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Food Service Software, Nutrition Softwares, School Lunch Software

COMMITTEE ON NUTRITION STANDARDS FOR NATIONAL SCHOOL LUNCH AND BREAKFAST PROGRAMS

VIRGINIA A. STALLINGS (Chair),

The Children’s Hospital of Philadelphia, University of Pennsylvania

KAREN WEBER CULLEN,

Children’s Nutrition Research Center, Baylor College of Medicine, TX

ROSEMARY DEDERICHS,

Minneapolis Public Schools, Special School District No. 1, MN

MARY KAY FOX,

Mathematica Policy Research, Inc., Cambridge, MA

LISA HARNACK,

Division of Epidemiology and Community Health, University of Minnesota, MN

GAIL G. HARRISON,

School of Public Health, Center for Health Policy Research, University of California, Los Angeles

MARY ARLINDA HILL,

Jackson Public Schools, MS

HELEN H. JENSEN,

Department of Economics, Iowa State University, Ames

RONALD E. KLEINMAN,

Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA

GEORGE P. McCABE,

College of Science, Purdue University, West Lafayette, IN

SUZANNE P. MURPHY,

Cancer Research Center of Hawaii, University of Hawaii, Honolulu

ANGELA M. ODOMS-YOUNG,

Department of Kinesiology and Nutrition, University of Illinois at Chicago, IL

YEONHWA PARK,

Department of Food Science, University of Massachusetts, Amherst

MARY JO TUCKWELL,

inTEAM Associates, Ashland, WI

Study Staff

CHRISTINE TAYLOR, Study Director

SHEILA MOATS, Associate Program Officer

JULIA HOGLUND, Research Associate

HEATHER BREINER, Program Associate

CAROL WEST SUITOR, Consultant Subject Matter Expert and Writer

ANTON BANDY, Financial Officer

GERALDINE KENNEDO, Administrative Assistant,

Food and Nutrition Board

LINDA D. MEYERS, Director,

Food and Nutrition Board

Software for School Cafeteria

From preschool to high school, programs aim to close Minnesota’s STEM achievement gap

Hands-on educational experiences are exposing low-income students in Minnesota to the concepts and opportunities found in the science, technology, engineering, and mathematics fields.

Jacob Wascalus | Community Development Project Manager

Published January 30, 2015   |  January 2015 issue

To better prepare low-income students for the future, some educational institutions, nonprofit organizations, and for-profit companies in Minnesota are implementing programs that are intended to kindle a passion for STEM (science, technology, engineering, and math) learning, from preschool onward. (Illustration by Ann Macarayan)As the industries fueling the global economy grow more technical and complex, the educational foundation of the U.S. workforce—particularly in science, technology, engineering, and mathematics (STEM)— plays an ever more central role in our nation’s competitive position and the employability of U.S. workers themselves.

In Minnesota, the educational pipeline supplying part of this workforce has sprung a leak: Many low-income children, who account for 38 percent of the state’s K-12 public school population, are underachieving in STEM.[1] In fact, compared to other states that lie entirely within the Ninth Federal Reserve District, Minnesota holds the dubious distinction of having the largest discrepancy between low-income students and their higher-income peers in several measures of STEM-related academic performance.[2]

To better prepare these students for the future, some educational institutions, nonprofit organizations, and for-profit companies in Minnesota are implementing programs that are intended to kindle a passion for STEM learning, from preschool onward, and help close the state’s STEM achievement gap.

Measuring the gap

Gaps in academic achievement in math and science between the state’s low-income students and their higher-income peers emerge early and persist through high school, according to Minnesota Compass, a social-indicator project of St. Paul-based Wilder Research. Over the 2012–2014 period, 41 percent of low-income students achieved the fifth grade science standards established by the Minnesota Department of Education (MDE), compared to 75 percent of their higher-income peers. A similar gap appears in eighth grade math performance over roughly the same period (2011–2014): 39 percent of low-income students met the state standards, compared to 71 percent of higher-income students. And in another measure, 24 percent of low-income high school students in 2012 tested as “able” in STEM subjects, compared to 45 percent of higher-income students.[3], [4] Despite this gap in academic achievement, low-income elementary and high school students reported a greater interest in science or STEM in general than their higher-income peers.

“We have this paradox of low-income kids having an interest in STEM subjects, but we’re just not able to turn that interest into achievement,” says Allison Liuzzi, a research scientist at Wilder Research.

The achievement gap could leave low-income students unprepared to enter the workforce, especially in STEM careers. According to the Minnesota Department of Employment and Economic Development (DEED), Minnesota had approximately 340,000 STEM jobs in in 2012, or roughly 12 percent of all jobs in the state. DEED projects that by 2022, employers will need enough STEM workers to fill approximately 108,000 replacement and new jobs.[5] While that figure equates to only about one-ninth of the approximately 900,000 total replacement and new jobs it projects for Minnesota by 2022, DEED expects employers will still require workers who display problem-solving abilities and other qualities associated with STEM work, even if the jobs they fill don’t fit the STEM definition that DEED used in its analysis.[6]

“There’s a concern that we’re not actually generating the number of people we need who are qualified in STEM, or even preparing those who have an interest in STEM to be able to pursue STEM careers,” says Liuzzi.

Levels and roles

Each level of Minnesota’s K-12 educational infrastructure—the MDE, the school districts, and the teachers—influences STEM instruction in distinct but connected ways. The MDE, which sets academic standards and credit requirements for all students enrolled in public K-12 schools in Minnesota, is enhancing STEM instruction by including more technical subject matter in the academic standards it sets for each grade, such as the requirement that students use geospatial technologies in social studies. That could mean, for instance, that an eleventh grader studying U.S. history would have to use mapping software such as ArcGIS or Google Earth to generate complementary analysis for a report.

“We’ve done this with all five major subjects—math, science, English language arts, social studies, and the arts,” says Doug Paulson, STEM integration specialist for the MDE.

Schools then take the academic standards set by MDE and create curricula in order to convey the lessons, skills, and knowledge necessary for students to progress from one grade to the next. The teachers, who instruct students in these courses, then design classes to best convey the subject matter.

“The curriculum is the roadmap for getting students from what they are thinking now to what we want them to master by the end of that grade level,” says Paulson, adding that there has been a recent shift in instruction toward integrating seemingly discrete subjects so students can begin to make connections between disciplines. “Schools and teachers can enhance STEM learning as they create this roadmap and develop lesson plans.”

STEM at three stages

As of 2011, nearly 100 nonprofit organizations, for-profit corporations, university departments, and school districts offered or underwrote programs to enhance STEM instruction in Minnesota, from preschool through high school.[7] While most of these programs are available to the general student population, some are directed toward students from low-income families. Described below are three STEM programs that reach or cater to low-income students at three different age levels: pre-kindergarten, elementary school, and high school.

Starting STEM education early in life

Starting in 2012, Minneapolis Public Schools, through its Early Childhood Family Education (ECFE) programming, began offering a course designed to help three- to five-year-olds exercise their problem-solving skills through exploration, discovery, and play. Called “Preschool STEM,” the 19-week course explores each of the STEM subjects through age-appropriate activities, such as investigating different shapes and patterns to sharpen skills of prediction; using Legos, blocks, and ramps to build, evaluate, and improve models; and experimenting with tools like scissors, crayons, and tape.

But what makes this course unique is its inclusion of parents in the classroom. For the first hour of each weekly, two-hour class, parents engage in the STEM activities alongside their children. The aim of the parental involvement is to enrich the kids’ experience while helping parents develop ideas of STEM-oriented activities to follow at home. During the second hour of class, the kids continue to play and learn, under the supervision of a licensed early childhood teacher, while the parents split off to participate in a facilitated child-development discussion with a licensed parent educator.[8]

“Little children are born problem solvers,” says Maureen J. Seiwert, executive director of early childhood education for Minneapolis Public Schools. “They’re always investigating and trying to figure out how something works. This class gives us the opportunity, in a more formal way, to really help develop these cognitive skills and to answer some of the questions parents may have about helping their kids at home.”

All ECFE courses, including the Preschool STEM course, are available on a sliding fee scale to residents of Minneapolis, and no families are turned away because of an inability to pay. Approximately 80 children were enrolled in the course in its debut year, when it was offered at three sites. Last year and this year, ECFE has offered the course at two sites and the enrollment has stood at 50–60 children. Across all ECFE courses, a majority of children—54 percent—were from low-income families.

Exploring STEM through “real world” engineering

STARBASE Minnesota, a St. Paul-based nonprofit organization, promotes STEM skills by presenting a challenge to elementary school students: engineer a human mission to Mars. Working in small teams at STARBASE Minnesota’s technology-rich facility, fourth and fifth graders participate in a five-day, progressive curriculum that guides them through a range of STEM-based lessons. The students apply science and engineering concepts, integrated with math, as they use technology such as robotics, vacuum pumps, wind tunnels, engineering-design software, and 3-D printers. Licensed STARBASE instructors, who specialize in STEM, guide students through the problem solving needed to get their rockets through the Mars atmosphere, land their rovers safely, design and power their Mars colonies, and test their prototypes, all while linking the students’ work to a wide range of STEM careers. Scientists and engineers from 17 local STEM-oriented corporations that partner with STARBASE also participate by giving interactive demonstrations of how STEM is used in their industries.

