Nutrition and Diet Therapy

• The routine hospital diets, also referred to as the “house” diet, include the regular diet, soft diet, and liquid diets.
• The regular diet is the most frequently ordered among the house diets and is also referred to as “general”, “house”, “full hospital” diet and diet as tolerated (DAT).
• The regular diet is a normal diet planned to provide the recommended daily allowances for the essential nutrients and to meet the caloric needs of a bedridden or ambulatory patients whose general condition does not require general modification or dietary restrictions.
• Highly spiced foods, rich, fatty foods and gas formers should also be avoided on the regular diet.
• Nutrition support therapy, also known as enteral nutrition, is the provision of liquid formula diets into the gastrointestinal tract.
• If additional calories and protein are necessary, milk, milk products, protein foods or nutritional supplements are given between meals on the regular diet.
• Tube feeding is a method of introducing food through a tube to persons with functional gastrointestinal tract either as supplemental nourishment or as the only source of nutrient intake.
• Desserts and snacks are usually available, but most choices on the menu consist of healthy options on the regular diet.
• The vanillymandelic acid (VMA) test is designed to diagnose the tumor, pheochromocytoma, in persons with unexplained hypertension.
• A diet of 1000mg calcium is necessary with 400 mg calcium likely to be contributed from food sources, and an additional 600mg derived from the oral supplementation of calcium gluconate.
• Failure to demonstrate significant change in VMA excretion with different diets suggests that dietary restrictions are not necessary prior to determining urinary VMA excretion.
• Food rich in serotonin such as avocadoes, bananas, eggplant, kiwi fruit, pineapple, pecans, butternuts and hickory nuts alter the test result and are therefore excluded.
• The serotonin test diet is used to diagnose calcinoid tumors of the intestinal tract.
• Jamorabo - Ruiz et al.,2011, Medical Nutrition Therapy for Filipinos 6th edition.
• Several references are available on guidelines about parenteral nutrition for practitioners and advanced nutrition students.
• Patients on a regular diet receive three meals per day, including breakfast, lunch, and supper.
• The dietary prescription for tube feeding should be specific in kind, amount, strength or dilution, and total volume for 24 hours.
• The route of feeding, recommended feeding intervals and volume per feeding should be clearly stated.
• Some ambulatory patients on selective regular menus are allowed to eat in the cafeteria, especially when a family member or guest come to visit.
• Tube feeding may be prepared from liquid foods using calculated formulas, from commercial preparations, or from regular or natural foods liquefied in a homogenizer or blender, and thus, called “blenderized feeding”.
• A satisfactory tube feeding must be nutritionally adequate, except for prescribed modifications for specific nutrients.
• It must be inexpensive, easily prepared, and stored.
• The Food Guide Pyramid provides a way to convert nutrient recommendations from the Recommended Energy and Nutrient Intakes (RENI) into a food plan and with these simply daily guidelines: choose most of the daily foods from the grain products group (5 - 8 servings), the vegetable group (at least 3 servings) and the fruit group (2 - 3 servings), eat moderate amounts of food from the milk group (1 serving), and the meat group (3 - 4 servings), and choose sparingly food that provide few nutrients and are high in fat, salt, and sugar.
• It should be well tolerated by the patient with no reaction in the GI tract to cause flatulence, diarrhea, vomiting, etc.
• The mixture should pass the 2 mm tube with relative ease.
• The prepared dilution is 1 kcal/ml.
• The soft diet follows the pattern of the regular diet with modifications in consistency and texture and is designed for patients who are psychologically and physically unable to tolerate a general diet.
• The total volume should not exceed 2300 ml per day or 100 ml/hr.
• Food allowed on the soft diet is low in fiber diet, connective tissue (seeds, elastin, skin, etc.) and are generally bland in flavor.
• The clear liquid diet should not be used for more than 2 days.
• Fats allowed include butter, margarine, cream, mayonnaise, and smooth plain peanut butter.
• Other liquids such as fruit drinks, popsicles, fruit ices and clear fruit juices are often allowed to supply additional calories.
• Fibrous vegetables are not allowed.
• Coarse, unrefined cereals include whole wheat breads, whole kernel corn, malagkit, and graham crackers.
• Vegetables allowed include whole or sliced, well cooked carrots, sayote, squash, upo, young patola, green beans, young peas, asparagus tips, beets, short stemmed mongo sprouts, tender well cooked leaves of kangkong, sili spinach, ampalaya.
• Nuts and rich pastries are not allowed.
• Meat, fish or substitute includes tender, lean pork, liver, chicken, brain, tongue, fish prepared by boiling, baking, or boiling.
• The clear liquid diet is used as a transition from NPO to full diet or soft diet and is intended to supply fluid and energy in a form that require minimal digestion.
• The full liquid diet contains all foods that are liquid at room temperature or could be liquefied at body temperature, such as canned melt-in-the-mouth milk beverages, plain sherbets and ice cream, plain puddings, soft custard, plain gelatin, strained fruit juices, coffee or tea with cream and sugar, bland creamed soups, malt and chocolate.
• Mild cheese, eggs, beans, and other legumes without skin (strained) are allowed.