Available Diet Orders at the University of Michigan Health ...

University of Michigan Health System
Patient Food and Nutrition Services

Available Diet Orders at the University of Michigan Health Systems

Diet Order Purpose & Indications General Description & Principles Further Details
General Diet
General Pediatric When no dietary modification is No dietary restrictions. N/A
Diet needed and solid foods can be
tolerated. Dietary restrictions based on age N/A
Anti-Dumping Diet limitations.
When no dietary modification is Nutrition Care Manual
Bariatric Diet needed but restrictions indicated This diet does not allow foods high
based on age limitations. in sugar and liquids will be provided
Bland Diet separate from meals. Smaller,
Used post-gastric surgery for more frequent meals are
patients exhibiting symptoms of encouraged.
dumping syndrome (nausea,
vomiting, diarrhea, etc) following
PO intake.

There are four diets that fall under All the diets have the following Nutrition Care Manual
the bariatric diet, each is a stepwise restrictions: no concentrated
progression to a discharge diet. sweets, low-fat, no caffeine, no N/A
These restrictions are placed to carbonated beverages and no
facilitate weight loss and straws.
maintenance, to avoid dehydration,
and to avoid distention of the gastric
pouch.

The bland diet is designed to avoid The bland diet consists of foods that
irritation of the gastrointestinal tract. are easily digestible and mildly
It is appropriate for people with seasoned. Fried foods, highly
peptic ulcer disease, chronic seasoned foods and most raw or
gastritis, reflux esophagitis or gas-forming fruits and vegetables
dyspepsia. are eliminated.

Revised 9/06 1

University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details

BRAT Diet This diet is typically used for A bland diet consisting of ripe N/A
Calorie Controlled controlling diarrhea and provides Bananas, Rice, Applesauce, and N/A
Diet low fiber, low residue foods that are Toast. This diet is intended for a
easier for the intestines to digest. very short duration (3 days or less)
due to nutritional inadequacies.
Used to promote weight loss.
This diet allows all foods but limits
total calorie intake to the designated
amount.

Cardiac Diet This diet order is typical for patients Limits red meat, cheese, whole N/A
with cardiovascular illnesses. Its milk, butter, and egg yolks, as well
Low Cholesterol purpose is to reduce serum as high sodium foods and N/A
Diet cholesterol and lipid levels, to avoid condiments. It promotes whole N/A
and prevent excessive sodium grains, beans, vegetables and
Clear Liquid Diet intake and to reduce heart disease fruits. 2
Revised 9/06 risk. This diet controls for total
dietary fat, saturated fat, cholesterol
and salt (3-4 gm sodium/day).

To reduce serum cholesterol and This diet limits cholesterol intake to
lipid levels, usually combined with a 200-300 mg/day by limiting red
low fat diet restriction. Used meat, cheese, whole milk, butter
commonly with hyperlipidemia, CAD and egg yolks.
and other cardiovascular illnesses.

This diet is used for pre-op and Allows visually clear and minimum
immediately post-op situations, or residue liquids. Intended for a very
for acute episodes of nausea and short durations (3 days or less) due
vomiting to promote bowel rest. to nutritional inadequacies.

University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details

Consistent To provide consistent A specified number of Nutrition Care Manual
Carbohydrate carbohydrates, based on patient carbohydrates, based on age, will
age, at meals and an HS snack to be provided at each meal without a
aid in glucose management. specific total calorie level goal to
ensure consistent carbohydrate
intake, simulating a carbohydrate
counting diet.

Dysphagia Diets To decrease the risk of aspiration There are four levels of this diet. Nutrition Care Manual
related to neurological, Each requires both a diet level and
neuromuscular or other etiology of liquid consistency to be designated
swallowing impairment. Prescribed to be a valid diet order. Level 1 –
by Speech Pathologist after a Provides pureed food/meats. Level
swallow evaluation has been 2 – Provides ground meats. Level 3
conducted. – Equivalent to Mechanical Soft
diet. Level 4 – This is a general diet
but still requires a liquid consistency
per Speech Pathology
recommendations.

Eating Disorder Diet The eating disorder diet is indicated This diet is calorie controlled, with N/A
for individuals diagnosed according increases in calories periodically to
to the Diagnostic Statistical Criteria goal and typically 4 meals/day.
(DSM-IV) with anorexia nervosa,
bulimia nervosa or an eating
disorder not otherwise specified and
treated in the University of Michigan
Eating Disorder Program.

