Evaluating and simulating long-term care menus to meet nutrient- and food-based standards.

Summary

This study simulated 10,000 one-day menus from a database of 1,365 items sourced from a major North American long-term care foodservice provider to assess compliance with both LTC-specific nutrient targets and Canada's Food Guide (2019). Current menus met most macronutrient targets but fell short on overall diet quality (mean HEFI-2019 score 57%), and only six of 10,000 simulated menus achieved simultaneous compliance with both nutrient- and food-based standards. The findings highlight significant implementation challenges for LTC dietitians and food service staff, pointing to the need for LTC-specific planning tools and practical supports.

Regional applicability

This research is specific to Canadian provincial regulations and Canada's Food Guide (2019), with menus sourced from a major North American foodservice company. The findings may have limited direct applicability to United Kingdom long-term care practice, which operates under different regulatory frameworks (Care Quality Commission standards, British Dietetic Association guidelines) and the Eatwell Guide. However, the methodological approach to menu compliance assessment and the identified challenge of reconciling nutrient and food-based standards simultaneously may inform UK long-term care menu development.

Key measures

Macronutrient and micronutrient target compliance; Healthy Eating Food Index (HEFI)-2019 scores; Canadian Food Scoring System (CFSS) classification; serving equivalents of food groups

Outcomes reported

The study evaluated 28 current and 10,000 simulated long-term care menus for compliance with nutrient targets and Canada's Food Guide (2019), finding that only six menus met both nutrient- and food-based standards simultaneously. Compliant menus were characterised by higher energy provision (2,857 kcal), greater nutrient density, and a mean Healthy Eating Food Index score of 77%.

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