FACULTY OF HOTEL AND TOURISM MANAGEMENT

BACHELOR OF SCIENCE (HONS.) FOODSERVICE MANAGEMENT

COURSE CODE: INSTITUTIONAL AND THERAPEUTIC MEALS PRODUCTION (HTF521)

TITLE:

THERAPEUTIC MEAL DIET (LOW SODIUM, HIGH VITAMIN B12, LOW PURINE)

GROUP:

THM2425BA

PREPARED BY:

NUR FATIHAH BINTI IMRAN (2023149635)

NUR SALWATI BINTI MAT RAPI (2023125669)

NUR FATIN AMIRAH BINTI KHAZALI (2023387713)

SITI NUR SAFIAH ZAHIRAH BINTI AFFENDI (2023164871)

PREPARED FOR:

DR SRI PUVANESVARI GANNASIN

SEMESTER:

MARCH 2024 – AUGUST 2024

TABLE OF CONTENT
LOW SODIUM, HIGH VITAMIN B12, LOW PURINE
1.0 INTRODUCTION
a) Background with the following information:
✓ Definition of the prepared TM
✓ Description/ Characteristics of the meal
✓ Appropriate users (Who should consume the meal?)
✓ Issues to consider, if any

2.0 MODIFIED RECIPE & DISCUSSION

a) Standard recipe
b) Modified recipes
c) Discussion on the selection of ingredients/ cooking techniques for the meal produced.

3.0 PROCEDURE
a. Step by step process described for the selected meals
✓ Materials and amounts are identified. Steps are easy to follow and in
paragraph form
b. Pictures for the selected meals
✓ Pictures are presented for each step described above, with the picture of
the final product.
c. Serving size of the final product
✓ Serving sizes are identified with amounts (in grams) to serve.

4.0 CONCLUSION
● Overall conclusion related to:
✓ experiment conducted
✓ Outcome (meal produced)
✓ Recommendations for improvements
✓ Sources of error

5.0 REFERENCES
● Uses references from the literature with/without personal experience to support
comments
1.0 INTRODUCTION

High Vitamin B12

This is a high vitamin B12 therapeutic diet meal plan designed to help sustain normal
brain function, support DNA and red blood cell production, and protect nerves. Therapeutic diets
are nutritionally balanced meal plans formulated to improve symptoms, reduce inflammation,
and aid in healing for certain medical conditions.
Puding roti is a Malaysian bread pudding dessert made by soaking bread pieces in an
egg-milk mixture flavored with vanilla and cinnamon. It is then baked until the bread absorbs the
custard and develops a caramelized top crust. The provided recipe uses ingredients like bread,
eggs, milk, butter, raisins, and brown sugar to increase the vitamin B12 content.
This high vitamin B12 diet would be appropriate for individuals suffering from vitamin
B12 deficiency, which can lead to anemia and neurological issues if untreated. It may be
prescribed for pregnant women at risk of anemia, elderly individuals with poor nutrient
absorption and patients with conditions affecting B12 absorption like Crohn's disease.
While therapeutic diets can be beneficial, there are some potential issues to consider
which are combining too many restrictive diets increases the risk of undernutrition, so this B12
diet should not be combined with other highly restrictive diets. Then therapeutic diets require
strict adherence and commitment from the patient for effectiveness. Thus, lack of interest or
hardship in following the diet can decrease quality of life.