STARBASE’s aim is for students to complete the program with a feeling of success in STEM, a strong understanding of what it’s like to be a scientist or engineer, and the motivation to pursue more STEM learning.

“We want to inspire kids in STEM by providing them with engaging and immersive experiences that would be difficult to replicate in the classroom,” says Kim Van Wie, executive director of STARBASE Minnesota.

Approximately 3,500 students from six school districts across the Minneapolis-St. Paul region attend STARBASE Minnesota each year; since its founding in 1993, the organization has served more than 49,000 students. And although the program is open to all, the organization’s target demographic is students from underserved backgrounds. Last year, 63 percent of students who attended STARBASE Minnesota were from low-income families. Historically, the average is 79 percent.

“Many students come to us with a limited view of the possibilities in STEM, especially engineering,” Van Wie says, noting that the STARBASE Minnesota program is free to schools. “Our goal is to help students see how successful they can be in STEM by conducting the exciting work of real scientists and engineers. We hope to inspire students to pursue more STEM throughout their middle school, high school, and post-secondary years and to realize the vast opportunities in STEM that await them in the future.”

On-the-job STEM learning

What’s the best way to jumpstart a young adult’s career in the information technology (IT) field? To Genesys Works, a national nonprofit organization that operates an office out of St. Paul, the answer is clear: with a job.

Genesys Works trains minority and low-income twelfth graders in the basics of IT and then places them at local businesses to complete a paid, year-long internship in a role that requires problem solving and interpersonal communication, such as PC deployment, desktop support, or help desk operations. The program provides students with an employment record; exposes them to soft skills necessary to successfully work in a professional environment; and, critically, teaches them essentials of the technical know-how that a career in IT requires—skills like the fundamentals of hardware, software, networks, and information security.

“We’ve found that the experience of succeeding in a professional work environment really helps our students feel that there is a future for them in this type of work,” says Jeff Tollefson, executive director of the Twin Cities office of Genesys Works. “They begin to connect the dots to see that in order to get one of those jobs full-time, they need to take the appropriate steps after high school.”

According to Tollefson, 95 percent of their interns attend some form of post-secondary school. Over the course of their senior year, they all convene biweekly to discuss their post-high school plans with Genesys Works’ counselors. During these meetings, the counselors talk to students about how to choose the right college and also provide help in filling out financing and scholarship applications.

Since its Twin Cities operation opened in 2008, Genesys Works has grown from placing an initial class of 11 student interns to placing 220 in 2014; historically, 90 percent of these students come from low-income families. Each intern works about 20 hours per week and earns $9,000–$10,000 for the year. The roster of businesses that employ interns from Genesys Works—47 to date—includes companies such as Target, 3M, and UnitedHealth Group.

“When we find students who have motivation and we connect them with meaningful opportunities, we see that magic can happen,” says Tollefson. “A lot of the people in the STEM pipeline might come from families whose parents are already working in a STEM field. But not our students. This job is a pretty life-changing opportunity for them.”

Not just a matter of equity

According to Wilder Research’s Liuzzi, the inquisitiveness that lends itself to a STEM career must be nurtured throughout the educational experience, for all students. Doing so is not just a matter of equity but is imperative for the future competitiveness of the U.S. economy.

“We know that there is a lot of opportunity in STEM, particularly as we look at occupational projections over the next decade or so,” she says. “We’re going to have a lot of positions to fill, and if we don’t close those gaps in achievement now, we’re not preparing ourselves to fill the jobs that we know we’re going to have down the road.”

STE(A)M for all

In many school districts, STEM-intensive programs are only available through optional enrichment classes or specialized magnet schools. But in one Minnesota district, STEM-intensive instruction is now a stage in every student’s K-12 career. In 2013, Austin Public Schools in Austin, Minn., opened I.J. Holton Intermediate School, a STEAM school (the “A” stands for “arts”) for all of the fifth and sixth graders in the system. In addition to teaching the core academic standards established by the Minnesota Department of Education, instructors at Holton follow a STEAM-heavy curriculum that challenges students to approach their schoolwork as an engineer would: with creativity, persistence, collaboration, systems thinking, communication, and ethical considerations.

“These are all habits of mind inherent in engineers,” says John Alberts, executive director of educational services for Austin Public Schools, “and they are very much STEM ways of thinking.”

Nearly 60 percent of the students who attend Austin Public Schools are from low-income families. For the stakeholders who championed the construction of Holton, access for all students was a top priority.

“Because of the demographic makeup of our student body, we felt it was important for all students to be exposed to this curriculum,” says Alberts. “We didn’t want it to be a school of choice or a choice program within the school itself. Ultimately, every fifth and sixth grade student who goes to public school in Austin will be exposed to the STEAM curriculum.”

A one-stop shop for STEM online

Parents, students, teachers, and businesses can learn more about Minnesota-based STEM educational resources by visiting www.mn-stem.com, a newly launched web site created by the Minnesota Department of Education, Boston Scientific, and the Minnesota High Tech Association. The online information portal aims to be a one-stop shop for all things STEM education, providing content such as profiles of STEM enrichment programs and information on connecting teachers who have STEM resource requirements with businesses that can meet those needs.

[1] Throughout this article and its sidebars, students are considered low-income if they are eligible for free or reduced-price school lunch. According to the U.S. Department of Agriculture, the eligibility threshold for free school lunch for the 2014–2015 school year for a family of four is a household income of $23,850 or less; for reduced-price lunch, the income threshold is $44,123.

[2] The National Center for Educational Statistics provides state-level data on students’ performance in the National Assessment of Educational Progress. See more at nces.ed.gov/nationsreportcard/states.

[3] “Able” students were those who met science and math benchmarks, as established by ACT, Inc., the organization that develops the ACT college readiness assessment. ACT, Inc., considers students to be lower-income if they have a self-reported family income of less than $50,000, a threshold that captures all of the students eligible for free- or reduced-price lunch but possibly includes some students who are not eligible.

[4] For more information about the academic achievement gap in STEM, visit www.mncompass.org/education/stem/disparities/income-status.

[5] DEED uses the Workforce Information Council’s definition of STEM jobs, which categorizes them as “Core” occupations or “Health Care” occupations. For more on this, visit www.labor.idaho.gov/publications/Exploring_High-Tech_Industry.pdf.

[6] DEED employment outlook projections can be viewed at apps.deed.state.mn.us/lmi/projections.

[7] To learn more about the programs available in Minnesota, visit www.starbasemn.org and click on “STEM Inventory of Local Programs.”

[8] For more information about ECFE and its STEM course, visit ecfe.mpls.k12.mn.us/general_information.

Software for School Cafeteria

Summer Food Service Program (SFSP)

Summer Food Service Program (SFSP)

SFSP 2016 v2During the school year, over 312,000 Minnesota children are eligible for free or reduced-price meals through the National School Lunch and School Breakfast programs. However, when the school year ends for the summer, these children may not have access to the nutritious meals they need.

The Summer Food Service Program provides free meals to children 18 and under to fill this gap.

Looking for a free meal near you?

SFSP Find a Summer Meal Site
Finding Free Summer Meals for Kids Is EasyUse the Summer Meal Map to find a free meal site near you, or call or text 612.516.3663 for locations!

Español

Para información sobre las comidas de verano para niños, visite el sitio de internet http://summerlunchmap.2harvest.org/, llame al 612.516.3663, o envíe un mensaje de texto con la dirección de su hohar al 612.516.3663.

Soomaali

Wixii akhbaar la xiriirta cuduntada lacag la’aanta ah ee caruurta loogu talagalay ee dugsiyada xiliga xagaaga waxaad ka eegtaa http://summerlunchmap.2harvest.org/, ama soo wac 612.516.3663, ama cinwaanka aad ku nooshahay fariin ahaan ugu soo dir lambarkaan 612.516.3663.

Hmoob

Yog xav paub txog kev noj mov dawb thaum lub caij ntuj so rau cov me nyuam, mus saib rau ntawm http://summerlunchmap.2harvest.org/, hu 612.516.3663, los sis sau koj qhov chaw nyob hauv xov tooj xa mus rau 612.516.3663.

Interested in starting or expanding an SFSP?

Catch a MealBecoming a sponsor of the Summer Food Service Program allows you to make a difference in your community and provide free meals to kids.

Minnesota

Wisconsin

SFSP sponsor grants

Thanks to our partners and supporters, Second Harvest Heartland is thrilled to be able to offer grant funding to new and experienced SFSP sponsors. Although Second Harvest Heartland’s 2016 grant application is now closed, please check back in spring 2017 for summer 2017 funding opportunities. With questions on the grant application or process, contact Child Hunger staff at 651.403.6060.

Best Practices & Tips for Sponsors

In an effort to support sponsors, Second Harvest Heartland has compiled a list of resources to facilitate a SFSP sponsorship. Click here to find creative ways in which previous sponsors have used grant funding, as well as links to futher information on best practices

Outreach materials

Second Harvest Heartland has outreach materials available for distribution in order to increase the participation at meal sites in your community. Outreach materials do not have year specific information and can be distributed multiple summers. To request or see outreach materials available, click on the link below.

