Liquid diets contain liquids or soft foods only and consist of various kinds such as full liquid, clear liquid, and soft diet, too, having different consistencies and variations. Full liquids and soft diets are understandable by their names but people are often stuck on the point that: what is a clear liquid diet?
A clear liquid diet is a liquid diet comprised of clear and liquid foods at room temperature. Foods included in the clear liquid diet are clear juices, sodas, broths, gelatin, and popsicles. According to a survey, clear liquid like coconut water is rich in electrolytes. It is useful in rehydrating the body when the water has been lost due to diarrhoea situations. Clear liquid diets are nutritionally inadequate for all age groups and are not recommended to consume more than 72 hours.
Foods Allowed on a Clear Liquid Diet:
Here is the list of foods that are allowed in a clear liquid diet:
- Plain water
- Fruit juices without any pulp or chunks
- Coffee and tea without milk and cream
- Clear soups without any chunks
- Plain Gelatin
- Popsicles without any fruit chunks
- Clear broths
- Ginger ale
- Electrolyte and sports drinks
- Clear and fat-free broths
- Hard candies such as peppermint or lemon drops
- Nutritional clear drinks such as Ensure clear
- Strained tomato or vegetable juice
Foods Not Allowed on a Clear Liquid Diet:
- Cola or any soda beverages
- Any alcoholic drinks
- Tomato or vegetable juices having pulp
- Any dairy products
- Fruit juices with pulp such as orange or grapefruit juice
- Any nectars
- Ice cream or any other thick dessert
- Any cream soups
- Non-clear nutritional supplements
- Chocolates or any other opaque candies
|Sample Menu for a Clear Liquid Diet|
|Apple juice||Cranberry juice||Grape juice|
|Chicken broth||Beef Bouillon||Chicken broth|
|Cherry gelatin||Orange gelatin||Lime gelatin|
|Ginger ale||Sports drink||Cola|
|Coffee (no creamer)||Iced tea||Hot tea|
|Grape juice||Apple juice||Cranberry juice|
|Kcal||Pro g||Fat g||CHO g||Fe mg||Na mg||K mg||Ca mg||P mg||Vit A IU||Thia mg||Nia mg||Rib mg||Asc mg|
Clear Liquid Diet & Its Purpose:
A clear liquid diet may be recommended for a variety of reasons by the doctor, including:
- Before a certain medical procedure
- Post-recovery after a medical procedure
- Prevention from a gastrointestinal distress
1. Before a Certain Medical Procedure:
Doctors may recommend following a clear liquid diet before certain types of medical procedures like medical imaging testing, endoscopy, colonoscopy, or any surgery. This diet ensures that nothing solid remains in the intestines, making it easier for the doctor to diagnose various medical conditions.
For medical procedures like endoscopy or colonoscopy, clear liquid diets are initiated because the inside of a person’s bowel needs to be examined in such a procedure. Any remaining solid might create a hindrance during the procedure. In the same way, before any surgery, doctors recommend stopping eating solid foods 8 hours before the surgery.
In case of intestinal surgery, a certain patient is recommended to follow a clear liquid diet plan before several days and is asked to stop consuming solid foods, making the intestines free from any pulp or chunks.
2. Post-Recovery after a Medical Procedure:
After a medical procedure comprising different surgeries, it is recommended to follow a clear liquid diet in the initial recovery days for better healing. Side effects such as vomiting and nausea are common due to general anaesthesia applications. Some people also face dysphagia after a surgery which might choke the food, so to avoid such acts, a clear liquid diet is recommended.
In a clear liquid diet after surgery, doctors ask to start the diet by swallowing few ice chips followed by slowly sipping of water and then switching to the basic clear liquid diets and this diet is followed until the body recovers after a postoperative period.
In surgeries such as bariatric surgery, the intestinal column requires some time to heal properly. For the initial days after such surgery, a clear liquid diet is recommended. Over the period, certain other soft foods are allowed under the supervision of a doctor or a nutritionist.
3. Prevention from gastrointestinal distress:
Clear liquid diets are also recommended to the patients facing some gastrointestinal distress facing:
- Severe nausea
- Frequent vomiting
- Loose or bloody diarrhoea
- Inflammatory bowel disease
Nutritional Support of Clear Liquid Diet in Medical Illness:
1 . During Gastrointestinal illness:
Dehydration is the main issue that occurs after vomiting or excessive diarrhoea and requires immediate fluid and electrolyte replacement therapy. The underlying infection associated with these symptoms may interfere with gastrointestinal digestion and absorption, leading to gastrointestinal illness. This illness worsens the conditions and leads to fluid losses.
Foods commonly found on a clear liquid diet are recommended during gastrointestinal illness due to their consistency and easily digestible properties. Clear liquid diets are easily absorbed, tolerate well and virtually leaves no residue or chunks in the GI tract. During the condition of hyperemesis gravid arum, liquids and food items such as salty, bland and low fat, and ginger ale are recommended all come under the clear liquid diet.
As a clear liquid diet is low in carbohydrates, it is scientifically noted that Emetrol, a pharmacological remedy for treating nausea and vomiting, shows antiemetic effects on a clear liquid diet. Clear liquid diets low in carbohydrates and other nutritional compounds slower down intestinal recovery.
