TLE 10 Name___________________________________ Score ____________ 1st Q

MODULE
Special Diet/ Therapeutic Diet for a Patient
8

A therapeutic diet is a meal plan that controls the intake of certain foods or nutrients. A therapeutic diet is sometimes called
a “special diet”. It is part of the treatment of a medical condition.
A therapeutic diet is usually a modification of a regular diet. It is modified or tailored to fit the nutrition needs of a
particular patient or resident (family member). Therapeutic diets are modified for (1) nutrients, (2) texture and/or (3) food allergies
or food intolerances.
The type of diet will be determined by the doctor. The dietician (or supervisor) will help the client plan his diet and work
with you (as a caregiver). The therapeutic diet will be planned to incorporate the client’s likes and dislikes, his ethnic background,
and his budget.
Who may order a therapeutic diet? A therapeutic diet order is made by a physician. In some cases, a physician’s assistant or
nurse practitioner is allowed to order a therapeutic diet under a physician’s guidance.
Dieticians, nurses and therapists often make recommendations to physicians about therapeutic diets for residents and
patients. Once the therapeutic diet is ordered, it is filled by the food service department. Filling a diet order in the food service
department is similar to a nurse filling a medication order. It must be done with the same importance.
Diets of Different Types of Patients
Type of Diet Description Common Purpose Food Often Foods to Avoid
Recommended
Normal regular Provides all essential of For clients who do not
good nourishment in normal need special diets
forms
Salt (mechanical) Same food as on the normal For clients who have - congee
diet, but chopped or strained difficulty chewing or - cream soup
swallowing
Bland Food mild in flavor and easy Avoids irritation of Puddings, creamed Fried foods, raw
to digest; omits spicy foods the digestive tract, as dishes, milk, eggs, vegetables or fruit,
with ulcer and colitis plain potatoes whole-grain products
clients
Low-residue foods low in bulk: omits Spares the lower Whole-grain products,
foods difficult to digest digestive tract; for uncooked fruits and
clients with rectal vegetables
diseases
High-calorie Food high in For underweight of Eggnog, ice cream,
calories, minerals, and malnourished clients frequent snacks, peanut
vitamins butter, milk
Low- calorie Food low in cream, butter, For clients who should skim milk, fresh fruit Fried foods, sauces,
and fats; cereals; low-fat lose weight and vegetables, lean gravies, rich desserts
desserts meat, fish
Low-fat Limited amounts of butter, For clients who have Veal, poultry, fish, Bacon, butter, cheese,
cream, fats, and eggs difficulty digesting skim milk, fresh fruits, fried foods, liver,
fats and may have gall and vegetables whole milk, ice cream,
bladder, cardio- chocolate
vascular, and liver
disturbances
Low-cholesterol Low in eggs, whole milk, Helps regulate the Fruits, vegetables, Brains, organ meat
cheese, and meat amount of cholesterol cereals, grains, nuts,
in the blood vegetable oil
Diabetic Balance of carbohydrates, For diabetic clients: Fresh fruits and High-sugar foods,
protein, and fats, devised matches food intake vegetables, lowsugar alcohol, carbonated
according to the needs of with insulin and products beverages
individual clients nutritional
requirements
High-protein Meals with highprotein Assists in the growth Milk, meat, eggs,
foods, such as meat, fish, and repair of tissues cheese, fish
cheese, milk, and eggs wasted by disease
Low-sodium Limited amount of foods For clients whose Puffed wheat/ rice or Canned vegetables,
containing sodium; no salt circulation would be shredded wheat, fruits, ham, luncheon meat,
allowed at the table impaired by fluid fruit juices frankfurters, most
retention; for clients cheese
with certain heart or
kidney conditions
Salt-free Completely without salt Most fresh or frozen
vegetables
Foods High in Cholesterol
Milk whole milk, cream, soft cheese, high fat cheese, ice cream, sour cream
Bread/Cereals pastry, sweet rolls, snack crackers, doughnuts, egg noodles
 Meat prime meat, organ meat, animal fat, lard, sausage, bacon, luncheon meat
Eggs egg yolks
Fats/Oils dressings with egg yolks, butter, lard, coconut oil, palm oil, margarines high in saturated fats
Desserts ice cream, pies, cakes, milkshakes, frappes
Foods High in Potassium
Apricots Low-sodium baking bran Potato with skin Beet greens
soda
Avocado Molasses chocolate Spinach Oranges
Bamboo shoots Nuts coffee Sweet potato
Bananas Nectarines Low-sodium baking powder Wheat gem
Foods High in Salt
A-1 sauce anchovies Bacon Barbecue sauce
Buttermilk Canned gravies Spaghetti Canned soups
Canned vegetables catsup Celery salt Cheese doodle
Chill sauce Corned beef Cheese- regular, processed, and Chinese food, canned or
spreads restaurant
Frozen breaded meat and fish Frozen TV dinners Ham-smoked or cured Hamburger helper mix st
TLE 10
Herring horseradish page 2
hotdogs Liverwurst 1 Q
Luncheon meat Meat tenderizes Mustard Nuts-salted
Olives Onion salt Pickels Relishes
Salted snack foods Sardines Sausage Soy sauce
Regular Diet
• has no restriction
• is nutritionally adequate in calories, protein, carbohydrates, fats, vitamins and minerals
• is for patients or residents with no special dietary needs
No Concentrated Sweets Diets (NCS)
• is considered a liberalized diet for diabetics when weight and blood sugar levels are under control.
• includes regular foods without the addition of sugar
• calories are not counted as in ADA calorie-controlled diet
Diabetic or Calorie Controlled Diets (ADA)
• control calories, carbohydrates, protein, and fat intake in balanced amounts to meet nutritional needs, control blood sugar
levels and control weight
• most commonly used calorie levels are: 1200, 1500, 1800 and 2000
No Added Salt Diet (NAS)
• regular diet with no salt packet on the tray
• food is seasoned as regular food
Low Sodium Diet (LS)
• may also be called a 2-gram Sodium Diet
• limits salt and salty foods such as bacon, sausages, cured meat, canned soup, salty seasonings, pickled foods, salted
crackers, etc.
• is used for residents or patients who may be “holding water” (edema) or who have high blood pressure, heart disease or first
stage of kidney disease
Low Fat/Low Cholesterol Diet
• used for patients or residents to reduce fat levels and/or treat medical conditions that interfere with how the body uses fat
such as diseases of the liver, gallbladder or pancreas.
• limits fat at 50 grams or no more than 30% calories derived from fat.
• low in total fat and saturate fats and contains approximately 250-300 mg cholesterol
High Fiber Diet
• prescribed for patients in the prevention or treatment of a number of gastrointestinal, cardiovascular, and metabolic diseases
• increases fiber from a variety of sources including fruits, legumes, vegetables, whole bread, and cereals
Renal Diet
• for renal/kidney patients
• plan is individualized for each patient depending if the patient is on dialysis
• restricts sodium, potassium, fluid, and protein specified levels • lab work is followed closely
Pureed Diet
• changes the regular diet to a soft pudding-like consistency
• for patients or residents with chewing or swallowing difficulties or with the condition of dysphasia
Food Allergy Modification
• food allergies treated are those due to an abnormal immune response to an otherwise harmless food
• food implicated with allergies is strictly eliminated from the diet.
• appropriate substitutions made to ensure meal is adequate
• the most common food allergens are milk, egg, soy, wheat, peanuts, tree nuts, fish, and shellfish
Tube Feedings
• used for patients who cannot take adequate food of fluids by mouth
• all or part of the patient’s nutritional needs are met through tube feedings
• some patients may receive food by mouth of they can swallow safely and a re working to be weaned off the tube feedings.
FT1. Analyze the following statements. Write the word TRUE if the statement is correct and FALSE if the statement is incorrect.
_____1. Only a physician, physician’s assistant or nurse practitioner can order a therapeutic diet.
_____2. A “No Concentrated Sweets” (NCS) diet includes regular food without the addition of sugar.
_____3. A diet manual should only be used by trained nursing staff.
_____4. A therapeutic diet is a meal plan that controls the intake of certain food or nutrients as part of the treatment for a medical
condition.
_____5. A regular diet has no restrictions.
_____7. Food implicated with allergies is not allowed for the patient
FT2. Complete the table by providing a sample meal plan or recipe on each diet.
Type of Diet Sample meal/recipe
Pureed Diet  Fruit juice without pulp.
 Puréed banana.
 Cooked cereal with milk.
 Puréed cooked egg.
 Milk.
 Coffee or tea.

