Perkins School for the Blind



Food Services Policies and Procedures ManualRevised 2014Section 1: Introduction TOC \o "1-3" \h \z \u Mission Statement Nutrition, Health and SafetyDietary GuidelinesSection 2: Policies and ProceduresSuggested Guidelines for Special Events Student BirthdaysSpecial EventsParty Food SuggestionsCook-Outs: ProceduresCookout & Picnic ProceduresBag Lunches for Off-Campus ActivitiesFood From HomeMenu ExpectationsFood Allergies and SensitivitiesPeanut and Nut PolicyOther Food AllergiesAllergy SafetyStudent Snack BarCash AccountsTypes of FoodRestaurant MealsTake-Out FoodsField Trips that Include Food, but Not MealsFood Preparation Classes and Recreational CookingWhen the Cook is AbsentCatered Functions on Campus ~ For Non-Educational DepartmentsSection III: Nutritional GuidelinesNutrition and Portion SizesWhat “Counts” as a Serving?Breads & Grain GroupVegetable GroupFruit GroupMeat GroupFats, Oils & SweetsVisualizing Portion SizesBeveragesHealthy SnacksHealthier Fast Food ChoicesFast Food Bandits (more than 600 calories each!) Avoid at all costs!Section IV: Special Diets and Feeding ProgramsSpeech/OT/Feeding ProgramsFood Textures ListFood Textures TableDietary Orders for Students Who Require Special DietsSection V: INDEPENDENT LIVING GUIDELINESGuidelines for Independent Living ProgramsBreakfast ChoicesA Hierarchy for Developing Food Preparation SkillsSection VI: Referances and ResourcesChoose What are Empty Calories?Calories for ChildrenEat the Right Amount of Calories for YouResources for Weight Management and Calories10 Tips for Healthier School DayTips for Eating Healthy When Eating OutMake Better Beverage ChoicesCut Back on Kids Sweet TreatsMake Celebrations Fun, Healthy and ActiveBe a Healthy Role Model for ChildrenSection VII: FormsBirthday RequestPicnic Food Order Form Page 1Feeding Program FormIntroductionMission Statement As a residential school, Perkins has an obligation to provide a well-balanced diet to promote the health of its students, and to meet the licensing requirements of the Department of Early Education and Care. Many Perkins students have special diet needs due to medical conditions, allergies and food sensitivities, cultural preferences and feeding disorders. In addition we must take into account the special needs of many of our students who are at risk for developing medical complications if they receive poor nutrition and inadequate exercise. Perkins is also committed to teaching principles and skills that will promote a healthy lifestyle as our students assume more responsibility for their own nutrition.The President of Perkins established the Food Service Committee, a cross campus group, consisting of the dietitian, representatives of the residential and educational programs, speech language and occupational therapists, storeroom and related feeding staff. The committee’s purpose includes:Supporting the Food Service Department and Health Services in providing balanced nutrition to the Perkins community.Establishing standard guidelines for menu changes, special events, and menu modifications for students who require special diets or feeding programs, and the use of cash accounts for the purchase of foods. Providing nutrition resources and guidelines for cooks, other staff and our students The Committee has issued this Food Service Policy Book that includes the policies and procedures it has established.Nutrition, Health and SafetyImplementing Massachusetts School Nutrition Standards for Competitive Foods and BeveragesTo:School Superintendents, Principals and Nutrition DirectorsFrom:Mitchell D. Chester, Ed.D., Commissioner, Department of Elementary and Secondary Education; John Auerbach, Commissioner, Department of Public HealthDate:November 15, 2011Recently, many states have created nutrition standards for foods and beverages sold in schools to improve child health and to help reduce the rate of childhood overweight and obesity. Schools in these states have been able to implement strong nutrition standards successfully and still maintain financial stability. In July 2010, the Massachusetts State Legislature passed a law requiring the Department of Public Health (DPH), in coordination with the Department of Elementary and Secondary Education (ESE), to develop evidence-based nutrition standards for Massachusetts public schools. The Commonwealth is committed to providing a healthy school environment for all students. That means offering nourishing food and beverage choices, such as nutrient-rich fruits, vegetables, whole grains, lean protein and low-fat dairy products that promote growth and development, enhance learning, and help students form healthy life-long eating habits. The new standards are focused on "competitive" foods and beverages sold or provided in public schools during the school day. The standards do not apply to school meals programs, which follow USDA national guidelines. Competitive foods and beverages are those provided in:School cafeteria à la carte items (sold separately from school meals)School stores, snack bars, vending machines and concession standsSchool booster sales, fund-raising activities and other school-sponsored or school-related eventsSchool buildings and any other location on school property, including classrooms and hallwaysThe standards apply to items sold or provided from 30 minutes before the beginning of the school day until 30 minutes after the school day ends. Foods and beverages sold in vending machines must meet the standards at all times. These standards take effect in all Massachusetts public schools in August, 2012. Having accurate information and helpful resources is one of the best ways to address concerns about the possible negative impact the new regulations may have on school finances. We have developed "Healthy Students, Healthy Schools: Guidance for Implementing Massachusetts School Nutrition Standards for Competitive Foods and Beverages." This guide will provide schools with practical information for implementing the nutrition regulations. It includes links to resources and features numerous examples from schools across Massachusetts which have already successfully created healthier environments for their students. In addition, ESE will conduct trainings and provide resources for nutrition services personnel and other school staff to help them with implementing the regulations. School officials are encouraged to communicate with school staff, teachers, food service personnel, school nurses, athletic staff, students, parents, etc., to help them understand their roles in creating healthy school environments. Thank you for your support in this important effort.Last Updated: November 21, 2011Dietary GuidelinesPolicies and Procedures SUGGESTED GUIDELINES FOR SPECIAL EVENTSStudent BirthdaysPerkins would like all of our staff and students to celebrate and recognize student birthdays. In accordance with many school districts in our area, we are encouraging healthy activities as a way to celebrate, as opposed to high fat and sugar confection offerings. Staff may choose to decorate chairs for the birthday child, have special choice of an activity, or read a special book. There are many ways to celebrate be creative!Perkins will provide birthday cakes for residential students in the cottages in the evening time. We will no longer honor these request for during the school day because there is a reasonable expectation that the child will celebrate after leaving school at their home as their family so chooses. Most school districts have moved forward with a no food celebration policy to decrease issues with allergies and increasing obesity trends.For residential students, please use the birthday cake request form and send via Schooldude.Refer to Forms section in the back of this manual for a copy of the Birthday Dessert Request Form.Special EventsThese events include activities that are planned for students such as concerts, dances and various kinds of parties. Storeroom requests for these events should be processed through designated person 5 days in advance via Schooldude. In general, refreshments probably are not needed for regular activities like the monthly concert. Refreshments should be provided at no more than one special event each week, and these refreshments should be chosen from the attached list, and should be foods that are available from storeroom that do not require special orders. The person who is in charge of approving the lists should determine the criteria for any event that involves an order from the bakery or foods that are not stocked by storeroom. These events should be special events that occur infrequently, like