Introduction:
Every individual requires a healthy balanced diet that is suited to their nutritional needs and
preferences so that they aren’t at risk of nutrient deficiencies and illnesses. Following a balanced
diet decreases your risk of obesity and therefore, other health implications caused by this such as
strokes, heart attacks and coronary heart disease. It isn’t just the foods you eat, but also the fluids
you drink as well because drinks can contain a lot of sugar, caffeine, preservatives, and additives that
can contribute to a poor health and wellbeing. Consequently, drinking a substantial amount of water
per day has many health benefits physically and mentally such as clearing skin, improving digestion
and improving concentration. The average amount of water that should be drank by adults per day is
around 8 glasses, but it does vary depending on age. The average calorie intake for women is 2000
calories per day whereas, for men it is 2500 meaning sticking to these will ensure that a healthy
weight is maintained. If individuals wish to lose weight then this calorie intake may decrease
depending on the amount of calories your body burns per day. Whereas, if you wish to gain weight
then the amount of calories will increase depending on how much you wish to gain.
Record food intake:
There are often some real concerns about someone’s dietary intake meaning an accurate record is
required of all the food and drink over a period of a few days. All food that is eaten must be
included, such as meals, snacks, sweets, drinks and food supplements, and portion sizes must be
indicated. If individuals suffer with anorexia, or have lost their appetite, this may be useful in making
individuals realise how much or how little they are actually consuming. Dieticians assess the daily
intake to enable them to plan and improve nutrition.
Maintaining nutritional needs:
The Health and social care Act 2008 means every health and social care organisation has individuals
in their care that have enough to eat and drink by providing them with the supplies to do so. They
also ensure that service users are well nourished and hydrated. In order to achieve this, service users
must have a nutritional needs assessment and if necessary after doing this, a plan is implemented to
ensure that the support is in place to ensure service users are malnourished.
Nutritional assessment score: What is it and why is it used by dietitians?
The ‘Malnutrition Universal Screening Tool’ known as the MUST has been used by multiple health
and social care professionals including dieticians since 2003. The Malnutrition Advisory Group
developed this and it is the most commonly used nutritional assessment tool in the UK, it is also
supported by the Royal College of Nursing and the British Dietetic Association.
There is a five-step process used by MUST in order to help diagnose malnutrition. The first step is
measuring height and weight to help calculate BMI so that the professional is able to distinguish
whether the service user is underweight, overweight, healthy weight or obese. The second step is
finding out if there has been any unplanned weight loss in the past 3-6 month and then you must
find out if the person has been acutely ill and there has been or is likely to be no nutritional intake
for >5 days. After this, professionals should add total score from steps 1-3 and once a person has
been identified as at risk of malnutrition, a care plan should be developed to inform carers about the
strategies that should be used to reduce the risk. Some of these strategies include:
• Referral to a dietician
• Food supplements
• Special dietary considerations, personal preferences, and familiar foods.
,Fluid balance:
The fluid content in the body is regulated by hormones in the process of homeostasis. A hormone
released by the pituitary gland known as the antidiuretic hormone decreases the amount of fluid the
kidneys produce, and adrenal glands produce aldosterone to stimulate the reabsorption of sodium in
the kidneys and subsequently causes water to be reabsorbed, maintaining homeostasis. Fluid
balance can become disturbed causing dehydration or water retention meaning diarrhoea, vomiting,
heatstroke, high blood glucose levels, and high temperature may be caused due to dehydration. If
fluid retention happens, it can result in heart failure, kidney failure, alcoholic cirrhosis of the liver
and obstruction of the lymphatic system. To help diagnose conditions, a useful tool is measuring
fluid that comes in and out of the body such as fluid in foods and in hospitals via drips and tube
feeding. Fluid leave the body through sweating, breathing out, in faeces, vomit, and urine.
Disclaimer: This portfolio and nutritional diet plan will support an individual over a 4 week period to
improve the service user’s nutrition health and well-being whilst meeting their nutritional/dietary
needs.
,Overview of service user and aim of nutritional plan
Barbara is an elderly individual who has recently had a stroke meaning she struggles to swallow. As a result, the aim of
her nutritional plan is to get the calories into her diet without causing her too much difficulty so that she is able to
maintain a healthy weight. Barbara will need some assisted walks to ensure that she can stay as active as possible for as
long as possible meaning she stays healthy and hopefully improve her health as a whole.
Service users age:
84
Nutritional needs/ dietary requirements Barbara will require a dysphagia and soft foods-based diet to ensure that
she is able to swallow the foods without difficulty. By doing this, it will
ensure that she has a substantial amount of calories as she is still receiving
the nutrients meaning she also prevents her risk of nutrient deficiencies.
