Healthy eating counseling and menu planning
INFORMATIZATION IN THE AIM OF CREATION AND NUTRITIVE EVALUATION OF HOSPITAL DIETS
There are clear parameters that dietary food which is given to certain patients frequently has a therapeutic role and together with other measures of treatment contributes to recovery. Food which is intended for the patient's diet in the hospital is a very sensitive product in comparison to all other types of diets because of the specificity of its preparation and execution. Every hospital patient should get an adequate diet according to the Decision on the standard of diet of hospital patients (NN number 121/07). Special attention regarding diet is given to patients after surgery, trauma, patients with disorders of the metabolism, intestinal disorders, renal and immunological disorders, etc. Sometimes patients cannot or are forbidden to take solid food, so it is specially prepared by mixing and given to the patients in a liquid state. It is clear that in all of these cases special attention is needed when choosing the food, ingredients, preparation, as well as number and schedule of meals. Each patient has a specially planned diet according to the biological needs of the body. Here, it is a must to know exact nutritional and energetic values of the food.
In order to acquire this data, it is necessary to create a menu, as well as to know the nutritional values for each diet in an information system. Such an approach enables quality diet for the patients with various aspects, as well as getting menus with complete indicators of nutritive values of food, meals and easier and quicker control of every change of patient's condition. Informatization is a must because of safer tracking, control and consumption of food.
With the help of a computer program, changes to the diet are made for hospital patients, thus leaving paper format sin history. There information solutions to hospital diets are considered innovative but are rarely seen in our hospitals. From 46 diets issued by the Standard, most frequently only 14 diets are prepared regularly, and others are made individually. The menus are regularly analyzed for the most commonly accepted diets such as: diet without restrictions, high-protein, diabetic, Mediterranean, nephrotic, postoperative, liquid, diet for feeding through tubes. The results show that macronutrients are mostly within the values recommended by the Standard. The average energy intake is 8358 kJ (1990 kcal), share of proteins 17%, (88g), fat 32 % (70g) and carbohydrates 51% (257g), while the average intake of cholesterol 227mg and fibers 26g.
A favorable relationship of fatty acids has been achieved. The average daily intake of saturated fatty acids is 21g, mono-unsaturated fatty acids 24g, and poly-unsaturated fatty acids 22g. By analyzing micronutrients is has been determined that all the menus through all the diets can satisfy the recommended daily intake of micronutrients. The average daily intake of minerals is: Na 2192mg (without added salt), K 3680mg, Ca 762mg, Mg 270mg, P 1352mg, Fe 13,5mg, Zn 8,5 mg, Cu 0,94mg. Average daily intake of vitamins: R.E. 1043µg, Retinol 93µg, Carotene 5607µg, Vitamin B1 1,1mg, Vitamin B2 1,5mg, Niacin 20,2mg, Vitamin B6 1,7mg, Vitamin C 131mg.
The results are interpreted according to the Rules of added diet (NN 46/11), supplement IV, where the recommended daily intake of micronutrients can be found. According to the nutritive evaluation, the best diet is the Mediterranean diet which has an ideal ratio of fatty acids, reduced intake of cholesterol and increased percentage off fibers which is in accordance with the recommendations from Mayo Clinic experts, and according to the guidelines by The American Heart Association (AHA), The European Society of Cardiology (ESC), The European Society of Hypertension (ESH). The results confirm the fact that a balance and variable diet contains adequate amounts of all nutrients, while the inadequate intake usually occurs as a consequence of unbalanced and irregular diet. We may not be able to control other factors of our health, but we can certainly control what we put in our stomach.
With this type of information program, we have created the basis for the scientific development of patient food which is very important today.
Eva Pavić, univ. spec. nutr. aliment. for Food Quality and Safety