Outreach poster

Second Harvest Heartland has an 11″x17″ poster available for download. (Note: Download the pdf file to the computer and print poster from file source in order to print in the correct size and dimensions.)

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: Mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; Fax: (202) 690-7442; or Email: program.intake@usda.gov.

This institution is an equal opportunity provider.

Customer Satisfaction, Food Service Software, Nutrition Softwares

Associations Between School Meals Offered Through the National School Lunch Program and the School Breakfast Program and Fruit and Vegetable Intake Among Ethnically Diverse, Low-Income Children

Ramona Robinson-O’Brien, PhD, RD, Assistant Professor,a Teri Burgess-Champoux, PhD, RD, LD, Lecturer,b Jess Haines, PhD, MHScRD, Instructor,c Peter J. Hannan, MStat, Senior Research Fellow,d and Dianne Neumark-Sztainer, PhD, MPH, RD, Professore
Author information ► Copyright and License information ►
The publisher’s final edited version of this article is available at J Sch Health
See other articles in PMC that cite the published article.

Abstract

BACKGROUND

Despite evidence in support of the health benefits associated with fruit and vegetable (FV) intake, national data indicate that FV consumption among school-aged children is below recommended levels, particularly among low-income children. School meals offered through the School Breakfast Program and National School Lunch Program can provide an important contribution to child FV intake. This study examines the proportion of fruits and vegetables consumed from school meals programs among ethnically diverse, low socioeconomic status children.

METHODS

Participants (n = 103) included fourth to sixth grade boys and girls from 4 urban elementary schools in St. Paul, Minnesota serving primarily low-income populations. Research staff interviewed children during school hours and recorded dietary intake via 24-hour recall. Analysis included descriptive statistics using cross tabulations and means.

RESULTS

Average reported mean (SD) daily FV intake was 3.6 (2.5) servings, with 80% of children consuming fewer than 5 daily servings of FV. On average, children consumed over half of their daily FV intake within school. Children with low FV intake (<5 FV servings daily) consumed a higher proportion of their daily intake at school than children with higher FV intake (≥5 FV servings daily) (39% vs 59%; p = .002).

CONCLUSIONS

Child FV intake is below recommended levels. School meals provide an important contribution to the daily FV intake among ethnically diverse, low socioeconomic status children, particularly among those with the lowest FV intake. School meals programs promoting FV intake within the school environment may provide an opportunity to encourage increased FV consumption.

Keywords: child nutrition, fruit and vegetable intake, school cafeteria, 24-hour recall

Despite the evidence in support of the health benefits associated with fruit and vegetable (FV) intake,1 national data indicate that FV consumption of school-aged children is below recommended levels.2 The dietary goals identified by Healthy People 2010 include increasing the proportion of youth who consume ≥2 daily servings of fruit and ≥3 daily servings of vegetables.3 Based on National Health and Nutrition Examination Survey (NHANES) data (1999–2000), the estimated mean daily intake of fruits and vegetables among boys and girls aged 9–13 years was 3.7 servings and only 18% to 20% of children in this age group consumed 5 or more daily servings of fruits and vegetables.2 Furthermore, youth from families with low socioeconomic status are likely to consume the fewest daily servings of fruits and vegetables.4 Based on Consumer Expenditure Survey data (1991 and 2000), per person FV expenditures were significantly less for low-income households compared to other households; $3.59 per capita per week versus $5.02, respectively.5

Although reported student satisfaction with breakfast and lunch could be improved,6 school meals provide an important contribution to the daily FV intake among ethnically diverse, low socioeconomic status children. School meals offered through the School Breakfast Program (SBP)7 and the National School Lunch Program (NSLP)8 make fruits and vegetables available to children from low-income households at a free or reduced rate. In 2006, the NSLP provided nutritionally balanced, low-cost or free lunch to more than 30 million school children.8 It is the position of the American Dietetic Association that the NSLP and SBP are a particularly important source of nutrients for school-age children from low-income families and state that the nutrition goals of the NSLP and SBP should be supported and extended through school wellness policies that enable students to develop lifelong healthful eating habits.9 In three school-based interventions, the lunch meal accounted for approximately 15% to 30% of the total daily intake of fruits and vegetables among school-aged children.10–12 Recent research conducted by the Food and Nutrition Service of the United States Department of Agriculture suggests that elementary school participants in the NSLP were more likely than nonparticipants to consume fruit juice at breakfast and consume at least 1 vegetable at lunch.6 This study provides further examination of the importance of school meals within a specific population believed to be at increased risk for inadequate intake of fruits and vegetables. This investigation examines the contribution of NSLP and SBP to FV intake between male and female fourth to sixth grade students using data from an ethnically diverse, primarily low-income sample of public elementary school children within an urban area in the United States.

The aim of this study examines associations between child daily FV intake and location of eating occasion (school vs nonschool) in a sample of ethnically diverse, low socioeconomic status, fourth to sixth grade students. The following research questions were addressed in this study: (1) What is the total daily FV intake in this population; (2) What proportion of the daily FV intake is consumed at school; (3) Does FV intake differ by gender, race, age, or weight status?; and (4) What role do school meals play in contributing to FV intake among those with the lowest FV intake?

METHODS

Study Population and Design

The study population for these analyses included 103 children (78 females, 25 males) in fourth to sixth grade (ages 9–12) from 4 urban elementary schools in St. Paul, Minnesota, serving primarily low-income populations who participated in an evaluation of the Ready. Set. ACTION! (RSA) program, a theater-based intervention aimed at obesity prevention.13 The present investigation utilizes baseline data collected prior to the intervention. Approximately 90% of the students at each school qualify for free or reduced school lunch.14 Nearly, all (102 of the 103 participants) consumed the school lunch provided by the NSLP while a smaller proportion (61 of the 103 participants) consumed school breakfast. The mean (SD) age of the male and female children included in these analyses was 10.5 (1.1) and 10.2 (1.1) years, respectively. The child self-reported ethnic distribution was as follows: African-American 53% (n = 55), Asian/Hmong 12% (n = 12), White 8% (n = 8), Hispanic 3% (n = 3), and mixed/other 24% (n = 25). Written consent was obtained from parents or primary caregivers for their child to participate in the study. The study population included a sizable proportion of overweight students with 56% of males and 36% of females with body mass index (BMI) ≥85th percentile for age and gender. The children also signed a written assent form.

Assessment of Dietary Intake

Dietary intake was assessed using a 1-day 24-hour dietary recall collected by research staff using Nutrition Data System for Research (NDS-R) on Tuesday—Friday to ensure that only weekday eating patterns were recorded. Dietary recalls were utilized to obtain a record of the type and number of foods and beverages consumed by participants during a complete 24-hour period (from midnight to midnight) for the day preceding the interview. Dietary interviewers trained by the Nutrition Coordinating Center (NCC) used NDS-R dietary data collection computer software to obtain 24-hour dietary recalls from participants via face-to-face interviews utilizing a standardized multiple-pass approach in which NDS-R displays computer prompts to assist interviewers in following a consistent, systematic approach. Interviews were conducted during the school day and took 30–45 minutes to complete. Participants were shown standardized food portion models to assist in estimating amounts of food consumed.

The school meals program provides children with opportunities to eat school breakfast, lunch, and snacks at school. The 24-hour recall data were analyzed using the NDS-R software, version 2006 (University of Minnesota, St. Paul, MN). Servings of fruits, vegetables, and total fruits and vegetables were calculated using the food group serving count system based on the 2005 Dietary Guidelines for Americans. A summed score was created for total FV servings.

Fruit Intake Measure

Fruit servings are defined per the Dietary Guidelines for Americans 2005 as 1 medium apple, banana, orange or pear; ½ cup of chopped, cooked, or canned fruit; ¼ cup of dried fruit or ½ cup of fruit juice. Fruit servings include fruit and juice consumed separately (plain) and in fruit salad, but did not include fried fruits.

Vegetable Intake Measure

Vegetable servings are defined per the Dietary Guidelines for Americans 2005 as 1 cup of raw leafy vegetables, ½ cup of other cooked or raw vegetables, or ½ cup of vegetable juice. Vegetable servings include vegetables and vegetable juice consumed separately (plain) and in recipes containing vegetables, eg, stew, soup, lasagna, pizza, salad, casseroles, and commercial entrees, but did not include fried vegetables such as french fries.

