Diet Manual For Nutrition Professionals Working At A Developmental Center

5m ago
7 Views
1 Downloads
3.36 MB
100 Pages
Last View : 1m ago
Last Download : 1m ago
Upload by : Giovanna Wyche
Transcription

DEPARTMENT OF DEVELOPMENTAL SERVICESSTATE OF CALIFORNIAHEALTH AND HUMAN SERVICES AGENCYDIET MANUAL“ Building Partnerships, Supporting Choices” 2003-State of California Department of Developmental Services- All Rights ReservedRevised 2004 & 2009 & 2010

2003- State of California Department of Developmental Services. Revised 2004, 2009,and 2010.This publication was developed for and under the direction and supervision of the State ofCalifornia Department of Developmental Services (DDS). All rights under federalcopyright laws are held by DDS.All parts of this publication may be reproduced in any form of printed or visual medium.Any reproduction of this publication may not be sold for profit or reproduction costswithout the exclusive permission of DDS. Any reproduction of this manual in whole orpart, shall acknowledge DDS in writing.

ACKNOWLEDGMENTThis diet manual was originally developed in 2003 by a team of dedicated nutritionalprofessionals working under the auspices of the Department of Developmental Services,a State of California Health and Human Services agency. The collaborative efforts ofthis group have resulted in a simplified manual designed for use by physicians and healthcare professionals in providing nutrition care to individuals with developmentaldisabilities.Revisions have been made in 2004, 2009 and again in 2010 to incorporate the mostcurrent medical nutritional therapy practices based on research findings since thedevelopment of this manual.On-going revisions will occur as advancements in medical nutritional therapy continue tobe made.Rebecca K. Yager, M.S., R.D.Departmental Food AdministratorStatewide Diet Manual Coordinator

PREFACEThe purpose of this diet manual is to establish a common language and practice forphysicians and other healthcare professionals to use when providing nutritional care toindividuals under the auspices of the Department of Developmental Services, a State ofCalifornia Health and Human Services agency. Standard use of diet terminology canassist in providing a smooth transition for individuals transferred between developmentalcenters, or placed in community facilities or group homes.This manual includes the most current information on diets in accordance with researchfindings. Nutritional adequacy of the diets is based upon the Dietary Reference Intakes(DRIs) established by The Food and Nutrition Board of the Institute of Medicine. Theappendix includes reference materials that are pertinent and/or useful in providingappropriate nutritional care for individuals with developmental disabilities.This manual has been simplified to include only those diets most routinely ordered.Each diet lists: PurposeDiet PrinciplesAdequacyFoods AllowedFoods To AvoidMeal Pattern to use in menu planning and /orSample Menu for one day (when appropriate)If you have specific questions regarding any diet or have a need for a diet not listed inthis manual, contact a Registered Dietitian.Like all diet manuals, the information included in this manual is to be used only as aguide. Some individuals may require more or less of certain nutrients. Individualizedassessments and care plans are essential in providing optimal nutritional care.Each facility that uses this manual may want to customize it by adding information that isunique to their operation. For example, a list of enteral nutrition products available atyour facility can be inserted in the enteral alimentation section.California Code of Regulations, Title 22, Chapter 8 requires that “a current therapeuticdiet manual be approved by the dietitian and the client care policy committee and shall bereadily available to the program, health support, and dietetic personnel. It shall bereviewed annually and revised at least every five years.” The manual approval page is tobe used to document the required annual review.

MANUAL APPROVALThis diet manual has been reviewed and approved for use atBy:Executive Director/AdministratorDateMedical DirectorDateDirector of Dietetics/Registered DietitianDate

