Strategies for Reducing Sodium in Schools

Transcription

1 Speaker Strategies for Reducing Sodium in Schools Connie L. Evers, MS, RDN, CSSD, LD Nutrition consultant developing programs, writing materials and providing hands-on training to educators, dietitians and other health care providers, parents and school nutrition staff. Specializes in children s health and is the author of How to Teach Nutrition to Kids, 4th ed. and Nutrition Fun with Brocc & Roll, 2nd ed. Dietitian for Pediatric Associates of the Northwest, a general pediatric practice in Portland, Oregon. Named the 2013 Outstanding Dietitian of the Year by the Oregon Academy of Nutrition and Dietetics. Graduated with honors from the University of Nebraska, and completed her dietetic internship and Master of Science degree in nutrition from the University of Iowa. Overview Background Salt and our sense of taste Sodium in health and food Strategies to reduce sodium in schools Low sodium options HISTORY OF SALT Meal Patterns/Menu Planning Fresh approach to recipes 1

2 Salt - A Cultural Phenomenon What is Salt? Salt is a mineral composed of sodium and chloride Sea Salt Himalayan Salt Kosher Salt Fleur de Sel Table Salt Salt = Salt What is it About Salt that Makes it so Desirable? Genetics we re born with it Taste preferences are innate Likely developed to meet a physical need Acquired Early dietary experience influences the preference for salty Enhances other flavors Salt vs. Sodium: What s the Difference? Salt is made up of about 40% sodium and 60% chloride Salt is the most common source of sodium in the diet No other ingredient except water is as widely distributed in food as salt 1 teaspoon of salt weighs ~6 grams and contains about 2,300 milligrams of sodium Gary K. Beauchamp, Monell Chemical Senses Center, 8thPangbornSensory Science Symposium, July 26, 2009 Dietary Guidelines for Americans

3 Sodium has an Important Role in Food & Beverages SODIUM AND FOOD Food preservation and safety Aides in texture Acts as a binder Fermentation control Stabilizer Color development Increases palatability/ enhances other flavors Sodium Consumption in the American Diet 2010 Dietary Guidelines for Americans recommend 2300mg of sodium/day (~1 tsp of salt) According to the CDC, Children eat about: 15% of sodium at breakfast 30% at lunch 39% at dinner 16% at snacks Recent research reviewed by the Institute of Medicine questions how much is too low. Dietary Guidelines for Americans 2010; IOM Committee Report on Sodium Intake in Populations: Assessment of the Evidence May 2013; CDC Vital Signs Sept Calories (kcal) Sodium (mg) 6-10 years of age Calories (kcal) Sodium (mg) years of age Calories (kcal) Sodium (mg) years of age Sodium comes from Different Food Sources Fats, Oils, Salad Dressings 3% Dry Bean, Peas, Legume, Nuts, Seeds 3% Crackers and Salty snacks from grain products 3% (% total diet ) Total American Population, 19+ Cakes, Cookies, Pies, Pastries 3% Pastas, cooked cerealsrice 3% Quick Breads Other Beverages 2% 4% RTE Cereals 2% Eggs 2% Yeast Breads, Rolls 7% Non-Yogurt Milk Products 8% Vegetables 12% Pancake, waffle, french toast, other grain products 1% Meat, Poultry, Fish 31% All Other Grains 16% NHANES Day 1 3

4 Function of Sodium in the Body Helps maintain fluid balance and adequate hydration in the body Helps transmit nerve impulses SODIUM AND HEALTH Influences contraction and relaxation of muscles Kidneys work to regulate sodium balance Excess sodium passes through urine Certain conditions can affect the body s normal handling of sodium Advancing age Health conditions Consumption of other nutrients Sodium and Blood Pressure in Adults Public Health Rationale for Sodium Reduction High blood pressure affects 1 in 3 adults Scientific studies suggest that sodium reduction does decrease blood pressure Not everyone is sodium sensitive Lifestyle modifications are essential Better diet (include reducing salt or increasing potassium) Regular physical activity Maintain a healthy weight Manage stress Avoid tobacco smoke Limit alcohol Sodium Intake Blood Pressure Heart Disease Risk American Heart Association Gradual reduction may help change taste acceptance in foods 4

