GROUP 2 - BLUEBERRIES

CASE STUDY

A 12 years old female student feels a slight fever while at school. She was brought to
the clinic and complained about her difficulty of mastication (chewing) and deglutition
(swallowing) due to her poor denture and tonsillitis. She was given medication and yet
the fever never stops so her parents decided to bring her to the hospital for her to be
treated since the child is not able to take enough food due to her condition. The student
weighs 32 kg.

Patients Information
Name of Patient: Jane Reyes
Age: 12 y.o.
Weight: 32kg
DBW: (Age in years x 2)+ 8= 32kg
Lab results and others: CBC & Urinalysis

TER, DBW, TER Computation

TER (Total Energy Requirement)
TER/DAY = 1000 + (100 X Age in years)
= 1000 + (100 x 12)
= 2200 kcal

DBW (Desirable Body Weight)

DBW = (Age in years x 2) + 8
= (12 x 2) + 8
= 24 + 8
= 32 kg

TER% Distribution
4kcal CHO - 65% CHO = 2200kcal x 0.65 = 1430 ÷ 4 = 357.5 → 355g
4kcal CHON - 15% CHON = 2200kcal x 0.15 = 330 ÷ 4 = 82.5 → 80g
9kcal FATS - 20% FATS = 2200kcal x 0.20 = 440 ÷ 9 = 48.8 → 45g
DISTRIBUTION (2,200 kcal, CHO 355 g, CHON 80 g, Fats 50g)

List No. of CHO CHON FAT Energy

exchange (355g) (80g) (50g)

I. Vegetables 5 15 5 - 80

II. Fruits 5 50 - - 200

III. LF milk 1 12 8 - 125

102
CHO: 355g - 102 = 253 ÷ 23 = 11 rice exchanges

IV. Rice A 5 115 - - 460

Rice B 3 69 6 - 300

Rice C 3 69 12 - 324

31
CHON: 80g - 31g = 49 ÷ 8 = 6 meat exchanges

V. LF Meat 6 - 48 6 246

6
FATS: 50 - 6 = 44 ÷ 5 = 8.8/9 fat exchange

VI. Fat 9 - - 45 405

TOTAL: 366 grams 79 grams 51 grams 2,195kcal

Diet with Definitions

SOFT DIET
 A soft diet is a diet that is used for people with chewing and swallowing

problems. This diet serves as a transition from a full liquid to a regular full diet. This diet

reduces fibre content and alters the consistency to a softer texture. A soft diet consists

of soft, low-fibre, and simple-to-digest foods. A gastrointestinal (GI) soft diet is another

name for this type of diet. After surgery or digestive trouble, it is used. For as long as

the doctor advises, this diet is adhered to. This can occur over the next two to three

weeks or whenever the patient’s bowel motions and appetite return to normal.

The foods in this diet may be cooked, mashed, chopped, ground, and pureed

to make them softer. Fruits and vegetables can be substituted for those that are hard,

raw, or dried by using soft-cooked versions. Typically, refined bread and cereals are

preferred to coarse, whole-grain varieties. Fish, poultry, and moist, soft meats are okay;

they don’t need to be ground unless you want to. Eating little, frequent meals might

lessen bloating or gas.

Foods in this diet are only altered in terms of texture and consistency. Fruits

and vegetables are prepared by being diced, or chopped, and cooked for a bit longer.

To make swallowing and chewing easier meat, poultry and fish can be ground, minced,

and moistened with a sauce. Crust bread, crackers, crisp rolls, and toast may initially be

restricted because they might be dry and challenging to swallow. It might not be

necessary to make any changes to milk or other dairy products such as pudding,

custard, or smooth yoghurt.

1-week Menu Plan Basing on the Diet

Diet Proportion: 2,200 kcal, Carbohydrates 355 g, Protein 80 g, Fat 50 g

Table Distribution of Exchanges per meal
 Food Number of Breakfast Morning Lunch Afternoon Supper
Groups Exchanges Snack Snack

Vegetable 5 2 1/2 2 1/2

Fruit 6 2 1 1 1 1

LF milk 1 1

Rice A 5 2 1/2 1 1 1/2

Rice B 3 1/2 2 1/2

Rice C 3 2 1

Meat 6 1 1 2 1/2 1 1/2

Fat 9 2 1 3 1 2

Day 1:

MEAL FOOD NO. OF SAMPLE MENU HOUSEHOLD

GROUP LIST EXCHANG MEASURE
E
 Breakfast Fruit 2 Ripe papaya (w/o 2 slices
skin & seeds)

Rice C 2 Oatmeal 3 cups

Morning snack Banana Smoothie (no sugar & ice)

