Fact sheetDiet specifications

Published on 1 Nov 2012


Energy diet (low) - weight management

This document is part of the ACI Diet Specifications for Paediatric Inpatients. It is not to be used for patient education.

Aim

To provide an energy-controlled diet with a wide variety of foods that will allow steady weight loss or prevent weight gain in low activity patients. For children over the age of 2 years only.

Characteristics

Foods should be low or reduced fat, low energy and may include artificial sweeteners. Low Glycemic Index (GI) foods should be included in every meal.

Target energy will depend on individual dietetic assessment and age of child as determined by the on-site clinical dietitian.

Aim for the following macronutrient distribution:

Carbohydrate: 45-50%E; Fat: <30%E (<10% energy from saturated fat); Protein: 20%E

A structured meal plan is recommended, to be planned by the dietitian according to patients’ individual needs. Intake should be regular and spread evenly through the day in appropriate serve sizes.

Midmeals to contain 1 serve protein containing food. Examples include:

  • low fat cheese
  • reduced fat yoghurt
  • ½ lean meat sandwich with poly- or monounsaturated spread
  • low fat milk.

Indications

For patients requiring a low energy diet for:

  • overweight and obesity
  • low activity patients (e.g. spinal injury)
  • increased appetite due to medications (e.g. mental health patients).

Nutritional adequacy

Nutritionally adequate.

Precautions

Dietitians may manipulate diet selections to individualise total energy prescription. Note this diet is not suitable for children under 2 years of age.

Specific menu planning guidelines

Allowed Not allowed
Hot main dishes

Main dishes ≤30% energy from total fat and ≤10% energy from saturated fat

Lean meat, skinless chicken, fish, eggs

Soy products (e.g. tofu, TVP)

Cooked legumes

Fried foods and dishes in cream sauces

High fat meats (e.g. sausages, bacon)

Pies and pastries

Sauces, gravies

Vinegar, tomato sauce, small serve low fat gravy

White sauces, sour cream
Starchy vegetables/pasta/rice

All without added fat or < 1g fat per serve

Small amounts of mono- or polyunsaturated oil (e.g. mashed and steamed potato, sweet potato)

Use low GI rice (e.g. basmati or doongara) if possible (see GI website for full list)

Single serves of pasta, rice, noodles

Fried and chipped potatoes

Fried rice

Vegetables

All without added fat

Steamed/boiled in water, stewed/baked without using fat

Fried, or served with margarine or white/cheese sauces

Soups

All with < 2g fat per serve (e.g. clear and low fat soups)

Clear, vegetable and low fat soups

Cream soups
Sandwiches

All with < 8g fat per serve

Salad vegetables/cottage cheese/ricotta

Tuna/lean meats/egg white

Wholemeal/wholegrain (low GI varieties) bread default

Spreads to be mono- or polyunsaturated margarines (max 1 portion per 2 slices of bread)

Peanut butter, cheese

High fat meats, salmon

Salads, dressings

< 2g fat per serve

Low fat or low joule dressing

Cream, mayonnaise or full fat dressing
Breads, cereals

All breads, preferably wholemeal/wholegrain (low GI varieties)

Rolled oats made on water

Higher fibre breakfast cereals only (e.g. rolled oats, muesli, bran cereals, Guardian®, Weet-Bix™).

At least 2 low GI cereal choices per breakfast (See GI website for full list)

Highly sugared breakfast cereals (> 30% sugar, unless primarily from added fruit)

Sweet breads

Spreads

Mono- or polyunsaturated margarine (max 1 portion per 2 slices)

Honey, jam, Vegemite™, peanut butter (portion controlled/slice)

Saturated fats (e.g. butter, shortening, lard, cooking margarine, coconut milk, palm oil)
Hot breakfast choices

Baked beans, spaghetti, mushrooms, boiled/ poached egg, scrambled egg using low fat milk

Fried egg, bacon, sausages

Hash browns

Fruit

All fresh and canned fruit in juice/water

Dried fruit, fruit canned in syrup

Juice

Yoghurt

Low fat and diet yoghurts

Full-fat yoghurt

Desserts

All with <2 g fat per serve

Low-fat dairy desserts, low-joule jelly

Low fat ice-cream (maximum 2 times per week)

Cakes and pastries, sugared jelly, cream

Full-fat ice-cream and toppings

Milk and cheese

All reduced fat dairy

Low fat milk

Ricotta or cottage cheese

Full fat milk

Hard cheese

Beverages

Water

Reduced fat milk

Reduced fat soy beverage

Low joule cordial or soft drinks

Full fat or flavoured milk

Cordial, soft drink

Juice

Biscuits

<2g fat per serve

Corn, rice cakes, crackers, wafers

All others
Miscellaneous

Lemon wedge

All midmeals to contain at least 1 protein containing food

1 sachet artificial sweetener per meal for children >13 years

Sugar sachet

Artificial sweetener sachets for children <13 years of age

Nuts, chocolate, chips

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. American Diabetes Association: Clinical recommendations for people with diabetes. 2008
  6. Thomas DE, Elliott EJ, Baur L Low glycaemic index or low glycaemic load diets for overweight and obesity (review); The Cochrane Collaboration and published in The Cochrane Library Issue 3, 2007.
  7. Luttikhuis HO et al Interventions for treating obesity in children The Cochrane Library Issue 2 2008
  8. Sydney Children’s Hospitals Network fact sheets:
  9. Shaw V and Lawson M. Clinical Paediatric Dietetics. 3rd Edition. 2007. Blackwell Publishing.
  10. University of Sydney Glycemic Index.
  11. Diabetes Australia Glycaemic Index.
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