Low  Oats. ...

Cholesterol  Barley and other whole grains. ...
Diet  Beans. ...
 Eggplant and okra. ...
 Nuts. ...
 Vegetable oils. ...
 Apples, grapes, strawberries, citrus fruits. ...
 Foods fortified with sterols and stanols

Los Sodium  Fresh and frozen vegetables (without sauces): Greens, broccoli, cauliflower, peppers, etc.
Diet  Fresh, frozen or dried fruits: Berries, apples, bananas, pears, etc.
 Grains and beans: Dried beans, brown rice, farro, quinoa and whole wheat pasta.

Bland
Breads and Grains Potatoes, crackers, bread, pasta, rice, and plain cereals

Meats and Other Proteins Roasted or baked poultry without the skin Smooth nut butter

Fats and Oils Healthy oils, such as olive oil, in moderation (a drizzle for flavor)
Low Calorie  Oats
 Greek Yogurt
 Soup
 Berries
 Eggs
 Popcorn
 Chia Seeds
 Fish

High Protein  Eggs

 Almonds
 Oats
 Chicken breast
 Yogurt
 Lean beef
 Broccoli
 Shrimps
 peanuts
Low-residue  Well-cooked fresh vegetables or canned vegetables without seeds, like asparagus tips, beets, green
beans, carrots, mushrooms, spinach, squash (no seeds), and pumpkin
 Cooked potatoes without skin
 Tomato sauce (no seeds)
 Ripe bananas
 Soft cantaloupe
 Honeydew
 Canned or cooked fruits without seeds or skin, like applesauce or canned pears
 Avocado

FT3. Classify if these foods are high in potassium (A), cholesterol (B), or salt (C).
1. Bacon- 6. Sausage 11. Canned vegetables 16. Corned beef
2. Spaghetti 7. Sardines 12. Catsup 17. Ice cream
3. Oranges 8. Milkshakes 13. Frappes 18. Cakes
4. Nuts 9. Pickles 14. Chocolates 19. Cheese
5. Soy sauce 10. Eggs 15. Donuts 20. Sweet Potatoes

FT4. What kind of patient/disease is recommended for the ff. diet.

1. Pureed diet
2. NCS
3. LS
4. Renal diet
5. High-fiber
6. Regular diet
7. low-cholesterol diet
8. ADA diet
9. Tube feedings
END