Assessment of BMI

Height and weight measures were assessed by trained research staff using standardized equipment and procedures.15 Age and sex-specific BMI z-scores were calculated based on the Centers for Disease Control and Prevention growth charts, which are age and sex specific.16

DATA ANALYSIS

Descriptively we present the mean intake of fruit, of vegetables, and of fruit and vegetables combined as servings per day (mean and standard deviation) in total and as the proportion of the total eaten at school. These data are then stratified separately by gender, race, age, and weight status. A final stratification contrasts those with the highest FV intake of ≥5 fruits and vegetables per day versus those consuming less than 5 daily FV servings. The cutoff of 5 servings per day was based on the dietary goals identified by Healthy People 2010 which include increasing the proportion of youth who consume ≥2 daily servings of fruit and ≥3 daily servings of vegetables.3 At present, some government-led campaigns no longer specifically promote the consumption of 5 servings of fruits and vegetables per day, and instead focus on a “more is better” message.17

The focus is on the proportion of healthful intake coming from the school meals program, and how this differs across personal characteristics (gender, race/ethnicity, age, weight status) and intake. Analysis of variance was used to generate p-values. The inclusion of p-values for differences in the combined FV intake is primarily used to direct attention to aspects of the data of greater interest, first of differences in daily intake, and secondly in differences of the proportions attributed to the school meals program, rather than for strict statistical testing. Note that in calculating the mean proportion, individual proportions are weighted equally, not by the amount of intake per individual. For example, a participant with a low total intake of fruits and vegetables may have a high proportion coming from the school meals program. SAS Version 9.1 (SAS Institute, Inc., Cary, NC) was used for all analyses.

RESULTS

Daily FV servings consumed by fourth to sixth grade children are shown in Table 1. Average reported mean (SD) daily FV intake was 3.6 (2.5) servings. Children consumed over half of their daily FV intake within school (54%). Daily FV intake among males (3.0 servings) was lower than FV intake among females (3.7 servings). The observed proportion of daily FV consumed at school among males and females were 64% and 51%, respectively (p = 0.09). Of 103 children, 82 (80%) consumed fewer than 5 daily servings of FV. When compared to children with higher FV intake (≥5 FV servings daily), children with lower FV intake (<5 FV servings daily) consumed a higher proportion of their daily intake at school (34% vs 59%) (p = .002). In this small dataset, daily FV intake and proportion of FV consumed at school did not differ statistically by gender, race, age, or weight status.

Table 1

Daily Fruit and Vegetable Servings Consumed by Fourth to Sixth Grade Children and Proportion Consumed at School (N = 103)

DISCUSSION

The primary aim of this study was to examine the cross-sectional associations between child FV intake and location of eating occasion for ethnically diverse, low socioeconomic status school-aged children. Findings suggest that for this population, the school meals program provided an important contribution to overall daily FV intake. The majority of participants reported low FV intake, with only 20% consuming ≥5 FV servings per day. Study participants consumed≥more than half of the daily FV intake at school. The school meals program appears to be particularly important for students with the lowest level of FV intake. Participants with the lowest daily FV intake consumed a significantly greater proportion of FV at school than students with the highest daily FV intake.

Findings indicating low levels of FV intake among children in this study are consistent with national data which indicate that boys and girls ages 9–13 consume 3.7 FV servings/day and only 18% to 20% of children in this age group consume 5 or more daily servings of fruits and vegetables.2 Children in this study consumed greater than 50% of their daily FV intake within the school setting. Previous studies have reported that the lunch meal accounted for an approximate range of 15% to 30% of the total daily FV intake.10–12 School meals offered through the SBP7 and the NSLP8 may provide an important opportunity for increased FV consumption. Previous research suggests that participants in SBP were more likely than nonparticipants to consume 100% fruit juice or some type of fruit for breakfast, compared with nonparticipants.6 Furthermore, about half of all NSLP participants consumed at least one vegetable at lunch, compared with 23% of nonparticipants; however, this pattern was primarily driven by increases in the consumption of potato foods, such as french fries and tater tots.6 The vegetable measure utilized in this investigation excludes fried vegetables (eg, french fries), and yet accounts for 44% of the daily vegetable intake among study participants.

The findings from this study, in conjunction with previous research6 underscore the importance of the School Meals Program for all children, but particularly for children from low-income families. School meals may have the greatest impact on the FV intake for children who may not have a high level of home FV availability and accessibility4,18,19 or exposure to parental modeling of FV intake.4,19–22 This issue becomes of even greater importance during hard economic times when families are making difficult decisions about how best to allocate financial resources. Some families may perceive fruits and vegetables as a costly option when compared to other more energy dense foods. A major strength of this study is the specific focus on children from low-income and ethnically diverse backgrounds who participated in the School Meals Program and who may be at greatest risk for low FV intake.

Limitations

Dietary intake was assessed using 24-hour recall data collected by research staff; however, it was limited to a single day and did not include direct observation. Furthermore, FV servings were somewhat lower than the self-reported daily FV intake reported in a companion survey completed by the children.23 This may have been due in part to the exclusion of fried potatoes from the vegetable 24-hour recall measure, or to bias due to self-report. Finally, because this study utilized a small convenience sample and did not control for a variety of possible confounding variables, we are unable to make generalizations beyond the population measured. A larger sample size may have provided additional insight into associations among participants with differing demographic characteristics and FV intake.

Conclusions

The majority of children consumed fewer than 5 daily servings of fruits and vegetables. School meals provided an important contribution to the daily FV intake among ethnically diverse, low socioeconomic status children, particularly among those with the lowest FV intake. School meals programs promoting FV intake within the school environment may provide an opportunity to encourage increased FV consumption.

IMPLICATIONS FOR SCHOOL HEALTH

The findings from this study support previous research indicating that school breakfast and school lunch make an important contribution to overall dietary intake of youth. Promoting nutrition education messages within the classroom and cafeteria and providing students with multiple opportunities to select fruits and vegetables at school lunch and school breakfast may lead to increased FV consumption long-term and assist in reducing childhood obesity and food insecurity.

Research results support and encourage the ongoing efforts of school administrators, educators, and school food service personnel to embrace the tremendous opportunity to expand and enhance programs promoting increases in intake of fruits and vegetables.

Schools are an ideal venue to promote improvements in FV preferences and increased FV consumption among elementary-aged children. In the past decade, a wide variety of school-based, multicomponent interventions have been developed to promote increased FV intake among elementary school children.11,12,24–26 Future research should involve continued investigation of the most effective intervention strategies aimed at promoting increased FV intake among school-aged children.

Policies and strategies designed to promote and strengthen school meals programs should be encouraged and supported. Recent legislation has prompted a review of the impact of school meals on nutritional intake of youth,27 thus it is an ideal time to consider opportunities to strengthen the school meals program.

Given the positive impact that the school meals program may have on the dietary intake of children we need to also examine dietary intake outside of the school year and promote alternative programs to parents to sustain the FV intake of children year-round. A greater emphasis on establishing school-home partnerships may further contribute to the promotion of health-enhancing habits among youth.

Acknowledgments

Human Subjects Approval Statement This study was approved by the University of Minnesota’s institutional review board and the Saint Paul Schools Research Committee.

This study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases and by the National Institutes of Health. The first author’s time was supported a grant from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