In infants, before initiating the clear liquid diets, pediatric oral rehydration solutions are recommended to maintain the fluid along with breastfeeding. In such a case, a person should introduce formula milk slowly, and if still intolerance is observed regarding enteral rehydration, then intravenous fluid therapy is recommended.
2. During Pancreatitis:
A clear liquid diet is recommended to initiate oral intake in mild to moderate pancreatitis. Initiating clear liquids and supplementing the diet with protein-containing, low-fat supplements are regarded as the best alternative in delayed gastroenteric feeding. The use of total parenteral nutrition along with gastroenteric tube feeding is recommended in pancreatitis.
Enteral feeding, in this case, provides various benefits, including the decrease in several bacterial translocations in the gut, direct nutrient supply providing sustained immune defence to the gut residing immunology constituents and better maintenance of lean body mass.
3. During Entero-Cutaneous Fistulas:
Entero-cutaneous fistulas during the initial management require close attention to electrolyte and fluid replacement therapy. Its ongoing management requires nutritional management and are usually managed with complete bowel rest and parenteral nutrition. Patients facing the condition of fistulas along with distal small bowel and colon conditions require the initiation of a clear liquid diet and parenteral nutrition with supplementation.
4. During Inflammatory Bowel Disease:
Clear liquid diets are highly recommended to patients facing inflammatory bowel disease. Due to long-term malnutrition in such patients, clear liquid diets can be given along with the addition of oral glutamine powders to enhance the immune system and to maintain mucosal integrity. Parenteral nutrition shows negative impacts in this aspect, so a clear liquid diet is the best choice for this complication.
As inflammatory bowel disease is a continuum of diseases and involves inflammation of the rectum and colon and patchy inflammation (Crohn’s disease), a fluctuating malabsorption pattern and near-normal bowel activity are seen highly. In some cases, malabsorption can be devastated, requiring nutritional support and urgent hospitalization to prevent dehydration. In such cases, clear liquid nutritional support is suitable. Enteral nutrition, along with small bowel nutrients, helps to moderate the production of inflammatory mediators.
Nutritional support of Clear Liquids in the Surgical Setting :
Uncomplicated Postoperative Setting:
Clear liquid diets are regarded as the initial postoperative meals and are regarded as necessary to avoid complications. Initiating postoperative feeding with regular food might increase the chances of fascial dehiscence, wound infection and sepsis postoperatively. Patients after an operation might face trouble in tolerating regular diets having maximum calories and nutrients and might face the problem of digesting them.
Patients tolerate oral intake in clear liquid diets best when initiated after an operation or a surgery. Bland items might cause trouble for them due to taste and consistency. However, if selected according to their preferences, a patient can tolerate this diet in the best way during the initial days. Clear liquid diets are often unpalatable, and some patients might refuse to consume them. However, this is the best option after an operation or surgery due to ease in digestibility and swallowing.
If we talk about nutrients, clear liquid diets lack the essential nutrients and don’t help recover fast after surgery. But clear liquid diets are usually given to patients for not more than 3-5 days, followed by full liquid and then a soft liquid diet. According to the health condition, a regular and balanced diet is introduced slowly, helping the patient meet the nutritional requirements of the body in a step by step order.
Suppose a doctor recommends clear liquid diets for a longer period after an operation or surgery. In that case, intake of certain protein supplements and clear liquid diets is the best way to avoid the wastage of lean body mass and muscle mass.
Thoracic surgery involves various sorts of options, such as coronary bypass surgery or other chest surgeries. In this case, clear liquid diets are the best option instead of the regular diet after surgery. Patients might feel gastrointestinal discomfort, and initiating a regular diet to them will create complications in swallowing, digesting and absorbing the nutrients leading to abdominal discomfort and pulmonary toilet. On the other hand, a clear liquid diet prevents nausea and vomiting and is easy to digest and swallow.
Gastrointestinal Surgeries (Bariatric, Oesophagal, Gastric, Small Bowel, Colon, and Pancreatobiliary)
Gastrointestinal surgeries involve bariatric, oesophagal, gastric, small bowel and pancreatobiliary surgeries and require various requirements for following a gastrointestinal surgery dictating the selection of postoperative oral intake.
Bariatric surgery: Bariatric surgery, also known as gastric bypass or banded gastroplasty, requires the initiation of a clear liquid diet involving a very small amount of water up to 30ml per hour, leading to other items of clear liquid diet excluding the simple carbohydrates. After six weeks or so, solid foods are gradually introduced based on the patient’s tolerance level focusing on the accommodation of the small gastric pouch.
Oesophagal surgery: This surgery is performed along with the immediate placement of an enteral feeding tube to ensure early nutrition support. In oesophagal cancer surgery, temporal plasy of the recurrent nerve is often seen, and aspiration is the most widespread concern due to disturbed stomach motility leading to denervation and dissection of perineural lymph nodes.
Clear liquid diets in oral intake are indicated in such situations, and progression of dietary advancement depends totally on the surgeon’s comfort level and patient’s condition. During Nissen fundoplication, oral intake in initiating sips of clear liquids is seen because a patient cannot handle bolus feeds. Clear liquid diets are then progressed to pureed and then to soft foods after several weeks.