the Senior Prom, or an individual student’s Senior Voice or Piano Recital. When students attend an activity and refreshments are provided, additional snacks should not be offered within the same block of time. (Example: If students attend an evening concert and have refreshments, bed-time snacks should not be offered when they return to the cottage.) Some students may wish to choose to have a regular cottage snack instead of the refreshments. In any case, the reasons for choosing just one snack should be explained to the student. Please notify food service department, 5 days in advance of meal cancelation due to special event.Several holidays especially Christmas, Thanksgiving and Easter may involve additional activities centered around a meal. Large group activities, such as the senior luncheon and the athletic banquet may also involve a meal. If an activity centers around a meal, and staff or wish to change the meal that is listed on the menu, this change should be approved by the Dietitian and Food Services Manager. If celebrations or parties involve items that are not on the menu or provided by storeroom, the Dietitian should be consulted.Party Food SuggestionsParty food should be selected from the food groups, part of the U.S.D.A.’s Food Guide Pyramid. Choose grains, fruit, vegetables, protein, and dairy foods. Limit food choices from the ‘others’ group of the pyramid which includes sweets, fats, oils, etc. otherwise known as ‘junk food.’ **Always keep in mind student medical issues such as FOOD ALLERGIES and ability to handle FOOD TEXTURES. **Choose a GrainChoose a Vegetablepopcorncarrot/cucumber/celery stickscrackerscauliflower/ broccoli cruditétortilla chipssalsarice cakespita chippretzelsChoose a FruitChoose a Proteinpieces of fresh fruithummus*melon slicescheese*pineapple chunks or wedgesChoose a Dairy Productmilk drinksyogurt (as a dip)*frozen yogurt*cheese*Try a Fruit Beveragemixed juicesfruit spritzer (juice w/ seltzer water)frozen fruit punch (frozen fruit slices or pieces added to mixed juices)Seltzer with lemon or limeIdeas for Putting It All Together‘Traditional Appetizers’crackers & cheesecrudités (broccoli, cauliflower) & veggie sticks (cucumber & celery)w/ fat-free creamy Italian dressing (for dipping)Fruit spritzer‘Sundae Party’banana slicespineapple ‘Film Food’popcornapple slices iced tea or juice‘Eastern Time’hummus**, baby carrots & pita wedges (hummus needs to be ordered in advance, not regularly stocked) cranberry spritzer‘Fiesta Time’salsa & chipsmelon slicescheese chunks*peach ice tea (frozen peach slices added to iced tea)‘Oh, the Variety’pretzelspepper strips w/ dressingAll of the above can be prepared with food available from the storeroom. *Foods that need to be refrigerated until ready to eat. (Storeroom will provide these foods for functions after it has closed only if it is able to be refrigerated until ready to eat.Procedures for Special EventsCook-Outs: ProceduresWhen requesting a cookout, please place request via Schooldude 5 business days in advance and remember to cancel the regular meal. Cookout & Picnic ProceduresUsing SchoolDude, at least 5 days in advance, the supplies must be ordered and the meal count must be modified or the regular meal canceled as appropriate. Bag Lunches for Off-Campus ActivitiesBag lunches are available for off campus activities, please follow the same procedures for cook-outs and picnics. The bag lunches can be picked up from the cottage. Coolers will be supplied for off campus trips.Food From HomeAll food brought in from off campus needs to adhere to the food allergy policy. Food served to students must not only meet the allergy policy but must also meet the campus wide initiative to provide healthy whole some foods. Perkins School for the Blind provides healthy, whole some foods for all students, and therefore caregivers and/or families do not need to send in food. Although sending food is unnecessary, if students do bring or receive food sent in from home we highly recommend these foods reflect the healthy initiative for school age children set forth by the state of Massachusetts. the safety of our students we remind staff to be diligent in checking all food labels for the presents of nuts.If students’ needs fall outside of these guidelines please contact the dietitian (*7467) to create an individualized plan.Menu ExpectationsPerkins is obligated to provide a nutritionally balanced diet to all students; for this reason it is imperative to follow the menu without changes, omissions or additions. Children learn about different kinds of foods through repeated exposure. Research shows a child should be offered a food repeatedly before eliminating the item from the meal plan. It is our policy to serve the menued meals. A full salad bar is available with the noon and evening meals. Milk and fruit are always available during meals. Students are encouraged to try small portions of all foods. In some cases menued foods may be served in different forms. For example, meats may be chopped or pureed for students with chewing problems. Occasionally it is necessary to provide an alternate protein to a student who consistently refuses menued proteins.Cottage staff should notify the Food Service Manager or the Dietitian if a student is consistently refusing to eat meals. FOOD ALLERGIES AND SENSITIVITIESPeanut and Nut PolicyPeanut and nuts allergies have become more prevalent and serious in school settings. A small exposure, even just peanut or nut residue on the hands of another person can, in some cases, result in a severe allergic reaction. Due to the severity of nut allergies, we continue to be proactive to prevent inadvertent exposure of a student with these allergies by having a peanut and nut free environment in all student areas or areas students are likely to frequent. This includes peanuts, ALL tree nuts and other nuts, products that MAY CONTAIN nuts or that have been processed in the same facilities as nuts. Please read labels carefully for the safety of our students.The following are the strategies for reducing potential exposure to nuts or peanuts. Peanut butter has been replaced in the storeroom with Sunbutter. This is a product made from sunflower seeds and has a similar taste and texture to peanut butter. Programs can request Sunbutter from the store room as they would peanut butter.Other acceptable alternatives are soy nuts, sunflower seeds and soynut butter. Check to be sure students you work with do not have a soy allergy.Student food sent in from home needs to be checked for peanuts or peanut butter or tree nuts and parents reminded when a lunch contains any of these. Staff may not bring these products for their personal use into student areas.Ingredients for all products should be checked and those labeled with “may contain traces of nuts” or are made with any peanut products need to be avoided in all student areas.Baked foods and foods used for student fund raisers, such as bake sales, needs to be nut free.Coconuts are considered an allergen and are also not allowed on our nut free campus. This includes raw, cooked and coconut milk products.Other Food AllergiesMany students at Perkins experience food allergies and sensitivities. In addition to nuts and peanuts, some of the common foods of concern include dairy (milk), eggs, chicken, wheat, seafood and fish, soy and some fruit. There are students with uncommon food allergies as well. It is extremely important to follow good allergy safety at all times. Allergy SafetyKnow which students have allergies and what they are.Don’t offer a student food unless you are sure there are no allergy issues, check, ask other staff, don’t assume.Read all food labels, especially for any new food, food that may have been changed by the manufacturer, any food a student has not had in a long time, or any time there is a question.Alert restaurant workers to student allergies when orderingStudents with allergies should not share food with other students, especially food sent in from home.Staff should refer to the dietitian for appropriate substitutions for cooking groups or other activities and special events.All food purchased on off-grounds activities needs to be checked before purchase. Some craft materials may include foods that students have allergies to, so screen craft projects in advance in these situations.Student Snack BarAll purchases in the Student Snack Bar should be made with the student’s own moneyA variety of snack foods and beverages are available for purchase from the machines or from the counter when the Snack Bar is open. The foods and beverages vary in nutritional content, low calorie, low fat options are