5 Sodium and Blood Pressure in Children Why Reduce Sodium in School Meals? Children can have high blood pressure too According to the CDC, 1 in 6 children ages 8-17 years has raised blood pressure Developing healthy lifestyle early is essential Cultivate healthy eating habits Regular physical activity Maintain a healthy weight According to the CDC, about 90% of US children ages 6-18 years eat too much sodium daily. 9% of their sodium comes from school cafeteria foods The goal of school meals is to provide healthy food choices to students thus influencing lifelong eating habits. The work you do each day will carry into the future, the future of every student served Target 1 of USDA s mandated sodium limits are now in effect CDC Vital Signs Sept 2014; American Heart Association CDC Vital Signs Sept 2014; SNDA IV USDA Sodium Reduction Targets Sodium Limits and Timeline SODIUM REDUCTION STRATEGIES IN SCHOOLS Target 1: SY Breakfast 540mg (K-5) 600mg (6-8) 640mg (9-12) Target 2: SY Breakfast 485mg (K-5) 535mg (6-8) 570mg (9-12) Final target: SY Breakfast 430mg (K-5) 470mg (6-8) 500mg (9-12) Lunch 1230mg (K-5) 1360mg (6-8) 1420mg (9-12) Lunch 935mg (K-5) 1035mg (6-8) 1080mg (9-12) Lunch 640mg (K-5) 710mg (6-8) 740mg (9-12) Code of Federal Regulations 5

6 Sodium Levels Vary in Different Foods Lower Sodium Food Group Milk Higher Sodium STRATEGY 1: IDENTIFY LOWER SODIUM OPTIONS Fruit Vegetables Grain Meat Meat Alternates Where to Find Sodium Values Product labels and nutrition facts panels To find the sodium values of foods without a label, such as fresh fruits and vegetables, use Food-a-Pedia USDA SuperTracker USDA Nutrient Database STRATEGY 2: MODIFY MEAL PATTERNS 6

7 Sodium Reduction Menu Challenges Breakfast Level 1 Sodium Targets How to keep student favorites Breakfast Level 1 Target (weekly menu average) K-5 <540 mg sodium Budget constraints 6-8 <600 mg sodium 9-12 <640 mg sodium Variety of foods K-8 use K-5 values Required Daily Breakfast Components Breakfast Sodium Reduction Tactics Required components: 1 cup milk 1 cup fruit 1 oz eq whole-grain rich grain* Menu must meet average daily calories, % calories from saturated fat, and sodium target for grade group Start with required breakfast components Total sodium of 1 cup each of Milk (unflavored) and fruit = 135 mg Remainder of sodium target available for additional grain(s) and other foods required to meet calorie needs K mg mg mg *weekly totals for grains can include meat/meat alternate Menu higher sodium foods with lower sodium foods Vary the grains offered Menu lower sodium meat/meat alternates 7

8 Week 1 Week 2 Breakfast Menu M T W Th F Menu Average 612 mg! WW Bagel w/peanut Butter Fruit Filled Roll (280) RTE Cereal and WW Sugar Donut and Biscuit and Sausage Gravy (370) WW Toast (300) Yogurt (310) (750) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Total: 580 mg Total: 490 mg Total: 510 mg Total: 520 mg Total: 960 mg Breakfast Sodium Reduction Tactic 1 Menu higher sodium foods with lower sodium foods Vary the grains offered Menu lower sodium meat/meat alternates Week 4 Week 3 Breakfast Menu Breakfast Sodium Reduction Tactic 2 Week 1 Tactic 1 M T W Th F WW Bagel w/peanut Butter Fruit Filled Roll (280) RTE Cereal and WW Sugar Donut and Biscuit and Sausage Gravy (370) WW Toast (300) Yogurt (310) (750) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Total: 580 mg Total: 490 mg Total: 510 mg Total: 520 mg Total: 960 mg WW Bagel w/peanut Fruit Filled Roll (280) RTE Cereal and WW Sugar Donut and Biscuit and Sausage Butter (370) WW Toast (300) Yogurt (310) Gravy (750) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Plain or Strawberry Plain or Strawberry Plain or Strawberry Plain or Strawberry Plain or Strawberry Milk (125) Milk (125) Milk (125) Milk (125) Milk (125) Total: 505 mg Total: 415 mg Total: 435 mg Total: 445 mg Total: 885 mg Menu higher sodium foods with lower sodium foods Vary the grains offered Menu lower sodium meat/meat alternates Menu Average 537 mg! 8

