Menu Planning for Special Groups

Child & Adolescent Health Statistics

Childhood overweight and obesity is a major public health issue Between 1985 and 1995, obesity prevalence in 7715yr olds tripled. Evidence that obesity is developing at a younger age (AIHW) Study indicated most popular activity reported by children 5-14yrs watching TV and videos (AIHW, 52000) Hrs per week spent watching TV > hrs of physical activity (Geelong study of adolescents) Carmel Lazarus February 2008 Social change influencing food preferences/intake

Carmel Lazarus Nutrition Manager & Consultant Dietitian

Email: clazarus@tpg.com.au Ph: 0416482199 University of Sydney
Carmel Lazarus February 2008

Childcare statistics
28% of Australian children attend LDCC 18% of Australian Children attend family day care 32% attend preschool No. of children in LDCC has doubled from 1991 to 1999 (AIHW) No. of children attending family day care increased by 30% (AIHW), same period Children spend minimum of 8hrs/day at the centres Children may be at the centres 5 days/week Childcare centres should provide 50% of the RDI for all nutrients Carmel Lazarus February 2008

Why is good nutrition important for Childcare?

Start good nutrition habits early Halt the rising prevalence of overweight/obesity Food choices/preferences are developed in childhood Young childrens eating habits influenced by environment, staff other children and parents Children spend a lot of time in childcare Eat at least 1 main meal and 2 snacks

Carmel Lazarus February 2008

Menu Planning Considerations

Balance between
Amount of food Type of food Variety of food

Menu Planning Considerations

Small amount of foods are eaten often Prefer simplicity Associate food with more than just eating Children will be actively learning during the day Examples set have a great influence on the children

Offer opportunity for exploration/learning Good food habits isnt instinctive

Need to be given guidance

Foster formation of sound food habits

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Accreditation Principles
www.ncac.gov.au

Nutrients at Risk
Energy Iron Calcium Zinc

Quality Area - Health 8.1: Food and drink are nutritious and culturally appropriate and healthy eating habits are promoted 8.2: Staff implement effective and current food handling standards and hygiene practices Quality Area - Respect for Children 2.4: Mealtimes are pleasant, culturally appropriate occasions and provide an environment for social learning and positive interaction8.4 Centre acts to control spread of infectious diseases.
Carmel Lazarus February 2008

Carmel Lazarus February 2008

Menu Planning Guidelines

Food and Nutrition: Directions for NSW 199619962000.Healthier food choices for child care centres Caring for Children- Food, Nutrition & Fun Activities: ChildrenCentral Coast Area Health Service Nutrition Dept, Nutrition Australia: Food and Nutrition Accreditation Guidelines for Child Care Centres, 2003 Nutrition Australia: Menu Planning for Childcare Centres NRVs, 2005 NRVs, AGTHE, 1998 NHMRC Dietary guidelines for Children and Adolescents
Carmel Lazarus February 2008

Developing a menu policy

Important to know what to measure your menu against Sets guidelines for staff and parents Helps ensure adequate nutrition Liaise with parents and staff in the development Employ a professional eg. APD

Carmel Lazarus February 2008

Nutrition Checklist
Caring for the Coast Central Coast Area Health Service Main Meals Lean red meat is included at least 4 x per fortnight Lean white meat is included at least 3 x per fortnight Vegetarian meal is included at least 2 x per fortnight Vegetarian meals are based on eggs, cheese, tofu or dried beans Fruit or vegetable high in Vitamin c is included with the vegetarian meal

Nutrition Checklist
Snacks planned on menu
Includes a dairy and/or bread/cereal food

Breads, Cereals, rice & pasta

Includes at least 2 serves of bread, cereal, rice, pasta Select high fibre types (multigrain, w/meal) 4 x per fortnight

Dairy Foods
3 serves of full cream dairy each day

Vegetables & Fruit

Menu includes at least 1 serve of vegetables daily Menu includes at least 1 serve of fruit daily Fruit juice, if served, is diluted and limited to once per day

