ASSIGNMENT - WRITING SPREADSHEETS

OBJECTIVE:

1. To familiarize the student with the writing of menus for a target population following

standard guidelines asoutlined in the attached FSM II diet manual.

2. To write modified diets from the regular menu according to a written diet manual

following specific criteria.

SPECIFIC CRITERIA:

1. 150 bed long term care facility

2. Approximately 10% of the population are on enteral feedings

3. The age range is from 60-100(+)

4. Dietary is reimbursed at a rate of $4.25/resident/day.

5. Basic kitchen equipment: stove with range top, griddle,

walk-in refrigerator, blender, toaster, food processor,

mixer, steamtable, steamer, and assorted small equipment

The menu must meet government regulations:

1. A minimum of 2000 calories/day

2. 6 oz meat – meat, poultry, fish, dry beans, eggs

3. 2-3 cups milk – 3 sources of calcium rich foods per day including milk

4. A vitamin C source daily

5. Vitamin A source 4 times/week

6. A total of 5 fruits/vegs per day (potato counted once per day) including the Vitamin C and Vitamin A sources

7. 6 servings of breads/starches/grains daily.

You must provide a computerized nutritional analysis of the week to demonstrate that the regulations have been fulfilled. For the analysis of the menus, you must use Diet Analysis Plus or NutriCalc.

You need one week of non-selective menus and spreadsheets to finish your cycle menu. One entire day of spreadsheets should appear on one sheet of paper. The spreadsheets must be done in EXCEL.

The diets will include:

House (regular)

Soft

Puree

No Added Salt (NAS)

Consistent Carbohydrate Count Diet

See the grading rubric for distribution of points for this assignment.

Fsmmenu

PUREED DIET

The pureed diet is composed of foods which require minimum mastication. The foods served are basically those on the normal soft diet modified in texture to accommodate the patient’s need.

ADEQUACY: This diet provides an adequate quantity of nutrients prescribed by the Recommended Daily Allowances.

APPROXIMATE COMPOSITION: Calories 2300, Carbohydrates 340 gms, Protein 65 gms, Fat 65 gms.

SUGGESTED MEAL PATTERN

Breakfast Lunch or Dinner

Pureed fruit or fruit juice Soup or juice

Cooked Cereal with milk/sugar Pureed entree

Breakfast Entree Pureed potato or Sub

Pureed Toast/marg/jelly Pureed vegetable

milk Pureed fruit or dessert

Beverage with milk/sugar Pureed bread/marg

Milk

Beverage/milk/sugar

FOODS ALLOWED /

FOODS TO AVOID

Beverage / Any beverage / None
Bread / Pureed enriched white bread, refined whole wheat and rye bread without seeds, white crackers, saltines, graham crackers (pureed) / Coarse whole grain breads, breads and crackers with seeds, nuts, or raisins
Cereals / Refined well-cooked cereals. Slurry of cold cereals / Cereals such as raisin bran, shredded wheat, or those with nuts, dried fruit
Cheese / Cream cheese, cottage cheese, melted mild processed cheese, melted cheddar cheese / All other cheeses
Desserts / Plain puddings, gelatin desserts, ice cream, sherbet, pureed baked items (cakes, brownies, cookies, pies etc.) / Any with nuts, seeds, raisins, coconut
Eggs / Scrambled, poached, mashed, hard cooked / Any except fried
Fat / Butter, margarine, cream, vegetable oil, mayonnaise / Excess fat on meats, fried foods
FOODS ALLOWED / FOODS TO AVOID
Fruits / Pureed cooked, canned fruits, mashed ripe banana, all fruit juices / Raw fruits, fruits with seeds and skins, stewed or canned berries
Meats, Fish. Poultry / Pureed beef, lamb, veal, chicken, turkey, ham, pork, sweetbreads, liver. Flaked white fish, canned salmon, tuna / Spiced luncheon meats, bacon, shellfish, fried meats
Potato or Substitute / Mashed white or sweet potatoes. Hominy. Pureed macaroni, noodles, refined rice, spaghetti / Fried potatoes, potato chips, whole grain rice
Soups / Any with pureed vegetables / Any made with vegetables not allowed
Vegetables / Pureed asparagus, beets, carrots, green beans, wax beans, mixed vegetables, spinach, creamed corn. All vegetable juices. Celery, onions, parsley, peppers, dried peas or beans cooked in soups or casseroles then pureed. Spaghetti sauce pureed. / Strongly flavored vegetables unless tolerated, broccoli, cabbage, whole kernel corn, brussel sprouts, sauerkraut. Raw vegetables.
Seasonings / Any seasoning / None
Sweets / Clear jellies, fruit preserved without seeds, honey, sugar, syrups, plain candy, milk chocolate / Candies made with nuts, dried fruits, raisins and coconut

SOFT DIET

Purpose: To provide an adequate diet with soft, easily chewed and digested foods. These foods are soft in texture, easily digested and moderately low in roughage.

Adequacy: The soft diet will meet the Recommended Daily Dietary Allowances set up by the National Research Council.

Approximate Composition: Calories 2000-2500, Carbohydrates 275-350 grams, Protein 75-95 grams, Fat 70-85 grams.