Gastric surgery: The initiation of oral intake in gastric surgery depends totally on the type and extent of the procedure, such as vagotomy and pyloroplasty. These procedures might lead to intractable peptic ulcers causing dumping syndrome. In this situation, non-concentrated sweet or isotonic clear liquid diets are initiated in low volumes.
Small bowel surgery: Small bowel surgery usually doesn’t require any dietary modification as postoperative ileus is not seen in this case.
Colon surgery: Colon surgery is often cured faster, and also no certain dietary modification is required in this type of surgery.
Pancreatobiliary surgery: This type of surgery often calls for curtailing regular food until the absence of biliary or pancreatic leak is verified. In most circumstances, the tolerance to clear liquids is generally good, but few side effects are also seen.
Pros and Cons of Clear Liquid Diets:
|A clear liquid diet is helpful to prepare the body before surgery and helps to recover fast after the surgery.||A clear liquid diet is low in nutrients and calories and makes a person malnourished if followed for a longer period.|
|A clear liquid diet is very easy to follow and is suitable for every patient.||Clear liquid diets lack the basic nutrients and make the person feeling hungry and tired.|
|A clear liquid diet comprises basic items such as plain water, clear juices, tea, which are easily accessible and inexpensive.||Following this diet might become boring after some time due to the availability of fewer food items.|
Benefits of a Clear Liquid Diet:
- A clear liquid diet is composed of liquids only, is easy to swallow and digest, and reduces strain on the digestive tract. It doesn’t allow any pulp or residue to remain in the GI tract.
- This diet is low in calories and major nutrients, but still, it is effective enough, providing electrolytes and a good proportion of glucose to keep the body hydrated.
- This type of diet is necessary to follow before the colonoscopy or endoscopy or before surgeries to prepare the bowel, making it free from any residues which might hinder during the surgery.
- A clear liquid diet is usually recommended during any gastrointestinal illness, and following this diet gives the stomach and intestine a chance to heal quickly. For minimizing the side effects of diarrhoea and vomiting, a clear liquid diet is initiated along with oral replacement therapy to overcome any dehydration.
Considerations for General Nutrition Regarding Clear Liquid Diet:
According to the 2020-2025 USDA Dietary Guidelines from the U.S. Department of Health and Human Services and the U.S Department of Agriculture, clear liquid diets are not adequate to meet the daily nutritional requirements. A person should advance towards the full liquid, pureed or soft diets and then to the regular balanced diet as soon as the condition becomes better, starting initially by clear liquid diet.
Suppose a patient is in a critical condition and a clear liquid diet is required for more than five days. In that case, the addition of supplements or high-protein gelatins is a good option to meet the nutritional intake and prevent malnutrition.
Side Effects of Clear Liquid Diet:
Clear liquid diets are helpful if a person is facing gastrointestinal problems, but this diet may leave symptoms of weakness and dizziness due to lesser nutritional components. It is advisable to intake this diet and avoid extreme and strenuous activities slowly to avoid such situations. A person can resume a normal routine back once a person starts following the regular and balanced meal plan.
Dietary Restrictions Associated with Clear Liquid Diet:
- Clear liquid diets are low in calories and nutrients and can lead to malnutrition and other complications if followed for a longer period.
- In clear liquid diets, if a person relies on soda, juices and other high-sugar and sweetened beverages, it can lead the body to be high in carbs and be risky for a diabetic patient.
- Patients following a clear liquid diet having diabetes need to follow a modified clear liquid diet and consult their dietitian. Clear liquid diets low in sugar can be initiated, or sugar-free clear liquids are also a good option. In the same way, if a person is taking insulin or glucose-lowering medications, then a patient can adjust the dose along with a clear liquid diet.
- Checking and maintaining blood sugar levels is a good initiative if a person follows a clear liquid diet, which can help maintain and control hypoglycemia and hyperglycemia.
- Patients facing swallowing difficulties might face the choking hazard when following a clear liquid diet. The clear liquid diet can be thickened to the right consistency on consultation with a dietitian or healthcare provider.
Risks Associated with Clear Liquid Diet:
A clear liquid diet is recommended to people facing any medical procedure or illness and is not safe to follow for more than 3-5 days. This diet is supervised by a doctor or a nutritionist and is advised not to follow without any consultation.
A clear liquid diet is low in nutrients, and if followed for a prolonged period, it can lead to severe malnutrition and cause certain nutritional deficiencies.
Clear liquid diets are a risk to follow in those people who are facing:
- Low BMI ranges
- Electrolyte imbalances
- Nutritional imbalances
- Eating disorders like anorexia or bulimia nervosa
- Endocrine disorders
As a clear liquid diet is high in carbohydrates so it might fluctuate the glucose levels. Diabetic patients should consult a doctor before following such a diet. Nutritional deficiencies and malnutrition due to following a clear liquid diet for a longer period can lead to certain other symptoms such as:
- Frequent headaches
- Irritability and mood changes
- Weakness and muscle pain
- Bone damage and heart problems
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