As Barbara has had a stroke, decreasing her saturated fat levels should be
good so that her cholesterol also decreases.
Energy expenditure/ recommended The website livestrong (nd) said that elderly females over 70 should
calories per day consume around 1870 calories per day to stay healthy meaning this is
how many Barbara should consume as she wishes to maintain her weight.
According to who? However, Barbara is sedentary meaning she should consume around 1500
calories.
Recommended daily exercise Minutes Type (s) of exercise Additional notes
The website For Barbara, because of her There is more
According to who? Stroke limited mobility exercise may exercises elderly
Association (nd) become difficult. Therefore, people are able
said that older walking is probably her best to do such as
individuals over option. Zumba and other
60 who have things that raise
suffered a stroke the heart rate.
should aim to do However, these
daily exercise. would not be
Therefore, suited to
Barbara should Barbara.
aim to do some
gentle exercise
everyday.
How will the nutritional plan below Lifestyle choices Personal food preferences e.g. Additional notes
support the following cultural/ socio-economic
Barbara cannot She wouldn’t have that much Carers would
swallow money due to her not working also be able to
, effectively anymore. Therefore, as she lives provide her with
meaning she can in a care home, food is able to be support in terms
only consume soft provided to her by the carers, so of helping her
foods and she doesn’t have to worry. actually consume
dysphagia foods her food.
How will the plan be monitored? Be
specific and explain why The plan will be monitored by her carers and possibly a dietician as she is
unable to manage on her own. Therefore, she is not going to be able to
effectively manage to control her own diet independently and will require
assistance with both food and activity levels.
Using My Fitness Pal produce clear plans to improve the nutritional health of two selected
individuals.
Service user 1: Barbara
Day 1:
Breakfast Ready brek with honey, smooth peanut butter and
strawberry puree
Snack Forti sip vanilla milk
Lunch Resource thickened chicken soup.
Snacks Chocolate mousse and fortisip chocolate
Dinner Dysphagia lasagne and an actimel
Fluid intake 1500ml water
Exercise Assisted gentle walk for 10 minutes + 31 cals
Evidence including: food analysis table, charts relating to portion sizes, information on food
packaging.
Every individual requires a healthy balanced diet that is suited to their nutritional needs and
preferences so that they aren’t at risk of nutrient deficiencies and illnesses. Following a balanced
diet decreases your risk of obesity and therefore, other health implications caused by this such as
strokes, heart attacks and coronary heart disease. It isn’t just the foods you eat, but also the fluids
you drink as well because drinks can contain a lot of sugar, caffeine, preservatives, and additives that
can contribute to a poor health and wellbeing. Consequently, drinking a substantial amount of water
per day has many health benefits physically and mentally such as clearing skin, improving digestion
and improving concentration. The average amount of water that should be drank by adults per day is
around 8 glasses, but it does vary depending on age. The average calorie intake for women is 2000
calories per day whereas, for men it is 2500 meaning sticking to these will ensure that a healthy
weight is maintained. If individuals wish to lose weight then this calorie intake may decrease
depending on the amount of calories your body burns per day. Whereas, if you wish to gain weight
then the amount of calories will increase depending on how much you wish to gain.
Record food intake:
There are often some real concerns about someone’s dietary intake meaning an accurate record is
required of all the food and drink over a period of a few days. All food that is eaten must be
included, such as meals, snacks, sweets, drinks and food supplements, and portion sizes must be
indicated. If individuals suffer with anorexia, or have lost their appetite, this may be useful in making
individuals realise how much or how little they are actually consuming. Dieticians assess the daily
intake to enable them to plan and improve nutrition.
Maintaining nutritional needs:
The Health and social care Act 2008 means every health and social care organisation has individuals
in their care that have enough to eat and drink by providing them with the supplies to do so. They
also ensure that service users are well nourished and hydrated. In order to achieve this, service users
must have a nutritional needs assessment and if necessary after doing this, a plan is implemented to
ensure that the support is in place to ensure service users are malnourished.
Nutritional assessment score: What is it and why is it used by dietitians?
The ‘Malnutrition Universal Screening Tool’ known as the MUST has been used by multiple health
and social care professionals including dieticians since 2003. The Malnutrition Advisory Group
developed this and it is the most commonly used nutritional assessment tool in the UK, it is also
supported by the Royal College of Nursing and the British Dietetic Association.
