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Table of Contents for the Digital Edition of 2009 Louisiana Dietetic Association Manual of Medical Nutrition Therapy
Table of Contents
Nutrition Assessment
Long-term
Acute care
Calculation of energy, protein, and fluid needs
Overview of height and weight calculations
Skinfold measurements
Dietary Recommendations
The 2005 US Dietary Guidelines
Food Safety
MyPyramid
Comparison of recommendations
Dietary Reference Intakes
House Diets
Regular Diet
High Protein, High Calorie Diet
Liberalized Geriatric Diet
Finger Food Diet
Clear Liquid Diet
Full Liquid Diet
Mechanically Altered Diets
Pureed Diet
Mechanical Soft Diet
Dysphagia Diets
Reduced Sodium Diet
Cardiac Management Diet
Dietary Mangagement of Diabetes
Regular, No Concentrated Sweets
Diabetic, Energy Controlled
Exchange Lists for Meal Planning
Meal Substitution Patterns
The Glycemic Index
Gastrointestinal Diets
Liberal Bland Diet
High Fiber Diet
Fiber Restricted Diet
Post-Gastrectomy Diet
Gluten-Free Diet
Fat Restricted Diet
Renal Diets
Temporary Renal Diet
Renal Diet (Hemodialysis)
HIV/AIDS
Cancer
Enteral Nutrition Support
Children with Special Healthcare Needs
Adverse Reactions to Food
Laboratory Data Interpretation
Drug-Nutrient Interactions
Selected Food Sources
Calcium
Vitamin A
Vitamin C
Fiber
Iron
Purine
Sodium/Potassium
Lactose Content of Foods
Common Abbreviations
Common Measurements
Literature Cited
Louisiana Dietetic Association Manual of Medical Nutrition Therapy Policies
Permission to Copy 2009 LDA Manual of Medical Nutrition Therapy
Patient Education Information
2009 Louisiana Dietetic Association Manual of Medical Nutrition Therapy
LDA
Manual
Louisiana Dietetic Association
Sixth Edition, 2009
ACKNOWLEDGMENTS
PREFACE
TABLE OF CONTENTS
Temporary Renal Diet……………………………………………………………………
Manual of Medical Nutrition Therapy
NUTRITION ASSESSMENT in Long-Term Care Facilities
Dietary Manager
NUTRITION ASSESSMENT in acute care facilities
Debilities:
CALCULATION OF ENERGY, PROTEIN, AND FLUID NEEDS IN ADULTS
For females 19 years and older (body mass index [BMI] 18.5-25 kg/m2])
• 1.900 = extra active (very hard exercise/sports and physical job
OVERVIEW OF HEIGHT AND WEIGHT CALCULATIONS
As an example, here are the weight ranges, the corresponding BMI ranges, and the weight status
Aim for a Health Weight: Aim Patient Booklet , Assess, Classify, Treat Laminated Card ,
Knee Height--the most common approach to estimate height is knee height since it correlates
Table 1-6. Frame Size Calculations for Males and Females using Height and Elbow Breadth
Percent usual body weight:
SKINFOLD MEASUREMENTS
DIETARY RECOMMENDATIONS
To prevent gradual weight gain over time, make small decreases in food and beverage
Pregnant women. In the absence of medical or obstetric complications, incorporate 30
Key Recommendations for Specific Population Groups
Key Recommendations for Specific Population Groups
14. When eating out, ask restaurant managers if the food being served contains any raw or
In a state subject to hurricanes or other disasters, such as Louisiana, it is also important to be
MyPyramid Food Intake Patterns
can be considered as 1 ounce equivalent from the grains group. At least half of all
2-3 years
Some grain products contain significant amounts of bran. Bran provides fiber, which is important
from each subgroup should be consumed to reach daily intake recommendations.
as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-
mostly juice and little fruit, shortfalls in fiber would be increased. For children 8 years of age and
found in milk and milk products, and supplementation may be needed.
iron (meats) or eat other non-heme iron containing foods along with a food rich in
A few plant oils, however, including coconut oil and palm kernel oil, are high in SFA and for
Commonality in recommendations for a healthy diet: The overwhelming number of patients
Nuts, Seeds,
Table 1-17. Food Components, Recommended Intake/d, Function, and Food Sources of Principal
Monounsaturated fatty
Table 1-18. Food Components, Recommended Intake/d, Function, and Food Sources of Principal
fatty acids.
