Meal Planning for Special Dietary Requirements

Background

One of the key roles of nutritionists and dieticians is to design meal plans for people with special dietary requirements. This requires a detailed understanding of the patient’s situation, their energy and nutrient requirements, and the various foods that must in some cases be avoided. In some cases it can be extremely challenging to create meals that are nutritionally adequate and palatable whilst keeping within the dietary constraints imposed by the patient’s condition.

The aim of this practical is to produce an ideal two-course meal for someone with specific dietary requirements. It should be as edible, attractive and palatable as possible with known energy and nutrient composition.

 Patient F: A seven year-old, epileptic male on a ketogenic diet

Recipes

Almond Crackers

Ingredients:

30gm Almond Flour ( whole ground blanched almonds)

20gm Macadamia Nuts, dry roasted with salt – finely ground in a blender

15gm Olive Oil

15gm Egg white – raw

1/8th teasoon Salt (optional)

Dairy Free Vanilla Pudding

Makes about 2 cups

Nutrition for entire recipe is:

1078 Calories  4:1 Ratio

14.24gm Protein

107.92gm Fat

12.48gm Carbohydrate

Ingredients

400gm (about 1 can) coconut milk, full fat

60g (about 4 large ) egg yolks

2g (1/2 tsp) pure vanilla extract

1 tsp. Salt

Bolognaise

Ingredients:

15g lean raw mince

2g beef stock cube

6g capsicum, raw finely chopped

6g celery, raw finely chopped

6g onion, raw finely chopped

6g carrot, raw finely chopped

6g mushroom, raw finely chopped

2g parmesan cheese

20g cream (35% fat)

7g butter

18g oil

1g garlic

15g Carloni Passata

The bolognaise is based on a ratio 4:1 and contains 322 calories, 5.5g protein, 32.2g fat, 2.6g carbohydrate.

The patient types have been chosen because they require you to make considerable changes to the normal balance of food groups, as might be found in a typical Western diet.

Once assigned a patient, your group can start researching their specific nutritional requirements (e.g. how much iron does this person need?) and dietary requirements (i.e. what types of foods are restricted in this person’s diet?) You should also refer to UK dietary guidelines looking more generally at the balance of foods, such as the ‘Eatwell Plate’, whilst also bearing in mind cultural food preferences where appropriate. These will help you to achieve an optimal balance between palatability, dietary variety and nutritional adequacy.

Following the diet analysis workshop in week 2, you will use the Nutritics diet analysis software to calculate the energy and nutrient composition of the two-course meal (including beverages) that you have designed. Your two-course meal should, when combined, meet current UK general and specific dietary guidelines, and should supply:

 Exactly (± 5 kJ) ⅓ × EAR for energy for your patient

 All other essential nutrients to at least ⅓ × RNI

 In accordance with UK recommendations, the following nutrients should be limited:

– Total fat: ≤ 33% total energy intake

– Saturated fat: ≤ 10% total energy intake

– Sodium: ≤ ⅓ RNI

Remember: ⅓ × DRV typically represents a small meal for one person. Would your patient be able to eat everything in one sitting? You must be able to eat the entire meal as part of the second practical session!

Report (25%)

 You are writing a report to a provider of food services (e.g. hospital, prison, school, industrial employer, airline) that needs to prepare meals for someone with your patient’s condition or food preference.

 In this report, you will be expected to:

 include a full description of the individual you created the meal around, explaining the nature of the individual’s condition or food preferences and details of the meal created, including full scientific evidence for the choices made

 outline the challenges that providers of food services might face preparing meals that are nutritionally-adequate yet palatable.

 Your report should include the energy and nutrient profile of the meal (an appendix containing the Nutritics report is acceptable). Make sure that you have calculated and checked the contribution of protein, fat and carbohydrate to total energy intake (TEI) and presented these as %TEI, as well as the gram values for each macronutrient and micronutrient.

 The word limit for the report is 1,500 words max. (excluding the energy and nutrient profile of the meal and reference list).

Reflection of reference sources (15%)

 You are expected to keep a library research log of all sources used and accessed during the development of your report – this must be submitted as an appendix with your report.

 This will form part of a reflective piece where you appraise a number of the references you have accessed and discuss their relative importance.

 The word limit for the reflection piece is 500 words max. (excluding the library research log).

The report and reflection of reference sources must be submitted online via Turnitin only (no hard copies). The deadline is Monday 16th March at 1.00 pm. Please include a word count.

Your report should be guided by the following assessment criteria:

 Understanding of the patient condition

e.g. sufficient knowledge of the nature of the patient’s condition to enable appropriate dietary recommendations (25%)

 Understanding of DRVs and balance of food groups

e.g. correct DRVs to minimize the risk of energy/nutrient deficiency / incorporation of as many food groups as possible (15%)

 Energy and nutrient content of the meal

e.g. how well does the proposed meal comply with the energy and nutrient criteria proposed? (10%)

 Discussion/reflection on the difficulties of designing an appropriate meal for this patient

e.g. identification of key challenges in designing a suitable meal and viable solutions (30%)

 Referencing & research log

e.g. good-quality sources and references cited in the correct format (10%)

 Style & structure of report

e.g. clear, logical structure and covers the important areas of the topic (10%)

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