All recommended daily servings and food group sources discussed in this module are according to the guidelines set forth by the USDA and can be downloaded from www.

Image Source: U. Department of Agriculture a www. When selecting foods included in the milk group, low fat and fat-free choices should be made to promote good health. In general, 1 cup of milk, soy milk, yogurt, and 1 ½ ounces of cheese are considered a serving size U. Recommended daily servings of milk products :.

Department of Agriculture a. gov suggests selecting a variety of foods high in protein with 8 ounces of seafood per week. In general 1 ounce oz.

of meat, ¼ cup of beans, 1 tablespoon of peanut butter, or ½ ounce of nuts or seeds are considered a serving of protein U.

You can view sources of protein by visiting choosemyplate. Recommended daily servings of protein :. Most fruits are low in fat and all fruits have no cholesterol U. Fruits are considered an important part of our diets and have many protective health benefits.

Eating a diet high in fruits has been shown to reduce the risk of heart disease, some types of cancer, obesity , and type 2 diabetes U. In general, 1 cup of fruit or fruit juices or ½ cup of dried fruit is considered a serving size from the fruit group U. Recommended daily servings of fruit :.

Most vegetables are low in fat and all vegetables have no cholesterol U. Vegetables are considered an important part of our diets and have many protective health benefits.

Eating a diet high in vegetables has been shown to reduce the risk of heart disease, some types of cancer, obesity , and type 2 diabetes U. In general, 1 cup of raw or cooked vegetables or 2 cups of leafy greens counts as one serving of vegetables U. Recommended daily servings of vegetables :.

Foods made from wheat, rice, cornmeal, rye, barley or other grains are considered grain products. Grain products are important sources of energy for our bodies. In general, 1 slice of bread, 1 cup cold cereal, ½ cup cooked cereal, rice, or pasta are considered to be a serving size of grain U.

Diets high in whole grain foods have been shown to reduce the risk of heart disease, stroke , type 2 diabetes, colorectal cancer, inflammatory diseases, helps to maintain a healthy blood pressure American Heart Association, b reduce constipation , and help maintain a healthy weight.

Select choices from the grain group from those that are high in fiber and made with whole grains for the most health benefit. You should strive to make at least half of your grains whole grains U. You can view sources of grains by visiting choosemyplate. gov at. Recommended daily servings of grains :.

Oils are NOT a food group, although they provide essential nutrients we need for our body U. Oils include items such as butter, oils, margarine, mayonnaise, salad dressings.

These food items should be used sparingly. Foods such as fish, nuts, and avocados are good choices of fats. Many foods we eat, especially those that are processed, often are high in fat.

This should be considered when planning meals. In general, 1 ounce of nuts, 1 tablespoon margarine, mayonnaise, or oils, and 2 tablespoons of salad dressings count for one serving of oils U.

You can view sources of oils by visiting choosemyplate. Recommended daily servings of oils :. Girls years old 5 tsp. Boys years old. Creating a basic menu plan involves selecting a food from each food group. To help create well-balanced meals, it is helpful to follow the ChooseMyPlate food guidelines.

gov suggests the following key points:. Use the communication skills learned throughout this course to educate patients about healthy food choices.

Food preferences are determined by our family, culture , religious beliefs, foods we may choose not to eat, such as animal products for vegetarians, and the area we grew up or in which we live.

There may be regional or ethnic differences in food preferences. Talk to the patient about their food preferences and beliefs. Watch the types of foods they eat. Make suggestions and ask for feedback. Ask them to share the foods they most enjoy. FEEDBACK: Food preferences are determined by a variety of factors such as family, culture, religious beliefs, regional and ethnic differences, personal preference, and allergies.

Various community resources are available to help families who cannot afford enough food. Use coupons when shopping for food and look for sales. Assist patients to plan meals weekly. Use items that are on hand or that wi ll spoil sooner first.

Make a shopping list and stick to it. Purchase items such as dried beans and canned fishes to help provide less expensive sources of protein.

When possible, buy in bulk. Purchase produce when it is in season as it will be freshest and cheaper. Frying foods is the least healthy option as this adds extra fat, cholesterol, and calories from using oils during the frying process.

Broiling, steaming, and roasting methods of cooking do not add extra calories, as long as butter, margarine, and oils are not used. To decrease the amount of fat and make healthier food choices, remove skin from meat and poultry, as this is where extra fat and cholesterol are.

