Diet is the main way for patients to intake nutrients. Hospital patient diets, formulated based on the basic nutritional needs of the human body and the medical needs of various diseases, can be divided into basic diet, therapeutic diet, special therapeutic diet, pediatric diet, diagnostic diet, and formula diet, etc. The recipes for various diets should be designed and prepared according to the requirements of dietary regulations.
Hospital Patient Diet Guidelines
Basic Diet
This is the foundation of hospital diets, with over 50% of hospitalized patients using this diet. Most therapeutic diets are derived from the basic diet.
(1) Regular Diet
1. Characteristics: This diet is similar to a healthy person's diet and provides three meals a day, with a 4-6 hour interval between meals.
2. Indications: It is suitable for patients with normal digestive function and no fever, as well as patients in the recovery period and those undergoing physical examinations.
3. Dietary Principles:
(1) The daily supply of nutrients should meet the recommended requirements for adults in China, with 70-90 grams of protein and 2200-2600 kilocalories of total energy. The diet should be formulated based on the principle of balanced nutrition.
(2) The daily variety of food should include at least five major categories, and should be visually appealing in terms of color, aroma, taste, and shape to enhance appetite. (3) Avoid strongly spicy and stimulating foods, and minimize the use of fried and indigestible foods.
(2) Soft Diet
1. Characteristics: This is a diet between semi-liquid and regular diets. In addition to three main meals, a snack is added.
2. Indications: It is suitable for low fever, indigestion, recovery from acute enteritis, oral diseases, the elderly, or those with chewing difficulties.
3. Dietary Principles:
(1) All foods such as meat, chicken, and vegetables should be cut into small, tender pieces.
(2) Foods should be non-irritating and easy to digest. Staple foods such as steamed buns, rice porridge, noodles, and congee should be the main focus. The daily supply of nutrients should meet or be close to the recommended supply for adults in China.
(3) Avoid using deep-fried cooking methods and strong and stimulating condiments. Choose vegetables with low fiber content. Avoid or minimize the use of large pieces of meat, poultry, leeks, bean sprouts, salted fish, salted meat, and other foods that are difficult to chew and swallow.
(3) Semi-liquid Diet
1. Characteristics: This is a transitional diet between liquid, soft, and regular diets. It consists of 5-6 meals a day, with 50-60 grams of protein and 1500-2000 kilocalories of total energy.
2. Indications: It is suitable for fever, gastrointestinal diseases, post-operative patients, and those with difficulty chewing.
3. Dietary Principles:
(1) Use non-irritating semi-solid foods and have small, frequent meals, with each meal having a total volume of about 300 milliliters.
(2) All foods should be finely chopped, soft, easy to chew, and swallow.
(3) Have small, frequent meals and avoid foods with high fiber content or coarse grains that are difficult to chew and swallow.
(4) General semi-liquid diet: The food is soft and low in dietary fiber. Depending on the condition and digestive capacity, some soft meat, soft vegetables, and peeled soft fruits can be eaten. Restricted semi-liquid diet: The diet restricts fiber content more strictly, and only uses filtered vegetable soup, fruit soup, and fruit juice, without any other fruits and vegetables.
(4) Liquid Diet
1. Characteristics: The food is in liquid form and is low in calories, protein, and other nutrients. It can only be used for short-term, 1-2 days. If long-term liquid intake is needed, a formula diet should be used instead.
2. Indications: It is suitable for acute infections, high fever, post-major surgery, acute gastrointestinal inflammation, difficulty swallowing, and critically ill patients.
3. Dietary Principles:
(1) All food used must be in liquid form or can be dissolved into liquid instantly.
(2) Provide 6-7 meals a day, with each meal being 200-250 milliliters. The total energy should not exceed 1000 kilocalories, and specific patients should follow the instructions of a nutritionist.
(3) Avoid excessive saltiness or sweetness. Pay attention to the balance between acidic and alkaline foods in the diet.
(4) Adjust the content of the liquid diet according to the condition. In addition to the general liquid diet, the hospital diet also includes clear liquid, cold liquid, and sugar-free liquid to meet the needs of different conditions. They are described as follows:
A: Clear Liquid
1) Characteristics: This is a restricted liquid diet that does not contain gas-producing foods. It aims to leave the least residue in the colon, and is lighter than a general liquid diet. Taking a clear liquid diet can provide liquid, a small amount of energy, and electrolytes to prevent dehydration.