TABLE OF CONTENTSGeneral Diets . Section 1House Diet .1.1Small Diet .1.3Small Plus .1.5Large Diet .1.7Extra Large Diet.1.9Texture Modifications of House Diet . Section 2Regular Texture .2.1Chopped Texture.2.2Ground Texture.2.4Pureed Texture .2.6Finger Foods .2.8Clear Liquid Diet . Section 3Clear Liquid Diet .3.1Full Liquid Diet.3.3Hydration . Section 4Hydration .4.1Estimating Daily Fluid Requirements For Healthy Individuals .4.2Thickened Liquid Diet .4.3Fluid Restriction Diet.4.4Therapeutic Diets . Section 5Anti-Reflux Diet .5.1Cholesterol Controlled Diet .5.3Chronic Obstructive Pulmonary Disease (COPD) Diet.5.6Consistent Carbohydrate Diet .5.7Fat Controlled Diet .5.10Fiber Controlled Diet .5.13High Fiber Diet .5.15Ketogenic Diet .5.19Reactive Hypoglycemic Diet .5.20Sodium Controlled Diet .5.21Renal Diet .5.24Adverse Reactions to Foods Diets .Section 6Egg-Free Diet.6.1Gluten-Free Diet .6.3Milk-Free Diet .6.6Lactose Controlled Diet .6.8Tyramine Restricted Diet.6.10Eating Disorder Diet .Section 7Prader-Willi Syndrome .7.1Religious Diets. Section 8Islamic Diet.8.1

Kosher Diet .8.2Vegetarian Diets.8.7Metabolic Disorder Diets. Section 9Maple Syrup Urine Disease (MSUD) Diet .9.1Phenylketonuria (PKU) Diet.9.2Enteral Alimentation.Section 10Enteral Alimentation.10.1Appendix. Section 11Body Mass Index .11.1Estimated Calorie Requirements For Specific Developmental Disabilities .11.3High Risk Conditions.11.4Suggested References For Additional Information.11.5

GENERAL DIETS

HOUSE DIETPURPOSE: This diet is the “core” diet, which serves as the foundation for all other dietdevelopment. The house diet is the medium portion size on the menu.DIET PRINCIPLES: The diet is based on principles found in the USDA My PyramidFood Guidance System, DASH (Dietary Approaches to Stop Hypertension) Eating Plan,American Cancer Society, American Heart Association and the Food and Nutrition Boardof the Institute of Medicine, The National Academies. The diet promotes higherconsumption of plant foods, such as whole grains, fruits and vegetables. It includes lowfat dairy products and encourages lower consumption of meats and high-fat foods. Thediet is planned to provide variety in food, color, texture and flavor as well as seasonalmenu variations.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrients.Approximate CompositionCalories:2000 – 2500Carbohydrate:45 – 65% kcalProtein:15 – 20% kcalFat:20 – 30% kcalFOODS ALLOWED: All foods served in the prescribed consistency are allowed inaccordance with the diet principles listed above.FOODS TO AVOID: None.1.1

BASIC MENU FRAMEWORKHOUSE DIET 2000 – 2500 KCALFOOD GROUPMeat (lean), Poultry, Fish, DryBeans, Eggs, & NutsServings6-7 ouncesGrainsBread, Cereal, Rice, & Pasta( at least ½ of all grains shouldbe whole grains)6-8 servingsVegetables(including dark green or deepyellow as a source of vitamin Aat least every other day)5-6 servingsFruits(at least 1 should be high invitamin C)4-5 servingsMilk, Yogurt, & Cheese(low-fat)3 servingsFats & Oils7 servingsDiscretionary CalorieAllowance*Total CaloriesServing Size1 oz. cooked meator poultry; 1 egg;¼ cup cooked drybeans or tofu; 1TB. peanut butter1 slice bread; ¾-1cup ready-to-eatcereal; ½ cupcooked cereal,rice or pasta1 cup raw leafyvegetables; ½ cupof othervegetables (rawor cooked); ½- ¾cup vegetablejuice1 medium apple,banana, orange,pear; ½ cupchopped, cookedor canned fruit;½- ¾ cup fruitjuice1 cup milk oryogurt; 1 ½ oz.natural cheese; 2oz. processedcheese1 tsp margarine,oil, butter,mayonnaise; 1TB. regular saladdressingKcal Range330-385 kcal480- 640 kcal125-150 kcal240-300 kcal270 kcal315 kcal240-440 kcal2000- 2500 kcal*Calories remaining after the recommended servings from each food group have beenmet through the consumption of nutrient dense foods. Calories may come from foodssuch as jelly, sugar, syrup or dessert.1.2