Low Purine Diet

A diet plan aimed at reducing the consumption of foods high in purines is known as a
low purine diet. Purines are organic compounds that are naturally present in some foods and
are also created by the body. Uric acid is created during the breakdown of purines and is
typically eliminated by the kidneys as urine. But too much uric acid can cause painful and
inflammatory crystals to accumulate in the kidneys and joints, which can result in kidney stones
and gout.
Bread slices are soaked in an egg-milk custard mixture and baked until the bread
absorbs the custard and forms a caramelized crust, making puding roti a Malaysian treat. To
lessen the purine level, the amount of raisins in this modified low-purine version has been
lowered from 3 tablespoons to 2 tablespoons. Reduced the amount of milk and water in the
custard mixture from 500ml to 375ml. To restrict fructose intake, thirdly, cut sugar from 6
tablespoons to 4 tablespoons. 7–8 bread pieces, 2 eggs, 2 tablespoons butter, 1 tsp vanilla, and
1/2 tsp cinnamon powder are the remaining components. This makes it possible to have a diet
dessert alternative with less sugar and less purines.
Gout sufferers might benefit from the reduced purine diet because it lowers the
accumulation of uric acid in their bodies, which can trigger gout episodes. renal stones, stops
the production of kidney stones made of uric acid. Hyperuricemia is the control of elevated
blood uric acid levels. Some renal conditions that affect the excretion of uric acid. It could also
be advised for people who are at risk, such those who are overweight or have a family history,
in order to prevent these illnesses.
Although the reduced purine diet is a useful dietary strategy, there are a few possible
problems to take into account which are extremely restrictive. If a diet plan isn't thoroughly
thought out, cutting out a lot of nutritious foods like beans, lentils, and some vegetables might
result in nutritional shortages. Second, adherence issues, which is the diet, calls for carefully
cutting back on or omitting a number of common items, which can be challenging to maintain
over time. Next, weight cycling like if you are overweight, losing weight gradually is advised
since rapid weight reduction might paradoxically raise your uric acid levels. Plus, individual
variations like some people may be more susceptible than others to the elevation of uric acid
levels caused by purine-rich meals. And lastly, medication requirements which are without
medication, dietary modifications are frequently insufficient to control severe hyperuricemia or
gout.

Low Sodium Diet

This is a low sodium therapeutic diet meal plan designed to restrict the amount of
sodium (salt) intake. On this diet, the goal is to consume no more than 2,300 milligrams (mg) of
sodium per day, which is about one teaspoon of table salt. Therapeutic diets are nutritionally
balanced meal plans formulated to improve symptoms, reduce inflammation, and aid in healing
for certain medical conditions like high blood pressure (hypertension). Reducing sodium intake
can help lower blood pressure levels.
Puding roti is a Malaysian bread pudding dessert made by soaking bread pieces in an
egg-milk custard mixture flavored with vanilla and cinnamon. It is then baked until the bread
absorbs the custard and develops a caramelized top crust. For this low sodium version, the
recipe has been modified which changes the salted butter to unsalted butter.
The low sodium diet can benefit individuals with the following conditions including high
blood pressure (hypertension) which reduces sodium intake to lower blood pressure. Secondly,
the riisk of stroke which is lowering sodium may decrease stroke risk and certain kidney
diseases that impair sodium excretion. It may also be recommended for preventing these
conditions in those at high risk, such as overweight individuals or those with a family history.
While a low sodium diet can effectively manage conditions like hypertension, there are
some potential drawbacks to consider which are highly restrictive. Eliminating too many foods
can lead to nutritional deficiencies if not carefully planned. Secondly, difficult adherence like
limiting sodium requires significant dietary changes that can be hard to sustain long-term.
Thirdly, individual differences like some may be more salt-sensitive than others in raising blood
pressure. Fourthly, medication needs such dietary changes alone are often insufficient for
severe hypertension without medication. Lastly, taste adjustment includes low sodium foods
may taste bland initially until taste buds adapt.
2.0 MODIFIED RECIPE AND DISCUSSION
2.1 Standard Recipe Bread Butter Pudding

