University of Michigan Health System Patient Food and Nutrition Services Nutrition Care Manual and Pediatric Diet Manual Administrators Email: [email protected] Available Diet Orders at the University of Michigan Health Systems Diet Order Purpose & Indications General Description & Principles Further Details When no dietary modification is needed and solid foods can be General Diet tolerated. No dietary restrictions. When no dietary modification is General Pediatric needed but restrictions indicated Dietary restrictions based on age Diet based on age limitations. limitations. Used post-gastric surgery for This diet does not allow foods high patients exhibiting symptoms of in sugar and liquids will be provided dumping syndrome (nausea, separate from meals. Smaller, vomiting, diarrhea, etc) following more frequent meals are Anti-Dumping Diet PO intake. encouraged. Nutrition Care Manual There are four diets that fall under the bariatric diet, each is a stepwise progression to a discharge diet. These restrictions are placed to All the diets have the following facilitate weight loss and restrictions: no concentrated maintenance, to avoid dehydration, sweets, low-fat, no caffeine, no and to avoid distention of the gastric carbonated beverages and no Bariatric Diet pouch. straws. Nutrition Care Manual The bland diet is designed to avoid The bland diet consists of foods that irritation of the gastrointestinal tract. are easily digestible and mildly It is appropriate for people with seasoned. Fried foods, highly peptic ulcer disease, chronic seasoned foods and most raw or gastritis, reflux esophagitis or gas-forming fruits and vegetables Bland Diet dyspepsia. are eliminated. Revised 3/07 1 University of Michigan Health System Patient Food and Nutrition Services Nutrition Care Manual and Pediatric Diet Manual Administrators Email: [email protected] A bland diet consisting of ripe This diet is typically used for Bananas, Rice, Applesauce, and controlling diarrhea and provides Toast. This diet is intended for a low fiber, low residue foods that are very short duration (3 days or less) BRAT Diet easier for the intestines to digest. due to nutritional inadequacies. This diet allows all foods but limits Calorie Controlled total calorie intake to the designated Diet Used to promote weight loss. amount. This diet order is typical for patients with cardiovascular illnesses. Its purpose is to reduce serum cholesterol and lipid levels, to avoid Limits red meat, cheese, whole and prevent excessive sodium milk, butter, and egg yolks, as well intake and to reduce heart disease as high sodium foods and risk. This diet controls for total condiments. It promotes whole dietary fat, saturated fat, cholesterol grains, beans, vegetables and Cardiac Diet and salt (3-4 gm sodium/day). fruits. To reduce serum cholesterol and lipid levels, usually combined with a This diet limits cholesterol intake to low fat diet restriction. Used 200-300 mg/day by limiting red Low Cholesterol commonly with hyperlipidemia, CAD meat, cheese, whole milk, butter Diet and other cardiovascular illnesses. and egg yolks. This diet is used for pre-op and Allows visually clear and minimum immediately post-op situations, or residue liquids. Intended for a very for acute episodes of nausea and short durations (3 days or less) due Clear Liquid Diet vomiting to promote bowel rest. to nutritional inadequacies. Revised 3/07 2 University of Michigan Health System Patient Food and Nutrition Services Nutrition Care Manual and Pediatric Diet Manual Administrators Email: [email protected] A specified number of carbohydrates, based on age, will To provide consistent be provided at each meal to ensure Consistent carbohydrates, based on patient consistent carbohydrate intake, Carbohydrate, age, at meals and an HS snack to simulating a carbohydrate counting Pediatric aid in glucose management. diet. Nutrition Care Manual A specified number of To provide consistent carbohydrates, based on calorie carbohydrates, based on calorie range, will be provided at each meal level range, at meals and an HS to ensure consistent carbohydrate snack to aid in glucose intake, simulating a carbohydrate Diabetic Diet management. counting diet. Nutrition Care Manual There are four levels of this diet. Each requires both a diet level and liquid consistency to be designated to be a valid diet order. Level 1 – To decrease the risk of aspiration Provides pureed food/meats. Level related to neurological, 2 – Provides ground meats. Level 3 neuromuscular or other etiology of – Equivalent to Mechanical Soft swallowing impairment. Prescribed diet. Level 4 – This is a general diet by Speech Pathologist after a but still requires a liquid consistency swallow evaluation has been per Speech Pathology Dysphagia Diets conducted. recommendations. Nutrition Care Manual Revised 3/07 3 University of Michigan Health System Patient Food and Nutrition Services Nutrition Care Manual and Pediatric Diet Manual Administrators Email: [email protected] The eating disorder diet is indicated for