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Concepts of Diet Therapy

NURS . 2018: . Diet Therapy. Objectives. At the end of this presentation students should be able to:. Identify the purpose of diet/nutrition therapy. Describe methods of dietary modifications for clients in primary and secondary care settings.

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Concepts of Diet Therapy

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Concepts of Diet Therapy



Diet TherapySlide2


At the end of this presentation students should be able to:

Identify the purpose of diet/nutrition therapy

Describe methods of dietary modifications for clients in primary and secondary care settings

Relate the role of the nurse in nutritional careSlide3

Diet/Nutrition Therapy

Nutrition care that encompasses the assessment and treatment of any disease, condition, or illness-

Medical nutrition therapy


Modified diet

Nutrition education

Specialized nutrition support with oral nutrition supplements

Tube feedings

Intravenous nutritionSlide4

Purpose of Nutrition Therapy

The purpose of nutrition therapy is to :-

Ensure adequate energy and nutrient intake- to prevent under and over nutrition (malnutrition)

Prevent insufficient intake of some micronutrients such as iron and


Prevent physiological consequences of malnutrition- LBW babies, NCDs and mortality

Improve adherence of recommendations such as RDA, UL, EAR etc. Slide5

Dietary modifications in nutrition therapy





Low Calorie

High Calorie

Low Cholesterol








Foods Allowed

Foods not allowed

Nutritional adequacy

and advice



diet for people who do not require texture or nutrient modification



Adequate if consumed as ordered

Clear Liquids

Hydration, bowel prep for some procedures, transition to solids from NPO

See through items liquid at room temperature-

juices, drinks, broth, popsicle, gelatin

Opaque Liquids,

solid foods


in all nutrients, low in energy. Consider nutrition supplement; monitor length, refer 5 or more days

Full Liquids

Chewing or swallowing difficulties

Foods liquid or pourable at room temperature- all clear items & dairy, custards, supplements

Solid foods, liquid at room temp. foods

with added solids e.g. ice cream with nuts



adequate when supplements consumed. If


consult doc for


. High fat/ low


long useSlide7



Foods Allowed

Foods not allowed

Nutritional adequacy

and advice

Mechanical or Dental Soft

Chewing or swallowing difficulties

Liquids, minced, soft, chopped, ground

foods; protein w/o bones, grizzle. Cooked beans and eggs. Desserts, Grains- cooked/soft; fruits and


- cooked, softWhole nuts, seeds, meat with casings, tough meats, hard crusted bread, raw vege and fruits/vege- edible skinNutri adequate if all food groups are consumed; may be low in fibre- consult nutritionist- re safe textures and doc re gag reflexPureedAdvanced chewing or swallowing difficultiesBlenderized or pureed foods. Any food allowed that can be pureed to a custard-like consistency w/o solids remaining. Can add liquid to get desired consistencyWhole nuts, seeds, hard bread/rolls, dried fruit, fruits/vege- edible skin, any food that cannot be pureed to a smooth consistencyNutri adequate if all food groups are consumed; avoid over-modification. Essential foods is presented in attractive manner to stimulate appetite- molds, garnishes.

Tucker &


, 2011Slide8

Food Modifications

Foods- particular those provide by the oral route may be modified based on

Energy needs

Nutrients- supplemental immunonutrition may be given to improve illness recovery such as included antibodies, antioxidants and additional minerals

Energy- may increase or decrease depending on type of illness and the metabolic demand

Preparation, flavouring, seasoning- low levels recommended in colitis, diarrhoea, CA of GI

These modifications affect the clients likelihood of acceptance

Based on presentation

Level of modification

Usual intake

Preparation style

Commentary form the nurseSlide9

Nurse’s responsibilities with nutritional care

The nurse has responsibility to assist in coordinating care and services.

The nurse usually collaborates with other members of the health care team in

nutritional assessment,

nutrition education,

delivery of dietary support- modified diets, tube feedings, IV nutrition.

The Physician is usually needed to assess gag, identify GI functionality, examine the presence of strictures,


& swallowing disorders- from these assessments the physician usually makes dietary prescriptions for regular diet, modified, enteral,


, palliative

The nurse collaborates with the physician to implement dietary prescriptions as well as to re-examine the patient for nutritional imbalances and serves as an advocateSlide10

Nurse’s responsibilities with nutritional care

Dietician and dietary department- is responsible for:-

anthropometric assessment and clinical assessment.

They recommend the appropriate biochemical tests that are needed to determine deficiencies.

From these assessments, they usually makes dietary prescriptions for regular diet, modified, enteral,


, palliative.

They usually provide more detail about the composition of the diet- total energy requirement, protein, and supplements that may be needed.

They also recommend preparation methods of foods.

They are also responsible for preparing data for nutrition education.

The nurse collaborates and ensures these actions are doneSlide11

Nurse’s responsibilities with nutritional care

The nurse also works with other health team

The nurse works with the phlebotomist, nutritionist, meal services department to ensure that the nutritional needs of the patients are met.

The nurse may also communicate with the family and the patient the changes that are important and necessary for health maintenance.

The nurse usually recommends follow up care and advocates for referral to HTN, Renal, DM, HIV/AIDS clinic and dietetics department. Slide12

Nurse’s responsibilities with nutritional care

The nurse also serves as Communicator

Explaining the treatment regime; advocating for more detailed explanation particularly of dietary prescriptions

Interpret rationale for diet

Assists in food selection, may advice on preparation style and techniques

Ensures that the ordering, delivery and administration of the prescribed dietSlide13

Nurse’s responsibilities with nutritional care

Nurse as Teacher/


Uses informal opportunities to teach- such as during medication administration, meal service and family visits

Plan instructions- useful in primary health care and health promotion and for new diagnoses

Counsels patient and family

Support, supplement and reinforce the information provided by the dietary departmentSlide14


Duggan, M., & Golden, B. (2007). Deficiency diseases. In C.


& H. Powers (Eds.),

Human Nutrition



Ed.) (pp 517-536). Edinburgh, UK: Elsevier Churchill Livingstone.

Smith, R. C. (2007). Nutritional support for hospitalized patients. In J. Mann & A. S.



Essentials of human nutrition (pp 33-52). New York, USA: Oxford University Press.Tucker, S. & Dauffenbach, V. (2011). Nutrition and diet therapy for nurses. Boston, USA: Pearson.