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FY590Elder Companion Lesson 4 Nutrition1Elizabeth B. Bolton21.This document is FCS5250/FY590, one of a series of the Depart ment of Family, Youth and Community Sciences, Florida Cooperativ e Extension Service, University of Florida, UF/IFAS, Gaines ville 32611. First published: September 1999. Re vised: January 2004. Reviewed by: Mary Ch ernesky, M.S. extension agent IV, Hillsborough County, Seffner ; Audrey Norman, c ourtesy extension agent, Palm Beach County, West Palm Beach 33415; Meredith Taylor, M.S., extension agent IV, Suwannee County, Live Oak, 32064. Please visit the EDIS Web site: http://edis.ifas.ufl.edu/ 2.Elizabeth B. Bolton, Ph.D., professor, Community Development, Department of Family, Youth and Community Sciences, Florida Coo perative Extension Service, University of Florid a, UF/IFAS, Gainesville, 32611. The Institute of Food and Agricultural Sc iences is an equal opportunity/affirmative action employer authorized to provide resea rch, educational information and other services only to individuals and inst itutions that function without regard to race color, sex, age, handicap, or national origin. For information on obtaining other extension publications, contact your count y Cooperative Extension Servic e office. Florida Cooperative Extension Service / Instit ute of Food and Agricultural Sciences / University of Florida / Christine Taylor Waddill Dean.
Lesson 4 Pg. 2 AGENTS TEACHING GUIDE Nutrition Part 1: Nutritional Health Part 2: The Food Guide Pyramid Part 3: Are My Hands Clean? Part 4: How to Measure Part 5: Food Safety...Storage and Handling Time: 2 to 3 Hours Instructor: Registered Dietician, Nutritionist, County Faculty Equipment/ Supplies: VCR/monitor; Videos-Eating Right is Basic III (available from the IFAS Media Library), How to Fight Bac! (included in Your Game Plan for Food Safety Activity kit, available from the Department of Family, Youth and Community Sciences Department); flourescent paint; black light and liquid soap; measuring spoons, cups, sugar, rice and water; transparencies created from Handouts C, E, F & G. Handouts:Part 1 FCS 8547: Determine Your Nutritional Health Handout A: Determine Your Nutritional Health Exercise Sheet Part 2 Handout B: What Did You Eat? 24 Hour Food Recall FCS 1047: The Food Guide Pyramid: A Guide to Daily Food Choices Handout C: Food Guide Pyramid for the General Population Handout D: Food Guide Pyramid Viewing Sheet FCS 8559-Eng: ENAFS (Elder Nutrition and Food Safety) Daily Food Guide Pyramid for Elders Handout E: Special Dietary Needs for Elders Part 3 Handout F: When Do I Wash? Part 4 Handout G: Liquid Measure Investigation Handout H: Dry Measure Investigation Part 5 Handout I: Food Safety IQ Test Handout J: Prevent Food Poisoning Handout K: Keeping Food Safe Viewing Sheet FCS 1081: Be Smart, Not Sorry Keep Food Safety in Mind Handout L: Check Sheet for the Kitchen and Safe Food Handling
Lesson 4 Pg. 3Objectives (Expected Outcomes): Program Participants will be able to: Evaluate their own diet in relation to the Food Guide Pyramid. Assist with planning, preparing, and serving food or meals according to the Food Guide Pyramid for Elders. Demonstrate proper hand washing techniques. Demonstrate proper measurement techniques. Demonstrate proper storage and preparation of hot and cold foods for food safety.
Lesson 4 Pg. 4LESSON PLAN Part 1: Nutritional Health Introduction: A proper diet and good nutrition can keep all of us healthy. For many older adults this is not an easy task. The warning signs of poor nutritional health are often overlooked. DO: Complete Handout A, Determine Your Nutritional Risk Exercise Sheet Distribute FCS 8547, Determine Your Nutritional Health and discuss the warning signs of poor nutrition. Have each participant total their score and compare with risk scoring on page 4 of the FCS 8547 publication. REFLECT What was your score? Were you at nutritional risk? What warning signs did you exhibit? APPLY: How will this assessment help you improve your nutritional status? How will it help you to assess the nutritional status of your elderly clients?
