Common special diets and allergies in Aged Care

There are many reasons why residents need to avoid particular foods, ranging from a food allergy or intolerance, swallowing difficulties, cultural or religious reason, or simply personal choice.

The latest Diet Score Report from the CSIRO found one in three Australians avoided certain foods and it wasn’t only younger generations. One in four older Australians (aged 70+) avoided one or more types of food.

Aged Care Chefs need to accommodate many dietary requirements of residents – including personal choice diets (vegan, vegetarian) and medically-prescribed diets to manage specific food allergies or swallowing difficulties. Careful cross-contamination practices, plus knowledge of what ingredients to avoid, limit, substitute or modify is a complex challenge.

Allergic reactions range from mild, moderate to a severe immune response (anaphylaxis) which may be life-threatening. These reactions can be triggered even with the smallest contact. Ninety per cent of all food allergies are caused by nine foods: cow’s milk, egg, peanut, tree nuts, wheat, soy, sesame, fish and shellfish.* If a resident has a food allergy, they must avoid it completely to prevent any adverse response. 

*Source: Australasian Society of Clinical Immunology and Allergy

Intolerances are different to allergies, although the terms are often confused. A food intolerance is a chemical reaction from eating or drinking a particular food, with a range of unpleasant, though non-life-threatening, symptoms as a result. Common intolerances are to dairy, wheat, egg, salicylates (found in strawberries and citrus), food additives and preservatives.

Gluten-Free Diets

Many people report suffering from a gluten sensitivity or intolerance and hence adopt a gluten free diet to help ease symptoms in the gut. Thankfully, many favourite dishes can be made using gluten-free alternative ingredients, so residents with a gluten sensitivity can still enjoy a varied, well-rounded, nutritious menu.

Lactose-Free Diets

Some people experience adverse reactions to dairy products due to the presence of lactose – the sugar found in milk. There are many lactose-free options which may be substituted including plant-based ingredients such as soy- or nut-based products, so residents can still enjoy all the traditional dairy-based desserts, breakfasts and main meals.

Vegetarian and Vegan Diets

The latest Roy Morgan research 2016 found the number of Australians choosing to be vegan or vegetarian had risen to 2.1 million (11.2% of the population). A vegetarian diet typically consists of plant-based foods plus eggs and dairy products. 

A vegan diet avoids all animal products including eggs, cheese and other milk-based foods. Vegetarian and vegan menus can still be deliciously varied and substantial with legumes, soy, nuts and vegetables providing a nutritious meat-substitute. Salads, soups, risottos and casseroles can all be made without meat and dairy, using vegetables, legumes, seeds and grains.

Texture-modified Diets for residents who have difficulty swallowing

People who need to eat soft-textured food can continue to eat well and enjoy a balanced diet by serving soft-textured, minced or pureed meals. Soft-prepared food can be enhanced by various sauces for added flavour and moisture.

Nil by Mouth

For a small number of residents, oral diets are not possible. In such cases, tube-feeding is an appropriate way for a resident to continue to receive adequate nutrients and fluids. The smell of food can be enough to give a person the sensation of eating a delicious meal and enhance the mealtime experience enormously. In some cases, foam food can be used so people can still experience taste without having to swallow.