Attachment B VHA Healthy Diet Guidelines.pdf

Last Updated: 9/2018

VHA HEALTHY DIET MODEL

VHA Healthy Diet Average Nutrient Goals* (based on daily avg. over 7 days)

Weekly Average Meal Guidelines

Calories: 2000-2400 per day or 600-700 per meal.

Adjusted appropriately based on average age and sex of population served.

Adopt appropriate standardized portion sizes to meet calorie goals.

Fat: 25-35 percent of calories, <10% of calories from saturated fat

No or minimal synthetic sources trans fats and partially hydrogenated oil. No margarines with hydrogenated fats.

Replace saturated fats with unsaturated liquid oils. Serve nonfat or low fat (1 or 2 %) milk. No or minimal deep fat fried foods. Select and serve lean meat, and poultry, minimally processed fish at all meals.

Sodium:2000-3000 per day or 600-1000 per meal

Reduce salt in recipes, substitute herbs and spices. Incorporate Dietary Approaches to Stop Hypertension (DASH) Diet principles.

Carbohydrate and Fiber: 25-30 grams fiber per day, 5-10 grams fiber per meal

Incorporate whole grains, vegetables and fruits daily to meet the fiber goals. Include fresh seasonal fruit and vegetables daily.

Include beans, lentils whole grains, and nuts in recipes. Offer nuts and whole grain foods for snacks.

Protein: 60-120 grams per day, 20-40 grams per meal

5 to 6 ounces meat, fish, poultry per day plus two 8-ounce servings of nonfat or low fat milk per day. Limit red meats (beef and pork) to 4 to 6 meals per week. Include fish 2 times per week. Strive to utilize responsible-use antibiotic proteins. Include plant based proteins: nuts, lentils and vegetarian entrees.

Discretionary Calories: Decrease calories from added sugars

Limit sweetened desserts to once a day.

Beverages: Support the daily fluid needs of approximately 8 or more cups water per day, adjusted based on population served. Decrease calories from added sugars.

Offer coffee and/or tea, decaffeinated as appropriate with all meals, limit fruit juice to 100% fruit juice, milk low fat (1 or 2%) or nonfat, unsweetened or no added sugar soda, fruit drinks or beverages.

Green Environmental Management Strategies (GEMS)

Include fresh seasonal fruit and produce in menu cycle. Source local produce and bread vendors**. Use re-useable or recyclable service ware as much as possible. Select products with recycled content. Strive to source products that reduce exposure to chemicals, hormones and nontherapeutic antibiotics. As able, establish a Farmers Market on site, eliminate Styrofoam, use compostable materials as available. Reduce waste, consider composting or food digestors.

All other Micronutrients 100% RDI for appropriate patient population

*Menu recommendations adapted from Dietary Scientific Report of the 2015 Dietary Guidelines Advisory Committee, Dietary Approaches to

Stop Hypertension (DASH) Eating Plan. VHA MOVE! Program materials. Creating a Preference for Meat & Poultry Produced According to

Responsible Antibiotic Use

**Produce vendors or producers must comply with United States Department of Agriculture Good Agricultural Practices, http://www.ams.usda.gov/AMSv1.0/gapghp. VHA specific guidance includes NFS Local Produce Procurement Guide.

1. MENUS

a. Cycle Menus are designed using standardized recipes in support of the VHA

Healthy Diet meal guidelines. Cycle menus consist of at least a 3-week cycle pattern for facilities with a VA Community Living Center (CLC), domiciliary or residential care programs. Cycle menus less than 3 weeks may be used for acute medical or short-stay

CLC residents. The minimum cycle for an acute care non-select menu is 3 days.

b. All menus are planned to provide adequate variety and adhere to cultural and religious preferences as appropriate. Menus will meet essential nutrients requirements and adhere to diet prescriptions in accordance with Nutrition Care Manual, available at:

[SharePoint link]. Appropriate therapeutic diets will be available for all meals based on the level of care provided at each facility.

c. Facilities are encouraged to advance Veteran-centered cultural transformation and the Veteran Experience in food service operations by offering dining programs that provide veterans meal choices as well as festive special occasion meals.

d. Facilities utilizing a broad selection room service menu and delivery model for meal service must create a non-select menu cycle for patients who do not order a room https://vaww.infoshare.va.gov/sites/Nutrition/NFS/FSB/GEMS/Shared%20Documents/Practice%20Green%20Health%20(PGH)%20Sustainability%20Awards/NFS%20ID%20Announcement%20for%20Creating%20a%20Preference%20for%20Meat%20and%20Poultry%20Produced%20According%20to%20Responsible%20ABX%20Use.pdf https://vaww.infoshare.va.gov/sites/Nutrition/NFS/FSB/GEMS/Shared%20Documents/Practice%20Green%20Health%20(PGH)%20Sustainability%20Awards/NFS%20ID%20Announcement%20for%20Creating%20a%20Preference%20for%20Meat%20and%20Poultry%20Produced%20According%20to%20Responsible%20ABX%20Use.pdf http://www.ams.usda.gov/AMSv1.0/gapghp https://vaww.infoshare.va.gov/sites/Nutrition/NFS/FSB/GEMS/Shared%20Documents/Local%20Sourcing/Local%20Produce%20Procurement%20Guide%205-17-14.docx service meal in accordance VHA Healthy Diet meal guidelines. The length of the menu cycle is based on the type of care being provided (1.a. above).

e. The VHA Healthy Diet (regular) and one therapeutic diet on the hospital menu cycle will be nutritionally analyzed at least once per year to assure nutritional guidelines are being met.

2. MEAL HOURS

a. Meal service hours scheduling is implemented to meet Veteran-centered care, care coordination, and regulatory requirements. NFS sites publish a schedule of specific meal times to various meal service points within the medical facility.

b. Meal hours and breaks for NFS employees are scheduled not to interfere with

Veteran meal service.