Energy diet (high)

Aim

To provide a diet containing approximately 120% energy than can be achieved on the Full diet alone.

Characteristics

Full diet plus addition of added fats, carbohydrate, and protein to foods; availability of extra foods, extra serves and extra mid-meals. Nutritional supplements may be used. Often combined with a high-protein diet.

Typical default mid-meals:

AM: Half sandwich with protein-containing filling+ full fat milk + extra as desired

PM: Cheese and biscuits + full fat milk + extras as desired

Supper: Full fat milk + cake/muffin + extras as desired

Indications

To be used for patients requiring above normal energy intake.

• failure to thrive
• inability to eat sufficient volume (e.g. disability, may be combined with texture modified)
• oncology
• burns
• respiratory conditions
• congenital cardiac anomalies
• unintentional weight loss or decreased food intake
• in combination with other therapeutic diets which may result in a reduced energy intake (e.g. low protein).

For Cystic Fibrosis, see Energy diet - cystic fibrosis.

Nutritionally adequate.

Precautions

Dietitians may need to consider ordering high-energy nutritional supplements. An additional protein source (e.g. a boiled egg) may be offered at a main meal for people with high protein requirements.

Not to be combined with diets that restrict fat or sugar.

May be combined with high protein diet.

Not to be used for anorexia nervosa or other eating disorders in paediatrics.

Specific menu planning guidelines

	Allowed	Not allowed
Hot main dishes	All Extra serves to be available Serve with extra oil/PC margarine or butter/ high fat dressing	-
Sauces, gravies	All Include white sauces, cheese sauces	-
Starchy vegetables/pasta/rice	All High energy mashed potato made on milk and margarine	-
Vegetables	All, with added margarine	-
Soups	All to be Band 1 with at least 360kJ/serve or served with thin cream/sour cream/margarine	-
Sandwiches	All Band 1 providing at least 800kJ/serve and at least 10g protein/serve or spread with high fat spread (margarine/cream cheese/mayonnaise)	-
Salads, dressings	Salads – one Band 1 choice per day containing at least 20g protein, all others to be Band 2 providing at least 10g protein per serve and served with high fat dressing	Low fat dressings
Breads, cereals	All bread Serve with extra spread PC Cereals served with cream	-
Spreads	All Send extra 1 portion control spread with each meal	-
Hot breakfast choices	All	-
Fruit	Canned fruit in syrup + glucose/dextrose polymer available at all meals Serve all with custard, yoghurt, cream, ice-cream	-
Yoghurt	Full fat yoghurts	Low fat and diet yoghurt
Desserts	All others Offer one Band 1 choice dessert containing at least 500kJ and at least 4g protein at 2 meals per day Serve all with cream (thin, thick or double) or ice-cream	Fruit or jelly served without milk dessert, ice-cream or cream
Milk and cheese	All full fat	-
Beverages	All others	Low joule cordial, low joule soft drink
Biscuits	All, serve crackers with high fat spread	-
Miscellaneous	Extra serves and larger serves to be available Extra midmeals to be available – offer one choice per midmeal of Band 1 sandwich or Band 1 dessert among other choices Fat/glucose supplements may be added to foods and beverages Nutritional supplements as prescribed by dietitian Sugar	Sachets of artificial sweetener

References

1. Agency for Clinical Innovation. Nutrition standards for paediatric inpatients in NSW hospitals. Sydney 2011.
2. Agency for Clinical Innovation. Nutrition standards for adult inpatients in NSW hospitals. Sydney 2011.
3. Dietitians Association of Australia. 2009. Nutrition manual 8th ed. Canberra: DAA.
4. American Dietetic Association. Paediatric Nutrition Care Manual. Chicago: ADA.
5. Sydney Children’s Hospitals Network fact sheets:
   • High energy eating for infants
   • High energy eating for children
6. Shaw V and Lawson M. Clinical Paediatric Dietetics. 3rd Edition. 2007. Blackwell Publishing.