Meal Patterns: Only a First Step in Menu Planning

The National Resource Center on Nutrition, Physical Activity and Aging analyzed 130 meals submitted by Older Americans Nutrition Program local providers from all over the country. Most meals were based on the 1972 meal pattern. Using a nutrient analysis software program, the Center found that none of the meals met the 1997-2004 RDAs/AIs. Surprised by these findings the Center further investigated the efficacy of meal patterns as compliance tools for Older Americans Act regulations.

What is nutrient analysis software?

Nutrient analysis software is a computer based tool that performs nutrient analyses based on user input of meal or recipe components. Computer-assisted analyses enable the menu planner to more easily adjust portion sizes and food components as needed to guarantee each meal meets 1/3 of the RDAs/AIs. Programs differ in comprehensiveness of database, nutrients analyzed, and ease of use.

See Creative Solutions, Nutrient Analysis Software for Menu Planning and Evaluation, for more on this topic.

What is a meal pattern?

A meal pattern is a menu-planning tool used to develop menus for a specific age group. Meal patterns should include food from each of four food groups- meat/meat alternate, vegetable/fruit, bread/bread alternate, and milk/milk alternate. Patterns can incorporate standards including: low sodium, low fat, low saturated fat, and low cholesterol as designated by State Units of Aging (SUA) guidelines. Standardized menus and recipes are essential to the plan.

How is a meal pattern used to develop a menu?

When developing a menu, each meal is required to include a variety of foods to assure that it contain at least 1/3 of the RDAs/AIs. The meal pattern is a template for the menu planner. It provides a framework of foods to include. Proper food preparation and handling should also be addressed. Detailed guidelines help to assure inclusion of all macro nutrients. Other guidance may be provided regarding meal accompaniments such as desserts, condiments including margarine, salad dressings and relishes, and beverages other than milk.

What are the benefits of using a meal pattern to develop a menu?

Meal patterns are simple and cost efficient tools that ensure the number of servings per food group are met at each meal.

What are the limitations of using a meal pattern as the only source of information to develop a menu?

For a meal pattern to function properly, meals must follow a narrow meal pattern with no deviation. This does not allow flexibility for seasonality, product availability or price fluctuation. Meal patterns can be used efficiently as a checklist. However, they do not ensure that RDAs/AIs requirements are met for protein, fat, fiber, vitamins A, B6, B12, C, calcium, magnesium, sodium, and zinc. To best ensure nutrient requirements are met and increase menu planning flexibility, computer-assisted nutrient analyses should be run.

Brief History of Meal Patterns used in OAA Nutrition Programs

It was first assumed that if a variety of foods were provided daily in specified amounts and proper food preparation and handling was practiced, the meal would provide at least 1/3 of the 1968 RDAs. The pattern became the quick checklist for determining the nutritional adequacy of a meal. Some SUAs added requirements that meals provide foods high in specific nutrients, such as vitamins A and C, as well as some other nutrients. Even with the added requirements, meal patterns still did not guarantee adequacy of all nutrients.

1972 Meal Pattern

In 2000, the Dietary Guidelines for Americans and the Food Guide Pyramid were updated and integrated. Below is the revised meal pattern based on them, including the food servings recommended in the Pyramid. However, even this pattern did not assure that the meals met 1/3 of the RDAs/AIs as required by the Older Americans Act. Meals are likely to need particular fruits and vegetables, whole grains, high-fiber, and calcium-rich foods that are known for their specific nutrient content.

Revised Meal Pattern

The Dietary Guidelines for Americans 2005 and a new Food Guidance System, My Pyramid, were recently released. In addition, the DRIs, including the RDAs/AIs, continued to be revised. Below is the USDA Food Guide for a 1600 kcal/day diet. It is designed to be in accord with the 2005 Guidelines. It emphasizes nutrient-dense foods, lean meats, low fat dairy products, and whole grains. Overall this meal pattern is designed to provide a variety of foods low in saturated fats, cholesterol, sodium (salt) and alcohol. The Guidelines allows for discretionary calories in addition to the nutrient-dense foods.