Lesson 4 Pg. 5 Handout A DETERMINE YOUR NUTRITIONAL HEALTH Exercise Sheet Use this checklist to determine if you are at nutritional risk. Circle the number next to each item that applies to you. I have an illness or condition that made me change the kind and/or amount of food I eat. 2 I eat fewer than 2 meals per day.3 I eat few fruits or vegetables, or milk products.2 I have 3 or more drinks of beer, liquor, or wine almost every day.2 I have tooth or mouth problems that make it hard for me to eat.2 I eat alone most of the time.1 I take 3 or more prescribed or over-the-counter drugs a day.1 Without wanting to, I lost or gained 10 or more pounds in the last 6 months.2 I am not always physically able to shop, cook, and/or feed myself.2 Total of Your Nutritional Score
Lesson 4 Pg. 6LESSON PLAN Part 2: The Food Guide Pyramid Introduction: Today we are going to explore a method of eating wh ich uses the food guide pyramid. Lets start by examining how well you are eating. Use the blank What Did You Eat? 24 Hour Food Recall sheet (Handout B) to record what you have had to eat dur ing the last 24 hours. I will guide your thinking and help you recall. (Work from the most recent meal, back 24 hours.) Put aside your recorded food recall. DO: Distribute Handout FCS 1047, The Food Guide Pyramid: A Guide to Daily Food Choices Show the Food Guide Pyramid section from the video Eating Right is Basic III and transparency created from Handout C, Food Guide Pyramid for the General Population Distribute Handout D, The Food Guide Pyramid viewing sheet When completed, distribute FCS8559-Eng, Food Guide Pyramid for the Older Adult Show transparency created from Handout E, Special Dietary Needs for Elders and distribute the handout. Discuss how the dietary needs for elders differ from those of the general population. REFLECT: Use the viewing guide to reflect and discuss. Possible Questions . What are the major food groups? How many servings of each do you need each day? Which group serves as the base of the pyramid? What counts as a serving from each food group? How is the Daily Food Guide Pyramid for Elders different from the Pyramid for the general population? APPLY: How did your food recall compare to the daily goal? What changes do you need to make in your diet according to the Food Guide Pyramid? How will you use this information in your work as an elder companion?
Lesson 4 Pg. 7 Handout BWHAT DID YOU EAT? 24 HOUR FOOD RECALLRecord the foods you have eaten in the last 24 hours. Include the amounts. Indicate the meal when the food was consumed.....B (Breakfast) L (lunch/midday) D(dinner/evening) S(snack) Meal CodeFood (indicate how prepared, i.e. fried)Amount Eaten
Lesson 4 Pg. 8 Handout CFOOD GUIDE PYRAMID FOR THE GENERAL POPULATION
Lesson 4 Pg. 9Handout DFOOD GUIDE PYRAMID VIEWING SHEET1.The bottom of the food guide pyramid is the ___________________ group. 2.You need _______ servings each day from this group. 3.Fiber comes from the Fruit, Vegetable and _____________ groups. 4.The second level of the pyramid has two food groups:___________________ and ___________________. 5.You need ______ servings from this level every day. 6.The two food groups on the third level provide _____________. 7.Milk, yogurt and cheese provide ________________. 8.Meat, Poultry and Fish provide __________________. 9.You need ______ servings from each of the two groups on the third level daily. 10.The tip of the pyramid is __________ _____________ and ________________. 11.They should be eaten in _____________________.