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Menu Policy
Strategies to comply with the menu policy:
Milk should be served with&.. All milk should be. Children will have access to . at all times Fruit juice should be. Children will be encouraged to have hands on experience with Only soy milks with. will be used as a milk substitute Desserts will be based on . Or .. Staff should sit with children and .will/will not be used as punishment or reward . will be on display for parents and staff Morning and afternoon tea should include. Dairy should be served.. Times a day
Meal Period Am tea MON Raisin Toast & Peanut butter Fresh cut fruit Chilli Con Carne & Chips Vanilla Yoghurt Skim Milk

Menu
TUES WED THURS Crumpet with Spread Fresh cut fruit Vegetable Soup & Bread Custard Toasted Pikelets Fresh cut fruit Vegetable Rissoles Rice pudding English muffin Fresh cut fruit

Lunch

Macaroni with mince sauce Banana Custard Dried fruit & nuts

Pm tea

Juice undiluted Croissant

Late Pm tea Cheese & Crackers

Carrot sticks

Grapes

Sandwiches

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Menu
Meal Period Am tea MON TUES WED THURS

Case Study Child Care Centre

You are a Consultant Dietitian and you have been asked to review the menu for a child care centre Where would you start? How would you assess the menu? Who would you involve?

Raisin Toast & Peanut butter Fresh cut fruit Chilli Con Carne & Chips Vanilla Yoghurt Skim Milk

Crumpet with Spread Fresh cut fruit Vegetable Soup & Bread Custard

Toasted Pikelets Fresh cut fruit Vegetable Rissoles Rice pudding

English muffin Fresh cut fruit

Lunch

Macaroni with mince sauce Banana Custard Dried fruit & nuts

Pm tea

Juice undiluted Croissant

Late Pm tea Cheese & Crackers

Carrot sticks

Grapes

Sandwiches

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Child Care Menu Review

Awareness of NCAC (national) guidelines Quality areas
Quality Area 2 Respect for Children: 2.4 - Mealtimes are pleasant culturally appropriate occasions and provide an environment for social learning & positive interaction Quality Area 8 Health: 8.1 - Food and drinks are nutritious and culturally appropriate and healthy eating habits are encouraged. 8.2 Staff implement effective and current food handling standards and hygiene practices.

Child Care Menu Review

Is there a policy detailing menu objectives
Food allergy policy nut-free zone nut Provide children with at least 50% of their daily RDI in the form of safe, appetising foods
Milk served with mid-meals midAll milk should be FCM Soy milks fortified with calcium Fruit juice diluted Lunches contain something from each food group Access to bread / fruit between meals
Carmel Lazarus February 2008

Carmel Lazarus February 2008

Nutrition Checklist
2 serves bread & cereals 1 serves dairy 1 serve meat/alternatives 1 serve fruit 1 serve vegetables
Nutrition Australia Menu Planning for Childcare Centres 2002

Menu Planning for Childcare Centres

Know your clientele Conduct a survey regarding food preferences etc Know your menu objectives Have a food and nutrition policy Know your resources available Decide on a menu type Design a menu template Develop recipes Trial recipes and check for menu fundamentals, consider diet profiles Revise purchasing plans Train staff Inform staff/parents Implement and evaluateFebruary 2008 Carmel Lazarus

Carmel Lazarus February 2008

Menu Planning for Athletes

MENU PLANNING FOR ATHLETES

Event may be big or small Commonwealth Games to local BBQ for a sporting team Understand your target catering to different athletes Training vs Competition Fluid Availability Adequate Energy and Protein CHO consider GI
Carmel Lazarus February 2008

Carmel Lazarus February 2008

Menu Planning Considerations

Menu Cycle length Meal times Seasonality Food Safety Cost Resources available
www.ais.org.au/nutrition www.ais.org.au/nutrition Burke L. Glycaemic Index: Its role in Sports Nutrition. Proceedings for GSSI Seminar on Recent Advances in Sports Nutrition. Kiens B. Diet and Exercise Performance: High CHO or high fat? Proceedings for Proceedings GSSI Seminar on Recent Advances in Sports Nutrition. OConnor H, Hay D. Nutrition sports basics. Australia: JB Fairfax Creative Cooking Fairfax

NUTRITION IN SCHOOL CANTEENS

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Fresh Tastes Resources

Menu Planning for School Canteens

NSW Healthy School Canteen Strategy: Canteen Menu Planning Guide NHMRC Dietary Guidelines for Children and Adolescents, AGPS, 2003 The Australian Guide to healthy eating NRVs www.health.nsw.gov.au www.schoolcanteens.org.au www.schools.nsw.edu.au