Lean cuts of meat can also be selected to decrease fat, cholesterol, and calories. Not only is the patient more likely to eat foods if they choose them, but it also helps to promote independence and self-determination. Working with a patient to plan meals and prepare foods can also help to strengthen the relationship.

Share tasks of food preparation, keeping in mind any physical or cognitive limitations a patient may have. For example, young children should not be allowed to use sharp knives and dangerous equipment. A person with dementia who may forget what they are doing should be closely supervised while using knives or the stove.

If adaptive equipment is available, teach and encourage the patient to use it. If they can assist to provide their own care, this will help promote self-esteem and independence. Getting involved in meal planning and preparation can also provide mental and physical stimulation, as well as relaxation and distraction.

It can be a time where patients are encouraged to be creative and draw upon their strengths and talents, especially if they enjoy cooking. Many people enjoy food, either cooking or eating it. There may not be a lot of equipment to choose from.

Discuss ideas with a supervisor about how to best do this. Mealtime is an excellent time to spend with a patient and their family. Make sure to always plan for extra time during meals so the patient does not feel rushed.

Sit next to or across from them whenever possible. Avoid doing other tasks while the patient is eating. Instead, use this time to socialize with them, unless they do not prefer it. If the patient has a swallowing problem, remember not to ask them questions while they are trying to chew or swallow, as this could lead to choking.

Plan conversation for the time in between bites. If the patient requires assistance to eat, sit next to them.

Be patient as they chew and do not rush them by trying to give them another bite of food while they are still chewing the first. Select nutritious foods that are contrasting colors and textures.

This adds to visual and chewing appeal. Try to vary the colors of the foods being served. Avoid serving foods that are all one color. Even for people who must have a mechanical diet , which is a diet that is altered in texture, such as food that is pureed or finely chopped , different colored foods can be selected.

For example, select a green, soft vegetable spinach , a red, crunchy fruit an apple , and colorful, chewy wild rice to go along with a piece of chicken and a glass of milk.

This lends visual and chewing appeal as the patient can see different colors and feel different textures as they chew. A poor appetite should be investigated. Some possible explanations of a poor appetite are :. Which of the following are possible causes of a poor appetite?

Select all that apply. FEEDBACK: Poorly fitting dentures or broken teeth can make chewing and eating difficult, leading to a poor appetite. Food can be expensive. Families on a tight budget may have trouble purchasing food.

FEEDBACK: Purchasing items from a salad bar or other self-service station in a grocery store often leads to higher prices. Whenever possible, purchase fresh fruits and vegetables from the produce aisle.

This is a healthier and less expensive option. Regularly checking expiration dates helps to prevent unnecessary waste. Planning meals with items on hand and that have not expired helps the patient and their family save money. Purchasing bulk items can help to save money.

However, if they are not needed and there is no storage space for them this can end up costing the patient money as food will more likely have to be thrown away. When coupons are used and sale items are purchased, this can help the patient and their family save money.

It is important to properly store food. Food that is improperly stored can lead to illness and is also a waste of money as it will have to be thrown out. Food should never be stored under a sink as it risks getting contaminated. Never store food with chemicals or other cleaners.

Food should be properly stored in the refrigerator or freezer, depending on the item and when it will be used.

Other foods such as dried items should be stored in their original packaging or in air tight containers in a pantry. Refrigerated foods should be kept at 40 degrees or below. Thermometers should be placed in the refrigerator and freezer to ensure they are in proper working order.

Frozen foods should always be kept at 0 degrees. When handling food, it is important to keep safety at the forefront of food preparation. You should wash your hands, cutting boards, and work surfaces immediately after handling raw meat, poultry, and fish.

True or False? Separate cutting boards should be used for raw meats and fresh vegetables. Never eat or serve raw eggs or eggs that have cracks in them.

To avoid the risk of contamination from raw meat, poultry, and fish, hands, cutting boards and work surfaces should be washed with hot soapy water after use. To avoid the risk of contamination from raw meats, poultry, and fish, use separate cutting boards for meats and fruits and vegetables.

Raw eggs and those with cracks in their shell should not be used. They should be discarded as the risk of salmonella is high. Many people use a microwave to cook or reheat food.

The United States Department of Agriculture has specific guidelines for safe use of a microwave for food preparation. The USDA has guidelines about safe food cooking temperatures. To avoid food-borne illnesses, these should be followed. Just because food appears to be cooked from the way it looks on the outside does not mean it is cooked in the center.

