Feeding Modalities

1. Feeding Modalities Number One, Most Important, Extremely Critical Practice Concept: “If the gut works, use it!” Routine Hospital Diets General or “House”: Regular foods served by choice or offered as a “set” menu. “Soft”: One or more diets that include tender cuts of meat, cooked veg & fruits with skins/seeds. (may include pureed diets)

2. Feeding Modalities • Soft diets may include the “bland” diet since these are usually low in fiber (“residue”). • Typically they do not include fried foods, spices, so-called “gas-forming” vegetables (Cruciferae) or onions and corn. • One variation is the “mechanical soft” diet which lies between the pureed and soft diets in consistency.

3. Liquid Diets • Can be available in many forms: clear vs. full are common Clear= Coffee, tea, carbonated beverages Clear fruit juices Gelatin, popsicles, hard candy Broth, boullions Problem: Low nutrient density High CHO, Low protein, Low fat At most, provide ~900 kcal/ day. >3 days = “at nutritional risk”

4. Liquid Diets Full Liquid Diets can include: Strained creamed soups Strained cereals Spray-dried eggs in liquids Vegetable juices Sherbet, ice creams, etc. All fruit juices Milk products, smooth yogurts Mild seasonings Butter, margarine, etc. Must individualize based on pt tolerances Can be low in niacin, folate, iron Another variant: Cold, semiliquid after throat surgery No acidic juices, hot beverages, chocolates

5. Increasing Nutrient Density Eat more often Enhance nutrient density Encourage eating Increase number and at mealtime size of servings

6. To Test Your Understanding 5. A. Protein source for depleted, anorexic pt. Why? B. What other component is important to this supplement?

7. 6. Pt supplemented with 240 ml of 3 different formulas: Sustacal, Meritene, and Delmark Milkshake. What do these products contribute (pro, kcal) to pts diet?