TEXTURE MODIFIED DIET: SUPPLEMENTED FLUID

Question 1

INDICATIONS FOR A SUPPLEMENTAL FLUID DIET

Answer 1

• Oral or plastic surgery of the face or neck
• Transitional phase between a clear liquid diet and a fibre restricted/ regular diet
• Used in conjunction with dilatation procedures for the treatment of oesophageal strictures
• Mandibular strictures
• Individuals unable to chew or swallow properly
• Oesophageal or pharyngeal disorders interfering normal handling of solid foods.

Question 2

CONTRA-INDICATIONS FOR A SUPPLEMENTAL FLUID DIET

Answer 2

• Individuals that are lactose intolerant – diet that consist of increased amounts of lactose containing food
• Temporary lactose intolerant individuals, usually after surgery, when given a high lactose full liquid diet
• Hypercholesterolemic individuals if diet consists of high fat diary and protein sources.
• Individuals with dysphagia unable to swallow thin liquids
• Not for long term use as it may lead to nutrient deficiencies especially due to it restricting certain food groups and food substances
• Not for use in individuals suffering from chronic constipation as it is relatively low in fibre.

Question 3

DEFINITION OF A SUPPLEMENTAL FLUID DIET

Answer 3

• A diet containing food that are liquid at body temperature supplemented with commercial liquid supplements.

Question 4

PURPOSE OF A SUPPLEMENTAL FLUID DIET

Answer 4

• Alternative oral source of nutrients for individuals unable to tolerate a normal diet due to problems with chewing and swallowing due to alterations in pharyngeal functions
• Recommended for individuals who underwent oesophageal surgery with anastomotic oedema
• Nutritious post-operative alternative for clear liquid diets for patients to weak to chew
• The meet of nutritional and normal caloric requirements with decreased stool frequency and volume.

Question 5

NOTES FOR IMPLEMENTING A SUPPLEMENTAL FLUID DIET

Answer 5

• Diet consist of high-caloric, high protein soups, cereals, desserts and drinks
• Caution with the application of this diet due to the large volume of liquid and nutritional adequacy
• Powdered glucose or glucose polymers may be dissolved in liquids like fruit juice to increase the liquids nutritional value
• Whey powders can be added to milks, puddings, hot cereals and milk shakes to ↑protein
• The use of whey protein tastes better than casein protein
• Fortified margarine added to hot liquids is recommended for individuals diagnosed with pulmonary obstructive disorders and DM as a replacement of simple sugars
• If a low-sodium diet is indicated low sodium soups, eggnogs, drinks and custards should be provided
• To prevent food poisoning especially in case of a Salmonella infection the use of raw eggs should be discouraged
• Excessive intake should also be discouraged as it may lead to a biotin deficiency due to the binding of avidin (heat-labile protein) found in raw egg whites with biotin.

Question 6

BREADS AND CEREALS ALLOWED AND NOT LIMITED IN A SUPPLEMENTAL FLUID DIET

Answer 6

ALLOWED:
Refines cooked cereals, strained wholegrain cereals, high protein cereals

TO AVOID:
Breads and all others

Question 7

PROTEIN ALLOWED AND LIMITED IN A SUPPLEMENTAL FLUID DIET

Answer 7

ALLOWED:
Eggs cooked to liquid consistency, egg substitutes, puddings, pasteurised eggs used in eggnog, salmonella-free frozen eggs

TO AVOID:
Raw eggs and egg whites, eggs cooked to a consistency that is considered hard

Question 8

VEGETABLES ALLOWED AND LIMITED IN A SUPPLEMENTAL FLUID DIET

Answer 8

ALLOWED:
All vegetable juices, vegetables pureed in soup

TO AVOID:
All raw or cooked vegetables such as carrots, beans, peas, broccoli, cauliflower

Question 9

FRUITS ALLOWED AND LIMITED IN A SUPPLEMENTAL FLUID DIET

Answer 9

ALLOWED:
All juices or nectarine
Pureed fruits of which the skin is removed

TO AVOID:
All fresh, frozen, or canned fruit such as peaches, apples, bananas, oranges, prunes.

Question 10

BEVERAGES ALLOWED AND LIMITED IN A SUPPLEMENTAL FLUID DIET

Answer 10

ALLOWED:
Milk, milk drinks, milk substitutes, carbonated beverages, cocoa, coffee, eggnog, tea, decaffeinated coffee, milk shakes, instant breakfast, cereal beverages, liquid dietary high protein/caloric supplements, yoghurt drinks, fruit-flavoured
beverages

TO AVOID
Any containing raw eggs/ egg whites, fruits, or other prohibited foods

Question 11

FAT AND OILS ALLOWED AND LIMITED IN A SUPPLEMENTAL FLUID DIET

Answer 11

ALLOWED:
Oils and margarine added to warm liquids
TO AVOID:
Nuts and seeds

Question 12

COOKING METHODS ALLOWED AND AVOIDED:

Answer 12

ALLOWED:
• Boiling
• Steaming
• Blending

AVOIDED:
•	Frying
•	Braising
•	Sautéing 
•	Grilling
•	Roasting