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Bird Flu
What it Means
to You and Your
Clients
Nutrition
Labeling
New Changes
Are in Store
JUNE 2015
Foodservice
Marketing
Success
Strategies
& ANFP Annual
Conference &
Expo Preview
ACE&&
ORLANDO, FL | 2015
Annual
Conference
& Expo
Artificial Nutrition
& Hydration
Client Conversations
Are Key
Nutrition & Foodservice Edge | June 2015 1
®P U B L I S H E D B Y
CONTENTS
3	 Food File
7	 Leaders & Luminaries
10	 Food Protection Connection
33	 Message From the Chair
39	 CDM Spotlight
Nutrition &
Foodservice Edge
DE PARTM ENTS
16
22
28
34
June 2015 / Volume 24 / Issue No. 6
1 HOUR SAN
	 FEATURES
16	 Nutrition Labeling—Past,
	 Present, Future
	 by Linda Eck Mills, MBA, RDN, LDN, FADA
New food labeling requirements will make it easier
for consumers to determine the nutritional value
of their food choices. Categories like calories,
sugar, and serving sizes have been adjusted on the
updated label.
22	 Artificial Nutrition & Hydration:
	 Conversations With Clients and 		
	 Families
	 by Brenda Richardson, MA, RDN, LD, CD, FAND
The decision to use artificial nutrition and hydration
(ANH) is a complex issue for clients and their
families. An overview of ANH is provided, along
with useful suggestions on how to support clients
with self-directed living.
28	 Foodservice Marketing Success
	 Strategies
	 by Ruby Puckett, MA, FFCSI
Marketing your food service is an important
strategy to grow your business and improve
customer satisfaction. Strategies for promoting
your department and its many products and
services are provided here.
34	 Meet Your Incoming 2015-2016 			
	 Officers and Directors
Learn about who is leading ANFP and the
Certifying Board in 2015-2016. This article
introduces incoming national leaders, and shares
their goals for office.
Nutrition & Foodservice Edge | June 20152
New Online Courses From
ANFP
Nutrition & Foodservice Edge®
is the premier
resource for nutrition and foodservice 	
professionals and those aspiring to careers 	
in this industry. It is published by the 	
Association of Nutrition & Foodservice Professionals.
	
Editor. . . . . . . . . . . . . . . . . . . . . . . . Diane J. Everett
	 deverett@ANFPonline.org
Contributing Writer. . . . . . . . . . . Laura E. Vasilion
	 lvasilion@ANFPonline.org
Advertising Sales. . . . . . . . . . . . . . . . .  Paula Fauth
	 pfauth@ANFPonline.org
Design. . . . . . . . . . . . . . . . . . . . . . . . . . Mercy Ehrler
	 mercy@advanceddesign-online.com
Nutrition & Foodservice Edge®
(ISSN 21649669)
is published monthly except combined issues
in July/August and November/December.
©2015 by the Association of Nutrition &
Foodservice Professionals, 406 Surrey
Woods Drive, St. Charles, IL 60174.
Phone: (630) 587-6336. Fax: (630) 587-6308.
Web site: www.ANFPonline.org
Periodicals postage paid at St. Charles, IL and
additional mailing offices. POSTMASTER:
Send address changes to Nutrition &
Foodservice Edge®
, 406 Surrey Woods Drive,
St. Charles, IL 60174.
Subscription Rates
Edge subscription rate for ANFP members is $15,
which is included with annual membership dues.
Subscriptions are available to other interested
parties for $40/year or $5/issue. Outside U.S.,
contact ANFP for pricing.
Editorial Policy
Readers are invited to submit manuscripts for
publication consideration. Please contact the
editor for specific publishing guidelines. Views
expressed by contributors do not necessarily
reflect the opinion of the association.
Printed in the U.S.A.
Lynne Eddy, MS, RD,
FAND, CHE
Associate Professor,
Business Management,
The Culinary Institute
of America,
Hyde Park, NY
Richard Hynes
Director, Consultant
Services,
Hobart Corp.,
Franklin, MA
Ruby Puckett, MA, FFCSI
Director, Dietary
Manager Training,
University of Florida Div
of Continuing Ed.,
Gainesville, FL
Marty Rothschild
President,
Aladdin Temp-Rite,
Hendersonville, TN
Bob Sala
Founder and Director
at Large,
Distribution Market
Advantage,
Hoffman Estates, IL
Renee Zonka, CEC,
RD, MBA, CHE
St. Charles, IL
E DI TORI AL ADVI S ORY B OARD
®
A L SO
I N
OUR
PAGE S
10 15
More ANFP news, inspiration, and education at www.ANFPonline.org
E DITOR’S NOTEBOOK Nutrition &
Foodservice EdgeJune 2015 / Volume 24 / Issue No. 6
In a busy foodservice operation, where delivering quality meals to
hungry clients is the top priority every day, the task of marketing
your offerings may seem daunting.  But your marketing programs
don’t have to be huge or costly, they can be as simple as creating
special signage or connecting with your facility’s public relations
department for help.  Our cover story discusses basic marketing con-
cepts, and sprinkles in a few simple ideas for promoting your food
service.  Use the information and the list provided as a springboard
for planning your publicity.
Bird flu is making headlines.  Your clients or administrator may ask
you about the risks.  Our resident food safety expert, Melissa Vac-
caro, MS, CHO, separates fact from fiction beginning on page 10.  
Make sure you have the answers you need on this timely topic.
Nutrition labeling is another timely subject in our pages this month.  
The new and improved food labels highlight the information of
greatest interest and importance to consumers.  See page 16 to learn
what’s changed.
This month we cover a subject that’s not always easy to talk about
with clients: artificial nutrition and hydration.  Make sure you know
what your clients and their families want in terms of ANH.  Strategies
for discussions are provided in our page 22 article.
And finally, take this opportunity to learn about your incoming na-
tional ANFP and CBDM leaders.  You can meet them beginning on
page 34.  They’re here to serve you!
Diane Everett, Editor deverett@ANFPonline.org
Marketing is one of my favorite topics. I enjoy brain-
storming ideas and putting thoughts into action to help
promote products and services. It feels good to carry out
a successful marketing campaign.
Bird Flu and Food Safety
A
D
Nutrition & Foodservice Edge | June 2015 3
FO OD FILE
A
D
Potatoes Are
Packed with
Nutrients
AN OLD-FASHIONED summer
cookout is not always a healthy affair, but
these 10 tips from the registered dieti-
tians at New York-Presbyterian Hospital
can easily convert a fatty food blitz into
a healthy and tasty menu:
1.	 Throw some unexpected foods on the
grill such as peaches, plums, pine-
apple, watermelon, avocado, summer
squash, beets, corn, or a whole wheat
pita.
2.	 Incorporate veggies into your BBQ
menu by making veggie crudité, sal-
ads, grilled veggie kebabs, veggie or
portobello mushroom burgers, or by
wrapping your grilled meats or fish in
large leaves of lettuce instead of buns.
DID YOU KNOW potatoes are a nutri-
ent powerhouse?
According to the non-profit Alliance for
Potato Research and Education, one
medium baked potato with skin on pro-
vides 30 percent Daily Value for Vitamin
C, more potassium than two bananas,
and as much fiber as a medium stalk of
broccoli. E
3.	 Cut the calories in your potato salad,
coleslaw, and macaroni salad by using
mustard, vinegar, or Greek yogurt
instead of mayonnaise.
4.	 Alcohol may stimulate your appe-
tite and add extra calories. Create
nonalcoholic drinks by infusing fresh
herbs, cucumber, and fruit into water
and seltzer for low calorie refreshing
drinks that kids can also enjoy.
5.	 Grilled chicken and turkey burgers
get a fresh burst of flavor when you
cut back on salt and marinate them
with fresh or dried herbs, spices, vin-
egars, or citrus juices.
6.	 Make refreshing smoothies with fresh
or frozen fruit, yogurt, and ice.
For more information, visit www.nyp.org
Learn more at www.apre.org
Continued on page 4
Nutrition & Foodservice
Professional Training Program
“During my course study with UND I was able to easily communicate
with the teaching staff regarding questions and concerns. The
assignments were challenging but helped me grow professionally.”
- Susan Tackaberry, CDM, CFPP, Dietary Director, The Wellstead of Rogers & UND Graduate
1.800.CALL.UND dietarymanagers.UND.edu
• Enroll anytime, online or by mail
• RD preceptor available (online)
• Excellent ANFP exam pass rates
• Spanish translation now available
7.	 Eat healthy fats by adding fish to
the menu, such as salmon, trout, and
tuna.
8.	 Tofu is delicious on the grill; the extra-
firm type works best on the bar-
beque. It’s also great when marinated
first!
9.	 Keep the food at a separate buffet
table. Everyone will be less tempted
to go for seconds if food is not in
front of them while eating.
10.	Be mindful of food safety. Wash
hands, keep raw food separate from
cooked food, cook food thoroughly,
and keep hot food hot and cold food
cold. When in doubt, throw it out!   E
10 Healthy Ways to Spice Up
Your Summer BBQ
Nutrition & Foodservice Edge | June 20154
Continued from page 3
O
Avocados: The Fruit Adding Good Fat
to Guilty Pleasures
Northwest Sweet
Cherries: A
Healthy Treat that
Cools the Heat
ONE OF THE HOTTEST FRUITS of summer is the avocado. Although known
for being high in fat, the avocado holds nutritional value that can be a healthy addi-
tion to even the most guilty of pleasures. For those looking for healthy alternatives
this summer, avocados can lower cholesterol, aid weight loss, and enrich a diet with
potassium and vitamins C and E.
SideChef, an award-winning step-by-step cooking app, features several recipes
that incorporate this fruit in interesting ways, including 15 Minute Easy Fish Tacos,
reprinted below. E
AS THE HEAT OF SUMMER ap-
proaches, cool fresh Northwest cherries
will be there to greet it, offering sweet
relief to those wanting to eat healthfully
and seasonally.
Northwest Cherries are a Sweet
Healthy Treat
Thanks to this year’s unseasonably warm
spring in the Northwest, cherry growers
are reporting that both their dark red
and yellow-blushed sweet cherries are
arriving early—giving everyone a chance
to enjoy both the flavor and anti-inflam-
matory benefits of these powerful little
fruits.
Not only are cherries a delicious sum-
mertime treat, but recent research also
suggests that they may reduce the
risk or modify the severity of chronic
diseases. Acting to “cool” inflammation,
cherries may be beneficial in combat-
ing arthritis, diabetes, cardiovascular
disease, blood pressure, and cancer.
Researchers found that consuming
about 45 (280 g) cherries daily may
significantly decrease circulating con-
centrations of specific inflammatory bio-
markers in the body. The research study,
published in The Journal of Nutrition,
was conducted at the USDA-ARS West-
ern Human Nutrition Research Center.
Because of the link between inflamma-
tory markers and some chronic diseases,
the changes in the identified biomark-
ers suggest that consuming cherries
may reduce risk or modify the severity
of diseases such as heart disease and
diabetes.
Cherries are high in phenolic com-
pounds, specifically anthocyanins, which
give them their deep ruby color and
15 Minute Easy Fish
Tacos
by Well Worn Fork
WellWornFork.com
EASY AVOCADO RECIPE
INGREDIENTS
•	 Salt and pepper to taste
•	 Sriracha to taste
•	 Cilantro to taste
•	 1 Avocado
•	 1 Tbsp. Mirin
•	 1/2 Tbsp. Hot Sauce
•	 1 Lime
•	 1 tsp. Sugar
•	 1/4 cup Mayonnaise
•	 2 cups Broccoli Slaw
•	 1 Jalapeño
•	 6 Flour Tortillas
•	 1 lb. Cod Fillets
INSTRUCTIONS
1.	 Preheat oven to 400 degrees.
2.	 Combine the broccoli slaw (2 cups), mayonnaise (1/4 cup), sugar (1 tsp.),
juice of 1/2 lime (1), hot sauce (1/2 Tbsp.), and mirin (1 Tbsp.) together in a
bowl with salt and pepper (to taste).
3.	 Season the cod fillets (1 lb.) with salt and pepper (to taste) and put on a
sheet tray. Cook in the oven for 5-10 minutes depending on thickness.
4.	 Slice the jalapeño (1) and avocado (1). It’s up to you if you want the jala-
peño with or without seeds.
5.	 Assemble the tacos on flour tortillas (6) with cod, sliced jalapeño, slaw,
sliced avocado, cilantro (to taste), sriracha (to taste), and a squeeze of the
remaining lime.
For more information, visit  www.SideChef.com
Nutrition & Foodservice Edge | June 2015 5
©2015NationalPasteurizedEggs,Inc.v6094
Get this recipe and more at SafeEggs.com/Strata
FREE CE
for CDM, CFPPs:
Supplier Relationships &
Partnership Experience
June 15
Register online:
SafeEggs.com/webinars
Great Food. SafeEggs.™
©2015NationalPasteurizedEggs,Inc.v6094
Safest Choice™
Pasteurized Shell Eggs
eliminate the risk of Salmonella.
Continued on page 6
Visit  www.nwcherries.com
have been shown to fight inflammation.
Cherries are also a good source of vita-
min C and fiber, and are a natural source
of melatonin, a compound which helps
regulate the body’s sleep cycle.
“Cherries bring more to the table than
just great flavor; they also have potent
anti-inflammatory effects as well as
other nutritional benefits,” says James
Michael, Vice President of Marketing for
the Northwest Cherry Growers.
Cherries are arriving at markets across
the country.  The season will wind down
in late July, but to extend the flavor and
health benefits even longer, Michael sug-
gests freezing them.  “Or simply enjoy
them straight from the freezer.” E
Nutrition & Foodservice Edge | June 20156
Continued from page 5
Consulting Dietitians,
Menu & Meal Card Programs,
and Support for Dining Services
in Long Term Care
www.ht-ss.com
National Ice Cream Day
is Sunday, July 19
NATIONAL ICE CREAM DAY is cel-
ebrated each year on the third Sunday in
July and is a part of National Ice Cream
Month.  This day is a fun celebration
enjoyed with a bowl, cup, or cone filled
with your favorite flavor of ice cream.
Thousands of years ago, people in the
Persian Empire would put snow in a
bowl, pour grape-juice concentrate over
it, and eat it as a treat.  They did this
when the weather was hot and used the
snow saved in the cool-keeping under-
ground chambers known as “yakhchal,”
or taken from the snowfall that still
remained at the top of mountains by the
summer capital.
It is believed that ice cream was first
introduced into the United States by
Quaker colonists who brought their
ice cream recipes with them.  Their ice
cream was sold at shops in New York
and other cities during the colonial era.
•  Ben Franklin, George Washington, and
Thomas Jefferson were known to have
been regular eaters of ice cream.
•	 First Lady Dolley Madison served ice
cream at the Inaugural Ball in 1813.
•  African American confectioner Augus-
tus Jackson created multiple ice cream
recipes as well as a superior technique
to manufacture ice cream in 1832.
• 	A Philadelphian, Nancy Johnson, was
issued the first U.S. patent for a small-
scale hand-cranked ice cream freezer
in 1843.
•	 It is estimated that there are over
1,000 ice cream flavors today.
National Ice Cream Day History
In 1984, President Ronald Reagan
proclaimed July as National Ice Cream
Month,  and established National Ice
Cream Day as the third Sunday in July. E
Visit  www.nationaldaycalendar.com
In this column we profile leaders
and luminaries in the culinary and
foodservice industry. We hope their
insights, experiences, and stories of
perseverance will help inspire you to
achieve your career goals.
Nutrition & Foodservice Edge | June 2015 7
LEADERS & LUMINARIES
Elana
Karpby Laura Vasilion
Executive Chef Elana Karp
BR I NG I NG
COOKI NG
HO ME
Elana Karp is the Vice President of Culinary at Plated, which provides
chef-designed recipes and quality pre-portioned ingredients, delivered di-
rectly to the door of subscribers.
After Karp graduated from Cornell University in 2008, she moved to
Paris to study cooking at Le Cordon Bleu. While in Paris, she hosted
pop-up dinners with classmates, and cooked for the Australian
Ambassador to France. Upon returning to New York, she worked
within the food industry while developing a school-based food
education program and culinary camp for children. Karp joined
Plated as Culinary Director in January 2013, and has been
creating recipes, crafting menus, and coordinating chef
partnerships ever since.
