MODIFICATION IN CONSISTENCY
Diets are modified as part of the treatment of a medical condition and are normally
prescribed by a physician and planned by a dietician. It is called a therapeutic diet and
is a modification of a regular diet.
Diets are modified for consistency, nutrition and new methods of making regular dishes.
This report will focus only on modification of diet in their consistency.
REASONS FOR MODIFICATION:
to provide change in consistency as in fluid and soft diets.
to increase or decrease bulk–high and low fiber diets.
to provide texture modifications due to problems with chewing and/or
swallowing
Two Main Types:
A. DIETS WITHOUT SOLIDS
B. DIETS WITH SOLIDS
A. DIETS WITHOUT SOLIDS
It is commonly known as liquid diets and consist of a variety of foods that are
liquid or liquify at room temperature.
Given During:
Febrile states
Post operative conditions
Wherever the patient is unable to tolerate solid food.
Two main types:
a. Clear fluid diet
b. Full fluid diet
c. Advanced full liquid diet
a. Clear Fluid Diet
A clear liquid diet consists of clear liquids that are easily digested and leave no
undigested residue in your intestinal tract
It helps maintain adequate hydration, provides some important electrolytes, such as
sodium and potassium, and gives some energy at a time when a full diet isn't possible
or recommended.
A clear liquid diet is not adequate in calories and nutrients. It should not be followed for
more than five days unless supplemented by high-protein gelatin or other low residue
supplements.
Most often prescribed for the following:
a. Before and after surgical procedures in the GI tract
b. Nausea
c. Vomiting
d. Diarrhea
e. After certain types of surgery
f. before colonoscopy
g.
The following foods are generally allowed in a clear liquid diet:
Water (plain, carbonated or flavored)
Fruit juices without pulp, such as apple or white grape juice
Fruit-flavored beverages, such as fruit punch or lemonade
Carbonated drinks, including dark sodas (cola and root beer)
Gelatin
Strained tomato or vegetable juice
Sports drinks
Clear, fat-free broth
Honey or sugar
Hard candy, such as lemon drops or peppermint rounds
Ice pops without milk, bits of fruit, seeds or nuts
Acute illness
The amount per feeding is 30 – 60 ml/hour. As the patients tolerance improves, the
amounts can be increased.
Note: Clear fluid diet does not include milk
b. Full Fluid Diet
A full liquid diet consists of liquids allowed on the clear liquid diet with the addition of
milk and small amounts of fiber. The diet may be used for short term such as a
transition step between the clear liquid and soft diet.
A well-planned full liquid diet is adequate in calories, protein and fat but may be
inadequate in vitamins (vitamin B12, vitamin A and thiamin), minerals (iron) and fiber.
It is free from cellulose and irritating condiments. Six or more feedings can be given
daily.
Most people only need it for five days to two weeks. It is important that a physician or
dietitian supervise the diet.
Indications:
patients who are unable to chew, swallow, or digest solids.
Acutely ill.
extensive oral surgery,
facial injuries,
esophageal strictures, and
carcinomas of the mouth and esophagus. I
Foods Allowed:
Beverages — Cocoa, coffee or tea.
Cereal — Fine or strained gruels.
Dessert — Soft custard, gelatin.
Eggs — Raw in broth with fruit juices or milk.
Fruit — All strained juices.
Miscellaneous — Butter, cocoa, sugar, salt.
c. Advanced Full Liquid Diet.
This diet may be prescribed to meet the nutritive requirements of a patient who must
receive a full liquid diet for an extended period of time or who has undergone oral
surgery and must have foods, which can pass through a straw.
Food permitted:
Full liquid diet made more nutritious by the addition of blended, thinned, and
strained meat, potatoes, and vegetables.
The protein content of the diet can be increased by incorporating whole egg, egg
white, nonfat dry milk in beverages and soups.
B. DIETS WITH SOLIDS
This diet allows solids in the food intake but are modified according to the needs of the
patients:
Types of diet with solids:
1. Low fiber (low residue diet)
2. Soft Diet
3. High Fiber Diet
Low Fiber diet:
The diet is made up of foods which can be completely absorbed, thereby leaving little or
no residue for formation of feces. This diet provides insufficient minerals and vitamins. It
must be supplemented. Foods high in fiber should be omitted.
