Three Day MenuAllison KliewerBaptist Health System Dietetic InternshipWithTexas Center for Infectious DiseaseMarch 6, 2013
3-Day Menu 2Three Day MenuAccording to the State Operations Manual for Long Term Care Facilities, a facility mustprovide a qualified dietitian to provide each resident with a nourishing, palatable, well-balanceddiet that meets the daily nutritional and special dietary needs of each resident (2013). Adietitian is qualified based on education, training, and experience with identification of dietaryneeds, planning and implementing of dietary programs and much more (2013). Specific trainingexperience includes developing therapeutic diets and developing regular diets to meet thespecialized needs of geriatric and physically impaired persons (2013). The Texas Center forInfectious Disease (TCID) operates as a state long term care facility. The following house menuwas designed to meet specialized dietary needs of the TCID patients.The house menu was to closely resemble that of the State Hospital’s AcceptableMacronutrient Distribution Ranges (AMDR), while following the “Dietary Guidelines forAmericans” 2010, and offering a culturally healthy and flavorful menu. The AMDR guidelinescan be seen in Appendix III. The Texas Center of Infectious Disease has a specific population ofpatients who suffer from tuberculosis among many other clinical diagnoses. Many of thepatients have multiple diseases, are often are substance users and abusers, and are admittedwith malnourishment. The patient population is multi-cultural and while most of the patientsare from Mexico, others are from other nations, such as, Nepal, Iraq, and Russia. The clinicaldiagnoses, nutrition status, and unique culture of the patients, were considered in the mealplanning.
3-Day Menu 3The cardiac menu was modeled to closely follow the American Heart Associationguidelines for a healthy diet; 4.5 cups of fruits and vegetables each day, two servings of fish perweek, at least three servings of fiber rich whole grains per day, less than 1,500 mg of sodiumeach day, no more than 450 calories of sugar-sweetened beverages per week, four servings ofnuts, legumes, and seeds per week, no more than two servings of processed meats per week,and less than seven percent of total energy intake from saturated fat. Guidelines also follow the“Dietary Approaches to Stop Hypertension” (DASH) diet that is encouraged by the NationalHeart, Lung, and Blood Institute, the U. S. Department of Health and Human Services, and theNational Institutes of Health.The 200 gram carbohydrate restricted diet also followed the cardiac or heart healthydiet plan, while limiting the carbohydrates at each meal. The purpose of a carbohydrate limiteddiet is to better control blood glucose, therefore helping to control diabetes. According to theNational Heart, Lung, and Blood Institute, those who have diabetes are at higher risk for heartdisease, have additional causes of heart disease, may develop heart disease at a younger age,and may develop a more severe form of heart disease. That is why it is important to followheart healthy eating patterns while controlling carbohydrate intake.The renal diet was restricted following the Nutrition Care Manual (NCM) guidelines forchronic kidney disease (2012). Nutrients were limited to 2.4 g sodium, 2.4 g potassium, and800 to 1,000 mg phosphorus (NCM, 2012).The mechanical soft or dental soft diet is modified from a regular diet for patients withdifficulty chewing or swallowing. Foods included in the diet are to be easily masticated. The
3-Day Menu 4mechanical soft food items were based on the Manual of Clinical Nutrition Management(2011).AnalysisThe house menu was adjusted to meet the nutrition standards of a cardiac, 200 gramcarbohydrate, renal, and mechanical soft diet. Data was analyzed using the Nutrition Calc Plussoftware (2009). The three day house menu and the nutrient analysis can be viewed inAppendix I and Appendix II.
3-Day Menu 5ReferencesAcademy of Nutrition and Dietetics Quality Management Committee. (2013). Academy ofNutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care andStandards of Professional Performance for Registered Dietitians. Journal of the Academyof Nutrition and Dietetics. In press.Silver Oaks Communications. (2009). Nutrition Calc Plus 3.2. The McGraw Hill Companies.University of Virginia Health System: Manual of Clinical Nutrition Management. (2011).Morrison Management Specialists, Inc.