2) Indications: It is used for the transition from intravenous fluids to a full liquid or semi-liquid diet after abdominal surgery, as well as for preparation before intestinal surgery or barium enema. It can also be used as the initial oral food for acute diarrhea, mainly consisting of liquid and electrolytes, and as the initial oral nutrition for severely debilitated patients.
3) Dietary Principles: Avoid using milk, soy milk, concentrated sweeteners, and all foods that can cause gas. The quantity of each meal should not be excessive; the energy and other nutrients supplied are insufficient and can only be used for a short period of time.
B: Cold Liquid
1) Characteristics: This diet consists entirely of cold, non-irritating liquid foods.
2) Indications: It is used for the first or second day after throat surgery, such as tonsillectomy, and is also suitable for patients with upper gastrointestinal bleeding.
3) Dietary Principles: Do not use hot foods, acidic foods, or any other irritating foods to avoid causing wound bleeding or irritating the throat.
C: Sugar-Free Liquid
1) Characteristics: The sugars in this liquid diet are mainly complex sugars, and concentrated sweet foods are avoided.
2) Indications: It is used for dumping syndrome and diabetes patients.
3) Dietary Principles: The content of sugar in the liquid diet should be minimized, and concentrated sweet foods and fruit juice drinks should be avoided. Instead, steamed eggs, strained rice porridge, tofu pudding, and thick rice soup can be consumed.
Therapeutic Diet
(1) High Protein Diet
1. Characteristics: Increase the protein content in the daily diet to 15%-20% of total energy, calculated per kilogram of body weight at 1.2-2 grams per day.
2. Indications: Malnutrition caused by various reasons, pre- and post-operative patients, anemia, tuberculosis, and hypoproteinemia.
3. Dietary Principles:
(1) Provide adequate energy and increase the protein content in the diet. The total daily protein supply should be 90-120 grams, but not exceed 20% of the total calorie intake. Among them, high-quality proteins such as eggs, milk, fish, and meat should account for 1/2 to 2/3 of the total.
(2) For patients with good appetite, increase the intake of foods rich in high-quality proteins such as eggs, meat, and milk in regular meals.
(3) For patients with poor appetite, use high-protein formula preparations containing 40%-90% protein to increase the protein intake.
(2) Low Protein Diet
1. Characteristics: Control the protein content in the daily diet to reduce the accumulation of nitrogenous wastes, reduce the burden on the liver and kidneys, provide adequate energy and other nutrients to improve the patient's nutritional status to approach or achieve nitrogen balance. The protein intake should be determined based on the patient's condition and individual factors such as body weight, age, sex, blood sugar, urine sugar, presence or absence of complications, labor intensity, and activity level. The daily protein intake should be between 20-40 grams.
2. Indications: Hepatic coma, acute nephritis, acute and chronic renal insufficiency.
3. Dietary Principles:
(1) Determine the protein quantity in the daily diet based on liver and kidney function.
(2) Provide sufficient energy in the daily diet, encourage the consumption of carbohydrates, vegetables, and fruits, and use starch to replace some staple foods if necessary.
(3) For patients with impaired kidney function, choose high-quality protein such as eggs, milk, lean meat, and substitute some staple foods with wheat starch.
(4) For patients with hepatic failure, choose foods high in branched-chain amino acids and low in aromatic amino acids, mainly soybean protein, and avoid meat protein.
(5) Provide sufficient vitamins, minerals, and other nutrients.
(3) Low Fat Diet
1. Characteristics: Control the fat intake in the daily diet to improve fat metabolism and prevent diseases caused by poor fat absorption. Depending on the patient's condition, the amount of fat control varies. It can be divided into general restriction, moderate restriction, and strict restriction.
2. Indications: Hepatitis, cirrhosis, pancreatitis, gallbladder diseases, hypertension, coronary heart disease, obesity, hyperlipidemia, and other diseases related to fat absorption disorders such as diarrhea.
3. Dietary Principles:
(1) The food should be light in taste. The daily fat intake should be 20%-25% of the total energy metabolism, or 0.8 grams per kilogram of body weight per day.
(2) Limit the total fat intake and reduce the intake of saturated fatty acids. Avoid using high-cholesterol foods such as egg yolk, pork brain, animal liver, kidney, caviar, crab roe, etc.
