1. Three Day Menu
Allison Kliewer
Baptist Health System Dietetic Internship
With
Texas Center for Infectious Disease
March 6, 2013

2. 3-Day Menu 2
Three Day Menu
According to the State Operations Manual for Long Term Care Facilities, a facility must
provide a qualified dietitian to provide each resident with a nourishing, palatable, well-balanced
diet that meets the daily nutritional and special dietary needs of each resident (2013). A
dietitian is qualified based on education, training, and experience with identification of dietary
needs, planning and implementing of dietary programs and much more (2013). Specific training
experience includes developing therapeutic diets and developing regular diets to meet the
specialized needs of geriatric and physically impaired persons (2013). The Texas Center for
Infectious Disease (TCID) operates as a state long term care facility. The following house menu
was designed to meet specialized dietary needs of the TCID patients.
The house menu was to closely resemble that of the State Hospital’s Acceptable
Macronutrient Distribution Ranges (AMDR), while following the “Dietary Guidelines for
Americans” 2010, and offering a culturally healthy and flavorful menu. The AMDR guidelines
can be seen in Appendix III. The Texas Center of Infectious Disease has a specific population of
patients who suffer from tuberculosis among many other clinical diagnoses. Many of the
patients have multiple diseases, are often are substance users and abusers, and are admitted
with malnourishment. The patient population is multi-cultural and while most of the patients
are from Mexico, others are from other nations, such as, Nepal, Iraq, and Russia. The clinical
diagnoses, nutrition status, and unique culture of the patients, were considered in the meal
planning.

3. 3-Day Menu 3
The cardiac menu was modeled to closely follow the American Heart Association
guidelines for a healthy diet; 4.5 cups of fruits and vegetables each day, two servings of fish per
week, at least three servings of fiber rich whole grains per day, less than 1,500 mg of sodium
each day, no more than 450 calories of sugar-sweetened beverages per week, four servings of
nuts, legumes, and seeds per week, no more than two servings of processed meats per week,
and less than seven percent of total energy intake from saturated fat. Guidelines also follow the
“Dietary Approaches to Stop Hypertension” (DASH) diet that is encouraged by the National
Heart, Lung, and Blood Institute, the U. S. Department of Health and Human Services, and the
National Institutes of Health.
The 200 gram carbohydrate restricted diet also followed the cardiac or heart healthy
diet plan, while limiting the carbohydrates at each meal. The purpose of a carbohydrate limited
diet is to better control blood glucose, therefore helping to control diabetes. According to the
National Heart, Lung, and Blood Institute, those who have diabetes are at higher risk for heart
disease, have additional causes of heart disease, may develop heart disease at a younger age,
and may develop a more severe form of heart disease. That is why it is important to follow
heart healthy eating patterns while controlling carbohydrate intake.
The renal diet was restricted following the Nutrition Care Manual (NCM) guidelines for
chronic kidney disease (2012). Nutrients were limited to 2.4 g sodium, 2.4 g potassium, and
800 to 1,000 mg phosphorus (NCM, 2012).
The mechanical soft or dental soft diet is modified from a regular diet for patients with
difficulty chewing or swallowing. Foods included in the diet are to be easily masticated. The

4. 3-Day Menu 4
mechanical soft food items were based on the Manual of Clinical Nutrition Management
(2011).
Analysis
The house menu was adjusted to meet the nutrition standards of a cardiac, 200 gram
carbohydrate, renal, and mechanical soft diet. Data was analyzed using the Nutrition Calc Plus
software (2009). The three day house menu and the nutrient analysis can be viewed in
Appendix I and Appendix II.

5. 3-Day Menu 5
References
Academy of Nutrition and Dietetics Quality Management Committee. (2013). Academy of
Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and
Standards of Professional Performance for Registered Dietitians. Journal of the Academy
of Nutrition and Dietetics. In press.
Silver Oaks Communications. (2009). Nutrition Calc Plus 3.2. The McGraw Hill Companies.
University of Virginia Health System: Manual of Clinical Nutrition Management. (2011).
Morrison Management Specialists, Inc.

6. Appendix I

7. 3-Day Menu 7
Appendix I (Continued)

8. 3-Day Menu 8
Appendix I (Continued)

9. 3-Day Menu 9
Appendix II

10. 3-Day Menu 10
Appendix II (Continued)

11. 3-Day Menu 11
Appendix III