Nutrition discussion

1. Critique a team presentation other than your own, and include what the presentation taught you and what is identified in the nutritional analysis.

2. What changes in the presentation would you recommend? Why?

3. Ask questions! Each team is responsible for responding to questions asked of their presentation. 

Remember to include sources of literature in your posts to back up the statements you make. Remember, we are all about evidence-based practice!

 as you  read  the presentations of your classmates,  be sure to  respond by addressing what  you learned from the presentation and nutritional analysis, any  changes you would suggest and why,  and any questions you have.  

Green team

Introduction

· The purpose of this presentation is to explore, assess and evaluate the nutritional menus available to the elderly population of Hispanics residing in assisted living centers.

· We will also research the optimal nutritional needs of the elderly population and then tailor revisions for healthier food selections based on the Hispanic culture and the elderly.

Examples of Assisted Living Menus

Current Menu Analysis

· Nutrition is important in all stages of life

· The hispanic food selections are delicious and nutritional but at times are high in sodium, fatty meats and high in simple sugars.

· The focus of the menus had a variety of carbohydrates and proteins but very little fiber. This age group should include fibers and proper water intake during every meal for proper digestion purposes.

· Foods provided in a hispanic population should still include adequate amount of protein, dairy, vegetables, grains and fruit selections for healing properties.

· The menu should include foods that have selections of low and high caloric options for dietary needs along with healthy fats, like avocados, fatty fish and cheeses.

· The latin menu offered a variety of carbohydrate, that is not ideal for the aging population. Fiber should be incorporated in every meal.

Sample Breakfast Menu

· Assorted cold cereals (105 kcal )

· 1 cup oatmeal with flax seeds (184 kcal)

· or 1 scrambled egg (91 kcal)

· 1 slice avocado wheat toast (150 kcal)

· 1 cup cantaloupes (60 kcal)

· 1 cup water, coffee, tea, cafe con leche and milk (0- 113 kcal)

Sample Lunch Menu

· Arroz con pollo (½ cup rice, 3 oz spices and peas) (240 kcal)

· or 3 oz grilled atlantic salmon fish (366 kcal)

· ½ cup dinner salad (20 kcal)

· 1 slice wheat bread (151 kcal)

· Steamed green beans with Red peppers (44 kcal)

· Natilla (delicate cream custard) (356 kcal)

· Beverage of choice ( water, coffee, tea, variety of juices, vita malt) (0- 220kcal)

Dinner Sample Menu

· 6 oz lentil soup (with squash, potatoes) (230 kcal)

· ½ cup steamed broccoli and carrots (19 kcal)

· ½ cup brown rice (216 kcal)

· 1 cup melon fruit salad (30 kcal)

· Sugar free soft serve vanilla yogurt (67 kcal)

· 1 cup beverage of choice (water, unsweetened fruit juices, decaf teas) (0- 176 kcal)

Compare Menus

Agape Senior and Grove facilities provide repetitive menus with little variety and poor options; moreover, high sugar desserts are encouraged at every meal. They offer margarine for breakfast, which is an unhealthy source of trans fats and is detrimental for health (American Heart Association, 2017). Furthermore, both facilities do not offer gluten-free, vegan, or vegetarian options. Both menus provide a variety of proteins; however, they are prepared either fried or barbequed. They accompany their meals with dinner rolls, which is a source of unhealthy carbohydrates. Lastly, healthy fats such as baked salmon fish dishes are missing from the menus as well. Both lists have high caloric, low nutrient meals such as barbeque beef platter or beef king casserole.

Our Sample Menu replaces margarine with healthy avocado on a slice of toasted wheat bread for breakfast. Also offered on the menu is grilled fish. Grilled fish is a good source of Omega-3 fats, which are critical for a healthy heart (Grodner, Stump & Dorner, 2020). Dinner rolls are replaced by whole wheat bread which is a good source of complex carbohydrates. Also, the menu created is based on cultural preferences and incorporates healthy palatable choices such as chicken with yellow rice and lentils, which are good sources of grains and proteins. The Sample Menu includes all the necessary foods needed for optimal intake of vitamins, minerals, proteins, carbohydrates, and healthy fats.