Table 1-19. Food Components, Recommended Intake/d, Function, and Food Sources of Principal
vitamin E may reinforce each
HOUSE DIETS
HIGH PROTEIN, HIGH ENERGY DIET
5. Serve double portions of well-liked foods
Sample Plan
LIBERALIZED GERIATRIC DIETS
individual as much independence as possible. Special adaptive feeding utensils and
between-meal refreshment. The caregiver should monitor the intake of meals and
FINGER FOOD DIET, REGULAR
breadsticks, crackers, toast
MODIFIED CONSISTENCY DIETS
Sample Plan
FULL LIQUID DIET
Sweets/Desserts As desired
MECHANICALLY ALTERED DIETS
breads, finely ground or chopped meats served with broth or gravy, cooked vegetables,
PUREED DIET
Miscellaneous
PUREED DIET
CHOPPED DIET (MECHANICAL SOFT)
MECHANICAL SOFT DIET
DYSPHAGIA DIETS
Group
DYSPHAGIA I DIET1
DYSPHAGIA II DIET
DYSPHAGIA II DIET
DYSPHAGIA III DIET
DYSPHAGIA III DIET
DYSPHAGIA IV DIET
DYSPHAGIA IV DIET
DYSPHAGIA DIET LIQUID CONSISTENCIES
HONEY CONSISTENCY
REDUCED SODIUM DIET
Brine (salt and water)
sulfites); and pickled fruits.
juice; hot pepper sauce; garlic
Broccoli: lemon juice
Food Groups Servings/Day
Discretionary
Sample Menu Plan
CARDIAC MANAGEMENT
16. Potential long term adverse effects of alcohol preclude health care professionals from
Discretionary
Sample Plan
The diet above is consistent with the NCEP ATP III, AHA, Dietary Approaches to Stop
DIETARY MANAGEMENT OF DIABETES
Note on No-Concentrated Sweets Diet for patients in nursing homes: The literature confirming
processed without
Sample Menu
DIABETIC, ENERGY CONTROLLED
SUGGESTED MEAL PATTERNS DIABETIC AND CALORIE-CONTROLLED DIETS
If meat/protein is omitted at the breakfast meal, add one ounce of meat to lunch or supper plan.
EXCHANGE LISTS FOR MEAL PLANNING
STARCH LIST
Wild rice, cooked
Fresh, Frozen, Unsweetened Canned Fruit, and 100% Fruit Juice with Serving Size
Milk and Yogurts
SWEETS, DESSERTS, AND OTHER CARBOHYDRATES
Food
NON-STARCHY VEGETABLE LIST
MEAT LIST
Medium-FatMeats and Meat Substitutes
Food
Oil: canola, olive, peanut
Light
Condiments
Coleslaw
MEAL PATTERN SUBSTITUTIONS FOR DIABETICS
The Glycemic Index (GI) is a measure of how carbohydrates raise blood glucose levels. Foods
Spaghetti, protein enriched
GASTROINTESTINAL DIETS
3. Plan a nutritionally balanced diet for the individual, eliminating foods that appear to
Foods That May Not be Tolerated on Liberal Bland Diets
LIBERAL BLAND DIET
HIGH FIBER DIET
Low Fiber Food
WAYS TO INCREASE DAILY FIBER INTAKE
Sample Menu Plan
FIBER/RESIDUE RESTRICTED DIET
Dairy
Sample Menu Plan
POST-GASTRECTOMY DIET
Food Group
Sample Menu Plan
GLUTEN-FREE DIET
clarify if they are made from wheat, rye, barley, or malt. Barley flavoring and malt
other allowed grains White
Soups
Sample Menu Plan
Additional information on celiac disease and the gluten-free diet can be obtained by contacting the
FAT RESTRICTED DIET
egg white and egg substitutes,
Sample Menu
Directory of Digestive Diseases Organizations for Patients
Materials: Monthly professional journal—The Journal of the American Dietetic Association;
Celiac Disease Foundation (CDF)
Cyclic Vomiting Syndrome Association (CVSA)
Materials: Cookbooks and general dietary recommendations; fact sheets; member newsletter—
Mission: To gather and disseminate information on pediatric gastroesophageal reflux and related
RENAL DIETS
6. In general, fluids do not need to be limited in the early stages of kidney disease. If
Food
Meat
0.8 g protein PRE- DIALYSIS RENAL DIET (65 kg IBW patient)
Sample Menu
compliance is also a problem (58-60). It is critical that patients work with registered dietitians
on dialysis.
Food Group
tomatoes.
Sample Menu Plan
Additional Information
HIV/AIDS
and mineral supplements providing 100% Daily Value are recommended for all
Provide the largest meal when patients appear the hungriest
CANCER
Information from the National Cancer Association
Supplements high in energy and protein.
Nutrition therapy can treat the nutrition-related side effects of radiation therapy.
the following: taste changes, xerostomia, thick saliva, mouth and throat sores, nausea/vomiting,
Problem
Encourage snacking between meals
ENTERAL NUTRITION SUPPORT
RECOMMENDATIONS
iii. Jejunum (nasojejunal)...the latter two should be used if the patient is at
CLASSIFICATION OF FORMULAS
decreases bacterial proliferation and contributes to sodium and
ADMINISTRATION9
ii. The feeding should not exceed 400-500 ml per feeding given over 10-30
Administration of Medication Through Feeding Tubes
COMPLICATIONS
times/day for one day)
ADITIONAL COMMENTS ON COMPLICATIONS
Problem
failure
Acidification
Monitoring Selected Laboratory Tests
Feeding Option
Formula Selection11
SAMPLE TUBE FEEDING CALCULATION FORM
CHILDREN WITH SPECIAL HEALTH CARE NEEDS
Minimal Time to Detect Changes in Growth12
Examination Survey.