Lesson 4 Pg. 10FOOD GUIDE PYRAMID VIEWING SHEETAnswer Sheet1.The bottom of the food guide pyramid is the Breads, Cereals, & Pasta group. 2.You need 6-11 servings each day from this group. 3.Fiber comes from the Fruit, Vegetable and Bread groups. 4.The second level of the pyramid has two food groups: Fruits and Vegetables 5.You need 5 servings from this level every day. 6.The two food groups on the third level provide iron 7.Milk, yogurt and cheese provide calcium 8.Meat, Poultry and fish provide protein 9.You need 2-3 servings from each of the two groups on the third level daily. 10.The tip of the pyramid is Fats Oils and Sugars 11.They should be eaten in moderation
Lesson 4 Pg. 11 Handout ESPECIAL DIETARY NEEDS FOR ELDERS Dehydration and constipation are co mmon problems for elders. Older persons can reduce their risk for these conditions by drinking 8 glasses of fluids daily. Older persons need more calciu m and vitamin D. The recommended number of servings for milk, yogurt, and cheese is 3 servings per day. It is important for elders to get en ough fiber, in order to stay regular and avoid constipation. Their diet should include 2 or more servings of fruit; 3 or more servings of vegetables; and 6 or more servings of bread, cerea l, rice, pasta and viandas (starchy roots). At least half of the grain servings should be whole grain foods. Food labels will show the amount of fiber contained in packaged or canned foods. Ethnic dishes such as red beans and rice, stir-fried tofu, and arroz con pollo (rice with ch icken) allow for diverse food preferences and customs. Elders may need to supplement their diet with calcium, vitamin D and/or vitamin B12. A health professional can help older persons make this decision.Source: Linda B. Bobroff, Ph.D., RD, LD/N, Professor and Ex tension Nutrition Specialist, Department of Family, Youth and Community Sciences, and Affiliate Professor, Food Scien ce and Human Nutrition Department, University of Florida.
Lesson 4 Pg. 12LESSON PLAN Part 3: Are My Hands Clean? Introduction: Washing our hands is very important for health and cleanliness. How can you tell if your hands are really clean after you have washed them? Can you think of some specific times you should wash your hands? DO: Have the participants wash their hands with soap and water at the sink. Make sure they dry them well. Give each participant some lotion mixed with fluorescent paint to rub on their hands as they would normally. Have participants hold their hands under a black light in a darkened room. Is the lotion worked into the hands well? Have the participants wash their hands again with the soap and water. Make sure they dry their hands well. You might have half the group wash with water and the other half with soap and water for comparison. Ask the group if they are really sure that their hands are clean. Then allow them to inspect their hands again while holding them under the black light. REFLECT: Was their still paint in the cracks and around the fingernails? Most of the participants will probably still have some paint in these areas. Discuss the importance of washing these areas carefully. What did you learn from this activity? We need to make sure we do a really good job when we wash our hands Why is it important to wash our hands? To reduce the risk of spreading germs and diseases. When are some times we should wash our hands? Answers will vary (before eating, after touching an animal). APPLY: Show transparency created from Handout F, When Do I Wash? Activity sheet Distribute the handout and have the participants answer the questions. Discuss the answers with the group. How will you use your knowledge with your work as an elder companion. Share the information with your elder client.
Lesson 4 Pg. 13 Handout FWHEN DO I WASH ?Circle the correct hand to show if you wash BEFORE or AFTER what you see in the picture
Lesson 4 Pg. 14LESSON PLAN Part 4: How Do I Measure Introduction: Accurate measurement of food is essential in some situations. When elderly clients are on special diets they have a specific amount they can eat. Today, we are going to learn how to do accurate measurements. DO: Divide participants into two teams . Liquid and Dry. Liquid Team: Provide this team with a pitcher containing one quart of water, two liquid measuring cups, one dry measuring cup, and one coffee cup. Dry Team: Provide this team with two dry measuring cups, one liquid measuring cup, one coffee cup, and three cups of sugar. Distribute Handout G, Liquid Measurement Investigation and Handout H, Dry Measurement Investigation for participants to place in their notebooks. REFLECT: When are accurate measurements important? When special diets require specific food amounts. APPLY: How will you use this measurement skill in your work as an elder companion? How will you use this information personally?
