Gulf Coast Veterans Health Care System Menu Analysis

Running head: GULF COAST VETERANS HEALTH CARE SYSTEM MENU ANALYSIS
Gulf Coast Veterans Health Care System Menu Analysis
Facility Menu Project
Deanna E. Cheathem, B.S.
University of Southern Mississippi
NFS 774 – Spring 2020
1
Introduction
A large role of food service management involves the process and execution of
appropriate menu development for hospitals and other associated healthcare operations. Menu
planning for healthcare facilities typically include one or more registered dietitian as the process
must involve meeting specific nutritional standards, achieving menu acceptability, while also
remaining cost effective and within a set budget. Successful food service operations are based on
skillful and thoughtful menu planning as the menu determines the level of labor, equipment, and
space that is needed to prepare and serve meals. The type of regular and therapeutic menus that
are selected for any health service facility should be tailored to the patients’ preferences and
prevalent health needs of the surrounding community. The process of menu planning can be
time-consuming and complex as it involves an intricate balance of achieving appropriate nutrient
content, acceptability, cost, variety, equipment, and staffing.
The Gulf Coast Veterans Health Care System of Biloxi, Mississippi (VA) offers a wide
variety of health care services for military veterans. The variation of health services includes the
hospital for acute care services and the Community Living Center (CLC), Blind Rehabilitation,
and Behavioral Health for extended care and rehabilitation services. Due to the outspread layout
and design of the VA campus, the food service management sector utilizes a decentralized food
delivery method with multiple retherm carts and foodservice delivery trucks. Presently, a cook-
chill food production method is used for the VA as this ready-prepared foodservice style offers
more flexibility in scheduling food preparation and lower labor costs. Disadvantages of this type
of food production, however, involves limited variety of food options for menu planning and
recipe adjustments. Over the past year, the VA has been in the process of transitioning to a more
conventional method of food production as well as revamping food variety and recipes.
2
Current Menu Practices
Currently, the VA provides a three-week non-select cycle menu for both acute care
services and extended care services. As seen in Tables B.1-B.14 in Appendix B, the food service
operations of the VA offer a regular diet menu as well as a variety of eight therapeutic diets that
are tailored for prevalent disease states of the served community. The facility determines which
diets to offer or which combinations are best suited for the patient’s health by working with the
physicians and associated health care team. In most cases, the diet orders are based on the
consult results from the clinical dietitian and speech pathologist. Respectable communication
and involvement of the interdisciplinary health team is essential for providing quality patient
care, especially regarding nutritional care. The regular and therapeutic diets for the VA have
been planned and tailored to for the demographics of the area and prevalent rates of diabetes
mellitus, hypertension, congestive heart failure, and dysphagia.
Through observation of the regular menu cycle in Appendix B, there is a notable
recurring pattern for the breakfast options that includes one type of fruit juice, two forms of
cereals, a protein, several types of grains or bread products, coffee, low fat milk, and a variety of
condiment options. The observed lunch options typically include a type of soup, meat, starch,
vegetable, fruit, and dessert option accompanied with a type of beverage and set of condiments.
Dinner menu options continue with the variety of meat and cooking methods used and typically
include a combination main entrée of a protein and starch, such as beef stew and rice. At least
one vegetable and one fruit option are available for dinner, as well as some form of bread,
dessert, beverage, and set of condiments that is appropriate for the type of main entrée.
Collectively, each meal over the course of this observed week offers an assortment of colors,
textures, consistencies, and methods of cooking.
3
The available therapeutic diets include mechanical, puree, soft, full liquid, low sodium,
diabetic/weight reduction, low cholesterol/fat, and renal. The menus for “Low Protein/Low
