02 | Develop Menus & Ensure Effectiveness of Standardized Recipes
cardiac diet should not have to receive a sugar-free chocolate cake for dessert.
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Dietary Reference Intakes
Most clients do not need to follow all these restrictions and find the limited palate of meal options unsatisfactory. Keep in mind that client satisfaction is tied to reimbursements and client retention. Often the access to more liberalized diets in senior living facilities allows for the use of a more acceptable variety of foods on the menu.
When the nutrient analysis of a menu dictates an alternate is required for a therapeutic modification of a diet, the use of a modified recipe or totally different item is in order. Planning a menu with alternate items that mix well with the primary base menu’s side items or entrées helps control the number of different items that need to be prepared.
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Specific information on nutrition therapy and food restrictions are covered in the Nutrition Fundamentals and Medical Nutrition Therapy textbook, which accompanies this textbook in many nutrition and foodservice professional training programs. See the ANFP Marketplace QR code for purchasing details.
Glossary
International Dysphagia Diet Standardisation Initiative (IDDSI) The worldwide standard used to describe texture modified foods and thickened liquids used for individuals with dysphagia of all ages
Nursing homes are beginning to use the International Dysphagia Diet Standardisation Initiative (IDDSI) as the foundation for texture modified foods and thickened drinks provided to clients. The use of global, standardized terminology and definitions for texture modified foods and thickened drinks help improve the safety and care of clients with dysphagia by helping staff communicate individual client needs to interdisciplinary teams. Figure 2.2 shows the IDDSI Framework which consists of a continuum of 8 levels (0-7), where drinks are measured from levels 0–4, while foods are measured from Levels 3–7. The IDDSI Framework provides a common terminology to describe food textures and drink thickness. See the QR code for the IDDSI Framework (IDDSI, 2019b). Also see the QR code for the IDDSI Detailed Definitions 2.0 for illustrations and instructions of thickness of liquids (IDDSI, 2019a). This valuable document can be used when instructing staff on the preparation and use of the IDDSI diet levels.
Monitoring the Menu and Meal Service
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The best meal service starts with a well-planned menu and finishes with a well-trained staff. No matter how well-designed the menu is, staff competencies and performance determine the final presentation of the meal to the client. During the meal service there are several steps that require monitoring.
• Ensuring the use and effectiveness of the standardized recipes by the production team is the start of creating the meal service.
• Using ingredient pull lists and production sheets with appropriate panning charts ensures the right items come to the serving line in the correct serving pans.