Fruit 1 Banana, lacatan ½ slice

LF Milk 1 Milk, low fat 1 cup

Tofu misua soup w/ ground pork and egg

LUNCH
Sponge gourd
(Patola)

Onions
Vegetable 2 1/2 1 cup
Tomato

Garlic

Spring onion

Fat 3 Oil (Olive) 3 tsps

Soybean Curd (Tofu) 2 ½ pieces

Meat 2½
Tenderloin (Ground) 2 ½ slices
Egg 1

Rice A 2½ Noodles, wheat, thin 2 ½ cup

Fruit 1 Banana, lacatan 1 piece

Afternoon snack Rice B 2 Mamon 2 pieces

Fruit 1 Applesauce 1 cup

(unsweetened)

Supper Rice B ½ Rice, well-milled ¼ cup

Squash soup

Squash

Onion
Vegetables 2½ 1¼
Ginger

Garlic

Fat 2 Oil (Olive) 2 tsps

LF meat 1½ Baked fish (Tilapia) ¾ slice

Day 2:

MEAL FOOD NO. OF SAMPLE MENU HOUSEHOLD

GROUP LIST EXCHANG MEASURES
 E

Breakfast Porridge with shredded boiled chicken

Rice B 1 Porridge 1 ½ cup

Lf Meat 1 Chicken breast 1 piece

Morning Snack Fat 1 mamon 2 pieces

Unsweetened Yogurt With Banana

Lf Milk 1 Yogurt ½ cup

Fruit 1 Banana, Lacatan ½ piece

Lunch Adobong Tofu

Meat 2½ Soybean curd, 1 ¼ cup

tofu

Vegetable Garlic Cloves, 1 clove

1 minced

Rice B 1 Rice, well-milled 1 cup

Fruit 2 Watermelon 1 slice

Afternoon snack Mashed Potato Without Milk

Rice A 1 Potato 1 piece

Fat 2 Margarine 2 tsp

Vegetable 1 Garlic (minced 2 cloves

and peeled )

Supper Chicken Soup

Vegetable Carrots

2½ Spring onion 1 ½ pcs

Garlic

Day 3:

MEAL FOOD NO. OF SAMPLE MENU HOUSEHOLD

GROUP LIST EXCHANG MEASURE
E
 Breakfast Rice C 2 Bread (mamon) 3 pcs

Fruit 2 Banana 1 pc

Meat 1 Liver (grind) ¼ cup

Morning snack Fruit Grapes (without skin

1 and seed) 12 pcs

LF Milk 1 Yogurt ½ cup

Meat 1 Egg (medium boiled) 1 pc

Lunch Rice A 2½ Cassava (mashed) 2 ½ slice

Tinolang Isda

Meat 2½ Tangigi 2 ½ pcs

Vegetable Ginger
Tomato
Malunggay
2½ leaves 2 ½ cup
Onion
Lemon grass

Fat 3 Fish oil 3 tsp

Fruit 1 Ripe papaya (without 1 slice

skin and seeds)

Afternoon snack Mashed sweet potato

Rice A 1 Sweet potato (peeled) 1 pc

Fat 1 Margarine 1 tsp

Rice B 2 Steamed bun 1 pc

Fruit 1 avocado 1 slice

Supper Tilapia with Sotanghon Noodle Soup

Meat 1½ Tilapia ¾ slice

Rice A 1½ Sotanghon 1 ½ cup

Vegetable Ginger
Spring onion
Garlic
2½ Black pepper 2 ½ cup
Carrot (cut into

Fat 2 Oil 2 tsp

Rice B ½ Rice (soft cooked) ¼ cup

Day 4:

MEAL FOOD NO. OF SAMPLE MENU HOUSEHOLD

GROUP LIST EXCHANGE MEASURE

Breakfast Fruit 1 Apple, Red (Juice) 1 piece

 Pancake (No Milk)

Rice C 2 Pancake 2 pieces

Fruit 1 Banana, Lacatan ½ piece

Meat 1 Egg, Chicken 1 piece medium

Whole

Fat 2 Margarine 2 teaspoons

Morning Snack Rice C 1 Egg Pie ⅛ slice

Unsweetened Yogurt with Banana

LF Milk 1 Yogurt ½ cup

Fruit 1 Banana, Lacatan ½ piece

Lunch Tinolang Isda (Hasa-Hasa)

Scallions

Vegetable 2½ Onions 2 ½ cup

Tomato

Ginger

Meat 2½ Hasa-Hasa (Fish) 2 ½ pieces

Fruit 1 Papaya, ripped 1 slice

Rice A 2 Rice, “Protein- ⅔ cup

reduced”