available. CASH ACCOUNTS: Cottage/Classroom Cash AccountsTypes of FoodCash accounts can be used to purchase a variety of foods, however foods should be similar to those that are offered on the Perkins menu and should not include soda, candy, foods high in salt, sugar, fat, such as doughnuts or other confections or have a low nutrient content. We recommend the purchase of high nutrient content foods that would include fruits, vegetables and wholesome sources or protein. Limited amounts of candy may be purchased for Halloween, Christmas, and Valentine’s Day and Easter; guidelines are available from the dietitian for the purchase of candy. Exceptions to this would be approved behavior plans with edible rewards. Also, any food approved by the dietitian for an individual student can be purchased from these cash accounts. In all cases, an identified individual should be assigned the responsibility of monitoring cash that is spent for food to ensure that the Food Service Committee guidelines are being followed. Good nutrition of Perkins students should be the primary consideration in the monitoring of cash expenditures.Occasions When Food Can Be Purchased with Cash AccountsRestaurant MealsThe supervisor should approve restaurant trips in advance. An activity sheet should be submitted to the supervisor describing the activity; meal and payment plan for the meal. All receipts must be returned for reimbursement.Restaurant meals may be provided for socialization, instruction, rewards and necessity to travel or appointments. Except in cases of necessity, restaurant meals should be provided no more than once a month. Meal costs limits per person (includes tax and tip):Breakfast $10, Lunch $12, Dinner $15In some situations, students (parents) should be expected to pay half the amount, or a specified amount, unless the trip is a reward or a necessary substitute for a meal, as in the case of a medical appointment that goes through a meal. Staff who are assigned the responsibility of escorting students to restaurants are not expected to pay for their meals; however they should order meals that are in the same price range as the students’. The school’s nutritional guidelines should always be considered. .Students should be expected to choose balanced meals in restaurant. Please refer to the nutrition and portion size section for guideline. Foods that are high in fat, sugar and salt should be discouraged.Take-Out FoodsIn some situations, a take-out meal may be substituted for a restaurant meal by an individual or group, or ordered as a part of an instructional activity. In this case, the restaurant guidelines apply. A cottage may also occasionally provide take-out meals in an emergency. Older students often like to order take-out meals with their own money. Cottages may set their own guidelines for students who order take-out meals, but this activity should be limited to once a week. Staff should not order take-out to eat at the table with students unless the group has ordered take-out.Field Trips that Include Food, but Not MealsOccasionally a field trip may be organized around a treat or may include a treat. If food is to be purchased on these field trips, the supervisor must approve them. During these approved field trips, staff that are assigned the responsibility of escorting the students are expected to purchase their own food. Food Preparation Classes and Recreational CookingStudents acquire much of their understanding of nutrition and many food preparation skills in their classrooms, cottages, Health and Home and Personal Management Classes and/or Adult Living programs. Activities should emphasize good nutrition, safe food handling, appropriate portion size and the development of skills that will be the most useful to individual students when they become adults. Teachers may consult the Hierarchy of Skills (Appendix B) to develop activities that are on an appropriate instructional level for their students.Recreational cooking is a common activity in some classrooms and cottages. Emphasis should be on skills the students can be expected to acquire and use independently. Activities should consider student interests and preferences, but foods should be those that make up a healthy diet. This can often be accomplished through the use of specific food preparation techniques.Budgetary limits for food preparation classes, Adult Living programs and recreational cooking should be set through discussion of teachers, coordinators and supervisors at the beginning of the year. Limits should be based on the purpose of food preparation activities, the number of students involved, the age of the students and the part the activity play in the students’ meal plans.When the Cook is Absent As a residential school, Perkins has an obligation to provide a well-balanced meal to students regardless of weather, illness or closed kitchens. If the cook for your cottage is out for personal, vacation or sick day(s) the food service manager will send an update via email on what changes will occur. If you have concern please call the Food Service Manager (7871) for help.CATERED FUNCTIONS ON CAMPUS ~ For Non-Educational DepartmentsWhether it is a black tie affair, a simple luncheon, productive business meeting or fun filled BBQ; Perkins food service & stores department takes pride in providing superior food and service to meet your individual needs.Successful catering at Perkins involves a partnership between the sponsor and the food service & stores department. For the food service & stores department, a successful event takes planning, proper allocation of staff, ordering of top-quality ingredients, excellent cooking, speedy delivery, a thoughtful presentation, and a commitment to listen to the feedback that emanates out of any event. For the sponsor, a successful event requires forethought to avoid last minute ordering, a careful review of the choices available prior to ordering, careful use of online ordering that ensure nothing is lost or miscommunicated, and thoughtful feedback at the time of the event so that any concerns can be addressed. ?This system, in conjunction with the Catering Guide, will streamline the ordering process and assist you in managing your budget. Furthermore, it will provide us and the facilities department with all the information we need to successfully support your event.?Please note that all orders must be placed online via school dude. (No exceptions). Food service & stores department will accept requests for parent events, trustees and/or non-Perkins staff (outside guest) events. Event request MUST be received via school dude at least 5 working days before the event. If your request is not received in advance it may not be processed. Any questions please call the food service and stores department at extension 7323Nutrition Guidelines Nutrition and Portion SizesPerkins has a wonderfully diverse population, both students and staff alike. This diverse population carries with it many personal and cultural ideas, habits and expectations regarding food. Each individual has his or her own viewpoint about food. These personal values should not interfere with helping a student during meals or teaching a student about food, nutrition and portion sizes. Also, what is appropriate for one student may not be appropriate for all. can help Americans (adults and children) with food choices and frequency of those choices. Please use this only as a guide, as many of our students have very different needs.Fats, oils & sweets include items such as, cookies, cake, butter, syrup, French fries, etc. These items should be used as little as possible. Better fats to choose are olive and canola oil over salad. Include omega 3’s from flaxseed, canola, avocado or salmon.When thinking about the milk group the choice should almost always be a low fat product. Regular cheese and ice cream should be chosen infrequently. Choose red meat or whole eggs 2-3 times a week only. Remove the skin from chicken and turkey. Fish should be served weekly.Eat lots of (non-starchy) veggies! 