REFERENCES

1. Van Duyn MA, Pivonka E. Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: selected literature. J Am Diet Assoc. 2000;100(12):1511–1521. [PubMed]
2. Guenther PM, Dodd KW, Reedy J, Krebs-Smith SM. Most Americans eat much less than recommended amounts of fruits and vegetables. J Am Diet Assoc. 2006;106(9):1371–1379. [PubMed]
3. Healthy People 2010 . Understanding and Improving Health. 2nd ed US Department of Health and Human Services; US Government Printing Office; Washington, DC: 2000.
4. Rasmussen M, Krolner R, Klepp KI, et al. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: quantitative studies. Int J Behav Nutr Phys Act. 2006;3:22. [PMC free article] [PubMed]
5. Blisard N, Stewart H, Jolliffe D. Low-Income Household’s Expenditures on Fruits and Vegetables. US Department of Agriculture; Economic Research Service; Washington, DC: 2004. [Accessed July 27, 2010]. Available at: http://www.ers.usda.gov/Publications/AER833/.
6. Gordon A, Fox M, Clark M, et al. School Nutrition Dietary Assessment Study-III: Vol. II: Student Participation and Dietary Intakes. US Department of Agriculture; Food and Nutrition Service; Office of Research; Nutrition and Analysis; Alexandria, VA: 2007.
7. USDA [Accessed June 20, 2008];School Breakfast Program. Available at: http://www.fns.usda.gov/cnd/breakfast/.
8. USDA [Accessed June 20, 2008];National School Lunch Program. Available at: http://www.fns.usda.gov/cnd/lunch/.
9. Pilant VB. Position of the American Dietetic Association: local support for nutrition integrity in schools. J Am Diet Assoc. 2006;106(1):122–133. [PubMed]
10. Bere E, Veierod MB, Bjelland M, Klepp KI. Outcome and process evaluation of a Norwegian school-randomized fruit and vegetable intervention: Fruits and Vegetables Make the Marks (FVMM) Health Educ Res. 2006;21(2):258–267. [PubMed]
11. Cullen KW, Watson K, Baranowski T, Baranowski JH, Zakeri I. Squire’s Quest: intervention changes occurred at lunch and snack meals. Appetite. 2005;45(2):148–151. [PubMed]
12. Perry CL, Bishop DB, Taylor G, et al. Changing fruit and vegetable consumption among children: the 5-a-Day Power Plus program in St. Paul, Minnesota. Am J Public Health. 1998;88(4):603–609. [PMC free article] [PubMed]
13. Neumark-Sztainer D, Haines J, Robinson-O’Brien R, et al. `Ready. Set. ACTION!’ A theater-based obesity prevention program for children: a feasibility study. Health Educ Res. 2008;11 [PMC free article] [PubMed]
14. Minnesota Department of Education [Accessed March 2006];School and District Statistics. Available at: http://education.state.mn.us/MDE/Data/Data_Downloads/School_and_District/Schooland_District_Statistics/index.html.
15. Lohman T, Roche A, Martorell R. Anthropometric Standardization Reference Manual. Human Kinetics Books; Champaign, IL: 1988.
16. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, et al. CDC growth charts: United States. Adv Data. 2000;(314):1–27. [PubMed]
17. [Accessed July 27, 2010];Fruits and Veggies, More Matters. Available at: www.fruitsandveggiesmorematters.org.
18. Cullen KW, Baranowski T, Owens E, Marsh T, Rittenberry L, de Moor C. Availability, accessibility, and preferences for fruit, 100% fruit juice, and vegetables influence children’s dietary behavior. Health Educ Behav. 2003;30(5):615–626. [PubMed]
19. van der Horst K, Oenema A, Ferreira I, et al. A systematic review of environmental correlates of obesity-related dietary behaviors in youth. Health Educ Res. 2007;22(2):203–226. [PubMed]
20. Cooke LJ, Wardle J, Gibson EL, Sapochnik M, Sheiham A, Lawson M. Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children. Public Health Nutr. 2004;7(2):295–302. [PubMed]
21. Fisher JO, Mitchell DC, Smiciklas-Wright H, Birch LL. Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes. J Am Diet Assoc. 2002;102(1):58–64. [PMC free article] [PubMed]
22. Hanson NI, Neumark-Sztainer D, Eisenberg ME, Story M, Wall M. Associations between parental report of the home food environment and adolescent intakes of fruits, vegetables and dairy foods. Public Health Nutr. 2005;8(1):77–85. [PubMed]
23. Robinson-O’Brien R, Neumark-Sztainer D, Hannan P, Burgess-Champoux T, Haines J. Fruits and vegetables at home: child and parent perceptions. J Nutr Educ Behav. 2009;41(5):360–364. [PMC free article] [PubMed]
24. Weber Cullen K, Baranowski T, Rittenberry L, et al. Socioen-vironmental influences on children’s fruit, juice and vegetable consumption as reported by parents: reliability and validity of measures. Public Health Nutr. 2000;3(3):345–356. [PubMed]
25. Reynolds KD, Franklin FA, Binkley D, et al. Increasing the fruit and vegetable consumption of fourth-graders: results from the high 5 project. Prev Med. 2000;30(4):309–319. [PubMed]
26. Perry CL, Bishop DB, Taylor GL, et al. A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children. Health Educ Behav. 2004;31(1):65–76. [PubMed]
27. Child Nutrition and WIC Reauthorization Act of 2004 [Accessed February 1, 2007];2004 Available at: http://www.fns.usda.gov/TN/Healthy/108-265.pdf. [PubMed]
Food Service Software

That’s Progress — Advancements in Hospital Foodservice By Maura Keller

By Maura Keller
Today’s Dietitian
Vol. 11 No. 8 P. 28

Today’s successful programs are catering to patients’ unique needs and safety, using technological innovations to streamline processes and personalize meal selection.

New technologies and innovative products can keep any industry fresh, and the hospital foodservice industry is no exception. Medical facilities, both large and small, are embracing technological advancements in food preparation, distribution, and safety. By doing so, they are impacting the health and well-being of their most important customers: the patients.

Current Trends
Gone are the days of paper menus on which patients, with pencil in hand, would “check” their menu choices. These days, hospitals are increasingly taking a more personalized approach to menu selection, preparation, and distribution. That’s because in a rapidly changing foodservice environment where products and merchandise can quickly become obsolete, staying on top of technology and trends is vital to the success of a foodservice program. Changes in the products, advances in technology, a focus on healthy living, and advancements in food safety can contribute to a profound shift in the way hospital chefs and dietitians operate their programs.

According to Sharron Lent, RD, vice president of patient and clinical services for ARAMARK Healthcare, the industry is seeing dining trends that are based on providing freshly prepared items, which are driving hospital foodservice operations to migrate from more batch-style cooking to models such as room service. This, in turn, is designed to allow patients to order what they want to eat, when they are ready to eat.

“This shift to a more individualistic foodservice delivery model has improved the quality, freshness, and convenience of hospital foodservice,” Lent says. “From an ARAMARK Healthcare perspective, our recipes were developed in partnership with The Culinary Institute of America, our internal culinary design team, and chefs across the country working in our partnering facilities to meet the special nutritional requirements of respective patient diets.”

Montefiore Medical Center in Bronx, N.Y., has recently started an a la carte food cart that plates and serves food right on the unit. “We offer breakfast, lunch, and dinner at alternating units,” says Chris Trivlis, director of foodservice at Montefiore Medical Center. “Our breakfast cart includes the preparation on the floor of fresh waffles, fresh fruit, hot cereals, eggs, French toast, bacon, and sausage. The smells are incredible.”
At Montefiore Medical Center, a foodservice advocate visits patients on special diets to try to customize their wants to the nutritional guidelines—in other words, giving them something more palatable within their dietary restrictions.

“Over the past few years, our operation has evolved from room service to what I call ‘a la carte service,’” says Stephen Bello, CEC, CCA, AAC, certified culinary administrator at South Nassau Communities Hospital in Oceanside, N.Y. “Our menu has numerous offerings, such as ethnical cuisine, comfort foods, and wholesome selections. All of our soups are prepared with the freshest ingredients using garden-fresh, local ingredients. When approaching special diets, our philosophy is simple: fresh, homemade selections minimizing the use of fat and sodium. We want our patients to taste the food. All of our deli and salad offerings are made to order. All menu selections come to the kitchen electronically. This system optimizes freshness and minimizes waste.”

Embracing Technology
High-end computer technologies are having a powerful impact on today’s hospital foodservice. For example, ARAMARK Healthcare has partnered with software companies to develop applications to manage the entire food production process—from ordering and receiving food to producing a final product. “This technology enables us to better manage cost, quality, and nutritional content of the food we are preparing,” Lent says.

The production system that ARAMARK Healthcare uses is designed to manage cost, quality, and nutritional outcomes and is integrated with their room service model. “To accommodate a room service approach, more and more hospitals are redesigning their back-of-the-house kitchen, moving away from the traditional timed assembly system to prepare meals more like a hotel does,” Lent says.

More of the kitchens at ARAMARK Healthcare’s partner hospitals are designed so that meals can be cooked to order and delivered when the patient wants to eat. Traditional kitchens prepare fixed menus in large quantities and serve to patients during fixed delivery periods, from 11 am to 1 pm.

“With the traditional model, if the patient is at a test or happens to be resting, they may not have a great meal experience,” Lent says. “With a room service approach, they can order when they like and have a fresh meal cooked to their liking and have it delivered when they want it.”

Montefiore Medical Center has a computer program that converts the doctor-prescribed diets for each patient into a menu. The meals are delivered to the floors on a specially designed cart that is heated on one side and refrigerated on the other. “This way, the foods stay hot and stay cold without blending temperatures on one tray,” Trivlis says.

Going one step further, South Nassau Communities Hospital’s delivery system has the ability to electronically track food from the time it leaves the kitchen to its delivery to the patient. “So if Mrs. Smith calls and wants to know where her food is, we have the ability to identify the tray’s location,” Bello says.

According to MaryPat Wais, RD, LDN, an ARAMARK foodservice manager at Central DuPage Hospital in Winfield, Ill., the hospital is providing patients with a room service menu that is available from 6:30 am to 6:30 pm. “Patients can call the room service call center anytime based on hunger, treatment schedules, their usual home routine, etc,” she says. “It allows patients to have control over their care and decisions.”

This has allowed for less wasted food because patients are calling when they desire the meal, not a day or hours before. In turn, Central DuPage Hospital can spend the extra food cost dollars on better quality and variety.

“The menu allows for over 33 options, and there are 12 different menus available to meet the specific needs of patients with diet restrictions,” Wais says. “The room service software allows the call center to take the order, the software interfaces with the hospital’s medical record system to ensure proper diet restrictions, allergies, and patient preferences are compliant. It then prints the ticket in the kitchen at three places, so the meal can be freshly made to order by the production staff. This ensures the meals are freshly prepared and reduces waste.”

What’s more, Central DuPage Hospital is using an automated robotic TUG, partnering with the company Aethon, to deliver meal trays to the patient unit. As Wais explains, a hostess receives the tray from the robot and delivers it to the patient. Aethon’s TUG Robotic Automated Delivery System is utilized to deliver meals between various locations within a hospital. The TUG’s computer has onboard maps with dedicated pathways and waypoints that the TUG uses to travel between two locations. While en route to a destination via these pathways, the TUG travels through hallways and utilizes an elevator to travel between floors.

“This technology has allowed the hostess more time to assist patients, improving the meal experience,” Wais says.

Advancements in Food Safety
If you’ve worked elsewhere in the foodservice industry—flipping burgers, tossing pizzas, or creating four-course meals—you know the important role cleanliness plays in creating a quality product. Just like you would never cook a fresh burger on an uncleaned fish grill, you also should never improperly store, cook, or handle food. Of course, food safety is a top priority for foodservice industry professionals within the medical industry. And technological advancements in refrigeration, preparation, and allergy indicators make hospital food safety a whole lot easier.