Drugs often cause immobility and hypomotility of the gastrointestinal tract and may
Chronic constipation
Energy and Protein Requirements:
Activity Level
Calculate Basal Metabolic Rate (BMR) in kilograms using WHO equations
Example: 9 month old girl with weight of 6.4 kg and length of 66 cm (height-age = 6 months). Ideal
Growth Velocity
The total water requirements for infants, children, and adolescents from the Institute of Medicine
Refer to OT
Cardiorespiratory illness
ADVERSE REACTIONS TO FOOD
provide nutrients that may be missing from the diet. This is of particular concern for individuals
LABORATORY DATA INTERPRETATION
Test
Calcium
Cholesterol2
Fasting Blood Glucose2
Blood Urea Nitrogen2
Enzyme Tests
alcoholic, pancreatic
Albumin2
DRUG-NUTRIENT INTERACTIONS
Selected drugs under these classifications are listed by generic and brand name along with
Medication
Medication
Medication
Medication
Medication
Medication
Class of Drug Drug Name
Saquinavir
abdominal pain,
SELECTED FOOD SOURCES
SELECTED FOOD SOURCES OF VITAMIN A
Selected Food Sources of Vitamin C
Selected Food Sources of Fiber
Selected Food Sources of Iron
Selected Food Sources of Purine
Food
Pecans, shelled
Vegetables
Fish
Lactose Containing Foods*
COMMON ABBREVIATIONS
PD
Common Measurements
LITERATURE CITED
15. Ozer BK, Gültekin T, Sağir M. Estimation of stature in Turkish adults using knee height.
4. O‘Neil CE, Nicklas TA. A Review of the Relationship between 100% Fruit Juice
20. Arnaud-Battandier F, Malvy D, Jeandel C, Schmitt C, Aussage P, Beaufrère B, Cynober
35. Niedert KC. Position of the American Dietetic Association: Liberalization of the Diet
2. Centers for disease control and prevention. Application of lower sodium intake
17. Khan NA, Hemmelgarn B, Herman RJ, Bell CM, Mahon JL, Leiter LA, Rabkin SW, Hill
31. Lee L, Grap MJ. Care and management of the patient with ascites. Medsurg Nurs.
48. Most MM, Craddick S, Crawford S, Redican S, Rhodes D, Rukenbrod F, Laws R; Dash-
64. Ellsworth JL, Kushi LH, Folsom AR. Frequent nut intake and risk of death from
7. Erkkilä A, de Mello VD, Risérus U, Laaksonen DE. Dietary fatty acids and
in subjects with coronary heart disease using multiple medications. Eur J Nutr.
Gastrointestinal Diets
16. Park Y, Hunter DJ, Spiegelman D, Bergkvist L, Berrino F, Van den Brandt PA, Buring
34. Pawson R, Mehta A. Review article: the diagnosis and treatment of haematinic
8. The Report of the Dietary Guidelines Advisory Committee on Dietary Guidelines for
13. Ihle BU, Becker GJ, Whitworth JA, Charlwood RA, Kincaid Smith PS. The effect of
28. Jungers P, Chauveau P, Ployard F, Lebkiri B, Ciancioni C, Man NK. Comparison of
43. Lucas PA, Meadows JH, Roberts DE, Coles GA. The risks and benefits of a low protein-
60. Morales López C, Burrowes JD, Gizis F, Brommage D. Dietary adherence in Hispanic
77. Nakamura H, Yamazaki M, Chiba Y, Tani N, Momotsu T, Kamoi K, Ito S, Yamaji T,
6. Monsuez JJ, Charniot JC, Escaut L, Teicher E, Wyplosz B, Couzigou C, Vignat N,
Enteral Nutrition
20. Brotherton A, Abbott J, Aggett P. The impact of percutaneous endoscopic gastrostomy
38. Rushdi TA, Pichard C, Khater YH. Control of diarrhea by fiber-enriched diet in ICU patients
55. Malaguarnera M, Pistone G, Elvira R, Leotta C, Scarpello L, Liborio R. Effects of L-
6. Loening-Baucke V. Functional constipation. Seminars in Pediatric Surgery. 1995;4: 26-
28. Hartman C, Eliakim R, Shamir R. Nutritional status and nutritional therapy in
Louisiana Dietetic Association
Permission to Copy
2 GRAM DIET SODIUM (2000 milligrams)
How to Follow a Low Salt Diet:
CARDIAC DIET
What to eat if you have heart
DIABETIC DIET
No Concentrated
INCREASING CALORIES IN YOUR DIET
What to do?
High Fiber Diet
Low Fiber Diet
How to eat more (when you
Do You Have Nausea or Vomiting?
Notes:
278