3-5 servings are the minimum. Just remember potatoes, squash, corn and peas are starchy vegetables and have slightly more calories than other veggies. Also, be careful how they are prepared or what you add to your veggies (butter adds taste BUT also calories!).Bring on the fruit! Whole fruits with the skin are best. Remember only 4 oz. of 100% fruit juice counts as a fruit serving.Bread & Pasta Group. Try to consume fiber through fruits and veggies, as well as grains. When choosing grains, like bread or pasta, choose whole grains and watch the portion sizes! (? cup of cooked pasta or rice = one serving)What “Counts” as a Serving?Serving sizes are the same for everyone but the number of servings someone needs is very different for each person. The Perkins population has students from ages 3-23, so you can imagine how the number of servings per student can vary. Below is a guide only, based on age. If a particular student has a meal plan, always defer to the plan. Portion size and number of servings should be applied to the entire day, meaning meals and snacks should be tallied. Any questions, call the Dietitian x-7467.Please remember that serving sizes are a standard measure and apply all the time. This means meal time, snack time, treat time and class time. If a student prepares food in class to be eaten in class or in the cottage, appropriate serving sizes still apply. For example, if a student prepares a small loaf of cornbread he should have a piece or a slice, not the whole loaf just because he made the item. If a student is preparing a food that is more than one serving, the student may choose a few friends with whom to share or can serve it at the table. If a student has prepared a treat in class, please help ensure that other “treat” food preparations are held on a different day to avoid students making and consuming high fat, low nutrient dense foods more than once daily. The list below gives examples of what ONE SERVING equals in each group.Number of servings per day/per age groupBreads & Grain Group3-6yrs.7-1212-13 and upExamples 3-44-56-111 slice of bread? hamburger or hot dog bun? English muffin or bagel1 small roll? muffin ? bagel? cup cooked cereal1 cup cold cereal? cup cooked rice, pasta, quinoaNumber of servings per day/per age groupVegetable Group3-6yrs.7-1212-13 and upExamples 2-32-33-5? cup cooked veggies? cup chopped raw1 cup leafy veggies? cup tomato sauce? cup cooked beans (if not counted as a meat)? cup vegetable juiceNumber of servings per day/per age groupFruit Group3-6yrs.7-1212-13 and upExamples1-22-32-4Med. whole fruit (apple, orange etc.)? grapefruit4oz. juice (100% juice)? cup berries? cup cut up fruit? dried fruitNumber of servings per day/per age groupDairy (Milk) Group3-6yrs7-12yrs12-13 years & upExamples2-33-43 for teens2-3 for 20 yrs & up1 cup milk1 cup yogurt1? oz cheese (~ 1 slice)Number of servings per day/per age groupMeat Group3-6yrs7-12yrs12-13 years & upExamples1-22-32-32-3 oz. lean meat2-3 oz. lean poultry2-3 oz. cooked fish1 whole egg? cup cooked beans (if not counted as a veggie)? cup tofuFats, Oils & Sweets No Recommended Serving Sizes: USE SPARINGLY (Small amounts)No specific serving sizes are provided because the main message is USE SPARINGLY! The healthiest fats to use are canola and olive oil. Limit candy, cake, ice cream, fried foods, chips, cookies, soda, etc. to special occasions. When having a treat use SMALL portion sizes.Visualizing Portion Sizes2-3ounces of this, 4 ounces of that and 1/3 of a cup… what does that look like?! The following common items will help you visualize what serving sizes look like in “real life”.Three ounces of meat or fish is about the size of a deck of cardsA medium size piece of fruit is about the size of a tennis ball. (For example and apple, orange, peach etc.)One and half ounces of cheese is about the size of four dice stacked togetherOne cup of rice, pasta or mashed potatoes is about the size of a baseball. (remember one serving of cooked pasta or rice is ? cup)Four ounces or ? cup of juice is about the size of a small teacup or two Dixie cups One teaspoon of butter is about the size of your fingertip and one tablespoon of peanut butter is the size of the tip of your thumbBeveragesIn accordance with pediatric recommendations, children should be served tap water and milk (1% or skim) at all meals unless otherwise indicated by a student’s individual meal plan. Tap water provides essential fluoride for proper dental health. The quality of the tap water is monitored regularly and continues to be well within safety guidelines. Food Services will supply milk and water at lunch and dinner. Juice (100%) is also provided at breakfast and.not at other meals.Milk consumption is vital to provide sufficient calcium for strong bones and teeth particularly now that we are discovering the majority of children and teens do not meet daily calcium recommendations. Research has shown us how important it is to form strong bones as a child and young adult to prevent bone disease such as osteoporosis. If a student is unable to drink milk for any reason please request a nutritional consult through the student’s nurse.Water should be available at all times and; should not be limited unless advised for medical reasons. Suggest tap water or seltzer (plain or w/ a splash of juice, lemon or lime).Remember that not all students can ask for drinks, so it is important for staff to anticipate and offer drinks throughout the day. This is especially important during hot weather. Healthy SnacksSnacking between meals can promote a faster metabolism, stabilize blood sugars and prevent poor food choices brought on by extreme hunger. Additionally, younger students whose stomach size just cannot accommodate enough food at regular mealtimes to meet their nutritional needs will also benefit. Healthy snacks can help stabilize mood and maintain energy levels throughout the day. Emphasize choosing fresh fruits and vegetables, which are packed with vitamins and fiber for relatively few calories and fat. Also, including calcium-rich snacks such as yogurt is especially important for our students to promote strong bones.Appropriate snacks include (choose one item from one-two columns):FruitsVeggiesDairyGrainsProteinOther- Med. Size piece of fruit- ? cup of berries, grapes* or cut-up fruit- ? cup dried fruit- ? cup raw or cooked veggie sticks with hummus- 1 cup (8oz) yogurt- 1 cup low fat milk- 1-2 oz. Cheese (this is one slice of cheese or cheese cube that looks like the size of four dice stacked together)-One slice of bread- 4-6 crackers- ? cup cereal- 1oz. Popcorn*-1 oz. granola-Cereal bar- 2Tbs. Sun Butter*- ? cup (4oz) pudding- 1 frozen fruit barIn general, as a snack provider, please allow a minimum of 1? hours between a snack and the next meal so that they do not interfere with upcoming meals. For example, a snack may be served in the classroom midmorning and later in the cottage after school. * These foods may pose a choking risk for some students. Please familiarize yourself with what textures are appropriate for your students.Healthier Fast Food ChoicesBe armed with the knowledge to make good choices and make convenience foods an exception, not an everyday occurrence. Any questions or for more information ask the Dietitian –ext. 7467 “Fast food restaurants are not optimal but realistically may be the only available food on occasion” Remember:The SMALLER! the size the better. ~Forget about super-sizing~Choose single sandwiches (avoid “double”, “big”, “whopper”, “deluxe”)SAVE! Calories by ordering seltzer water (add lemon or lime!)ADD! More nutrients by ordering low fat milk.SAVE! Calories by choosing healthier condiments. ~Try a grilled chicken sandwich with BBQ sauce instead of mayo. ~Ask for extra ketchup, lettuce, tomato, onions, pickles and mustard instead of mayo or cheese.~Choose light or low fat salad dressings.~Forget the croutons and crunchy noodles on the salad.SHARE! Split your fries with a friend.TRY! Something different and order a side salad or baked potato to accompany your sandwich.REMOVE! The skin from fried chicken or order grilled.ORDER! Dessert infrequently and try to include fresh berries.ORDER! Veggies as pizza toppings and pass on the meat toppings.CHOOSE! Milk (skim milk even better) instead of cream in your coffee.FORGET! The meat on the breakfast sandwich.PASS! On the muffins, YES even the lowfat.Fast Food Bandits (more than 600 calories each!) Avoid at all costs!Dunkin Donuts2 Frosted or iced donuts2 Coconut donuts2 Whole wheat glazed donutsChocolate chip muffinCoffee cake muffinBiscuit sausage egg & cheese sandwichLarge coolattasBurger King Whopper w/wo cheeseDouble whopper w/wo cheeseChicken sandwich w/ mayoBK Big fishDouble cheeseburger w/wo baconCroissandwich w/ sausage. egg & cheeseSpecial Diets and Feeding ProgramsSpeech/OT/Feeding ProgramsMany students at Perkins have feeding or swallowing disorders which require modifications in food textures or consistencies. Some students are unable to meet all their nutritional needs through oral intake alone and thus require feeding tubes. When determined by a feeding team that this is the case the School is committed to creating a collaboration between teaching, residential and related services staff in