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Therapeutic diets
Content
Therapeutic diets
Types of diets (modifications)
Management strategies
Malnutrition
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
arteries
Excessive weight
Reduce saturated fats
Limit excessive sugar
High fibre - constipation
Increase fibre in the diet
Ensure fluids are being
consumed
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
malnutrition
High energy and high protein
Energy and nutrient dense foods
Pick foods from the menu which can be
fortified
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
care.
Menu integration
Example of an Australian
menu
Nutrition vs Flavour
Salt
Sugar
Fat
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
day
Minimum serving size Comments
Fruit
Fresh
Other
1
1
1 fresh piece
120g canned fruit
100ml fruit juice
One piece of fresh fruit per day
Vegetables
Starchy
Dark green/leafy
Other
1
1
2
90g
60g
60g
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 ½ 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
available
Fats and spread 4 serves 1 tsp butter
1 tsp margarine
1 tablespoon oil
Unsaturated margarine should be
available
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
energy
Recipe reduction reduces nutrients and
energy
Recipe fortification
Adding a
nutritional
supplement
power
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
obtained
Foodservice tools
Standardised Recipes
Examples
of standard
recipes
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
care
Questions
Karen Abbey
Aged care and foodservice specialist dietitian
www.nutcat.com.au