INGREDIENTS UNITS

White bread 7-8 pieces

Butter 2 tbsp

Raisins 3 tbsp

Sugar 2 tbsp

Eggs 2 nos

Vanilla essence 1 tbsp

Cinnamon powder 1 tbsp

Evaporated milk 1 can

Plain water ¼ cup

Custard flour 2 tbsp

2.0 MODIFIED RECIPE & DISCUSSION

2.2.1 Low Purine Diet Modified Recipe for Bread Butter Pudding

INGREDIENTS UNITS

White bread 7-8 pieces

Butter 2 tbsp

Raisins 2 tbsp

Sugar 1 tbsp
 Eggs 2 nos

Vanilla essence 1 tbsp

Cinnamon powder 1 tbsp

Evaporated milk 1 can

Plain water ¼ cup

Custard flour 2 tbsp

2.2.2 High Vitamin B12 Modified Recipe for Bread Butter Pudding

INGREDIENTS UNITS

White bread 8-10 pieces

Butter 2 tbsp

Raisins 2 tbsp

Sugar 1 tbsp

Eggs 3 nos

Vanilla essence 1 tbsp

Cinnamon powder 1 tbsp

Evaporated milk 600ml

Plain water ¼ cup

Custard flour 2 tbsp

2.2.1 Low Sodium Diet Modified Recipe for Bread Butter Pudding
 INGREDIENTS UNITS

White bread 8-10 pieces

Unsalted Butter 2 tbsp

Raisins 2 tbsp

Sugar 1 tbsp

Eggs 3 nos

Vanilla essence 1 tbsp

Cinnamon powder 1 tbsp

Evaporated milk 600ml

Plain water ¼ cup

Custard flour 2 tbsp

2.3 Discussion On The Selection of Ingredients/ Cooking Techniques for The Meal
Produced

2.3.1 Bread Butter Pudding in Low Purine Diet

INGREDIENTS DISCUSSION

White bread By consuming white bread regularly according to RDA

(Recommended Daily Allowance) or according to nutritional needs
per day from the Ministry of Health RI, beneficial for health as
follows can reducing bad cholesterol (LDL) and increasing good
cholesterol (HDL) in the blood, benefits from high content of fiber
and niacin. Other than that, white bread also can strengthen and
maintain the health of the cardiovascular system. The consumer of
white bread also can stay focused whereas the nutrition of white
bread has the ability to make us stay concentrated and focused.
Those benefits come from quite high content zinc that is gained
from the white bread. (A. P. M. Rd, 2018)

Raisin Raisins are a good source of dietary fiber, which can help improve
digestion, promote regular bowel movements, and aid in weight
management by providing a feeling of fullness for the low purine
diet. For example, the person who has gout, they usually have a
very limited amount of food that can be consumed. Bread butter
pudding contains a good source of fruit like raisins that are rich in
essential nutrients like iron, potassium, magnesium, and B
vitamins. These nutrients support various bodily functions,
including energy production, muscle function, and immune health.
Raisins provide natural sweetness, which can help reduce the
need for added sugars in recipes and snacks. This can contribute
to better blood sugar control and lower calorie intake. (Cafasso,
2023)

Low fat milk For the dairy product, the researcher replaced the fresh milk to
low-fat milk. This is because the low-fat milk is naturally low in
 purines, the substances that break down into uric acid in the body.
This makes it a safe choice for people who need to limit purine
intake to prevent gout flare-ups. Low-fat milk is essential for bone
health whereas maintaining good bone health is particularly
important for people with gout, as some medications can affect
bone density.(Sissons, 2023)

Sugar Sugar contributes to the browning of baked goods through the

Maillard reaction and caramelization, which develop complex
flavors and appealing color. The heating of sugar can produce
pleasant aromas that enhance the overall sensory experience of
food. (Zeroin & Zeroin, 2023)

Eggs Eggs are an excellent source of complete protein, containing all

nine essential amino acids needed by the body. Furthermore, eggs
provide antioxidants such as lutein and zeaxanthin, which are
important for eye health. (Eggs and Eye Health - Australian Eggs,
2018)

Evaporated milk Evaporated milk has about 60% of its water content removed,
resulting in a thicker, creamier texture compared to regular milk.
This contributes to a richer and more luxurious mouthfeel in bread
pudding. Evaporated milk is an excellent source of calcium,
vitamin A, niacin and sodium. (Puerto Rican Bread Pudding Made
With Evaporated Milk Nutrition, n.d.)

