Synergy Diet Parameters
Parameters
Each diet parameter is set in the Synergy Database to aid in meeting the Dietary Reference Intakes (DRI) for adults
(males 51 to 70 years of age (average weight 175 lb or 80 kg1); or >70 years of age if available). Although diets may be
able to have more or less than the lower and upper limits, the parameters are utilized for menu planning and ensuring
that each diet meets the below definitions.
Regular Diet
This diet is intended to meet the needs of healthy adults (age 51+). It incorporates recommendations from Canada's
Food Guide to Healthy Eating (CFG) (2007), including the following2:
 Vegetable & fruits group: 7 servings
 Grain group: 7 servings
 Milk & alternatives group: 3 servings
 Meat & alternatives group: 3 servings
The Regular diet is set to meet the minimal macronutrient requirements for healthy adults (males 51 to 70 years of age;
or >70 years of age if available) including the following macronutrient distributions, which are based on 2,000 kcal
consumption. The diet is assessed using Acceptable Macronutrient Distribution Ranges (AMDR), Dietary Reference
Intakes (DRI), Adequate Intake (AI) or Recommended Dietary Allowance (RDA) established by the US Food and Nutrition
Board of the Institute of Medicine, National Academy of Sciences (NAS):
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Ideal Parameters (g/day)
Lower
Ideal
Upper
1800
2000
2400
225
275
325
60
75
100
Calories
Carbohydrates3
Proteins3
45-65%
10-35%
Fats3
20-35%
50
60
80
Fibre3
21-30 g/day
21
25
30
Sodium*3,4
1200-3400 mg/day
1200 mg
2300 mg
3400 mg
Calcium3
1000-2000 mg/day
1000 mg
1200 mg
2000 mg
Vitamin D**2,3
400-4000 IU/day
400 IU
800 IU
4000 IU
The lower, ideal and upper parameters are used to identify deficiencies, ideal intakes and toxicities based on Estimated
Average Requirement (EAR), RDA and Tolerable Upper Intake Level (UL).
*Sodium values have been changed to reflect Health Canada’s Sodium Reduction Strategy for Canada (2010). The lower
parameter is based on the EAR, the ideal parameter is set to Health Canada’s average daily sodium intake target by
2016, and the upper parameter is the current Canadian daily intake average as of 2010. Most therapeutic diets will
comply with the above regulations however due to the clinical natural of some of the below diets (i.e. HiPro/HiCal) the
upper limit may be exceeded.
**Vitamin D values are based on daily RDA standards and do not include CFG recommendation for adults over the age of
50 to consume vitamin D supplementation of 400 IU/day (10 µg/day).2
Sysco Canada, Inc.
Last revised June 2013
In developing a menu, the CFG is used as a guide, but since the CFG was developed for well/healthy adults and the
geriatric population was not the primary target, health issues that have diet considerations are priority. Synergy
provides nutritional analysis so every menu type can be analyzed and reported against the appropriate DRI. This allows
menu planning to also consider the other 'guidelines' of variety, avoiding repetition, color, costs, therapeutic and texture
modification, production and labour, and client acceptance. This diet is used as the basis of all therapeutic and texture
modified diets.
All Therapeutic diets are to be used as guidelines in the diet planning process. The presentation of diseases will vary
between residents, which may lead to modified and individualized care plans. Please ensure the following diets (i.e.
renal, diabetic, heart healthy etc.) are tailored if need be, to meet the nutrition care goals of the individual residents.
Allergy Diets
Lactose Restricted
This diet is for people with lactose intolerance or lactase enzyme deficiency. Lactose is restricted by providing
substitutions for lactose containing foods and reducing the use of lactose containing ingredients in recipes.5
Gluten Restricted
This diet eliminates products containing gluten, which is generally present in wheat, rye, barley and sometimes oats.5
Diabetic Diets6
Diabetic Low Calorie (Diabetic LoCal)
This diet is for people with diabetes who require reduced calories. Calories and carbohydrates are modified by utilizing
reduced, beverages and condiments, providing substitutions for high fat items and serving smaller portions of
carbohydrate containing foods, including desserts.
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Ideal Parameters (g/day)
Ideal
Upper
1500
1800
205
245
Calories
Carbohydrates6
45-60%
Lower
1400
190
Proteins6
15-20%
55
65
85
Fats3
20-35%
35
45
60
Fibre6
25-50 g/day
25
30
35
Sodium3,4
1200-3400 mg/day
1200 mg
2300 mg
3400 mg
Sysco Canada, Inc.
Last revised June 2013
Diabetic Maintenance (Diabetic Maintain)
This diet is for people with diabetes who are in a maintenance status. Carbohydrates are modified by reducing
concentrated sweets, utilizing reduced calorie items (as necessary) and limiting high fat foods.
