Content of the specifications
These specifications give guidance about the type and quantities of suitable foods for adult inpatients needing a range of diets in hospital. There are four broad categories of diets:
- those that restrict or eliminate particular food items (e.g. allergy or fluid diets)
- those that reduce or increase the level of particular nutrients (e.g. low-fat or high-fibre diets)
- those that quantify the level of particular nutrients (e.g. 50mmol sodium or 50g protein diets)
- those that specify the appropriate texture or presentation of food (e.g. soft- or cold-food diets).
Normal menu selection processes should accommodate other food preferences.
Some sites may have access to additional operational diets such as “early breakfast” or “fluids served in mugs” etc. These are not related to a clinical need and therefore are not included in these specifications.
For each diet, eight pieces of information are provided:
- Aim describes the broad objective of the diet with any quantitative daily targets.
- Characteristics describes the general patterns of foods used in the diet.
- Indications lists some common medical or surgical conditions for which the diet is often prescribed.
- Nutritional adequacy provides an assessment of whether the diet is adequate alone or whether it needs supplementation to be nutritionally adequate.
- Precautions gives instructions or warnings regarding use of the diet in hospitals.
- Paediatrics indicates suitability for use of these diets in paediatrics.
- Specific menu planning guidelines lists the foods allowed and not allowed on the diet.
- References gives a selection of authoritative sources supporting the diet specifications.
Use of the specifications
Diet prescription
The Diet Specifications are not designed to be used for patient education or as a resource other than to provide an appropriate diet whilst a person is an inpatient in a NSW hospital.
The Specifications do not attempt to define appropriate diets to be prescribed for individual patients. Diets must not automatically be ordered for patients with the medical or surgical indications noted in the specifications, because a very restrictive diet may prevent good nutritional recovery for patients who are undernourished or eating poorly.
Appropriate health professionals may alter the diets to meet individual patients’ needs.
Diet combinations
Combinations of diets can be ordered (e.g. low saturated fat and sodium restricted), but there is no need to specify a full diet where it is to be combined with other therapeutic diets.
Paediatrics
When combined with an age-appropriate diet, many of these diets are suitable for use in paediatrics.
The age-appropriate diet will ensure the types of foods offered, textures, serve sizes and frequency of meals are suitable for the child. If a diet specifies a nutrient amount (e.g. sodium 80-100mmol), combining it with an age appropriate diet (e.g. child 4–8 years) will provide less of the nutrient. For example, the child 4–8 years diet uses half serves, so when combined with the sodium 80 - 100mmol diet, the child will receive around 40-50mmol of sodium. These clinical judgements will need to be made by a clinical dietitian.
Some diets are not suitable for use in paediatrics due to the restriction of essential nutrients for child development. These will be noted for each diet. Please refer to the Paediatric diet specifications for additional paediatric specific diets.
Foods allowed / not allowed
In the specific menu planning guidelines, it is not possible to list all foods or recipe items that may be suitable or unsuitable. Specific guidelines and some common examples are usually included, but other foods or dishes may also be suitable or unsuitable, depending on their nutritional profile, ingredients and texture.
Trade names of some common products have been used in some cases to clarify the intention of the guidelines, but their inclusion does not imply endorsement or recommendation of these products, nor indicate that similar products are unsuitable.
These specifications are designed for patients in hospital; they are not intended as education material for patients prescribed therapeutic diets. For this reason they do not mention foods that are not normally available in hospitals, such as alcoholic beverages, takeaway foods and specialty gourmet items.
Food availability
Not all products listed as being allowed for a specific diet will be available at all sites and some foods may be reserved for use in therapeutic diets only.
Nutritional supplements
These specifications do not attempt to indicate which nutritional supplements comply with each diet, since it is assumed that a dietitian will order the type and volume of supplements according to the patient’s individual needs. In many cases, nourishing foods such as flavoured milk and yoghurt are suitable alternatives to commercial supplements.
Rare diets
These specifications cover diets commonly used across NSW public hospitals. They do not include special diets designed for research purposes or particular treatment situations. The local dietitian will need to specify those diets and communicate with the food service about feasibility and implementation.