Lesson 4 Pg. 15 Handout GLIQUID MEASUREMENT INVESTIGATION 1)Measure a cup of liquid into each of the following: 2)Place a second liquid cup at eye-level on a table or counter. Pour each cup into the liquid cup and record the results: Just Right More Less Liquid Cup________________________________________________Dry Cup________________________________________________Coffee Cup________________________________________________3)Conclusions:
Lesson 4 Pg. 16 Handout H DRY MEASUREMENT INVESTIGATION 1)Measure a cup of sugar into each of the following: 2)Place a second dry cup on a table or counter. Pour each cup into the dry cup and record the results: Just Right More Less Liquid Cup________________________________________________Dry Cup________________________________________________Coffee Cup________________________________________________3)Conclusions:
Lesson 4 Pg. 17LESSON PLAN Part 5: Food Safety . Storage and Handling Introduction: Foodborne illness is most commonly contracted by improper handling of food and cross contamination. Did you know that a senior citizen is at a higher ri sk for foodborne illness? We are going to explore your knowledge of various food safety practices and learn about the best practices. DO: Give each participant a copy of Handout I, Food Safety IQ Test to complete. Dont go over the answers yet. Participants will hold the quizzes until the end to see if they change their mind on any items. Show Food Safety video How to Fight Bac! Show transparencies created from Handout J, Prevent Food Poisoning and distribute the handout to the class. Discuss. Give each person a copy of Handout K, Keeping Food Safe Viewing Sheet to complete. Use FCS 1081, Be Smart, Not SorryKeep Food Safety in Mind to summarize. REFLECT: Ask participants to take out Handout I, Food Safety IQ Test, and see how their answers correspond to the video. APPLY: Ask participants to complete Handout L, Check Sheet for Kitchen and Safe Food Handling Do you need to change any of your own food safety practices? How will you use food safety practices with your elderly clients? Review the points under Safe Storage of Food.
Lesson 4 Pg. 18Handout IFOOD SAFETY IQ TESTBefore the lesson, answer the true/false statements in the left-hand column. Circle T if the statement is true; circle F if the statement is false. Fo llowing the lesson, respond to the statements by circling T or F in the right-hand column. At the conclusion of the lesson, please return this questionnaire to the instructor. You will receive an answer sheet after the lesson. BeforeStatement After Lesson Lesson T F1.Food poisoning bacteria multiply rapidly at ordinary room T F temperatures. T F2.Ground meat is less likely to contain food-poisoning T F bacteria than most fresh meat and poultry because the grinding destroys the bacteria. T F3.Hard-cooked eggs can safely be stored at room temperature T F for up to 2 days. T F4.The U.S. government guarantees raw meat is free from harmful T F bacteria. T F5.If food looks or smells strange, its okay to take a small taste T F to decide whether to use it. T F6.The kitchen counter is a good place to thaw meat because room T F temperature speeds up thawing. T F7.Extra care needs to be taken when microwave cooking pork or T F poultry. T F8.Its safe to eat raw or lightly cooked meat, fish, poultry and eggs. T F T F9.Its safe to use your hands to mix potato salad. T F T F10.Food poisoning can result from not properly cleaning, T F your hands equipment or work surfaces.
Lesson 4 Pg. 19 Handout J PREVENT FOOD POISONING Keep It Clean Wash hands with soap and hot water before handling food...especially after using the toilet. Never use plates, utensils, cutting boards and counter tops that were used for raw food without cleaning them thoroughly first. Cook It Well Use pasteurized milk. Cook meat, poultry, seafood and eggs thoroughly. Use a temperature of 325o F or above when cooking in the oven. Cook meat and poultry until the recommende d internal temperature is reached. FoodInternal Temperature Ground beef, pork, lamb 160o F Roasts and steaks of beef, veal, pork (medium)160o F Ham -Requires cooking before eating Fully cooked, to reheat 160o F 140o F Poultry -Ground chicken/turkey Whole chicken/turkey Breast turkey, chicken 165o F 180o F 170o F
Lesson 4 Pg. 20 Handout J (continued)PREVENT FOOD POISONING Dont Wait...Refrigerate Perishable foods (such as leftovers and deli items) should be at room temperature no longer than 2 hours. Cool foods such as soups and stews quickly by refrigerating them in shallow pans. Food Storage As soon as you get home from food shopping, wash your hands and put away foods that need refrigeration or freezing. Leave eggs in their carton(s) and put them in the refrigerator. Place raw meat or poultry on a pl ate to keep their juices away from other foods in the refrigerator. The temperature of your refrigerator should always be 40o F or less. Your freezer should be at least 0o or less. Leftovers Divide leftover foods into smaller portions, put in covered, shallow containers and refrigerate or freeze within 2 hours after cooking. Date leftovers. If they are refrigerated, use within 2-3 days; if they are frozen you can keep them for 2-3 months. When its time to use those leftovers, cover and reheat leftovers to 165o F. Bring sauces, soups and gravy to a boil.