Revised 9/06 3

University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details

Low Fat Diet (60 The fat-restricted diet is indicated Lower fat menu items are provided Nutrition Care Manual
gm/day) for individuals with maldigestion, in place of full fat items. Nutrition Care Manual
High Fiber Diet - malabsorption and disorders in Nutrition Care Manual
High Residue transport of dietary lipids. To Focuses on whole grains, beans,
Low Fiber Diet - provide no more than 60 gm fat/day vegetables and fruits to increase
Low Residue for malabsorption issues related to fiber content of diet.
GI disease, pancreatitis, and some
types of liver disease. Limits use of whole grains, beans,
vegetables and fruits to lower fiber
Used for certain GI conditions to content of diet.
promote gut health.

Used for certain GI conditions when
high fiber diets can aggravate
symptoms.

Fluid Restricted Diet This diet is used for patients with Total amount of fluid (including IVF, N/A
edema and fluid control issues such fluid taken with medication pushes,
as kidney disease, CHF, etc. mealtime/snack time PO intake, etc)
is recorded to not exceed
designated level. If no kitchen fluid
restrictions indicated, ½ of total
daily allotment will be allowed by
the kitchen. Note: the fluid content
of solid foods are not included in the
estimation of total fluid intake.

Revised 9/06 4

University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details
Full Liquid Diet
Gluten Free Diet To limit solid foods when digestion Allows any liquids or liquidifed N/A
may be compromised. For post-op foods. Also permits smooth, N/A
GVHD#1 transition from clear liquids to solid strained foods of pudding
GVHD#2 foods, for severe GI strictures, or for consistency. N/A
wired jaw conditions.

This diet is for gluten sensitive A diet free of products containing
individuals or those individuals gluten (wheat, barley, and rye).
diagnosed as having Celiac
Disease.

This is the initial diet for patients Foods are included one at a time to
who have developed Graft versus check for tolerance and start with
Host Disease of the gastrointestinal foods such as broth, Pedialyte, Jell-
tract. The foods allowed on this diet O, and popsicles.
are low in acid, fat, lactose,
caffeine, and fiber to minimize GI
irritation and promote wound
healing.

This diet is for patients with Graft This selective diet provides foods Nutrition Care Manual
versus Host Disease of the moderately low in indigestible
gastrointestinal tract who have carbohydrates, and restricted fat
tolerated the limited GVHD #1 diet and lactose. New foods are added
without worsening GI symptoms. one at a time to check for tolerance.

Revised 9/06 5

University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details
High Calorie, High Foods that are high in protein and
Protein For use with patient who have calories are provided, such as Nutrition Care Manual
Ketogenic Diet failure to thrive, significant weight whole milk, ice cream, butter, Nutrition Care Manual
loss or poor appetite/PO for peanut butter, etc. This diet should
Kosher Diet extended period of time. be accompanied by a "nutrition
supplement of choice" order.
Used with some patients for the
treatment of epilepsy. The dietary It is a diet very high in fats and low
restriction of this diet makes the in carbohydrates.
body burn fat for energy instead of
glucose.

A kosher diet is indicated for The University of Michigan Medical N/A
individuals of Jewish faith who Center does not have a kosher food
adhere to the Jewish dietary laws, service. The following options are
known as Kashruth. This diet order offered to individuals who wish to
will provide the patient with keep kosher while in the hospital:
specially prepared meals that fit commercially prepared kosher
standard Kosher guidelines. dinners, disposable dishes and
flatware, and assistance with menu
selections.

Lactose Restricted This diet is for individuals who are Lactose free milk products, such as N/A
Diet lactose intolerant or whom lactose Lactaid milk, and milk alternatives,
is temporarily restricted for GI such as soy milk, are provided in
related issues. place of lactose containing foods.

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University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details
N/A
MCHC Room Currently Room Service is only N/A N/A
Service Patient available in MCHC. If a patient is N/A
Requires Menu unable to use the Room Service It consists of foods which are
Assistance phone in menu ordering, this diet minced, chopped, or ground
order will ensure a member of the according to individual need.
Mechanical Soft Room Service staff will come assist
Diet the patient in ordering food It excludes fresh fruits and
preferences. vegetables, with the exception of
Modified Microbial bananas, oranges and apples
Diet The mechanical soft diet is (assuming each will be peeled).
indicated for individuals who have Hot and cold foods should be eaten
difficulty with mastication due to within 1-2 hours of tray delivery,
conditions such as absence of otherwise these foods should be
teeth, loose dentures, and sore discarded. Other foods with high
gums. It may be useful for microbial content are also excluded.
individuals with varices,
inflammation or strictures of the
esophagus, and following radiation
therapy to the oral, pharyngeal, or
laryngeal areas.