SMALL DIETPURPOSE: This diet is indicated for individuals who require a calorie-controlled diet toachieve and/or maintain desirable body weight.DIET PRINCIPLES: The small diet (1000-1500 calories) is based on the house diet andprescribed consistency. Some high calorie foods are omitted. Some desserts are allowedin moderation.ADEQUACY: The need for vitamin and mineral supplementation should be assessed onan individual basis, as the Dietary Reference Intakes (DRIs) may not be met at the lowercalorie level.FOODS ALLOWED: Most foods served on the prescribed consistency are allowed.Portion sizes are reduced to control calories. Non-caloric foods are allowed as desired.FOODS TO AVOID: None.Approximate CompositionCalories:1000 – 1500Carbohydrate:45 – 65% kcalProtein:15 – 20% kcalFat:20 – 30% kcal1.3

BASIC MENU FRAMEWORKSMALL DIET 1000 – 1500 KCALFOOD GROUPMeat (lean), Poultry, Fish, DryBeans, Eggs, & NutsServings4 – 5 ouncesGrainsBread, Cereal, Rice, & Pasta( at least ½ of all grains shouldbe whole grains)3 – 5 servingsVegetables(including dark green or deepyellow as a source of vitamin Aat least every other day)3 – 4 servingsFruits(at least 1 should be high invitamin C)3 servingsMilk, Yogurt, & Cheese( low-fat)2-3 servingsFats & Oils2-5 servingDiscretionary Calories*Total CaloriesServing Size1 oz. cooked meator poultry; 1 egg; ¼cup cooked drybeans or tofu; 1 TB.peanut butter1 slice bread; ¾-1cup ready-to-eatcereal; ½ cupcooked cereal, riceor pasta1 cup raw leafyvegetables; ½ cupof other vegetables(raw or cooked); ½¾ cup vegetablejuice1 medium apple,banana, orange,pear; ½ cupchopped, cooked orcanned fruit; ½- ¾cup fruit juice1 cup milk oryogurt; 1 ½ oz.natural cheese;2 oz. processedcheese1 tsp margarine, oil,butter, mayonnaise;1 TB. regular saladdressingKcal Range220 – 275 kcal240 – 400 kcal75 – 100 kcal180 kcal180 – 270 kcal90-225 kcal15-50 kcal1000 – 1500 kcal*Calories remaining after the recommended servings from each food group have beenmet through the consumption of nutrient dense foods. Calories may come from foodssuch as jelly, sugar, syrup or dessert.1.4

SMALL PLUS DIETPURPOSE: This diet is indicated for individuals of large stature who require a caloriccontrolled diet to achieve and/or maintain desirable body weight.DIET PRINCIPLES: The small plus diet (1500 – 2000 calories) follows the principlesof the house and small diets and prescribed consistency. The diet is designed to provide acalorie level that is between the house and small diet. Some high calorie foods areomitted. Some high calorie desserts are allowed in moderation.ADEQUACY: The need for vitamin and mineral supplementation should be assessed onan individual basis, as the Dietary Reference Intake (DRIs) may not be met at a calorielevel that is less than 2000 calories.Approximate CompositionCalories:1500 – 2000Carbohydrates:45 – 65% kcalProtein:15 – 20% kcalFat:20 – 30% kcalFOODS ALLOWED: Most foods served on the prescribed consistency are allowed inaccordance with the house and small diet principles. Portion sizes are reduced to controlcalorie intake. Non-caloric foods are allowed as desired.FOODS TO AVOID: None1.5

BASIC MENU FRAMEWORKSmall Plus Diet 1500 – 2000 KCALFOOD GROUPMeat (lean), Poultry, Fish, DryBeans, Eggs, & NutsServings5 – 6 ouncesGrainsBread, Cereal, Rice, & Pasta( at least ½ of all grains shouldbe whole grains)Vegetables(including dark green or deepyellow as a source of vitaminA at least every other day)5 – 6 servingsFruits(at least 1 should be high invitamin C)3-4 servingsMilk, Yogurt, & Cheese( low-fat)3 servingsFats & Oils5-7 servings4 – 5 servingsDiscretionary CalorieAllowance*Total CaloriesServing Size1 oz cooked meat orpoultry, 1 egg; ¼ cupcooked dry beans ortofu; 1 TB peanutbutter1 slice bread; ¾-1cup ready-to-eatcereal; ½ cup cookedcereal, rice or pasta1 cup raw leafyvegetables; ½ cup ofother vegetables(raw or cooked); ½ 3/4 cup vegetablejuice1 medium apple,banana, orange, pear;½ cup chopped,cooked, or cannedfruit; ½-3/4 cup fruitjuice1 cup milk or yogurt;1 ½ oz naturalcheese; 2 ozprocessed cheese1 tsp margarine, oil,butter, mayonnaise;1 TB regular saladdressingKcal Range275 – 330 kcal400-480 kcal100-125 kcal180-240 kcal270 – 360 kcal225 – 315 kcal50 – 150 kcal1500 – 2000 kcal*Calories remaining after the recommended servings from each food group have beenmet through the consumption of nutrient dense foods. Calories may come from foodssuch as jelly, sugar, syrup or dessert.1.6

