nutrition service providers guide barbara kamp, ms, rd national resource center on nutrition,...
TRANSCRIPT
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Nutrition Service Nutrition Service Providers GuideProviders Guide
Barbara Kamp, MS, RDBarbara Kamp, MS, RDNational Resource Center onNational Resource Center onNutrition, Physical Activity &Nutrition, Physical Activity &
AgingAging
4th State Units on Aging Nutritionists & Administrators Conference August 20064th State Units on Aging Nutritionists & Administrators Conference August 2006
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The Challenge
From the Science … to Policy … to the Public …
… to “Me”
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Nutrition Service Providers Guide
Provides assistance in applying the Dietary Guidelines for Americans to:• Programs • Group Menu Planning• Food Production • Food Service
Parallels messages from other materials
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Nutrition Service Providers Guide
• AoA & National Resource Center on Nutrition, Physical Activity & Aging
• Input - n4a, NANASP
• Reviewed - SUA nutritionists
• Reviewed - HHS Office of Disease Prevention and Health Promotion
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Nutrition Service Providers Guide
Part IPart I Purpose History & Process Importance Implementation
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Importance
• Good nutrition is vital to health
• Older adults need nutritious, tasty, culturally appropriate, safe meals for successful aging
• DGAs help assure appropriate food choices to ensure DRIs are met
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Nutrition Service Providers Guide
ImplementationImplementation General DGAs Program Planning
Considerations for OAA Nutrition Programs
Tips for Meal Planning Resources
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Key Recommendation:Adequate Nutrients
Within Calorie Needs
Consume a variety of nutrient-dense foods and beverages within and
among the basic food groups while choosing foods that limit intake of
saturated and trans fat, cholesterol, added sugars, salt, & alcohol
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Program Planning
Consideration
• Provide meals that include all food groups
• Provide meals & beverages high in nutrients but within calorie needs of program participants (nutrient dense)
• Provide opportunities for food choices based on individual needs & cultural food preferences
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Tips for Meal Planning
• Seek menu ideas from program participants
• Choose foods with little or no added sugar, sodium or fat
• Control portion sizes to control calories and meal costs
• Limit use of processed food items
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Resources
• Dietary Guidelines for Americans, 2005 Appendices A and B www.health.gov/dietaryguidelines/
• 5 A Day for Better Health Program, tips and recipes www.5aday.gov/recipes/tips.html
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Key Recommendation:Adequate Nutrients
Within Calorie Needs
Meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the DASH Diet
Plan or the USDA Food Guide
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Program Planning
Considerations
• Use DASHDASH Plan or USDA Food GuideUSDA Food Guide Both plans take into consideration a range of calorie levels to meet the nutrient needs of men and women at various ages and activity levels
• Provide meals in a calorie range of 550 – 700 calories per meal; the daily recommended level is 1600 to 2000 calories depending on level of activity
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Tips for Meal Planning
• Use lists of foods rich in selected nutrients (see DGAs appendices & tables)
• Use standardized recipes & portion sizes specified in recipes
• Identify high sodium foods; offer them infrequently; & offer lower sodium alternatives
• Identify & offer high potassium foods
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Resources
• USDA – MyPyramid.gov What counts as….
• Dietary Guidelines for Americans, 2005 Appendices A and B www.health.gov/dietaryguidelines/
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Key Recommendation:
Adequate Nutrients Within Calorie Needs
People over age 50People over age 50Consume vitamin B-12 in its
crystalline form (fortified foods or supplements)
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Program Planning
Considerations
• Use fortified foods to meet the vitamin B-12 requirements since man people over age 50 have reduced ability to absorb naturally occurring vitamin B-12
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Tips for Meal Planning
• Include fortified ready to eat whole grain cereals for breakfast meals
• Use fortified ready to eat whole grain cereals in casseroles, in meatloaves, or as breading for fish
• Use fortified ready to eat whole grain cereals in baked goods, i.e. crisp toppings, muffins, cookies
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Resources
• National Institute of Health:
Office of Dietary
Supplements http://ods.od.nih.gov/factsheets/vitaminb12.asp#h2
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Key Recommendation:Adequate Nutrients
Within Calorie Needs
Older adultsOlder adultsConsume extra vitamin D from vitamin D-fortified food and/or
supplements
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Program Planning
Considerations
• Select foods rich in vitamin D, a nutrient important for optimal calcium absorption and muscle functioning
• Include vitamin D fortified low-fat or fat-free milk, soy beverage, or orange juice with each meal
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Tips for Meal Planning
• Provide low-fat, vitamin D-fortified soy beverage or lactose-free milk as an alternate for those who are lactose intolerant
• Include vitamin D fortified, ready to eat whole grain cereal in food products such as muffins, crisps, or cookies