Custard flour Many custard flours contain added vanilla flavoring, which can
enhance the overall taste of the bread pudding, making it more
aromatic and flavorful. Some custard flours are fortified with
additional nutrients like calcium and vitamins, which can add
nutritional value to the bread pudding. Custard flour also promotes
bone health and is a great energy booster towards the person who
uses this low purine diet in their life. (Koul, 2024)

● Bread Butter Pudding Cooking Techniques in Low Purine Diet

 COOKING DISCUSSION
TECHNIQUE

Baking The outcome discusses how baking can be a healthy cooking

technique for low purine diet patients. Baking also provides
consistent, even heat, which is crucial for bread butter pudding.
However, baking enhances some nutrients and makes the protein
in bread butter pudding easier to digest, making it a better and
healthier way of cooking food than frying. (Appliances, 2023).
Other than that, baking also allows the flavors from the ingredients
like butter, sugar, and the raisins to meld together over time,
creating a more complex and well-rounded taste even though the
recipe has been modified.

● Bread Butter Pudding in High Vitamin B12 Diet

INGREDIENTS DISCUSSION

White bread White bread is made from refined wheat flour, which is easily
digested and provides quick energy due to its high carbohydrate
content. This high vitamin B12 diet is not focusing on the intake of
white bread since white bread is not typically considered a
significant source of vitamin B12. Vitamin B12 is primarily found in
animal-derived foods such as meat, fish, eggs, and dairy products.
However, some commercial brands of white bread may be fortified
with vitamin B12 along with other B vitamins. (A. S. M. Rd, 2024)
 Raisin Raisins are another excellent source of vitamin B12, as well as
antioxidants and iron as per (Blogger, 2024). While raisins are a
nutritious snack and provide other essential nutrients such as
fiber, potassium, and antioxidants, they are not a significant
source of vitamin B12. It's important to consume a varied diet that
includes a wide range of foods to ensure you get all the essential
nutrients your body needs.

Fresh milk Fresh milk is high in calcium and vitamin D, which are essential for
strong bones and teeth. Then, fresh milk also contains potassium,
which helps maintain healthy blood pressure as per (Rd, 2023).
After the modification of the recipe, the researcher has added the
amount of milk since the milk is a natural source of vitamin B12.
Consuming milk can contribute to meeting your daily vitamin B12
requirements, especially for individuals who may not consume
other animal-derived foods rich in this vitamin.

Eggs Eggs also can be so important in a high vitamin B12 diet because
Eggs are one of the few plant-based foods that naturally contain
vitamin B12. According to (Blogger, 2024), a single large egg
typically provides about 0.6 micrograms of vitamin B12, which is
approximately 25% of the recommended daily intake for adults.

Evaporated milk Evaporated milk is concentrated milk with a higher protein content
compared to regular milk. Protein is essential for various bodily
functions, including muscle repair and growth, and including
evaporated milk for the person who consumes the high vitamin
B12 diet. According to (Mba, 2020), evaporated milk may help you
gain weight healthily because of its high concentration of nutrients
and lack of added sugar, which is associated with the
development of heart disease and type 2 diabetes when
consumed excessively.

Custard flour Actually, custard flour is not inherently a source of vitamin B12,
nor is it typically fortified with this nutrient. But, the researchers
 prepare custard using milk fortified with vitamin B12 to increase
the nutritional value of the bread butter pudding. Other than that,
they also can add some egg-based custard to take advantage of
the vitamin B12 content in eggs. So, the bread butter pudding that
is prepared can contain all the necessary ingredients according to
the needs of a high vitamin B12 diet.

● Bread Butter Pudding Cooking Techniques in High Vitamin B12 Diet

COOKING DISCUSSION
TECHNIQUE

Baking The baking method is the most suitable method for preparing the
bread butter pudding. Next, baking in an oven provides a controlled
environment where we can maintain a consistent temperature. This
is crucial for custard-based dishes, as it helps prevent curdling and
ensures the custard is smooth and creamy for the bread butter
pudding.

