Fw: Full Liquid Diet? Evidence based?

[Guest guest]

Regarding a texture issue: If a patient cannot tolerate " pureed " and needs a

liquid diet then we can add appropriate liquids to a " liquid " diet tray or can

order " blenderized " diet (liquid foods that can be taken via a straw, like a

" wired jaw "  diet).  Cannot tell you how many times " Full liquid " has been

ordered postop chole, post pancreatitis or even a patient with DOCUMENTED

lactose intolerance (twice for us in the past 3 weeks).

Definitely an eduation process for doctors & nursing about how it is

inappropriate in >90% of the time it is ordered. 

Holly

________________________________

To: rd-usa

Cc: hl brewer

Sent: Thu, June 16, 2011 8:49:31 AM

Subject: RE: Full Liquid Diet? Evidence based?

Thanks Joanne for the explanation. ly, if a resident in my SNF cannot eat

solid food of any texture for any reason, I provide a liquid diet composed of

food, not medical nutritionals. It tastes better and often the residents accept

it in mugs or through a straw if SLP allows their use. Evidence based is needed,

but the reality out there at times is very different and we have to improvise

and compromise to take care of the residents, and at times, their families.  I

have found it very helpful to be able to quote the NCM as “the†backup for

providing such a diet many times, especially when dealing with a hospice patient

whose family does not accept NPO, or a demented resident that won’t allow

anyone

to feed them but will pick up a mug or bowl and drink out of it.  My

justification for its use is always close at hand and adds not only to my

credibility but also to my comfort level doing this.

 

Digna

 

From:rd-usa [mailto:rd-usa ] On Behalf Of Joanne

Larsen

Sent: Thursday, June 16, 2011 8:27 AM

To: rd-usa

Cc: hl brewer

Subject: Re: Full Liquid Diet? Evidence based?

 

 

Colleagues,

Reply to RD-USA listserv only. You do not have my permission to forward.

As the editor who created the Nutrition Care Manual, vetted the authors

/ reviewers and edited every word for the initial launch and the first

update, I can tell you why the Full Liquid diet is in NCM. Dietitians

who ordered NCM complained to the publisher that their facility's

doctors wanted a full liquid diet so the publisher insisted the full

liquid diet be added to NCM over my objections and documentation that

there is no science in published literature for a full liquid diet or a

progression from clear liquid to full liquid to soft to regular diets.

This and clear liquid diets are the only instance of a diet being

inserted in NCM that are not evidence or research based.

healthy regards,

Joanne Larsen MS RD LD

>

> In our facility we're deleting it from our diet list this month - just

> have to

> get the nurses to stop " advancing as tolerated " and a few damn

> surgeons to stop

> ordering it. But it can still be found in the Nutrition Care Manual

> online

> (pdf about what it is and that there is no evidence for it).

>

> Holly

> ----------

> Holly Lee Brewer, MS RD CDE

> Pediatric Dietitian, Diabetes Educator

> Medical Nutrition Therapist, Las Vegas, NV

>

> Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com

> 301st MDS, NAS JRB Fort Worth (Carswell), TX

> Joint Base Balad, Iraq (Jan-Jul 2009)

>

> ________________________________

> From: " Dineright4@... <mailto:Dineright4%40aol.com> "

> <Dineright4@... <mailto:Dineright4%40aol.com>>

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Sent: Wed, June 15, 2011 10:22:25 PM

> Subject: The Great Cancer Hoax - Full Liquid Diet? Evidence

> based?

>

>

>

> Too busy lately, so getting into this discussion late.

>

> For all the RDs that SAY they insist on Evidence Based Medicine, I ask;

> Show me the evidence for hospitals to serve full liquid diets. I've NEVER

> found it, but tens of thousands of RDs nationwide still do this. (I

> THOUGHT

> that practice was stopped years ago!)

>

> I don't work in hospitals anymore, but recently was visiting a friend in

> CCU for GI bleed with a full liquid diet on his plate. 2% milk, pudding,

> cream of potato soup, and ice cream.

>

> I was embarrassed for my profession.

>

> Please, would some RD that insists on EBM please show me the evidence for

> that?

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

> Fax:

> DineRight4@... <mailto:DineRight4%40aol.com>

>

> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author

> of the

> Certified LEAP Therapist (CLT) Training Course.

>

> Re: The Great Cancer Hoax - extended thru 6/20

>

> _http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/_

>

> (http://www.sciencebasedmedicine.org/index.php/fatigued-by-a-fake-disease/)

>

>

> On Mon, Jun 13, 2011 at 11:18 PM, Jacqui Pressly <_Jpress50@..._

>(http://health.groups.yahoo.com/group/rd-usa/post?postID=gJl7O9-0Wsq_2MXaOdDcGa\

MTi7GYQ

>Q

>

> qfD4nP2Os6mSiBLs_6OsOEUFIunjUNDecytZLrYhlHZ) > wrote:

>

> >

> >

> >

> > ,

> > Where is it that this dx doesn't exist? That's what I would be cautious

> > about.

> >

> > Jacquelyn A. Pressly, RD, CLT

> > The NATURAL dietitian

> > Specializing in Wellness and Prevention, Personal Nutrition Coaching

> > and Designer Lifestyle Plans to help you get on the health track

> > Northeast Ohio & Western Pennsylvania

> > Internet and telecounseling available for distance clients

> >

> > _jpress50@..._

>(http://health.groups.yahoo.com/group/rd-usa/post?postID=2n1nW2HOEaLO84cXflZaGx\

n6_ABLxdnwkd6i4Xoi6_FNA0sRcNMgb3hQgncOHblofIntwCHgp7gClw

>w

>

> )

> >

> > If you are what you eat, then dietitians are the doctors of the future

> >

> >

> > Re: The Great Cancer Hoax - extended thru 6/20

> >

> > But are they doing things like adrenal fatigue (dx doesn't exist), liver

> > detox, homeopathy and this type of medicine - red flags should be up

> IMHO.

> > As should traditional medicine MDs when excessive and unwarranted and

> over

> > prescribing drugs.

>

>