This diet is indicated for patients
with suppressed immune function or
neutropenia (an absolute neutrophil
count below 1000/mm3). Its goal
is to decrease the amount of
bacteria in the diet since a food
product with a high microbial count
may lead to colonization of the
gastrointestinal tract, thereby
increasing the risk of developing an
infection.

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University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details

Mushy Soft, 6 Small This diet is intended for patients The diet is designed to eliminate N/A
Meals who are post-esophogectomy. The foods that might be too coarse to N/A
diet consistency is modified for pass through a partially obstructed
comfort and to reduce blockage esophagus or healing esophageal
post surgery, as well as more anastomosis. Carbonated
providing smaller, more frequent beverages are avoided to minimize
meals. intrathoracic gastric distention.

No Fat Diet This diet is used for chyle Fat-free options of standard foods
leaks/chylous effusions. will be provided as available. MCT
oil may be needed to provide
essential fatty acids and meet
caloric needs.

Low Phosphorus This diet is typically part of a renal It restricts intake of high N/A
Diet diet order but is also used with any phosphorus foods such as milk
individual with elevated phosphorus products, poultry, fish, meat, eggs,
levels resulting from dietary intake grains and legumes.
of phosphorus. It restricts intake of
high phosphorus foods such as milk
products, poultry, fish, meat, eggs,
grains and legumes.

Revised 9/06 8

University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details

Potassium This diet is typically used with the High potassium foods are restricted, Nutrition Care Manual
Restricted Diet renal population, but is also used degree of restriction is dictated by
with any individual with elevated designated mEq/day level. Foods
Protein Restricted potassium levels resulting from that are restricted include bran
Diet dietary intake of potassium. There flakes, dried beans and peas, nuts,
are three levels of restriction milk, and several fruits and
available with 80 mEq/day being the vegetables.
most liberal and 60 mEq/d being the
most restrictive.

Dietary protein modifications may Protein restriction should be based N/A
be indicated for individuals who on a dietitian’s recommendations to
have renal failure or hepatic ensure nutrition needs. Fifty
encephalopathy. Nutritional percent of the protein intake should
management will depend on the be of high-biological value protein
type and stage of the disease. (i.e. eggs, meat, milk), to ensure
sufficient intake of essential amino
acids.

Pureed Diet A pureed diet is indicated for The pureed diet consists of liquid Nutrition Care Manual
individuals who are unable to chew and semi-liquid foods. Individual
Renal Diet solid foods related to poorly fitting food tolerances must be considered Nutrition Care Manual
Revised 9/06 dentures, mouth or throat pain, etc. in food selection. The individual’s
The foods included in the pureed condition should determine the 9
diet require no mastication. restrictions of the diet.

A renal diet is intended for This diet limits foods and
individuals with impaired renal condiments high in sodium, as well
function and entails the following as bran, dried bean and peas, nuts
restrictions: 70 mEq potassium, no and several fruits and vegetables.
added salt, low phosphorus diet.

University of Michigan Health System
Patient Food and Nutrition Services

Diet Order Purpose & Indications General Description & Principles Further Details

Soft Diet To decrease peristalsis and limit Includes easily digestible foods Nutrition Care Manual
Sodium Restricted stimulation of the GI tract, typically there are low fiber, mildly seasoned, Nutrition Care Manual
Diet used with PUD and GERD. Often and tender. Omits caffeine and
Tonsil and used as a transitional diet after alcohol. N/A
Adenoids Diet surgery, as well.
Nutrition Care Manual
Vegetarian Diet Indicated for individuals with Restricts foods high in sodium
hypertension or fluid retention often (cured, processed) and eliminated
Wired Jaw Diet resulting from cardiovascular, renal high sodium condiments (salt, soy
or liver disease. sauce, MSG). Note: No added salt
diet provides ~3-4 gm Na/day.

For use with patient who have had Usually a diet advancement from
recent tonsillectomy and/or clear liquid diet to general as
adenoidectomy. tolerated, with no red dyes or red
foods allowed.

Vegetarian diets are used by Dietary restrictions based on
individuals who abstain from eating patients own restrictive practices.
all or specific foods of animal origin. Meat alternatives and soy products
are provided in place of meat and
dairy.

Indicated for individuals who have This diet is a liquid or liquefied diet. N/A
had jaw reconstruction, traumatic Six to eight small liquid meals per
injury with fixation, day are encouraged to provide
temporomandibular joint (TMJ) sufficient intake of energy, nutrients,
repair, or surgical resection of the and fluids. An energy-dense, high-
jaw for treatment of head and neck protein liquid supplement should be
cancer, and are unable to chew included daily
while the jaws are immobilized or
until the surgical site heals.

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