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Resources
• National Institute of Health:
Office of Dietary Supplements http://ods.od.nih.gov/factsheets/vitamind.asp#h2
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Key Recommendation:
Sodium & Potassium
Choose and prepare foods with little salt. At the same time, consume potassium-
rich foods, such as fruits and vegetables
Older adults.Older adults. Aim to consume no more than 1,500 mg of sodium per day, and meet the potassium recommendation
(4,700 mg/day) with food
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Program Planning
Considerations
• ~10% sodium naturally in foods
• ~75 - 77% added during processing
• Use “no added salt” or “low-sodium”
• Prepare foods without adding salt
• Serve potassium rich fruits & vegetables frequently
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Tips for Meal Planning
• Prepare baked or boiled potatoes instead of boxed mashed potatoes
• Select fresh or frozen vegetables or low sodium canned vegetables
• Use fresh or frozen lean meats instead of cured cuts of meat
• Avoid processed meats or pre-prepared items
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Resources
• DASH Eating Plan• www.nhlbi.nih.gov/health/public/heart/www.nhlbi.nih.gov/health/public/heart/• hbp/prevent/sodium/sodium.htmhbp/prevent/sodium/sodium.htm
• Dietary Guidelines for Americans, 2005 Appendix B-1 Food Sources of Potassium Table 15: Range of Sodium Content for
Selected Foods
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Part IIPart II
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Nutrition Service Providers Guide
Part II - ApplicationPart II - Application Menu Development•DASH Meal Plan
•USDA Food Guide Meal Plan
• Sample Menus at 550-700 Calories
•DRIs
•Recipes & Menu Analysis
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Meal Planning Guides
• Meal patterns – planning not compliance
• Two recommended, SUA choice DASH Eating PlanDASH Eating Plan calorie range:
1,600 to 3,100 calorie levels USDA Food Guide Meal PlanUSDA Food Guide Meal Plan calorie
range: 1,000 to 3,200 calorie levels
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DASH Meal Pattern
PromotesPromotes Grains Vegetables Fruits Nuts & seeds Legumes Non & Low-fat
dairy foods
LimitsLimits Meat Fish Poultry Fats Sweets Sodium
DDietary AApproaches to SStop HHypertension
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USDA Food Guide Meal Plan
• Grains Whole grain,
Other grains
• Vegetables Dark green,
Orange, Legumes, Starchy, Other
• Fruits
• Milk
• Lean meat & beans
• Oils
• Discretionary calorie allowance
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Menus
• Center designed Menus
• Nutrient analysis using Food Processor by ESHA
• All foods & ingredients selected are USDA standard
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Computer Assisted Analysis vs Meal
Pattern
• Creative SolutionsMeal Patterns: Only a First Step in Menu Planning
• Designed 2 menus Met meal pattern & met RDA / AI Met meal pattern & DID NOT met RDA / AI
• http://nutritionandaging.fiu.edu/creative_solutions/meal_patterns.asp
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Targets
• Vitamins A, B6, B12, C, D, E
• Minerals Calcium, potassium, sodium
• Fiber
• Saturated Fat & Cholesterol
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Menu Development:
Appeal
• Variety of Foods
• Different forms, shapes, textures, colors
• Different Temperatures
• Vary flavors w/in meal & day to day
• Seasonal, traditional, ethnic foods
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Menu Development:
Nutrition
• Caloric range
• Limit fat, cholesterol, sodium
• Adequate protein & carbohydrate
• Increased fiber
• Adequate vitamins & minerals
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Chicken MenuChicken MenuEmphasis: Sodium, calcium, calories, beans
Stewed chicken with vegetablesStewed chicken with vegetables 2oz chicken + 1/2 vegetables + broth = 1cup
• Egg noodles (1 cup)• Five bean salad (1/2 cup)• Fresh fruit salad with citrus and yogurt dip• (1/2 cup, includes melons, orange, grapes + 2
TB yogurt dip)• Fat-free milk (1 cup)
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Chicken Menu
StandardStandard Meal ContentMeal Content
CaloriesCalories 550-700 kcal 584 kcal
% fat% fat 30-35% 22 %
FiberFiber 7 – 8 g 10 g
CalciumCalcium 400 mg 507 mg
PotassiumPotassium 1566 mg 916 mg
SodiumSodium 500 mg 254 mg
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Meatloaf SandwichMeatloaf SandwichSpecial emphasis: whole grains, fruit, vitamin E, calcium
Open-faced Meatloaf SandwichOpen-faced Meatloaf Sandwich 2 oz meatloaf w/ 1 sl. 7 grain bread
• Gravy (2 Tb)• Baked Winter Squash (1/2 cup)• Waldorf Salad on Greens (1/2 cup, apples,
walnuts, raisins on romaine)• Orange Rice Pudding (1/2 cup)• Fat-free Milk (1 cup)
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Meatloaf Meal
StandardStandard Meal ContentMeal Content
CaloriesCalories 550-700 kcal 834 kcal
% Fat% Fat 30-35% 18%
FiberFiber 7 – 8 g 9 g
CalciumCalcium 400 mg 1129 mg
PotassiumPotassium 1566 mg 1666 mg
SodiumSodium 500 mg 627 mg
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Turkey MenuTurkey MenuSpecial Emphasis: Fiber, potassium, sodium, vitamin E
• Roast turkey (2 oz)
• Baked sweet potato (1 small)
• Broccoli (1/2 cup)
• Whole wheat roll (1 2.5” roll)
• Apple raisin Crisp (1/2 cup, includes topping of whole wheat flour, fortified flake cereal; almonds & raisins)
• Fat-free milk (1 cup)
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Turkey Menu
StandardStandard Meal ContentMeal Content
CaloriesCalories 550-700 kcal 724 kcal
% Fat% Fat 30-35% 25 %
FiberFiber 7 – 8 g 13 g
CalciumCalcium 400 mg 630 mg
PotassiumPotassium 1566 mg 1763 mg
SodiumSodium 500 mg 423 mg
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Nutrition Service Providers Guide
• Print copy: late September 2006
• Online version:
• www.nutritionandaging.fiu.edu
• www.aoa.gov• www.healthierus.gov/dietaryguidelines
• Other resources:Toolkit, Chapter 4