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Ideal Parameters (g/day)
Lower
Ideal
Upper
1500
1800
2100
185
245
285
Calories
Carbohydrates6
45-60%
Proteins6
15-20%
60
75
100
Fats3
20-35%
45
60
70
Fibre6
25-50 g/day
25
30
35
Sodium3,4
1200-3400 mg/day
1200 mg
2300 mg
3400 mg
Diabetic High Calorie (Diabetic HiCal)
This diet is for people with diabetes who require increased calories. Carbohydrates are modified by reducing
concentrated sweets and limiting high fat foods. Larger portions of protein and complex carbohydrate starches are
utilized to increase the calories.
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Ideal Parameters (g/day)
Ideal
Upper
2200
2500
300
340
Calories
Carbohydrates6
45-60%
Lower
2000
275
Proteins6
15-20%
85
95
120
Fats3
20-35%
60
70
80
Fibre6
25-50 g/day
25
30
35
Sodium3,4
1200-3400 mg/day
1200 mg
2300 mg
3400 mg
Sysco Canada, Inc.
Last revised June 2013
Diabetic Renal (DiabRe)
This diet is a combination of the Diabetic Maintenance and Renal Diet. This diet addresses the needs of residents who
are diabetic and require restrictions of nutrients including; protein, (0.6-0.8 g/kg), sodium, potassium and phosphorus.
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Ideal Parameters (g/day)
Lower
Ideal
Upper
2000
2400
2800
250
310
385
45
60
80
Calories
Carbohydrates6
Proteins7
23-35 kcal/kg
45-60%
9-12%
Fats3
20-35%
60
70
85
Fibre6
25-50 g/day
25
30
35
Sodium3,4
1200-2300 mg/day
1200 mg
2000 mg
2400 mg
Phosphorus7
Potassium7
800-1000 mg/day
2000-3000 mg/day
800 mg
2000 mg
900 mg
2400 mg
1000 mg
3000 mg
Diabetic Renal Liberalized (DiabReLib)
This diet is a combination of the Diabetic Maintenance and Renal Liberalized Diet. This diet addresses the needs of the
residents who are diabetic and CKD who can tolerate liberalized amounts of protein (1.2 g/kg), sodium, phosphorus and
potassium7,8,9,10,11.
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Lower
2000
250
Ideal Parameters (g/day)
Ideal
Upper
2300
2800
310
385
Calories
Carbohydrates6
23-35 kcal/kg
45-60%
Proteins5
16-20%
80
100
120
Fats3
20-35%
60
70
85
Fibre6
25-50 g/day
25
30
35
Sodium5
1200-3000 mg/day
1200 mg
2300 mg
3000 mg
Phosphorus7
800-1000 mg/day
800 mg
1000 mg
1200 mg
Potassium7
3000-4000 mg/day
3000 mg
3500 mg
4000 mg
Sysco Canada, Inc.
Last revised June 2013
Renal (Renal)
This diet is considered a low protein, electrolyte controlled diet to address the needs of residents with CKD. Protein
intake is controlled by serving smaller portions of the entrée and limiting condiments/side items that would contribute
extra protein. Phosphorus, sodium and potassium are modified by providing substitutions for high phosphorus, sodium
and potassium foods7,8,9,10,11.
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Lower
2000
275
45
Ideal Parameters (g/day)
Ideal
Upper
2300
2800
310
385
60
80
Calories
Carbohydrates3
Proteins5
23-35 kcal/kg
45-65%
9-12%
Fats3
20-35%
60
70
85
Fibre3
21-30 g/day
21
25
30
Sodium3,4
1200-2300 mg/day
1200 mg
2000 mg
2400 mg
Phosphorus6
800-1000 mg/day
800 mg
1000 mg
1200 mg
Potassium6
2000-3000 mg/day
2000 mg
2400 mg
3000 mg
Renal Liberalized (Renal Lib)
This diet addresses the needs of the CKD residents, which may or may not be receiving dialysis treatments, which are
allowed to receive liberalized amounts of nutrients. This diet is designed to provide 23-30 kcal/kg, 1.2 g protein (or 1620% protein), and moderated amounts of sodium, potassium and phosphorus to meet the needs of this population.
Macronutrient
Calories
Carbohydrates3
Proteins6
Fats3
Fibre3
Sodium3,4
23-35 kcal/kg
45-65%
16-20%
20-35%
21-30 g/day
1200-3000 mg/day
Ideal Parameters (g/day)
Lower
Ideal
Upper
2000
2300
2800
230
260
290
75
90
100
50
65
75
21
30
35
1200 mg
2300 mg
3000 mg
Phosphorus7
800-1200 mg/day
800 mg
1000 mg
1200 mg
Potassium7
3000-4000 mg/day
3000 mg
3500 mg
4000 mg
Sysco Canada, Inc.
AMDR, DRI, AI, RDA (g/day)
Last revised June 2013
Reducing Diet (Reduc)
This diet is for people who do not have diabetes, but require reduced calories. Calories are modified by utilizing reduced
calorie desserts, beverages and condiments, providing substitutions for high fat items and serving smaller portions.