Food which contain residue but not fiber such as milk are also omitted or restricted.
Indicated for:
Patient’s with inflammatory bowel disease (IBD) flares,
for bowel surgery and colonoscopy prep,
for patients with infectious colitis or acute diverticulitis.
Recovery after bowel surgery
Partial intestinal obstruction.
Whenever necessary to reduce bulk in the gastrointestinal tract.
Food Samples:
Refined Grains
Seedless, skinless fruit and vegetables
Well cooked or canned vegetables without seeds (like asparagus tips, beets,
green beans, carrots, mushrooms, spinach, squash (no seeds),
Ripe Bananas, Soft cantaloupe,Avocado
Milk and dairy ( in moderation)
Meats (lean ,tender and soft)
Juices made without seeds or pulp, like apple, no-pulp orange, and cranberry
Strained vegetable juices
Soft Diet:
Soft food diet is one that includes foods that are easy to chew and swallow and
excludes is between liquid diet and normal diet.
Soft diet includes both liquid and solid foods which contain restricted amount of
indigestible carbohydrates. and no tough connective tissue foods with a hard texture.
.This diet is nutritionally adequate.
It is soft in texture and bland in flavor.
Two main types:
There are two main types:
1. Mechanical soft diet
2. Pureed soft diet
Mechanical soft diet:
This includes food that does not require much chewing. Foods can be chopped,
ground, mashed, or puréed. These foods are soft and tender, and should be able to be
mashed a fork.
Puréed soft diet.
This is more limited than a mechanical soft diet because it doesn’t require chewing. It
include puréed foods or liquid foods. Liquids can be added to make swallowing easier.
Indicated for:
difficulty chewing (e.g., poorly fitting dentures, missing teeth, recovering from
dental or mouth surgery, general weakness)
difficulty swallowing (e.g., dysphagia; recovering from mouth, neck, or throat
surgery; general weakness)
are undergoing radiation therapy for your head, neck, or stomach area, which
may lead to digestive upset or pain in your mouth or throat
were previously on a liquid diet after surgery or long-term illness and are
gradually reintroducing solid foods
have trouble moving or feeling portions of your mouth (such as your tongue or
lips)
Examples:
peeled,finely chopped,mashed,cooked,blended fruits and vegetables:
Ripe bananas and avocados can be eaten as as is
Porridge,soft breadmrefined grains
Tender meats
Soft dairy products
Eggs- finely chopped if boiled
It is not necessary to eliminate all spices, only gastric irritants like black pepper, chilli
pepper, cloves etc.,can be eliminated.
3. High Fiber Diet
Dietary fibre plays a significant role in colonic function.This is a normal diet with fibre
increased to 15–20 gms daily.Fluid intake is also increased.
Concentrated foods should be replaced by those of greater bulk.
Indications:
treatment of diverticulosis,
obesity,
constipation,
diarrhea
irritable colon.
It is beneficial in the treatment of hyperlipidemia, hypercholesterolemia and
diabetes mellitus
Kinds of Fiber and sample sources:
A. Soluble Fiber:
This type of fiber dissolves in water to form a gel-like material.it includers plant pectin
and gum. Soluble fiber draws water into your gut, which softens your stools and
supports regular bowel movements.
Sources:
oats, peas, beans, apples, citrus fruits, carrots, barley ,psyllium, sweet potatoes
B. Insoluble Fiber
Insoluble fiber doesn’t dissolve in water. It includes plant cellulose and
hemicellulose.This type of fiber promotes the movement of material through your
digestive system and increases stool bulk.
Sources:
Wheat bran and wheat germ
Oat bran
Berries, including blackberries, blueberries, raspberries, strawberries, etc.
Whole grains, especially barley, quinoa, sorghum, millet, amaranth, oatmeal and rye
Fruits with peel and seeds
Green vegetables
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lesson_5_Section_1C.htm
