TE 3 Food Quality Guideline.pdf

EXHIBIT 3

US COAST GUARD FOOD QUALITY GUIDELINES

INTRODUCTION.

Diet and nutrition have significant affects on the health and morale of Coast Guard personnel. Coast Guard dining facilities must provide nutritious meals to support the operational demands of the unit and meet the dietary needs of Coast Guard personnel. In addition, dining facilities should provide nutritional information to their customers to assist them in making informed decisions on their diet and in making beneficial changes to their eating habits.

1. Purpose: This Exhibit is designed to assist the unit in fulfilling its operational missions. Since the food service program directly affects the unit’s nutritional well-being and morale, it is essential that the unit provides quality resolutions to any food service problems quickly and when possible, to the member’s satisfaction.

2. Highly Encouraged: This Exhibit highly encourages using the recommendations but does not set requirements or act as a checklist for compliance purposes. The guidelines were designed to aid in planning Coast Guard Culinary Specialist (CS) and contracted staff in planning menus in the promotion of healthy food choices.

1.1. Dietary Guidelines for Americans

Nutrition standards are based upon national standards, which include the Dietary Guidelines for Americans, published by the Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA), and the DASH (Dietary Approaches to Stop Hypertension) Eating Plan. The Dietary Guidelines are jointly issued and updated every five years to reflect advances in technology and medicine as well as an understanding of how food affects overall health and an increased knowledge of changing dietary needs. The guidelines were first issued in 1980 and were most recently revised in 2005. An overview is outlined in this chapter and can be accessed in it’s entirety at http://www.healthierus.gov/dietaryguidelines/.

The new dietary guidelines were revised to provide Americans advice to promote a healthy lifestyle and carry ten basic messages:

a. Aim for a healthy weight

b. Be physically active every day

c. Let the Food Pyramid guide your food choices

d. Choose a variety of grains daily, especially whole grains

e. Choose a variety of fruits and vegetables daily

f. Keep food safe to eat

g. Choose a diet low in saturated fat and cholesterol and moderate in total fat

h. Choose beverages and foods to moderate your intake of sugars

i. Choose and prepare foods with less salt

j. Drink alcoholic beverages in moderation

1.1.1. Diseases

US COAST GUARD FOOD QUALITY GUIDELINES

Major causes of morbidity and mortality in the United States are related to poor diet and a sedentary lifestyle. Specific diseases and conditions linked to poor diet and lack of physical activity include, but are not limited to:

a. Cardiovascular disease

b. Type II diabetes

c. Hypertension

d. Osteoporosis

e. Oral disease

f. Malnutrition

g. Certain cancers

A basic premise of the Dietary Guidelines is that nutrient needs should be met primarily through food consumption. Foods provide an array of nutrient and other compounds that may have beneficial effects on health. In some cases, fortified foods may be useful sources of one or more nutrients that otherwise might be consumed in less than the recommended amounts.

Supplements may be useful when they fill a specific identified nutrient gap that cannot or is not otherwise being met by the individual’s food intake. Nutrient supplements cannot replace a healthful diet. Individuals who are already consuming the recommended amount of a nutrient in food will not achieve any additional health benefit if also taking the nutrient as a supplement. In some cases supplements and fortified foods may cause intakes to exceed the safe levels of nutrients. Another important premise of the Dietary Guidelines is that foods should be prepared and handled in such a way that reduces risk of food borne illness.

1.2. DASH (Dietary Approaches to Stop Hypertension) Eating Plan

The DASH (Dietary Approaches to Stop Hypertension) Eating Plan makes it easier to consume less salt and sodium because it is rich in fruits and vegetables. The DASH eating plan is low in saturated fat, cholesterol and total fat, and emphasizes fruits, vegetables and low fat dairy foods. It also includes whole grain products, fish, poultry and nuts. It is reduced in red meat, sweets and sugar-containing beverages. It is rich in magnesium, potassium and calcium, as well as protein and fiber. Studies have shown that blood pressure can be lowered by following the DASH Eating Plan and reducing the amount of sodium consumed. Information about the DASH Eating Plan can be found at http://dashdiet.org/.

