nutrient and texture modifications

regular/house diet

• Most liberal diet- not therapeutic or texture modified

• Based on general, healthful nutrition using the dietary guidelines for Americans

• Incorporates a variety of foods to meet patient preferences and needs

what is the heart healthy diet

• what does it limit(3)

• eliminates (1)

• encourage (6)

• fiber amount (1)

• limit sat fat, cholesterol, and sodium

• eliminates trans fats

• encouraged veg, fruit, whole grains, legumes, low fat/fat free dairy, and fish

• 22-38 g a day/ 14g per 1000 cals

what is the consistent carbohydrate diet

provides same amount of total carbs daily, distributed evenly across all meals and snacks

choric kidney disease diet

modifications in protein, sodium, pottassium, phosphorus, and fluids

what is fiber restriction diet

• restricts what (g)

• what food groups

• how long

• less than 13 grams of fiber a day

• Restricts whole grains, seeds, whole nuts, raw fruits, raw vegetables, and connective tissues of meats

• Not intended for long term use (just for a few days)

what is clear liquid diet (consist of what) (how long)

• all fluids, clear and transparent at body temp

• Primarily consists of sugar, water, and salt

  • Broths, flavored ice/popsicles, apple/cranberry juice

  • Can use clear liquid supplements for protein (ensure clear, boost breeze, liquacel)

• short term use

full liquid diet

• Contains all foods on clear liquid diet, as well as foods such as thin cereals, strained cream soups, milkshakes, pudding, and pulp-free juices

  • May incorporate oral nutrition supplements to help meet nutrient needs

what is done when someone needs modificationf for chewing and swallowing difficultires

the IDDSI framework

levels of IDDSI for foods

regular

soft and bite sized

mined and moist

pureed

liquidized

levels of IDDSI for drinks

thin

slightly thick

mildly thick

moderately thick (same as liquisized food)

extremely thick (same as pureed food)

level 0- thin liquids

-amount left in siringe after 10 secs

<1 ml

level 1- slightly thick

-amount left in after 10 secs

1-4 ml

level 2- mildly thick drinks

-amount left in syringe after 10 secs

4-8 mL

level 3- liquidized foods; moderately thick liquids

• drinkability and staw?

• shape retention

• amount left in syringue after 10 secs

-drinkable from cup

-can use straw but moderate effort

- >8 mL left

level 4- pureed food; extremely thick liquids

-drinkability

-chewing?

-shape retention

-flow through fork?

-not drunk from cup but eaten with spoon

-no chewing required

-can hold shape

-does not flow or drip through fork

level 5- minced and moist foods

-eaten with what

-size of pieces

-lumps?

-relation to fork

-eaten with spoon or fork

-4mm wide and 15 mm long

-has lumps but easily squished with tongue

-When pressed with a fork particles easily separated between and come through tines of a fork

level 6- soft and bite sized foods

-size

-relation to fork

-no more than 1.5cm X 1.5 cm

-When a sample size is pressed with tines of a fork the thumb nail blanches to white and the sample squashes/breaks apart and does not return to its original shape when fork is removed

level 7- easy to chew/ regular foods

-fork relationship

-texture

-Easy to chew foods must break apart easily with the side of a fork or spoon, and pass the fork pressure test

-Regular foods have no texture restrictions