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, 2016 2 Today’s Presenters Jo-Anne Taylor, RN, BSN Steuben County Public Health Wilma Stewart, MS, RDN, CDN Consultant Dietitian
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
August 22, 2016 4 Mo Most st Sodi dium um Co Come mes s From Processed Pr cessed an and d Re Rest stauran aurant t Fo Foods ds Source: Matted RD, et al. J AM Coll Nutr 1991:10:383-393
August 22, 2016 5 A Na National ional In Initiative tiative
August 22, 2016 6 Pa Partners rtners 2010 Grantees 2013 Grantees
August 22, 2016 7 NYSOFA’s Requirements • Standardized Recipes • Portion Control • Meals are palatable, attractive and satisfying • Follow current dietary guidelines • Nutrient Analysis
August 22, 2016 8 Co Collectin llecting g Da Data • Sodium Practices Assessment Tool (SPAT) • Nutrient Analysis
August 22, 2016 9 De Deve velopment lopment of of the he Sodi dium um Practi ctices ces Assessment sessment Tool l (SPAT ) Reviewed literature • Gathered available tools •
Sod odiu ium m Pra ractice ctice Assess ssessment ment Too ool l
August 22, 2016 11 SPAT T Ac Action on Pl Plan an
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
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
August 22, 2016 14 Nu Nutrien ent An Anal alysis sis • Accurate Recipes • Software • Product Specific Sodium Data • Senior Meal Menus
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
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.
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
August 22, 2016 18 Ut Utilizing ilizing Ev Evaluation aluation Da Data • To determine interventions and create action plans Modifi ificat cations ions Toward rds Reduc ucing ing Sodium um Highes hest t Sodium ium Items Sodium-free seasonings, herbs • Identi tified fied and spices Bases and gravy mixes • Reduce salt, base or amount of Commercial salad dressings • • seasoning packets Tomato products • Cooking from scratch Cheeses • • Substitute lower sodium products • Pre-prepared entrees •
August 22, 2016 19 Results Re sults 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% 54% Stuffed Pepper r meal 1112 mg 510 mg Chicke ken Parmesan mesan 1585 mg 988 mg 38%
August 22, 2016 20 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
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
August 22, 2016 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, green peppers and rice.
August 22, 2016 23 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
August 22, 2016 24 Results What improved Baseline Follow up % improvement ProAction Fall/Spring 1005 mg 805 mg 20 % menu cycle menu cycles at senior meal sites – State 1167 mg 856 mg 27% Aggregate
August 22, 2016 25 Cha Challenge enges s – Turnover of staff – Standardized recipes – Flavor of food – Cost – Time to enter nutrient analysis – Portion Control
August 22, 2016 26 Pr Product oduct De Details ails Product duct Quan antit tity Regular lar Lower er Sodium dium mg Sodi 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
August 22, 2016 27 Pr Product oduct 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 ½ c (121g) 60mg beans, drained & rinsed Kidneys Meatloaf, purchased RTS 4 oz (128g) 305mg Meatloaf, homemade 4 oz (128g) 182mg
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
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)
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
August 22, 2016 31 Th Thank ank you! ou! Qu Questions estions?
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