Sodium” and “Low Protein/Low Sodium/Low Potassium” as seen in Appendix B, are no longer
offered as the nutrient content of these menus were planned based on obsolete evidence
regarding appropriate protein intake and renal disorders. The renal diet that took the place of the
outdated low protein renal diet focuses on limiting the intake of phosphorus, potassium, and
sodium, rather than limiting protein. The menu items for the renal diet resemble the regular diet,
but any items that are high in the limited nutrients listed above are removed and/or substituted
with a more appropriate item. The low sodium diet is designed to closely resemble the regular
menu, but no salt is added during the cooking process. This simply takes the same food products
that is offered on the regular menu and deems it as a “Low Sodium” item. Additionally, salt
packets are removed from the condiment set and sodium substitutions are provided upon request.
The diabetic/weight reduction and low cholesterol/fat diets are similar to the low sodium
diet as they are developed to offer more heart healthy food options. These items typically reflect
the regular diet as well, but less sodium, sugar, and fat are added during the cooking process. In
the situation that a food item has a high amount of naturally occurring sodium, sugar, or fat, the
food is substituted with another item that is within set nutrient guidelines for diabetic or low-fat
diets. The texture modified diets, including mechanical, puree, and soft, mirror all of the options
offered on the regular menu, but are adapted to meet the texture requirements for that diet order.
In the case that food items can not be altered to meet the specifications of a texture modified diet,
an available substitution is selected. The full liquid diet, however, differs greatly from the
regular menu as this menu plan consists mainly of nutrition supplements, soups, gelatin cups,
puddings, and other assorted beverage options to help meet estimated nutritional needs.
4
Communication of Menus
The communication of the menu choices available for patients of the VA is accomplished
with printouts, as seen in Appendix A, of the menu cycles that are available upon request in both
acute and extended care units. Being that the VA utilizes a three-week cycle non-select menu,
providing a menu for each meal to patients is not considered to be necessary as the patient will
receive whatever items are preselected for that day unless allergies, religious beliefs, or
preferences state otherwise. Patient preferences are addressed by the clinical dietitian as an acute
care patient is required to have a dietary consult within 72 hours of admission and a resident of
the extended care units is required to have a dietary consult within five days following their
admission. Though allergies and religious beliefs are entered into the medical chart on initial
admission to the facilities, the clinical dietitian is responsible for entering any additional food
preference information into the chart within the obligatory time frames.
The medical chart communicates with the VistA Nutrition and Food Service Systems
Software (VistA Software) that uses a computerized tally system to communicate the number of
servings and ingredients needed for a meal with the food production staff. Additionally,
allocations for any substitute items are programed into the tally system, automatically adjusting
the number of servings and ingredients needed for the standardized recipes. The tray assembly
staff utilize tray tickets that have been prepopulated by the VistA Software to further specify diet
orders, portion sizes, substitutions, and any ordered texture modifications for the patient or
resident tray line assembly process. Acute care patient trays are assembled in the decentralized
kitchen location and transported via tray retherm carts. Due to the larger census of the extended
care units, food items are brought to the various facilities in bulk and set up in a buffet service
fashion to be used by food service employees to complete the tray line assembly process.
5
Nutrition Profile and Analysis
Presently, the VistA Software program assesses and analyzes the nutrient contents of the
regular and therapeutic diets that are offered at the VA’s acute and extended care facilities.
Though the VistA Software is designed to calculate the nutrient contents of the developed
menus, further discussion with the current food service management staff reveals that it is
