Energy diet - VLED replace 3 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 primarily from oral liquid feeds only.
Characteristics
A very restrictive diet of foods with minimal energy content, to be combined with three meal replacement supplements per day (eg Optifast® VLCD, Optislim® 2000, KicStart™ VLCD), to provide a total intake of <3360kJ (800kcal) per day. Only two cups of additional vegetables (cooked or salad) allowed per day.
Indications
Morbid obesity or overweight (BMI >27) with complications; rapid weight loss before surgery.
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 dietitian. They are not suitable for pregnant women, the elderly, or patients with porphyria, recent myocardial infarction, unstable angina, or severe renal or kidney failure.
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 (e.g. Benefibre™ 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. For patients on VLED3 for extended periods, 5-10g fat / oil per day may be included to prevent cholelithiasis and cholecystitis.
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, beetroot, broccoli, brussels sprouts, cabbage, carrots, cauliflower, Chinese vegetables, eggplant, Jerusalem artichokes, leeks, silverbeet, snow peas, spring onions, squash, zucchini, without any margarine or sauces | All others, including potato, turnip, parsnip, globe artichokes, 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 All other dressings |
| Breads, cereals | - | All |
| Spreads | 5-10g fat / oil may be included for patients on VLED3 for extended periods, eg with salads or vegetables | All others |
| Hot breakfast choices | - | All |
| Fruit | - | All |
| Yoghurt | - | All |
| Desserts | Low-joule jelly | All others |
| Milk and cheese | - | All |
| 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. |