Menu Planning And Sample Menu Templates Page 7
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11Adult Day Care Resource Manual for the USDA CACFP
There are three ways the regular diet menu can be modified to meet special nutrition needs:
Therapeutic diets (such as low fat, low sodium, or calorie-modified)
Consistency-modified diets (change in food texture)
Combination diets
o More than one therapeutic diet (such as a low fat, low sodium diet)
o Therapeutic diet with consistency-modified foods (such as a calorie-modified, pureed
diet)
Therapeutic diets
are ordered by a physician or other authorized medical authority. They are designed
to assist in the management of disease or disorders by reducing or increasing specific foods,
ingredients, or nutrients (for example, fat or sodium).
The ADA (1998, 2000) recommends a “liberal approach” to writing menus for therapeutic diets for
older adults. A “liberal approach” means that only a few foods are restricted on therapeutic diets.
With the approval of the physician or registered dietitian, occasional “treats” may be served to
improve participant satisfaction.
All therapeutic diets must follow the CACFP
meal pattern except for specific medical conditions.
According to CACFP guidelines found in 7 CFR, part 226.20h, “Substitutions because of medical
needs shall be made only when supported by a statement from a recognized medical authority which
includes recommended alternate foods.” Documentation of the medical need and a list of alternate
foods must be kept on file and in the individual plan of care.
Consistency-modified diets are those in which the food
Some participants may
texture has been changed to make chewing easier or to
require a therapeutic diet
promote safe swallowing. Changes in consistency can be
in which a specific food,
based on either the regular diet or a therapeutic diet. All
diet orders must specify a regular or therapeutic diet
ingredient, or nutrient has
when consistency changes are requested.
been reduced or increased.
Consistency-modified diets may include thickened
beverages. The purpose of the changes in the texture of
beverages is to promote safe swallowing and prevent
food or fluids from getting into the lungs. The changes
in food consistency are usually recommended by a
swallowing therapist, physician, or registered dietitian. A
registered dietitian will need to review the diets ordered
and write consistency-modified diets appropriate for the
participants.
44
National Food Service Management Institute
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