Insert a thermometer into the thickest part of the meat or the center of the food. Do not allow the thermometer to touch bone, fat, or gristle United States Department of Agriculture, Use a thermometer to test for doneness. Poultry should be cooked to degrees. Ground beef should be cooked to degrees.

Leftovers should be reheated to degrees. Steaks, chops, and roasts should be cooked to degrees. They should save all receipts and turn them in to the appropriate place, and account for all money that was spent as soon as possible after shopping.

Use checks instead of cash whenever possible. Always keep to the food budget and the grocery list. They should never purchase items for themselves or borrow money from their patient to buy something for themselves while shopping for the patient.

Not only is this stealing company time, but they risk mixing up items, receipts, and money. This could lead to trouble. Some patients may require a modified diet due to health conditions, diseases, or problems with chewing, swallowing, or choking. Sometimes, certain medications may even interact with certain foods, and a patient may need to have more or less of a certain food while on that medication.

Modified diets are changes made in a particular nutrient or the texture of the food. Diets may be ordered by a physician. The patient may need to have more or less of a certain nutrient. For example, they may have an order to eat foods low in potassium if they have kidney disease or low in sodium if they have heart failure.

Or, they may have an order that says they should eat a diet high in protein. It is in place for the health and safety of their patient. When in doubt, they should seek guidance from a supervisor. Low calorie foods are foods that are low in calories. Foods may be labeled as reduced calorie, low calorie, or light.

Generally, these foods have fewer calories than other products of the same type. Low fat foods are foods that are low in fat. Always read the label. Patients should not reduce caloric intake without speaking to their doctor.

It can be very difficult to follow a low calorie and low fat diet, especially long-term. Low sodium foods are foods that are low in sodium or salt. Read food labels to check for the amount of sodium listed.

For patients who are on low sodium diets, this is a special concern. Foods that contain a lot of sodium tend to be prepared foods, frozen dinners, canned soups and meats, and prepared boxed foods such as macaroni and cheese and pastas that are ready to eat with sauce. Offer herbs, spices, and lemon or lime zest to improve the flavor of foods for these patients.

It can take some getting used to not eating a high amount of sodium in the diet. Sugar free or no sugar added foods are those that do not have sugar in them or that do not add sugar to the ingredients.

Patients who are diabetic may be on a sugar free diet and need to watch the amount of sugar they consume. Sugar free products tend to have artificial sweeteners such as saccharin or aspartame.

Always read the nutrition label to check for the amount of sugar in a food. Sugar is added and hidden in many food products. Patients on these types of diets may need extra calories or protein to help promote healing or weight gain if they are malnourished.

It is best to provide snacks throughout the day or smaller meals in order to increase the amount of calories or protein in the diet, rather than to serve larger meals with a larger amount of food. The University of Pittsburgh Medical Center UPMC has suggestions for increasing protein into the diet.

The type of diet the patient has been prescribed can be found in the Care Plan. There are numerous reasons why a patient may be on a modified diet. This is because excess sodium causes the body to retain hold in more water.

This excess water causes the heart to pump harder. For people who have heart or kidney problems, this makes their organs have to work harder than they are able. Excess sodium in their diets can cause a progression worsening of their disease. The excess fluids can also lead to edema swelling in their bodies.

The Care Plan will specify how much sodium the patient should have in their diet. Which of the following foods should a person on a low sodium diet avoid? FEEDBACK: Low sodium diets may be required of a patient with heart or kidney disease or those with high blood pressure.

Foods that are high in sodium include frozen and boxed dinners, many pre-prepared foods, and canned foods such as soups, stews, and chili. Patients who have heart and kidney disease may also need to watch their fluid intake.

Just as in high sodium diets, excess water can make their heart and kidneys have to work harder. For patients with these types of problems, excess fluids can lead to a worsening of their disease. Diuretics are medications that help the body to reduce fluid volume.

Many people take diuretics to help lower blood pressure, or if they have heart disease. They help the heart to work less hard, as diuretics help remove water from the body. Too much water in the body makes the heart work harder, which weakens the heart and may cause or worsen heart failure.

Some diuretics also remove potassium from the body. Other patients may have low potassium levels from other reasons such as excessive diarrhea, sweating, or vomiting and may need to eat diets higher in potassium to replace potassium that is lost.

As we have discussed, potassium is necessary for a healthy body and heart. Low levels of potassium can cause an irregular heart rate, weakness, fatigue, muscle cramps, and constipation Mayo Clinic, According to the National Kidney Foundation , here are some foods which are high in potassium:.

