A review into the use of ‘light diets’ for patients on surgical wards

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Abstract:

Background: 

The use of unnecessary or inappropriate dietary restriction may place patients at increased risk of malnutrition, the consequences of which are widely recognised (Alberda et al., 2006). The ‘light diet’, a historical approach to post-operative nutrition, is commonly requested for the dietary management of surgical patients. The aim of the review was to quantify the use and establish knowledge and understanding of the ‘light diet’. Methods: 

A literature search using the term ‘light diet’ was conducted using MEDLINE (1966 August 2005) and EMBASE (1980 August 2005).Surgical patients (170) were reviewed on a single day and those on a ‘light diet’ (indicated by bed signs) were recorded. A questionnaire of five multiple choice and open questions was developed, piloted and distributed to 100 multidisciplinary health professionals within the surgical directorate (surgeons, doctors, nurses, auxiliaries, dietitians and caterers) at random. All patients on a ‘light diet’ were asked if they were clear on what the dietary instruction involves. Results: 

No literature was found using the search term ‘light diet’. Ten per cent of patients (17/170) were found to be on a ‘light diet’ on the day of the review; none of the patients understood the reason the diet was prescribed. The completion rate for the staff questionnaires was 67%. Fifty-six believed that the diet consisted of soup and dessert, 30 small frequent meals and <10 thought it consisted of low fibre choices or light coloured foods, e.g. meringue, rice. The reasons given for prescribing a ‘light diet’ were following any gastrointestinal (GI) surgery, any GI investigation, oesophageal stent insertion, bowel obstruction, renal transplant or cardiothoracic surgery. The duration of the diet ranged from 1 to 7 days or on end point including the patient eating more, bowel function returned, level of nausea or at the surgeon's discretion. No group of healthcare professionals was identified as being responsible for providing dietary information although nurses or dietitians were most frequently cited. None of the staff were aware of any clinical evidence or hospital policy to support the use of ‘light diets’. Discussion: 

There appears to be little evidence to support or refuse the use of ‘light diets’. Patients and healthcare professionals appear to be unclear of advocacy for the use of ‘light diets’. Conclusions: 

The advocacy of a ‘light diet’ is neither evidence based practice nor best practice. Reference 

Alberda, C., Graf, A. & McCargar, L. (2006) Malnutrition: etiology, consequences, and assessment of a patient at risk. Best Pract. Res. Clin. Gastroenterol.20, 419–439.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-277X.2008.00881_40.x

Publication date: August 1, 2008

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