● Bread Butter Pudding in Low Sodium Diet

INGREDIENTS DISCUSSION

White bread White bread is often available in varieties that have been
specifically formulated to be lower in sodium. This allows
individuals on low sodium diets to choose brands or types that fit
their dietary requirements. But, in the market, they can find bread
that has no sodium content instead using the white bread. (Miller,
2020). Furthermore, we also need to prioritize other people who
have digestive issues. This white bread may be easier to digest
than whole grain or multigrain breads. This can be an added
benefit for those needing to manage multiple dietary concerns,
including sodium intake.

Sugar The sugar acts as the flavor enhancer to the bread butter pudding,
 so it will make low-sodium diets more flavorful. Sugar provides a
quick source of energy. According to (Department of Health &
Human Services, n.d.), the sugar intake should be consumed in
moderation, especially for those managing blood sugar levels, it
can be a helpful ingredient in a balanced diet for providing quick
energy without adding sodium.

Fresh milk Milk is a good source of essential nutrients such as calcium,

vitamin D, potassium, and protein. These nutrients are important
for overall health and can help balance a diet that might be lacking
in variety due to sodium restrictions. (Department of Health &
Human Services, n.d.-b)

Unsalted butter According to the ingredient given by COD, the standard recipe
uses salted butter but they have replaced the salted butter to
unsalted butter since this bread butter pudding is prepared for
patients who use a low sodium diet. In fact, unsalted butter does
not contain added salt, making it naturally lower in sodium
compared to salted butter. This helps individuals control their
sodium intake more effectively. People who use this type of diet
really recommend using unsalted butter in their meal.

Eggs The function of eggs in the preparation of making this bread butter
pudding is to make it stick to each other and create a great
consistency of the pudding itself. According to (What Foods Are
Low in Sodium? Make Healthier Choices, n.d.), for this low sodium
diet, whole eggs are excellent sodium-free options. But, the
patients who use this diet, they can freely find these in powder
form, which has no salt at all.

Evaporated milk The use of evaporated milk might be not suitable for the consumer
of this diet. Maybe they can reduce the amount or can replace it
with plain yogurt. According to the (FoodData Central, n.d.), the
amount of sodium in evaporated milk is 83 mg. Other suggestions
is to use coconut milk whereas it has less than 15 mg per serving
 and can be found in both canned and carton form. (Cutting Salt?
12 Items to Stock for a Lower Sodium Diet, 2021). Those low
sodium dieters can easily find the ingredients to be consumed in
their diets.

● Bread Butter Pudding Cooking Techniques in Low Sodium Diet

COOKING DISCUSSION
TECHNIQUE

Baking Baking gives the bread butter pudding a desirable texture—crisp

and golden on top, while soft and creamy inside. This contrast in
textures enhances the overall eating experience. This could be the
great combination once served with the custard sauce.
3.0 PROCEDURE
LOW SODIUM DIET

a) Step by step process described for the selected meals

- Materials and amounts are identified
- Steps are easy to follow and in paragraph form
b) Pictures for the selected meals
- Pictures are presented for each step described in above, with the picture of the
final product

1. Combine ingredient B which is 500 ml sugar syrup, 2 eggs, 1 tbsp of vanilla essence , 1
tsp of cinnamon powder . Tear the 7-8 pieces of bread and add it to ingredient B. Let it
soak for a while.

2. Add 1 ½ tbsp of raisins and 2 tbsp of melted unsalted butter. Mix well. Then pour in.
Sprinkle the remaining 1 ½ tbsp of raisins over the mixture
 3. Bake at a temperature of 180 celsius for 30 minutes or until cooked.

4. Custard sauce: Mix all the ingredients which is 1 tin of evaporated milk, 1/4 cup of water,
2 tbsp of custard flour and 2 tbsp of sugar in a pot and stir until thickened. Pour over the
bread pudding
 c) Serving size of the final product
- Serving size are identified with amounts (in grams) to serve

5. 200 gram puding roti (306 kcal)

HIGH VITAMIN B 12

a) Step by step process described for the selected meals

- Materials and amounts are identified
- Steps are easy to follow and in paragraph form
b) Pictures for the selected meals
- Pictures are presented for each step described in above, with the picture of the
final product
1. Combine ingredient B which is 500 ml sugar syrup, 3 eggs, 1 tbsp of vanilla essence , 1
tsp of cinnamon powder . Tear the 8-10 pieces of bread and add it to ingredient B. Let it
soak for a while.

