YOU!

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