Description
Additional foods and supplements are added to meals or between meals to increase protein and energy intake.
Indications
A high-protein, high-calorie diet is served when protein and energy requirements are increased by stress, protein loss (protein losing enteropathy, nephrotic syndrome), and catabolism. This diet may be indicated in patients with:
· protein-energy malnutrition
· failure to thrive
· cancer
· burns
· cystic fibrosis
· human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)
· chronic gastrointestinal diseases
This diet may also be indicated in preparation for surgery. An increase in energy is required to promote the efficient utilization of proteins for anabolism.
Nutritional Adequacy
The diet can be planned to meet the Dietary Reference Intakes (DRIs) as outlined in Statement on Nutritional Adequacy in Section IA.
How to Order the Diet
Order as “High-Protein, High-Calorie Diet.” The dietitian determines a target level of protein and energy to meet individual needs based on guidelines as stated in Estimation of Protein Requirements in Section II.
Planning the Diet
The diet is planned as a Regular Diet with addition of between-meal supplements that increase energy intake by at least 500 kcal and protein intake by 25 g for adults. Examples of high-protein, high-energy supplements are milk shakes, eggnogs, puddings, custards, and commercial supplements.
For children, the diet generally should provide 120% to 150% of the Dietary Reference Intakes (DRIs) for energy and protein. The actual amounts of energy and protein provided will depend on the child’s or adolescent’s age, height, weight, medical status, and nutrition goals.