Continued on page 8
Nutrition & Foodservice Edge | June 20158
QWhy do you think providing a
cook-at-home service is an impor-
tant trend?
I think cook-at-home services are
important because there’s end-
less value in cooking and eating at
home. Not only do you know every-
thing that’s going into your food, but
you learn a life skill in the process,
and then get to connect with those
you love in the kitchen and around
the table. Plated allows everyone to
participate in this amazing experi-
ence, without the hassles of meal
planning and grocery shopping.
QWhat is one of the most im-
portant life lessons you have learned
from being a chef?
When things don’t work out, or is-
sues arise, it’s important to go with
the flow and figure out a solution.
We ship hundreds of thousands of
meals per week all across the United
States. That means that occasionally
one fulfillment center won’t be able
to source the right type of lettuce,
or one vendor will send us too few
onions. When things like that hap-
pen, it’s up to my team to figure out
how to make what we do have into
the best recipe possible and the
most amazing customer experience.
QWhat moment are you most
proud of in your career?
A few months after Plated launched,
we got an email from a customer
saying that she had been with her
boyfriend for years and they had
recently started cooking Plated
Continued from page 7
QTell us about where you grew
up and how that influenced your
interest in cooking.
I grew up in New York City, which is
a melting pot of cultures as well as
food. There are always new restau-
rants popping up, from a $1 dump-
ling shop to a fancy steakhouse, and
endless options of dishes to try. This
variety of cuisines sparked my inter-
est in food and cooking.
QWhat ethnic influences from
your childhood make their way into
your cooking?
I grew up in a Jewish family where
every holiday—from Passover to the
Fourth of July to birthdays—was
centered on food. I wouldn’t say that
Jewish food itself has had a huge
influence on my cooking (although
I do always need a bowl of chicken
soup if I’m not feeling well), but the
culture of sitting down and eating a
meal as a family definitely has.
QWhen did you first know you
wanted to cook for a living?
Cooking as a profession really did
not occur to me until I started
culinary school. I actually enrolled
in a short-term introductory cook-
ing program in Paris, thinking I’d
just stay for one month, learn a few
skills, and then head back home to
New York to my career in educa-
tion. After about one week in this
cooking program, I was hooked. I
realized I could make a career out
of cooking, something that brought
me tons of joy, and decided to enroll
full time. I stayed in Paris for a year,
getting a culinary degree from Le
Cordon Bleu, and I’ve been working in
food ever since.
QIf you could prepare a meal of
your choice for anyone, living or dead,
who would that be and what would you
cook?
I’d want to cook for my friends and
family. I would prepare this one
pan rosemary roasted chicken with
parsnips and carrots. It’s so simple to
make, requires almost no clean up,
and can be tweaked by season de-
pending on what vegetables are avail-
able. It is a Plated classic recipe and
actually was the inspiration for our
cookbook, which is coming out from
Clarkson Potter next spring.
QIf you were unable to cook for
a living, what other profession would
you have pursued?
I’d probably still be working in educa-
tion. Before cooking, I worked as a
second grade teacher and earned a
degree in childhood education. Work-
ing with kids was exhausting, but tons
of fun and something I really enjoyed.
Luckily, I still get to teach in my role at
Plated. I’m able to teach busy Ameri-
cans all over the country to cook and
enjoy it, and feel proud of their newly
acquired culinary skills. Food educa-
tion has always been important to me
and I’m still committed to that mission
here; educating customers about the
power of real, non-processed, good
food.
Nutrition & Foodservice Edge | June 2015 9
together. She made him one of
our meals—Chicken Paillard with
Shaved Asparagus Salad and Olive
Oil Smashed Potatoes—and dur-
ing dinner, he proposed. She was
overjoyed and credited the dinner
for the proposal. While I’m sure the
dinner wasn’t why her boyfriend
decided he wanted to marry her,
the story was so special nonethe-
less. It made me realize that we
were creating a product that was
an important part of people’s lives
and something they felt really con-
nected to. Hearing that story was
my proudest career moment so far,
because it was when I knew I was
doing something big.
QWhat advice would you give
to someone wanting to follow in
your footsteps?
Follow your passion. I know that
sounds cliché and predictable, but I
really believe it. If you had told me
five years ago that I’d be where I am
today, I never would have believed
it. But I followed my passion, stayed
open to any opportunities that came
my way, and wasn’t afraid to get my
hands dirty. That led me to a job and
career that I love so much, it never
feels like I’m going to “work.” E
Laura Vasilion is a freelance writer
with 25 years of experience writing
for various publications including
Newsweek and Reader’s Digest. In
her Chicago Tribune ChicagoNow
blog, she interviews one person from
each country in the world about their
life. Visit www.chicagonow.com/
talking-world/
lvasilion@ANFPonline.org
MULTIGEN
Simple
innovations
that make
all the
difference.
MULTIGEN
www.burlodgeusa.com
Multi-portion point
of service cart for:
• cook-serve
• cook-chill
• cook-freeze
Follow your passion. I stayed open
to any opportunities that came my way
and wasn’t afraid to get my hands dirty.
That led me to a job and career that
I love so much, it never feels like I’m
going to work.
Nutrition & Foodservice Edge | June 201510
FOOD PROTECTION CONNECTION
Bird Flu
by Melissa Vaccaro, MS, CHO
Avian influenza A (AI)—or bird flu—is making
headlines across America. The average person does not
understand what bird flu is, or if it should be a worry for
them. AI is not as simplistic as it may sound as there are
many classifications, some of which are a concern and
some are not. Certain types affect only animals, and oth-
ers can potentially impact humans.
Wild birds are believed to be behind the current U.S. out-
break. Since mid-December, the USDA has been dealing
with several highly pathogenic avian influenza (HPAI) ‘H5’
cases. It started along the Pacific, Central and Mississippi
flyways (migratory bird paths); however by the time this
article is read, it will have spread across the U.S. The states
not affected at this point are studying their emergency
response plans.
Two types of AI are identified: low pathogenic (LPAI)
and highly pathogenic (HPAI). This difference refers to
the ability of the virus to produce disease and mortality in
chickens. AI viruses are classified by a combination of two
groups of proteins:
1 HOUR SAN
and Food Safety
Nutrition & Foodservice Edge | June 2015 11
HPAI H5N1: “Asian” H5N1 is the type causing worldwide
concern. High path AI spreads rapidly and is often fatal to
chickens and turkeys. This has not been detected in the
United States. Human illness has been reported.
LPAI H5N1: “North American” H5N1 is of less concern. It
is common in wild birds and in most cases caused minor
sickness to not noticeable signs of disease. It is rarely fatal
in birds. LPAI H5N1 is not known to be a human health
concern.
Mixed Origin HPAI: In the Pacific flyways, H5N8 virus
mixed with North American AI virus, creating new mixed-
origin viruses. These mixed origin viruses, H5N2 and a
new H5N1 in the Pacific Flyways.
•	HPAI H5N2 mixed strain has been found in North
American Flyways. It mixes Eurasian H5 virus with North
American N2 virus. No human cases have been associ-
ated with either the North American or the Eurasian
lineages of HPAI H5N2 viruses. This seems to be the
largest concern in the United States.
•	New APAI H5N1 mixed strain virus is not the same as
the Asian H5N1 virus found in Asia, Europe, and Africa
that caused human illness. It mixes Asian HPAI H5
genes with LPAI North American N genes.
A I A N D H U M A N H E A LT H
According to the Centers for Disease Control and Pre-
vention (CDC), current outbreaks of highly pathogenic
avian influenza (HPAI) H5 viruses in U.S. domestic and
wild birds have the potential to cause human infections.
(http://www.cdc.gov/flu/news/avian-h5-viruses.htm)
Though no human infections with these viruses have
been reported at this point and the CDC believes the risk
of human infection is low, similar H5 viruses have in-
fected people in other parts of the world, and it’s possible
that human infections associated with these viruses may
occur in the U.S.
Most human infections with similar HPAI viruses in other
countries have occurred after prolonged and close contact
with infected birds. Out of an abundance of caution, all
federal and state agencies are monitoring the spread of AI
in the United States. As a general rule cautions should be
taken. The CDC recommends that people should avoid
wild birds and potentially infected domestic poultry; ob-
•	Hemagglutinin—H proteins of which there are 16
(H1-H16)
•	Neuraminidase—N proteins of which there are 9
(N1-N9)
The primary strains detected are HPAI H5N8,
novel HPAI H5N1, and HPAI H5N2.
H5N8: A threat to wild birds and poultry, but no human
cases have been associated with this virus.
Continued on page 12
HOW TO
E NSURE YOUR
FO O DSERVICE
O PE RATION IS
PROTECTED
Nutrition & Foodservice Edge | June 201512
Continued from page 11
serve wild birds only from a distance, avoid contact with
domestic birds (poultry) that appear ill or have died; and
avoid contact with surfaces that appear to be contami-
nated with feces from wild or domestic birds.
E CO N O M I C I M PAC T
The largest concern with AI in the U.S. is its economic
impact on the poultry and egg industry and consumers.
Import/export bans and mass loss of poultry could result
in large economic impacts on the industry. Once found in
or around a farm, the entire population of birds is usually
destroyed (culled). As a result, counties begin to ban poul-
try exports from those areas. Although farmers may have
strong prevention measures in place, in many cases the
farmer is at the mercy of migratory birds that may be flying
overhead and excrete while over the farm. Already in 2015
millions of birds in the U.S. have been culled.
Consumers get concerned and lose faith in the industry,
which could reduce consumption of eggs and poultry. Due
to the economic impact to the farmer, prices of eggs and
poultry will certainly rise.
A I A N D FO O D SA F E T Y
The United States Department of Agriculture has provided
the following questions and answers regarding food safety
as it relates to poultry and egg consumption. (USDA, April
2015)
Q Can I get avian influenza from eating poultry
or eggs?
A No. Poultry and eggs that are properly prepared and
cooked are safe to eat. Proper food safety practices are
important every day. In addition to proper process-
ing, proper handling and cooking of poultry provides
protection from viruses and bacteria, including avian
influenza. As we remind consumers each and every
day, there are four basic food safety steps to follow:
CLEAN, SEPARATE, COOK, and CHILL.
Q How can USDA assure consumers that avian
influenza infected meat will not enter the food
supply?
A The chance of infected poultry entering the food chain
is extremely low. As part of the USDA highly pathogen-
ic avian influenza response plan, infected birds do not
enter the food supply. Additionally, USDA’s Food Safety
and Inspection Service inspection program personnel
are assigned to every federally inspected meat, poultry
and egg product plant in America. All poultry prod-
ucts for public consumption are inspected for signs of
disease both before and after slaughter. The “inspected
for wholesomeness by the U.S. Department of Agricul-
ture” seal ensures the poultry is free from visible signs
of disease.
Q Does proper food handling prevent avian
influenza?
A Avian influenza is not transmissible by eating prop-
erly prepared poultry, so properly prepared and
cooked poultry and eggs are safe to eat. The chance
of infected poultry or eggs entering the food chain is
Avian influenza is not
transmissible by eating properly
prepared poultry, so properly
prepared and cooked poultry and
eggs are safe to eat.
Nutrition & Foodservice Edge | June 2015 13
extremely low because of the rapid onset of symptoms
in poultry as well as the safeguards USDA has in place,
which include testing of flocks, and federal inspection
programs. USDA works to educate the public about
safe food handling practices in response to numerous
questions from the public about the human risk associ-
ated with avian influenza.
Q What does proper food handling mean?
A Proper handling and cooking of poultry provides
protection against all avian influenza viruses, as it does
against other viruses and bacteria, including Salmo-
nella and E.coli. Safe food handling and preparation
is important at all times. USDA continually reminds
consumers to practice safe food handling and prepara-
tion every day.
	 Cooking poultry, eggs, and other poultry products to
the proper temperature and preventing cross-contam-
ination between raw and cooked food is the key to
safety. You should:
•	 Wash hands with warm water and soap for at least
20 seconds before and after handling raw poultry
and eggs;
•	 Prevent cross-contamination by keeping raw poul-
try and eggs away from other foods;
•	 After cutting raw meat, wash cutting board, knife,
and countertops with hot, soapy water;
•	 Sanitize cutting boards by using a solution of 1
tablespoon chlorine bleach in 1 gallon of water;
•	 Use a food thermometer to ensure poultry has
reached the safe internal temperature of at least
165 °F to kill foodborne germs that might be pres-
ent, including the avian influenza viruses.
W H AT I S B E I N G D O N E
What is being done to prevent and stop the spread of
HPAI? A tremendous amount of work goes into controlling
the spread of AI.
•	 Early detection is key to preventing the spread of the
virus. Surveillance programs have been in place for
many years, both in the US and overseas.
•	 The United States has the strongest AI surveillance
program in the world. The USDA and poultry industry
partners are actively looking for the disease.
•	 States have AI Emergency Response Plans in place.
•	 Commercial poultry flock testing is well established.
•	 Regulatory agencies immediately quarantine poten-
tially‐infected flocks and collect samples for AI testing.
•	 Once a flock is confirmed positive, the regulatory
agency and the USDA work with the producer/bird
owner to create a flock plan. The plan includes apprais-
al, indemnity and depopulation of remaining birds,
carcass disposal, and cleaning and disinfection of the
premises.
•	 To meet federal requirements for HPAI response, the
regulatory agency also conducts surveillance testing
within 10 km of the affected farm and notifies all other
poultry owners within a 20 km area.
Since AI is making front page news, it’s important to know
the facts. When your clients and administrators ask ques-
tions about bird flu, you’ll have the knowledge and under-
standing to answer them. E
Continued on page 14
P R O P E R LY CO O K P O U LT RY A N D E G G S A N D P R E V E N T C R O S S - CO N TA M I N AT I O N
Nutrition & Foodservice Edge | June 201514
1. 	 Avian influenza is ______ by eating properly prepared
poultry.
	 A.	 spread
	 B. 	not transmissible
	 C. 	transmissible
2.	 Asian HPAI H5N1 has
	 A.	 Not been found in the United States
	 B.	 Has caused human illness
	 C.	 Both A and B
3.	 The low pathogenic (LPAI) and high pathogenic (HPAI)
difference means
	 A.	 The ability of the virus to produce disease and 	
	 mortality in chickens
	 B.	 The ability of the virus to produce disease and 	
	 mortality in humans
	 C.	 The ability of the virus to produce disease and 	
	 mortality in poultry and humans
4.	 Which virus is less pathogenic?
	 A.	 LPAI H5N1
	 B.	 HPAI H5N1
	 C.	 HPAI H5N8
Reading Bird Flu and Food Safety and successfully completing these questions online has
been approved for 1 hour of sanitation CE for CDM, CFPPs. CE credit is available ONLINE
ONLY. To earn 1 San CE hour, purchase the online CE quiz in the ANFP Marketplace. Visit
www.ANFPonline.org/market, select “Publication,” then select “CE article” at left, then
search the title “Bird Flu and Food Safety” and purchase the article.
FOOD PROTECTION CONNECTIONReview Questions
1 HOUR SAN
5.	 How can I avoid getting an AI virus?
	 A.	 Avoid close contact with wild birds
	 B.	 Avoid close contact with domestic birds that appear ill
	 C.	 Both A and B
6.	 What is being done to control the spread of AI?
	 A.	 Surveillance and testing of flocks
	 B.	 Removal of any ill poultry from farms
	 C.	 Not allowing backyard flocks
7.	 According to the CDC, the chance of human infection with
HPAI in the U.S. is
	 A.	 High
	 B.	 Low
	 C.	 Will not occur
M A K E YO U R C E H O U R S AU D I T P R O O F
Attention CDMs! Purchase your online CE products in the ANFP
Marketplace and your completed CE hours will be automatically
reported in your continuing education record. This includes all
ANFP online courses, archived webinars, and CE online articles.
