Diets and Oral Supplements

1. Diets and Oral Supplements Good Shepherd Medical Center – Longview Created by: Clinical Dietitians, 2013

2. Objectives • Participant will be able to identify foods appropriate for diets offered • Participant will be able to identify oral supplements and implications for use • Participant will be able to identify goals for oral supplementation

3. Oral Diets • ALL Diets MUST have a Physician Order and be entered into Meditech. • Verbal orders are not appropriate. • Diets served will match what is entered into Meditech.

4. Clear Liquid (CL) • Overview – transitional diet to promote return of normal digestion • Inadequate in protein and calories

5. Full Liquid (FL) • Overview – transitional diet w/ easy to consume and digest food for minimal GI tract stimulation • Inadequate in protein and calories for most patients.

6. Pureed • Purpose – smooth food which provides a modified texture for dysphasia

7. Low Fiber/Low Residue • Overview – minimizes GI stimulation • Also known as GI soft diet

8. Mechanical Soft • Overview – soft, simple to chew foods • Purpose – transition from pureed diet

9. Renal • Overview – restricts protein, potassium, sodium and phosphorus

10. Consistent Carbohydrate (Con CHO) • Overview – appropriate portions of CHO foods w/ fat intake modification, consistent timing of meals • PORTION SIZE is the key to success • 1 CHO choice = 15 gm CHO

11. Regular • Overview – no restrictions • Encourage healthful foods choices to limit fat and salt (sodium) intakes

12. Bariatric • Clear Liquid • 1st stage post-op; inadequate in protein, calories and micronutrients • Restricted to 2-4 oz per meal • Frequent liquids throughout the day • Full Liquid • 2nd stage post-op • Restricted to 2-4 oz per meal • Frequent liquids throughout the day • Protein Supplements

13. Bariatric • Pureed • 3rd Stage post-op • 3-5 oz per meal; follows Pureed diet guidelines for consistency • Protein Supplements • Mechanical Soft • 4th Stage post-op • 3-5 oz per meal; follows Mechanical Soft guidelines

14. Bariatric • Regular • 3-5 oz per meal • 6 small meals and snacks per day • Protein Supplements PRN • Encourage consumption of appropriate food choices over protein supplementation • **Fluids should be consumed between meals without straws.

15. Oral Supplements • Ensure Complete • Ensure Clear • Glucerna Shake • Juven • Scandi Shake • Powdered product; mix with milk • Mighty Shake • Optisource

16. Oral Supplements • Ensure Complete • Commonly associated w/Regular diet • 8 oz, 350 kcal, 13 gm protein, 52 gm CHO • Flavors: Vanilla, Chocolate, Strawberry • Ensure Clear • 6.7 oz, Clear Liquid Supplement • 200 kcal, 7 gm protein, 43 gm CHO • Flavors: Apple, Mixed Berry

17. Oral Supplements • Glucerna Shake • Commonly associated w/Con CHO diet • 8 oz, 220 kcal, 10 gm protein, 29 gm CHO • Flavors: Chocolate, Vanilla, Strawberry, Butter Pecan • Pediasure w/ Fiber • 8 oz, 240 kcal, 7 gm protein, 33 gm CHO • Flavors: Vanilla

18. Oral Supplements • Scandi Shakes • 440 kcal, 5 gm protein, 58 gm CHO • Flavors: Vanilla, Strawberry, Chocolate • Mighty Shakes • 4 oz, 200 kcal, 6 gm protein, 30 gm CHO • Flavors: Vanilla, Chocolate, Strawberry • Mighty Shakes – Sugar Free • 4 oz, 200 kcal, 8 gm protein, 20 gm CHO • Flavors: Vanilla

19. Oral or Tube Supplements • Beneprotein –mixed w/ H2O • 25 kcal, 6 gm protein, 0 gm CHO • Protein supplement • Juven – mixed w/ H2O • Promotes wound healing and maintenance of lean body mass • 80 kcal, 14 gm Amino Acids (not a complete protein) • Flavors: Orange, Fruit Punch, Unflavored