HOSPITAL DIETARY SERVICES latest 1.ppt

Types of diets followed during particular disease conditions .
Dash diet, diabetic diet, Renal care diet

1. HOSPITAL DIET
LT COL CHANDNI
LT FEMI T F

2. WHY DIET???
In an era of Antimicrobial resistance –
immunomodulation & dietary
supplements will be the guide to GOOD
HEALTH

3. OUR PANACEA…

5. KEY POINTS
IMPORTANCE OF NUTRITION
GOAL OF DIETARY SERVICES
HOSPITAL DIETS
NURSES RESPONSIBILITY

6. MERITS OF A BALANCED DIET
The merits of a balanced diet
include:
•Relaxation to the mind.
•Maintenance of body weight.
•Increase in muscle performance.
•Better workout capacity.
•Regulation of emotions and
•Decrease in lipid levels, such as
triglycerides, cholesterol and so on.

7. PURPOSE OF DIET MODIFICATION
•Tomaintainorrestoregoodnutritionalstatus;
•Tocorrectnutritionaldeficiencythatmayhave
occurred;
•Toaffordresttoaparticularpartofthebodythat
mayhavebeenaffectedbyillnessorsurgery
•Toadjustthedietbasedonthedigestive
capabilityoftheclient;
•Toadjustthedietbasedontheabilityoftheclient
tometabolizenutrients;
•Totreatorpreventedema;
•Toeliminateoffendingfoodsubstance

8. DIETARY SERVICES

9. Overall goal of the dietary service is to
provide nourishing and appetizing
meals to all patients and personnel as
efficiently and economically as
possible.

10. HOSPITAL DIETS

20. HOSPITAL DIET
The diet served to a
patient during his stay in
the hospital.
Types of Hospital Diets:-
‘O’Ordinary Diet
‘C’Convalescent Diet
‘S’ Subsistence Diet
‘N’No Diet
‘F’Fluid Diet

21. REGULAR DIET
Tomeetthenutritionalneedsof
adolescents,adultsandgeriatricphasesof
thelifespan.
Includesthebasicfoodgroupsanda
varietyoffoods
Providesapproximately3375calories.
Designedtoprovideexceptionally
generousamountsofallrecognized
nutrientsandmeetsorexceedstheRDA
forallnutrientstabulated.

22. ORDINARY ‘O’ DIET
It usually contains any and all foods
eaten by the person in health.
It provides recommended allowances
of all nutrients, permits the use of all
foods
This is the most frequently used of all
diets.
Types –Ordinary Veg, Ordinary
OVO, Ordinary Non -Veg

23. INTERVALS & INDICATIONS OF
FEEDING
Three regular meals are taken
Two snacks
INDICATIONS
All ambulatory patients
When patients condition does
not necessitate a modified diet.
This diet forms the basis of all
modified diets.

24. CONVALESCENT‘C’ DIET
This is high protein diet.
Foods Included
All food groups of regular diet
with emphasis on extra milk,
egg, cheese, fish and poultry.
Protein foods are increased
100-150gms or more per day.
It may also be planned as soft
or fluid diet when necessary

25. INTERVALS & INDICATIONS OF FEEDING
Three large meals and
high protein beverages
are served in between
Indications
Protein deficiency
Before and after surgery
Burns
Increased metabolic rate

26. SUBSISTENCE‘S’ DIET
•It is the special diet allowance to the
patients when admitted to the
hospital after 1200 hrs till 1800hrs
•Foods Included-All foods
in regular diet but of less ration scale.
•Intervals of feedings
–One full evening meal is served
–Milk and beverages are served in
between

27. NO‘N’ DIET
There is no specific quantity of any itembut
substituted by extra as prescribed.
Food items are demanded according to the
condition of the patient.
Intervals depend upon type of diet prescribed for
the particular patient

28. EXTRAS ON ‘N’ DIET
VEGETABLE 170
CONDIMENTS 07
ONION 30
POTATO 110
EGGS OARB
COFFEE OARB
TEA OARB
SUGAR 90
MILK 1640
LIVER 454