Some patients need to avoid taking in extra potassium in their diets. This may be due to kidney disease or from taking certain diuretics.

While many diuretics deplete get rid of potassium, some diuretics help the body hold onto potassium. For these patients, they may be asked to not consume extra potassium. Just as not enough potassium can lead to problems, too much potassium can also lead to problems, such as irregular heart rhythms.

If potassium levels are too high in the body, the patient may feel weakness, numbness, or tingling, and too high levels of potassium can cause an irregular heart rate or heart attack National Kidney Foundation, Diets low in potassium may be prescribed for these patients.

Also be cautious to avoid using salt substitutes, which are high in potassium. Which of the following foods should a person on a low potassium diet avoid?

FEEDBACK: Bananas, potatoes, beans, tomatoes, peanut butter, and dried fruits are some foods that are high in potassium and should be avoided on a low potassium diet. Some patients may need to limit their fat or cholesterol intake.

People with heart disease, high cholesterol levels, gallbladder disease, liver disease, and some digestive problems may have to limit how much fat or cholesterol is in their diets. This means that foods that are irritating to the gastric mucosa stomach lining need to be eliminated.

This is because certain foods make the stomach produce more acid. Increased acid can lead to irritation of the stomach or other parts of the digestive tract such as the small or large intestine. Foods high in acid content can also irritate the esophagus as they are being swallowed.

Here are some foods to avoid for a bland diet :. Some people may be required to be on a gluten — free diet. Gluten is a protein in wheat, rye, and barley, and helps to hold foods together Celiac Disease Foundation, c.

People on a gluten-free diet may have digestive problems, such as celiac disease. Celiac disease is an autoimmune disorder in which ingestion of gluten leads to damage to the small intestine. Eating gluten leads to damage on the villi , which are finger-like projections lining the small intestine.

These villi are important to help us absorb nutrients. When they are damaged, malabsorption difficulty absorbing nutrients can occur. This can lead to many health problems. According to the Celiac Disease Foundation b about 1 in people around the world have Celiac disease with 2.

Other people may just prefer to be on a gluten-free diet. Here is a list of foods to avoid for people on a gluten — free diet :.

It can be frustrating for a person who cannot have gluten to find foods they can have. Many foods are naturally gluten-free such as fruit, vegetables, meat, poultry, dairy, beans, legumes, and nuts Celiac Disease Foundation, a.

Here is a list of items according to the Celiac Disease Foundation that a person on a gluten — free diet can have :. There are many products now found on the market that make bread, cereals, and pasta without gluten in them. These items may be more expensive. It is important to always read the label.

Many foods are made with wheat in them, which is often used as a thickener. Which of the following foods should a person on a gluten-free diet avoid? Select all. FEEDBACK: Foods with wheat such as cereals and breads, foods with barley, and those containing rye should all be avoided by a person on a gluten-free diet.

Gluten is a protein found in products with wheat, rye, and barley. Some people may be on a vegetarian diet for health, personal, or religious reasons.

There are many different types of vegetarian diets, which indicate what types of foods are avoided. According to the American Heart Association a there are several types of vegetarian diets, including lacto-vegetarian, ovo-vegetarian, vegan, and semi-vegetarian.

Lacto — vegetarian : excludes meat, fish, poultry, and eggs. This diet allows dairy products, along with fruits, vegetables, nuts, seeds, grains, legumes, lentils, and peas. Ovo — vegetarian : excludes meat, fish, poultry, and dairy, but allows eggs, along with fruits, vegetables, nuts, seeds, grains, legumes, lentils, and peas.

Vegan : excludes all meat, fish, poultry, eggs, dairy products, and any food with these ingredients. Foods allowed include fruits, vegetables, nuts, seeds, grains, legumes, lentils, and peas. Semi — vegetarian : excludes red meat, but may allow poultry, fish, eggs, and dairy products, along with fruits, vegetables, nuts, seeds, grains, legumes, lentils, and peas.

It is important to remember that people who eat vegetarian type diets need to consume enough nutrients in their diets for good health. While they do not get protein from meat, fish, and poultry, protein can be found in other food sources.

Excellent alternatives to meat protein include soy proteins and protein from legumes, lentils, peas, and milk products. Liquid diets are those that patients may be on for a short period of time for a specific reason.

Some people may need to be on a liquid diet prior to a medical procedure, test, or surgery. Others may be on a liquid diet in order to help heal their stomach or intestines from a medical condition.