Macronutrient
Calories
Carbohydrates3
Proteins3
Fats3
Fibre3
Sodium3,4
AMDR, DRI, AI, RDA (g/day)
45-65%
10-35%
20-35%
21-30 g/day
1200-3400 mg/day
Ideal Parameters (g/day)
Lower
Ideal
Upper
1400
1500
1800
165
205
245
40
75
130
35
50
60
21
30
35
1200 mg
2300 mg
3400 mg
Hi Calorie/Hi Protein Diet (Hi Pro/Hi Cal)
This diet is set to provide at least 120% of the Recommended Dietary Allowances for energy and protein in order to
improve the nutritional status of malnourished clients. This diet usually exceeds the 30% of total calories from fat, due
to the addition of fat to increase the caloric density of foods. Calories and protein are modified by adjusting portion
sizes, using fortified recipes, and utilizing high calorie-protein sources including: whole milk and milk products, peanut
butter, margarine/butter, mayonnaise, gravy, sugar, etc.5
Macronutrient
Calories
Carbohydrates3
Proteins3
Fats3
Fibre3
Sodium3,4
Sysco Canada, Inc.
AMDR, DRI, AI, RDA (g/day)
45-65%
10-35%
20-35%
21-30 g/day
1200-3400 mg/day
Ideal Parameters (g/day)
Lower
Ideal
Upper
2200
2400
3000
270
330
390
90
120
180
50
80
90
21
30
35
1200 mg
2300 mg
3400 mg
Last revised June 2013
Heart Healthy Diet (Heart)
This diet modifies the fat, cholesterol, and sodium in the diet by providing substitutions for high fat/cholesterol/sodium
foods12
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Ideal Parameters (g/day)
Lower
Ideal
Upper
1800
2000
2400
225
275
325
65
85
120
Calories
Carbohydrates3
Proteins8
45-65%
15-20%
Fats8
25-30%
50
60
75
Fibre6
21-30 g/day
21
30
35
Cholesterol12
<200 mg/day
100 mg
200 mg
300 mg
Sodium3,4
1200-2300 mg/day
1200 mg
2000 mg
2300 mg
Vegetarian Diet (Veggie)
This diet excludes meat, fish, and poultry, but does allow eggs and dairy products.
Macronutrient
AMDR, DRI, AI, RDA (g/day)
Ideal Parameters (g/day)
Lower
Ideal
Upper
1800
2000
2400
225
275
325
46
75
120
50
65
90
21
30
35
1200 mg
2300 mg
3400 mg
Calories
Carbohydrates3
Proteins3
Fats3
Fibre6
Sodium3,4
45-65%
10-35%
20-35%
30 g/day
1200-3400 mg/day
Iron12
10-16 mg/day
8 mg
16 mg
45 mg
Vitamin B1212
2-2.4 µg/day
2.0 µg
2.4 µg
ND
DIET ORDERS
In Synergy the combination of a diet and texture creates a Diet Order. Please review the Valid/Invalid Diet/Texture Grid
for Synergy. Some Diet Orders will be marked as ‘Invalid’ as the addition of thickeners and products to make texture
variations will exceed the Diet Parameters as outlined above.
Sysco Canada, Inc.
Last revised June 2013
References
1. Statistics Canada, Viewed Feb 4 2013
http://www.statcan.gc.ca/pub/82-003-x/2008002/article/10569-eng.pdf
2. Health Canada, Viewed Feb 4 2013
http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/food-guide
aliment/view_eatwell_vue_bienmang-eng.pdf
3. Health Canada, Viewed Feb 4 2013
http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/nutrition/dri_tables-eng.pdf
4. Health Canada, Viewed Feb 4 2013
http://www.hc-sc.gc.ca/fn-an/alt_formats/pdf/nutrition/sodium/strateg/reduct-strat-eng.pdf
5. Manual of Clinical Dietetics (ADA & DC, 2000).
6. Canadian Diabetes Association – Critical Practice Guidelines 2008
http://www.diabetes.ca/files/cpg2008/cpg-2008.pdf
7. Academy of Nutrition and Dietetics, Viewed April 2013
http://andevidencelibrary.com/topic.cfm?cat=3929&auth=1
8. Cleveland Clinic - Reference for CKD Disease Progression, Viewed March 2013
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/chronic-kidneydisease/
9. British Dietetic association – Nutrition Therapy for Haemodialysis, Viewed March 2013
http://www.bda.uk.com/publications/statements/RNG_ProteinRequirementsAdultsHaemodialysisPerito
nealDialysis.pdf
10. National Kidney Foundation (NKF/DOQI) Guidelines 2000, Viewed March 2013
http://www.kidney.org/professionals/KDOQI/guidelines_commentaries.cfm
11. The Renal Association, Viewed March 2013
http://www.renal.org/Clinical/GuidelinesSection/NutritionInCKD.aspx
12. Practice Evidence Based Nutrition (PEN), Viewed Jan 2013
Sysco Canada, Inc.
Last revised June 2013