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              Diet Manual for Long-Term Care Residents 
                        2014 Revision 
           
           
           
       The Office of Health Care Quality is pleased to release the latest revision of the Diet Manual for 
       Long-Term Care Residents. This manual is a premier publication—serving as a resource for 
       providers, health care facilities, caregivers and families across the nation.  
        
       In long-term care facilities, meeting nutritional requirements is not as easy as it sounds. It is 
       important to provide a wide variety of food choices that satisfy each resident’s physical, ethnic, 
       cultural, and social needs and preferences. These considerations could last for months or even 
       years. Effective nutritional planning, as well as service of attractive, tasty, well-prepared food 
       can greatly enhance the quality of life for long-term care residents.   
        
       The Diet Manual for Long Term Care Residents was conceived and developed to provide 
       guidance and assistance to nursing home personnel.  It has also been used successfully in 
       community health programs, chronic rehabilitation, and assisted living programs. It serves as a 
       guide in prescribing diets, an aid in planning regular and therapeutic diet menus, and as a 
       reference for developing recipes and preparing diets.  
        
       The publication is not intended to be a nutrition-care manual or a substitute for individualized 
       judgment of a qualified professional. Also included, is an appendix that contains valuable 
       information to assess residents’ nutritional status. 
        
       On behalf of the entire OHCQ agency, I would like to thank the nutrition experts who 
       volunteered countless hours to produce this valuable tool. We also appreciate Beth Bremner and 
       Cheryl Cook for typing the manual. The full committee includes: 
           
                      Committee Chairs 
                    Beth Bremner and Jan Madden 
                            
                     Committee Members 
       Heather Albertson, Pat Cierniak, Blenda Eckert, Nancy Ferrone, Anita Gathogo, Angela Lang, 
       Jonine Natale, Siony Placiente, Jean Smith, Tim Smith-Kayode, Joan Todd and Becky Weavil. 
                            
                            
                            
                            
                            
                            
       Patricia Tomsko Nay, MD, CMD, CHCQM, FAAFP, FAIHQ, FAAHPM 
       Executive Director and Acting Medical Director 
        
           
        
        
        
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               Diet Manual 2014 Revision   
                
               Table of Contents 
                
               Regular Diet                                                                          5-7 
               Mechanical Soft (Dental Diet)                                                         8-10 
               Dysphagia Level 1 (Pureed Diet                                                        11-14 
               Dysphagia Level 2 (Mechanically Altered Diet)                                         15-19 
               Dysphagia Advanced Level 3 Diet                                                       20-23 
               Full Liquid Diet                                                                      24-26 
               Clear Liquid Diet                                                                     27-28 
               Restricted Fiber Diet / Restricted Residue Diet                                       29-30 
               Increased Fiber Diet                                                                  31-33 
               Pleasure Feedings                                                                     34 
               Small Regular and Large Portion Sizes                                                 35 
               Small Portions Diet                                                                   36-37 
               Large Portion Diet                                                                    38      
               Vegetarian Diet                                                                       39-41 
               Lacto-Ovovegetarian Meal Plan                                                         42 
               Vegan Meal Plan                                                                       43 
               No Added Salt Diet                                                                    44 
               Low Sodium Diet (2 – 4 grams)                                                         45 
               Cholesterol Restricted and Fat Controlled Diet                                        46-49 
               Limited K+ Diet & Liberalized Renal Diet                                              50 
               Renal Diet                                                                            51-53 
               Potassium Containing Foods (over 300 mg K+ per serving)                               54-63 
               Renal Diet High Phosphorus Foods                                                      64 
               Renal Diet Continued                                                                  65      
               Simplified Guideline for Standard Carbohydrate Controlled Diet                        66-67 
               Carbohydrate Controlled Diet                                                          68-95 
               Calorie Restricted (Low Calorie) Diet                                                 96 
               Limited Concentrated Sweets (LCS) Diet                                                97-99 
               Diabetic Diet Calculated                                                              100 
               Lactose Reduced Diet                                                                  101-102 
               Kosher Diet                                                                           103-107 
               Enteral Nutrition                                                                     108-110 
               Parenteral Nutrition                                                                  111-113 
               Gluten Free Diet                                                                      114-118 
               Finger Food Diet                                                                      119-122 
               Thickened Liquids                                                                     123 
                
                
                
                
                
                
                
                
                
                
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             Appendix 
                    Estimated Calorie Needs Method I                                      124-125 
                    Estimated Calorie Needs Method II                                     126 
                    Estimated Protein Needs                                               127-128 
                    Miffin – St. Jeor Equation and Cheat Sheet                            129 
                    Estimated Fluid Needs/Serum Osmolality                                130-131 
                    Estimated Height                                                      132 
                    Nutrition Assessment Guidelines: When adjustments are required        133 
                    Calculation Metabolically Active Weight and Ireton Jones Equation     134-135 
                    References and Recommended Readings for Calculating Energy Needs  136 
                    Body Mass Index & Table                                               137      
                    MAO Inhibitors and Food Interactions                                  138-139 
                    Fiber Content of Common Food                                          140-144 
                    Recipes for Fiber Supplements                                         145 
                    Caffeine Content of Foods and Beverages                               146-147 
                    Scoop Sizes                                                           148 
                    Milligrams and Milliequivalent Conversions                            149 
                    Measures and Metric Conversions                                       150 
                    Abbreviations                                                         151 
                    Official “Do No Use” List                                             152-153 
                    Recipe for Puree Bread                                                154-158 
                    French Toast Souffle Recipe                                           159 
                    Super Shake Recipe                                                    160 
                    Food Guide Pyramid, Dietary Guidelines for Americans 2005 and          
                      DASH Diet, DRI’s 2010, My Plate For Older Adults, Information 
                      regarding risks of tube feeding for older adults and Culture Change 
                      Movement.                                                           161                        
                     
              
              
              
              
              
              
              
              
              
              
              
              
              
              
              
              
              
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