August 22, Cutting the Salt: Addressing Sodium Reduction in Senior Meals at ProAction of Steuben & Yates, Inc.

Transcription

1 August 22, 2016 Cutting the Salt: Addressing Sodium Reduction in Senior Meals at ProAction of Steuben & Yates, Inc.

2 August 22, Today s Presenters Jo-Anne Taylor, RN, BSN Steuben County Public Health Wilma Stewart, MS, RDN, CDN Consultant Dietitian

3 August 22, CDC s Vision of Sodium Reduction Funded demonstration project in 2010 Expand on what was learned Interventions Involve food industry to change food supply

4 August 22, Most Sodium Comes From Processed and Restaurant Foods Source: Matted RD, et al. J AM Coll Nutr 1991:10:

5 August 22, A National Initiative

6 August 22, Partners 2010 Grantees 2013 Grantees

7 August 22, NYSOFA s Requirements Standardized Recipes Portion Control Meals are palatable, attractive and satisfying Follow current dietary guidelines Nutrient Analysis

8 August 22, Collecting Data Sodium Practices Assessment Tool (SPAT) Nutrient Analysis

9 August 22, Development of the Sodium Practices Assessment Tool (SPAT) Reviewed literature Gathered available tools

10 Sodium Practice Assessment Tool

11 August 22, SPAT Action Plan

12 August 22, 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

13 August 22, 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

14 August 22, Nutrient Analysis Accurate Recipes Software Product Specific Sodium Data Senior Meal Menus

15 August 22, RECIPES 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

16 August 22, Nutrient Analysis Software 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.

17 August 22, Product Specific 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

18 August 22, Utilizing Evaluation Data To determine interventions and create action plans Highest Sodium Items Identified Bases and gravy mixes Commercial salad dressings Tomato products Cheeses Pre-prepared entrees Modifications Towards Reducing Sodium Sodium-free seasonings, herbs and spices Reduce salt, base or amount of seasoning packets Cooking from scratch Substitute lower sodium products

19 August 22, Results What improved Baseline Follow up 2 % improvement Lemon Pepper Fish 1362 mg 788 mg 42% Beef Goulash meal 1011 mg 639 mg 37% Stuffed Pepper meal 1112 mg 510 mg 54% Chicken Parmesan 1585 mg 988 mg 38%

20 August 22, Lemon Pepper Fish Menu 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

21 August 22, 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

22 green peppers and rice. August 22, Stuffed Pepper Menu 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,

23 August 22, Chicken Parmesan Menu Original Menu mg Sodium Modified Menu mg Sodium Chicken Parmesan 910 Chicken Parmesan 327* Rotini 0 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

24 August 22, Results What improved Baseline Follow up % improvement ProAction Fall/Spring menu cycle menu cycles at senior meal sites State Aggregate 1005 mg 805 mg 20 % 1167 mg 856 mg 27%

25 August 22, Challenges Turnover of staff Standardized recipes Flavor of food Cost Time to enter nutrient analysis Portion Control

26 August 22, Product Details Product Quantity Regular mg Sodium Lower Sodium mg Sodium Gravy mix 5 g (2oz svg) Base 5 g Spaghetti Sauce ½ cup No Salt Added Roast Turkey Breast 3 oz (84g) Ham 3 oz (84g) Mushroom Soup RTS 10 oz (298g)

27 August 22, Product Details 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 ½ c (121g) 60mg beans, drained & rinsed Kidneys Meatloaf, purchased RTS 4 oz (128g) 305mg Meatloaf, homemade 4 oz (128g) 182mg

28 August 22, Sustainability Standardized recipes and menus Communication with staff and contractors on the goal to reduce sodium Documentation Technical assistance - NYSOFA

29 August 22, Resources cdc.gov/salt heart.org/sodium health.ny.gov nyc.gov/health (Dietary Guidelines for Americans)

30 August 22, Additional Resources Dialogue4Health webinars Sodium Reduction in Food Service tip sheets Florida International University s Nutrition Toolkit

31 August 22, Thank you! Questions?