10A ncac 06K .0203 MENU PLANNING REQUIREMENTS

(a) Agencies providing congregate nutrition or home delivered meal services must comply with the following menu planning requirements:

(1) Each meal served shall contain at least one-third of the current daily Recommended Dietary Allowances as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences. If a nutrition program provides additional meals, then the nutrient analysis of the combined food items may be used to document that at least two-thirds of the Recommended Dietary Allowances have been provided for two meals per day or 100% of the Recommended Dietary Allowances for three meals per day, rather than each individual meal providing one-third of the nutrients.

(2) All foods must be identified on the menu in order to calculate nutrient value.

(3) The calorie content must be at least 700 calories per meal.

(4) The sodium content shall not exceed 1,300 mg per meal.

(5) Recipes for all foods used in combination must be supplied to the person responsible for certifying the menu to facilitate nutrient analysis. When recipe ingredients are changed, the recipe must be re-submitted for approval by the licensed dietitian/nutritionist.

(6) All prepared or breaded meat items or meat in combination must be specified on the menu.

(7) The form of vegetable or fruit used (fresh, frozen, dried, or canned) must be indicated on the menu for nutrient analysis.

(b) Menu Requirements

(1) All menus shall be written at least 20 days in advance of the meal and shall be certified by a licensed dietitian/nutritionist to assure the menus provide one‑third of the current Recommended Daily Allowances.

(2) All regular menus shall be submitted to the dietitian/nutritionist for review and approval at least two weeks prior to use.

(3) The approved menus shall be kept on file, with any changes in writing, for at least one year by the service provider.

(4) At least one hot or cold nutritious meal shall be provided daily at least five days a week. Frozen, canned, dehydrated, or nutritional supplement products may also be used for emergency situations and additional or weekend meals. All frozen meals shall be dated with the delivery dates.

(5) Menus with serving dates must be posted in a conspicuous location in each congregate meal site as well as each preparation area.

(6) All menus shall be adhered to subject to seasonable availability of food items as well as availability of USDA donated food.

(1) Prior to serving a therapeutic diet, a physician's prescription written according to the guidelines in the current North Carolina Dietetic Association Diet Manual shall be on file with the nutrition service provider.

(2) Each therapeutic diet prescription shall be re‑ordered in writing by the physician every six months. Menus for each type of therapeutic diet must be written by a qualified dietitian/nutritionist. Menus for the therapeutic diets shall follow the standard set forth in the North Carolina Dietetic Association Diet Manual. These menus shall remain on file for at least one year.

(d) Each food group and amount of the following "Menu Pattern" shall be offered and must be available to be served to each participant.

MENU PATTERN FOOD GROUP AMOUNT

Meat/Meat Alternative 2 ounces cooked, edible portion or equivalent

Bread/Grains 2 servings

Vegetables/Fruits 2 servings

Fats total fat not to exceed 30% of total calories per meal

Dairy 1 serving

(1) Meat/Meat Alternative Group.

(A) The total protein content of each meal must be no less than 21 grams. Of this, 14 grams must be a "complete protein" in the form of 2 oz. edible meat, fish or poultry, exclusive of fat, bone, or gristle. One-half cup cooked drained dried beans, peas or lentils may be used as a substitute for 1 oz. of meat. One cup of dried beans may be used as a substitute for 2 oz. meat; however, a "complementary" protein source must be served at the same meal with the one cup dried beans in order to serve a complete protein (i.e., rice, corn, or cornbread). Other protein sources such as one egg or two tablespoons peanut butter may also be substituted for 1 oz. meat.

(B) Ground meat may be used in entrees no more than twice in one week. Casseroles or other mixed dishes must have ingredients specified on the menu to facilitate nutrient analysis.

(2) Bread/Grains Group. Each meal shall contain two servings of a whole grain or enriched grain product.

(3) Vegetable/Fruit Group.

(A) Each meal must contain two servings of different fruits and vegetables. When salad is served, it must be placed in a separate compartment of a compartmental tray to avoid mixing with other foods or served in a separate salad bowl. Juice may fulfill no more than half of the vegetable/fruit requirement for any one meal.

(B) One serving of vitamin C-rich food must be served twice per week. The USDA Food Values Handbook lists all foods containing Vitamin C.

(4) Fat Group. Total fat shall not exceed 30% of the total calories per meal. One teaspoon of butter or fortified margarine in an individual covered package chip or container may be used if it adds palatability to the menu. The menu must identify whether gravy, salad dressing, mayonnaise, margarine or butter is used when served.

(5) Dairy Group. Each meal must contain a total of no less than. 400 mg. calcium. This may be obtained by one serving of 8 ounces of whole, low fat, skim, buttermilk, chocolate (not chocolate drink), sweet acidophilus milk, or Ultra High Temperature (UHT) milk, fortified with vitamins A &D in an individually sealed carton, or other foods.

History Note: Authority G.S. 143B-181.1(c);

Eff. November 1, 1993;

Amended Eff. July 1, 2003;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. September 6, 2016.