29. NUTRAMUL 57
BISCUIT 57
BREAD 170
ATTA/RICE 170
DAL 60
OIL 30
CHEESE 28
FRESH CREAM 28
BUTTER 28
JAM 28
DALIA 57
SAGO 30
CITRUSFRUIT 230
RAISINS 57

30. INDICATIONS
Patients needing special diets
Burns patient
Patient recovering from any major
illnesses.
Small children

31. FLUID ‘F’ DIET
Foods included-All liquids
like milk, soups, and
beverages. Egg, fruit juices
are also included
The diet is free from
cellulose and irritating
condiments.

32. FLUID DIET
Clear fluid diet
Full fluid diet
Advanced full fluid diet
Adenoidectomy and
tonsillectomy cold fluid diet

33. INDICATIONS
Acute infections
Gastritis
After Surgery
Patients too ill to eat solid
foods

34. Clear Fluid Diet
postoperative patient's first feeding
periods of acute illness
food intolerance
To reduce colon fecal matter for
diagnostic procedures.

35. Clear Fluid Diet….
limitedtofat-freebroth,water,fruitdrinks
withoutpulp,fruiticetea,coffee
substitutes,andsugar. Provides
approximately1146calories.
Belowtherecommended dietary
allowances(RDA)
Helpstomaintainfluidbalanceofbody.
Used only for a short time

36. Full Fluid Diet
extensive oral surgery,
facial injuries,
esophageal strictures,
carcinomas of the mouth and
esophagus.
Transition between a clear liquid and
a regular diet for the post-surgical
patient.

37. Full Liquid Diet….
Milk form the basis.
juices, strained soups, thinned,
cooked cereals, custards, ice
cream, egg flip, and milk.
Provides approximately 2000
calories.

38. Advanced Full Liquid Diet
Thisdietmaybeprescribedtomeetthe
nutritiverequirementsofapatientwhomust
receiveafullliquiddietforanextended
periodoftime
Whohasundergoneoralsurgeryandmust
havefoods,whichcanpassthroughtube.

39. Diet chart-2000ml, 1800Kcal
TIME FEED VOL KCAL
0800H 1egg+150ml milk 200 167
1000 Soup+20GmsButter 200 187
1200 150ml milk+protein-(1scoop)200 115
1400 1 eggs+150Ml milk 200 167
1600 Soup+20gms butter 200 187
1800 milk 200 62
2000 1 eggs+150ml milk 200 167
2200 Soup+20gms butter 200 187
0000 150ml milk+fresublin(1scoop)200 115
0200 1 egg+150ml milk 200 167
0400 Soup+20gms butter 200 187
0600 milk 200 62

40. This diet contains:
VOLUME: 2000ML
CALORIES: 1800KCAL
PROTEIN: 60GMS
FAT:158GMS
CARBS: 137GMS

41. ADVANCED FULL LIQUID DIET
High-proteinbeveragesare
servedwithmealsand
betweenmeals.
Providesapproximately4028
calories.
MeetstheRDAforall
nutrientstabulated.

43. an example:
Total 1 ltr diet
Soyaflour 35 gms
Besan 35 gms
Milk 1000 ml
Rice 30 gms
Oil 30 gms
Sugar 100 gms

44. Tonsillectomy and Adenoidectomy
Cold Liquid Diet
Thisdietisusedfollowingatonsillectomy
andadenoidectomy(T&A).
Providesonlycoldliquids,whicharefreeof
irritantsoracidproperties.
Foodsallowed-flavoredgelatins,icecream,
sherbet,andmilk.Ahighproteinbeverageis
servedbetweenmeals.