(3) Choose oils with high content of monounsaturated fatty acids, such as tea oil, for cooking, as it helps to regulate blood lipids.
(4) Use mushrooms, black fungus, kelp, soy products, olive vegetables, and other foods that help regulate blood lipids. Increase the dietary fiber content appropriately to help reduce blood cholesterol.
(5) Limit the use of salted foods such as salted duck eggs, preserved eggs, and pickles. Avoid foods and seasonings with unknown salt content.
(6) Avoid or minimize the use of fried foods, fatty meats, lard, and other high-fat foods. Use skimmed milk, powdered milk, egg whites, fish, shrimp, poultry, fresh fruits, and vegetables instead.
(4) Low Cholesterol Diet
1. Characteristics: Control the daily intake of cholesterol to below 300 milligrams.
2. Indications: Hyperlipidemia, gallstones, hypertension, coronary heart disease, etc.
3. Dietary Principles:
(1) Control the total energy intake to maintain body weight within the normal range.
(2) Control the total fat intake and reduce the intake of saturated fatty acids. Limit the consumption of high-cholesterol foods such as egg yolk, pork brain, animal liver, kidney, and fish roe.
(3) Use oils for cooking with high content of monounsaturated fatty acids, such as tea oil, to help adjust blood lipids.
(4) Use foods such as mushrooms, black fungus, kelp, soy products, and olive vegetables that help regulate blood lipids. Increase the dietary fiber content appropriately to help lower blood cholesterol levels.
(5) Limit the intake of salt to less than 3 grams per day. Weigh the salt used in cooking with a scale before adding it to the food. Use vinegar and sugar as seasonings to adjust the taste.
(6) Calculate the sodium content in foods with known salt content. Prepare the food according to the calculated weight and adjust the nutritional formula according to the clinical condition.
(5) Low Salt Diet
1. Characteristics: Control the daily intake of salt, with a total intake of sodium not exceeding 2000 milligrams.
2. Indications: Heart failure, hypertension, acute nephritis, preeclampsia, and various conditions that cause water retention.
3. Dietary Principles:
(1) The daily intake of salt should not exceed 3 grams. The specific salt content in the daily diet should be determined based on the patient's condition. For patients with significant ascites, the salt intake should be 1 gram per day, and for general hypertension, 3 grams per day.
(2) Weigh the salt used in cooking with a scale before preparing and cooking the food. As a taste adjustment, vinegar and sugar can be used for cooking.
(3) Prepare the food with a known salt content and weigh it accordingly. Provide other nutrients according to normal needs.
(4) Avoid all salted foods such as salted duck eggs, preserved eggs, and pickles. Avoid foods and seasonings with unknown salt content.
(6) Salt-Free Diet
1. Characteristics: Avoid adding salt, soy sauce, and other sodium-containing condiments to the food during preparation. The total sodium intake is limited to less than 1000 milligrams.
2. Indications: Same as low salt diet, but for more severe cases.
3. Dietary Principles:
(1) Generally used for a short period of time.
(2) Avoid all foods and pickled products that contain salt. Avoid using salt and high-salt condiments during food preparation.
(3) Observe the patient's blood sodium level during use to prevent hyponatremia. If necessary, use a small amount of potassium salt soy sauce instead of salt.
(7) Low Residue Diet
1. Characteristics: Limit the intake of dietary fiber in order to reduce the stimulation of the digestive tract and the volume of feces.
2. Indications: Diarrhea, recovery period of enteritis, typhoid fever, anal tumors, throat and digestive tract surgery, gastrointestinal bleeding, esophageal varices, and colon allergies.
3. Dietary Principles:
(1) All foods should be cut into small, tender pieces. Vegetables should be mashed after removing the coarse fiber. A low-fat diet should also be provided.
(2) Choose refined grains such as white rice and fine flour as staple foods, and avoid coarse grains, large pieces of meat, fried foods, and strongly flavored condiments. Avoid or minimize the use of whole grains, bean sprouts, celery, leeks, pineapples, and other foods that are difficult to chew and swallow.
(3) Have small, frequent meals, and follow a low-residue or soft rice diet depending on the patient's condition.
(8) High Fiber Diet
1. Characteristics: Increase the dietary fiber content to at least 25 grams per day. The purpose is to increase the volume and weight of feces, stimulate intestinal peristalsis, reduce the pressure in the intestinal lumen, and increase the excretion of bile acids and harmful substances in the intestines.