Melissa Vaccaro, MS, CHO is a
Food Program Specialist for the PA
Department of Agriculture and an
Executive Board Member for the
Central Atlantic States Association of
Food and Drug Officials (CASA). She
is co-author of the SURE™ Complete
HACCP Food Safety Series.
mvaccaro86@gmail.com
Continued from page 13
A R T I C L E S O U R C E S :
•	 Centers for Disease Control and Prevention. Information on
Avian Influenza. http://www.cdc.gov/flu/avianflu/, May 2015
•	 USDA, Avian Influenza. http://www.usda.gov/wps/portal/
usda/usdahome?contentidonly=true&contentid=avian_influ-
enza.html
•	 www.flu.gov, May 2015
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Nutrition & Foodservice Edge | June 201516
TRE NDS IN NUTRITION
In 1993 the FDA introduced the Nutrition Facts label.
The goal was to help consumers make informed choices
about the foods they eat by providing nutritional informa-
tion on the packages. Today, the FDA is looking to update
the Nutrition Facts label and require calorie labeling on
restaurant menus and vending machines since Americans
consume about one-third of their food away from home.
What Will be Added to the Nutrition Facts Label?
The new Nutrition Facts label will contain various updated
categories and graphics designed to help consumers make
more healthful choices. Highlights of changes include:
•	Calories – There will be greater emphasis on calories
with larger and bolder fonts. Calories are important to
know in order to maintain a healthy weight.
Nutrition
Labeling
by Linda S. Eck Mills, MBA, RDN, LDN, FADA
EXAMINATION
OF CHANGES
IN NUTRITION
LABELING
Past, Present,
Future
Nutrition & Foodservice Edge | June 2015 17
•	Calories From Fat – The type of fat is more important
than the total amount of fat. Total fat, saturated fat and
trans fat will remain on the label.
•	Amount Per Serving – This will be replaced with the
actual serving size, such as “Amount per cup.”
•	Total Carbohydrate – This will be replaced with “Total
Carbs.”
•	Vitamin A and Vitamin C – These nutrients will
become voluntary and not mandatory on labels since
deficiencies are not common.
Calorie Labeling Requirements for Restaurant
Menus and Vending Machines
Restaurants and fast-food chains with more than 20 loca-
tions have until December 1, 2015 and vending machine
•	Sugar – “Added Sugars” will be included on the label.
This will show the sugar that is added during food pro-
duction.
•	Percent Daily Value – This information will be moved
to the left side of the label.
•	Serving Sizes – The serving size will be changed to re-
flect what is actually being eaten and not what individu-
als should be eating.
•	Number of Servings – This information will be more
prominent.
•	Dual Column Format – This format will be used on
items that contain at least two times the serving size and
less than or equal to four times the serving size. Exam-
ples include a 19 oz. can of soup or a pint of ice cream.
•	Vitamin D and Potassium – These nutrients will be
mandatory on the label since there is evidence that in-
dividuals are not consuming enough of these nutrients,
which can lead to chronic diseases.
What Will be Removed from the Nutrition
Facts Label?
As nutrition science has evolved, and based on feedback
on the current label, the following information on the label
will change:
Continued on page 18
CURRENT PROPOSED
CURRENT VS. PROPOSED LABEL
Nutrition & Foodservice Edge | June 201518
Continued from page 15
operators have until December 1, 2016 to comply with the
new labeling requirements. This means that you will begin
seeing calorie labeling not only on restaurant menus, but
also restaurant-type facilities selling prepared foods for im-
mediate consumption such as grocery stores, convenience
stores, movie theaters, and bowling alleys.
What the New Labeling Requirements Mean
to You
As a Certified Dietary Manager, now is the time to take a
close look at your operation. Do you have access to infor-
mation for items you serve in a restaurant-type location
or for foods you sell on-site or for vending machines you
operate? Do the menus you receive from a corporate office
provide you with calorie information for each menu item
in an easy-to-use format? Where can you provide calorie
The FDA transferred from the
Department of Agriculture to the
Federal Security Agency.
The FDA was officially established as an
agency of the Department of Health and
Human Services. This agency was part of the
Food and Drug Administration Act of 1988
and was formed to provide education,
information, enforcement, and research.
The Food, Drug, and Insecticide
Administration becomes the Food and Drug
Administration (FDA), under the Department
of Agriculture.
The FDA enforces the Fair Packaging and Labeling Act
for food and other items. This act requires that products
used in interstate commerce be honestly and informa-
tively labeled.
H ISTO RY
According to the FDA, these are some significant dates in US Food and Drug Law history.
LEARN MORE
The Food and Drug Administration website is loaded
with information and resources on the new labeling
requirements and how they were developed.
Linda@dycomserv.com
information to your clients? Plan ahead for any required
changes.
The bottom line is Nutrition Facts labels are a tool to help
individuals maintain healthy dietary practices by making
informed choices. E
Linda S. Eck Mills, MBA, RDN, LDN,
FADA is a career coach and speaker.
She is the co-author of Flavorful Forti-
fied Food—Recipes to Enrich Life and
Food First! Enhancing the Nutritional
Value of Meals with Fortified Food.
Mills directs the ANFP Program at Le-
high Carbon Community College and
works in correctional food service.
Continued from page 17
•	 Highlights of the Proposed Rules—	
www.fda.gov/Food/GuidanceRegulation/
GuidanceDocumentsRegulatoryInformation/LabelingNutrition/
ucm387533.htm
•	 Proposed Changes to the Nutrition Facts
Label—www.fda.gov/Food/GuidanceRegulation/
GuidanceDocumentsRegulatoryInformation/LabelingNutrition/
ucm385663.htm#images
•	 Calorie Labeling on Restaurant Menus and Vending
Machines—www.fda.gov/Food/IngredientsPackagingLabeling/
LabelingNutrition/ucm436722.htm
•	 Nutrition Facts Label Programs and Materials—www.fda.
gov/Food/IngredientsPackagingLabeling/LabelingNutrition/
ucm20026097.htm
SOURCES:
• 	 www.fda.gov
•	 www.eatrightpro.org
•	 www.andjrnl.org
Nutrition & Foodservice Edge | June 2015 19
The food label is recreated
by the FDA and the Food
Safety and Inspection
Service of the Department
of Agriculture. Basic
per-serving nutritional
information becomes known
as “Nutrition Facts” as part
of the requirements under
the Nutrition Labeling and
Education Act of 1990.
The Nutrition Labeling and Education
Act required all packaged foods to
have a nutrition label. In addition, all
health claims for foods were required
to be consistent with terms defined by
the Secretary of Health and Human
Services. This was the first time some
health claims could be used on foods
and definitions for words such as “low
fat” and “light” were established.
The Food Allergy Labeling and
Consumer Protection Act required
labeling of foods that contain the
major food allergens – eggs, fish,
shellfish, milk, peanuts, tree nuts, soy,
and wheat.
Changes are made to the
Nutrition Facts panel and
Menu Labeling Requirements.
Trans-fat content is required on food
labels. This is the first change to the
food label.
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Nutrition & Foodservice Edge | June 201522
As our population lives longer, healthcare provid-
ers are faced with the challenge of supporting quality of care
while also honoring self-directed living. One of the most
complex decisions for clients and families concerns the use
of artificial nutrition and hydration (ANH). These decisions
incorporate many factors for consideration. It is critical for
providers to compassionately convey the realities of ANH,
including potential harms at the end of life. This article of-
fers an overview of ANH along with practical suggestions on
how to proactively support clients with self-directed living.
B AC KG R O U N D
Conversations with clients and families about whether
to use artificial nutrition and hydration (ANH) in frail
elders with advanced disease can be challenging. Ethi-
cal principles, case law, and formal opinions of medical
and advocacy groups uphold the position that ANH is a
medical intervention, and decisions regarding its use fall
under the same pattern as informed consent used in all
medical decision-making. This includes educating and
informing clients and families about benefits and harms
to allow client decision-making within the framework
NUT RITION
CONNECTION
by Brenda Richardson, MA, RDN, LD, CD, FAND
Artificial
Nutrition
HydrationConversations with
Clients and Families
&
HOW TO
PROACTIVELY
SUPPORT
C L I E NTS W ITH
SE L F -DIRECTED
L I VI NG
Artificial Hydration:
Administration of fluid through non oral means; routes
include intravenous or subcutaneous (also called hypoder-
moclysis), rectal (proctoclysis), and enteral.
Artificial Nutrition:
Non oral, mechanical feeding either by intravenous or
enteral route. Enteral feedings may be provided through
either nasogastric tubes or gastrostomy, esophogostomy,
or jejunostomy tubes that are placed either endoscopically
or in open surgical procedures. Intravenous nutrition is
administered through a central line and often is called total
parenteral nutrition (TPN). Parenteral nutrition can also be
administered through a peripheral vein.
Client Autonomy:
The right of clients to make decisions about their medical
care without their healthcare provider trying to influence
the decision. Client autonomy does allow for healthcare
providers to educate the patient, but does not allow the
healthcare provider to make the decision for the patient.
Beneficence:
A principle of medical ethics according to which a person
should do good to others, especially when one has a pro-
fessional duty to do so.
Nonmaleficence:
Ethical principle of doing no harm.
Table 1 Definitions:
Table 2 Definitions:
Nutrition & Foodservice Edge | June 2015 23
tices are medical intervention with benefits and burdens
similar to other medical interventions. (See definitions in
Table 1.)
Continued on page 24
of the client’s overall values and specific goals for the
intervention.
This requires that providers be knowledgeable about the
research findings on benefits and harms of artificial nutri-
tion and hydration, and have the communication skills to
convey these to clients and families in an understandable
and culturally appropriate manner.
E T H I C A L A N D L E G A L I S S U E S
The ethical issues have been discussed over the past 40 or
50 years, with the current consensus being that ANH prac-
Decisions around ANH involve the
ethical principles of client autonomy,
beneficence, and nonmaleficence.
(See Definitions in Table 2.)
Nutrition & Foodservice Edge | June 201524
Many medical and advocacy organizations
stress the importance of informed consent
to allow client autonomy—including inform-
ing clients and families of alternative treat-
ments and interventions to ANH.
Continued from page 23
To ensure the client is making the decision, providers need
to be fully aware of the client/family goals while clients
and families need to be fully informed about whether the
intended interventions can realistically achieve these goals.
There is also the need to be aware of possible side effects of
interventions while weighing the benefits of the treatment.
Many medical and advocacy organizations—such as the
Academy of Nutrition and Dietetics, the American Medical
Association, the American Geriatrics Society, the Al-
zheimer’s Association, the American Academy of Hospice
and Palliative Medicine, the American Nursing Association,
and others—have position statements on the provision
of ANH that also indicate that ANH practices are medical
interventions, with possible benefits and predictable side
effects. These organizations stress the importance of truly
informed consent to allow client autonomy to be possible.
This includes informing clients and families of alternative
treatments and interventions to ANH.
The Academy of Nutrition and Dietetics shares in a
position paper that, “Enteral
nutrition
may not
be
ap-
propriate
for
terminally
ill
older
adults
with
ad-
vanced disease
states, such
as
terminal demen-
tia,
and
should
be
in
accordance with advanced
directives.
The development of
clinical
and
ethical
crite-
ria
for
the
nutrition
and hydration of
persons
through-
out
the
life
span
should
be
established
by
members
of
the
healthcare team, including
the registered dietitian.”
The Centers for Medicare and Medicaid Services State
Operations Manual Appendix PP - Guidance to Surveyors
for Long-Term Care Facilities includes regulatory language
regarding use of Feeding Tubes in §483.25(g) Naso-Gas-
tric Tubes (F 322):
Overview: A decision to use a feeding tube has a
major impact on a resident and his or her quality
of life. It is important that any decision regarding
the use of a feeding tube be based on the resident’s
clinical condition and wishes, as well as applicable
federal and state laws and regulations for decision
making about life-sustaining treatments.
Considerations Regarding the Use of Feeding
Tubes: The regulations at §483.25(g) require that
the resident’s clinical condition demonstrates the
use of a feeding tube to be unavoidable. A feed-
ing tube may be considered unavoidable only if
no other viable alternative to maintain adequate
nutrition and/or hydration is possible, and the use
of the feeding tube is consistent with the clinical ob-
jective of trying to maintain or improve nutritional
and hydration parameters.
The interdisciplinary team, with support and guid-
ance from the physician, is responsible for assuring
the ongoing review, evaluation and decision-mak-
ing regarding the continuation or discontinuation
of all treatments, devices, or approaches implement-
ed to care for the resident. Involving the resident,
family, and/or the resident’s legal representative in
discussions about the indications, use, potential
benefits and risks of tube feeding, types of approach-
es, and alternatives helps support the resident’s right
to make an informed decision to use or not use arti-
ficial nutrition and hydration.
In the Dining Practice Standards released in 2011 from the
Pioneer Network, relevant research trends include:
•	Feeding tubes have not been shown to reduce the risk of
aspiration or prolong survival in residents with end-stage
dementia.
•	Oral
secretions
and/or
gastric
content
are
often the
source of aspiration pneumonia or pneumonitis and thus
will not be resolved with the placing of a tube.
•	Studies in the elderly with dementia have shown little
to no improvement in weight. In situations when there
was improvement in weight, there was no improve-
ment in clinical outcome for residents. Enteral feeding is
also considered for wound care as a means to improve
Nutrition & Foodservice Edge | June 2015 25
Continued on page 26
wound healing, however data over a six month follow up
has shown no impact on pressure ulcers or on infections
such as cellulitis associated with wounds.
•	Percutaneous
endoscopic
gastrostomy
(PEG) and
percutaneous
endoscopic
jejunostomy
(PEJ) tubes do
not improve
a
resident’s
quality
of
life. Placing a PEG
tube
in
residents with
advanced dementia
should
be
strongly
discouraged.
So why is it still so hard for healthcare providers to have
conversations about ANH with clients and families? Is it
lack of knowledge on the part of clients and families? Is it
lack of knowledge of interdisciplinary healthcare providers
about the evidence-based research regarding provision of
ANH to seriously ill frail elders? Is it because of unrealistic
expectations of what can be accomplished by ANH on the
part of clients, families, and clinicians?
Some say that clients and families have unrealistic expec-
tations and demand unreasonable interventions for their
loved ones. Yet, research indicates that when presented
with all the relevant facts, clients and families generally opt
to forgo more aggressive interventions when benefits are
marginal. Conversations are important!
CO N S I D E R ATI O N S FO R FAC I L IT Y
“ CO N V E R SATI O N P L A N ”
It is critical to have an overall facility plan that addresses
how “conversations” about ANH will be administered. The
following areas are some factors to consider with the over-
all plan. (See Table 3.)
•	 Develop a facility program that identifies overall planning
for “having the conversation.” Determine how to incor-
porate information and “conversations” with Admissions,
Nutrition Risk Programs, Physician Involvement, Interdis-
ciplinary Team (IDT), Dining Programs, Care Planning, etc.
Be sure training occurs throughout the facility for proper
implementation.
•	 Develop a resource folder or notebook that includes
client education brochures, research, and resources for
helping clients and families make decisions about use of
artificial nutrition and hydration. Make the information
readily available.
•	 When having conversations be sure to determine an ap-
propriate setting: These important conversations should
occur with the client and/or authorized decision-maker
in a private setting that is conducive to comfortable and
intimate communication. There should be no interrup-
tions, and the overall tone should be respectful and car-
ing.
•	 During conversations it is important to listen. The clinician
should determine what the client and family understand
about the disease, and listen to what is important overall
to the client and family.
•	 Use conversation to impart knowledge to the client and
family, while clarifying any misconceptions and present-
ing alternative interventions that can realistically achieve
client-specific goals of care, along with known possible
harms and benefits of each.
•	 Allow the client and family to express emotions, while
empathizing, and assuring the client and family that
support will be there for them.
•	 Once emotions have settled, have a joint discussion with
the client and family about the next steps, and then fol-
low facility protocols to honor their decisions.
•	 The facility should follow up periodically to determine
whether and how client goals are being met by the
interventions, and adjust the treatment plan together
accordingly.
•	 Documentation in the medical record should clearly
reflect the conversations, nutrition interventions, and
ongoing care and services honoring informed choice.
Table 3: ANH Plan
Nutrition & Foodservice Edge | June 201526
S U M M A RY
Discussions about use of ANH in elderly clients with
advanced chronic illness should be held with clients and
their families considering the client’s overall values and
goals, as well as the specific goals for ANH, the current
clinical status, and likely course with and without ANH,
and guided by the current evidence-based research of
known benefits and harms of intervention.