LARGE DIETPURPOSE: This diet is indicated for individuals who require additional calories beyondthose provided by the house diet to achieve and/or maintain desirable body weight. Theportion sizes of the house diet may be multiplied or beverages may be fortified toincrease calories.DIET PRINCIPLES: This diet is based on the house diet and prescribed consistencywith additional calories provided by increasing the volume/enriching entrees, starchesand beverages.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrients.Approximate CompositionCalories3000 - 3500Carbohydrate 45 - 65% kcalProtein15 - 20% kcalFat20 - 30% kcalFOODS ALLOWED: All foods served in the prescribed consistency are allowed.FOODS TO AVOID: None1.7

BASIC MENU FRAMEWORKLARGE DIET 3000 – 3500 KCALFOOD GROUPMeat (lean), Poultry, Fish, DryBeans, Eggs, & NutsGrainsBread, Cereal, Rice, & Pasta( at least ½ of all grains shouldbe whole grains)Vegetables(including dark green or deepyellow as a source of vitamin Aat least every other day)Fruits(at least 1 should be high invitamin C)Milk, Yogurt, & Cheese(low-fat)Fats & OilsServings10 – 11 ouncesServing Size1 oz. cooked meator poultry; 1 egg;¼ cup cooked drybeans or tofu; 1TB. peanut butter12 – 14 servings 1 slice bread; ¾-1cup ready-to-eatcereal; ½ cupcooked cereal,rice or pasta6 servings1 cup raw leafyvegetables; ½ cupof othervegetables (rawor cooked); ½- ¾cup vegetablejuice6 servings1 medium apple,banana, orange,pear; ½ cupchopped, cookedor canned fruit;½-¾ cup fruitjuice3 servings1 cup milk oryogurt; 1 ½ oz.natural cheese; 2oz. processedcheese7-10 servings1 tsp margarine,oil, butter,mayonnaise; 1TB. regular saladdressingDiscretionary CalorieAllowance*Total CaloriesKcal Range550 – 605 kcal960 – 1120 kcal150 kcal360 kcal270 kcal315-450 kcal395 – 545 kcal3000 – 3500 kcal*Calories remaining after the recommended servings from each food group have beenmet through the consumption of nutrient dense foods. Calories may come from foodssuch as jelly, sugar, syrup or dessert.1.8

EXTRA LARGE DIETPURPOSE: This diet is indicated for individuals who require additional calories beyondthose provided by the large diet to achieve/maintain desirable body weight. The portionsizes of the large diet may be further multiplied and beverages fortified to increasecalories.DIET PRINCIPLES: This diet is based on the large diet and prescribed consistencywith additional calories provided by increasing the volume/enriching entrees, starchesand beverages.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrients.Approximate CompositionCalories4000 - 4500Carbohydrate 45 - 65%Protein15 - 20%Fat20 - 30%FOODS ALLOWED: All foods served in the prescribed consistency are allowed.FOODS TO AVOID: None1.9

