Transcript The Challenges of DRI Implementation in California

The Challenges of DRI
Implementation in California
Barbara Estrada, M.S., R.D.
Public Health Nutrition Consultant
California Department of Aging
4th State Units on Aging Nutritionists & Administrators Conference
August 2006
California’s Elderly
Nutrition Program
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33 PSAs
250 + service providers
Diverse population
California’s Elderly
Nutrition Program
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Program Diversity
– Cambodian
– Filipino
– Hispanic
– Russian
– Asian
California’s Elderly
Nutrition Program
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Last year Elderly Nutrition Programs in
California provided 18,476,009 meals
California’s Elderly
Nutrition Program
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33 AAA RDs
88 Program RDs
California’s Elderly
Nutrition Program
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Menu Standards
Title 22 California Code of Regulations
– Provided nutrition requirements
– Must be changed
– Old ENP regulations regarding meal
standards were very specific
– New ENP regulations will be general
First Attempt
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New Menu Standards were developed
and sent out to stakeholders for
comment
The new Standards were based on
2000 Calories per day
First Attempt
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685 Calories per meal
2 servings of bread
2-3 servings of vegetables
1-2 servings of fruit
Sodium <1,000 mg
Protein 3 ounces
First Attempt
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First Draft was released in July of 2005
Comments were accepted until
January of 2006
Several programs provided studies or
surveys that addressed the amount of
food and costs.
First Attempt
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CDA withdrew the first draft and asked
the programs to continue to operate
on the AoA requirement that all meals
meet the 2005 Dietary Guidelines.
Updated Menu Standard
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535 Calories per meal (Based on 1600
per day)
14 gm of protein per entree
Vitamin A – 250 μg
Vitamin C – 25 mg
Sodium ~ 800 mg
Fiber > 7 gm
California Component Meal Pattern
Food Group
Required
servings/ meal
Serving sizes for
1600 calorie level
Lean meat / beans
1 serving
2 ounces = 1 serving
1 – 2 servings
½ cup = 1 serving
1 serving
½ cup = 1 serving
Vegetable
Fruit
Bread or Grain
1 – 2 servings / ½
must be whole grain
Milk or milk
alternate
1 serving
Fat
Optional
Dessert
Optional - limit
sweets use fruit
1 slice Bread or ½ cup of
rice or pasta = 1 serving
1 cup or equivalent
measure
Select foods high in
fiber and low in fat
and sugar
Dash Diet
Food Group
Grains
1,600 Calories
Daily
6 servings
550 calories per
meal
2 servings
Vegetables
3-4 servings
1.5-2 servings
Fruits
4 servings
1.3 servings
Low-fat or fat free
dairy
2-3 servings
1 serving
Meat, poultry, fish
1-2 servings (3 oz
each)
3-4 servings
1 serving (2 oz.)
Seeds, nuts,
legumes
Fats and oils
2 servings/week
Sweets
0 servings
1 serving
USDA Menu Pattern
Food Group
1,600 Calories Daily
550 calories/ meal
Grains
5 ounces
1.7 ounces
Vegetables
2 cups (4 servings)
.7 cups
(1.3 servings)
Fruits
1.5 cups
.5 cups
Milk
3 cups
1 cup
Lean meat and
beans
5 ounces
1.7 -2 ounces
Oils
22g
7g
Discretionary
calorie allowance
132 calories
44 calories
California’s Elderly
Nutrition Program
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Providing guidance without writing
underground regulations?
Updated Menu Standard
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Sodium the real challenge
Effect of Potassium
Culturally appropriate meals
New Regulations
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CDA RDs are in the process of
changing the California Code of
Regulations
New language will be more general
Guidance will be provided along with
choices of how to meet the Federal
regulations.