unknown as to when the last review was completed to ensure compliance with nutritional
guidelines. For the development of the regular and therapeutic menus, the VA uses the Nutrition
Care Manual, or NCM Diet Manual, that is published and updated annually by the Academy of
Nutrition and Dietetics (AND). This diet manual encompasses nationally published nutritional
recommendations from the United States Department of Agriculture (USDA) and uses
supportive evidence-based summaries for clinical recommendations for over 200 health
conditions.
Three randomly selected days, as seen in Appendix C, were used to gather a generalized
nutrition profile and compare the nutrient content analysis to the Dietary Reference Intakes
(DRI) and Dietary Guidelines as stated in the AND Nutrition Care Manual. The nutrient analysis
was completed based on the average nutritional needs for a female and male between the ages of
31 to 50 years old. The items that are highlighted in Tables C.1-C.3, as seen in Appendix C,
indicate the menu items that were selected to be included in the analysis of nutrient content for
the regular, mechanical, low sodium, diabetic, low cholesterol, and full liquid diet. The selected
items were entered into the Diet Analysis Plus Software to assess the nutrient content of each
menu item. The total nutrient contents for macronutrients, vitamins, and minerals were recorded
and analyzed, as seen in Appendix D. The daily totals were averaged and interpreted as
percentages of daily values to evaluate the compliance with nutritional guidelines.
6
Regular Menu. The regular menu nutrient content was observed to frequently exceed various
nutritional guidelines, specifically in fat, cholesterol, and vitamins. The macronutrients
including calories, protein, carbohydrates, and saturated fat fell into the acceptable range of
values. Fat and cholesterol levels, however, exceeded the recommended limit, while dietary fiber
fell short by 23%. The only two vitamins that were met appropriately for the regular menu was
folate and vitamin A. Niacin, riboflavin, thiamin, vitamin B6, B12, C, and D exceeded guidelines
by 13-64%. Vitamin E was the exception as it only met 52% of the daily recommended values.
Minerals, including calcium, iron, and zinc, were shown to be adequate while potassium (54%)
and magnesium (85%) fell short. Sodium levels were observed to repeatedly exceed the desired
limits throughout the observed three days with an average of 140% of daily values.
Mechanical Diet Menu. The nutritional content of the mechanical diet menu was observed to
mirror the nutrient analysis of the regular menu as the all of the food selections were the same.
The mechanical diet typically reflects the regular diet options as most of the menu items are
already at the suitable texture level for this level of modification. In the case that the food items
are not the appropriate texture, they are simply chopped or altered to meet the appropriate
consistency. The following menu items were changed or chopped to meet mechanical texture
standards during the observed three days: roast beef, chicken noodle casserole, vegetable soup,
chicken patty, fruit cocktail, baked chicken, barbeque chicken, broccoli, and chicken stew. All
other menu selections from the regular menu were served without any further texture
modifications as they were suitable for this type of therapeutic diet.
Low Sodium Diet Menu. The observed therapeutic low sodium menu closely resembled the
regular diet menu; however, small alterations and substitutions were implemented to reduce the
overall sodium content of the meals. In doing so, other nutrient contents were affected, resulting
7
in changed macronutrient and micronutrient levels. The regular condiment kits for this
therapeutic diet are substituted with a low sodium condiment kit, reducing the amount of sodium
per day by approximately 600 milligrams. Additionally, low sodium menu items are prepared
separately from the regular diet menu items as no salt is added during the cooking process.
These low sodium menu selections help the nutrient content of this menu meet the specified
guidelines. The AND Nutrition Care Manual states that a low sodium diet should have the
sodium content restricted to 1,500-2,000 milligrams per day. The average sodium level for the
observed three days was found to be approximately 1,910 milligrams, meeting the daily value
guidelines by 96% for this micronutrient. Additionally, the fat and saturated fat macronutrient
contents were reduced by 15-20% from the regular diet menu, placing these nutrient contents in