developing a treatment plan that assists the student in improving oral motor abilities and thus reducing their dependency on feeding tubes. The Food Service Committee is concerned with feeding programs that involve modifications to the regular menu only if these modifications change the nutritional composition of an individual student's diet. A texture change alone does not meet these criteria. If the feeding program requires the addition of liquids other than water to the foods that appear on the menu, items that appear on the menu are deleted, other items are substituted and/or food is prepared in a form that changes its nutritional content, the following guidelines should be observed. Liquids to moisten food will be provided, usually in the form of extra sauces for each meal for those students who require modifications to the regular diet as a result of reduced oral motor abilities. Feeding programs are usually developed by speech or occupational therapists, with input from other clinical, residential, teaching and medical staff. The Dietitian should approve the nutritional component. The feeding program will be documented on a Feeding Program Form, which will be completed by the speech or occupational therapists and distributed to members of the student's team, and will also be sent to the Dietitian. Speech or Occupational therapists may submit the form to the Dietitian. A goal of these programs is to normalize the students' eating habits and to promote healthy, safe eating habits. Staff involved with students on feeding programs must receive training to carry out these programs. In general, foods should be served as menued. If foods must be separated out to meet a child's individual needs, nutrition becomes an issue and the ingredients contained in the mixed foods should be offered. Menu options that encourage tolerance for a variety of tastes should be offered, such as salsa, ketchup, mustard, tabasco, Mrs. Dash, spices, vinegar, lemon and pepper which may be available in the dining room. Pepper may not be appropriate for some students. 435292550279300017240255027930001628775502920Regular00Regular16287751702435Chopped00Chopped301942524003000016287752931795Fine Chopped00Fine Chopped301879036950650016287754255770Mashed00Mashed41141655589270Thin Puree00Thin Puree2095505617845Thick Puree00Thick Puree3038475123698000Food Textures ListFood Textures TableTexturesDescriptionExamplesRegularStudent eats meal as prepared. No texture restrictionsAny foodChoppedMeal is cut into smaller than bite sized pieces (1/2 inch) and served with sauce893445825500 ? inch Fine ChoppedMeat is ground and vegetables and starches (i.e. pasta) are cut into even smaller pieces than chopped texture (1/8 inch) and served with a sauce10458453238500 1/8 inch MashedMeal should only consist of foods that can be mashed with a fork. Food is mashed into soft, lumpy consistency. This student will receive his/her meats pureed. Students on this texture may eat fish, meatballs, and meatloaf mashed with a fork and served with a sauce. All other meats must be pureedWell cooked vegetables, such as mashed carrotsSoft fruits, such as banana, avocado, ripe pearFork mashed fishOatmealThick PureeMeat is blended into a thick consistency. This texture is thicker than the mashed with no lumpsGreek yogurtHummusPudding cupsThin Puree Meal is blended into a thin consistency. This texture is thinner than the thick puree.ApplesaucePlain Stonyfield yogurtKetchupDietary Orders for Students Who Require Special DietsStudents who require special foods that are substituted for items on the regular menu or added to the student’s diet will need a dietary order from the Dietitian. A parent, residential coordinator, nurse, or physician will generally initiate referrals; however therapists, social workers, teachers, supervisors or other concerned parties may also initiate them. Any staff who receives the request will communicate it to the Dietitian. Notify the Dietitian by email or phone x 7467. The Dietitian will conduct an observation, usually during mealtime, and prepare a recommendation. The recommendations will be provided to the students’ parents or guardian and all pertinent staff who work with the child. Any therapeutic diet requires a medical recommendation from the student’s health provider. Based on the Dietitian’s evaluation, a dietary order for a particular food(s) may be completed. Any special food that is ordered for a specific student is for use by that student only.INDEPENDENT LIVING GUIDELINESGuidelines for Independent Living Programs These guidelines are designed to outline important issues related to nutrition of students, food safety, and sanitation.Descriptions of Perkins Independent Living ProgramsPerkins Independent Living Programs fall into three categories in the area of menu planning, food shopping and preparation:Independent Living Programs with full supervision: Students plan menus, shop, and/or prepare food under full supervision of staff. They usually prepare a limited number of meals per week and may participate in one or more of the activities listed above.Menu- Create a menu that will be repeated every four to six weeks, with student input, and have it reviewed by the Dietitian. A meal choice list may be created and utilized in place of a four to six week menu that is preapproved by the Dietitian. Independent Living Programs with limited supervision: Students plan menus, shop and/or prepare some meals under staff supervision. Supervision may be offered for any of the activities listed above according to student need. Students plan and prepare some individual meals using a nutritional guide/ choice list for all or some meals with a supervisor in the area, but without assistance and constant monitoring.Menu- Create a cyclical menu that will be repeated every four to six weeks for the meals that will be prepared under supervision or use a nutritional guide with a “choice” format to prepare breakfasts, lunches and dinners and have these menus monitored by Independent Living Program staff. Students must demonstrate the ability to plan nutritional meals using this format before they are allowed to prepare other meals without supervision. Submit individual cyclical menus for these meals to the Dietitian.Independent Living Programs with distant supervision: Supervision is offered for a few hours a week upon request, otherwise supervision is available only by calling a staff person who is in another area of the building or another building.Menu- Students may or may not use a nutritional guide/ choice list. Menus for the first month of the program will be submitted to the Dietitian. Thereafter, menus will be kept and submitted upon request. The Dietitian will determine how often he/she wishes to check these menuBreakfast Choices(Typical instructional guideline for independent program students is making their own purchases)Select one food item from each columnFruit(Choose 1-2 servings)Breads and Grains (Choose 1-3 servings)Protein (Choose 1-2 servings)4 oz. Serving of 100% juiceApple (fortified with vit. C)ApricotOrange/Orange blendsPineappleGrapeCranberry (fortified with vit. C)One serving? cup grape nuts or granola? cup cold cereal1 ? cups puffed cereal? cup hot cereal ? bagel1 slice breadOne Serving1 cup milk (preferably low fat)1 cup/8oz yogurt1 egg? cup “egg beaters”1 cup/8oz soy milkOr1 med. orange1 med. apple? grapefruit? cup melon? cup berries? cup canned fruit? cup dried fruit (raisins, dates, apricots)? english muffin1 waffle2 oz muffin (small)Breakfast Bar (nut-peanut free)2 Tbl. Sun butter1 cup cottage cheese2 slices or 2 oz cheese (preferably low fatPlease be aware:Depending on calorie requirements some people may need more than one serving from each category.Vegetables are always a good choice! Serving = ? cup cooked or chopped raw.If milk, yogurt or calcium fortified juice is not chosen a calcium supplement may be needed.