Energy diet - VLED replace 2 meals
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To provide a very low-energy diet (VLED) with nutritional intake from two oral liquid feeds and one low-energy meal only (at breakfast).
Characteristics
A very restrictive diet of foods with a low energy content, to be combined with two meal replacement supplements per day (eg Optifast® VLCD, Optislim® 2000, KicStart™ VLCD), to provide a total intake of <5000kJ (1200kcal) per day. One breakfast meal (cereal + low-fat milk, one egg, one slice toast) plus two cups of additional vegetables (cooked or salad) are allowed per day.
Indications
Morbid obesity or overweight (BMI >27) with complications.
Nutritional adequacy
This diet may not be nutritionally adequate. Check with a dietitian.
Precautions
VLEDs must be ordered and supervised by a medical officer and a dietitian. An additional two litres of water should be consumed daily (part of this allowance may be replaced by low-calorie soft drink). Nil to eat at mid-meals. A fibre supplement (eg Benefiber™ or Metamucil™) may be required to maintain normal bowel function. Depending on individual requirements, additional protein may be required to maintain skin integrity and lean tissue.
Paediatrics
Not suitable for use in paediatrics.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | - | All |
| Sauces, gravies | - | All |
| Starchy vegetables / pasta / rice | - | All |
| Vegetables | Steamed / boiled asparagus, beans, broccoli, brussels sprouts, cabbage, carrots, cauliflower, silverbeet, snow peas, squash, zucchini, without any margarine or sauces | All others, including corn, green peas, legumes, pumpkin, sweet potato |
| Soups | Clear soups only | All others |
| Sandwiches | - | All |
| Salads, dressings | Side salad (including any of: celery, capsicum, carrots, cucumber, lettuce, mushrooms, onions, radish, sprouts, tomato) with low-joule dressing | All other salad vegetables |
| Breads, cereals | One slice wholemeal toast at breakfast One serve high-fibre breakfast cereal | All others |
| Spreads | - | All |
| Hot breakfast choices | One boiled or poached egg | All others |
| Fruit | - | All |
| Yoghurt | - | All |
| Desserts | Low-joule jelly | All others |
| Milk and cheese | 150ml low-fat milk at breakfast | All other milk and cheeses |
| Beverages | Black tea and coffee Low-joule cordial or soft drink | All others |
| Biscuits | - | All |
| Miscellaneous |
Artificial sweetener, lemon wedge, salt and pepper
Herbs and spices | Sugar portions, alcohol |
References
- Bereznicki L. Very-low calorie diets: a review of the evidence. Aust Pharmacist 2008;27:724-7. 2
- Delbridge E, Proietto J. State of the science: VLED (very low energy diet) for obesity. Asia Pac J Clin Nutr 2006;15 Suppl:49-54.
- National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults. Canberra: NHMRC; 2003.
- Nestle Australia. Optifast VLCD. Additional allowances.
- Optislim.
Getting started. - KicStart. About KicStart VLCD.
Change log
April 2022
| Section updated | Change |
|---|---|
| Nutritional adequacy | Deleted Nutritionally adequate |
| Added This diet may not be nutritionally adequate. Check with a dietitian. |