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The Challenges of DRI Implementation in California Barbara Estrada, M.S., R.D. Public Health Nutrition Consultant California Department of Aging 4th State Units on Aging Nutritionists & Administrators Conference August 2006 California’s Elderly Nutrition Program 33 PSAs 250 + service providers Diverse population California’s Elderly Nutrition Program Program Diversity – Cambodian – Filipino – Hispanic – Russian – Asian California’s Elderly Nutrition Program Last year Elderly Nutrition Programs in California provided 18,476,009 meals California’s Elderly Nutrition Program 33 AAA RDs 88 Program RDs California’s Elderly Nutrition Program Menu Standards Title 22 California Code of Regulations – Provided nutrition requirements – Must be changed – Old ENP regulations regarding meal standards were very specific – New ENP regulations will be general First Attempt New Menu Standards were developed and sent out to stakeholders for comment The new Standards were based on 2000 Calories per day First Attempt 685 Calories per meal 2 servings of bread 2-3 servings of vegetables 1-2 servings of fruit Sodium <1,000 mg Protein 3 ounces First Attempt First Draft was released in July of 2005 Comments were accepted until January of 2006 Several programs provided studies or surveys that addressed the amount of food and costs. First Attempt CDA withdrew the first draft and asked the programs to continue to operate on the AoA requirement that all meals meet the 2005 Dietary Guidelines. Updated Menu Standard 535 Calories per meal (Based on 1600 per day) 14 gm of protein per entree Vitamin A – 250 μg Vitamin C – 25 mg Sodium ~ 800 mg Fiber > 7 gm California Component Meal Pattern Food Group Required servings/ meal Serving sizes for 1600 calorie level Lean meat / beans 1 serving 2 ounces = 1 serving 1 – 2 servings ½ cup = 1 serving 1 serving ½ cup = 1 serving Vegetable Fruit Bread or Grain 1 – 2 servings / ½ must be whole grain Milk or milk alternate 1 serving Fat Optional Dessert Optional - limit sweets use fruit 1 slice Bread or ½ cup of rice or pasta = 1 serving 1 cup or equivalent measure Select foods high in fiber and low in fat and sugar Dash Diet Food Group Grains 1,600 Calories Daily 6 servings 550 calories per meal 2 servings Vegetables 3-4 servings 1.5-2 servings Fruits 4 servings 1.3 servings Low-fat or fat free dairy 2-3 servings 1 serving Meat, poultry, fish 1-2 servings (3 oz each) 3-4 servings 1 serving (2 oz.) Seeds, nuts, legumes Fats and oils 2 servings/week Sweets 0 servings 1 serving USDA Menu Pattern Food Group 1,600 Calories Daily 550 calories/ meal Grains 5 ounces 1.7 ounces Vegetables 2 cups (4 servings) .7 cups (1.3 servings) Fruits 1.5 cups .5 cups Milk 3 cups 1 cup Lean meat and beans 5 ounces 1.7 -2 ounces Oils 22g 7g Discretionary calorie allowance 132 calories 44 calories California’s Elderly Nutrition Program Providing guidance without writing underground regulations? Updated Menu Standard Sodium the real challenge Effect of Potassium Culturally appropriate meals New Regulations CDA RDs are in the process of changing the California Code of Regulations New language will be more general Guidance will be provided along with choices of how to meet the Federal regulations.