Afternoon Snack Rice B 1 Mamon 2 pieces

Watermelon Smoothie (no sugar & ice)

Fruit 1 Watermelon 1 slice

LF Milk 1 Milk, low fat 1 cup

Supper Rice B 1/2 Rice, well-milled ¼ cup

Fruit 2 Saging, lacatan 1 piece

Baked Tilapia

Meat 1 1/2 Tilapia 1 ½ slice

White Stock

LF meat 1 1/2 Chicken, breast 1 ½ slice

Stalk celery
Vegetable 2 1/2 2 ½ cup
Yellow onion

turnip

Day 5:

MEAL FOOD NO. OF SAMPLE MENU HOUSEHOLD

GROUP LIST EXCHANGE MEASURE

Breakfast Fat 2 Avocado 2 pcs

 Meat 1 Poached egg 1 pc

Rice C 2 Bread (mamon) 4 pcs

Morning Snack Pancakes with fresh milk

Meat 1 Egg 2 pcs

Fat 1 Butter 1 tbsp

Rice A 1 Cornstarch
Baking 2 ½ cups
powder

Rice C Pancake 3 pcs

Milk 1 Low-fat
yogurt 2 ½ cups
Low-fat milk

Lunch Rice A 2 1/2 Rice ¾ cup

Steamed lapu-lapu fish and Squash Puree

LF meat 2½ Lapu-lapu fish 1 ¼ slice

Squash 1 ¼ pcs
Vegetable
2½ Onion
Stalk leek 2 ½ pcs
Carrot

Fat 3 Butter ¼ cup

Sesame oil 3 tbsp

Fruit 1 Banana 1 pc
(lakatan)

Afternoon snack Egg sandwich with Fresh peach smoothie (without ice)

Meat 1 Egg 2 pcs

Rice C 1 White bread 2 pcs

Fruit 1 Peach 1 pc

Milk 1 Low-fat yogurt ½ cup

Supper Plain Rice Porridge

Rice B 1/2 Rice 2 ¼ cups

Day 6:

MEAL FOOD GROUP NO. OF SAMPLE MENU HOUSEHOLD

LIST EXCHANGE MEASURE

Breakfast Vegetable 1 Mashed Potato 1 cup

 LF Milk 1 Milk, low fat 1 cup

Morning Snack Banana Smoothie (w/o iced and sugar)

Fruit 1 Banana, ½ pc
Latundan

LF Milk 1 Yogurt ½ cup

Milk 1 cup

Lunch Baked Peeled Eggplant

Vegetable 1 eggplant 1 pc

Fat 2 Oil, Canola 1 tbs

Grilled Tuna

LF Meat 2½ Tuna belly 2 ½ lb

Vegetable 1 Garlic, minced 1 glove

and peeled

Fat 1 Sesame oil 1 tsp

Rice B 1 Rice , soft 1

cup
2 cooked 3

Afternoon Snack Rice B 1 Mamon 1 pieces

Supper Ginisang Ampalaya w/ egg, well cooked

Ampalaya

Vegetable 2 Garlic
1 cup
Onion

Tomato

Fat 2 Oil, Canola 3 tbsp

Meat 1 Raw eggs 2 pieces

2

Chicken, Crab and Mushroom soup

Green Onion 1 piece

Vegetable Parsley 2 tsp

1
Mushroom 1 cup
(chopped w/o
roots)

Crab leg meat 1 cup

LF Meat Chicken breast, 1 cup

1 skin removed

Egg white, 2 pieces

beaten

Day 7:
 MEAL FOOD GROUP NO. OF SAMPLE HOUSEHOLD
LIST EXCHANGE MENU MEASURE

Breakfast 1 Pancake 1 pc

Fat 1 Avocado 1 pc

Morning Snack Rice B 1 Mamon 2 pcs

Lunch Sarciadong Galunggong

Vegetable 2 Tomato 1pc

LF meat 2½ Fish 2 ½ pcs

Egg

Fat 1 Oil (canola) 2 tbsp

Afternoon Snack Mashed Potato

3 Potato 1 pc

Supper 1 Rice 1 cup

Chicken Sotanghon Soup

LF meat 2 Chicken 2 pcs

(breast)

Sotanghon 1 pack
noodles

Cabbage ⅛ kl
Vegetable
Onion (peeled 1
and slice)

Fat Oil (canola) 2 tbsp

Foods allowed and Not Allowed

Foods and Liquids ALLOWED Foods and Liquids NOT ALLOWED

 ➢ Soft boiled vegetables (carrots, ➢ Hard crackers or crisps
cucumber, beetroot) ➢ Cold drinks
➢ Soups, broth ➢ Husky foods (popcorn, sesame
➢ Yogurt seeds)
➢ Applesauce ➢ Sugary foods
➢ Pudding ➢ Alcohol
➢ Mashed potato ➢ Spicy foods
➢ Rice (soft cooked)
·
➢ Soft pieces of meat
➢ Squash (pureed)
➢ Spinach
➢ Ginger Tea
➢ Scrambled Egg