This role of the CDM is reflected in the Association of
Nutrition & Foodservice Professionals’ Position Paper: The
Role of the Certified Dietary Manager in Person-Directed
Dining, stating the CDM who works in long-term care
is expected to seek continuing education and informa-
tion in order to implement the best practices and recog-
nized standards of practice for elder nutrition care and
person-directed dining. The Certified Dietary Manager,
in collaboration with the dietitian and the interdisciplin-
ary team, has an essential role both in facilitating this
process, as well as in monitoring it for desired outcomes.
Continued from page 25
Brenda Richardson, MA, RDN, LD,
CD, FAND is a lecturer, author, and
consultant.  She works with Dietary
Consultants Inc. in business relations
and development, and is president/
owner of Brenda Richardson Associ-
ates, Inc.
brendar10@juno.com
REFERENCES
i
•	 O’Sullivan Maillet J, Baird Schwarz D, Posthauer ME; Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and
Dietetics: ethical and legal issues in feeding and hydration. J Acad Nutr Diet. 2013;113(6):828-833.
• 	 State Operations Manual: Appendix PP—Guidance to surveyors for long term care facilities. Revised February 6, 2015. Centers for Medicare
and Medicaid Services Website: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/
CMS1201984.html (Accessed April 28, 2015)
• 	 Association of Nutrition & Foodservice Professionals (formerly Dietary Managers Association), The Role of the Certified Dietary Manager in
Person-Directed Dining—April 2011  http://anfponline.org/Resources/position_papers.shtml  (Accessed April 28, 2015)
• 	 Association of Nutrition & Foodservice Professionals, Code of Ethics for the Certified Dietary Manager, http://anfponline.org/About/CDM_
CFPP_credential.shtml (Accessed April 29, 2015)
ADDITIONAL RESOURCES:
• 	 ALS Association: Information About Feeding Tubes Website:  http://www.alsa.org/als-care/resources/publications-videos/factsheets/
feeding-tubes.html
•	 American Hospice Foundation: Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful?  Website: http://americanhospice.
org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/
• 	 WebMD: Questions and Answers: Artificial Nutrition and Hydration and End of Life Decision Making Website: http://www.webmd.com/
balance/faqs-artificial-nutrition-hydration-end-of-life-decision-making-medref
•	 Nutrition411: Facts About Tube Feeding Website:  http://www.nutrition411.com/content/facts-about-tube-feeding
• 	 Nutrition 411: Interdisciplinary Nutrition Care Plan: Tube Feeding  Website: http://www.nutrition411.com/content/interdisciplinary-nutrition-
care-plan-tube-feeding  
•	 The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines and Standards Library  Website:  http://www.
nutritioncare.org/Library.aspx
Healthcare professionals must recognize the importance
of establishing nutrition treatment goals that are resident
centered, and that respect the unique values and personal
decisions of the older adult. Section 2 of the Code of Eth-
ics for the Certified Dietary Manager, Principle #10 states,
“The Certified Dietary Manager provides sufficient in-
formation to enable clients to make their own informed
decisions.” Having conversations about ANH with clients
and families is vital for informed choice, resident-centered
care decisions, and quality of life. E
Nutrition & Foodservice Edge | June 2015 27
Take your credential and
GO FURTHER.
Certificate of Advanced Learning:
Healthcare Foodservice Finance - Beyond the Basics
As a seasoned Healthcare Foodservice Director, how are
your financial skills? Finance control is the core to a successful
operation. This advanced online course will provide
participants with a better understanding of the financial
process and tools to manage them successfully.
*Prerequisite: Minimum CDM certification one year prior to enrollment.
Start today at www.ANFPonline.org/market
• Define the key factors that influence Foodservice
Financial Performance
• Explain the role of the MENU in financial accountability.
• Identify the opportunity for profit and/or loss in the
retail/revenue services.
• Develop a dashboard with relevant Key Performance
Indicators (KPI)
30 CE hours | $250 ANFP Members | $270 Non-Members
CE
30 HOURS
CBDM Approved
1. 	 Artificial nutrition is:
	 A.	 Oral feeding using artificial flavors
	 B. 	 A new fasting program that is supported by best practice
	 C. 	 Non-oral, mechanical feeding by intravenous or enteral route
2.	 Artificial hydration is:
	 A.	 Administration of fluid through non oral means
	 B.	 Hydration using artificial or alternative sweeteners
	 C.	 Serving liquids in a frozen state such as popsicles, etc.
3.	 The Centers for Medicare and Medicaid Services State Operations
Manual Appendix PP states that:
	 A.	 Decisions to use a feeding tube should be made strictly on the 	
	 resident’s clinical condition
	 B.	 A decision to use a feeding tube has a major impact on a 	
	 resident and his or her quality of life
	 C.	 The resident and family should not be included in discussions 	
	 and information regarding use of a tube feeding
4.	 Conversations with residents and families should include:
	 A.	 Being held in a private setting with no interruptions
	 B.	 “Listening” with opportunities to inform and share knowledge
	 C.	 Both A and B
Reading Artificial Nutrition and Hydration (ANH): Conversations with Clients and Families and
successfully completing these questions online has been approved for 1 hour of CE for CDM,
CFPPs. CE credit is available ONLINE ONLY. To earn 1 CE hour, purchase the online CE quiz in the
ANFP Marketplace. Visit www.ANFPonline.org/market, select “Publication,” then select “CE
article” at left, then search the title “Artificial Nutrition and Hydration (ANH): Conversations with
Clients and Families” and purchase the article.
NUTRITION CONNECTIONReview Questions
5.	 Many medical and advocacy organizations have position statements
on the provision of ANH that stress:
	 A.	 ANH always has positive benefits
	 B.	 The importance of informing residents and families of 	
	 alternative treatments and interventions
	 C.	 The ultimate decision is always made by the physician
6.	 The CDM is expected, in collaboration with the dietitian and the
interdisciplinary team, to provide sufficient information to enable
residents to make their own informed decisions as seen in the:
	 A.	 Association of Nutrition & Foodservice Professionals’ Code of 	
	 Ethics Principle #10
	 B.	 Association of Nutrition & Foodservice Professionals’ Position 	
	 Paper: The Role of the Certified Dietary Manager in Person-	
	 Directed Dining
	 C.	 Both A and B
7.	 Having conversations about use of ANH is vital for:
	 A.	 Informed choice, resident-centered care, and quality of life
	 B.	 Residents with end stage diseases only
	 C.	 Establishment of supplies needed
M A K E YO U R C E H O U R S AU D I T P R O O F
Attention CDMs! Purchase your online CE products in the ANFP Marketplace and your completed CE hours will be automatically reported in
your continuing education record. This includes all ANFP online courses, archived webinars, and CE online articles.
Nutrition & Foodservice Edge | June 201528
FOODSERVICE IDEAS
As a post-graduate student, I took a course in
marketing which used the now out-of-print book The Hid-
den Persuaders, by Vance Packard. Mr. Packard provided
many examples of the importance of marketing. One such
example has remained with me throughout my career, and
I’ve paraphrased it below.
A large soap manufacturer spent millions of dollars on
research to make the most perfect face soap. The com-
pany packaged the soap, promoted it, and distributed it
to various markets. The soap didn’t sell. The company
was forced to recall the entire product and conduct more
research. They looked at the target audiences, previous
distribution channels, promotional efforts, price, and
packaging of the soap. Their research indicated the need
for a new plan as the soap was not the problem; it was the
marketing and packaging that needed an overhaul. The
company developed a new package design to gain the at-
tention of the intended audience—women. Distribution
was now to a more upscale audience, and at an increase
in price. The new (old) soap sold out in six months, and
within two years the company was making a profit on the
sale of the product to their target market of women. It
turns out the soap was indeed excellent, but the company
initially failed to follow basic marketing principles.
Foodservice
Marketing
by Ruby Puckett, MA, FFCSI
Success Strategies
Nutrition & Foodservice Edge | June 2015 29
U N D E R S TA N D TA R G E T M A R K E TI N G
A target market is a subgroup within the population rather
than the population as a whole. This market segment is
where the company or organization should direct its pro-
motional efforts. For example, the southern states would
be a primary target market for grits and biscuits, because
these items tend to be more popular menu options in the
South.
How can you use target marketing in your facility to pro-
mote your food service, as well as market yourself and the
profession? To answer this, we must know our customer
base, understand their needs, and then develop goods and
services to meet those needs. It’s necessary to determine
such things as the culture, religion, language, gender, eco-
nomic status, generation, preferences (local, organic, etc.),
and special needs (vegan, gluten-free, etc.) of our audi-
ence. This is called market segmentation. The above list
contains both large and small market subsegments. Select
the largest group and strive to meet their needs first. This
large group is your primary target market. And as resourc-
es permit, try to meet the smaller group’s needs.
I D E N TI F Y YO U R P R O D U C T M IX
Next, identify all the products offered for sale by your
department, such as grab-and-go or take-out items that
can be eaten elsewhere in the facility or brought home.
Products may include food for a variety of customers that
is purchased in the cafeteria, c-store, vending machines,
food court, guest meals, or catering—anything that will
satisfy the needs and demands of your customer groups.
“Products” can also be services, places, ideas, or even
people. Service encompasses education of employees,
clients, and the community, and may include such things
as providing nutrition information, weight loss classes,
one-on-one counseling, and printed materials.
Ideas are a valuable service and include brainstorming,
providing suggestions for foodservice initiatives, partici-
pating in the department’s strategic planning process, and
more. Ideas for improving safety and sanitation, and meet-
ing survey agency standards are ideas that will promote
the efficiency and effectiveness of the department. Em-
ployees may have many excellent suggestions and should
be encouraged to share their ideas.
Marketing is a management tool that focuses on identify-
ing the needs, wants, and demands of customers to obtain
products and services of quality and value in their target
market. A major objective of marketing is to focus on
customers’ needs. The needs of the customer are “things”
required for a state of well-being, both physical (food,
safety and shelter) and mental (belonging, affection, and
self-expression). Refer to Maslow’s hierarchy of needs for
more on this. All customers have wants, as well. The cus-
tomer may desire something but not need it. Demands are
wants that are supported by resources that allow the wants
to be fulfilled.
HOW TO
USE TAR GET
MARKETING TO
PRO MOTE YOUR
FOOD SERVICE
Continued on page 30
Nutrition & Foodservice Edge | June 201530
People are also a service, such as the maintenance engi-
neers that maintain the foodservice equipment, external
company representatives that introduce new products and
services, and any employee within the organization that
provides service to the department—such as the safety of-
ficer that teaches fire safety. Many departments inside the
organization, as well as external people, provide services
to the food and nutrition department.
D E T E R M I N E D I S T R I B U TI O N C H A N N E L S
Identifying product distribution channels may be simple
or complex. Distribution channels are the routes that
products follow from field to fork. These routes may be
direct from the manufacturer to the department, or to the
middleman (such as a vendor) and then to your depart-
ment. In a foodservice operation, distribution includes
delivering food to the client’s bedside via tray service, wait
staff serving menu items in the dining room, customers
enjoying a self-serve buffet, and staff delivering customer
selections through 24-hour room service. Food may also
be distributed off site for catered events.
E S TA B L I S H E F F E C TI V E P R I C I N G
Pricing is a component of marketing. Price is the cost of
the product to the customer and is linked to revenue and
profit goals. Accurate cost information is critical to effec-
tive pricing. Also, knowing what the competition charges in
your geographic area can help you determine your product
pricing.
Calculating the cost of a product is important. Actual Cost
is one method used and represents the total expenditures
required to create the product, including the money paid
for raw materials, labor, rent, utilities, insurance, and so
forth. Another method of pricing is Food Cost Basis to
determine the selling prices. Frequently, the prices are
determined by using one cost—usually the raw materi-
als—as the basis for establishing the selling price. A for-
mula is used to calculate the relationship of the food cost
to the selling cost. Most foodservice departments use this
method to price items in the cafeteria and in c-stores. The
formula is 40 percent for food cost and 60 percent for la-
bor, other expenses, and profit. So, if a small orange juice
costs 40 cents, it would sell for $1.00. Another method is
Fixed Pricing, where a standard price for a product or an
event has been determined in advance for various menus
or menu items.
Continued from page 29
Pricing varies from one geographic area to another, due
to cost of living factors. Pricing should also take into ac-
count the quality of the product. When quality increases,
cost should lower through increased efficiency. A continu-
ous quality improvement (CQI) program allows the food
service to provide increased and better service to meet
customer needs.
C H O O S E E F F E C TI V E P R O M OTI O N S
Promotions are methods used to convey information
about products or services to customers. A number of
techniques can be used to promote products including ad-
vertising, personal selling, public relations, and merchan-
dising. Other techniques include newspaper ads, Internet
specials, personal phone calls, and catalogs.
Foodservice department promotions might include post-
ing menus with price and nutritive value for each food
item, using the Internet and social media to advertise
specials, providing discount coupons and meal deals as
appropriate, and preparing a department newsletter to
distribute in the cafeteria and on client meal trays. Use
your imagination to determine other ways to market your
products and services.
Personal selling means marketing by word of mouth. If
the foodservice department produces quality food at a
competitive price served by friendly personnel in a sanitary
environment with pleasant ambience, customers will tell
others, including prospective patrons.
Sales promotions are another way to publicize new items.
Provide a sales promotion for a new product or service,
such as an ice cream shop or a coffee kiosk. These promo-
tions are typically short in duration to generate interest
and create a sense of urgency for buyers.
Public relations is an important promotional tool. Become
friends with the local newspaper editor. Promote a new
menu item that is being served to customers by providing
the food editor with the recipe, a color photo of the item,
and nutrition information. During Pride in Foodservice
Week, spotlight the department by introducing personnel
at a coffee, hosting a trivia contest, or distributing informa-
tion on a hot topic in nutrition. Promote new better-for-you
foods in the cafeteria that have reduced fat, sugar, and salt
content.
Continued on page 32
Nutrition & Foodservice Edge | June 2015 31
10 Quick Tips
for Marketing Your Food Service
1. Celebrate cultural diversity.
Designate one or more days each week to highlight
the foods of a particular ethnic group. Develop
menu items that give patrons an opportunity to
savor the unique spices, aromas, and tastes of fare
from other lands.
2. Promote daily specials.
Reduce pricing on select menu items each day.
Advertise daily specials in employee newsletters,
on signage, on tent cards, and anywhere else that
will attract the attention of potential customers.
Give them another reason to dine with you.
3. Sample products.
If it’s for free, it’s for me. Who doesn’t like going to
big box stores and sampling savory new spreads,
meat on toothpicks, and cool beverages in mini
paper cups? Try this approach in your food service.
4. Enhance the atmosphere.
Boost the appeal of your cafeteria with attractive
table decorations, a pleasant color scheme, and
friendly staff that’s customer focused. Make guests
feel welcome and cared for while dining.
5. Offer coupon savings.
Put a $1 off coupon incentive in the staff newsletter
to attract facility employees to your food service
and keep them on the property at mealtime. Fast
food restaurants make liberal use of savings cou-
pons, why shouldn’t you?
6. Make a wrong right.
If a customer has gotten less than stellar service,
provide an apology and a savings coupon to help
smooth things over. Righting a wrong will ease the
sting of a bad customer service experience.
7. Offer a money back guarantee.
Let’s face it. Many people don’t think of the hospi-
tal cafeteria as a quality culinary experience. Allow
them to give your food service a try without risk. If
you’re confident in the quality of your menu items,
offer customers a money back guarantee if they’re
unhappy with their order.
8. Expand your coffee program.
The popularity of coffee products and novelty
hot beverages has exploded in recent years. Save
employees and facility guests a trip to the drive-
through on their way to work, and make your food
service a coffee destination. Sales of bagels, muf-
fins, and other breakfast fare will improve if they
are marketed on your coffee menu.
9. Promote choice.
People love to have choices. Empower them to
make decisions about their menu selections. Yel-
low mustard, brown mustard or Dijon mustard?
Tabasco, sriracha, or chipotle? Without over-
whelming them with too many offerings, give them
options to make their meal just the way they like it.
10. Consider customer comments.
Requesting feedback makes customers feel like
their opinion matters. Seek their input. If you see
a pattern when it comes to customer complaints,
you need to act. Minimize your weaknesses and
capitalize on your strengths!