9 Breakfast Menu Breakfast Sodium Reduction Tactic 3 Week 1 Tactic 2 M T W Th F WW Bagel w/peanut Butter Fruit Filled Roll (280) RTE Cereal and WW Sugar Donut and Biscuit and Sausage Gravy (370) WW Toast (300) Yogurt (310) (750) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Total: 580 mg Total: 490 mg Total: 510 mg Total: 520 mg Total: 960 mg RTE Cereal (115) Pancakes (270) Oatmeal (65) Yogurt (50) Biscuit and Sausage ½ Eng. Muffin (150) Granola Bars (160) Gravy (750) Canned Fruit (5) Fresh Fruit (5) Dried Fruit (5) Fresh Fruit (5) Canned Fruit (5) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Total: 475 mg Total: 480 mg Total: 275 mg Total: 420 mg Total: 960 mg Menu higher sodium foods with lower sodium foods Vary the grains offered Menu lower sodium meat/meat alternates Menu Average 522 mg! Breakfast Menu Lunch Level 1 Sodium Targets M T W Th F Week 1 Tactic 3 WW Bagel w/peanut Butter Fruit Filled Roll (280) RTE Cereal and WW Sugar Donut and Biscuit and Sausage Gravy (370) WW Toast (300) Yogurt (310) (750) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Total: 580 mg Total: 490 mg Total: 510 mg Total: 520 mg Total: 960 mg WW Bagel w/peanut Yogurt (50) w/ RTE Cereal and WW Sugar Donut and Cheese Omelet (300) Butter (370) Granola (55) WW Toast (300) Yogurt (310) and Muffin (230) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Fresh Fruit (5) Canned Fruit (5) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Chocolate Milk (200) Total: 580 mg Total: 315 mg Total: 510 mg Total: 520 mg Total: 740 mg Lunch Level 1 Target (weekly menu average) K-5 <1230 mg sodium 6-8 <1360 mg sodium 9-12 <1420 mg sodium Menu Average 533 mg! K-8 use K-5 values 9

10 Sodium Levels in 9-12 Lunch Menu Components Daily Lunch Menu Pattern Milk: 1 cup Fruit: 1 cup 0-10 Vegetables: 1 cup processed with salt, up to 500/cup Grains per 1 oz. eq (2X) Meat/Meat Alternate per oz. eq. Sodium (mg) (2X) Grade Group Milk Offered Fruit Offered Vegetable Offered Grains Offered Meat/MA Offered Calorie Range K-5 1 cup ½ cup ¾ cup 1 oz eq/day 1 oz eq/day cup ½ cup ¾ cup 1 oz eq/day 1 oz eq/day cup 1 cup 1 cup 2 oz eq/day 2 oz eq/day Lunch Sodium Reduction Tactics Combine Products to Lower Sodium Blend onsite for lower-sodium products Use portion control for higher sodium foods Serve breakfast for lunch 10

11 9-12 Lunch Meal Example Lunch Sodium Reduction Tactic 1 piece Homemade Lasagna made with 1 oz. eq. Whole-grain Rich Noodle 10 mg 1 oz. eq. Lean Ground Beef 80 mg 1 oz. eq. Part-skim Mozzarella cheese 170 mg ½ c. Lower-sodium Tomato Sauce 300 mg 1 oz. eq. Bread Stick 130 mg 1 c. Romaine Lettuce 8 mg 1 c. Fresh Apple Slices 1 mg 1 c. Fat Free Chocolate Milk 200 mg Blend onsite for lower-sodium products Use portion control for higher sodium foods Serve breakfast for lunch Salad Dressing: 2T mg Sodium in Condiments Lunch Sodium Reduction Tactic Condiment Portion Sodium (mg) Ketchup 1 Tbsp. 190 Ranch Dressing, low fat 1 Tbsp. 150 Mustard, yellow 1 Tsp. 60 BBQ Sauce 1 Tbsp. 175 Soy Sauce 1 Tsp. 340 Blend onsite for lower-sodium products Use portion control for higher sodium foods Serve breakfast for lunch 11

12 Breakfast for Lunch STRATEGY 3: TAKE A FRESH APPROACH TO RECIPES Tips For Reducing Sodium in Recipes Tips For Reducing Sodium in Recipes Gradually reduce amounts in recipes to find least sodium and taste acceptable versions Save sodium for where it counts for taste on the surface 1. Add fresh vegetables or whole grains to prepared foods 2. Balance days with higher sodium offerings by serving lower sodium offerings 3. Start a windowsill herb garden in the cafeteria to get students interested in fresh herbs then use the herbs in low sodium dips and dressings 4. Have a flavor bar with shakers of spice blends for students to punch up their own meals. 5. Create lower sodium alternatives by adding yogurt to commercially prepared salad dressings or making your own condiments 12

13 Recipe Challenge Additional Tips How can the sodium be lower in this menu? Southwest Salad (romaine, lettuce, black beans, corn, WOW! chicken, cheese, salsa) 1100 mg Whole Grain Tortilla Chips Low Sodium Taco Seasoning on Banana meat Milk Natural cheese instead of processed Corn (canned or frozen without added salt) Black beans (canned or cooked without salt) 1620 mg Keep chocolate milk and serve whole grain cookie student favorites! Spicy cereal mix for intense flavor on top Custom Dressing: half salsa, half yogurt Be Positive Encourage everyone on staff to be positive Be excited about new options: fresh, spicy, juicy, crunchy Use exciting menu descriptors Offer samples prior to featuring on menu Bring school staff onboard - enlist their help! Offer samples at a meeting or in-service Recap Salt and our sense of taste Sodium in health and food Low sodium options Meal Patterns/Menu Planning Fresh approaches to recipes 13