How to Develop a Menu

Nutrition Requirements http://health.gov/dietaryguidelines/Default.asp 2010 http://health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf 2015 Dietary Guidelines for Americans being developed AND MyPlate at: http://www.choosemyplate.gov/

Foods and Food Components to Reduce Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults. Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids. Consume less than 300 mg per day of dietary cholesterol. Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats. Reduce the intake of calories from solid fats and added sugars. Limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium. If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.5

Considerations Food Preferences Trends Budget Availability and Skills of Foodservice Workers Preparation and Scheduling Requirements Physical facilities (layout, design, age and condition of equipment)

Types of Menus Single Use Static Cycle A la carte Table d’hote Du Jour Special evens Fine Dining Static Restaurant Cycle Different every day for a specified time period (3 weeks-repeat) A la carte Menu items priced as individual items Table d’hote Complete meal for a fixed price Du Jour Menu of the day

Other Menus Room-service Spoken Preselected Bedside Room-service: call foodservice department and place order; order is verified with patient’s diet order, prepared and delivered to patient’s room Spoken: tell customers the menu by a foodservice worker, who records Preselected: given to patient upon arrival/or in room. Eliminates menu printing, distribution, collection. Food cost and staff reduced Bedside: requests are placed into computer system, eliminates paper menus, cost of system is expensive

Menu Revision Holidays and Theme Days Seasonal change Customer survey results Plate waste studies Change in service Availability

Menu Planning Steps Meat or meat alternative Starch Vegetables Salads/ Soup Bread Dessert Beverages Appetizers Garnish Plan Breakfast last Then the Alternate menu or menu substitution

Template Breakfast Lunch / Dinner Fruit or Juice Hot or cold cereal Meat or meat alternative Bread – Butter/Margarine Beverage Appetizer or Soup Entree; Meat or meat alternative, potato, rice or pasta, vegetable Fruit or vegetable salad Bread - Butter/Margarine Dessert Beverage

Diets Regular – general or house Regular is the starting point for all diet modifications Use Patterns Meet DRI’s

Complete an analysis Complete an analysis using data at: http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00 For the DI menu project- do not use nutrient analysis software. Look up the food items yourself and complete a manual analysis. After you have determined that the Regular menu is adequate you can modify the menu for the therapeutic diets.

Variety Double check at the end of planning to make sure that repetition is kept at a minimum See next slide

Menu Repeat Form Monday Tuesday Wednesday Item Served B L D Scramble Eggs X Mashed Potatoes Jello

Distribution Nutrient Total Calories 1600 2200 2800 Protein (g) 77 101 135 Fat (g) 53 73 93 Carbohydrates (g) 204 280 356

Sample Pattern Food 1600 kcal 2200 kcal 2800 kcal Milk (cups) -Skim -2% 2 - 1 Vegetables (1/2 cup) 3 4 5 Fruit (choices) Bread (choices) 6 9 11 Meat (oz) 7 Fat (g) 53 73 93

Sample Menu- 2100 kcal Breakfast Lunch Dinner Orange Juice (1/2 cup) Whole-grain cereal (3/4 cup) Banana (1/2) Whole-wheat toast (2 slices) Margarine (2 tsp) Jelly/Jam (1 tbsp) 2% Milk (1 cup) Coffee/Tea Lunch Vegetable Soup (1 cup) Saltine crackers (4) Lean beef patty (3 oz) Hamburger bun (1) Mustard (1 tbsp) Ketchup (1 tbsp) Sliced tomato (2oz) and lettuce Fresh fruit salad (1/2 cup) Graham crackers (4) 2% Milk (1 cup) Coffee/Tea Dinner Green salad (3.5 oz) Vinegar and oil dressing (1 tbsp) Broiled skinless chicken breast (3 oz) Herbed brown rice (1/2 cup) Steamed broccoli (1/2 cup) Whole-grain roll (1) Margarine (2 tsp) Low-fat frozen yogurt (1/2 cup) Medium apple (1) Coffee/Tea

Menu Evaluation Features: Menu pattern Color and eye appeal Texture and consistency Flavor combinations Sizes and shapes Food temperatures Preparation methods Popularity Da-to-Day Distribution Customer Preferences

Food Code 3-201.11 Compliance with Food Law (B) Food prepared in a private home may not be used or offered for human consumption in a food establishment http://www.fda.gov/Food/GuidanceRegulation/RetailFoodProtection/FoodCode/ucm186451.htm

Child Nutrition Programs Team Nutrition is an initiative of the USDA Food and Nutrition Service to support the Child Nutrition Programs http://teamnutrition.usda.gov/ Meal Patterns http://www.fns.usda.gov/cacfp/meals-and-snacks

Reference Foodservice Manual For Health Care Institutions; Ruby Parker Puckett, John Wiley & Sons, 2013 Chapter 16