Nutritional Care means the meeting of nutritional needs, required during the different stages of life & health conditions. 

The care process is made up of:
1.    Assessment of nutritional status
2.    Identification of nutritional needs / problems
3.    Planning the main objectives of nutritional Care.
4.    Application of nutritional activities essential to meet the objectives
5.    Evaluation of nutritional upkeep.

Hospitalized patients with different illnesses require much more care than simply providing a tray for each meal.  Patients intake of diet, adequacy of nutrients, if require the support of enteral or parentral feeding or simply by rewarding dieting patttern & menu.  Along with it the need to give diet counselling etc.

Nutritional Intervention : Diet Modification
Therapeutic diets are based on a normal, adequate diet that is modified as necessary to provide for individual requirements.  In general, the therapeutic diet should vary from the individual’s diet as little as possible, unless inadequacies must be remedied.

Modifications of  the Normal Diet.
Therapeutic diets may be defined as quantitative and qualitative modifications of the normal diet.  The qualitative diet is an adequate diet adjusted according to the type of food allowed.  The quantitative diet is calculated with an increase or decrease in the amount of the food constituents.

The adjustment in diet may take any of the following forms :

•     Change in consistency of foods (liquid diet, soft diet, etc.)

•     Increase or decrease in energy value of diet (weight - reduction diet etc.)

•     Increase/decrease in type of foods (sodium restricted diet.)

•     Elimination of specific foods (gluten free diet)

•     Adjustment in the ratio and balance of proteins, fats (diabetic diet, renal diet)

•     Rearrangement of the number and frequency of meals (diabetic diet)

Standard Hospital Diets.
The types of standard diets are usually referred to as general, light, soft and liquid.  These diets are used routinely for the patients with certain physical conditions and serve as a foundation for the diversified therapeutic diets.

1.General or Adequate Normal Diet:
In some hospitals, the general diet is also known as the “regular”. “full” or “house” diet.  A normal diet is defined as one which consists of all kinds of foods eaten by a person in good health.  It is planned keeping in mind the basic food groups so that optimum amounts of all nutrients are provided.  Since the patient is on bed-rest, a reduction of 10% in energy intake should be made and too much of fried and fatty foods should be avoided since they are difficult to digest.  The advantage of taking normal diet as the basis is that it provides a similarity of psychological and social needs of the sick with those who are healthy.  This also avoids the patient being labelled as sick and on a “special diet”  which is different from his own normal diet.

2.Soft Diet
The soft or light diet is used as a transition.  It is an adequate diet that is soft in consistency, easy to chew,  made up of simple easy digestible foods, is moderately low in cellulose and connective tissue. Such a diet is planned for conditions in which mechanical ease in eating or digestion is desired.  It is appropriate for patients who have few or no teeth or ill-fitting dentures.  This diet is prescribed for acute infections, certain gastroinstestinal disorders and at the post-operatiave stage.

3.    Liquid Diets :
Liquid diets are commonly ordered for patients with conditions requiring nourishment that is easily digested and consumed or that has minimal residue.

The two varieties of oral liquid diets are :
    FULL LIQUID DIET
    CLEAR LIQUID DIET

Full Liquid Diet :
The full liquid diet is made up of foods that are liquid at room or body temperature.  For example, icecream and gelatin are both considered to be liquids.  If properly designed and consumed, the diet is considered adequate for maintenance requirements except for fibre.  If this diet is to be continued for a long time, then protein and vitamin supplements can be added to it.

Clear Liquid Diet
The clear liquid diet is frequently ordered for post operative patients to furnish fluids, some electrolytes, and small amounts of energy prior to the return of gastroinstential function.  It is an inadequate diet composed chiefly of water and carbohydrates, therefore it should be used for a very short time.
The clear liquid diet cannot replace the electrolytes lost in vomitting and diarrhoea.  Electrolytes may need to be added or they are supplied in the parenteral fluids that these patients are also receiving at the same time.  This diet is served at frequent intervals to supply the tissue with fluid and relieve thirst.