the appropriate dietary guideline range.
Diabetic/Consistent Carbohydrate Diet Menu. The diabetic diet menu, or consistent
carbohydrate diet menu, is also considered to be the “weight reduction” menu for the facilities of
the VA. This therapeutic menu also reflects the regular diet menu selections; however, the
regular condiment kits are substituted with sugar free condiment kits and the prepared food items
are cooked without any added salt, fat, or sugar products. These alterations and substitutions did
exhibit to have a positive effect on the fat and cholesterol levels, but the carbohydrate content
was reduced to a deficient amount. This therapeutic menu is borderline obsolete as the AND
Nutrition Care Manual has guidelines for consistent carbohydrate diets and also explains that
weight reduction is not an appropriate goal for an institutional health care setting as recovery and
rehabilitation increases nutritional needs. Though the protein, fat, saturated fat, and dietary fiber
contents were within appropriate ranges, carbohydrates were analyzed to be inadequate by 16%
and the calories were reduced by 9% from the regular menu analysis.
8
Low Cholesterol/Fat Diet Menu. Comparably, the low cholesterol and fat diet menu imitates
the meal items from the regular menu while making minor preparation adjustments and
implementing substitutions when necessary. For a low cholesterol or low fat diet, the AND
Nutrition Care Manual suggests the nutrient content of saturated fat to be less than 16 grams with
cholesterol remaining under 200 milligrams per day. Further analysis of this therapeutic menu
exhibited that items that were naturally high in fat were substituted with a lower fat food item.
Just as the low sodium and diabetic diets were prepared without salt or sugar, the low fat menu
items were cooked without any additional fat products being added. Collectively, this
therapeutic diet met the dietary guidelines for calories, protein, carbohydrates, fat, saturated fat,
dietary fiber, folate, thiamin, iron, and magnesium sufficiently. Otherwise, cholesterol, niacin,
riboflavin, vitamin A, B6, B12, C, D, E, calcium, potassium, and sodium nutrient levels were
either exceeded or inadequate by 10% of the suggested DRIs. While cholesterol did decrease by
112 milligrams from the regular menu, the cholesterol nutrient content of the low fat menu was
analyzed to be higher than the recommended guidelines by 55%.
Full Liquid Diet Menu. The full liquid diet menu drastically differs from the other reviewed
therapeutic diets as it exhibits very little resemblance to the regular diet menu. For the VA, full
liquid diets are considered to be a complex modification because of the high rate of altered
mental status residents at the CLC for senior citizens. Full liquid diets are often used as a post-
operative transition diet, but for the CLC residents it is provided for severely ill individuals who
have significant difficulty swallowing or chewing solid foods. Unfortunately, altered mental
status and other comorbidities associated with the elderly population go hand in hand with
dysphagia, aspiration, and often the development of aspiration pneumonia. The analyzed
nutrient content averages of the full liquid therapeutic diet consisted of a wide variety of texture
9
appropriate menu items. At each meal, a type of juice, entrée, dessert, coffee, milk, tea, and
supplement shake were provided with a multitude of different flavors and combinations selected.
The nutrient analysis reveals that calories, protein, carbohydrates, fat, saturated fat, and
cholesterol contents were in the appropriate range established by the AND Nutrition Care
Manual and DRIs. Dietary fiber, however, was shown to be inadequate as the analyzed diet only
provided approximately 16% of the needed daily value. The recommended intake for dietary
fiber may still be accomplished as this assessment does not acknowledge any form of dietary
fiber supplements that may be provided as part of the medication regimens for patients and
residents. Niacin, iron, sodium, and zinc contents were all considered adequate while potassium
was the only micronutrient to be insufficient by 15%. Folate, riboflavin, thiamin, vitamin A, B6,
B12, C, D, E, calcium, and magnesium significantly exceeded the suggested intake guidelines.
Discussion and Recommendations
The current menu practices and communications for the food service system at the VA
has several strengths, limitations, and room for improvement regarding the quality and process of