1.3. Food Guide Pyramid

The food guide pyramid is a visual representation of the Dietary Guidelines. The goal is to provide guidelines for a diet adequate in protein, vitamins, mineral and fiber without excessive amounts of calories, fat, saturated fat, cholesterol, sodium, added sugars and alcohol. The pyramid may be accessed at www.mypyramid.gov. The number of servings from each level of the pyramid is dependent upon individual calorie requirements.

a. Grains. Make half your grains whole. The pyramid emphasizes whole grain and cereals as the base of a nutritious diet. Wheat, corn, oats and other grains have very little fat and are cholesterol free. These foods provide complex carbohydrates, an important source of energy. They also provide vitamins, mineral and fiber.

b. Vegetables. Vary your vegetables. Vegetables are naturally low in fat and contain no cholesterol. Vegetables are a good source of vitamins, especially A and C; fiber; folate;

US COAST GUARD FOOD QUALITY GUIDELINES

and minerals, such as iron and magnesium. Vegetables that are dark in color provide more nutrients. Starchy vegetables such as corn, peas and lima beans contain at least four times the calories than an equal quantity of a non-starchy vegetable such as broccoli or green beans (1/2 cup corn = 80 calories, ½ cup broccoli = 20 calories).

c. Fruits. Focus on fruits. Fruits are low in fat and are cholesterol free. Fruits and fruit juices provide important amounts of vitamins and minerals such as vitamins A, C and potassium. Whole fruits, especially fresh fruits with skins, provide fiber whereas fruit juice does not. Fruit juices should be consumed less often than fruit because they contain more calories than fruit. Only juices containing 100 percent fruit juice can count as a fruit serving. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up or pureed.

d. Milk. Get your calcium-rich foods. Milk products provide protein, vitamins and minerals. Milk, yogurt and cheese are the best dietary source of calcium, and are necessary for the formation of strong bones and teeth. Dairy products made from whole milk contain fat and cholesterol. Low fat and fat free options (i.e., 1% or fat free milk, low fat or fat free yogurt and reduced fat cheeses) are available and generally contain equal amounts of calcium. Lactose free products are also available.

e. Meat and Beans. Meat, poultry and fish supply protein, B vitamins, iron and zinc.

Other foods in this group such as dry beans, eggs and nuts are similar to meats in providing protein and most vitamins and minerals. Most meat and poultry choices should be lean or low-fat. The average healthy young adult requires approximately 5 to 7 ounces of cooked lean meat, poultry or fish per day. For example, 6 ounces a day might come from: one (1) egg (equals one (1) ounce lean meat) for breakfast; two (2) ounces sliced turkey in a sandwich at lunch; and a three (3) ounce cooked hamburger for dinner.

2 1/2 – 3 ounces of lean beef, pork, lamb, poultry, or fish equals one serving. ½ cup of cooked beans, one (1) egg, two (2) tablespoons of peanut butter or 1/3 cup nuts equal one (1) ounce of meat. One (1) ounce of any protein provides seven (7) grams of protein.

The meat and beans group is an excellent place to trim fat in the diet. Red meat does not need to be avoided; choosing 90% lean red meat with 10% fat is a good choice.

Remove the skin from poultry; eat more fish, dry beans and peas. When cooking meats, broil, roast or braise instead of frying. Egg yolk is a concentrated source of cholesterol;

therefore whole eggs should be consumed in moderation. Egg whites contain no cholesterol and can often be substituted for whole eggs in recipes.

f. Fats, Oils and Sweets. Use sparingly. Ensure most of your fat sources come from fish, nuts and vegetable oils. Limit solid fats like butter, stick margarine, shortening and lard.