BASIC MENU FRAMEWORKEXTRA LARGE DIET 4000 – 4500 KCALFOOD GROUPMeat (lean), Poultry, Fish, DryBeans, Eggs, & NutsServing Size1 oz. cookedmeat or poultry;1 egg; ¼ cupcooked drybeans or tofu;1TB. peanutbutter15 – 17 servings 1 slice bread; ¾ 1 cup ready-to eat cereal; ½ cupcooked cereal,rice or pastaKcal Range715 – 770 kcalVegetables(including dark green or deepyellow as a source of vitamin Aat least every other day)9 servings225 kcalFruits(at least 1 should be high invitamin C)9 servingsMilk, Yogurt, & Cheese( low-fat)3 servingsFats & Oils10 -12 servingsGrainsBread, Cereal, Rice, & Pasta(at least ½ of all grains should bewhole grains)Servings13 – 14 ounces1 cup raw leafyvegetables; ½cup of othervegetables (rawor cooked); ½- ¾cup vegetablejuice1 medium apple,banana, orange,pear; ½ cupchopped, cookedor canned fruit;½-¾ cup fruitjuice1 cup milk oryogurt; 1 ½ oz.natural cheese; 2oz. processedcheese1 tsp margarine,oil, butter,mayonnaise; 1TB. regular saladdressing1200 – 1360 kcal540 kcal270 kcal450-540 kcalDiscretionary Calorie600 – 795 kcalAllowance*Total Calories4000 – 4500 kcal*Calories remaining after the recommended servings from each food group have beenmet through the consumption of nutrient dense foods. Calories may come from foodssuch as jelly, sugar, syrup or dessert.1.10

TEXTUREMODIFICATIONS OFHOUSE DIET

REGULAR TEXTUREPURPOSE: This diet is for persons who require no food consistency modifications.DIET PRINCIPLES: No modifications are required. This diet texture can apply to any portionsize or therapeutic diet.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrients.FOODS ALLOWED: All foods are allowed.FOODS TO AVOID: None.REGULAR TEXTURE SAMPLE MENUBREAKFASTOrange JuiceDry CerealScrambled ti with MeatballsTossed Lettuce Salad withDressingGarlic BreadFruit CupMilkCondiments2.1DINNERBaked Chicken BreastSteamed Potatoes with GravyBroccoliCherry CrispBreadMargarineMilkCondiments

CHOPPED TEXTUREPURPOSE: This diet is for persons who have difficulty chewing some regular foods or havedifficulty cutting up foods.DIET PRINCIPLES: Some foods are modified by dicing, chopping or cutting into bite-sizedpieces as tolerated. Most meats are cubed and raw vegetables and hard fruits are finely diced.This diet texture can be applied to any portion size or therapeutic diet.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrients.FOODS FOR THE DAYMILK & MILKPRODUCTSMEAT OR SUBSTITUTEBREADS, CEREALS,PASTA & LES OFFOODS ALLOWEDMilk, cottage cheese, slicedcheese.Cubed meat and poultry, wholefish, tender sliced lunchmeat andcheese, eggs, *Peanut Butter,cooked dried beans and peas.Whole grain, enriched bread,cereals, crackers, pasta, or rice.EXAMPLES OFFOODS TO AVOIDNoneCubed cooked vegetables,shredded lettuce, vegetable juice,finely diced raw carrots andcelery. White or sweet potato.May be fresh, canned, or frozen,served whole (except apples),diced, or as juice. Soft fresh fruitas tolerated.Margarine, butter, salad oil,mayonnaise.Puddings, ice cream, sherbet,cakes, cookies, gelatin, pastries,pie, sugar, jelly, salt, herbs andspices, flavorings, pepper.Whole raw vegetablesalads, whole rawcarrots and celery.All othersNoneWhole fresh apples.Whole hard freshfruit.None* Peanut Butter mixed with honey or jelly and margarine (to soften).2.2

CHOPPED TEXTURE SAMPLE MENUBREAKFASTOrange JuiceDry CerealScrambled EggsToastMargarineMilkCoffeeCondimentsLUNCHMinced Spaghetti with CubedMeatballsShredded Lettuce Salad withDressingGarlic BreadDiced Fruit CupMilkCondiments2.3DINNERCubed Baked Chicken Breastwith GravySteamed Potatoes with GravyDiced BroccoliCherry CrispBreadMargarineMilkCondiments