Menu Option 1: South Florida Meals on Wheels

Healthy Food Options (information per recommended serving size)

Baked Chicken. Calories: 165 Carbs: 0 Protein: 31 Fat: 3.6

Chicken Sausage. Calories: 110 Carbs: <1g Protein: 18g Fat: 3.5g

Sweet Potatoes: Calories: 114 Carbs: 27g Protein: 2.1g Fat: .1g

Omelet: Calories: 358 Carbs: 1g Protein: 21g Fat: 28g

Turkey Lasagna: Calories: 420 Carbs: 38g Protein: 40g Fat: 12g

Vegetarian Chili: Calories: 219 Carbs: 38g Protein: 15g Fat: 1.5g

Mixed Vegetables: Calories: 60 Carbs: 12g Protein: 2g Fat: 0g

Spinach: Calories: 7 Carbs: 1g Protein: 1g Fat: 0g

Unhealthy Food Options

Moonpie: Calories: 220 Carbs: 40g Protein: 3g Fat: 6g (high sugar content, empty calories)

Meatloaf and Gravy: Calories: 200 Carbs: 8g Protein: Fat: 11g (cholesterol and sugar)

Pork Riblet in BBQ Sauce: Calories: 357 Carbs: 6g Protein: 19g Fat: 17g (Sugar, fat, cholesterol)

Macaroni and Cheese: Calories: 310 Carbs: 44g Protein: 13g Fat: 9g (saturated fat, high carbs, white flour)

Breaded filet of fish: Calories: 260 Carbs: 23g Protein: 16g Fat: 12g (high carbs, white flour, fat)

Beef Patty in Gravy: Calories: 110 Carbs: 2g Protein: 10g Fat: 7g (saturated fat and cholesterol)

Menu Option 2: North East Florida Meals on Wheels

Healthy Food Options (information per recommended serving size)

Lemon Pepper Fish. Calories: 90 Carbs: 0g Protein: 15g Fat: 3g

Beef and Cabbage Casserole: Calories: 212 Carbs: 27g Protein: 18.6g Fat: 8.1g

Omelet: Calories: 358 Carbs: 1g Protein: 21g Fat: 28g

Brussels Sprouts: Calories: 56 Carbs: 11 g Protein: 4 g Fat: 0g

Green Beans: Calories: 28 Carbs: 5 g Protein:1.5g Fat: .5g

Mixed Vegetables: Calories: 60 Carbs: 12g Protein: 2g Fat: 0g

Carrots: Calories: 25 Carbs: 6g Protein: .6g Fat: .1g

Broccoli: Calories: 31 Carbs: 6g Protein: 2.5g Fat: 0g

Unhealthy Food Options

Gravy: Calories: 188 Carbs: 13g Protein: 24.6g Fat: 14g (unnecessary empty carbs and unhealthy fats)

Hamburger: Calories: 354 Carbs: 29g Protein: 20 Fat: 17g (cholesterol and empty carbs)

Ranch Dressing: Calories: 145 Carbs: 2g Protein: .3g Fat: 15g (saturated fat, high carbs)

Cornbread: Calories: 94 Carbs: 15g Protein: 1g Fat: 2.7g (high carbs, white flour, sugar)

Fruit Cobbler: Calories: 330 Carbs: 56g Protein: 3g Fat: 11g (High sugar and calorie content)

Menu Analysis

●Meals from both menus are varied and meet the essential nutrient components of a balanced meal, including fats, proteins, vitamins and minerals

●Recipients receive a balanced diet throughout the week to meet the nutritional needs of their age group

●However, menus have several unhealthy options that could be eradicated or replaced to improve the menu

●The S. Florida menu contains many varieties to meet the dietary requirements and cultural preferences of the diverse population

●The NE Florida menu does not contain the options and variety as the South Florida Menu