2. Indications: Constipation, diabetes, obesity, post-anal surgery recovery period, cardiovascular disease, etc.
3. Dietary Principles:
(1) Increase the intake of foods rich in dietary fiber. The total daily intake should be above 20 grams.
(2) Encourage the patient to drink plenty of water, with a minimum of 6-8 cups per day. Drinking plain saltwater or warm water on an empty stomach can stimulate intestinal peristalsis.
(3) Limit the intake of refined foods and avoid strong seasonings.
(4) If it is difficult to increase dietary fiber in the diet, commercial dietary fiber formulas can be used if conditions permit.
(9) High-Calorie Diet
1. Characteristics: The daily energy supply should be above 35 kilocalories per kilogram of body weight, with a total energy intake of above 2000 kilocalories. This diet aims to meet the nutritional needs of malnourished and high metabolic patients, prevent and delay the occurrence of complications, provide patients with adequate nutrition, and improve their quality of life.
2. Indications: Low body weight, anemia, tuberculosis, typhoid fever, hyperthyroidism, recovery period of illness, etc.
3. Dietary Principles:
(1) Increase food intake for patients who cannot meet their energy needs. Increase the amount of easily appetizing dishes as much as possible.
(2) In addition to regular meals, additional high-energy foods or increased meal frequency can be used to increase energy intake.
(3) For patients with poor appetite, partially replace regular meals with high-energy nutritional supplements or enteral nutrition to increase overall energy and nutrient intake.
(10) Postpartum Diet
1. Characteristics: High energy, high protein, and more soups.
2. Indications: Lactating mothers.
3. Dietary Principles:
(1) Provide sufficient energy, protein, minerals such as calcium, phosphorus, iron, copper, and vitamins. Daily protein intake should be 100-120 grams, fat 80-90 grams, and carbohydrates 400-500 grams.
(2) Drink plenty of water. In addition to the three main meals, add soup 1-2 times a day.
(11) Low Iodine Diet
1. Characteristics: Limit the daily intake of iodine to below 50 micrograms.
2. Indications: Thyroid goiter.
3. Dietary Principles:
(1) Avoid or consume less iodine-rich foods such as seafood.
(2) Do not use iodized salt or drink high iodine water.
(12) High Potassium Diet
1. Characteristics: This diet has a hypotensive effect.
2. Indications: Hypokalemia.
3. Dietary Principles:
(1) To prevent hypokalemia, the daily potassium intake should be no less than 3120 milligrams. Adjust the potassium and sodium intake based on blood potassium and sodium levels.
(2) Choose protein-rich lean meat, fish, shrimp, and beans (except for low-protein diets); coarse grains, fresh fruits, and vegetables; and meat soup, vegetable soup, and fresh fruit juice.
(13) Low Potassium Diet
1. Characteristics: Limit foods high in potassium.
2. Indications: Hyperkalemia.
3. Dietary Principles:
(1) Do not use or limit the intake of high-potassium foods. This includes dried beans, foods high in dietary fiber, chili, and other stimulating foods.
(2) Limit or avoid high-protein foods such as lean meat, fish, shrimp, and poultry, as well as concentrated meat and vegetable soups and fruit juices. Choose foods with less than 250 milligrams of potassium. Soak or boil foods in water to reduce potassium content.
(14) Low Phosphorus Diet
1. Characteristics: Limit the daily intake of phosphorus to below 500 milligrams.
2. Indications: Renal failure, hyperphosphatemia, and uric acid stones.
3. Dietary Principles:
(1) Avoid or consume less foods high in phosphorus, such as dried beans, lean meats, eggs, duck eggs, fish, and nuts.
(2) Control the intake of phosphorus-containing foods, weigh the food before cooking, and adjust according to the patient's need.
(15) Vegetarian Diet
1. Characteristics: Avoid all meat products.
2. Indications: Buddhism, severe hypertension, hyperlipidemia, etc.
3. Dietary Principles:
(1) Guarantee adequate energy supply. Choose plant-based protein and oil, and consume more fruits, fresh vegetables, beans, and soy products.
(2) Avoid animal foods and animal fats, and cook separately.
(16) Hui Ethnic Diet
1. Characteristics: Prohibit the consumption of pork products.
2. Indications: Hui ethnic group.
3. Dietary Principles:
(1) Avoid pork, pork offal, and pork