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Menu Planning Guidelines

Recommended no. of serves 4-7 yrs 1- 2 2 1 2 5- 7 8-11yrs 1- 2 1 2 1 2 6- 9 12-18yrs 121- 2 1 3 3 3 5-11

Menu Planning Considerations for School Canteens

Extra Foods Lean meat, fish, poultry, nuts legumes Milk, yoghurt, cheese Fruit Vegetables, legumes Cereals

NSW School Canteen Menu Planning Guide Carmel Lazarus February 2008

Increasing levels of overweight and obesity Ideal setting to educate about healthy food choices Need to run at a profit or break even The food preferences of the students may be different to parents School canteens provide a substantial proportion of a students daily intake Can put into practice the learnt healthy nutrition messages Can influence food choice at school and the wider community Use the Canteen menu planner Breakfast is often skipped Intake of fruit and vegetables is < desirable
Carmel Lazarus February 2008

School Canteen Guidelines

Developed in response to the increasing rates of obesity in school children Consistent with healthy eating messages taught in school Aligned with
National dietary guidelines for children and adolescents Australian Guide to Healthy Eating

School Canteen Principles

Green
Foods to be consumed freely; to fill the menu Fruit, vegetables, whole grains, lean meats, reduced fat dairy

Amber
Foods with some nutritional value but higher in fat and/or energy, therefore should be consumed in limited quantities

Red
Foods to be consumed no more than ONCE PER TERM Confectionary, deep fried foods, sugar sweetened beverages

Stoplight analogy:

Green, Amber, Red

Carmel Lazarus February 2008

Carmel Lazarus February 2008

School Canteen Guidelines

MENU PLANNING FOR HEALTH PROMOTION

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Health Statistics
2.5 million Australians are obese (1 in 5 males, 1 in 6 females) 4.9 million are overweight (2004/5 NHF data) Heart, stroke and vascular disease kill more Australians than any other group (36.9% of all deaths in 2003) Greater proportion premature dealth/illness from excess body dealth/illness fast than tobacco and high BP (2004/5 NHF data) 54% of Australians are not sufficiently active to gain health benefits 8% have diabetes 20% smoke daily 30% have high blood pressure 10% drink at harmful levels Estimates that >50% of premature deaths are related to POOR DIET. Carmel Lazarus www.aihw.gov/au/cvd/heartweek February 2008

Menu Planning for Health Promotion

Diet related diseases are very costly to the Australian health care care system Australians are spending more on foods prepared outside the home Both parents working Less time to prepare Less skills to prepare/cook Caterers can have an impact in providing more healthy choices Usually needs to be an incentive for promoting nutritious foods May be a business philosophy May have theme days to promote the business and offer healthy choices May provide a niche market, and provide the edge Still need to run at a profit
Carmel Lazarus February 2008

Natraburgers

Peppercorn Meats

Carmel Lazarus February 2008

Carmel Lazarus February 2008

10.30am 11.00am 11.30am 12.00noon 12.30pm 1.00pm 1.30pm 2.00pm 2.30pm 3.00pm 3.30pm

Prizes will be drawn on Friday, 12th May 2000 at the following times: St Vincents Private Hospital Heart Health Promotion Day (outside David Jones).

Healthy Food Hamper (donated by Coles)

12 packets (1 box) Peppercorn Gourmet Meat plus 1 bottle of Jacobs Creek Wine Food Hamper (donated by David Jones Ltd) $50 Voucher redeemable from Fruit & Vegetables Section of David Jones Ltd. 1 Month Free Membership City Gym plus bottle Jacobs Creek Wine Food Hamper (donated by David Jones Ltd) 1 Month Free Membership City Gym plus bottle Jacobs Creek Wine 3 x bottles Jacobs Creek Wine 1 Month Free Membership City Gym plus bottle Jacobs Creek Wine Healthy Food Hamper (donated by Coles) $50 Voucher redeemable from Fruit & Vegetables Section of David Lazarus February 2008 Jones plus 1 Month Free Carmel Membership to City Gym
SHOPPING PLAZA BONDI JUNCTION