Lesson 4 Pg. 21 Handout J (continued)PREVENT FOOD POISONING Food Preparation Thaw frozen meat in the refri gerator or in the microwave oven. Never thaw food on the kitchen counter. Wash towels and cloths after using, especially if you cleaned meat juices with them. Replace sponge frequently. Use one cutting board for meats and a different one for cutting vegetables. If you only have one cutting board, wash it with hot, soapy water after cutting raw meats to prevent juices from coming into contact with other foods. Marinate meats in the refrige rator, never on the kitchen counter top. Never baste meat with the marinade. Safe Shopping Never buy dented, rusty or bulging cans. Check the expiration, sell by, or use by date. Buy and use the products before this date, Buy only refrigerated, clean, uncracked eggs. Frozen foods should be frozen to the touch. Place wrapped meats away from other foods in your shopping cart.
Lesson 4 Pg. 22 Handout J (continued)PREVENT FOOD POISONING Safe Shopping (continued) Buy perishable foods (meat, poultry, seafood, frozen foods, dairy products and delicatessen) last. As soon as you are finished with the grocery shopping, go home immediately. Put food in a cooler or ice chest if it will take you more than an hour to get home. If In Doubt...Throw It Out Throw out any food that may be unsafe....especially if it will be eaten by people who are at-risk for food poisoning: -pregnant women -infants and young children -senior adults -cancer and AIDS patients
Lesson 4 Pg. 23Handout KKEEPING FOOD SAFE VIEWING SHEET1.Food poisoning has symptoms like ______________ 2._______________ causes food poisoning. 3._______________ slows the growth of bacteria. 4.Leftovers should be stored in the _____________________. 5.______________ stops bacteria from growing, but does not kill it. 6.To kill bacteria in eggs, meat or poultry, these foods must be cooked _______________________ 7.Hot foods should be kept _______; cold foods should be kept _________. 8.Hands must be washed vigorously for _____ seconds to be clean. 9.Cutting boards should be scrubbed with ________ soapy water. 10.Keep food safe from insects and animals by storing in ____________________________ 11.Food with observable mold should be _________________. 12.Food Safety Motto: When in doubt, _____________ it out.
Lesson 4 Pg. 24KEEPING FOOD SAFE VIEWING SHEET Answer Sheet 1.Food poisoning has symptoms like Flu 2. Bacteria causes food poisoning. 3. Cold slows the growth of bacteria. 4.Leftovers should be stored in the Refrigerator/freezer 5. Freezing stops bacteria from growing, but does not kill it. 6.To kill bacteria in eggs, meat or poultry, these foods must be cooked thoroughly 7.Hot foods should be kept hot ; cold foods should be kept cold 8.Hands must be washed vigorously for 20 seconds to be clean. 9.Cutting boards should be scrubbed with hot soapy water. 10.Keep food safe from insects and animals by storing in jars with tight lids 11.Food with observable mold should be thrown away 12.Food Safety Motto: When in doubt, throw it out.
Lesson 4 Pg. 25Handout LCHECK SHEET FOR THE KITCHEN AND SAFE FOOD HANDLING In the kitchen, do you: YesNo ( )( )Keep work surfaces clean? ( )( ) Keep work area orderly so that work may be done without hazard? ( )( ) Use only clean utensils in preparing, cooking and serving food? ( )( )Use clean dishcloths and towels? ( )( )Use very hot water and deterg ent to wash utensils and dishes? In handling foods, do you: YesNo ( )( )Refrigerate unused foods and clean up any spills right away? ( )( )Cover all foods that are refrigerated? ( )( )Refrigerate warm foods before they cool? Prompt refrigeration discourages growth of bacteria that occurs when foods cool at room temperature. ( )( )Cook meats until they are done? Te mperature charts are given in most basic cookbooks. ( )( )Wash fresh fruits and vegetables before using? ( )( )Check expiration dates on food packages before you buy?