Protein diet - high
This document is part of the ACI Diet Specifications for Paediatric Inpatients. It is not to be used for patient education.
Aim
To provide a diet containing approximately 120% protein (average 15g extra per day) than can be achieved on the full diet alone. This diet also provides approximately 125% energy of the full diet.
Characteristics
Full diet plus addition of extra high protein foods and supplements. Often combined with a high energy diet. Extra serves and large serves to be available. Mid meals should contain protein.
Mid-meals:
- AM: Half protein containing sandwich + full fat protein enriched milk + extra as desired
- PM: Cheese and biscuits + full fat protein enriched milk + extras as desired
- Supper: Yoghurt + extras as desired
Milk-based desserts should be available at both lunch and dinner.
Indications
- weight loss or decreased food intake
- protein energy malnutrition
- failure to thrive
- inability to eat sufficient volume (e.g. disability, may be combined with texture modified)
- oncology
- burns
- respiratory conditions
- congenital cardiac anomalies
- liver failure.
For Cystic Fibrosis, see separate CF diet.
Nutritional adequacy
Nutritionally adequate.
Precautions
Dietitians may need to order high-protein nutritional supplements.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | All Extra serves to be available Add cheese to main dishes where appropriate | - |
| Sauces, gravies | All Include white sauces/cheese sauces | - |
| Starchy vegetables/pasta/rice | All. High-protein mashed potato made with skim milk powder and milk and/or cheese topping | - |
| Vegetables | All | - |
| Soups | Cream soups, high-protein soups made on milk and added skim milk powder Offer Band 1 soup containing at least 5g protein at 2 meals per day | Clear soups |
| Sandwiches | All with protein containing filling such as meat, chicken, fish, eggs, cheese or peanut butter All Band 1 sandwiches providing at least 10g protein per serve | - |
| Salads, dressings | One Band 1 salad per day containing at least 20g protein, all others to be Band 2 providing at least 10g protein per serve | - |
| Breads, cereals | All | - |
| Spreads | All | - |
| Hot breakfast choices | All to contain protein (e.g. eggs, baked beans, bacon, sausage) | - |
| Fruit | All fruit Preferably served with yoghurt or custard | - |
| Yoghurt | All | - |
| Desserts | All others High-protein custards made on milk and skim milk powder/egg Offer one Band 1 dessert at 2 meals per day | Fruit or jelly served without milk dessert, ice-cream |
| Milk and cheese | All Fortify milk with skim milk powder Offer milk drink with every meal and at mid-meals All cheeses | - |
| Beverages | All | - |
| Biscuits | All | - |
| Miscellaneous | One choice per midmeal to contain protein (e.g. cheese/Band 1 dessert/milk/Band 1 sandwich) Extra midmeals to be available High-protein nutritional supplements Sugar | - |
References
- Agency for Clinical Innovation. Nutrition standards for paediatric inpatients in NSW hospitals. Sydney 2011.
- Agency for Clinical Innovation. Nutrition standards for adult inpatients in NSW hospitals. Sydney 2011.
- Dietitians Association of Australia. 2009. Nutrition Manual 8th ed. Canberra: DAA.
- American Dietetic Association. Paediatric Nutrition Care Manual. Chicago: ADA.
- Iowa Dietetic Association. 2007. Simplified Dietetic Manual. 10th edition. Ames: Blackwell.
- Sydney Children’s Hospital Network factsheets: High Energy Eating for Infants and High Energy Eating for Children.
- Shaw V and Lawson M. 2007. Clinical Paediatric Dietetics. 3rd Edition. Blackwell Publishing.