MAIN DISH: Tofu Misua Soup with Ground Pork and Egg

Ingredients:
● Sponge gourd (Patola)
 ● Onions
● Tomato
● Garlic
● Spring onion
● Oil (Olive)
● Soybean Curd (Tofu)
● Tenderloin (Ground)
● Noodles, wheat, thin (Misua)
● Salt & pepper to season
● 1 Knorr pork cube
● Egg

Instructions:

1. Prepare the tofu, slice them up into cubes and pat them dry to remove excess

moisture. In a separate pot, prepare 2 cups of water and place in the egg. Once it

boils, take it off the heat after 5 minutes.

2. Heat oil in a cooking pot. Once the oil becomes hot, pan fry the tofu until the

outer part turns light brown. Note: the tofu does not need to be cooked

completely at this point.

3. Remove the tofu from the pot. Set aside.

4. Using the remaining oil, saute garlic until golden brown. Add tomatoes and onion.

Continue to cook until they soften. Afterwards, put the grinded pork in and mix

well until fairly cooked. Pour water. Let it boil.

5. Add Knorr Pork Cube. Stir. Cover the pot and cook in medium heat for 15

minutes.

6. Add misua and patola. Cover and cook for 5 minutes.

7. Season with salt and ground black pepper. Stir.

8. Add spring onions. Transfer to a serving bowl along with the peeled egg

HEALTH TEACHING
 Since the patient is complaining of difficulty of mastication and deglutition due to
her poor denture and tonsillitis, a soft diet is advised. The advantage of a soft diet
makes eating safer and easier for those who have difficulty chewing and swallowing.
Food included in this diet must be soft and small and require minimal chewing. This is to
ensure that the patient will meet the desired nutrient needed. If unsure whether a food is
safe to eat, speak with a healthcare professional such as a registered dietitian.

A physician may prescribe her anti-inflammatory or anti-bacterial drugs to help

the patient fully recover from tonsillitis. Also it is important that the patient will not eat
food that is not allowed to suppress and not trigger relapse of her illness. Provide dental
care after meals. Understanding was verbalised.

CONCLUSION

Jane Reyes is 12 years old and 32 kilograms - weight. She is suffering from
tonsillitis caused by streptococcal bacteria. The result of CBC shows bacterial infection
in her throat which leads to her difficulty of swallowing and mastication affected by her
poor dentures as well. Considering the patient's circumstances, a soft diet is advised for
Jane, which she should follow for seven days in order to recover from her illness and
reduce any symptoms or pain she may be experiencing. A meal plan based on a soft
diet is created in an effort to satisfy Jane's dietary needs. The course of treatment calls
for consuming at least 2200 calories daily. The distribution of total energy requirements
restricts an approximation of the number of servings needed for carbohydrates, protein,
and fat. The patient's required nutritional intake is calculated to be 355g of
carbohydrates, 80g of protein, and 45g of fat.

The goal of the 7-day soft diet meal plan is to provide a balance of nutrition, with
enough calories in order to eliminate any malnutrition and to have an adequate intake of
protein, carbohydrate and fat which will create a healthy weight gain. The total energy
requirement distribution also maintains the consumption of all essential nutrients,
vitamins and minerals.

The meal plan concludes a dietary consumption for the patient who is on a soft
diet due to difficulty swallowing or mastication caused by poor dentures or other
conditions where food needs to be easy for chewing and digestion, like tonsilitis.
Provided that the guidelines are met and a health teaching plan is rendered, the patient
will be able to recover from her illness and be back to her healthy and lively state again.

Resources:
Administrator, C. G. I. (2018, September 24). Soft and Mechanical Soft Diet.

Jackson Siegelbaum-Gastroenterology.-https://www.gicare.com/gi-health-

resources/soft-and-mechanical-soft-diet/

Kannall, E. (2018, June 11). What Is a Soft Diet Used For? Healthy Eating | SF

Gate. https://healthyeating.sfgate.com/soft-diet-used-for-9584.html

Kubala, M. J. S. (2020, April 2). Soft Food Diet: Foods to Eat and Foods to

Avoid. Healthline. https://www.healthline.com/nutrition/soft-food-diet

Low Fiber Diet / Soft Foods Diet. (n.d.). Cleveland Clinic.

https://my.clevelandclinic.org/health/articles/15637-gastrointestinal-soft-diet-

overview