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Senior Se nior Me Meal als s at at ProA oAct ction ion of - - PowerPoint PPT Presentation

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Cutting ing the Sa Salt: : Addr ddres essin sing g So Sodium dium Reduction duction in in Senior Se nior Me Meal als s at at ProA oAct ction ion of St Steu euben ben & Yat ates, s, Inc. August 22, 2016 August 22,

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SLIDE 1

August 22, 2016

Cutting ing the Sa Salt: : Addr ddres essin sing g So Sodium dium Reduction duction in in Se Senior nior Me Meal als s at at ProA

  • Act

ction ion of St Steu euben ben & Yat ates, s, Inc.

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August 22, 2016 2

Today’s Presenters

Jo-Anne Taylor, RN, BSN Steuben County Public Health Wilma Stewart, MS, RDN, CDN Consultant Dietitian

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August 22, 2016 3

CDC’s Vision of Sodium Reduction

  • Funded demonstration project in 2010
  • Expand on what was learned
  • Interventions
  • Involve food industry to change food supply
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August 22, 2016 4 Source: Matted RD, et al. J AM Coll Nutr 1991:10:383-393

Mo Most st Sodi dium um Co Come mes s From Pr Processed cessed an and d Re Rest stauran aurant t Fo Foods ds

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SLIDE 5

August 22, 2016 5

A Na National ional In Initiative tiative

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SLIDE 6

August 22, 2016 6

Pa Partners rtners

2010 Grantees 2013 Grantees

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SLIDE 7

August 22, 2016 7

NYSOFA’s Requirements

  • Standardized Recipes
  • Portion Control
  • Meals are palatable, attractive and

satisfying

  • Follow current dietary guidelines
  • Nutrient Analysis
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SLIDE 8

August 22, 2016 8

Co Collectin llecting g Da Data

  • Sodium Practices Assessment Tool

(SPAT)

  • Nutrient Analysis
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SLIDE 9

August 22, 2016 9

De Deve velopment lopment of

  • f the

he Sodi dium um Practi ctices ces Assessment sessment Tool l (SPAT)

  • Reviewed literature
  • Gathered available tools
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SLIDE 10

Sod

  • diu

ium m Pra ractice ctice Assess ssessment ment Too

  • ol

l

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August 22, 2016 11

SPAT T Ac Action

  • n Pl

Plan an

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August 22, 2016 12

SPAT Actions

  • Reduced number of high sodium foods in a

meal

  • Reduced number of high sodium items

purchased

  • Using lower sodium gravy mix, ham and

turkey

  • Diluting higher sodium tomato products with

lower sodium tomato products

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SLIDE 13

August 22, 2016 13

SPAT Actions

  • Reducing amount of seasoning packets used

in stuffing mix and rice pilaf mix

  • Reduced amount of salad dressings used in

salads

  • Use lower sodium cheese (Swiss) and

cheese & cream sauce mixes

  • Use smaller, thus lower sodium, rolls
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SLIDE 14

August 22, 2016 14

Nu Nutrien ent An Anal alysis sis

  • Accurate Recipes
  • Software
  • Product Specific

Sodium Data

  • Senior Meal Menus
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SLIDE 15

August 22, 2016 15

RECIPES CIPES

  • Do recipes include:

Serving size Number of servings in recipe Amount of each ingredient

________

  • Best practice is to review

recipes with production staff to ensure the ingredients and amounts are exactly as prepared

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August 22, 2016 16

Nut Nutrient ent Ana Analysis sis Softw tware are

  • Food Processor, Esha Research, Inc.
  • The program has import/export

capability

  • Brand name products were added to

the database

  • Consider training needs for persons

who will be using the program.

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August 22, 2016 17

Pr Produ duct ct Spe pecif ific ic

Nutrition Facts Labels, Vendors or Online

  • Size of container
  • Number of servings per

container

  • Serving size

(note if dry mix or prepared product)

  • Sodium content per

serving

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August 22, 2016 18

Ut Utilizing ilizing Ev Evaluation aluation Da Data

  • To determine interventions and create

action plans

Highes hest t Sodium ium Items Identi tified fied

  • Bases and gravy mixes
  • Commercial salad dressings
  • Tomato products
  • Cheeses
  • Pre-prepared entrees

Modifi ificat cations ions Toward rds Reduc ucing ing Sodium um

  • Sodium-free seasonings, herbs

and spices

  • Reduce salt, base or amount of

seasoning packets

  • Cooking from scratch
  • Substitute lower sodium products
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August 22, 2016 19

What at impro proved ed Baseli seline ne Follo llow w up 2 % improve provement ment

Lemon Pepper Fish 1362 mg 788 mg 42% Beef Goulas ash h meal 1011 mg 639 mg 37% Stuffed Pepper r meal 1112 mg 510 mg 54% Chicke ken Parmesan mesan 1585 mg 988 mg 38%