“Extras” should be used sparingly – Servings:Butter, cream cheese, sugar & jelly = 1 tsp., Syrups = 2 Tbl.Remember, over the entire day most people need the following servings: 6-11 Grain, 3-5 Vegetable, 2-4 Fruit, 2-3 Dairy, 2-3 MeatA Hierarchy for Developing Food Preparation Skills Factors influencing success with food preparation tasks include tactile sensitivities, wrist rotation, hand skills, impulse control, and organizational strategies. Developing effective hand washing is also an important part of learning to prepare food. Cold Foods:Wash fruits or vegetables that can be eaten whole, raw, and not peeled, for example, blueberries, cherry tomatoes, green beans, peaches, plums, apples.Try different types of apples, describe the different colors, examine the various shapes, and note the different flavors, sweet, sour, and tart.If the food has a pit or seeds, these may need to be removed by staff.The student may need to be taught how to eat around a center pit and to not swallow it. Remove grapes from their stems. Show students the difference between seeded and unseeded grapes.Peel a banana.Eat whole or introduce slicing with a plastic knife, and add to a fruit salad Peel a navel orange and separate it into sections.Assemble a salad that involves only washing and breaking food into pieces by hand, for example, lettuce or other greens such as romaine or spinach, cheeses, lean deli meats, cherry tomatoes, and green beans. Many salads come prepared in plastic bags. To serve the salad the only skills needed are locating a salad bowl, opening the bag (or asking for assistance to do so), and pouring out of the bag. The saving of time and reduction of wasted food offset the extra cost of packaged salad or prepared vegetables.Prepare sandwiches involving no cutting or spreading, for example, sliced turkey and cheese. Meats and cheeses from the deli may be easier to open than those prepackaged in vacuum-packed plastic. Precut rolls are sometimes easier to handle than bread. Sandwiches can be assembled in a square plastic container.Students may not want condiments such as mustard or mayonnaise, but if they do, a squeeze bottle can put a dab in the center of the opened roll, then be “squished”, rather than spread when the sandwich is assembled.Make beverages using cold water from the tap or water dispenser. Use pre-measured packets or spoon granular powders from a container. For some students, containers having lift off tops may be easier to open than screw top covers. Encourage student to notice the crystals dissolving, that is, they are not felt with the spoon or a grainy sound is not heard. Demonstrate an effective stirring method.Make beverages using powders or syrups and cold milk, stirring thoroughly. Make instant pudding using a rotary eggbeater or a wire whisk. Pour ready-made cold beverages, such as juice, milk, or ice water. Milk type cartons may be hard to hold and to open. Grooves tactually identify which side to open. Many milk and juice containers have screw tops. These pour spouts are sealed under the cover and may be difficult to open. Choose containers that are suited to the hand strength and size of the students. Also consider the size, shape, and durability of the drinking cup. When pouring beverages from a pitcher, consider the size and weight of the container, and the effectiveness of the spout. Check with the cottage staff to see if the student already has a pouring method that works. Assemble a sandwich involving spreading. Working on frozen slices of bread reduces tearing. The bread will thaw quickly at room temperature.Rolls are sometimes easier to work with than bread. An ice cream scoop can put tuna or chicken salad in the center of the roll, and then the top put on without spreading. Sun butter and jelly are difficult for some students to manage. A spoon can be used for the jelly. Sometimes holding the bread in the hand gives more feedback for spreading. Because the technique for each student may be very different, the occupational therapist may be an important resource person when teaching this, and other, food preparation skills.Assemble a salad involving peeling and/or slicing. Select a knife or peeler that suits a student’s hand skills. A serrated edge knife works best for tomatoes. A straight edged small chef’s knife works well for most other foods. Dull knives that do not cut effectively can be more dangerous than a sharp knife. Place items flat side down on a cutting board whenever possible. Cut the item in half first to produce a flat side, and remove any pits. Relatively easy to slice foods include bananas, orange wedges (cut into chunks), celery, cucumbers, hard-boiled eggs (try an egg slicer), zucchini, ripe pears and peaches, strawberries (remove hulls first).Relatively easy to peel foods include carrots and potatoes. They are harder to slice or chop. Many foods that are thoroughly washed do not need to be peeled. Introduce use of the can opener, or cans that can be opened by pulling a tab. Consider the student’s hand skills, strength, and safety awareness when deciding to introduce this skill and when selecting a can opener. Combinations:Assemble salads and sandwiches involving spreading, slicing, and using a can opener. Stir in sliced bananas or canned fruit into instant pudding. Drain the canned fruit in a colander first.Prepare salsaPrepare, measure, assemble, and/or mix a food item or recipe with an adult to do any heating in an oven or cooking on stovetop. Examples include:VegetablesCasserolesMeatloafBreading chicken or pork chopsQuick breadYeast breadsNachosDeviled eggsPizzaIntroduce use of small appliances:Detailed safety instructions must be followed. These are available from the Secondary Services Home and Personal Management teachers.These appliances include: Microwave ovens Hot shotsToastersElectric can openersBlendersIntroduce use of the Oven, and then introduce use of the Stovetop. Secondary Services Home and Personal Management teachers have detailed instructions to use when teaching these skills.Resources and ReferencesChoose 94234072898000Choose MyPlateUSDA Nutrition Tips: 10 tips to a great plateWhat are Empty Calories are Empty Calories? Currently, many of the foods and beverages Americans eat and drink contain empty calories – calories from solid fats and/or added sugars. Solid fats and added sugars add calories to the food but few or no nutrients. For this reason, the calories from solid fats and added sugars in a food are often called empty calories. Learning more about solid fats and added sugars can help you make better food and drink choices. Solid fats are fats that are solid at room temperature, like butter, beef fat, and shortening. Some solid fats are found naturally in foods. They can also be added when foods are processed by food companies or when they are prepared.Added sugars are sugars and syrups that are added when foods or beverages are processed or prepared. Solid fats and added sugars can make a food or beverage more appealing, but they also can add a lot of calories. The foods and beverages that provide the most empty calories for Americans are:Cakes, cookies, pastries, and donuts (contain both solid fat and added sugars)Sodas, energy drinks, sports drinks, and fruit drinks (contain added sugars)Cheese (contains solid fat)Pizza (contains solid fat)Ice cream (contains both solid fat and added sugars)Sausages, hot dogs, bacon, and ribs (contain solid fat)These foods and beverages are the major sources of empty calories, but many can be found in forms with less or no solid fat or added sugars. For example, low-fat cheese and low-fat hot dogs can be purchased. You can choose water, milk, or sugar-free soda instead of drinks with sugar. Check that the calories in these products are less than in the regular product. In some foods, like most candies and sodas, all the calories are empty calories. These foods are often called "empty calorie foods." However, empty calories from solid fats and added sugars can also be found in some other foods that contain important nutrients. Some examples of foods that provide nutrients, shown in forms with and without empty calories are:Food with some empty caloriesFood with few or no empty caloriesSweetened applesauce (contains added sugars)Unsweetened applesauceRegular ground beef (75% lean) (contains solid fats)Extra lean ground beef (95% or more lean)Fried chicken (contains solid fats from frying and skin)Baked chicken breast without skinSugar-sweetened cereals (contain added sugars)Unsweetened cerealsWhole milk (contains solid fats)Fat-free milkMaking better choices, like unsweetened applesauce or extra lean ground beef, can help keep your intake of added sugars and solid fats low. A small amount of empty calories is okay, but most people eat far more than is healthy. It is important to limit empty calories to the amount that fits your calorie and nutrient needs. You can lower your intake by eating and drinking foods and beverages containing empty calories less often or by decreasing the amount you eat or drink.Calories for ChildrenIt is important to know how many calories children need each day to make sure they are eating the right amount for proper growth and development. Too many calories increases the risk of obesity, while not enough calories increases the risk of becoming underweight and malnutrition. Following the estimated energy intake for sedentary