For example, the management of a hospital diet office is linked with ARAMARK Healthcare’s food management software, which enables them to integrate with the patient’s electronic medical records to manage nutrition care orders and take into consideration food allergies, which enhances patient safety.

“The advancements have enabled us to manage quality, nutritional value, safety, and costs more closely,” Lent says.

Likewise, Montefiore Medical Center has redesigned the trayline for maximum tray accuracy and temperature control. “The census increases dramatically at certain times due to such things as ‘swine flu,’ and we have to be able to feed all patients on a timely basis,” Trivlis says. Montefiore also continually monitors temperatures, proper food handling, and overall food safety from delivery to preparation to serving the patient.

While food safety is a priority for any foodservice facility, foodservice employees’ safety is also vital. “In 2008, my team and I started a program called Culinary Ergonomics. The program assessed all areas of the operation and concerns relating to physical repetitive trauma,” Bello says. “My philosophy was that if an athlete prepares himself before the big game, then why wouldn’t members of my cooking team prepare themselves physically to meet the demands of foodservice? Since then we have evolved; we have specific stations in the kitchen where employees can take a short window of time and stretch before or during their shift.” Team members who have become ambassadors of this program wear the ergonomic “patch” on their uniforms.

As part of the hospital foodservice industry, you know how critical cleanliness is to patients’ health. Unswept floors, soiled tables, and employees with poor hygiene can have a dramatic effect on all facets of a foodservice operation. The same can be said for the food safety equipment. While patients may not see how clean a hospital’s foodservice equipment is, they can certainly taste it.

Currently, South Nassau Communities Hospital’s foodservice department has implemented Anamac humidity control systems in its refrigeration and freezer units. “This technology has reduced airborne bacteria, reduced compressor run times, and increases the shelf live of food 100%,” Bello says. “The system also reduces the risk of employee slips and falls associated with wet floors.”

On the Horizon
Improved efficiencies in nutrition, foodservice technology, and patient satisfaction is the “name of the game” for hospitals.

“Hospital food programs have improved with new delivery systems, new computer programs, and new products from different vendors,” Trivlis says. “I envision meals on demand similar to hotel room service.”

Other facilities have embraced additional ways to facilitate their operations from a technological and environmental perspective.

Last year, Bello developed a program called Culinary Organizational Objectives Through Knowledge, or COOK for short, whereby each month someone from his culinary team presents to the group a technique, cuisine, regional ingredient, etc. “This avails members of the team to hone in on their presentation skills, as well as the sharing of knowledge,” Bello says. “Many of the presentation ideas have been incorporated into patient specials.”
Bello also developed an initiative called Controlling Our Spending Through Stewardship, or COSTS. Every week, he presents to the department a specific area of the food market that is volatile. “This knowledge gives our frontline employees a better understanding of costs at work and at home,” he says.

From a technological and ecological perspective, Bello’s kitchen has spearheaded the hospital’s green initiative. “Things like recycling paper, bottles, cans, shrink wrap, cardboard, and paper have proven to eliminate excess tonnage from the waste stream,” Bello says. “And our ‘Power Up Power Down’ energy awareness campaign has been contagious. Great things are happening at South Nassau Communities Hospital, thanks to the vision of our president and chief executive officer, Joseph Quagliata, and administration. They truly understand that food plays a major role in the recovery of our patients. They have and continue to support technology, education, and all of our wonderful initiatives.”

Speedy Solutions
With the hectic pace of the medical industry, speed-scratch cooking is one of the hottest cuisine trends. Speed scratch is, by definition, a system of combining value-added food products with fresh fruits, vegetables, and other components to create unique, signature dishes. Value-added products can be anything from preportioned cuts of veal to premade sauces to frozen dough products.

The concept of using convenience food products to enhance dishes is not revolutionary; home cooks have been using packaged mixes for gravy and canned soups in casseroles for decades. But what is new is the growing acceptance by medical foodservice personnel of using value-added products to cut prepping and cooking times. And in an industry where good help is hard to find, using convenience products to lessen the labor and time involved in food preparation makes sense.

Today’s marketplace allows hospital foodservice operators to choose exactly what level of value-adding they want—from recipe-building sauces and seasonings to fully prepared meal components. Popular examples of commercial ingredients used in speed-scratch cooking include frozen pastas, seasoned rice, packaged sauces, canned tomatoes, and bread and pizza dough.

With the right ingredients and proper preparation, speed-scratch cooking offers an ideal way to integrate value-added ingredients with fresh foodstuffs to create unique, flavorful menu options. Together with some of the latest technologies, foodservice entities within the medical industry are making significant strides in food handling and overall nutritional options for patients.

— Maura Keller is a Minneapolis-based writer and editor.

Cafeteria Software, Food Service Software, Software for Cafeteria

Infinity Retail Café Renovation and Expansion at Aurora Medical Center Kenosha in Kenosha, Wis.

Written by Donna Boss, Contributing Editor

A small linear retail location barely met the needs of visitors and staff at Aurora Medical Center Kenosha for many years. But an ever-expanding outpatient population paired with the hospital’s expansion to 73 inpatient beds eventually rendered the existing space insufficient.

Aurora-Kenosha-Cafeteria-and-Servery-1The mobile cash register station can be moved to the end of the hot food station. This allows the entire retail area to remain open and staffed with one person during weekends and evenings when transactions are low. Photo courtesy of Zimmerman Architectural Studios, Milwaukee, Wis.“The café was outdated, selections were limited due to café design and equipment necessity, customer flow was congested and café seating was limited,” says Bruce Parker, system retail and catering manager, Aurora System food and nutrition services. “We wanted a café with a fresh new look and to expand the space to disperse retail customers more evenly. And we wanted to create a retail experience that would help drive higher revenues and increase customer satisfaction.”

Finding the space to expand and meet goals of what was named Infinity Café proved challenging for the project team. “The coffee shop had a linear shape with only one service line, and back access only to bakery and cold cases,” says Christine Guyott, FCSI, RD, principal at Robert Rippe & Associates, the project’s foodservice design consultant. “Therefore, the space didn’t allow staff to change to self-serve options in low-volume traffic periods. Additional space was critically needed to make this into a right-size retail café.”

However, the project could not add any additional space to the building, so the design team used a former seating space to enlarge the servery to 1,235 square feet. The café also includes a 1,500-square-foot seating area that can accommodate 88 people. A corridor divides the seating area in half, yet allows natural light to penetrate into both areas. A new café feature is a private dining room.

Five Stations and Versatile Equipment

Aurora-Kenosha-Cafeteria-and-Servery-2Creative planning, such as shaping the salad bar to fit in a limited amount of space, opens up space for multiple menu options. Photo courtesy of Zimmerman Architectural StudiosThe larger space allows for increased and better traffic flow, giving customers much more room to see menu options, which also increased substantially. For example, a grill station with a flattop features a new gourmet burger concept called Hungry Burgers as well as daily specials. The entrée station contains an exhibition action station featuring healthy entrées and salads made to order.

Another popular new feature, the display cooking station, necessitated adding an exhaust hood onto the existing building. “This was the biggest challenge so we added it toward the back where it could be the most easily accommodated,” Guyott says.

A new sub concept named First Edition Grinders adds to menu items available in a deli area that also features specials made to order. Naan Za, a new gourmet pizza concept, features naan pizza crust with a variety of toppings.

The hot food and deli stations back up to the kitchen. The positioning allows staff to easily replenish the stations’ food items via a pass-through hot/cold unit from the adjacent kitchen. Refrigeration sits beneath the grill, flattop and charbroiler providing staff with easy access to ingredients during production. Refrigerated prep tables at the hot station and sandwich station also contribute to staff easily moving cold food prep from the kitchen into this space during down times.

Aurora medical center dining-RoomCustomers can choose among 88 dining seats, including single countertop seats overlooking the exterior courtyard, 2-tops for more privacy, banquettes of 2 or 4 for flexibility, a large table for group settings and several 4-tops. Photo courtesy of Aurora Medical Center Kenosha; photography by Bruce ParkerStaff working at the hot food and deli stations use high speed ovens as an alternative to fryers, versatile hot and cold wells, pass-through hot/cold units, open-air merchandising units, shaped steam pan inserts and serving casserole pans.

“Space was still limited so there was a focus on the use of lineal countertop space for merchandising,” Guyott says. “We designed a uniquely shaped salad bar that customers access for salad on the front side and snacks on the back side.” Customers can select from 40 rotating and occasionally themed menu items at the salad bar, which contains color-coated aluminum inserts.

The café also features a dessert station and cold and hot beverages.

Another labor-saving solution puts the cash register station on wheels so staff can move it to the end of the hot food station. “This allows the entire retail area to remain open and staffed with one person during weekends and evenings when transactions are low,” Guyott says.

The renovation generated a 33 percent increase in retail revenue during the past year. “Traffic is up in part by the addition of a new cashless employee-debit system and the acceptance of credit card transactions in the café,” Parker says. With the realization that staffing resources will continue to be crucial to support the new café, he adds, “This renovation project demonstrates that with sound planning and great project partners, an investment like this is bound to pay dividends both in increased revenue and customer satisfaction and loyalty.”