Re Results sults

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August 22, 2016 20 Original Menu mg Sodium Modified Menu mg Sodium Lemon Pepper Fish 130 Lemon Pepper Fish 130 Tartar Sauce 79 Tartar Sauce 79 Macaroni & Cheese 237 Red Skin Potato 31 Stewed Tomatoes 270 Zucchini & Tomatoes 136 Coleslaw 263 Pineapple Coleslaw 13 Wheat Roll 210 Wheat Roll 210 Margarine 60 Margarine 60 Tropical Fruit 10 Pumpkin Crunch 26 Fat free Milk 103 Fat free Milk 103 Total 1362 Total 788 Changed starch to lower sodium item, used frozen or fresh zucchini with lower sodium tomato product, used vinegar base dressing rather than coleslaw dressing

Lemon Pepper Fish Menu

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August 22, 2016 21

Beef Goulash Menu

Original Menu mg Sodium Modified Menu mg Sodium Beef Goulash 418 Beef Goulash 310* Creamed Corn 280 Italian Vegetable Blend 16 Italian Bread 170 Italian Bread 170 Margarine 30 Margarine 30 Fruit Cocktail 5 Fruit Cocktail 5 Fat Free Milk 103 Fat Free Milk 103 Orange Juice 5 Orange Juice 5 Total 1011 Total 639 *Spaghetti Sauce Modified to ½ Spaghetti Sauce and ½ Pizza Sauce

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August 22, 2016 22 Original Menu mg Sodium Modified Menu mg Sodium Stuffed Pepper w/ Sauce 634 Stuffed Pepper Casserole 190* Squash 2 Squash 2 Fresh Green Salad 18 Raspb’ry Vinagarette Drsg 145 Italian Bread 170 Italian Bread 170 Margarine 30 Margarine 30 Tropical Fruit 10 Tropical Fruit 10 Fat Free Milk 103 Fat Free Milk 103 Orange Juice 5 Total 1112 Total 510

*Change purchased stuffed pepper topped with pizza sauce to homemade casserole which included black pepper, Worcestershire sauce, pizza sauce, lemon juice, onion, green peppers and rice.

Stuffed Pepper Menu

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August 22, 2016 23 Original Menu mg Sodium Modified Menu mg Sodium Chicken Parmesan 910 Chicken Parmesan 327* Rotini Rotini 0 Fresh Green Salad 32 Fresh Green Salad 18 Italian Drsg 135 Italian Drsg 135 Italian Bread 170 Italian Bread 170 Margarine 30 Margarine 30 Pudding 200 Pudding 200 Fat Free Milk 103 Fat Free Milk 103 Apple Juice 5 Orange Juice 5 Total 1585 Total 988

*Chicken Parmesan made with plain chicken breast instead of breaded chicken and sauce made with spaghetti sauce and pizza sauce

Chicken Parmesan Menu

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SLIDE 24

August 22, 2016 24

Results

What improved Baseline Follow up % improvement ProAction Fall/Spring menu cycle 1005 mg 805 mg 20 % menu cycles at senior meal sites – State Aggregate 1167 mg 856 mg 27%

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August 22, 2016 25

Cha Challenge enges s

–Turnover of staff –Standardized recipes –Flavor of food –Cost –Time to enter nutrient analysis –Portion Control

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August 22, 2016 26

Pr Product

  • duct De

Details ails

Product duct Quan antit tity Regular lar mg Sodi dium Lower er Sodium dium mg Sodi dium

Gravy mix 5 g (2oz svg) 320 140 Base 5 g 720 140 Spaghett tti i Sauce ce ½ cup 490 170 No Salt Added Roast t Turke rkey Breast 3 oz (84g) 720 390 Ham 3 oz (84g) 890 530 Mushroo hroom m Soup RTS TS 10 oz (298g) 870 90

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August 22, 2016 27

Pr Product

  • duct De

Details ails

Product Quantity Sodium Hamburger Bun 60 g 320 mg Hamburger Bun 43 g 200 mg Kaiser roll 48 g 170 mg Coleslaw dressing 13 g (1 Tblsp) 160 mg Mayonnaise 13 g (1 Tblsp) 70 mg Chicken Breast 4 oz (112g) 71 mg Chicken Breast, breaded, cooked 4 oz (112g) 580 mg Bean Salad, canned ½ c (121g) 470mg Bean salad, homemade, frozen grn & yel beans, drained & rinsed Kidneys ½ c (121g) 60mg Meatloaf, purchased RTS 4 oz (128g) 305mg Meatloaf, homemade 4 oz (128g) 182mg

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August 22, 2016 28

Su Sust stain ainability ability

  • Standardized recipes and menus
  • Communication with staff and

contractors on the goal to reduce sodium

  • Documentation
  • Technical assistance - NYSOFA
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August 22, 2016 29

Re Resourc sources es

  • cdc.gov/salt
  • heart.org/sodium
  • health.ny.gov
  • nyc.gov/health
  • www.cdc.gov/ (Dietary Guidelines for Americans)
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August 22, 2016 30

Ad Additional ditional Re Resource sources

  • Dialogue4Health webinars

www.dialogue4health.org

  • Sodium Reduction in Food Service tip sheets

www.nnphi.org

  • Florida International University’s Nutrition

Toolkit

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August 22, 2016 31

Th Thank ank you!

  • u!

Qu Questions estions?