GROUND TEXTUREPURPOSE: This diet is for persons who have difficulty chewing and/or swallowing. It isintended to minimize the need for chewing and to ease swallowing.DIET PRINCIPLES: Foods are finely minced or ground, and moistened. Foods that are forkmashable are included. This diet texture can be applied to any portion size or therapeutic diet.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrientsFOODS FOR THEDAYMILK & MILKPRODUCTSMEAT ORSUBSTITUTEEXAMPLES OF FOOD ALLOWEDBREADS,CEREALS, PASTA,& RICESoft, moist bread products such as moistenedbreadcrumbs or bread pudding. Cookedcereals (oatmeal, farina, malt-o-meal).Moistened rice and small chopped urt, cottage cheese, custard, cheesespread (ground).Moistened ground meats, ground driedbeans. Meat salads made with ground meatand vegetables. Scrambled eggs. Soft tofu.EXAMPLES OFFOODS TO AVOIDString cheese or other cheeselarger than diced.Unmoistened meats, wholehamburger patty, cold cuts,whole hard cooked egg.Bread with: seeds, nuts, dryfruits, unsoaked crackers, goldfish crackers, teddy grahams,dry cereal, coarse whole graincereals not softened by soaking.Minced or ground tomatoes, peas, beets, lima Raw crunchy vegetableswithout sauce or dressing.beans, creamed or pureed corn, kidneyPotato chips, whole french fries.beans, spinach, gelled vegetable salads.Mashed potatoes, ground tater tots, mincedpotato salad, tender steamed potatoes thatcan be mashed with a fork.Ground or minced baked apples, ripe banana, Raw and crunchy fruit, fruitroll-ups, dried fruit, coconut.peaches, crushed pineapple, canned/cookedfruit, applesauce, pureed raisins, fruitcocktail, blueberries, strawberries.Pineapple sauce and pureed bananas can beused if crushed pineapple and mincedbananas are not tolerated.Margarine, butter, salad oil, mayonnaise.Moistened soft cookies, cubed cake.Seeds, unmoistened cookies,plain peanut butter.2.4

GROUND TEXTURE SAMPLE MENUBREAKFASTOrange JuiceCooked CerealScrambled EggsMoistened RMinced Spaghetti with GroundMeatballsGround Lettuce Salad withDressingMoistened Garlic BreadcrumbsGround Fruit CupMilkCondimentsGround Baked Chicken BreastWith GravySteamed Potatoes with GravyGround BroccoliGround Cherry CrispMoistened BreadcrumbsMargarineMilkCondiments2.5

PUREED TEXTUREPURPOSE: This diet is for persons who have chewing or swallowing problems and may notsafely handle a ground texture.DIET PRINCIPLES: Foods are pureed to smooth consistency unless already in a comparativelysmooth form such as mashed potatoes. This texture can be applied to any diet portion size ortherapeutic diet.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrients.FOODS FOR THEDAYMILK & MILKPRODUCTSMEAT ORSUBSTITUTEEXAMPLES OF FOOD ALLOWEDBREADS, CEREAL,PASTA, & RICEMoistened bread crumbs or pureed bakedbread pudding. Cooked cereals (pureedoatmeal, farina, malt-o-meal). Moistenedpureed rice or rice cereal, pureed pasta.Pureed: tomatoes, peas, beets, lima beans,pureed creamed corn, kidney beans, spinach,pureed gelled vegetable salads, mashedpotatoes, pureed tater tots, and pureed potatosalads.Pureed: baked apples, banana, peaches,pineapple sauce, canned/cooked fruit,raisins, fruit cocktail, blueberries,strawberries and applesauce.Margarine, butter, salad oil, mayonnaise.Pureed soft cookies or cake, ice ORIESYogurt, pureed cottage cheese, custard, icecream.Pureed meat, poultry, fish, eggs, cookeddried beans. Soft tofu.2.6EXAMPLES OFFOODS TO AVOIDHard and semi-hard cheesesused alone.All others.All others. Dry cereal, coarsewhole grain cereals not softenedby soaking.Whole creamed corn. All otherpotato products.Raw and crunchy fruit, fruitroll-ups, dried fruit, coconut.Seeds, unmoistened cookies,peanut butter (by itself).