Facts of Note

  • Size of Hospital: 73 beds
  • Daily retail meal transactions: 360 average; up to 450 peak
  • Average check: $4.14
  • Hours of operation: 6:30 a.m. to 6:30 p.m., Monday through Friday; 7 a.m. to 2:30 p.m., Saturday and Sunday
  • Staffing: 2 until 10:30 a.m.; 3 from 10:30 a.m. until 11:30 a.m.; 4 for lunch from 11:30 a.m. until 2 p.m.; 3 until 2:30 p.m.; 2 until 3 p.m.; and 1 from 3 p.m. to 6:30 p.m.
  • Website: www.aurorahealthcare.org

Innovators

  • At Aurora Kenosha: Lisa Schairer, director of support services; Bruce Parker, corporate retail and catering manager, Aurora System food and nutrition service; Margaret Muske, site leader
  • Foodservice design: Robert Rippe & Associates, Minneapolis; Christine Guyott, FCSI, RD, principal; Joy Enge, RD, senior equipment specialist; and Amy Fick, senior project manager.
  • Architect: Zimmerman Architectural Studios, Milwaukee
  • Equipment dealer: Boelter Companies, Milwaukee
Software for School Cafeteria

Hometown Heroes: Pizzas and Subs coming to Hemingford

Wordware Inc, is the best lunch software provider.

Amber Ningen, Editor

Anyone up for some freshly made pizza?

Soon you’ll be able to grab pizza, subs and more at a new pizza place/sandwich shop in Hemingford!

Hometown Heroes: Pizzas and Subs will be opening at 404 Niobrara on Sunday, May 1.

Owner Roger Christianson, who owns the business with Beth Dahl, said all the renovations have been done for about a week. All that’s left to do is some paperwork and getting the food in the coolers ready to make.

Christianson said the excitement and positive comments from everyone has them eager to get the doors open and the food devoured.

So why the name Hometown Heroes: Pizzas and Subs? Christianson is a big fan of Superman and other super heroes. Dahl says he is always trying to get new super hero stuff and thinks he has finally found a way to do it. Seriously, though, it’s a play on the word heroes (subs). Christianson said they have only been here for a couple years and are always amazed at the true hometown feel of Hemingford.

“It’s more than a place to live, it really is home,” he said. “We also hope to find some of our true hometown heroes. We are thinking of having a sort of drawing where you can nominate your favorite hero and you and they would win a free lunch.”

Christianson decided to take on this business venture after he was approached with an amazing opportunity.

“It’s always been my dream to have my own family run shop and coupled with the ability to bring some delicious variety to Hemingford, we just couldn’t say no,” he said.

If you’re looking for a place to go eat on Sundays, Hometown Heroes: Pizzas and Subs will be a great place to go as it will be open from 11 a.m. to 8 p.m. Christianson said they knew they wanted to be open on Sundays.

“We are really trying to bring options and variety to Hemingford so this was important to us,” he said.

The pizza place/sandwich shop will be open every day except Mondays. Christianson said they are willing to tweak their schedule as necessary, such as staying open later on Fridays or Saturdays or opening earlier on Sundays.

“We really just need to see what the community wants and needs,” he said.

The business will offer a $5 lunch special Monday through Friday. Customers will also have the option to text in their order!

Dahl, who is a paraeducator at Hemingford Schools, will plan on continuing there as she really enjoys working with the students. She will be at the pizza place/sandwich shop in her free time. Christianson will be at the business full time. Their son, Rhett, will also be a main helper down at the shop.

“He’ll be sure to greet everyone that comes in,” Christianson said.

Christianson’s mom, Sue, will also be down helping out. Christianson said she has tons of experience in the pizza industry and will be a great asset.

“Besides, Rhett’s kind of fond of his grandma,” Christianson said.

The biggest challenge Christianson sees for this business venture will be exceeding everyone’s expectations.

“The amount of support we have already is amazing and figuring out what works and what doesn’t might take us a little bit of time, but we know we can get there,” he said.

If you’d like to keep up to date with Hometown Heroes: Pizzas and Subs, be sure to give them a “Like” on Facebook by searching Hometown Heroes: Pizza and Subs.

All in all, Christianson and Dahl are picturing this shop as a place where everyone can come in and enjoy good food and hang out.

“We are thrilled to have this opportunity. I can’t imagine doing this anywhere but here,” Christianson said. “Although we haven’t been here long the amount of support and excitement that we are getting really make us positive that this is where we want our hometown to be.”

 

Software for School Cafeteria

Making School Lunch Healthy and Tasty on a Shoestring

Wordware Inc is the best in providing School Lunch Software

Oakland and W. Contra Costa school districts are innovating more nutritious, less fatty meals that kids will like

Think of Jennifer LeBarre as the general of the Oakland Unified School District’s food service.

Every day, she marshals an army of 300 employees who prepare, cook, deliver and serve 21,000 lunches (and 6,500 breakfasts) to 107 schools, some with as few as 35 students and others with more than 1,000. She must devise meals for schools that have no kitchens to warm up hot food as well as those with warming ovens.

As director of the district’s nutrition service, LeBarre crafts weekly menus that she hopes will satisfy all constituents: federal and state agencies that set guidelines on student nutrition, school administrators, parents and, last but not least, her customers—the students. She must do all of this without spending more than about $1.20 for the food on the plate – less than half of what some wealthier districts spend.

“It’s difficult to please all the people,” said LeBarre, in an obvious understatement.

These days, LeBarre is tackling a challenge that would defy many a chef: creating more-nutritious meals that aren’t more expensive. She’s determined to use more scratch cooking, fresh fruits and vegetables and whole grains, and even vegetarian options. The healthier choices are not always embraced by the kids, at least not right away, but LeBarre is among the many school-food professionals who are taking very seriously their role in attacking childhood obesity and related ailments.

In the past few years, in fact, school lunch reform has become a cause célèbre in many school districts in the Bay Area as concerns mount about children’s health. And the Oakland school district, along with the West Contra Costa County Unified School District, is among the pioneers in injecting healthier food choices into their menus despite a paucity of resources and the challenges of re-educating taste buds.

School lunch funding in districts where many of the students are low-income is provided primarily by the National School Lunch Program, operated by the U.S. Department of Agriculture. A revised school lunch law signed amidst much fanfare by President Barack Obama in January increases the federal reimbursement – but only by 6 cents per lunch, to a total of $2.81. The state provides another 22 cents; the $3.23 total must cover not only the food itself, but also labor — the single most expensive ingredient in producing meals — and overhead.

Schools also rely on commodities provided by the USDA, like surplus cheese, and fruit from a special program begun by former Sen. Hillary Clinton that sends surplus from local military bases.

“Once, we got bags of fresh apple slices—a ton of them—and put them on the menu three times,” said Lisa Maloney, a supervisor in the West Contra Costa County schools district nutrition service. “The kids were getting sick of them.”

Low-income school districts face a double-edged challenge: the don’t have the money for fancy food, but they have a higher percentages of kids who are overweight, as measured by the state’s physical fitness tests.

Among Oakland and West Contra Costa district students, more than a third were considered overweight in school year 2008-2009, according to the state’s fitness test. Healthy school lunches may not be a cure-all for such problems, but they play an important role in children’s and teen’s daily diet and nutrition education, says Gail Woodward-Lopez, associate director of the Center for Weight and Health at UC Berkeley.

“Children that eat federally reimbursable lunches tend to have better nutrition than kids who don’t,” said Woodward-Lopez. “School lunch does lead to more healthful eating.” A study published by the American Heart Journal in September 2010 backs her up. It found that the best ways to combat childhood obesity were to increase physical activity, reduce amount of time watching TV or a compute monitor, and improve the nutritional value of school lunches.

A Better Bean Burrito

Lisa Maloney recalls that when she started her job in West Contra Costa County a few years ago, she discovered her meals had competition from a neighborhood store. “One of my schools had an outside vendor coming in and selling authentic Mexican food to the students,” she said. “The kids were texting their orders and the restaurant would deliver to the front door of the school.”

She went to the principal and the school delivery was stopped.

The districts’ schools have closed campuses, and Maloney aims to capture as many customers as possible for the lunch program. “This is a revenue raising department,” she said. “We have to be raising as much as possible.” School districts contribute some money to the school nutrition service when the budget permits, but in lean times, that funding support is slashed, she explained.

Maloney, a nutritionist, supervises 10 schools and 10 different menus—including elementary, middle and high school breakfasts and lunches. Her department serves 16,000 lunches a day to students, 65 percent of whom qualify for the free or reduced cost. The full cost of a lunch, including an entrée, two sides and milk, is $2 for elementary students and $2.50 for middle and high schoolers. The sides include fresh fruit, fruit juice, lettuce and tomato cup and fruit juice bars. And for this, the department has an annual budget of $600,000 to spend just on food—about 80 cents to $1 per meal, says Barbara Jellison, director of the nutrition service.