Foods on a liquid diet must be in their liquid state. There are two types of liquid diets: clear liquid and full liquid. A rule of thumb for clear liquid diets is that you should be able to see through them. They may be colored, such as popsicles and jello, but you can see through these foods.

A full liquid diet means the person can have all items on the clear liquid food list plus also items like cream of wheat, milk shakes, yogurt, and pudding.

A person on a full liquid diet can have all foods on a clear liquid diet plus cream of wheat, milk shakes, frozen yogurt, yogurt, and pudding.

Frozen yogurt would not be allowed on a clear liquid diet as it is made with dairy. Beef broth, jello, and apple juice would be allowed on a clear liquid diet. Soft diets are used for people who may have poor dentition , this refers to the strength, number of, and arrangement of teeth in the mouth who are recovering from a gastrointestinal surgery, and people who have difficulty with chewing and swallowing.

Soft foods require almost no chewing. They are easy to chew and swallow. Raw fruits and vegetables, hard-to-chew meats, and dry foods that can easily be choked on such as crackers and dry toast should be avoided. A mechanically altered diet is a diet in which the texture consistency of the food is changed to help the person chew or swallow.

A mechanically altered diet is given to a person who has dysphagia. Dysphagia means difficulty chewing or swallowing. A dysphagia diet or mechanically altered diet makes it easier to chew and swallow food and reduces the risk of aspiration Ohio State University Wexner Medical Center, A mechanical soft diet is a diet that consists of food that is made softer and easier to chew and swallow by changing the texture of the food.

For example, by cooking chopped or diced carrots until soft, they can be mashed or pureed. Cooked foods can also be chopped, diced, or ground.

This helps a person who has trouble chewing and swallowing to still take in the nutrients they need. A diet that is pureed consists of food that is cooked and then chopped, blended, or ground into a thick paste that is the consistency of baby food or mashed potatoes.

No chewing is required for this type of diet. Which of the following foods are safe to eat on a mechanical diet? FEEDBACK: Meatloaf, applesauce, cream of wheat, yogurt, jello, egg salad, cottage cheese, and pudding are safe foods for a person on a mechanical diet to eat.

Dried fruit, salad, crackers, granola, tough meats, gum, and popcorn are not safe foods for a person on a mechanical diet. Always follow the Care Plan. When in doubt, ask your supervisor. When food is mechanically altered chopped , ground, or pureed it may lose its appeal to the patient.

It looks different than the food they are used to. Important things to keep in mind when preparing mechanically altered diet s :. It is very important, especially for a patient with a swallowing problem to be in an upright position during mealtime and to be kept upright for minutes after eating to prevent choking.

It is okay to put all the food items together in the blender instead of blending each separately when preparing a pureed diet for a patient, as this saves time. Keep patients in an upright position during a meal and for minutes after a meal to prevent aspiration.

Never put all the foods together in a blender. Keep foods separately on a plate just as you would when serving any patient, whether the food is pureed or not.

This helps to keep food attractive and appealing for a patient, which aids in helping them maintain good nutrition. Always use proper food safety and storage precautions. Meet with your board-certified clinician to review your assessment and develop your custom weight loss treatment plan.

Your Clinician might prescribe appropriate medications for you — in many cases, GLP-1s like Wegovy, Saxenda, or Zepbound. Measure your progress in our free app and meet with a Dietitian, Fitness Coach, or your Clinician to make sure you stay on track.

Prescription care Your Clinician might prescribe FDA-approved medications like GLP-1s. Nutrition plan Develop a personalized plan with your Registered Dietitian to sustain your progress.

Clinician check-ins Meet with your Clinician to adjust your plan and get ongoing care. Fitness plan Build on your progress with a fitness plan developed with your Fitness Coach. Free companion app Use the web app to log your progress, request refills, and message with your Care Team.

How do I sign up? To get started, simply complete the Sequence quiz. If there is no current availability in your state, and you qualify for the program, we will contact you as soon as consultation times open up. What medications do you prescribe? The exact medication that your clinician will prescribe depends on your medical history, biology, and insurance coverage.

When appropriate, your clinician may prescribe GLP-1 medications including Tirzepatide brand name Mounjaro , Semaglutide brand names Wegovy, Ozempic, and Rybelsus , Liraglutide brand names Saxenda and Victoza , or Dulaglutide brand names Trulicity.

In addition, many members have had success with other medications such as Naltrexone, Bupropion, Zonisamide, and Topiramate. Is Sequence available in every state?