●Both menus could be improved to include more vegan, allergy-friendly and diabetic-friendly options

Sample Menu 1: Meals on Wheels South Florida

Breakfast

Omelet: Calories: 358 Carbs: 1g  Protein: 21g Fat: 28g

2 whole grain waffles:170 calories, 1.5g of saturated fat, 2g of sugar, 26g of carbs and 5g of protein

Chicken Sausage. Calories: 110 Carbs: <1g Protein: 18g Fat: 3.5g 

One cup of whole milk: 61 calories, 3g of protein, 4g of carbs, 3g of fat

Lunch

Turkey Lasagna: Calories: 420 Carbs: 38g  Protein: 40g Fat: 12g

Mixed Vegetables: Calories: 60 Carbs: 12g Protein: 2g  Fat: 0g

Sweet Potatoes: Calories: 114 Carbs:  27g Protein: 2.1g  Fat: .1g

1 cup of water

Sample Menu 1: Meals on Wheels South Florida

Dinner 

Mixed protein salad that contains baked chicken. Calories: 165 Carbs: 0 Protein: 31 Fat: 3.6

8 oz of apple juice: 110 calories, 28g of carbs, 0g fat, and 1g of protein

1 cup of water

Sample Menu 2: Meals on Wheels North East Florida

Breakfast

1 cup of Greek yogurt: 290 calories, 34g of carbs, 130g of fats, 8g of protein

1 apple: 104 calories and 50g of carbs

40g of whole grain oatmeal: 150 calories, 27g of carbs, 2g of fat, and 6g of protein

1 cup of water
Lunch

Beef and Cabbage Casserole: Calories: 212 Carbs:  27g Protein: 18.6g  Fat: 8.1g

Brussels Sprouts:  Calories: 56 Carbs: 11 g Protein:  4 g Fat: 0g

1 cup of water
Sample Menu 2: Meals on Wheels North East Florida

Dinner

Lemon Pepper Fish. Calories: 90 Carbs: 0g Protein: 15g Fat: 3g 

Broccoli: Calories: 31 Carbs: 6g Protein: 2.5g  Fat: 0g

1 cup of brown rice: 150 calories, 32g of carbs, 1g of fat, and 3g of protein

1 cup of water

South Florida
V.S. Sample Menu Comparison

· A lot of carbohydrates including potatoes and Moon pie

· The vegetables and fruits are not enough

· Food such as meat in most meals

· All nutritional requirement included

· The caloric, protein, and fats requirements considered for the elderly patient throughout the day

· Fresh deep colored fruits

North East Florida
V.S. Sample Menu Comparison

· Too many food options with high calories such as Fruit cobbler, cornbread, and gravy

· Reduced fruits in diets

· Different types of meats which could not be appropriate for elderly population

· Simple breakfast with high fiber, proteins, calcium, proteins and decreased calories such as apples

· Appropriate food option with fiber, calcium and fats

· Foods rich in omega-3-fatty acids such as sardines and fish

Barriers to Optimal Health

Socioeconomic challenges- low socioeconomic status due to lack of enough funds to purchase nutritious food

Health of the population- elderly people are prone to co-morbid diseases which limits food intake due to disease restrictions, medications, and disease associated symptoms.

Barriers to Optimal Health Contd.

Food cultures of the population- food taboos prevent some people in eating certain foods thus lacking important nutrients in the body.

Health literacy level on nutrition- the uneducated population on healthy and beneficial foods will usually consume foods high unhealthy elements leading to micronutrient deficiency.

Summary

· Meals on Wheels help the elderly (over 60 years old) receive nutritious meals and provide places where they can interact

· Meals on Wheels in South and North East Florida were compared

· African American and Hispanic cultures were also compared in food preference

· Elderly people in nursing care require a diet containing the right amount of fiber, protein, carbohydrate, fat, and vitamins and minerals

· There were various barriers to nutrition but as a nurse we must educate and work with the person’s cultural preferences to build an adequate menu and improve their nutritional status