Check the Nutrition Fact labels on products to ensure they are low in saturated fats, trans-fats and sodium. Choose foods and beverages that are low in added sugars. A low fat style of eating allows room for use of some fats and high fat foods in moderation.

Consume less than 10 percent of calories from saturated fats and less than 300 mg/day of cholesterol, and keep trans fat (partially hydrogenated fats) consumption as low as possible. Total fat intake should be no more than 20 to 35 percent of calories with most fats coming from foods such as fish, nuts and vegetable oils.

1.4. USDA Food Guide

US COAST GUARD FOOD QUALITY GUIDELINES

The USDA Food Guide below suggests amounts of food to consume from the basic food groups, subgroups, and oils to meet recommended nutrient intakes at 12 different calorie levels.

Nutrient and energy contributions from each group are calculated according to the nutrient-dense forms of foods in each group (e.g., lean meats and fat-free milk). The table also shows the discretionary calorie allowance that can be accommodated within each calorie level, in addition to the suggested amounts of nutrient-dense forms of foods in each group. More information on eating patterns, food sources and nutrients may be found at http://www.health.gov/DietaryGuidelines/, Dietary Guidelines for Americans, 2005, Appendix A and Appendix B.

1.5. Nutrients – Macronutrients

Nutrients are required by the body in order to sustain life. During digestion, food is broken down into nutrients, which are absorbed into the bloodstream and carried to every cell in the body.

Carbohydrates, proteins and fats are macronutrients, needed by the body in large amounts.

a. Protein. Protein is necessary to build and repair body tissues. The primary sources of protein include meat, fish, poultry, eggs, dairy product, nuts and legumes. Protein should comprise 15% of an individual’s total caloric intake or approximately ½ gram of protein per pound of body weight. There are four (4) calories per gram of protein.

b. Carbohydrate. Carbohydrates are the main source of fuel or energy for the body. The primary sources of carbohydrates include whole grains, cereals, fruits, vegetables and simple sugars. Carbohydrates should comprise 55 – 60% of an individual’s total caloric intake. The majority of these should be complex carbohydrates. There are four (4) calories per gram of carbohydrates.

c. Complex carbohydrates. Complex carbohydrates are composed of chains of smaller carbohydrate molecules (simple sugars). They are digested more slowly and provide the body with energy for a longer period of time than simple carbohydrates. They also provide valuable sources of fiber and nutrients. Sources include grains, legumes and starchy vegetables.

d. Simple carbohydrates. Simple carbohydrates are sugars such as glucose, sucrose (table sugar) and fructose. They are absorbed into the bloodstream very rapidly and provide a quick source of energy. Simple sugars provide few, if any nutrients, other than calories. Sources include table sugar, honey, jams and jellies, candy and skinless fruit.

e. Fat. Fats and oils are part of a healthy diet, but the type of fat makes a difference to heart health, and the total amount consumed is also important. Fat functions as a source of energy and as a vehicle to transport fat-soluble vitamins such as vitamins A, D, E and K and carotenoids. Fat should comprise no more than 20 to 35 percent of calories.

There are nine (9) calories per gram of fat.

1) Saturated fat. Excess saturated fats in the diet can lead to fatty deposits along the walls of vital arteries. These deposits can restrict or block the flow of blood leading to a heart attack or stroke. Saturated fats are generally solid at room temperature. Sources of saturated fats include meats, cheese, whole milk, butter, and some vegetable oils such as palm oil and coconut oil.

US COAST GUARD FOOD QUALITY GUIDELINES

2) Trans fat. May also be known as partially hydrogenated oils. Trans fats may be found in margarine, doughnuts, crackers, fried foods, baked goods and other snack foods. Scientific evidence shows that consumption of trans fats increases the risk of heart disease by raising low density lipoprotein (LDL) or bad cholesterol levels in the blood.

