Each resident shall be served food to meet the resident's
needs and to meet physician's orders. The facility shall use this Section to
plan menus and purchase food in accordance with the following Recommended
Dietary Allowances of the Food and Nutrition Board of the National Research
Council, National Academy of Sciences.
a) Milk and Milk Products Group: 16 ounces or
more of Grade A whole or low fat pasteurized milk where milk is used for fluid
consumption. Calcium equivalents for eight ounces of milk:
1) 11/2 ounces natural cheese,
2) Two ounces processed cheese,
3) One cup yogurt, or one cup frozen
yogurt,
4) One cup cottage cheese,
or
5) 11/2 cups ice cream or ice
milk.
b) Meat Group: A
total of 6 ounces (by weight) of good quality protein to provide 38 to 42 grams
of protein daily. To ensure variety, food items repeated within the same day
shall not be counted as meeting a required serving. The following are examples
of one serving.
1) Three ounces (excluding
bone, fat and breading) of any cooked meat such as whole or ground beef, veal,
pork or lamb; poultry; organ meats such as liver, heart, kidney; prepared
luncheon meats.
2) Three ounces
(excluding skin and breading) of cooked fish or shell fish or 1/2 cup canned
fish.
3) Three ounces of natural or
processed cheese or 3/4 cup cottage cheese.
4) Three eggs (minimum weight 21 ounces per
dozen, considered a medium egg).
Note: If one egg is served at a meal, a protein food of good
quality may be reduced from six to five ounces for the remaining meals. If two
eggs are served at a meal, a minimum of two ounces of good quality protein
shall be served at each of the remaining meals.
5) 11/2 cups cooked dried peas or beans, six
tablespoons of peanut butter, or one cup nuts, not more than twice a week and
provided that eggs, milk or lean meat is served at the same meal.
6) Three ounces of soy protein containing not
less than 21 grams of protein or in combination with other sources of quality
protein to equal 21 grams of protein, provided that it is acceptable to the
resident population.
7)
Combinations of all above examples are acceptable, provided that the minimum
standard of six ounces of a good quality protein food is served daily and
provided that the combinations do not conflict with eye appeal or
palatability.
8) The content of
meat alternative products shall be listed on the menu.
c) Vegetable and Fruit Group: Five or more
servings of fruits or vegetables.
1) A
serving consists of:
A) 1/2 cup chopped raw,
cooked, canned or frozen fruit or vegetables;
B) 3/4 cup fruit or vegetable juice;
or
C) One cup raw leafy
vegetable.
2) The five
or more servings shall consist of:
A) Sources
of vitamin C
i) One serving of a good source
of vitamin C (containing at least 60 mg of vitamin C); or
ii) Two servings of a fair source of vitamin
C. This may be more than one food item and shall contain a total of at least 65
mg of vitamin C.
B) One
serving of a good source of vitamin A at least three times a week supplying at
least 1000 micrograms retinol equivalent (RE) of vitamin A.
C) Other fruits and vegetables, including
potatoes, that may be served in 1/3 cup or larger portions.
3) To ensure variety, food items
repeated within the same day shall not be counted as meeting a required
serving.
d) Bread,
Cereal, Rice and Pasta Group: Six or more servings of whole grain, enriched or
restored products. One serving equals:
1) One
slice of bread,
2) 1/2 cup of
cooked cereal, rice, pasta, noodles, or grain product,
3) 3/4 cup of dry, ready-to-eat
cereal,
4) 1/2 hamburger or hotdog
bun, bagel or English muffin,
5)
One 4-inch diameter pancake,
6) One
tortilla,
7) Three to four plain
crackers (small),
8) 1/2 croissant
(large), doughnut or danish (medium),
9)
1/16
cake,
10) Two cookies, or
11)
1/12 pie
(2-crust, 8").
e) Butter
or Margarine: To be used as a spread and in cooking.
f) Other foods shall be served to round out
meals, satisfy individual appetites, improve flavor, and meet the individual's
nutritional and caloric needs.
g)
Meals for the day shall be planned to provide a variety of foods, variety in
texture and good color balance. The following meal patterns shall be used.
1) Three meals a day plan:
A) Breakfast: Fruit or juice, cereal, meat
(optional, but three to four times per week preferable), bread, butter or
margarine, milk, and choice of additional beverage.
B) Main Meal (may be served noon or evening):
Soup or juice (optional), entree (quality protein), potato or potato
substitute, vegetable or salad, dessert (preferably fruit unless fruit is
served as a salad or will be served at another meal), bread, butter or
margarine, and choice of beverage.
C) Lunch or Supper: Soup or juice (optional),
entree (quality protein), potato or potato substitute (optional if served at
main meal), vegetable or salad, dessert, bread, butter or margarine, milk, and
choice of additional beverage.
2) Other meal patterns may be used if
facilities are able to meet residents' needs using such plans.