infants, toddlers, children and teens can help them maintain a healthy weight and growth pattern.4 to 8 Year OldsThe recommended dietary intake for sedentary females ages 4 to 8 years is 1,200 calories a day eaten as 4 oz grain, 1 cup vegetables, 1.5 cups fruit, 2 cups milk and 3 oz meat total for the day. The recommended dietary intake for sedentary males at this age is 1,400 calories a day eaten as 5 oz grain, 1.5 cup vegetables, 1.5 cups fruit, 2 cups milk and 4 oz meat total for the day. If the child is moderately active, add 200 to 300 calories extra.9 to 13 Year OldsThe recommended dietary intake for sedentary females ages 9 to 13 is 1,600 calories a day eaten as 5 oz grain, 2 cup vegetables, 1.5 cups fruit, 3 cups milk and 5 oz meat total for the day. The recommended dietary intake for sedentary males at this age is 1,800 calories a day eaten as 6 oz grain, 2.5 cup vegetables, 1.5 cups fruit, 3 cups milk and 5 oz meat total for the day. If the child is moderately active, add 200 to 400 calories extra.14 to 18 year oldsThe recommended dietary intake for sedentary females ages 14 to 18 is 1,800 calories a day eaten as 6 oz grain, 2.5 cup vegetables, 1.5 cups fruit, 3 cups milk and 5 oz meat total for the day. The recommended dietary intake for sedentary males at this age is 2,200 calories a day eaten as 7 oz grain, 3 cup vegetables, 2 cups fruit, 3 cups milk and 6 oz meat total for the day. If the child is moderately active, add up to 200 calories for females, and 400 calories for malesEat the Right Amount of Calories for weight-management-calories/weight-management/better-choices/amount-calories.htmlEveryone has a personal calorie limit. Staying within yours can help you get to or maintain a healthy weight. Reaching a healthier weight is a balancing act. The secret is learning how to balance your "energy in" and "energy out" over the long run. "Energy in" is the calories from foods and beverages you have each day. "Energy out" is the calories you burn for basic body functions and physical activity.A balancing act:? Where is your energy balance?Maintaining weight — Your weight will stay the same when the calories you eat and drink equal the calories you burn.Losing weight — You will lose weight when the calories you eat and drink are less than the calories you burn.Gaining weight — You will gain weight when the calories you eat and drink are greater than the calories you burn.The current high rates of overweight and obesity in the U.S. mean that many people are taking in more calories than they burn.Stumbling Blocks:Concerned about being able to eat the right amount of calories? Here are some common "stumbling blocks" and ideas to help you overcome these barriers:"I don't understand calories." ??"Calorie" is just the term used to describe the amount of energy a food or drink provides when you eat it. Carbohydrates, fat, protein, and alcohol all provide energy — and this energy is measured in calories. Think of calories as a measurement unit — like inches, pounds, or gallons. You need energy from foods and drinks to fuel your body — for everything from breathing to physical activity. But if your foods provide more energy than you use, your body stores the rest as fat.If I use a calorie counter, why do I have to pay attention to my Daily Food Plan?It's important to consider more than just calories when making food choices. Your Daily Food Plan is designed to provide the nutrients you need while staying within your calorie limits. Use your Daily Food Plan to determine how much you should eat from each of the 5 food groups."I don't have time to count calories."People who are successful at managing their weight have found ways to keep track of how much they eat in a day, even if they don't count every calorie. Most people eat the same general types of food on a regular basis. Take some time up front to compare calorie labels, and over time, you will learn which options are the better choices.Also, if you Focus on Foods You Need and Eat Fewer Empty Calories ?you will be a big step closer to eating the right amount of calories for you."I have no idea how many calories I am supposed to eat to manage my weight."Your calorie needs depend on a number of factors including: your height, weight, and physical activity level. You can get your personal daily calorie limit with your Daily Food Plan. Try to stay at (or a little below) this number each day. Taking in more calories (even just 100 calories more each day) can result in gradual weight gain over time.The calories in your Daily Food Plan are averages.? For best results, track your body weight over time. If you are gaining weight, or not losing at all, decrease your calorie intake (or increase your physical activity).Resources for Weight Management and Calories \s10 Tips for a Healthier School Day: USDA Nutrition Tips for Eating Healthy When Eating outAs a beverage choice, ask for water or order fat-free or low-fat milk, unsweetened tea, or other drinks without added sugars.Ask for whole-wheat bread for sandwiches.In a restaurant, start your meal with a salad packed with veggies, to help control hunger and feel satisfied sooner.Ask for salad dressing to be served on the side. Then use only as much as you want.right000Choose main dishes that include vegetables, such as stir fries, kebobs, or pasta with a tomato sauce.Order steamed, grilled, or broiled dishes instead of those that are fried or sautéed.Choose a small" or "medium" portion. This includes main dishes, side dishes, and beverages.Order an item from the menu instead heading for the "all-you-can-eat" buffet.If main portions at a restaurant are larger than you want, try one of these strategies to keep from overeating:Order an appetizer-sized portion or a side dish instead of an entrée.Share a main dish with a friend.If you can chill the extra food right away, take leftovers home in a "doggy bag."When your food is delivered, set aside or pack half of it to go immediately.Resign from the "clean your plate club" - when you've eaten enough, leave the rest.Keep your meal moderate in calories, fat, and sugars:Ask for salad dressing to be served "on the side" so you can add only as much as you want.Order foods that do not have creamy sauces or graviesAdd little or no butter to your food.Choose fruits for dessert most often.On long commutes or shopping trips, pack some fresh fruit, cut-up vegetables, low-fat string cheese sticks, or a handful of unsalted nuts to help you avoid stopping for sweet or fatty snacks.Make Better Beverage Choices: USDA Nutrition Tips Back on Kids Sweets: USDA Nutrition Tips Celebrations Fun, Healthy and Active: USDA Nutrition Tips a Healthy Role Model for Children: USDA Nutrition Tips GUIDELINES FOR AMERICANS, 2010 ix Eating and physical activity patterns that are focused on consuming fewer calories, making informed food choices, and being physically active can help people attain and maintain a healthy weight, reduce their risk of chronic disease, and promote overall health. The Dietary Guidelines for Americans, 2010 exemplifies these strategies through recommendations that accommodate the food preferences, cultural traditions, and customs of the many and diverse groups who live in the United States. By law (Public Law 101-445, Title III, 7 U.S.C. 5301 et seq.), Dietary Guidelines for Americans is reviewed, updated if necessary, and published every 5 years. The U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS) jointly create each edition. Dietary Guidelines for Americans, 2010 is based on the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010 and consideration of Federal agency and public comments. Dietary Guidelines recommendations traditionally have been intended for healthy Americans ages 2 years and older. However, Dietary Guidelines for Americans, 2010 is being released at a time of rising concern about the health of the American population. Poor diet and physical inactivity are the most important factors contributing to an epidemic of overweight and obesity affecting men, women, and children in all segments of our society. Even in the absence of overweight, poor diet and physical inactivity are associated with major causes of morbidity and mortality in the United States. Therefore, the Dietary Guidelines for Americans, 2010 is intended for Americans ages 2 years and older, including those at increased risk of chronic disease. Dietary Guidelines for Americans, 2010 also recognizes that in recent years nearly 15 percent of American households have been unable to acquire adequate food to meet their needs.1 This dietary guidance can help them maximize the nutritional content of their meals. Many