3) Polyunsaturated/monounsaturated fat. These fats may help reduce the risk of heart disease when substituted for saturated fats in the diet. They are generally liquid at room temperature and are derived from plant sources. Polyunsaturated fats include safflower oil, corn oil, sunflower oil and soybean oil. Monounsaturated fats include peanut oil, canola oil and olive oil.

f. Cholesterol. Cholesterol is a fat-like substance produced by the body and also found in foods of animal origin. It does not contain any calories; however, excess dietary cholesterol may contribute to fatty deposits along the walls of vital arteries. Sources of cholesterol include meats, egg yolks, whole milk, whole milk cheeses and butter. There are two types of cholesterol found in the body, low density lipoprotein (LDL) and high density lipoprotein (HDL).

1) LDL. Also known as “bad cholesterol.” LDL builds up in the arteries and may lead to heart disease; the higher the level of LDL, the higher the risk of heart disease. To decrease the risk of elevated LDL in the blood, most members need to decrease their intakes of saturated fat and trans fats; many need to decrease their dietary intake of cholesterol. The recommended level of LDL cholesterol is <130 MG/DL or lower; less than 100 MG/DL is optimal.

2) HDL. Also known as “good cholesterol.” HDL levels of 60 MG/DL or higher in the blood may help to reduce the risk of heart disease. The recommended level of HDL cholesterol is 40 MG/DL or higher for men, 50 MG/DL or higher for women.

g. Fiber. Diets rich in dietary fiber have been shown to have a number of beneficial effects, including the decreased risk of coronary heart disease. There is also interest in the potential relationship between diets containing fiber-rich foods and lower risk of Type II diabetes. Fiber is not an actual nutrient since it does not supply any vitamins, minerals or calories. However, it does perform vital functions. The recommended dietary fiber intake is 14 grams per 1,000 calories consumed. There are two types of fiber.

1) Soluble fibers. Soluble fibers dissolve in water and include pectins and gums. Sources include apples, bananas, dried beans, peas and oatmeal. Soluble fiber may help lower blood cholesterol levels.

2) Insoluble fibers. Insoluble fibers do not dissolve in water and include cellulose and lignin.

Sources include wheat bran, whole-wheat flour and fibrous material in fresh fruits and vegetables. Insoluble fiber aids in digestion and may prevent constipation.

1.6. Nutrients – Micronutrients

Vitamins and minerals perform a variety of specialized functions by the body. Compared with macronutrients, the body only requires vitamins and minerals in small amounts, hence the name micronutrients. Vitamins and minerals do not contain calories. Each nutrient has a specific and unique function to perform so it is important to consume a diet containing a variety of foods to ensure adequate intake of all nutrients. Vitamins are classified as either water-soluble or fat-soluble.

US COAST GUARD FOOD QUALITY GUIDELINES

a. Water soluble. Water soluble vitamins dissolve in water and thus cannot be stored by the body. They must be replenished on a daily basis and are more fragile and may be washed out or destroyed in food preparation. Water soluble vitamins are vitamins B and C.

b. Fat soluble. Fat soluble vitamins must be transported throughout the body via fat and can be stored in body fat. An excess intake of fat soluble vitamins can be dangerous because they will be stored in the body and could prove toxic or cause serious negative effects in the body. Fat soluble vitamins are vitamins A, D, E and K.

1.7. Weight Management

Ideally, the goal for adults is to achieve and maintain a body weight that optimizes their health.

Eating fewer calories while increasing physical activity are the keys to controlling body weight.

While overweight and obesity are currently significant public health issues, not all members need to lose weight. Members at a healthy weight should strive to maintain their weight;

underweight members may need to increase their weight.