Nutrition & Foodservice Edge | June 201532
Merchandising or displaying products is another promo-
tion technique. Customers will purchase more of an item
if it has visual appeal. Make up a sample plate. Combin-
ing foods with attractive colors and varied textures on
the plate will go a long way in creating meal appeal and
marketing your menu.
D O N ’ T FO R G E T TO M A R K E T
YO U R S E L F
Finally, it’s important to market yourself, your credentials,
and your accomplishments. Make others aware of what
your job entails, the education you have, and the skillset
you bring to the job. Market the profession and its high
standards, such as the requirement for certification or a
degree, and the need for continuing education.
Remember that marketing is a process to meet the wants,
needs, and demands of the customer. The process includes
knowledge of the target market and characteristics of the
customers. Develop a marketing plan for your food service
that includes product, placement, price, and promotion,
and watch your satisfaction scores and profits soar. E
rpuckett@dce.ufl.edu
Ruby Puckett, MA, FFCSI is the
director of dietary manager training
at University of Florida, Division of
Continuing Education, Gainesville, Fla.  
She’s a member of ANFP’s Editorial
Advisory Board.   
Continued from page 30
Anum Ali
Paulo Allarde
Leticia Avelar
Frankie Bailey
Darnell Bartley
Antonio Brown
Michael Buck
Rebecca Burch
Claire Chrystal
Doug Crisp
Kimberly Densham
Jennifer DeSander
Cathy DeYoung
Andrea Dildy
Kay Douglas
Cheryl Dowell
Michelle Drouillard
Jade Fagerland
Tanya Florexile
David Galvan
Sandra Garcia
Laurie Gattman Sheldon
Giovanna Giancola
Holly Gilbertson
Gayle Gilchrist
Susanna Gray-Proctor
Robert Hatano
Lakeisha Hawthorne
Marcia Herceg
Tracy Hockenberry
Kyu Jang
Valerie Kampf
Karen Kay Garcia
Brian Kice
Neal Lavender
Sau Lee
The Certifying Board for Dietary Managers announces that 87
individuals passed the CDM Certification Exam in April. During that
time, 82 individuals activated their credential and are now officially
CDM, CFPPs. Congratulations to the following new CDMs:
CDM Certified Dietary Manager
Certified Food Protection Professional|CFPP® ®
Mary Maples
Rozell Marasigan
Michael Marino
LeeAnn Martin
Nya McAlister
Eric McClung
Alicia McCole
Steven McCoy
Marcus McGrew
James McKinney
Curtis Mensch
Wilfrido Mercado
Tracey Miller
Alberta Moore
Jessica Morrison
Bryan Mullet
Jason Mullikin
Clarence Nichols
Tamra O’Neal
Richard Page
Joshua Posey
Marsha Reynolds
Ericka Rieckers
Rebecca Riker
Brent Russell
Sharon Schmidt
Kurt Seeger
Julie Shelton
Brenda Sluder
Tami Stansbury
Wanda Stone
Stephanie	Stratman
Sheila Streider
Cinda Strickler
Iadanza Thomas
Jeremy Tishler
Maurice Tomat
Chhayleng Touch
Kyra Tyler
Alyssa Van
Peursem
David Wall
Rhonda
Washington
Wayne Webb
Mary Weiser
April Williams
Augustine	Wojcik
Nutrition & Foodservice Edge | June 2015 33
MESSAGE FROM THE CHAIR
The benefits I’ve experienced have been very
rewarding. As a new member, I had the privilege
of being mentored by long-time members that
have been very successful. With this mentoring
opportunity I saw the value of members gaining
experience and knowledge in the industry. I have
profited greatly from the wisdom of other nutrition
and foodservice professionals, and I’ve been able
to share my industry insights and experiences with
peers over the years. This has provided a winning
combination for all involved, and has afforded value
both ways.
One of the biggest advantages ANFP offers me is
the opportunity to increase my knowledge in the
profession through courses, seminars, workshops,
publications, and other education avenues. This is
invaluable in terms of personal and professional
growth, and it’s also important to the facilities and
clients we serve.
Working together, we can raise awareness of ANFP
standards and practices. The association can be
shown in a positive light as members showcase
what the group has to offer others in this career
field. If members take the time to convey their
needs, great value can be provided to the organiza-
tion and, by extension, our members.  
The ability to contact and connect with our col-
leagues may be the biggest membership value of
all. There is really no substitute for peer-to-peer
interaction. You can build valuable relationships with
other members that can pay off when looking for a
new job or when needing referrals or recommenda-
tions on products and services. ANFP meetings,
casual networking events, and our online member
community—ANFPConnect—give you opportunities
to meet and mingle with your peers.
I know that dues and fees for professional organiza-
tions can be a bit expensive.  Yet, that money can
provide great value to you in the future, and to the
organization. Our dues dollars support a myriad
of advocacy efforts and other initiatives that bring
value to the profession and to our credential.
I encourage you to get involved in ANFP and enjoy
the benefits of being an active member of your
professional association! E
The Association of Nutrition & Foodservice Professionals has value for each member. I joined the
organization in 1990 and have found that being involved enhances my professional success and
personal confidence. I’ve been able to give to and receive from the association. ANFP has given
me the ability to do both.
Deborah McDonald, CDM, CFPP is the Program Administrator
for Food Service at North Texas State Hospital, Wichita Falls
Campus. She has worked in food service for 35 years.
dmcdonald@anfponline.org
by Deborah McDonald, CDM, CFPP
The Value of Your ANFP Membership
The ability to contact
and connect with our
colleagues may be the biggest
membership value of all.
Nutrition & Foodservice Edge | June 201534
Meet Your Incoming 2015-2016
Officers and Directors
®
2015 -2016 BOARD
CONGRATULATIONS to the following individuals, who will serve as national leaders on the ANFP
Board of Directors and the Certifying Board for Dietary Managers in 2015-2016. The ANFP Leadership
Development Committee recommended these individuals, and their names were distributed to mem-
bers in late winter. The ANFP Board then approved this slate at their March 11 meeting. They will take
office June 1, 2015.
These incoming board members join current ANFP national leaders whose positions will change as
follows on June 1. Deborah McDonald, CDM, CFPP ascends to the position of 2015-2016 ANFP
Chair of the Board; Janice Hemel, CDM, CFPP becomes Chair Elect; Kathryn Massey, BA, CDM,
CFPP becomes Immediate Past Chair; and Ken Hanson, CDM, CFPP moves from Treasurer Elect to
Treasurer. Best wishes to all ANFP volunteer leaders in their new roles!
O F F I C E R S
Nurturing careers,
Setting standards,
Sharing best practices.
®
2 0 1 5 - 2 0 1 6 B O A R D O F D I R E C T O R S
Chair Elect
Janice Hemel, CDM, CFPP
Dighton, KS
Treasurer Elect
Sharon Vermeer, CDM, CFPP
Maurice, IA
Immediate Past Chair
Kathryn Massey, BA, CDM, CFPP
Sioux City, IA
Cindy Cothern, CDM, CFPP
Mound Valley, KS
John Hickson, CCA, FMP, CHESP,
CDM, CFPP
Slidell, LA
Richard Hoelzel, CDM, CFPP, FMP
Cabot, AR
Larry J. Jackson, CDM, CFPP
Americus, GA
Richard “Nick” Nickless, CDM, CFPP
Hanahan, SC
Sherri Williams, CDM, CFPP
Fayetteville, AR
D I R E C T O R S AT L A R G E
CDM, CFPPs
Deb Dawson, CDM, CFPP
Johnston, IA
H C I L I A I S O N
Amy B. Lewis, MBA
SimplyThick, LLC
Mystic, CT
Carl Mulder
Aladdin Temp-Rite
Hendersonville, TN
Corporate Partners
Gary Blake
Creative Solutions in
Healthcare, Inc.
Fort Worth, TX
Jeff Patton
Brookdale Senior Living, Inc.
Brentwood, TN
Joyce Gilbert, PhD, RDN
St. Charles, IL
Industry PartnersChair
Deborah McDonald,
CDM, CFPP
Burkburnett, TX
Treasurer
Ken Hanson, CDM, CFPP
Ankeny, IA
A N F P P R E S I D E N T & C E O
Nutrition & Foodservice Edge | June 2015 35
Continued on page 36
Janice Hemel, CDM,
CFPP
Dighton, KS
Certified Dietary Manager,
Lane County Hospital and
Long-Term Care
Years Worked in Food
Service: 29
Years in ANFP: 23
Sharon Vermeer,
CDM, CFPP
Maurice, IA
Food Services Manager,
Orange City Area Health
System
Years Worked in Food
Service: 19
Years in ANFP: 16
A N F P C H A I R E L E C T: A N F P T R E A S U R E R E L E C T:
Notable Volunteer Activities
ANFP Board Treasurer; ANFP Audit/Finance, Education
Content, and Leadership Development Committees;
Kansas ANFP Chapter President, School Liaison, Secretary,
Treasurer, and several committees; Nutrition & Foodser-
vice Education Foundation Board Member; President -
Home Extension Service
Why are you interested in serving ANFP at the
national board level?
I have enjoyed my experience on the board so far [most
recently serving as treasurer] and feel I give a different out-
look. I like to look at all sides of the picture when topics
are being discussed to see what will be the best outcome
for all CDMs. Increased communication from the board
to the members is essential to work together on changes
that are happening within the industry and organization.
I live, eat and sleep ANFP, and I want to help make it the
“go-to” association in the food industry.
What do you think you’ll bring to the ANFP Board?
I come from a small town in western Kansas. I have learned
how to do more with less, think outside the box, and see
the picture from all sides. I can use these talents to help
ANFP move forward in the future to ensure our CDMs have
the education and tools it takes to be successful members.
This will help keep our association strong for many years to
come. We need to be accessible to our members and to the
foodservice industry to make the best better.
Notable Volunteer Activities
ANFP Board Director at Large; ANFP Chapter Leadership
Team; CBDM Item Writer; Iowa ANFP Chapter President
Why are you interested in serving ANFP at the
national board level?
I’ve really enjoyed the time I have already spent on the
board [most recently serving as director at large]. There is
so much more to learn about ANFP. It is an honor to volun-
teer at the national level!
As a CDM, our management skills and leadership are vital
to a well-run kitchen. Because, let’s face it, that’s the one
thing patients and residents can control. It’s something
to look forward to: not just the food, but the fellowship.
What we do creates that for them. What we do matters.
As CDMs, we need to market ourselves to our CEOs and
bosses, helping them to see the great value a well-run
department affords them. I believe we can help CDMs do
that by things we do as a national board.
What do you think you’ll bring to the ANFP Board?
I have a real passion for CDMs. One of the advantages of
our board is that it is comprised of people from all dif-
ferent areas of the country, which affords us many points
of view. By working as a team, we can incorporate those
views and do what is best for our organization and all of us
as CDMs.
Nutrition & Foodservice Edge | June 201536
Cindy Cothern,
CDM, CFPP
Mound Valley, KS
Dietary Manager,
Montgomery Place
Years Worked in Food
Service: 25
Years in ANFP: 17
John Hickson, CCA,
FMP, CHESP,
CDM, CFPP
Slidell, LA
Independent Food
Safety Auditor,
Verify International
Years Worked in Food
Service: 28
Years in ANFP: 3
A N F P D I R E C TO R AT L A R G E : A N F P D I R E C TO R AT L A R G E :
Notable Volunteer Activities
ANFP Legislative Committee; Kansas ANFP Chapter Educa-
tion Chair and Legislative Spokesperson
Why are you interested in serving ANFP at the
national board level?
ANFP has been good to me through the years. The mem-
bers have become like family to me, and I definitely have
more time on my hands with the children moved out of
the house. It is a perfect opportunity for me to give back
to an organization that has supported me for many years.
When I became active at the state level I was surprised to
find that I have some talent working with government af-
fairs! After doing some speaking with CDMs and members
of Congress, I found I have a voice, and people want to
hear it. It would be my pleasure to serve the members and
help the organization that has helped me so much over
the years.
What do you think you’ll bring to the ANFP Board?
I’ll bring dedication to our association and to our mem-
bers, an enthusiastic attitude, and a willing spirit. I am
excited to learn new ways to serve. I believe we have a
bright and exciting future ahead of us, and I look forward
to assisting our association in preparing for that future.
Notable Volunteer Activities
Louisiana ANFP Chapter President and Membership Chair;
ANFP Professional Development Committee; Second
Harvesters Volunteer Teaching Chef; National Restaurant
Association Education Foundation Exam Item Writer for
ServSafe and ManageFirst Programs
Why are you interested in serving ANFP at the
national board level?
I was raised to always give back to my community in the
best way possible. I would like to help my fellow CDMs
achieve all they can, by expanding our education offerings
to our members. I believe that with over 28 years of expe-
rience within the foodservice industry it is time to share
my education and experience with up and coming CDMs.
What do you think you’ll bring to the ANFP Board?
I will bring a wealth of industry knowledge to the board,
along with my successful team building skills. I am an “at-
tack the issue/problem” now and resolve it immediately
type of person. I enjoy working with a diverse group of in-
dividuals and working on common ground for the good of
the whole association. I have a solid history of producing
results within a limited budget. I have built and success-
fully managed multiple foodservice operations; I deal ef-
fectively with customers, executives, and stakeholders on a
regular basis. All of these achievements are critical to the
success of any organization. My educational background,
experience, and skills are diverse, and I look forward to
serving ANFP members.
Continued from page 35
Nutrition & Foodservice Edge | June 2015 37
Carl Mulder
Hendersonville, TN
Vice President of Sales and
Marketing, Aladdin
Temp-Rite
Gary Blake
Fort Worth, TX
Owner & Founder, Creative
Solutions in Healthcare, Inc.
ANFP DIREC TOR AT L ARGE—
CORPOR ATE PARTNER:
ANFP DIREC TOR AT L ARGE—
INDUSTRY PARTNER:
Why are you interested in serving ANFP at the
national board level?
The Board of Directors is integral to the growth and suc-
cess of ANFP.
Because I recognize the importance of ANFP to the CDM
community in food service and the positive impact its
members have on the industry, I’ve personally been af-
filiated with ANFP for many years; my company, Aladdin
Temp-Rite, has supported ANFP for many more.
Working with ANFP is an exciting opportunity to contrib-
ute to the organization’s future by bringing value to its
CDM members. Through mentoring, peer interactions and
educational engagement programs that provide learning
at every career stage, ANFP has so much to offer members
and potential members. We will continue to build on that
success.
What do you think you’ll bring to the ANFP Board?
As a member of the corporate foodservice supplier/partner
community, I have a very diverse background in finding
answers to challenges, and successfully resolving problems
that arise in the foodservice industry.
While serving as the Chair of the Industry Advisory Coun-
cil this next year, it affords me the opportunity to liaise
between ANFP’s corporate partners and the board.
The ultimate goal is more CDM members and supplier
partners that support the organization, leading to a stron-
ger, more valuable ANFP.
Notable Volunteer Activities
Recipient of ANFP’s 2014 Leading Change Partnership
Award; Member of Fort Worth Academy School Board
Why are you interested in serving ANFP at the
national board level?
I value the services of nationally-certified dietary manag-
ers, and I want to support their professional organization.
As the leader of a large group of skilled nursing facilities, I
have come to realize over the past 15 years the importance
of having a well-qualified dietary manager at the helm of
each of my dietary departments, and I see the benefits of
having a strong professional organization to support the
certified dietary manager.
What do you think you’ll bring to the ANFP Board?
I bring direct hands-on experience with the issues fac-
ing dietary managers in long-term care every day. When
founding Creative Solutions in Healthcare, one facility at a
time, I realized first-hand the challenges and rewards that
our dietary managers experience every day. I appreciate
the range of decisions that a dietary manager must make,
and how these decisions have a profound impact on the
lives of our residents. I believe that this grassroots knowl-
edge will serve me well when helping to make decisions
about the future of ANFP.
Continued on page 38
Nutrition & Foodservice Edge | June 201538
Richard Hoelzel, CDM, CFPP, FMP
Larry Jackson, CDM, CFPP
Richard “Nick” Nickless, CDM, CFPP
Sherri Williams, CDM, CFPP
Amy Lewis, MBA, SimplyThick LLC
(Corporate Partner)
Jeff Patton, Brookdale Senior Living, Inc.
