All special diets should be based upon the normal requirements of the individual... If one food substance must be restricted, the diet must in all other respects be adequate.
Rose Simmonds, Handbook of Diets (1937)
Menu planners must devise a standard menu that meets the nutritional needs of most of the population. Any special dietary requirements or nutritional needs of specific patient groups can be met by separate à la carte or cyclical menus.
Standard hospital menus should:
Table 12.1: Food and drink dietary descriptors
Type of Diet
Meet the nutritional needs of most of the population spanning nutritionally vulnerable to nutritionally well
Diets that cater to cultural, religious or lifestyle beliefs (including veganism) and reasonably meet the personal preferences of patients
Dietary modifications as a prescribed part of the treatment of a medical condition e.g., renal disease, swallowing difficulties, food allergies
The nutritional requirements for specific patient groups that vary from the standards specified e.g. children, mental health service users, older adults
Menu coding provides information for patients, carers and staff to enable them to make an informed choice whilst in hospital. The purpose is to highlight dishes that are suitable for patients’ specific requirements.
Patients requiring more specialist therapeutic diets should be catered for via a specialist à la carte menu so as not to limit choice for most other patients.
The four key diets that should be identified on standard inpatient menus are:
Other optional menu codes that hospitals can choose to use on their standard menus depending on the dietary needs of their patients include:
The following diets should be met by the standard menu and highlighted using menu coding. This section covers the following standard menu codes:
1.1 Healthier Eating
1.2 Higher Energy
1.3 Higher Protein (Optional)
1.4 Easy to Chew
The following special diets are typically met by separate à la carte menus. This section will cover the following religious, cultural, personal and lifestyle considerations:
2.3 Asian Vegetarian
The details here are given so that any changes to the general standards can be considered and incorporated at the menu planning stage.
Therapeutic diets covered in this section:
3.1 Modified Texture
3.2 Finger Foods
3.3 Renal Suitable
3.4 Food Allergy
3.5 Gluten Free
3.6 Other Therapeutic Diets
3.6.1 Low FODMAP
3.6.2 Catering for Immune-supressed Patients (Previously Neutropenic)
3.6.3 Liver Disease (Decompensated)
3.6.4 Test or Investigation
There are several special patient groups within the general hospital population whose nutritional requirements may vary from the standards already specified. These may include but are not limited to children, patients in critical care and mental health patients and those most vulnerable or those highlighted through nutritional screening. Menus need to be planned or additional options offered to take varied requirements into consideration. Operational processes and cost need to be considered in these cases.
The following section covers the following specific patient groups:
4.2 Critical illness
4.4 Older adults
4.6 Mental health