45. SCALE OF ENTITLEMENT FOR RATION
AUTH: AFI 1/ S/ 70
FOOD ITEM‘O’
NV
‘O’ OVO‘O’ VEG‘C’ NV‘C’ OVO‘C’ VEGSD FD
MILK(ML) 440640 1080 1100 1300 1740 440 1540
EGGS(NO) 0204 - 03 05 - - 02
MUTTON(G
)
230- - 230 - - - -
CHICKEN 340- - 340 - - - -
FRUIT(G) 230230 230 230 230 230 - 230
BREAD - - - 170 170 170 - -
JAM - - - 28 28 28 - -
BUTTER - - - 28 28 28 - -
CREAM - -- - 28 28 28 - -

46. CONTD…
FOOD ITEM O’
NV
O’
OVO
O’ VEG‘C’ NVC’ OVO‘C’ VEGSD FD
ATTA/RICE 600600600 260 260 260 230 -
SUGAR 90 92 90 90 90 90 40 90
DAL 60 60 60 60 60 60 30 -
OIL 60 60 60 60 60 60 30 -
VEGETABLE 170170170 170 170 170 170 -
POTATO 110110110 60 60 60 - -
ONION 60 60 60 60 60 60 - -
SALT 20 20 20 20 20 20 - -
TEA 9 9 9 9 9 9 7 9
CEREAL
A(sago, suji)
- - - 30 30 30 - -
CEREAL
B(oats,
cornflakes,
dalia)
- - - 57 57 57 - -
CONDIMENT
S
14 14 14 14 14 14 4 -

47. DIET AS PER AGE
AGE DIET
0 to 6 months BF
6 months to 5 yrs N/2
5yrs to 10 yrs O/2
Above 10 yrs O diet
Daily Diet sheet IAFM –1266 duly filled
should be submitted to QM Office/LO
before 12 noon

48. Daily Diet sheet IAFM –1266 duly filled
should be submitted to QM Office/LO before
12 noon

52. Monthly Diet sheet –IAFM 1292 should be
maintained and must tally with the daily diet
sheet. Should be summed up and submitted
to the QM Office by 5
th
of every month.

57. THERAPEUTIC DIETS

59. What is therapeutic
diet?
The modification of normal meal
to treat the indiscriminate health
state of an individual.

60. THERAPEUTIC DIET
Depending upon the case
•Renal diet
•Cardiac diet
•Hepatic Diet
•Diabetic Diet
•Low calorie or high
calorie diet
•Fat free diet

61. Renal diet;
Low potassium foods: apple , cranberries,
pineapple grapes. Cauliflower ,onion, pepper,
radish, lettuce.
Limit amount of fluids ; candies, chewing
gum etc
Protein: daily requirement based on stage
and dialysis.

62. Nutrition for chronic renal
failure
Low protein and low sodium diet for
chronic renal failure
NutrientallowanceSedentary workersModerate workersHeavy workers
Proteins 20 g 30 gm 40 gm
Calories 2040 2197 2363
Sodium 180 mg 215 mg 255 mg
Potassium 1226 mg 1382 mg 1982mg
Phosphorus 441 mg 586mg 717 mg

63. Food to be avoided
Extra milk or milk products
Meat, poultry and fish
Dry fruits
Extra pulses, cereals, legumes, peas, beans
Cakes, biscuits and bakery products, jams
Coca cola, squash, sharbat
Fruits and fruit juices like lemon, mango, lime,
plums
Green leafy vegetables if potassium is restricted

64. CARDIAC DIET
A healthy-heart diet are to eat food
that help to obtain or maintain
levels of cholesterol and fatty
molecules
-Reduce overall cholesterol/ low
density lipoproteins
-Increase high density lipoproteins
-Reduce other harmful lipids

65. DASH diet
Is an acronym for Dietary Approach to stop
hypertension
The diet is rich in important nutrients and
fiber but much less sodium

66. Dash diet recommendations
Sodium intake 5-10grams
Calcium rich diary product with low fat
Include canola or olive oil rich in mono
saturated oils
Choose whole grains over white flour or pasta
products
Fresh fruits ,vegetables , legumes, nuts
everyday

67. Dietary guidelines in diabetes
Maintain ideal body weight
Choose simple carbohydrate
Protein from vegetarian source
Restriction of fat and oils
Increase fiber
Add salad , whole pulses, whole cereals and
sprouts
Avoid fasting