(Industry Partner)
Debra Dawson, CDM, CFPP (HCI Liaison)
Thanks for Serving
A N F P D I R E C TO R S AT L A R G E
C E R TI F Y I N G B OA R D
A N F P D I R E C TO R S AT L A R G E
Theresa Fightmaster
Yvonne Foyt, CDM, CFPP
Kristin Klinefelter, RD
Dana Moyers, NHA
Barbara Thomsen, CDM, CFPP
CarieAnn Williams, CDM, CFPP
Terri Edens, CDM, CFPP, LNHA
Kevin Loughran, Healthcare
Services Group (Industry Partner)
Beth Naber, MS, RD, US Foods
(Corporate Partner)
Sue Zins, CDM, CFPP,
2014-2015 CBDM Chair
Paula Bradley, CDM, CFPP,
2014-2015 ANFP Immediate Past Chair
The following individuals will continue serving
ANFP or the CBDM in leadership roles in 2015-2016.
We appreciate their ongoing commitment to serve!
The following national leaders will complete their
term of service on May 31, 2015. ANFP and the
CBDM are grateful to them for their leadership.
Timothy L. Bauman,
DHCFA, CDM, CFPP
Sylvania, OH
President/Owner, BBSLLC
Years Worked in Food
Service: 41
Years in ANFP: 25
C E R TI F Y I N G B OA R D M E M B E R :
Notable Volunteer Activities
Ohio ANFP Chapter President and Webmaster; Fellow with
the National Center for Nutrition Leadership; CBDM Item
Writer; Board Member of three CDM certification pro-
grams; Board Member of ASHFSA/AHF, MedAssets, HPS,
NOSS, Wood County Health District, Food & Nutrition
Advisory BGSU
Why are you interested in serving on the
Certifying Board for Dietary Managers?
A chance to advance both the profession and the organiza-
tion are top goals when I serve on the CBDM. Champion-
ing education and getting greater national recognition
for our credential and government advocacy activities are
priorities. I work hard to get donations, vendor support,
and work on behalf of the membership. Supporting certi-
fication programs across the nation is an excellent way to
increase the membership and visibility of the organization.
What do you think you’ll bring to the CBDM?
I look forward to giving back to something that has done
so much for me through the years. I have served in the
trenches as a member and enjoyed serving Ohio ANFP. I
have produced many articles for the magazine and have
served on several national ANFP committees including
the CBDM Item Writers Committee. I attended the ANFP
Leadership Institute and, as a result, was named a Fellow
with the National Center for Nutrition with MOWAA. I
served as a board member for three CDM course pro-
grams and am a frequent speaker. Wherever I can pro-
mote education, the organization and industry, I do.
Continued from page 37
C E R TI F Y I N G B OA R D
Truly Proud!-Article on Mentorship 2015
Truly Proud!-Article on Mentorship 2015
Truly Proud!-Article on Mentorship 2015
Truly Proud!-Article on Mentorship 2015

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Truly Proud!-Article on Mentorship 2015

  • 1. Bird Flu What it Means to You and Your Clients Nutrition Labeling New Changes Are in Store JUNE 2015 Foodservice Marketing Success Strategies & ANFP Annual Conference & Expo Preview ACE&& ORLANDO, FL | 2015 Annual Conference & Expo Artificial Nutrition & Hydration Client Conversations Are Key
  • 2.
  • 3. Nutrition & Foodservice Edge | June 2015 1 ®P U B L I S H E D B Y CONTENTS 3 Food File 7 Leaders & Luminaries 10 Food Protection Connection 33 Message From the Chair 39 CDM Spotlight Nutrition & Foodservice Edge DE PARTM ENTS 16 22 28 34 June 2015 / Volume 24 / Issue No. 6 1 HOUR SAN FEATURES 16 Nutrition Labeling—Past, Present, Future by Linda Eck Mills, MBA, RDN, LDN, FADA New food labeling requirements will make it easier for consumers to determine the nutritional value of their food choices. Categories like calories, sugar, and serving sizes have been adjusted on the updated label. 22 Artificial Nutrition & Hydration: Conversations With Clients and Families by Brenda Richardson, MA, RDN, LD, CD, FAND The decision to use artificial nutrition and hydration (ANH) is a complex issue for clients and their families. An overview of ANH is provided, along with useful suggestions on how to support clients with self-directed living. 28 Foodservice Marketing Success Strategies by Ruby Puckett, MA, FFCSI Marketing your food service is an important strategy to grow your business and improve customer satisfaction. Strategies for promoting your department and its many products and services are provided here. 34 Meet Your Incoming 2015-2016 Officers and Directors Learn about who is leading ANFP and the Certifying Board in 2015-2016. This article introduces incoming national leaders, and shares their goals for office.
  • 4. Nutrition & Foodservice Edge | June 20152 New Online Courses From ANFP Nutrition & Foodservice Edge® is the premier resource for nutrition and foodservice professionals and those aspiring to careers in this industry. It is published by the Association of Nutrition & Foodservice Professionals. Editor. . . . . . . . . . . . . . . . . . . . . . . . Diane J. Everett deverett@ANFPonline.org Contributing Writer. . . . . . . . . . . Laura E. Vasilion lvasilion@ANFPonline.org Advertising Sales. . . . . . . . . . . . . . . . . Paula Fauth pfauth@ANFPonline.org Design. . . . . . . . . . . . . . . . . . . . . . . . . . Mercy Ehrler mercy@advanceddesign-online.com Nutrition & Foodservice Edge® (ISSN 21649669) is published monthly except combined issues in July/August and November/December. ©2015 by the Association of Nutrition & Foodservice Professionals, 406 Surrey Woods Drive, St. Charles, IL 60174. Phone: (630) 587-6336. Fax: (630) 587-6308. Web site: www.ANFPonline.org Periodicals postage paid at St. Charles, IL and additional mailing offices. POSTMASTER: Send address changes to Nutrition & Foodservice Edge® , 406 Surrey Woods Drive, St. Charles, IL 60174. Subscription Rates Edge subscription rate for ANFP members is $15, which is included with annual membership dues. Subscriptions are available to other interested parties for $40/year or $5/issue. Outside U.S., contact ANFP for pricing. Editorial Policy Readers are invited to submit manuscripts for publication consideration. Please contact the editor for specific publishing guidelines. Views expressed by contributors do not necessarily reflect the opinion of the association. Printed in the U.S.A. Lynne Eddy, MS, RD, FAND, CHE Associate Professor, Business Management, The Culinary Institute of America, Hyde Park, NY Richard Hynes Director, Consultant Services, Hobart Corp., Franklin, MA Ruby Puckett, MA, FFCSI Director, Dietary Manager Training, University of Florida Div of Continuing Ed., Gainesville, FL Marty Rothschild President, Aladdin Temp-Rite, Hendersonville, TN Bob Sala Founder and Director at Large, Distribution Market Advantage, Hoffman Estates, IL Renee Zonka, CEC, RD, MBA, CHE St. Charles, IL E DI TORI AL ADVI S ORY B OARD ® A L SO I N OUR PAGE S 10 15 More ANFP news, inspiration, and education at www.ANFPonline.org E DITOR’S NOTEBOOK Nutrition & Foodservice EdgeJune 2015 / Volume 24 / Issue No. 6 In a busy foodservice operation, where delivering quality meals to hungry clients is the top priority every day, the task of marketing your offerings may seem daunting. But your marketing programs don’t have to be huge or costly, they can be as simple as creating special signage or connecting with your facility’s public relations department for help. Our cover story discusses basic marketing con- cepts, and sprinkles in a few simple ideas for promoting your food service. Use the information and the list provided as a springboard for planning your publicity. Bird flu is making headlines. Your clients or administrator may ask you about the risks. Our resident food safety expert, Melissa Vac- caro, MS, CHO, separates fact from fiction beginning on page 10. Make sure you have the answers you need on this timely topic. Nutrition labeling is another timely subject in our pages this month. The new and improved food labels highlight the information of greatest interest and importance to consumers. See page 16 to learn what’s changed. This month we cover a subject that’s not always easy to talk about with clients: artificial nutrition and hydration. Make sure you know what your clients and their families want in terms of ANH. Strategies for discussions are provided in our page 22 article. And finally, take this opportunity to learn about your incoming na- tional ANFP and CBDM leaders. You can meet them beginning on page 34. They’re here to serve you! Diane Everett, Editor deverett@ANFPonline.org Marketing is one of my favorite topics. I enjoy brain- storming ideas and putting thoughts into action to help promote products and services. It feels good to carry out a successful marketing campaign. Bird Flu and Food Safety A D
  • 5. Nutrition & Foodservice Edge | June 2015 3 FO OD FILE A D Potatoes Are Packed with Nutrients AN OLD-FASHIONED summer cookout is not always a healthy affair, but these 10 tips from the registered dieti- tians at New York-Presbyterian Hospital can easily convert a fatty food blitz into a healthy and tasty menu: 1. Throw some unexpected foods on the grill such as peaches, plums, pine- apple, watermelon, avocado, summer squash, beets, corn, or a whole wheat pita. 2. Incorporate veggies into your BBQ menu by making veggie crudité, sal- ads, grilled veggie kebabs, veggie or portobello mushroom burgers, or by wrapping your grilled meats or fish in large leaves of lettuce instead of buns. DID YOU KNOW potatoes are a nutri- ent powerhouse? According to the non-profit Alliance for Potato Research and Education, one medium baked potato with skin on pro- vides 30 percent Daily Value for Vitamin C, more potassium than two bananas, and as much fiber as a medium stalk of broccoli. E 3. Cut the calories in your potato salad, coleslaw, and macaroni salad by using mustard, vinegar, or Greek yogurt instead of mayonnaise. 4. Alcohol may stimulate your appe- tite and add extra calories. Create nonalcoholic drinks by infusing fresh herbs, cucumber, and fruit into water and seltzer for low calorie refreshing drinks that kids can also enjoy. 5. Grilled chicken and turkey burgers get a fresh burst of flavor when you cut back on salt and marinate them with fresh or dried herbs, spices, vin- egars, or citrus juices. 6. Make refreshing smoothies with fresh or frozen fruit, yogurt, and ice. For more information, visit www.nyp.org Learn more at www.apre.org Continued on page 4 Nutrition & Foodservice Professional Training Program “During my course study with UND I was able to easily communicate with the teaching staff regarding questions and concerns. The assignments were challenging but helped me grow professionally.” - Susan Tackaberry, CDM, CFPP, Dietary Director, The Wellstead of Rogers & UND Graduate 1.800.CALL.UND dietarymanagers.UND.edu • Enroll anytime, online or by mail • RD preceptor available (online) • Excellent ANFP exam pass rates • Spanish translation now available 7. Eat healthy fats by adding fish to the menu, such as salmon, trout, and tuna. 8. Tofu is delicious on the grill; the extra- firm type works best on the bar- beque. It’s also great when marinated first! 9. Keep the food at a separate buffet table. Everyone will be less tempted to go for seconds if food is not in front of them while eating. 10. Be mindful of food safety. Wash hands, keep raw food separate from cooked food, cook food thoroughly, and keep hot food hot and cold food cold. When in doubt, throw it out! E 10 Healthy Ways to Spice Up Your Summer BBQ
  • 6. Nutrition & Foodservice Edge | June 20154 Continued from page 3 O Avocados: The Fruit Adding Good Fat to Guilty Pleasures Northwest Sweet Cherries: A Healthy Treat that Cools the Heat ONE OF THE HOTTEST FRUITS of summer is the avocado. Although known for being high in fat, the avocado holds nutritional value that can be a healthy addi- tion to even the most guilty of pleasures. For those looking for healthy alternatives this summer, avocados can lower cholesterol, aid weight loss, and enrich a diet with potassium and vitamins C and E. SideChef, an award-winning step-by-step cooking app, features several recipes that incorporate this fruit in interesting ways, including 15 Minute Easy Fish Tacos, reprinted below. E AS THE HEAT OF SUMMER ap- proaches, cool fresh Northwest cherries will be there to greet it, offering sweet relief to those wanting to eat healthfully and seasonally. Northwest Cherries are a Sweet Healthy Treat Thanks to this year’s unseasonably warm spring in the Northwest, cherry growers are reporting that both their dark red and yellow-blushed sweet cherries are arriving early—giving everyone a chance to enjoy both the flavor and anti-inflam- matory benefits of these powerful little fruits. Not only are cherries a delicious sum- mertime treat, but recent research also suggests that they may reduce the risk or modify the severity of chronic diseases. Acting to “cool” inflammation, cherries may be beneficial in combat- ing arthritis, diabetes, cardiovascular disease, blood pressure, and cancer. Researchers found that consuming about 45 (280 g) cherries daily may significantly decrease circulating con- centrations of specific inflammatory bio- markers in the body. The research study, published in The Journal of Nutrition, was conducted at the USDA-ARS West- ern Human Nutrition Research Center. Because of the link between inflamma- tory markers and some chronic diseases, the changes in the identified biomark- ers suggest that consuming cherries may reduce risk or modify the severity of diseases such as heart disease and diabetes. Cherries are high in phenolic com- pounds, specifically anthocyanins, which give them their deep ruby color and 15 Minute Easy Fish Tacos by Well Worn Fork WellWornFork.com EASY AVOCADO RECIPE INGREDIENTS • Salt and pepper to taste • Sriracha to taste • Cilantro to taste • 1 Avocado • 1 Tbsp. Mirin • 1/2 Tbsp. Hot Sauce • 1 Lime • 1 tsp. Sugar • 1/4 cup Mayonnaise • 2 cups Broccoli Slaw • 1 Jalapeño • 6 Flour Tortillas • 1 lb. Cod Fillets INSTRUCTIONS 1. Preheat oven to 400 degrees. 2. Combine the broccoli slaw (2 cups), mayonnaise (1/4 cup), sugar (1 tsp.), juice of 1/2 lime (1), hot sauce (1/2 Tbsp.), and mirin (1 Tbsp.) together in a bowl with salt and pepper (to taste). 3. Season the cod fillets (1 lb.) with salt and pepper (to taste) and put on a sheet tray. Cook in the oven for 5-10 minutes depending on thickness. 4. Slice the jalapeño (1) and avocado (1). It’s up to you if you want the jala- peño with or without seeds. 5. Assemble the tacos on flour tortillas (6) with cod, sliced jalapeño, slaw, sliced avocado, cilantro (to taste), sriracha (to taste), and a squeeze of the remaining lime. For more information, visit www.SideChef.com
  • 7. Nutrition & Foodservice Edge | June 2015 5 ©2015NationalPasteurizedEggs,Inc.v6094 Get this recipe and more at SafeEggs.com/Strata FREE CE for CDM, CFPPs: Supplier Relationships & Partnership Experience June 15 Register online: SafeEggs.com/webinars Great Food. SafeEggs.™ ©2015NationalPasteurizedEggs,Inc.v6094 Safest Choice™ Pasteurized Shell Eggs eliminate the risk of Salmonella. Continued on page 6 Visit www.nwcherries.com have been shown to fight inflammation. Cherries are also a good source of vita- min C and fiber, and are a natural source of melatonin, a compound which helps regulate the body’s sleep cycle. “Cherries bring more to the table than just great flavor; they also have potent anti-inflammatory effects as well as other nutritional benefits,” says James Michael, Vice President of Marketing for the Northwest Cherry Growers. Cherries are arriving at markets across the country. The season will wind down in late July, but to extend the flavor and health benefits even longer, Michael sug- gests freezing them. “Or simply enjoy them straight from the freezer.” E
  • 8. Nutrition & Foodservice Edge | June 20156 Continued from page 5 Consulting Dietitians, Menu & Meal Card Programs, and Support for Dining Services in Long Term Care www.ht-ss.com National Ice Cream Day is Sunday, July 19 NATIONAL ICE CREAM DAY is cel- ebrated each year on the third Sunday in July and is a part of National Ice Cream Month. This day is a fun celebration enjoyed with a bowl, cup, or cone filled with your favorite flavor of ice cream. Thousands of years ago, people in the Persian Empire would put snow in a bowl, pour grape-juice concentrate over it, and eat it as a treat. They did this when the weather was hot and used the snow saved in the cool-keeping under- ground chambers known as “yakhchal,” or taken from the snowfall that still remained at the top of mountains by the summer capital. It is believed that ice cream was first introduced into the United States by Quaker colonists who brought their ice cream recipes with them. Their ice cream was sold at shops in New York and other cities during the colonial era. • Ben Franklin, George Washington, and Thomas Jefferson were known to have been regular eaters of ice cream. • First Lady Dolley Madison served ice cream at the Inaugural Ball in 1813. • African American confectioner Augus- tus Jackson created multiple ice cream recipes as well as a superior technique to manufacture ice cream in 1832. • A Philadelphian, Nancy Johnson, was issued the first U.S. patent for a small- scale hand-cranked ice cream freezer in 1843. • It is estimated that there are over 1,000 ice cream flavors today. National Ice Cream Day History In 1984, President Ronald Reagan proclaimed July as National Ice Cream Month, and established National Ice Cream Day as the third Sunday in July. E Visit www.nationaldaycalendar.com
  • 9. In this column we profile leaders and luminaries in the culinary and foodservice industry. We hope their insights, experiences, and stories of perseverance will help inspire you to achieve your career goals. Nutrition & Foodservice Edge | June 2015 7 LEADERS & LUMINARIES Elana Karpby Laura Vasilion Executive Chef Elana Karp BR I NG I NG COOKI NG HO ME Elana Karp is the Vice President of Culinary at Plated, which provides chef-designed recipes and quality pre-portioned ingredients, delivered di- rectly to the door of subscribers. After Karp graduated from Cornell University in 2008, she moved to Paris to study cooking at Le Cordon Bleu. While in Paris, she hosted pop-up dinners with classmates, and cooked for the Australian Ambassador to France. Upon returning to New York, she worked within the food industry while developing a school-based food education program and culinary camp for children. Karp joined Plated as Culinary Director in January 2013, and has been creating recipes, crafting menus, and coordinating chef partnerships ever since. Continued on page 8
  • 10. Nutrition & Foodservice Edge | June 20158 QWhy do you think providing a cook-at-home service is an impor- tant trend? I think cook-at-home services are important because there’s end- less value in cooking and eating at home. Not only do you know every- thing that’s going into your food, but you learn a life skill in the process, and then get to connect with those you love in the kitchen and around the table. Plated allows everyone to participate in this amazing experi- ence, without the hassles of meal planning and grocery shopping. QWhat is one of the most im- portant life lessons you have learned from being a chef? When things don’t work out, or is- sues arise, it’s important to go with the flow and figure out a solution. We ship hundreds of thousands of meals per week all across the United States. That means that occasionally one fulfillment center won’t be able to source the right type of lettuce, or one vendor will send us too few onions. When things like that hap- pen, it’s up to my team to figure out how to make what we do have into the best recipe possible and the most amazing customer experience. QWhat moment are you most proud of in your career? A few months after Plated launched, we got an email from a customer saying that she had been with her boyfriend for years and they had recently started cooking Plated Continued from page 7 QTell us about where you grew up and how that influenced your interest in cooking. I grew up in New York City, which is a melting pot of cultures as well as food. There are always new restau- rants popping up, from a $1 dump- ling shop to a fancy steakhouse, and endless options of dishes to try. This variety of cuisines sparked my inter- est in food and cooking. QWhat ethnic influences from your childhood make their way into your cooking? I grew up in a Jewish family where every holiday—from Passover to the Fourth of July to birthdays—was centered on food. I wouldn’t say that Jewish food itself has had a huge influence on my cooking (although I do always need a bowl of chicken soup if I’m not feeling well), but the culture of sitting down and eating a meal as a family definitely has. QWhen did you first know you wanted to cook for a living? Cooking as a profession really did not occur to me until I started culinary school. I actually enrolled in a short-term introductory cook- ing program in Paris, thinking I’d just stay for one month, learn a few skills, and then head back home to New York to my career in educa- tion. After about one week in this cooking program, I was hooked. I realized I could make a career out of cooking, something that brought me tons of joy, and decided to enroll full time. I stayed in Paris for a year, getting a culinary degree from Le Cordon Bleu, and I’ve been working in food ever since. QIf you could prepare a meal of your choice for anyone, living or dead, who would that be and what would you cook? I’d want to cook for my friends and family. I would prepare this one pan rosemary roasted chicken with parsnips and carrots. It’s so simple to make, requires almost no clean up, and can be tweaked by season de- pending on what vegetables are avail- able. It is a Plated classic recipe and actually was the inspiration for our cookbook, which is coming out from Clarkson Potter next spring. QIf you were unable to cook for a living, what other profession would you have pursued? I’d probably still be working in educa- tion. Before cooking, I worked as a second grade teacher and earned a degree in childhood education. Work- ing with kids was exhausting, but tons of fun and something I really enjoyed. Luckily, I still get to teach in my role at Plated. I’m able to teach busy Ameri- cans all over the country to cook and enjoy it, and feel proud of their newly acquired culinary skills. Food educa- tion has always been important to me and I’m still committed to that mission here; educating customers about the power of real, non-processed, good food.