menu development and implementation. One of the advantages of a non-select cycle menu is
that it offers stability, consistency, and low operating costs. The current menu practices of the
VA demonstrate these benefits and also succeed with offering a respectable amount of variety for
a non-select menu style. The combination of a non-select cycle menu and the application of
cook-chill production methods allow for more flexibility in scheduling kitchen staff for meal
preparation and lower operational labor costs. The three-week cycle aspect can be seen as a
positive as it provides stability regarding patient or resident food preferences. It is not a major
concern for individuals with food allergies or food aversions that stay in the extended care units
as the meals that are to be prepared are fixed, consistent, and reoccurring.
10
Some observed limitations of the menu practices and communications for the VA include
the current use of the VistA Software and lack of choices that the patient or residents have when
selecting their menu items. Due to the non-select menu design, patients and residents do not
look over menus to select their meals, rather, they get whatever is on the menu that day with the
exception of any allergies, religious beliefs, or food aversions/preferences. The VistA Software
is a program that integrates the automation of nutrition screening, assessment, diet order entry,
food preferences, and nutrient analysis of meals. This multifunctioning automated tool, however,
is outdated and not user-friendly for the food service management team. This obsolete software
includes the outdated low protein renal diets that were previously used and the method of
entering patient food preferences has proven to be a difficult and time consuming process.
Fortunately, the VA is currently beginning the transition towards using a new nutrition
care management program called Computrition. This software provides nutrition services such
as electronically managing diet orders, prepopulating tray tickets, nutrient analyses, and is
considerably more user-friendly. A recommendation that would be beneficial for the regular diet
menu is to limit the use of fat during the cooking process to help decrease the fat and cholesterol
nutrient content to the appropriate dietary range. Additionally, staying up to date on current
research, specifically for diabetic and renal diets, would be beneficial to help ensure that patients
are receiving the highest possible quality of care. The low cholesterol and fat diet could be better
improved by having lighter substitutions to take the place of the scrambled eggs at breakfast.
Replacing the eggs would decrease the amount of cholesterol by 237 milligrams for one day,
bringing it well into the appropriate range for dietary recommendations. The current transition to
Computrition has given the VA the opportunity to begin to implement positive changes within
menu planning and development to help improve their overall variety and nutritional content.
11
References
Academy of Nutrition and Dietetics. (n.d.). NCM diet manual. Retrieved January 22, 2020, from
https://www.nutritioncaremanual.org/
Computrition. (n.d.). Food service software solutions. Retrieved January 22, 2020, from
http://www.computrition.com/
Department of Veterans Affairs VistA Health System Design and Development. (2005). VistA:
Nutrition and food service user manual (Version 5.5).
Wadsworth, Cengage Learning. (2009). Diet analysis plus: Software (10th ed.). Cengage.
Retrieved January 22, 2020, from https://www.cengage.com/dietwellnessplus/
12
Appendix A
Table A.1 – Patient & Resident Menu Communications
13
Appendix B
Table B.1 – Week 1: Sunday
14
Table B.2 – Week 1 – Sunday Continued
15
Table B.3 – Week 1 – Monday
16
Table B.4 – Week 1 – Monday Continued
17
Table B.5 – Week 1 – Tuesday
18
Table B.6 – Week 1 – Tuesday Continued
19
Table B.7 – Week 1 – Wednesday
20
Table B.8 – Week 1 – Wednesday Continued
21
Table B.9 – Week 1 – Thursday
22
Table B.10 – Week 1 – Thursday Continued
23
Table B.11 – Week 1 – Friday
24
Table B.12 – Week 1 – Friday Continued
25
Table B.13 – Week 1 – Saturday
26
Table B.14 – Week 1 – Saturday Continued
27
Appendix C
Table C.1 – Week 1 – Sunday Menu Items Selected for Nutrient Analysis
28
Table C.2 – Week 1 – Monday Menu Items Selected for Nutrient Analysis
29
Table C.3 – Week 1 – Tuesday Menu Items Selected for Nutrient Analysis
30
Appendix D
Table D.1 – 3 Day Average Nutrient Analysis & Evaluation

