Menu Planning 650-25-45-10

(Revised 1/1/12 ML#3303)

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1. All meals provided must:

1. Comply with the most recent Dietary Guidelines for Americans (DGs), published by the Secretary and the Secretary of Agriculture; and
2. Provide a minimum of 33 1/3 percent of the dietary reference intakes (DRIs) established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences, if the project provides one meal per day. A minimum of 66 2/3 percent of the allowances must be provided if the project provides two meals per day. If the project provides three meals per day, 100 percent of the allowances must be provided).  

The DGs describe food choices that promote good health. The DRIs help assure that nutrient needs are met.

2. Dietary Reference Intakes (DRIs) are quantitative estimates of nutrient intakes for use in planning and assessing healthy diets.  The DRIs include several nutrient based reference value sets including:

1. Estimated Average Requirement (EAR): “the average daily nutrient intake level estimated to meet the requirements of half the healthy individuals in a particular life stage and gender group”;
2. Recommended Dietary Allowances (RDA): “the average daily nutrient intake level sufficient to meet the nutrient requirements of nearly all (97 to 98%) healthy individuals in a particular life stage and gender group”;
3. Adequate Intake (AI): “a recommended average daily nutrient intake level based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) of healthy people that are assumed to be adequate – used when RDA cannot be determined”;
4. Tolerable Upper Intake Level (UL): “the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.  As intake increases above the UL, the potential risk of adverse effects may increase”; and
5. Acceptable Macronutrient Distribution Range (AMDR): “range of intake for a particular energy source (macronutrients include carbohydrates, proteins, fats) that is associated with reduced risk of chronic disease while providing intakes of essential nutrients. If an individual consumes in excess of the AMDR, there is a potential of increasing the risk of chronic diseases and/or insufficient intakes of essential nutrients.

3. The South Dakota Division of Adult Services and Aging developed recipes and menus that meet current DRI requirements. The menus were developed and nutritional analyses completed by Adele Huls, PhD, RD, LMNT, LN.

The recipes and menus are posted on the South Dakota website and are available for use by North Dakota providers.  The recipes and menus can be accessed at: http://dss.sd.gov/elderlyservices/services/seniormeals/menusandrecipes.asp

4. Contract entities that do not use the menus developed by the South Dakota Division of Adult Services and Aging must address the following:

1. Develop menus that comply with the most recent Dietary Guidelines for Americans (DGs) and meet current DRI recommendations. North Dakota will follow guidelines used by South Dakota in the development of menus to meet current DRI requirements. Guidelines for nutrient values are listed in #5.
2. Use a cycle menu format (minimum of four weeks) that is rotated at set intervals and reflects seasonal availability of foods.
3. To the maximum extent practicable, consider the special dietary needs arising from health requirements, religious requirements, or ethnic backgrounds of eligible clients.
4. The cycle menus, recipes, and nutritional analysis must be submitted to Aging Services Division through the request for proposal process and/or upon request. The submitted materials must be signed by the contract entity’s licensed registered dietitian or licensed nutritionist.
5. The following guidelines for nutrient values must be used in developing menus:

	Nutrient	Value
	Basic Components *denotes required
	*Calories (kcal)	735.00
	Water	1233.30
	*Protein (g) actual is 18.8 - our goal is based on 17% of calories and wt/ht/activity of reference person (75 yo male 68” 153#) Lightly Active	31.24
	Carbohydrates (g) based on 53% of calories	97.40
	*Dietary Fiber (g)	10.29
	*Fat (g) based on 30% of calories - can be lower	24.50
	Net Carbs	87.11
	Vitamins
	*Vitamin A RAE	300.00
	*Vitamin B-6 (mg)	0.60
	*Vitamin B-12 (mcg)	0.80
	*Vitamin C (mg)	30.00
	*Vitamin D (mg) (or 200 IU)	5.00
	Folate DFE (mcg)	133.30
	Minerals
	*Calcium (mg)	400.00
	*Magnesium (mg)	140.00
	Iron (mg)	2.70
	*Sodium (mg) goal: 800 or less in future	1000.00
	Potassium (mg) goal: 1567.0 in future	1250.00
	*Zinc (mg)	3.75

 

Contract entities should strive to meet nutrient values on a daily basis. Averaging of nutrient values over a 5-day or 7-day period is allowable.

6. A meal pattern is a menu-planning tool that ensures the number/numbers of servings per food group are met at each meal. Meal patterns do not ensure that nutrient requirements are met; therefore, computer-assisted nutrient analyses must be run (see #5).

The following meal pattern is based on the 2005 Dietary Guidelines for Americans and the Food Guide Pyramid. 

FOOD GROUP	SERVINGS PER MEAL	PORTION SIZE
Bread or Bread Alternative	2 servings	1 serving = 1/2 cup cooked pasta, rice or cereal; 1 slice of bread (1 oz.) or equivalent combinations
Vegetable	2 servings	1 serving = ½ cup or equivalent measure (may serve an additional vegetable instead of a fruit)
Fruit	1 serving	1 serving = ½ cup or equivalent measure (may serve an additional fruit instead of a vegetable)
Milk or Milk Alternative	1 serving	1 serving = 1 cup (8 oz) or equivalent measure
Meat or Meat Alternative	1 serving	1 serving = 2 oz or equivalent measure
Fats	1 serving	1 serving = 1 teaspoon or equivalent measure
Dessert	1 serving	1 serving = 1/2 cup (optional)

7. Menu changes must be documented and approved by a licensed registered dietitian or licensed nutritionist. It is recommended that a list of approved substitutions be maintained at the meal site.
8. Provision of a special or therapeutic diet to a client requires a signed physician’s order. Menus must be planned with the advice of a licensed registered dietitian to establish appropriate nutritional therapy.
9. Nutrition Services contract entities are prohibited from providing vitamin and/or mineral supplements to clients.