USDA Food Guide

DASH stands for the Dietary Approaches to Stop Hypertension. This food plan promotes fruit, vegetable, and low fat dairy foods and limits meat, fish, and poultry. Other high fat and super sweet foods are limited along with sodium, which is especially important for those with high blood pressure.

DASH Diet

MENU EXAMPLES TO ILLUSTRATE MEAL PATTERN
PROS & CONS

 Although all meal patterns can, when used by a food and nutrition professional, meet the RDAs/AIs and Dietary Guidelines requirements, no pattern can ensure this all the time. It is possible to follow a meal pattern and fail to meet the RDAs/AIs. Menus below are based on the 2005 USDA Food Guidance System.

• Menu #1 meets the OAA requirements of 1/3 RDAs/AIs and follows the Dietary Guidelines for Americans 2005, with the exception of vitamins D and E.
• Menu #2 follows the same meal pattern as the previous menu but fails to meet the 1/3 RDAs/AIs requirement.
• Menu #2 Revised demonstrates the changes made to meet the 1/3 RDAs/AIs requirement.

MENU #1:

MENU #1 Nutrient Analysis

MENU #1 Computer Analysis
Menu 1 used the updated meal pattern. All nutrients except Vitamins D and E meet 1/3 of the RDA/AI. RDAs/AIs for vitamins D & E are difficult to meet through dietary intake and typically require supplementation. Sun exposure is perhaps the most important source of vitamin D as it initiates vitamin D synthesis in the body. However, older adults have a diminished capacity to make vitamin D from sunlight. This further justifies the use of fortified foods and supplementation per the 2005 Dietary Guidelines. Foods high in vitamin D include fish oils, salmon, mackerel, canned tuna, sardines, fortified milk, fortified cereals and margarine. Some foods sources high in Vitamin E are nuts, salad dressing (specifically olive oil based), herring and fortified cereals. Thoughtful planning of meals with these foods reduces the challenge of meeting the RDAs/AIs.  

MENU #2:

MENU #2 Nutrient Analysis

MENU #2 Computer Analysis

Menu #2 follows the same pattern as Menu #1 did, but fails to meet requirements for fiber, folate, magnesium, potassium, zinc and Vitamins A, C, D, E and K. It also greatly exceeds the recommendation for sodium. This menu clearly demonstrates the shortcomings when meal patterns are used alone to assure compliance.

MENU #2 REVISED:

MENU #2 REVISED Nutrient Analysis

MENU #2 REVISED Computer Analysis

Using the computer analysis for Menu #2, changes were made to ensure that all RDAs/AIs standards were met. The changes maintained the style and quality of the meal and satisfied the nutrient requirements. Changing the mashed potatoes to a baked sweet potato accomplished two goals at once; it decreased sodium and increased potassium. Substituting steamed broccoli for yellow squash increased fiber, vitamins A, C, and E as well as adding more color to the plate. Replacing white bread with whole wheat bread increased fiber and also met the Dietary Guideline recommendation to include more whole grains. Dessert is an important part of overall meal satisfaction. Fresh fruit salad is both a sweet meal ending and increases the vitamin, potassium, and fiber content of the meal. Vitamins D & E are still below the 1/3 RDA/AI goal, but as discussed earlier in Menu #1, are difficult to meet with diet alone.

Computer-assisted menu planning offers greater flexibility for creating ethnically, regionally, and seasonally appropriate menus. It helps reduce repeated use of high nutrient density food items through easy substitutions and comparisons on paper. Nutritionists and registered dietitians have specific expertise in nutrition, food safety and foodservice, as well as in program administration. Their skills in interpreting computer program outputs and using nutrient analyses to improve menus should be more widely available to ensure that tasty nutritious safe meals are the hallmark of OAA Nutrition Programs. In sum, while meal patterns serve as a basic framework for menu planning, compliance with Older Americans Act nutrition regulations can only be consistently assured through computer assisted nutrient analysis.

Compiled by Barbara Kamp, MS, Melissa Coel, Omayra Berrios, and staff of the National Resource Center on
Nutrition, Physical Activity, and Aging
Florida International University , Miami , FL.
Contact: nutritionandaging@fiu.edu

December 2005

This project is supported, in part, by a grant from the Administration on Aging, Department of Health and Human Services (DHHS). Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, reflect official DHHS policy.