Facility Menu Project - NFS 774 Spring 2020 - Gulf Coast Veterans Health Care System
3 Day Nutrient Analysis & Evaluation
Nutrients Regular Diet Mechanical Diet Low Sodium Diet Diabetic/CC Diet Low Cholesterol & Fat Diet Full Liquid Diet
Macronutrients DRIs & NCM Sun. Mon. Tues. Avg. % DV Sun. Mon. Tues. Avg. % DV Sun. Mon. Tues. Avg. % DV Sun. Mon. Tues. Avg. % DV Sun. Mon. Tues. Avg. % DV Sun. Mon. Tues. Avg. % DV
Energy 2000 kcals 1944 2112 2100 2052 103% 1944 2292 2100 2112 106% 1860 1904 1833 1866 93% 1704 2159 1777 1880 94% 1759 2203 1833 1932 97% 2005 1896 1778 1893 95%
Protein 50-175g 78 72 125 92 100% 78 78 125 94 100% 78 70 121 90 100% 78 80 121 93 100% 79 75 121 92 100% 71 70 69 70 100%
Carbohydrates 225-325g
217 254 207 226 100% 217 268 207 231 100% 214 241 187 214 95% 191 275 174 213 84% 204 312 187 234 100% 328 310 297 312 100%
Diabetic/CC Diet* 255-285g*
Fat 44-78g 88 90 91 90 115% 88 101 91 93 115% 81 75 72 76 100% 72 84 71 76 100% 69 65 72 69 100% 48 43 37 43 97%
Saturated Fat < 22g
27 23 27 26 100% 27 22 27 25 100% 25 15 17 19 100% 20 18 17 18 100% 20 15 17 17 100% 16 16 12 15 100%
Low Cholesterol & Fat* < 16g*
Cholesterol < 300mg
418 375 472 422 141% 418 380 472 423 141% 416 353 332 367 122% 393 378 332 368 123% 281 318 332 310 155% 98 109 76 94 31%
Low Cholesterol & Fat* < 200mg*
Dietary Fiber 25.2-30.8g 19 19 20 19 77% 19 19 20 19 77% 21 20 23 21 85% 21 28 23 24 95% 21 29 23 24 97% 5 5 2 4 16%
% of Kcal as Fat 20-35% 41 38 39 39 112% 41 39 38 39 112% 39 35 32 35 101% 37 35 36 36 103% 35 27 32 31 100% 22 20 19 20 100%
% of Kcal as Sat Fat < 10% 13 10 12 12 117% 13 9 12 11 113% 12 7 8 9 100% 10 8 9 9 100% 10 7 8 8 100% 7 8 6 7 100%
Vitamins
Folate 400mcg 452 440 329 407 102% 452 518 329 433 108% 432 494 331 419 105% 391 519 293 401 100% 428 519 331 426 107% 626 605 620 617 154%
Niacin 14-16mg 15 25 30 23 146% 15 25 30 23 146% 15 23 30 23 142% 15 28 30 24 152% 16 27 30 24 152% 15 16 15 15 96%
Riboflavin 1.1-1.3mg 2.2 1.9 2.3 2 164% 2.2 1.9 2.3 2 164% 2.1 1.8 2.1 2 154% 1.9 1.9 2.1 2 151% 2 1.9 2.1 2 154% 2.8 3.1 3 3 228%
Thiamin 1.1-1.2mg 1.2 1.6 1.1 1 118% 1.2 1.6 1.1 1 108% 1.1 1.5 1.1 1 103% 1 1.6 1.1 1 103% 1.1 1.7 1.1 1 108% 1.6 1.5 1.5 2 128%
Vitamin A 700-900mcg 741 1198 994 978 109% 741 1198 994 978 109% 1555 1204 875 1211 135% 1543 1199 862 1201 133% 1555 1205 875 1212 135% 1244 6835 1321 3133 348%
Vitamin B6 1.3mg 1.1 1.5 1.8 1 113% 1.1 1.5 1.8 1 113% 1.1 1.5 1.8 1 113% 1.2 2.2 1.8 2 133% 1.3 2.2 1.8 2 136% 2.6 2.6 2.5 3 197%
Vitamin B12 2.4mg 4.8 2.6 2.9 3 143% 4.8 2.6 2.9 3 143% 4.8 2.5 2.5 3 136% 4.6 2.6 2.5 3 135% 4.6 2.5 2.5 3 133% 8.8 10.1 9.8 10 399%
Vitamin C 75-90mg 141 43 162 115 128% 141 43 162 115 128% 141 43 231 138 154% 93 27 169 96 107% 155 89 231 158 176% 269 269 294 277 308%
Vitamin D 600mcg 816 802 714 777 130% 816 802 714 777 130% 781 788 605 725 121% 719 801 586 702 117% 721 788 605 705 117% 1224 2117 1983 1775 296%
Vitamin E 15mg 6.53 7.8 9 8 52% 6.53 7.8 9 8 52% 6.8 7.8 9.3 8 53% 7.7 7.9 9.2 8 55% 7.8 7.9 9.3 8 56% 45 43 42 43 289%
Minerals
Calcium 1000mg 987 827 876 897 90% 987 827 876 897 90% 861 685 679 742 74% 886 717 665 756 76% 900 737 679 772 77% 2264 2330 2243 2279 228%
Iron 8-18mg 11 13 11 12 100% 11 13 11 12 100% 11 12 10 11 100% 11 20 10 14 100% 11 20 10 14 100% 24 23 19 22 100%
Magnesium 320-420mg 256 256 314 275 86% 256 256 314 275 86% 283 247 321 284 89% 270 288 307 288 90% 284 308 321 304 95% 444 448 429 440 138%
Potassium 4700mg 2397 2288 2924 2536 54% 2397 2288 2924 2536 54% 2469 2163 2951 2528 54% 2318 2757 2703 2593 55% 2566 2943 2951 2820 60% 4358 4101 3583 4014 85%
Sodium 2300mg
2546 4376 2771 3231 140% 2546 4376 2771 3231 140% 1640 1946 2145 1910 96% 2344 3905 2495 2915 127% 2344 3543 2497 2795 122% 2084 2822 2225 2377 103%
Low Sodium Diet* 1500-2000*
Zinc 8-11mg 13 8 10 10 100% 13 8 10 10 100% 13 7.2 10 10 100% 13 8 9.7 10 100% 13 7.8 10 10 100% 17 18 17 17 100%
*Mechanical & Full Liquid Diets do not differ from the Regualr DRIs Nutritional Needs based on Avg DRI for 31-50 y.o. Females & Males from USDA & AND's NCM Nutrient within 10% of DRI Goal Nutrient out of DRI Goal Range
31