individuals diagnosed according to the Diagnostic Statistical Criteria (DSM-IV) with anorexia nervosa, bulimia nervosa or an eating This diet is calorie controlled, with disorder not otherwise specified and periodic increases in calories to treated in the University of Michigan goal. Typically 4 meals/day are Eating Disorder Diet Eating Disorder Program. served. The fat-restricted diet is indicated for individuals with maldigestion, malabsorption and disorders in transport of dietary lipids. To provide no more than 60 gm fat/day for malabsorption issues related to Low Fat Diet (60 GI disease, pancreatitis, and some Lower fat menu items are provided gm/day) types of liver disease. in place of full fat items. Nutrition Care Manual Focuses on whole grains, beans, High Fiber Diet - Used for certain GI conditions to vegetables and fruits to increase High Residue promote gut health. fiber content of diet. Nutrition Care Manual Used for certain GI conditions when Limits use of whole grains, beans, Low Fiber Diet - high fiber diets can aggravate vegetables and fruits to lower fiber Low Residue symptoms. content of diet. Nutrition Care Manual Revised 3/07 4 University of Michigan Health System Patient Food and Nutrition Services Nutrition Care Manual and Pediatric Diet Manual Administrators Email: [email protected] Total amount of fluid (including IVF, fluid taken with medication pushes, mealtime/snack time PO intake, etc) is recorded to not exceed designated level. If no kitchen fluid restrictions indicated, ½ of total daily allotment will be allowed by This diet is used for patients with the kitchen. Note: the fluid content edema and fluid control issues such of solid foods is not included in the Fluid Restricted Diet as kidney disease, CHF, etc. estimation of total fluid intake. To limit solid foods when digestion may be compromised. For post-op Allows any liquids or liquidifed transition from clear liquids to solid foods. Also permits smooth, foods, for severe GI strictures, or for strained foods of pudding Full Liquid Diet wired jaw conditions. consistency. This diet is for gluten sensitive individuals or those individuals diagnosed as having Celiac A diet free of products containing Gluten Free Diet Disease. gluten (wheat, barley, and rye). This is the initial diet for patients who have developed Graft versus Host Disease of the gastrointestinal tract. The foods allowed on this diet are low in acid, fat, lactose, Foods are included one at a time to caffeine, and fiber to minimize GI check for tolerance and start with irritation and promote wound foods such as broth, Pedialyte, Jell- GVHD#1 healing. O, and popsicles. Revised 3/07 5 University of Michigan Health System Patient Food and Nutrition Services Nutrition Care Manual and Pediatric Diet Manual Administrators Email: [email protected] This diet is for patients with Graft This selective diet provides foods versus Host Disease of the moderately low in indigestible gastrointestinal tract who have carbohydrates, and restricted fat tolerated the limited GVHD #1 diet and lactose. New foods are added GVHD#2 without worsening GI symptoms. one at a time to check for tolerance. Nutrition Care Manual Foods that are high in protein and calories are provided, such as For use with patient who have whole milk, ice cream, butter, failure to thrive, significant weight peanut butter, etc. This diet should High Calorie, High loss or poor appetite/PO for be accompanied by a "nutrition Protein extended period of time. supplement of choice" order. Nutrition Care Manual Used with some patients for the treatment of epilepsy. The dietary restriction of this diet makes the body burn fat for energy instead of It is a diet very high in fats and low Ketogenic Diet glucose. in carbohydrates. Nutrition Care Manual The University of Michigan Medical Center does not have a kosher food A kosher diet is indicated for service. The following options are individuals of Jewish faith who offered to individuals who wish to adhere to the Jewish dietary laws, keep kosher while in the hospital: known as Kashruth. This diet order commercially prepared kosher will provide the patient with dinners, disposable dishes and specially prepared meals that fit flatware, and assistance with menu Kosher Diet standard Kosher guidelines. selections. Revised 3/07 6 University of Michigan Health System Patient Food and Nutrition Services Nutrition Care Manual and Pediatric Diet Manual Administrators Email: [email protected] This diet is for individuals who are Lactose free milk products, such as lactose intolerant or whom lactose Lactaid milk, and milk alternatives, Lactose Restricted is temporarily restricted for GI such as soy milk, are provided in Diet related issues. place of lactose containing foods. Currently Room Service is only available in MCHC. If a patient is unable to use the Room Service phone in menu ordering, this diet MCHC Room order will ensure a member of the Service Patient Room Service staff will come assist Requires Menu the patient in ordering food Assistance preferences.