DIETS THAT

Description
ALTER
CONSISTENCY
Clear liquid diet

Indications

Water, simple sugars, electrolytes

Fiber free
Minimal digestion/motility
Short periods only (low calorie; minimal
protein)

Postop ileus (resolving)

Acute gastroenteritis
Partial intestinal obstruction
Prep for Dxtic GI procedures
Used to advance diet from
NPO

Full liquid diet

Water, calories, protein

Clear liquid + dairy, soups, eggs, soft cereals

Vitamins and minerals may be inadequate

(esp folic acid, Fe, B6)

Dysphagia
Partial obstruction
Prep for some Dxtic GI
procedures
Used to advance diet from
clear fliquid

Soft diet

Tender foods
No raw fruits, vegs, coarse breads/cereals
Can be designed to meet all nutritional
requirements

Pts unable to chew/swallow

hard/coarse food
Assist transition

from full liquid to regular diet

Pt weak/poor dentition
Head and neck surgery pts
Pt w esophageal strictures

DIETS THAT
RESTRICT/MO
DIFY DIETARY
COMPONENTS
Na+ restriction

Fat restriction

2.3g/d
1g/d

40-60g/d

HTN
CKD
Heart failure
Chronic liver dz
Fat malabsorption
syndromes

Low
cholesterol, low
saturated fat
Protein
restriction

Limit production of nitrogenous waste

products

At least 0.6g/kg/d

Hyperlipidemia

Hepatic encephalopathy
Advanced CKD
Inborn errors of amino acid
metabolism

Other

Gluten restriction (Celiac dz)

K+ and PO4- reduction (CKD)
Low FODMAPs (Fermentable Oligo, Di, Mono saccharides and
Polyols)
Short chain carbs

o
Fructose, lactose, fructans (gluten grains),
galactans (legumes), polyols (xylitol, sorbitol)
o
Their ingestion increases delivery of readily
fermentable substrate and water to the distal
small intestine and proximal colon, which are
likely to induce luminal distension and induction
of functional gut symptoms.

DIETS THAT
SUPPLEMENT
DIETARY
COMPONENTS
High fiber
High K+
High Ca2+

Compensate for K+ loss caused by diuretics

Prevent postmenopausal OP

(controversial)

Prevent and Tx HTN

Prevent CRC (controversial)

Diet

Guidelines

Indications

House/regul

No diet restrictions or modifications

ar

Adequate in all essential nutrients

All foods are permitted

Can be modified according to patients food

preferences

Mechanical

Includes soft-textured or ground foods that are easily

soft

masticated and swallowed

Decreased ability to chew or swallow

Presence of oral mucositis or esophagitis

May be appropriate for some patients

with dysphagia

Pureed

Includes liquids as well as strained and pureed foods

Full liquid

Clear liquid

Low-fiber

Includes foods that are liquid at body temperature

Includes milk/milk products

Can provide approximately:

o
25003000 mL fluid
o
15002000 cal
o
6080 g high quality protein
o
<10 g dietary fiber
o
6080 g fat/d

Includes foods that are liquid at body temperature

Foods are
Very low in fiber

Lactose-free

Virtually fat-free

Can provide approximately:

o
2000 mL fluid
o
400600 cal
o
<7 g low-quality protein
o
1 g dietary fiber
o
<1 g fat/d
This diet is inadequate in all nutrients and

should not be used >3 d without

supplementation
Foods that are low in indigestible carbohydrates
Decreases stool volume, transit time, and

frequency

Inability to chew or swallow solid

foods

Presence of oral mucositis or

esophagitis
May be appropriate for some
patients with dysphagia
May be appropriate for patients
with severely limited chewing ability
Not appropriate for lactasedeficient patients unless commercially
available lactaseenzyme tablets
provided

Ordered as initial diet in the

transition from NPO to solids
Used for bowel preparation
before certain medical or surgical
procedures
For management of acute
medical conditions warranting
minimized biliary contraction or
pancreatic exocrine secretion

Management of acute radiation enteritis and

inflammatory bowel disease when narrowing or
stenosis of the intestinal lumen is present

Carbohydrat

e controlled
diet (ADA)

Calorie level should be adequate to maintain or achieve

desirable body weight (DBW)
Total carbohydrates are limited to 5060% of

total calories
Ideally fat should be limited to 30% of total

calories

Diabetes mellitus

Acute renal

Protein (g/kg DBW) 0.6

For patients in renal failure who are not undergoing

failure

Calories (per kilogram DBW) 35-50

dialysis

Potassium (g/d) variable

Fluid (mL/d) u/o +500

Diet

Guidelines

Indications

Hemodialysi

Protein (g/kg DBW) 1.0-1.2

For patients in renal failure on hemodialysis

Calories (per kilogram DBW) 30-35

Sodium (g/d) 1-2
Potassium (g/d) 1.5-3.0
Fluid (mL/d) u/o +500

Peritoneal

Protein (g/kg DBW) 1.2-1.6

dialysis

Calories (per kilogram DBW) 25-35

For patients in renal failure on peritoneal dialysis

Sodium (g/d) 3-4

Potassium (g/d) 3-4
Fluid (mL/d) u/o +500

Hepatic

In the absence of encephalopathy do not restrict protein

Management of chronic liver disorders
In the presence of encephalopathy initially restrict
protein to 4060 g/d then liberalize in increments of 10
g/d as tolerated
Specify sodium and fluid restriction according to severity
of ascites and edema

Low

Limits or restricts milk products

Commercially available lactaseenzyme tablets can

lactose/lacto
be used
se-free
Low-fat

<50 g total fat per day

Fat/cholester Total fat >30% total calories

Saturated fat limited to 10% of calories

ol restricted
<300 mg cholesterol

<50% calories from complex carbohydrates

Lactase deficiency

Pancreatitis
Fat malabsorption

Hypercholesterolemia

Low-sodium

Sodium allowance should be as liberal as possible to

maximize nutritional intake yet control symptoms
No added salt is 4 g/d; no added salt or highly salted
food; 2 g/d avoids processed foods (ie, meats)
<1 g/d is unpalatable and thus compromises adequate
intake

Indicated for patients with hypertension, ascites,

and edema associated with the underlying disease