Suggested Meal Plan

Breakfast Lunch or Dinner

Fruit Juice 1/2 cup Soup or Juice 1/2 cup

Cereal 1/2 cup Meat or Substitute2-3 ozs

Egg or Substitute 1-2 each Potato or Sub. 1/2 cup

Crisp Bacon 1-2 each Vegetable 1/2 cup

Toast or Sweet Roll 2 each Salad 1/2 cup

Margarine 2 tsp. Bread or Rol 1 each

Jelly 1-2 packets Margarine 1 tsp

Milk 1 cup Dessert or Fruit 1/2 cup

Coffee/Tea Milk 1/2 cup

Coffee/Tea

Condiments available: Sugar, Lemon, Salt, Pepper

FOOD / ALLOWED / NOT ALLOWED
Beverage / Any / None
Bread / Refined, enriched white, rye or wheat bread or toast; crackers, melba toast, rusk, hot breads, biscuits baked cornbread, rolls, waffles, pancakes / Fried cornbread; bread or crackers with seeds, nuts or raisins; cracked wheat bread
Cereal / Any corn, rice, or oat cereal; refined wheat cereal, Cream of Wheat, farina, Pettijohns. Hot or cold cereals / Shredded wheat, cereals with nuts, raisins, seeds, etc.
Cheese / Mild American, cottage cheese, edar cheeses / Any with seeds, nuts, or hard to chew pieces
Dessert / Cakes, cookies, puddings, custards, gelatin, ice cream; allowed fruits; pies from allowed fruits; whipped toppings / desserts prepared with coconut, dried fruits, nuts
FOOD / ALLOWED / NOT ALLOWED
Egg / Boiled, creamed, poached, scrambled / Fried
Fat / Butter, cream, margarine, mayonnaise, mayonnaise type salad dressings, crisp bacon, vegetable oil / Fried foods
Fruit / Any cooked or canned without seeds or skins – applesauce, peeled baked apple, apricots, cherries, fruit cocktail, orange or grapefruit sections, peaches, pears, plums; fresh ripe banana, oranges & grapefruit without
membrane. All fruit juices / Fruits containing seeds and skins; raw fruits except those allowed.
Meat / Baked, broiled, creamed or stewed meat; Tender beef, chicken, fish, lamb, liver, pork, ham, turkey, veal, canned salmon, or tuna. Crisp bacon. Mild luncheon meats / Fried meat, fish or fowl; spiced luncheon meats, other highly spiced meats, shellfish.
Potato or Substitute / White potatoes, baked, boiled, creamed, escalloped, mashed; grits, macaroni, noodles, rice, spaghetti, sweet potatoes, yams. / Fried potatoes, potato chips, potato skins
Salad / Any made with allowed fruits or vegetables / Raw fruit or vegetable salads
Soup / Broth or cream soups made with allowed foods or strained/blended / Highly seasoned soups, those made from strongly flavored vegetables
Sweets / Plain candies, honey, jelly, sugar, jams from allowed fruits, syrups, milk chocolate,
marshmallows / Candies with coconut, candied fruits, nuts, raisins, spicy jellies, other jams
Vegetable / Cooked asparagus, beets,
carrots, baby okra, wax or
green beans, peas, spinach, squash, tomato, peeled ripe tomato, broccoli flowers, cauliflower, mushrooms, vegetable juices / Other raw and cooked vegetables, fried vegetables, dried beans and peas
FOOD / ALLOWED / NOT ALLOWED
Miscellaneous / Cream sauces, mild herbs and spices (nutmeg, cinnamon) chocolate, cocoa, strained or jellied cranberry sauce, gravy, lemon juice, salt, pepper, vinegar / Highly seasoned foods, catsup, whole cranberry sauce, garlic, horseradish, hot sauces, mustard, nuts, olives, pickles, popcorn, raisins, spices

CONSISTENT CARBOHYDRATE COUNT DIET

FOR

DIABETIC RESIDENTS

Purpose: To provide a less restrictive diet for patients with maturity onset diabetes and for those whose blood sugar and weight are under control.

Diet Principles:

1. The diet provides adequate nourishment with the elimination of

sugar and foods containing a high concentration of sugar.

2. Carbohydrate foods are planned according to the following

distribution:

Breakfast, lunch, and dinner – 5 Carbohydrate exchanges at

each meal

3 PM and 8 PM snack – 1 carbohydrate exchange each snack

3. Foods high in refined sugar are limited: see the following

list:

Candy

Condensed Milk

Frosting and Icing

Fruit in Heavy Syrup

Honey

Jams, Jellies, and Preserves

Sorghums

Sugar

Sweetened Carbonated Beverages

Sweetened Chewing Gum

Syrup

REGULAR NO ADDED SALT (NAS)

This diet is adequate in all nutrients and provides at least 2000 calories daily. All foods ae included that appear on the regular menu or special modifiction diet for that day. Salt packets are eliminated from the tray.

Sodium content of the regular diet has been determined using the Diet Analysis Plus program. Adjustments will be made to the regular menus that exceed 3-4 grams of sodium per day. Included in the weekly average are such items as ham, bacon, cheese and processed meats when they are on the menu. Menus are planned so that smoked or cured meats do not appear on the menu more than 1 to 2 times per week nor twice in the same day. Processed cheese appears on the menu 1-2 times per week. Prepared convenience foods, which are concentrated sources of sodium are used only if they fit into the 3-4 gram sodium allotment for the day.

The geriatric patient whose taste buds have been altered and dulled by the aging process, illness, or medication may not accept diets lower in sodium, therefore, to promote adequate intake and nutrition the 3-4 gram sodium restriction is used.