therapeutic diets - aic learning institute diets portion... · increase fibre in the diet ......

32
Therapeutic diets

Upload: hanga

Post on 26-Jun-2018

224 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Therapeutic diets

Page 2: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 3: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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.

Page 4: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 5: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Example of therapeutic diets

Page 6: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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)

Page 7: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Glycemic index

Page 8: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Heart – low fat/low cholesterol

Diets high in fat can cause blockages in

arteries

Excessive weight

Reduce saturated fats

Limit excessive sugar

Page 9: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are
Page 10: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

High fibre - constipation

Increase fibre in the diet

Ensure fluids are being

consumed

Page 11: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Gluten free (wheat)

Page 12: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Lactose free (avoid milk)

Page 13: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 14: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 15: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 16: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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.

Page 17: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Menu integration

Page 18: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Example of an Australian

menu

Page 19: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Nutrition vs Flavour

Salt

Sugar

Fat

The great debate in aged care

Page 20: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 21: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 22: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are
Page 23: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 24: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Recipe fortification

Adding a

nutritional

supplement

power

Page 25: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Recipe reduction

Page 26: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Example of a recipe

Page 27: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 28: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Examples

of standard

recipes

Page 29: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Standard recipe examples

Page 30: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Standard recipe process

Page 31: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

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

Page 32: Therapeutic diets - AIC Learning Institute diets portion... · Increase fibre in the diet ... Therapeutic diets to be used when necessary Ensure that residents with malnutrition are

Questions

Karen Abbey

Aged care and foodservice specialist dietitian

[email protected]

www.nutcat.com.au