  • 11. Nutrition & Foodservice Edge | June 2015 9 together. She made him one of our meals—Chicken Paillard with Shaved Asparagus Salad and Olive Oil Smashed Potatoes—and dur- ing dinner, he proposed. She was overjoyed and credited the dinner for the proposal. While I’m sure the dinner wasn’t why her boyfriend decided he wanted to marry her, the story was so special nonethe- less. It made me realize that we were creating a product that was an important part of people’s lives and something they felt really con- nected to. Hearing that story was my proudest career moment so far, because it was when I knew I was doing something big. QWhat advice would you give to someone wanting to follow in your footsteps? Follow your passion. I know that sounds cliché and predictable, but I really believe it. If you had told me five years ago that I’d be where I am today, I never would have believed it. But I followed my passion, stayed open to any opportunities that came my way, and wasn’t afraid to get my hands dirty. That led me to a job and career that I love so much, it never feels like I’m going to “work.” E Laura Vasilion is a freelance writer with 25 years of experience writing for various publications including Newsweek and Reader’s Digest. In her Chicago Tribune ChicagoNow blog, she interviews one person from each country in the world about their life. Visit www.chicagonow.com/ talking-world/ lvasilion@ANFPonline.org MULTIGEN Simple innovations that make all the difference. MULTIGEN www.burlodgeusa.com Multi-portion point of service cart for: • cook-serve • cook-chill • cook-freeze Follow your passion. I stayed open to any opportunities that came my way and wasn’t afraid to get my hands dirty. That led me to a job and career that I love so much, it never feels like I’m going to work.
  • 12. Nutrition & Foodservice Edge | June 201510 FOOD PROTECTION CONNECTION Bird Flu by Melissa Vaccaro, MS, CHO Avian influenza A (AI)—or bird flu—is making headlines across America. The average person does not understand what bird flu is, or if it should be a worry for them. AI is not as simplistic as it may sound as there are many classifications, some of which are a concern and some are not. Certain types affect only animals, and oth- ers can potentially impact humans. Wild birds are believed to be behind the current U.S. out- break. Since mid-December, the USDA has been dealing with several highly pathogenic avian influenza (HPAI) ‘H5’ cases. It started along the Pacific, Central and Mississippi flyways (migratory bird paths); however by the time this article is read, it will have spread across the U.S. The states not affected at this point are studying their emergency response plans. Two types of AI are identified: low pathogenic (LPAI) and highly pathogenic (HPAI). This difference refers to the ability of the virus to produce disease and mortality in chickens. AI viruses are classified by a combination of two groups of proteins: 1 HOUR SAN and Food Safety
  • 13. Nutrition & Foodservice Edge | June 2015 11 HPAI H5N1: “Asian” H5N1 is the type causing worldwide concern. High path AI spreads rapidly and is often fatal to chickens and turkeys. This has not been detected in the United States. Human illness has been reported. LPAI H5N1: “North American” H5N1 is of less concern. It is common in wild birds and in most cases caused minor sickness to not noticeable signs of disease. It is rarely fatal in birds. LPAI H5N1 is not known to be a human health concern. Mixed Origin HPAI: In the Pacific flyways, H5N8 virus mixed with North American AI virus, creating new mixed- origin viruses. These mixed origin viruses, H5N2 and a new H5N1 in the Pacific Flyways. • HPAI H5N2 mixed strain has been found in North American Flyways. It mixes Eurasian H5 virus with North American N2 virus. No human cases have been associ- ated with either the North American or the Eurasian lineages of HPAI H5N2 viruses. This seems to be the largest concern in the United States. • New APAI H5N1 mixed strain virus is not the same as the Asian H5N1 virus found in Asia, Europe, and Africa that caused human illness. It mixes Asian HPAI H5 genes with LPAI North American N genes. A I A N D H U M A N H E A LT H According to the Centers for Disease Control and Pre- vention (CDC), current outbreaks of highly pathogenic avian influenza (HPAI) H5 viruses in U.S. domestic and wild birds have the potential to cause human infections. (http://www.cdc.gov/flu/news/avian-h5-viruses.htm) Though no human infections with these viruses have been reported at this point and the CDC believes the risk of human infection is low, similar H5 viruses have in- fected people in other parts of the world, and it’s possible that human infections associated with these viruses may occur in the U.S. Most human infections with similar HPAI viruses in other countries have occurred after prolonged and close contact with infected birds. Out of an abundance of caution, all federal and state agencies are monitoring the spread of AI in the United States. As a general rule cautions should be taken. The CDC recommends that people should avoid wild birds and potentially infected domestic poultry; ob- • Hemagglutinin—H proteins of which there are 16 (H1-H16) • Neuraminidase—N proteins of which there are 9 (N1-N9) The primary strains detected are HPAI H5N8, novel HPAI H5N1, and HPAI H5N2. H5N8: A threat to wild birds and poultry, but no human cases have been associated with this virus. Continued on page 12 HOW TO E NSURE YOUR FO O DSERVICE O PE RATION IS PROTECTED
  • 14. Nutrition & Foodservice Edge | June 201512 Continued from page 11 serve wild birds only from a distance, avoid contact with domestic birds (poultry) that appear ill or have died; and avoid contact with surfaces that appear to be contami- nated with feces from wild or domestic birds. E CO N O M I C I M PAC T The largest concern with AI in the U.S. is its economic impact on the poultry and egg industry and consumers. Import/export bans and mass loss of poultry could result in large economic impacts on the industry. Once found in or around a farm, the entire population of birds is usually destroyed (culled). As a result, counties begin to ban poul- try exports from those areas. Although farmers may have strong prevention measures in place, in many cases the farmer is at the mercy of migratory birds that may be flying overhead and excrete while over the farm. Already in 2015 millions of birds in the U.S. have been culled. Consumers get concerned and lose faith in the industry, which could reduce consumption of eggs and poultry. Due to the economic impact to the farmer, prices of eggs and poultry will certainly rise. A I A N D FO O D SA F E T Y The United States Department of Agriculture has provided the following questions and answers regarding food safety as it relates to poultry and egg consumption. (USDA, April 2015) Q Can I get avian influenza from eating poultry or eggs? A No. Poultry and eggs that are properly prepared and cooked are safe to eat. Proper food safety practices are important every day. In addition to proper process- ing, proper handling and cooking of poultry provides protection from viruses and bacteria, including avian influenza. As we remind consumers each and every day, there are four basic food safety steps to follow: CLEAN, SEPARATE, COOK, and CHILL. Q How can USDA assure consumers that avian influenza infected meat will not enter the food supply? A The chance of infected poultry entering the food chain is extremely low. As part of the USDA highly pathogen- ic avian influenza response plan, infected birds do not enter the food supply. Additionally, USDA’s Food Safety and Inspection Service inspection program personnel are assigned to every federally inspected meat, poultry and egg product plant in America. All poultry prod- ucts for public consumption are inspected for signs of disease both before and after slaughter. The “inspected for wholesomeness by the U.S. Department of Agricul- ture” seal ensures the poultry is free from visible signs of disease. Q Does proper food handling prevent avian influenza? A Avian influenza is not transmissible by eating prop- erly prepared poultry, so properly prepared and cooked poultry and eggs are safe to eat. The chance of infected poultry or eggs entering the food chain is Avian influenza is not transmissible by eating properly prepared poultry, so properly prepared and cooked poultry and eggs are safe to eat.
  • 15. Nutrition & Foodservice Edge | June 2015 13 extremely low because of the rapid onset of symptoms in poultry as well as the safeguards USDA has in place, which include testing of flocks, and federal inspection programs. USDA works to educate the public about safe food handling practices in response to numerous questions from the public about the human risk associ- ated with avian influenza. Q What does proper food handling mean? A Proper handling and cooking of poultry provides protection against all avian influenza viruses, as it does against other viruses and bacteria, including Salmo- nella and E.coli. Safe food handling and preparation is important at all times. USDA continually reminds consumers to practice safe food handling and prepara- tion every day. Cooking poultry, eggs, and other poultry products to the proper temperature and preventing cross-contam- ination between raw and cooked food is the key to safety. You should: • Wash hands with warm water and soap for at least 20 seconds before and after handling raw poultry and eggs; • Prevent cross-contamination by keeping raw poul- try and eggs away from other foods; • After cutting raw meat, wash cutting board, knife, and countertops with hot, soapy water; • Sanitize cutting boards by using a solution of 1 tablespoon chlorine bleach in 1 gallon of water; • Use a food thermometer to ensure poultry has reached the safe internal temperature of at least 165 °F to kill foodborne germs that might be pres- ent, including the avian influenza viruses. W H AT I S B E I N G D O N E What is being done to prevent and stop the spread of HPAI? A tremendous amount of work goes into controlling the spread of AI. • Early detection is key to preventing the spread of the virus. Surveillance programs have been in place for many years, both in the US and overseas. • The United States has the strongest AI surveillance program in the world. The USDA and poultry industry partners are actively looking for the disease. • States have AI Emergency Response Plans in place. • Commercial poultry flock testing is well established. • Regulatory agencies immediately quarantine poten- tially‐infected flocks and collect samples for AI testing. • Once a flock is confirmed positive, the regulatory agency and the USDA work with the producer/bird owner to create a flock plan. The plan includes apprais- al, indemnity and depopulation of remaining birds, carcass disposal, and cleaning and disinfection of the premises. • To meet federal requirements for HPAI response, the regulatory agency also conducts surveillance testing within 10 km of the affected farm and notifies all other poultry owners within a 20 km area. Since AI is making front page news, it’s important to know the facts. When your clients and administrators ask ques- tions about bird flu, you’ll have the knowledge and under- standing to answer them. E Continued on page 14 P R O P E R LY CO O K P O U LT RY A N D E G G S A N D P R E V E N T C R O S S - CO N TA M I N AT I O N
  • 16. Nutrition & Foodservice Edge | June 201514 1. Avian influenza is ______ by eating properly prepared poultry. A. spread B. not transmissible C. transmissible 2. Asian HPAI H5N1 has A. Not been found in the United States B. Has caused human illness C. Both A and B 3. The low pathogenic (LPAI) and high pathogenic (HPAI) difference means A. The ability of the virus to produce disease and mortality in chickens B. The ability of the virus to produce disease and mortality in humans C. The ability of the virus to produce disease and mortality in poultry and humans 4. Which virus is less pathogenic? A. LPAI H5N1 B. HPAI H5N1 C. HPAI H5N8 Reading Bird Flu and Food Safety and successfully completing these questions online has been approved for 1 hour of sanitation CE for CDM, CFPPs. CE credit is available ONLINE ONLY. To earn 1 San CE hour, purchase the online CE quiz in the ANFP Marketplace. Visit www.ANFPonline.org/market, select “Publication,” then select “CE article” at left, then search the title “Bird Flu and Food Safety” and purchase the article. FOOD PROTECTION CONNECTIONReview Questions 1 HOUR SAN 5. How can I avoid getting an AI virus? A. Avoid close contact with wild birds B. Avoid close contact with domestic birds that appear ill C. Both A and B 6. What is being done to control the spread of AI? A. Surveillance and testing of flocks B. Removal of any ill poultry from farms C. Not allowing backyard flocks 7. According to the CDC, the chance of human infection with HPAI in the U.S. is A. High B. Low C. Will not occur M A K E YO U R C E H O U R S AU D I T P R O O F Attention CDMs! Purchase your online CE products in the ANFP Marketplace and your completed CE hours will be automatically reported in your continuing education record. This includes all ANFP online courses, archived webinars, and CE online articles. Melissa Vaccaro, MS, CHO is a Food Program Specialist for the PA Department of Agriculture and an Executive Board Member for the Central Atlantic States Association of Food and Drug Officials (CASA). She is co-author of the SURE™ Complete HACCP Food Safety Series. mvaccaro86@gmail.com Continued from page 13 A R T I C L E S O U R C E S : • Centers for Disease Control and Prevention. Information on Avian Influenza. http://www.cdc.gov/flu/avianflu/, May 2015 • USDA, Avian Influenza. http://www.usda.gov/wps/portal/ usda/usdahome?contentidonly=true&contentid=avian_influ- enza.html • www.flu.gov, May 2015
  • 17. Design Planning 101 for Foodservice Operations Healthcare Hospitality Are you preparing for a renovation? Or would you like to improve the workflow of your current opera- tion? Understanding the basics of space planning and design can benefit any foodservice operator. Knowing the stages and processes of foodservice design allows CDMs, foodservice directors, and chefs to be effective members of the design team, and provide critical input and direction for new construc- tion projects or for renovations of current opera- tions. CDMs can positively influence their operation’s future plans by being knowledgeable and proactive. This online education module will help you gain in- sights and skills in foodservice design, and help you and your team deliver great food to your residents, patients and customers, and perhaps you can act on your “design dream.” $40—Members $50—Non-Members Health care has moved into a new phase, and at the heart of the industry is the desire to create positive experiences for residents and patients. Improved satisfaction scores is a goal that all operators are striving to achieve, and a hospitality-based style of service will help meet this challenge. Find out why it’s important, for career advancement, that a CDM be an expert at hospitality services. Learn tools to lead your department in creating a higher level of service for your patients and residents. With these skills, CDMs can transform their operation to drive satisfaction scores into the highest percentiles and help their facility meet its financial goals. $40—Members $50—Non-Members Individual Course Price: $40 ANFP Members; $50 Non-Members Order today in the ANFP Marketplace: www.ANFPonline.org/market NEW Online Courses ANFP has released two new online courses for foodservice professionals 1 2 ® MAKE YOUR CE PROOF 5 hrs. CE 5 hrs. CE 5 HOURS 5 HOURS Attention CDMs! Purchase your online CE products in the ANFP Marketplace and your completed CE hours will be automatically reported in your continuing education record. This includes all ANFP online courses, archived webinars, and CE online articles.