68. Nutrition in diabetes mellitus
Foods not allowed:
-Glucose, sugar, honey, all
sweets, chocolates and
candies

69. Foods to be avoided or
restricted:
-Potatoes, jam, arbi, sweet potatoes,
alcoholic beverages, fried fruits,
paratha, puri, pakoras, dal moth, deep
fried vegetables, dry fruits, saturated
oils

70. Foods to be used freely:
Green leafy vegetables, tomatoes,
cucumbers, lemon, clear soups, black coffee
and tea without sugar, butter milk

71. Daily menu for diabetic person
nutrients SedentaryworkersModerate workersHeavy workers
Calories 1300kcal 1600 kcal 1900kcal
Protein 60 gm 66 gm 70 gm
CHO 170 gm 223gm 232 gm
Fats 33 gm 39 gm 39 gm

73. FEVER

74. Diet in fever
The nutritional requirements depend on the
nature, severity and duration of the fever,
calories requirement is more.
Frequent feeding must be given to the client
and fats must be restricted
Fluid intake must be from 3000-5000 ml in the
form of glucose, fruits juices
A readily digestible foods must be given
When fever goes down, bread with milk, milk
puddings or rice dal must be given

75. Diet in high grade fever
Light diet:
-It must be given 2 hourly and contents must
include milk, barley water, glucose at regular
intervals
-To rebuild body tissues extra proteins must be
given
-Examples milk, egg, curd etc
-Fried foods and diet containing fibers should
be avoided

76. DIARRHOEA

77. Diet in diarrhea
Diarrhoea is increased frequency of loose or
watery stools. It occurs in infectious condition
of colon.
Fluidsshould be given quarter to one hourly
frequently
Oral rehydration solution must be given

79. OFFICER/OFFR FAMILY PTS IN OD MAY
DRAW FOLLOWING IN LIEU OF ATTA/RICE
Cereal for breakfast +cornfakes/oatmeal/
sago /dalia / semolina 57Gm
Cereal for pudding 30gm
Butter 30Gm
Jam/honey/marmalade 28gm
Bread 170Gm

81. DIET MILK
ENTITLED(
ML)
MILK
RETAINED
IN COOK
HOUSE
0700HRS 1000HRS 2100HRS
O DIET NV 440 240(for
curd &tea)
- 200 -
OVO VEG 640 240(for
curd , tea)
- 200 200
O DIET VEG 1080 480(for
curd ,tea)
200 200 200
C DIET NV 1100 400(curd&p
ud)
200 200 200
C DIET OVO VEG 1300 600(for
curd.Pudd
&tea)
200 200 300
CDIET VEG 1740 840 curd,
pd, tea)
300 200 400
F DIET 1540 140(for
curd &tea)

82. NURSES’S RESPONSIBILITY

83. NURSES’S RESPONSIBILITY IN DIET
Assisting patients to obtain nourishment either
through feeding or assisting in feeding.
Motivating patient to eat.
Proper planning of diet.
Assisting patients with special problems about
therapeutic diets.
Supervising and/or distributing the diet at ward
level.
Daily ward requisition for diets and extras in
accordance with the instructions.

84. THANK
YOU

87. SOME WEIGHT LOSS TIPS for 20
days
No sugar
No juices
No corn products
No combining proteins and carbohydrates
All dinners should be cereal free
Exercise only as much as you can
Practice portion control

88. Fruits to avoid
Bananas
Leechies
Chikoos
Mangoes
Grapes
Custard apple
Pineapple
Musk melon

89. Fruits allowed
Papaya
Peeches
Apricots
Cherries
Pomegranate
Guava
pears

90. VEGETABLES NOT ALLOWED
Potatoes
Jimikand
Arbi
Jackfruit
Beetroot
Green peas
carrots

91. VEGETABLES ALLOWED
Cabbage
Cauliflower
Capsicum
Mushrooms
Lady finger
Spinach
Kaddu
Spring onions
Tinda
tori