The new DiningRD Diet Manual is launching September 24th! Our new manual provides updated diet options to support safe, individualized, and evidence-based nutrition care for your residents. Please don’t hesitate to reach out to our Client Success Team with any questions regarding our new diet manual and diet options – our nutrition experts are here to help!
Available diets will include:
Therapeutic Diets
• Consistent Carbohydrate (CCHO)
• Heart Healthy
• 2 Gram Sodium
• CKD Diet (Renal)
• Gluten Restricted
• Finger Foods
• Large Portions
• Small Portion
Texture Modified Diets
• Regular
• Mechanical Soft Ground
• Mechanical Soft Chopped Meat
• EC7 (Easy to Chew – IDDSI Level 7)
• SB6 (Soft & Bite-Sized – IDDSI Level 6)
• MM5 (Minced & Moist – IDDSI Level 5)
• PU4 (Pureed – IDDSI Level 4)
• LQ3 (Liquidized – IDDSI Level 3)
Diet Precautions
• Consistent Carbohydrate (CCHO) Precautions
• No Added Sodium (NAS) Precautions
• Heart Healthy Precautions
• CKD Diet (Renal) Precautions
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FAQ’s
Why are diet options changing?
Our team of nutrition experts is proud to stay aligned with current evidence-based practice and clinical standards. We have nearly 1,000 Registered Dietitians on our team who aim to continuously improve clinical consistency and simplify menu planning.
What diets are changing?
We are removing both the Strict Renal Diet and the Liberal Renal Controlled-Carbohydrate Diet. We are only moving forward with the Liberal Renal Diet. Additionally, we are moving towards discontinuing the National Dysphagia Diets (NDD) and moving exclusively towards the IDDSI framework for texture-modified diets.
Why are we removing the Strict Renal Diet from the menu software?
The Strict Renal Diet is no longer considered appropriate for the long-term care population due to its highly restrictive nature. It often limits essential nutrients and food variety, which may result in residents experiencing poor appetite, food refusal, and ultimately, malnutrition. Modern approaches to nutrition for older adults with kidney disease prioritize quality of life, adequate intake, and clinical flexibility. Therefore, removing the strict version supports a more realistic, sustainable, and person-centered approach.
Why are we removing the Liberal Renal Controlled-Carbohydrate Diet?
The Liberal Renal Controlled-Carbohydrate Diet was developed to manage both kidney disease and diabetes simultaneously. However, in practice, this approach has proven to be overly complicated, offering limited benefit beyond the Liberal Renal Diet itself. Additionally, current diabetes guidelines for older adults recommend moderate, individualized carbohydrate intake rather than tight control, especially when it risks poor nutrition. By removing this hybrid diet, we simplify options while still allowing personalized care when necessary.
Why are we keeping the Liberal Renal Diet? (Now renamed CKD Diet – Renal in the upcoming Diet Manual)
The Liberal Renal Diet is the most appropriate standard for long-term care residents with kidney disease. It offers a balance between renal nutrition guidelines and the need for adequate calories and protein, which are often compromised in older adults. Unlike more restrictive diets, it allows for moderate sodium and phosphorus intake, tailored protein levels, and careful potassium adjustments based on individual lab results. It aligns with current clinical recommendations emphasizing resident-centered care and nutritional adequacy.
Why are we removing the National Dysphagia Diets (NDD)?
The National Dysphagia Diets were introduced over two decades ago, but they are now considered outdated and inconsistent. There are no standardized testing methods associated with NDD, leading to variation in how food textures and liquid consistencies are interpreted across different teams and facilities. Because of these inconsistencies and safety concerns, professional and regulatory organizations no longer endorse the use of the NDD, prompting the transition to a more structured and universally accepted system.
Why are we moving exclusively to the IDDSI framework?
The International Dysphagia Diet Standardization Initiative (IDDSI) is now the global standard for texture-modified diets. It offers clear definitions and simple testing methods—such as the syringe flow test and fork pressure test—to reliably classify both foods and liquids. IDDSI enhances safety, reduces variation, and improves communication among dietary, nursing, and therapy staff. Endorsed by the Academy of Nutrition and Dietetics, ASHA, and regulatory bodies, IDDSI replaces the NDD in nearly all current diet manuals and is required in many care settings.
Why are we renaming the Dental Soft Diet to Mechanical Soft Ground?
“Dental Soft” is not a standardized term recognized by national guidelines. “Mechanical Soft Ground” more accurately describes the texture modification and aligns with industry-accepted terminology. The new name helps reduce confusion among nursing, speech therapy, and dietary teams. “Mechanical Soft Ground” clearly conveys that the diet consists of foods that are soft in texture and the meat is ground to minimize chewing difficulty—ideal for residents with dental issues, mild dysphagia, or difficulty managing regular textures.
What does this mean if I am integrated with my Electronic Health/Medical Record?
We want to reassure all communities using our menu software that our team is fully prepared to support a smooth transition as diet terminology updates are implemented. For those whose electronic medical records need to be updated to reflect the new diet names, our dietitians and Client Success Team have proactively reached out to ensure a seamless transition. Diets will be changing on September 24th, and on that day you may review the diets flowing from your electronic medical record to the DiningRD MealCard to confirm accurate transfer. If you have any concerns or have an integration but have not yet spoken with your Client Success Specialist, please reach out to our team as soon as possible. We are committed to making this change as easy and efficient as possible while minimizing disruptions to your community.
What should I communicate to staff and residents about these changes?
To your staff, emphasize that these changes are grounded in current evidence and align with best practices. They should be reassured that individualized nutrition care remains a top priority and that simplification improves safety and resident satisfaction. For residents and families, communicate that these updates will lead to better food variety, improved mealtime enjoyment, and safer, more personalized care—without compromising health goals.
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Key References
• Academy of Nutrition and Dietetics: jandonline.org
• Position Paper: Individualized Nutrition Approaches in LTC, 2018
• IDDSI adoption guides from Academy, ANFP & ASHA (May 2019)
• Renal Patients in the Acute Care Setting: Can They Tolerate a Liberalized Diet?
• IDDSI Official Site – https://www.iddsi.org
• IDDSI – Common Ground with NDD & IDDSI
• National Kidney Foundation – Nutrition Guidelines for CKD – www.kidney.org
• Nutrition Care Manual – Older Adult Nutrition