other Americans consume less than optimal intake of certain nutrients even though they have adequate resources for a healthy diet. This dietary guidance and nutrition information can help them choose a healthy, nutritionally adequate diet. The intent of the Dietary Guidelines is to summarize and synthesize knowledge about individual nutrients and food components into an interrelated set of recommendations for healthy eating that can be adopted by the public. Taken together, the Dietary Guidelines recommendations encompass two over-arching concepts: Maintain calorie balance over time to achieve and sustain a healthy weight. People who are most successful at achieving and maintaining a healthy weight do so through continued attention to consuming only enough calories from foods and beverages to meet their needs and by being physically active. To curb the obesity epidemic and improve their health, many Americans must decrease the calories they consume and increase the calories they expend through physical activity. Focus on consuming nutrient-dense foods and beverages. Americans currently consume too much sodium and too many calories from solid fats, added sugars, and refined grains.2 These replace nutrient-dense foods and beverages and make it difficult for people to achieve recommended nutrient intake while controlling calorie and sodium intake. A healthy eating pattern limits intake of sodium, solid fats, added sugars, and refined grains and emphasizes nutrient-dense foods and beverages—vegetables, fruits, whole grains, fat-free or low-fat milk and milk products,3 seafood, lean meats and poultry, eggs, beans and peas, and nuts and seeds. A basic premise of the Dietary Guidelines is that nutrient needs should be met primarily through consuming foods. In certain cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise might be consumed in less than recommended amounts. Two eating patterns that embody the Dietary Guidelines are the USDA Food Patterns and their vegetarian adaptations and the DASH (Dietary Approaches to Stop Hypertension) Eating Plan. A healthy eating pattern needs not only to promote health and help to decrease the risk of chronic diseases, but it also should prevent foodborne illness. Four basic food safety principles (Clean, Separate, Cook, and Chill) work together to reduce the risk of foodborne illnesses. In addition, some foods (such as milks, cheeses, and juices that have not been pasteurized, and undercooked animal foods) pose high risk for foodborne illness and should be avoided. The information in the Dietary Guidelines for Americans is used in developing educational materials and aiding policymakers in designing and carrying out nutrition-related programs, including Federal food, nutrition education, and information programs. In addition, the Dietary Guidelines for Americans has the potential to offer authoritative statements as provided for in the Food and Drug Administration Modernization Act (FDAMA). The following are the Dietary Guidelines for Americans, 2010 Key Recommendations, listed by the chapter in which they are discussed in detail. These Key Recommendations are the most important in terms of their implications for improving public health.4 To get the full benefit, individuals should carry out the Dietary Guidelines recommendations in their entirety as part of an overall healthy eating pattern. 1. Nord M, Coleman-Jensen A, Andrews M, Carlson S. Household food security in the United States, 2009. Washington (DC): U.S. Department of Agriculture, Economic Research Service. 2010 Nov. Economic Research Report No. ERR-108. Available from . 2. Added sugars: Caloric sweeteners that are added to foods during processing, preparation, or consumed separately. Solid fats: Fats with a high content of saturated and/or trans fatty acids, which are usually solid at room temperature. Refined grains: Grains and grain products missing the bran, germ, and/or endosperm; any grain product that is not a whole grain. 3. Milk and milk products also can be referred to as dairy products. 4. Information on the type and strength of evidence supporting the Dietary Guidelines recommendations can be found at . 5. See Chapter 3, Foods and Food Components to Reduce, for additional recommendations on alcohol consumption and specific population groups. There are many circumstances when people should not drink alcohol. Key Recommendations Balance calories to manage weight Prevent and/or reduce overweight and obesity through improved eating and physical activity behaviors. Control total calorie intake to manage body weight. For people who are overweight or obese, this will mean consuming fewer calories from foods and beverages. Increase physical activity and reduce time spent in sedentary behaviors. Maintain appropriate calorie balance during each stage of life—childhood, adolescence, adulthood, pregnancy and breastfeeding, and older age. Food and Food Components to Reduce Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults. Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids. Consume less than 300 mg per day of dietary cholesterol. Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats. Reduce the intake of calories from solid fats and added sugars. Limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium. Foods and nutrients to increase Individuals should meet the following recommendations as part of a healthy eating pattern while staying within their calorie needs. Increase vegetable and fruit intake. Eat a variety of vegetables, especially dark-green and red and orange vegetables and beans and peas. Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains. Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.6 Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds (no nuts in student areas). Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry. Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils. Use oils to replace solid fats where possible. Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products. DIETARY GUIDELINES FOR AMERICANS, 2010 ixFor more detailed references on our policies and procedures please refer to Healthy Students, Healthy Schools: Revised guidance for implementing the Massachusetts school nutrition standards for competitive food and beverages (June 2012)\sSpecial Dietary Item Request FormDate: Student Name: Printed Student Name: Cottage: The above student will require the following special food item(s). Please have staff call the Dietitian (Ext. 7467). Thank you. OtherAnne Rollins MS RD LDNcc: Referring Nurse, Medical Record, Food Services & Stores Department, Residential Supervisor, CRL, Cook.Picnic Request*REQUESTS MUST BE SUBMITTED AT LEAST 5 DAYS IN ADVANCE!Date Submitted:Date and Time Wanted:Staff Requesting:Coordinator Notified: Allergy Alert: Sandwiches:How many:Pre-assembled (yes or no): Bread Choice:Fillings:Toppings:Condiments:Snacks: Beverages: Picnic Food Order Form Page 1Available Picnic FoodsBread Choices:Protein:Condiment:Snacks:Beverages:Whole wheat Oatmeal (not Dairy free) Pita Soft TortillasEnglish MuffinsHamburger RollsHotdog RollsBagelsTuna SaladSB & J TurkeyHam Chicken SaladCheese (American or Swiss)LettuceTomato PicklesOnionSliced CucumberFruit Apple SauceYogurtChips Fig NewtonsPretzels Veggie sticksCelery Sticks w/SunbutterSaltinesGraham CrackersNut Free Trail MixApple Juice BoxFruit Punch BoxWater (Bottled)Foods ordered:Date:*Orders are submitted to Coordinator. Coordinator gives a copy to the Cooks AND submits to school dude.*Fill out a separate form for an Allergy meal. This form will replace the “Allergy Tag.”Picnic Food Order Form Page 2Updated 10/30/12Feeding Program FormName of Student: Date:Allergies:Yes: (please list):NoLiquid ConsistencyRegular/Thin LiquidsThickened to NectarThickened to HoneyNo Liquids by Mouth Date and Results of Swallow StudyMeal/Texture ConsistencyRegularChoppedFine ChoppedMashedThick PureeThin PureeNo Food by MouthExplanation: Menu Substitutions/Restrictions:Regular diet (no modifications)Menu Changes (additions – for low weight students who have nutritional concerns or oral motor needs)*Menu Changes (subtractions – for overweight students who require reduced calorie intake)*Menu Changes (substitutions – for sensory or allergy needs)*Changes/Additions/Subtractions from regularly offered table foods (including Allergies): Supervision Required: IndependentMonitorNeeds AssistanceRequires Constant Supervision Describe:Additional Information AttachedAdaptive Utensils/Equipment/Seating/Special Set-Up: see attached photo or formOT:SLP: CRL:SignatureSignatureSignature ................
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