There is a five-step process used by MUST in order to help diagnose malnutrition. The first step is
measuring height and weight to help calculate BMI so that the professional is able to distinguish
whether the service user is underweight, overweight, healthy weight or obese. The second step is
finding out if there has been any unplanned weight loss in the past 3-6 month and then you must
find out if the person has been acutely ill and there has been or is likely to be no nutritional intake
for >5 days. After this, professionals should add total score from steps 1-3 and once a person has
been identified as at risk of malnutrition, a care plan should be developed to inform carers about the
strategies that should be used to reduce the risk. Some of these strategies include:
• Referral to a dietician
• Food supplements
• Special dietary considerations, personal preferences, and familiar foods.
,Fluid balance:
The fluid content in the body is regulated by hormones in the process of homeostasis. A hormone
released by the pituitary gland known as the antidiuretic hormone decreases the amount of fluid the
kidneys produce, and adrenal glands produce aldosterone to stimulate the reabsorption of sodium in
the kidneys and subsequently causes water to be reabsorbed, maintaining homeostasis. Fluid
balance can become disturbed causing dehydration or water retention meaning diarrhoea, vomiting,
heatstroke, high blood glucose levels, and high temperature may be caused due to dehydration. If
fluid retention happens, it can result in heart failure, kidney failure, alcoholic cirrhosis of the liver
and obstruction of the lymphatic system. To help diagnose conditions, a useful tool is measuring
fluid that comes in and out of the body such as fluid in foods and in hospitals via drips and tube
feeding. Fluid leave the body through sweating, breathing out, in faeces, vomit, and urine.
Disclaimer: This portfolio and nutritional diet plan will support an individual over a 4 week period to
improve the service user’s nutrition health and well-being whilst meeting their nutritional/dietary
needs.
,Overview of service user and aim of nutritional plan
Barbara is an elderly individual who has recently had a stroke meaning she struggles to swallow. As a result, the aim of
her nutritional plan is to get the calories into her diet without causing her too much difficulty so that she is able to
maintain a healthy weight. Barbara will need some assisted walks to ensure that she can stay as active as possible for as
long as possible meaning she stays healthy and hopefully improve her health as a whole.
Service users age:
84
Nutritional needs/ dietary requirements Barbara will require a dysphagia and soft foods-based diet to ensure that
she is able to swallow the foods without difficulty. By doing this, it will
ensure that she has a substantial amount of calories as she is still receiving
the nutrients meaning she also prevents her risk of nutrient deficiencies.
As Barbara has had a stroke, decreasing her saturated fat levels should be
good so that her cholesterol also decreases.
Energy expenditure/ recommended The website livestrong (nd) said that elderly females over 70 should
calories per day consume around 1870 calories per day to stay healthy meaning this is
how many Barbara should consume as she wishes to maintain her weight.
According to who? However, Barbara is sedentary meaning she should consume around 1500
calories.
Recommended daily exercise Minutes Type (s) of exercise Additional notes
The website For Barbara, because of her There is more
According to who? Stroke limited mobility exercise may exercises elderly
Association (nd) become difficult. Therefore, people are able
said that older walking is probably her best to do such as
individuals over option. Zumba and other
60 who have things that raise
suffered a stroke the heart rate.
should aim to do However, these
daily exercise. would not be
Therefore, suited to
Barbara should Barbara.
aim to do some
gentle exercise
everyday.
How will the nutritional plan below Lifestyle choices Personal food preferences e.g. Additional notes
support the following cultural/ socio-economic
Barbara cannot She wouldn’t have that much Carers would
swallow money due to her not working also be able to
, effectively anymore. Therefore, as she lives provide her with
meaning she can in a care home, food is able to be support in terms
only consume soft provided to her by the carers, so of helping her
foods and she doesn’t have to worry. actually consume
dysphagia foods her food.
How will the plan be monitored? Be
specific and explain why The plan will be monitored by her carers and possibly a dietician as she is
unable to manage on her own. Therefore, she is not going to be able to
effectively manage to control her own diet independently and will require
assistance with both food and activity levels.
Using My Fitness Pal produce clear plans to improve the nutritional health of two selected
individuals.
Service user 1: Barbara
Day 1:
Breakfast Ready brek with honey, smooth peanut butter and
strawberry puree
Snack Forti sip vanilla milk
Lunch Resource thickened chicken soup.
Snacks Chocolate mousse and fortisip chocolate
Dinner Dysphagia lasagne and an actimel
Fluid intake 1500ml water
Exercise Assisted gentle walk for 10 minutes + 31 cals
Evidence including: food analysis table, charts relating to portion sizes, information on food
packaging.