2. Add 1 ½ tbsp of raisins and 2 tbsp of melted unsalted butter. Mix well. Then pour in.
Sprinkle the remaining 1 ½ tbsp of raisins over the mixture

3. Bake at a temperature of 180 celsius for 30 minutes or until cooked.

4. Custard sauce: Mix all the ingredients which is 600 ml milk, 1/4 cup of water, 2 tbsp of
custard flour and 2 tbsp of sugar in a pot and stir until thickened. Pour over the bread
pudding

c) Serving size of the final product

- Serving size are identified with amounts (in grams) to serve

5. 210 gram of puding roti (372 kcal)

LOW PURINE DIET

a) Step by step process described for the selected meals

- Materials and amounts are identified
- Steps are easy to follow and in paragraph form
b) Pictures for the selected meals
- Pictures are presented for each step described in above, with the picture of the
final product

1. Combine ingredient B which is 500 ml sugar syrup, 2 eggs, 1 tbsp of vanilla essence , 1
tsp of cinnamon powder . Tear the 7-8 pieces of bread and add it to ingredient B. Let it
soak for a while.

2. Add 1 tbsp of raisins and 2 tbsp of melted unsalted butter. Mix well. Then pour in.
Sprinkle the remaining 1 tbsp of raisins over the mixture
 3. Bake at a temperature of 180 celsius for 30 minutes or until cooked.

4. Custard sauce: Mix all the ingredients which is 1 tin of evaporated milk, 1/4 can of water,
2 tbsp of custard flour and 1 tbsp of sugar in a pot and stir until thickened. Pour over the
bread pudding
c) Serving size of the final product
- Serving size are identified with amounts (in grams) to serve

5. 190 gram of puding roti (240 kcal)

4.0 CONCLUSION
4.1 Experiment Conducted

According to the results of the experiment, bread butter pudding is a great option for a diet that
prioritizes a high intake of vitamin B12, low consumption of purines, and low sodium. Because
of this, it's an ideal choice for anyone who wishes to adhere to specific dietary guidelines. It's
critical to monitor the ingredients that are regularly employed in these dishes and make the
required adjustments to guarantee that the nutritional objectives of each diet are satisfied. By
prioritizing ingredient management, bread butter pudding can be tailored to accommodate
various dietary requirements without compromising on taste or nutritional value. Nutritional
goals that necessitate thorough consideration of nutritional balance can be met with careful
consideration of appropriate substitutes.Therefore, by making adjustments and wise decisions
during the cooking process, bread butter pudding can be a flexible and healthy solution for
people on a personalized diet plan.

4.2 Outcome

Type of diet Result

Low sodium diet

Low purine diet

High vitamin b12

4.3 Recommendation For Improvement

The adjusted ingredients are suitable for low-sodium diet users since unsalted butter has been
used in place of butter. This is since a low-sodium diet should only eliminate or minimize
sodium.
The next advice for a low-purine diet is to limit raisins to just 2 tablespoons. Sugar is also
lowered to just one tablespoon.
If the original quantity was seven to eight, then 8 or ten pieces, adding bread is advised as a
high-vitamin B12 meal. Moreover, milk is increased to 600 ml and eggs are increased from two
to three. Dairy products with low fat content, such as milk, can raise the total amount of vitamin
B12.

4.4 Sources Of Error

This recipe has been modified with a few errors. First, full cream milk should be used instead of
low-fat milk while following a diet high in vitamin B12. This is due to the absence of vitamin B12
in low-fat milk. The ground nuts and coconut milk are high in purine and can induce goat, so if
you are following a low-purine diet, you should substitute thick, low-fat milk for the coconut milk.
While it is crucial to cut back on or eliminate salt from all cooking for a low-sodium diet. This is
because those with high blood pressure should not consume salt due to its high sodium content.
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