The rest of the lunch sale price includes employee salaries, utilities, and transportation. Several trucks are employed driving prepared meals from the central kitchen in Richmond to schools around the county. The central kitchen does some scratch cooking and also prepares bagged lunches for schools that have no kitchen facilities to warm up hot meals. The total annual budget is $11 million.

Because the district participates in the federal school lunch program, it can only charge enough to cover costs. Jellison says they use a software program to create weekly menus that satisfy nutritional guidelines set by the USDA. No more than 30 percent of calories can come from fat and less than 10 percent from saturated fats. Lunches must provide one third of the recommended daily allowance of protein, vitamins, iron, calcium and calories.

Maloney sets the bar higher than federal guidelines anyway. She wants to completely eliminate three ingredients from their menus: hydrogenated oils, high fructose corn syrup and isolated soy protein—a plant-based protein.

“I guess I should include sodium in there, too,” she said.

She has been trying out more vegetarian offerings and working on incorporating brown rice and more whole grains into menus, but the kids vote with their mouths. “It’s hard. If you want to raise the fiber content to 50 percent or more, it will be a dry product,” she said. “I’m not going to lie to you. We have chicken nuggets. Kids will eat them.” But she is pushing for prepared foods with lower sodium content by pressuring the vendors who sell to the district. “Manufacturers just want to sell their products. They’ll only change if we force them to,” Maloney said.

Recently, she said, her staff sampled a new bean and cheese burrito to include on the menu, and it tasted great when the sales rep offered it. But when they ordered some, the burritos weren’t as good, and had a high amount of isolated soy protein, the cheap filler that Maloney wants to eliminate.

“The manufacturer does a bait-and-switch. They bring in the Cadillac version of the burrito for us to sample,” she said. “So, we’re going with a different bean and cheese and beef burrito.”

Cooking from Scratch—for 21,000

Jennifer LeBarre took over as director of nutrition services for the Oakland public schools five years ago. She’d begun in 1998 and worked as a field supervisor, managing 25 sites. There were three central kitchens until budget cuts this year forced one to close. Now, there is one at Prescott Elementary and one at Oakland High. Some schools have no kitchens or cafeterias, and kids eat their lunch in multipurpose rooms. Some school kitchens have only ovens to re-heat prepared foods, while others do 80 percent of their cooking or assembly on site. She’s a proponent of scratch cooking as much as she can be, given limited resources.

In 2005, the federal lunch program encouraged school districts to design their own wellness policies, and Oakland took on the task in part, LeBarre said, because “we also started worrying about childhood obesity.”

Oakland school menus now feature Meatless Mondays, offering pasta primavera, vegetable stir-fry and bean and cheese burritos as alternatives. “We don’t emphasize what’s not there,” she said. “ We tell them, ‘you don’t need beef or pork or chicken to have a complete lunch.’” Brown rice is a regular feature, as is tofu. A vegan stroganoff fell flat with students, but she’s working with a vendor in Davis to concoct a quiche that kids will gobble down. She has a process for choosing new foods. “Can we afford it? Can we do it in our facilities? Does it meet wellness policy? And will students like it?” she said.

Like Lisa Maloney, LeBarre won’t jettison the tried and true lunchtime favorites, such as hot dogs and hamburgers. But she is also working to make the old favorites into healthier, leaner versions. So, Oakland students can choose turkey or chicken dogs, and the hamburgers served have more beef and less cheap soy filler. LeBarre says she’s looking at grass-fed beef as a lower fat alternative, if her budget allows it. And budget is the bottom line.

The federal reimbursement for low-income students barely covers the costs of serving nutritious meals, and because of the economy, for the first time in many years the district has seen the number of eligible students increase. In the last two years, 4 percent more students are eligible for free lunches, LeBarre said. “In the Bay Area, a lot of families can’t afford even the 40 cents for a reduced-cost lunch,” she said. “For a family of four, it becomes a road block.” In Oakland, the full-price lunch costs students $3 in middle and high school and $2.25 in elementary school.

Oakland has many schools in which 85 percent or more of students qualify for free or reduced-cost lunches, so under the federal Provision 2 program, all students in the school eat for free. “There is a lot of talk at the national level about eliminating the ‘reduced’ category,” LeBarre said, which would mean allowing kids in that category to eat for free, too.

Like many school nutrition services directors at Bay Area schools, LeBarre is anticipating the arrival of new school lunch nutrition standards, which are part of new federal school lunch law.

The problem, said Phyllis Bramson, nutrition service director for the state education department, is that while the new guidelines are good, they are also more costly.

“The IOM [Insitiute of Medicine] said the cost of additional whole grains and fruits and vegetables would cost in the neighborhood of 20 cents per meal,” Bramson said. “Six cents is a wonderful carrot, but it’snot going to cover the additional cost.”

LeBarre said that 6 cents more adds up to about $230,000 extra in her budget, but she’ll need $1.3 million to serve lunches that meet the new standards. “There’s a disconnect between the cost and reimbursements,” she said. “If we were going to do food like Berkeley’s schools, we’d need $2.09 more per meal.”

Meanwhile, she is committed to experimenting with new foods, pushing the envelope of what Oakland students know and like. “We’re going to be doing taste testing with sushi,” LeBarre said. “We’ll try out California rolls and vegetarian rolls at Fremont High.”

This is the second in a series of articles on school lunch and nutrition. The articles were produced as a project for The California Endowment Health Journalism Fellowships, a program of USC’s Annenberg School for Communcation & Journalism. Next: In Piedmont and Orinda, when money is no object, healthy, tasty food is on the menu.

Software for School Cafeteria

It’s time to invest in schools – and food service programs

More than half the schools in the United States are spending less per pupil this year than they were in 2008 when the last Great Recession hit. While there are many reasons for these spending cuts, the fact that the country as a whole is more than $46 billion behind in infrastructure support and improvement is hard to ignore.

As experts all over the country begin to discuss how important it is that we return to funding our children’s education, we also know that it’s important that we spend money more efficiently than we have in the past. Too many administrators still look at food service programs as a frustrating part of their day to day operations, instead of the exciting opportunity to influence our kids to make healthy lunch choices while providing the district with valuable data about what is and is not working in the school nutrition program.

Get teachers back to what they should be doing

Many teachers express frustration with the amount of paperwork they need to do around school lunches. Between placing lunch orders, communicating with parents about what their children should be getting, and trying to orchestrate the free and reduced meals programs, teachers have the right to be frustrated.

Whereas many lunch programs offer the ability for parents to pay ahead and online, MySchoolAccount also gives kids and parents the ability to pre-order their meals. This saves paperwork time for teachers, and helps kids make healthier choices.

Reduce waste by planning ahead

Schools provide meals to the vast majority of American kids during the school year. There is an obligation for schools to provide healthy choices to kids, but the struggle can be getting kids to choose healthier items.

Studies have shown, however, that when kids place their orders early in the day instead of needing to make a choice in the lunch line, they’re more likely to experiment with new foods, and are more likely to choose healthier options.

Let the food service program lead the charge in improving the school’s infrastructure

Schools that have happy, healthful, efficient nutrition programs have happier, more involved parents and healthier kids with fewer behavior problems. There’s a lot more about our schools that needs to be revamped and revitalized to get them back up to the standard our children deserve, but serving healthy meals without breaking the school’s budget is a great way to take a big step forward.

Nutrition Softwares, School Lunch Software, Software for Cafeteria

Cafeteria software helps schools curb food waste

Wordware’s School Lunch Software, Point of sale software can help cut down on wasted food.

Wasted food is a significant problem for food service establishments, especially public school cafeterias. Food can only be left out for a certain amount of time and excess is tossed. Plate waste is also an issue, as students take more than they often eat. While donating the extra to food banks seems to be one option, legal and health considerations make that infeasible.

Those at some of the nation’s largest school districts have sought to tackle the problem. Teresa Wantabe discusses the situation at Los Angeles Unified and the steps administration has taken in a Los Angeles Times article. The nation’s second-largest school system, Los Angeles Unified serves 650,000 meals a day. However, food waste is a real problem for the district.

“Students throw out at least $100,000 worth of food a day — and probably far more, according to estimates by David Binkle, the district’s food services director,” writes Wantabe. “That amounts to $18 million a year — based on a conservative estimate of 10% food waste — which Binkle says would be far better spent on higher-quality items, such as strawberries or watermelon.”

California schools are not the only districts struggling with wasted food. Forty-percent of all of the lunches served in Boston Public Schools are wasted. Moreover, it’s a problem that extends beyond schools. Nationwide, the annual cost of food waste is more than $1 billion.

While food waste is an issue that affects many service establishments, it is particularly pronounced at schools. They are also in the greatest need of solutions, as they meet new government health and nutrition regulations. New guidelines, for example, require that cafeterias serve fresh produce and fruit. Yet, this can be expensive and much of it is being wasted.

According to Cornell University and Brigham Young University’s 2013 research of 15 Utah schools, extra produce, including fruits and vegetables, costs school districts $5.4 million each day. However, $3.8 million of it is being tossed out into the trash.

Cafeteria point of sale software can help schools cut down on wasted food. Food cost calculation software can also help administrators figure out costs and make the best use of their food and nutrition budget.

by Food Service Solutions