Carmel Lazarus February 2008

Heart Week Promotions

ENTER TO WIN! Answer this question correctly to be eligible to win one of these fabulous prizes: David Jones Healthy Food Hamper Coles Healthy Food Hamper Orlando Wyndham Estate Red Wines 1 Month membership to the City Gym Peppercorn Low Fat Gourmet Meat
True/False:

Considerations for a Staff Cafeteria

Have potential to be models for healthy environments Captive audience due to position May provide more flexibility and customisation Regular feedback with in house clientele Access service daily Usually long term clientelle offer choice
Carmel Lazarus February 2008

The 7-A-Day Program (a partnership project of the Dietitians Association of Australia and Coles) encourages all Australians to eat 7 serves of fruit and vegetables a day. TRUE / FALSE

Carmel Lazarus February 2008

Nutrition Guidelines
AGTHE 5 food groups NHMRC Australian Dietary Guidelines for Adults, AGPS, 2003 NSW Health Menu assessment tool NSW Health Policy Directive Healthier Food and Drink Choices for Staff and Visitors in NSW Health Facilities

www.healthyactive.gov.au

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Menu Planning Steps

Know your customers
Conduct surveys, have suggestion box

Menu Planning Steps

Search for products and recipes Develop standard recipes Implement and communicate Evaluate the menu regularly
Waste audits Temperature checks Taste tests

Know you menu objectives/Incorporate Nutrition Goals

The items provided comply with the standards

Cater to food preferences, cultural diversity, religious needs Construct menu (cycle, pattern,) Decide on a template offer variety
Carmel Lazarus February 2008

Include Promotional days

Eg. Heart week or Diabetes week
Carmel Lazarus February 2008

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Carmel Lazarus February 2008

Recipe Development/Product Evaluation

Base your menu on the guidelines Design nutritional parameters to assist in evaluating new products for the cafeteria Promote healthy foods Make healthy foods affordable and appealing

Promoting/Marketing the Service

Include new menus in the organisations newsletters/intranet/email Position healthy foods where they are easily accesses and visible List healthier foods at the top of the menu Use appropriate menu descriptions/symbols/colour codes Ensure healthy foods are as affordable or cheaper Incorporate health promotion days
healthy heart dish (lucky door prize to staff purchasing this) High calcium/reduced fat desserts during healthy bones week

Publish recipes/display recipes of healthy foods Offer free samples of healthy foods being trialled or to be promoted
Carmel Lazarus February 2008 Carmel Lazarus February 2008

Case Study - Worksite Canteen

You have been asked to review the menu in a staff canteen. The customer satisfaction survey has shown 75% of responses were dissatisfied with the current choices of food and would like to see more healthy options on the menu. Where do you start?
Carmel Lazarus February 2008

MENU
BREAKFAST LUNCH Egg & bacon Roll Chicken Burger DINNER MIDMEALS

Lamb Curry & Muffins Rice Fish and Chips Steak and Vegetables Lasagne & Salad Cakes Slices Fruit

Breakfast with Hot Dog the lot Toast and Spreads Sausages Beef Burger Sandwiches

Carmel Lazarus February 2008

Worksite Canteen
Look at the equipment available Staff Skills & Knowledge Standards
Diabetes Australia AGTHE Dietary Guidelines Fresh Tastes School Canteens Buyers Guide
NSWSCA Guidelines <800kJ/100g, <3g saturated fat/100g, <350mg Na/100g

NSW Health Policy Directive

NSW Health Menu Assessment Tool for main meals:

<15g fat, <450mg sodium
Carmel Lazarus February 2008 Carmel Lazarus February 2008

NSW Health Policy Directive

NSW Health Policy Directive

Carmel Lazarus February 2008

Carmel Lazarus February 2008

NSW Health Policy Directive

Keys to Menu Planning & Assessment

Know your Client preferences & demographics Have Menu Objectives to measure the menu against Familiarise yourself with the relevant tools & policies Understand your budget/food service system/equipment and storage facilities Engage staff, involve in process Recognise the staff skills and staffing levels Is your Menu Design relevant & appropriate Understand Menu combinations - texture / taste / nutrition / presentation / variety

Carmel Lazarus February 2008

Carmel Lazarus February 2008

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