specialized diets in-service presentation musc dietetic interns 2011

Specialized DietsIn-Service Presentation

MUSC Dietetic Interns 2011

Renal Diet

At MUSC a renal diet is ordered for patients with kidney failure.

The kidneys play an important role in body function:– Filtering the blood– Removing waste products– Balancing electrolytes - Sodium and Potassium– Fluid balance

Renal Diet

At MUSC renal diet patients are limited to:– 2000mg Sodium– 2000mg Potassium – 1200mg Phosphorus– Protein intake is monitored and/or restricted on an

individual basis.

High Potassium Foods to Avoid

Fruits:

Vegetables:

Foods to Limit

Milk:

Dairy:

Protein:

Foods to Enjoy

Low Protein:

Low Sodium:

Low Potassium:

Low Phosphorus:

Soaking Potatoes

A special process called “leaching” or soaking helps remove the potassium from potatoes. This can be done at MUSC giving

renal patients more food choices.

Renal Sample Diet

• Dinner2oz grilled pork chop

½ cup rice

½ cup green beans with onion and basil

½ cup applesauce

Dinner Roll

1 cup water with lemon

Low Sodium Diet

At MUSC low sodium diets are given to those who have hypertension (high blood pressure), cardiac, liver or renal disease. o Sodium raises blood pressure.

Low Sodium Diet = 2 grams sodium/day.o Each meal can exceed the sodium

limit by 100 mg.

Why Low Sodium?

Sodium raises blood pressure.

If untreated, high blood pressure will eventually damage the heart, causing:

o Strokeo Heart attacko Heart failure

Foods to Limit

• Sodium is typically higher in processed and convenience foods, such as:o Ham, bacon, sausage, and other deli-style meatso Canned vegetables

• At MUSC low sodium diets do not allow:• Ham, Bacon, or Sausage• Soups (except reduced sodium chicken noodle)• Stir-Fry

Foods to Limit Continued…

Low sodium diets do not allow salt packets to be added to a meal.

If patients complain about their “food with no flavor,” suggest spicing it up with:– Mrs. Dash– Pepper– Lettuce– Tomatoes– Mustard– Green Peppers– Onions

Low Sodium Diet Example

Breakfast:– Veggie Omelet– Wheat Toast– Fruit– Juice– Coffee with Sugar

and Creamer

Carbohydrate Counting

Type 1 Diabetes

What is it?– Insulin not produced in

pancreas– Must supplement with insulin

Who is at risk?– Only 5% of the population– Mostly children and young

adults– Genetics and environment

Type 2 Diabetes

What is it? Increased at risk cultures:

African Americans, Native Americans, Latino

Can have insulin resistance OR insulin shortage

Insulin helps to absorb glucose, so lack of it can lead to diabetic complications.

Carbohydrate Counting Diet

Carbs in food raise blood sugar levels.

Level I, II, III Limits fat, cholesterol, and

salt intake Consuming a consistent

level of carbohydrates avoids spikes in blood sugar!

Foods to Monitor

Breads

Fruits/Starchy Vegetables

Dairy

Sweets

Foods to Enjoy

Non-Starchy Vegetables

Low Fat Cheeses

Eggs/Lean Meats

Dairy with No Added Sugar

Sample Meal – Level II

Lunch – 75 grams of carbohydrates– 1 cup vegetable soup with 4-6

crackers– 1 turkey sandwich (2 slices

whole wheat bread, 1 oz turkey, 1 oz low fat cheese, 1 tsp mayo)

– 1 small apple

Gluten-Free Diet

What is Gluten?

Gluten is protein found in:

– Wheat– Rye– Barley– Oats

Gluten can severely damage the intestine’s ability to absorb nutrients in those with gluten sensitivity.

Foods to Avoid

Wheat Products (Flour)– Breads, Wraps, Pancakes, Waffles,

Cookies, Cereals, etc.

Oatmeal Processed Meats

– Sausage, Deli Meats

Breaded meats– Oven Fried Chicken, Meatloaf

Pasta French Fries Soy Sauce

Foods to Enjoy

Corn Baked Potatoes Soaked Potatoes Rice Meat

– Marinated Chicken Breast, BBQ Chicken, Baked Fish, BBQ Pork, Hamburger Patty

Fruit Vegetables Milk and Milk Products

Gluten-Free Sample Meals

Breakfast:– Rice Krispies with skim milk, fresh

fruit cup, eggs, yogurt

Lunch– Hamburger patty with ketchup,

tossed salad with oil and vinegar, baked potato with margarine and sour cream, sherbet

Dinner– Baked fish with green beans, corn,

tossed salad with oil & vinegar dressing, pudding

Cross-Contamination

Store gluten-free foods separately from foods that contain gluten.

Separate cooking equipment– Pans, pots, plates, etc.

Personal containers for condiments– Peanut butter, mayonnaise, mustard, etc.

Prepare gluten-free foods in a separate area from foods that contain gluten.

– OR sanitize kitchen areas

Toddler Diet – For Ages 12 months to 3 years

Balanced Meals for Healthy Children

Fruits and Vegetables

Small Portions and Finger

Foods

Toddler Diet - Reasoning

Little mouths need little bites – prevent choking.

Children may not be able to use utensils.

Foods to Avoid

Food that has not been cut up

Hot Dogs Grapes Big Sandwiches

Skim MilkSaladTater TotsJunk Food or

Sugary Foods

Diet Jeopardy

MUSC Diet JeopardyRenal Low

SodiumCarbohydrate Gluten Free Toddler

$100

$200

$300

$400

$500

$100 $100$100 $100

$200 $200 $200 $200

$300 $300 $300 $300

$400 $400 $400 $400

$500 $500 $500 $500

Final Jeopardy

Thank You!