Prevention of weight gain is critical, because while the behaviors required are the same, the extent of the behaviors required to lose weight makes weight loss more challenging than prevention of weight gain. Small decreases in calorie intake can help avoid weight gain, especially if accompanied by increased physical activity. For example, for most adults a reduction of 50 to 100 calories per day may prevent gradual weight gain, whereas a reduction of 500 calories or more per day is a common initial goal in weight-loss programs. Similarly, up to 60 minutes of moderate- to vigorous- intensity physical activity per day may be needed to prevent weight gain, but as much as 60 to 90 minutes of moderate-intensity physical activity per day is recommended to sustain weight loss for previously overweight people.

Some calorie-lowering strategies include eating foods that are low in calories for a given measure of food (e.g., many varieties of vegetables and fruits and some soups). However, when making changes to improve nutrient intake, one needs to make substitutions to avoid excessive calorie intake. The healthiest way to reduce calorie intake is to reduce the intake of added sugars, fats and alcohol, all which provide calories but few or no essential nutrients.

1.7.1. Key Recommendations:

a. Maintain body weight in a healthy range, balance calories from foods and beverages with calories expended.

b. Prevent gradual weight gain over time; make small decreases in food and beverage calories and increase physical activity.

For more information on weight management, see references (a) and (b).

1.8. Physical Activity

Regular physical activity and physical fitness make important contributions to a member’s health, sense of well-being and maintenance of a healthy body weight. Maintenance of good physical fitness enables a member to meet the physical demands of work and leisure comfortable. Members with higher levels of physical fitness are also at lower risk of developing

US COAST GUARD FOOD QUALITY GUIDELINES

chronic diseases. Conversely, a sedentary lifestyle increases risk for overweight and obesity and many chronic diseases, including coronary artery disease, hypertension, type II diabetes and certain types of cancer. Just 30 minutes of moderate physical activity on most days provides some protective health benefits.

To prevent the gradual accumulation of excess weight in adults, approximately 60 minutes of moderate- to- vigorous- intensity physical activity on most days of the week may be needed to prevent unhealthy weight gain. While moderate-intensity physical activity can achieve the desired goal, vigorous-intensity physical activity generally provides more benefits. Control of caloric intake is also advisable. Elevating the level of daily physical activity may also provide indirect nutritional benefits. A sedentary lifestyle limits the number of calories that can be consumed without gaining weight. The higher the member’s physical activity level, the higher his or her energy requirements and the easier it is to plan a daily food intake pattern that meets recommended nutrient requirements.

a. Proper hydration is important when participating in physical activity. Drinking water is the best fluid in maintaining hydration. Consuming beverages containing caffeine may act as a mild diuretic and could lead to dehydration if consumed in large quantities. Any non-caffeinated beverage may be used towards hydration, but may add excess discretionary calories.

1) Replacement approach. Food counts for approximately 20 percent of your total fluid intake, so if two (2) liters of water or other beverages a day (a little more than eight (8) cups) were consumed along with your normal diet, this typically replaces the fluids lost through normal body functions.

2) Eight 8-ounce glasses of water a day. Another approach to water intake is the “8 x 8 rule” – drink eight 8-ounce glasses of water a day. This may also be stated “drink eight 8-ounce glasses of fluid a day,” as all fluids count toward the daily total. Though the approach isn’t supported by scientific evidence, many people use this basic rule as a guideline for how much water and other fluids to drink.

3) Dietary recommendations. The Institute of Medicine advises that men consume roughly three (3) liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.

b. Apart from the above approaches, if a person drinks enough fluid so that they rarely feel thirsty, the fluid intake is probably adequate.

1.8.1. Key Recommendations:

a. Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being and a healthy body weight.

b. Engage in at least 30 minutes of moderate-intensity physical activity on most days of the week to reduce the risk of chronic diseases.

c. Engaging in physical activity on most days of the week with vigorous intensity and longer duration provides greater health benefits.

US COAST GUARD FOOD QUALITY GUIDELINES

d. To help manage body weight and prevent gradual, unhealthy weight gain, engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements.

More information regarding the Coast Guard Health Promotion Program, weight management and physical fitness can be found at http://www.uscg.mil/worklife “Health Promotion.”