PUREED TEXTURE SAMPLE MENUBREAKFASTOrange JuicePureed Cooked Refined CerealPureed Scrambled EggsPureed Bread PuddingMilkCoffeeCondimentsLUNCHPureed Spaghetti with PureedMeatballsPureed Lettuce Salad withDressingPureed Garlic Bread BakePureed Fruit CupMilkCondiments2.7DINNERPureed Baked Chicken Breastwith GravyMashed Potatoes with GravyPureed BroccoliPureed Cherry CrispPureed Bread PuddingMilkCondiments

FINGER FOODSPURPOSE: This diet is appropriate for persons who exhibit a desire to eat with their fingersdespite training to develop hand movements to utilize utensils.DIET PRINCIPLES: All foods offered on this diet must be must be given in a form that aperson can easily handle with their fingers, without risk of spilling much of the food. This dietmodification can apply to persons on regular or chopped textures, any portion size, general ortherapeutic diet.ADEQUACY: This diet meets the Dietary Reference Intakes (DRIs) for most nutrients.FOODS ALLOWED: All foods that a person can easily handle with their fingers without riskof spilling much of the food. Foods that can be placed in a mug or glass to drink.FOODS TO AVOID: Any small foods that may be hard to pick up due to dexterity problems(corn, peas, rice, etc.). Any slippery foods that may be difficult to pick up due to dexterityproblems (noodles in sauce, fruits in heavy syrup, macaroni in cheese sauce, etc.).FINGER FOODS SAMPLE MENUBREAKFASTOrange JuiceDry CerealScrambled Egg SandwichMilkCoffeeCondimentsLUNCHDINNERMeatballs Cut in HalfVegetable Sticks with Dressingfor DippingGarlic BreadSliced FruitMilkCondi

This diet is the "core" diet, which serves as the foundation for all other diet development. The house diet is the medium portion size on the menu. DIET PRINCIPLES: The diet is based on principles found in the USDA My Pyramid Food Guidance System, DASH (Dietary Approaches to Stop Hypertension) Eating Plan,

Related Documents:

Sep 02, 2002 · Ocs Diet Smoking Diet Diet Diet Diet Diet Blood Diet Diet Diet Diet Toenails Toenails Nurses’ Health Study (n 121,700) Weight/Ht Med. Hist. (n 33,000) Health Professionals Follow-up Study (n 51,529) Blood Check Cells (n 68,000) Blood Check cell n 30,000 1976 19

Bruksanvisning för bilstereo . Bruksanvisning for bilstereo . Instrukcja obsługi samochodowego odtwarzacza stereo . Operating Instructions for Car Stereo . 610-104 . SV . Bruksanvisning i original

10 tips och tricks för att lyckas med ert sap-projekt 20 SAPSANYTT 2/2015 De flesta projektledare känner säkert till Cobb’s paradox. Martin Cobb verkade som CIO för sekretariatet för Treasury Board of Canada 1995 då han ställde frågan

service i Norge och Finland drivs inom ramen för ett enskilt företag (NRK. 1 och Yleisradio), fin ns det i Sverige tre: Ett för tv (Sveriges Television , SVT ), ett för radio (Sveriges Radio , SR ) och ett för utbildnings program (Sveriges Utbildningsradio, UR, vilket till följd av sin begränsade storlek inte återfinns bland de 25 största

Hotell För hotell anges de tre klasserna A/B, C och D. Det betyder att den "normala" standarden C är acceptabel men att motiven för en högre standard är starka. Ljudklass C motsvarar de tidigare normkraven för hotell, ljudklass A/B motsvarar kraven för moderna hotell med hög standard och ljudklass D kan användas vid

LÄS NOGGRANT FÖLJANDE VILLKOR FÖR APPLE DEVELOPER PROGRAM LICENCE . Apple Developer Program License Agreement Syfte Du vill använda Apple-mjukvara (enligt definitionen nedan) för att utveckla en eller flera Applikationer (enligt definitionen nedan) för Apple-märkta produkter. . Applikationer som utvecklas för iOS-produkter, Apple .

Plan and monitor animal diet and nutrition LANAnC46 Plan and monitor animal diet and nutrition 1 Overview This standard covers planning and monitoring the diet and nutrition for animals in your care. You will need to identify the nutritional requirements of the animals and develop feeding plans containing all the necessary information for those responsible for feeding the animals. You will .