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Running head: GULF COAST VETERANS HEALTH CARE SYSTEM MENU ANALYSIS

Gulf Coast Veterans Health Care System Menu Analysis

Facility Menu Project

Deanna E. Cheathem, B.S.

University of Southern Mississippi

NFS 774 – Spring 2020

time-consuming and complex as it involves an intricate balance of achieving appropriate nutrient

content, acceptability, cost, variety, equipment, and staffing.

Current Menu Practices

mellitus, hypertension, congestive heart failure, and dysphagia.

Through observation of the regular menu cycle in Appendix B, there is a notable

textures, consistencies, and methods of cooking.

Nutrition Profile and Analysis

percentages of daily values to evaluate the compliance with nutritional guidelines.

nutritional guidelines, specifically in fat, cholesterol, and vitamins. The macronutrients

modifications as they were suitable for this type of therapeutic diet.

the appropriate dietary guideline range.

Diabetic/Consistent Carbohydrate Diet Menu. The diabetic diet menu, or consistent

analyzed to be higher than the recommended guidelines by 55%.

Discussion and Recommendations

Nutrition and food service user manual (Version 5.5).

Retrieved January 22, 2020, from https://www.cengage.com/dietwellnessplus/

Table A.1 – Patient & Resident Menu Communications

Table B.1 – Week 1: Sunday

Table B.2 – Week 1 – Sunday Continued

Table B.3 – Week 1 – Monday

Table B.4 – Week 1 – Monday Continued

Table B.5 – Week 1 – Tuesday

Table B.6 – Week 1 – Tuesday Continued

Table B.7 – Week 1 – Wednesday

Table B.8 – Week 1 – Wednesday Continued

Table B.9 – Week 1 – Thursday

Table B.10 – Week 1 – Thursday Continued

Table B.11 – Week 1 – Friday

Table B.12 – Week 1 – Friday Continued

Table B.13 – Week 1 – Saturday

Table B.14 – Week 1 – Saturday Continued

Table D.1 – 3 Day Average Nutrient Analysis & Evaluation

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