Testimony Studies on Diet and Foods, was soon exhausted. A new and enlarged volume, titled Counsels on Diet and Foods, Appeared in 1938. It was referred to as a “second edition,” and was prepared under the direction of the Board of Trustees of the Ellen G. White Estate. A third edition, printed in a smaller pageFile Size: 1MBPage Count: 408Explore furtherCounsels on Diet and Foods — Ellen G. White Writingsm.egwwritings.orgCounsels on Diet and Foods — Ellen G. White Writingsm.egwwritings.orgEllen G. White Estate: A STUDY GUIDE - Counsels on Diet .whiteestate.orgCounsels on Diet and Foods (1938) Version 105www.centrowhite.org.brRecommended to you b

(not hungry at all) 0---1---2---3---4---5---6---7---8---9---10 (so hungry you get cramps) 8 Dieting History . Atkins Mayo Clinic diet Subway diet HCG Diet Pritkin diet Fasting The Zone Raw diet Caveman diet South Beach Blood Test diet Low Ca

Zone Diet Typical U.S. Diet Rice Diet) Duke MCD 20 0 50 100 200 300 Calories/day 1000 (Ketonuria) Low Glycemic Index Diet Mediterranean Diet Protein Power, Paleo, So. Beach Phase 1, Duke LCD Atkins Induction, Keto So. Beach Phase 2 Atkins Maintenance DASH Diet VLCD Low Carbohydrate Ketogenic Diet

Low Carb Low Fat Hypnosis Atkins Diet Mayo Clinic Diet Richard Simons Scarsdale Diet Sugar Busters Slim Fast South Beach Diet Acupuncture Diet Pills from MD Diet Shots from MD Diet Center Jenny Craig Overeaters Anonymous Optifast / Medifast LA Weight Loss Nutri System Psychological Counse

And here is a quick overview of this diet plan in PDF. Although it's just a quick preview of the diet plan, we've been working on a complete ebook including recipes so stay tuned! :-) Also see more diet plans here ("regular" ketogenic diet plan, keto & paleo diet plan and diet plan for the fat fast.)

Cabbage diet, colon cleanse diet, HCG diet, Atkins diet, Dukan diet. Diet pills Weight loss clinics: Jenny Craig, Weight Watchers, Nutri-System 40 Billion dollars sp

Diet and nutrition are important aspects of IBD management. “Diet” refers to the foods we eat. “Nutrition” is a term that refers to properly absorbing food and staying healthy. A well-balanced diet with adequate intake of protein, carbohydrates and fat, as well as vitamins and minerals, is nec-essary

Nutrition in the Care of Liver Transplant Patients 1. Nutrition Status / Causes of Malnutrition 2. Nutrition Support (TF / TPN) 3. Pre-Transplant Diet (or Early / or Non-candidate Liver patients) 4. Early Post-Transplant Diet vs. Long-term Post-Transplant Diet 5. Poor Intake Tips (Pre- and Post-Transplant) 6. Micronutrient Deficiencies 3

och krav. Maskinerna skriver ut upp till fyra tum breda etiketter med direkt termoteknik och termotransferteknik och är lämpliga för en lång rad användningsområden på vertikala marknader. TD-seriens professionella etikettskrivare för . skrivbordet. Brothers nya avancerade 4-tums etikettskrivare för skrivbordet är effektiva och enkla att

Den kanadensiska språkvetaren Jim Cummins har visat i sin forskning från år 1979 att det kan ta 1 till 3 år för att lära sig ett vardagsspråk och mellan 5 till 7 år för att behärska ett akademiskt språk.4 Han införde två begrepp för att beskriva elevernas språkliga kompetens: BI

**Godkänd av MAN för upp till 120 000 km och Mercedes Benz, Volvo och Renault för upp till 100 000 km i enlighet med deras specifikationer. Faktiskt oljebyte beror på motortyp, körförhållanden, servicehistorik, OBD och bränslekvalitet. Se alltid tillverkarens instruktionsbok. Art.Nr. 159CAC Art.Nr. 159CAA Art.Nr. 159CAB Art.Nr. 217B1B

produktionen sker på ett reproducerbart sätt. Alla geler som produceras testas därför för att kontrollera att de upprätthåller den kvalité som krävs för produktion av läkemedel. De biologiska läkemedlen kan sorteras på olika egenskaper och för geler som separerar med

Due date of deliverable: 31.12.2012 Document identifier: docx Revision: 1_ 1 Date: 2013-04-16 . SmartAgriFood 31.12.2012 docx Page 2 of 58 The SmartAgriFood Project The SmartAgriFood project is funded in the scope of the Future Internet Public Private Partner-ship Programme (FI-PPP), as part of .