  • 18. Nutrition & Foodservice Edge | June 201516 TRE NDS IN NUTRITION In 1993 the FDA introduced the Nutrition Facts label. The goal was to help consumers make informed choices about the foods they eat by providing nutritional informa- tion on the packages. Today, the FDA is looking to update the Nutrition Facts label and require calorie labeling on restaurant menus and vending machines since Americans consume about one-third of their food away from home. What Will be Added to the Nutrition Facts Label? The new Nutrition Facts label will contain various updated categories and graphics designed to help consumers make more healthful choices. Highlights of changes include: • Calories – There will be greater emphasis on calories with larger and bolder fonts. Calories are important to know in order to maintain a healthy weight. Nutrition Labeling by Linda S. Eck Mills, MBA, RDN, LDN, FADA EXAMINATION OF CHANGES IN NUTRITION LABELING Past, Present, Future
  • 19. Nutrition & Foodservice Edge | June 2015 17 • Calories From Fat – The type of fat is more important than the total amount of fat. Total fat, saturated fat and trans fat will remain on the label. • Amount Per Serving – This will be replaced with the actual serving size, such as “Amount per cup.” • Total Carbohydrate – This will be replaced with “Total Carbs.” • Vitamin A and Vitamin C – These nutrients will become voluntary and not mandatory on labels since deficiencies are not common. Calorie Labeling Requirements for Restaurant Menus and Vending Machines Restaurants and fast-food chains with more than 20 loca- tions have until December 1, 2015 and vending machine • Sugar – “Added Sugars” will be included on the label. This will show the sugar that is added during food pro- duction. • Percent Daily Value – This information will be moved to the left side of the label. • Serving Sizes – The serving size will be changed to re- flect what is actually being eaten and not what individu- als should be eating. • Number of Servings – This information will be more prominent. • Dual Column Format – This format will be used on items that contain at least two times the serving size and less than or equal to four times the serving size. Exam- ples include a 19 oz. can of soup or a pint of ice cream. • Vitamin D and Potassium – These nutrients will be mandatory on the label since there is evidence that in- dividuals are not consuming enough of these nutrients, which can lead to chronic diseases. What Will be Removed from the Nutrition Facts Label? As nutrition science has evolved, and based on feedback on the current label, the following information on the label will change: Continued on page 18 CURRENT PROPOSED CURRENT VS. PROPOSED LABEL
  • 20. Nutrition & Foodservice Edge | June 201518 Continued from page 15 operators have until December 1, 2016 to comply with the new labeling requirements. This means that you will begin seeing calorie labeling not only on restaurant menus, but also restaurant-type facilities selling prepared foods for im- mediate consumption such as grocery stores, convenience stores, movie theaters, and bowling alleys. What the New Labeling Requirements Mean to You As a Certified Dietary Manager, now is the time to take a close look at your operation. Do you have access to infor- mation for items you serve in a restaurant-type location or for foods you sell on-site or for vending machines you operate? Do the menus you receive from a corporate office provide you with calorie information for each menu item in an easy-to-use format? Where can you provide calorie The FDA transferred from the Department of Agriculture to the Federal Security Agency. The FDA was officially established as an agency of the Department of Health and Human Services. This agency was part of the Food and Drug Administration Act of 1988 and was formed to provide education, information, enforcement, and research. The Food, Drug, and Insecticide Administration becomes the Food and Drug Administration (FDA), under the Department of Agriculture. The FDA enforces the Fair Packaging and Labeling Act for food and other items. This act requires that products used in interstate commerce be honestly and informa- tively labeled. H ISTO RY According to the FDA, these are some significant dates in US Food and Drug Law history. LEARN MORE The Food and Drug Administration website is loaded with information and resources on the new labeling requirements and how they were developed. Linda@dycomserv.com information to your clients? Plan ahead for any required changes. The bottom line is Nutrition Facts labels are a tool to help individuals maintain healthy dietary practices by making informed choices. E Linda S. Eck Mills, MBA, RDN, LDN, FADA is a career coach and speaker. She is the co-author of Flavorful Forti- fied Food—Recipes to Enrich Life and Food First! Enhancing the Nutritional Value of Meals with Fortified Food. Mills directs the ANFP Program at Le- high Carbon Community College and works in correctional food service. Continued from page 17 • Highlights of the Proposed Rules— www.fda.gov/Food/GuidanceRegulation/ GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ ucm387533.htm • Proposed Changes to the Nutrition Facts Label—www.fda.gov/Food/GuidanceRegulation/ GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ ucm385663.htm#images • Calorie Labeling on Restaurant Menus and Vending Machines—www.fda.gov/Food/IngredientsPackagingLabeling/ LabelingNutrition/ucm436722.htm • Nutrition Facts Label Programs and Materials—www.fda. gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ ucm20026097.htm SOURCES: • www.fda.gov • www.eatrightpro.org • www.andjrnl.org
  • 21. Nutrition & Foodservice Edge | June 2015 19 The food label is recreated by the FDA and the Food Safety and Inspection Service of the Department of Agriculture. Basic per-serving nutritional information becomes known as “Nutrition Facts” as part of the requirements under the Nutrition Labeling and Education Act of 1990. The Nutrition Labeling and Education Act required all packaged foods to have a nutrition label. In addition, all health claims for foods were required to be consistent with terms defined by the Secretary of Health and Human Services. This was the first time some health claims could be used on foods and definitions for words such as “low fat” and “light” were established. The Food Allergy Labeling and Consumer Protection Act required labeling of foods that contain the major food allergens – eggs, fish, shellfish, milk, peanuts, tree nuts, soy, and wheat. Changes are made to the Nutrition Facts panel and Menu Labeling Requirements. Trans-fat content is required on food labels. This is the first change to the food label. Special members-only pricing is good through June 30, 2015. Start Your CE-Year Off With a Bang! • HR Toolkit for Managers • Professional Ethics • Medical Terminology & Drug-Nutrient Interaction • Culinary Solutions: Basics of Soups and Sauces All 20-hr. CE courses are 20 percent off in June Order at: www.ANFPonline.org/market JUNE CE MONTHLY SPECIAL LOOKING TO FILL A POSITION? The CDM Career Net- work is a member of HEALTHeCAREERS Network, which provides targeted exposure to qualified candidates. CDMCareer Netw rk.Career Netw rk. Are you seeking new employment? Or do you just want to beef up your resume? Turn to the CDM Career Network to learn about job opportunities and resources to help with resume writing, interviewing, and more. Job listings are posted by specialty, location, and employer. You can apply to job postings directly online. If you’re seeking a new position, post your resume to help prospective employers find you (confidentially, if you prefer). Dozens of articles designed to help you before, during, and after your job search are also available free to ANFP members. Looking for New Career Opportunities? Enjoy unlimited access to the CDM Career Network at no cost! Visit www. healthecareers.com
  • 22. Bring Value to the Table Bronze Level ...better by degrees. D ® – PASTEURIZED SHELL EGGS – Professional Development 201 5 ANF P ANNUAL CO NF ER ENCE & EXPO ® Education Session Topics • Foodservice Department Design/ Renovation • ABCs of Successful Surveys • Center of the Plate • Quality Indicator Survey Success • Nutrition and Hydration Approaches • Prevention and Treatment of Pressure Ulcers • Value of the CDM Role • Deficiency-Free Joint Commission Surveys • Sanitation Surveys and Training • Current Menu Trends • Workplace Communication Strategies • Team Building Sterling Level Gold Level Platinum Level Thank you to our Sponsors! Lt. Col. Rob “Waldo” Waldman, the Wingman, overcame a lifelong battle with claustrophobia and a fear of heights to become a combat decorated Air Force fighter pilot and highly successful businessman, entrepreneur, and New York Times bestselling author. KEYNOTE SPEAKER Lt. Col. Rob “Waldo” Waldman NEVER FLY SOLO
  • 23. ACE&& ORL ANDO, FL | 2015 Annual Conference & Expo Shona McCue, CDM, CFPP Director of Nutrition Services Cook Hospital and Nursing Home - Cook, MN “Attending the ANFP Annual Confer- ence is one of the best investments you can make in yourself and your career. It provides you the opportunity to in- crease your knowledge, keep up with current trends and build on your skills. Through the networking opportuni- ties, I have met so many wonderful people and built lasting friendships.” Kim Kyle, CDM, CFPP Dietary Consultant Creative Solutions in Healthcare - Ft. Worth, TX “Attending the ANFP ACE helps me to stay abreast of new innovations and regulations in foodservice. The com- radery among the CDMs is contagious! I always learn something new and return from the conference energized, motivated and ready to tackle the world of healthcare foodservice!” Register Today www.ANFPonline.org > click “Events” Sign up by July 10 and save $100 AUGUST 2-5, 2015 HYATT REGENCY GRAND CYPRESS Education • Networking • Exhibits See what past attendees have to say about ACE 20 HOURS ACE SPECIAL EVENTS Sunday, August 2 Opening Reception - Celebrate the start of the conference at the Opening Reception! Catch up with your colleagues and make new acquaintances as you begin your ACE journey. Monday, August 3 Annual Business Meeting & Breakfast - Join us to celebrate the success of both the organization and the critical leaders that steer the direction of ANFP. NFEF Foundation Gala - The Nutrition & Foodservice Education Foundation (NFEF) is hosting this very special evening of food, entertainment, and networking to celebrate the profound impact of NFEF donors’ support in advancing the important work of the Foundation. Tuesday, August 4 Expo - The Expo is a must-see event where exhibitors showcase how their products and services can contribute to your operational effectiveness and bottom line.
  • 24. Nutrition & Foodservice Edge | June 201522 As our population lives longer, healthcare provid- ers are faced with the challenge of supporting quality of care while also honoring self-directed living. One of the most complex decisions for clients and families concerns the use of artificial nutrition and hydration (ANH). These decisions incorporate many factors for consideration. It is critical for providers to compassionately convey the realities of ANH, including potential harms at the end of life. This article of- fers an overview of ANH along with practical suggestions on how to proactively support clients with self-directed living. B AC KG R O U N D Conversations with clients and families about whether to use artificial nutrition and hydration (ANH) in frail elders with advanced disease can be challenging. Ethi- cal principles, case law, and formal opinions of medical and advocacy groups uphold the position that ANH is a medical intervention, and decisions regarding its use fall under the same pattern as informed consent used in all medical decision-making. This includes educating and informing clients and families about benefits and harms to allow client decision-making within the framework NUT RITION CONNECTION by Brenda Richardson, MA, RDN, LD, CD, FAND Artificial Nutrition HydrationConversations with Clients and Families &
  • 25. HOW TO PROACTIVELY SUPPORT C L I E NTS W ITH SE L F -DIRECTED L I VI NG Artificial Hydration: Administration of fluid through non oral means; routes include intravenous or subcutaneous (also called hypoder- moclysis), rectal (proctoclysis), and enteral. Artificial Nutrition: Non oral, mechanical feeding either by intravenous or enteral route. Enteral feedings may be provided through either nasogastric tubes or gastrostomy, esophogostomy, or jejunostomy tubes that are placed either endoscopically or in open surgical procedures. Intravenous nutrition is administered through a central line and often is called total parenteral nutrition (TPN). Parenteral nutrition can also be administered through a peripheral vein. Client Autonomy: The right of clients to make decisions about their medical care without their healthcare provider trying to influence the decision. Client autonomy does allow for healthcare providers to educate the patient, but does not allow the healthcare provider to make the decision for the patient. Beneficence: A principle of medical ethics according to which a person should do good to others, especially when one has a pro- fessional duty to do so. Nonmaleficence: Ethical principle of doing no harm. Table 1 Definitions: Table 2 Definitions: Nutrition & Foodservice Edge | June 2015 23 tices are medical intervention with benefits and burdens similar to other medical interventions. (See definitions in Table 1.) Continued on page 24 of the client’s overall values and specific goals for the intervention. This requires that providers be knowledgeable about the research findings on benefits and harms of artificial nutri- tion and hydration, and have the communication skills to convey these to clients and families in an understandable and culturally appropriate manner. E T H I C A L A N D L E G A L I S S U E S The ethical issues have been discussed over the past 40 or 50 years, with the current consensus being that ANH prac- Decisions around ANH involve the ethical principles of client autonomy, beneficence, and nonmaleficence. (See Definitions in Table 2.)
  • 26. Nutrition & Foodservice Edge | June 201524 Many medical and advocacy organizations stress the importance of informed consent to allow client autonomy—including inform- ing clients and families of alternative treat- ments and interventions to ANH. Continued from page 23 To ensure the client is making the decision, providers need to be fully aware of the client/family goals while clients and families need to be fully informed about whether the intended interventions can realistically achieve these goals. There is also the need to be aware of possible side effects of interventions while weighing the benefits of the treatment. Many medical and advocacy organizations—such as the Academy of Nutrition and Dietetics, the American Medical Association, the American Geriatrics Society, the Al- zheimer’s Association, the American Academy of Hospice and Palliative Medicine, the American Nursing Association, and others—have position statements on the provision of ANH that also indicate that ANH practices are medical interventions, with possible benefits and predictable side effects. These organizations stress the importance of truly informed consent to allow client autonomy to be possible. This includes informing clients and families of alternative treatments and interventions to ANH. The Academy of Nutrition and Dietetics shares in a position paper that, “Enteral
nutrition
may not
be
ap- propriate
for
terminally
ill
older
adults
with
ad- vanced disease
states, such
as
terminal demen- tia,
and
should
be
in
accordance with advanced directives.
The development of
clinical
and
ethical
crite- ria
for
the
nutrition
and hydration of
persons
through- out
the
life
span
should
be
established
by
members
of
the healthcare team, including
the registered dietitian.” The Centers for Medicare and Medicaid Services State Operations Manual Appendix PP - Guidance to Surveyors for Long-Term Care Facilities includes regulatory language regarding use of Feeding Tubes in §483.25(g) Naso-Gas- tric Tubes (F 322): Overview: A decision to use a feeding tube has a major impact on a resident and his or her quality of life. It is important that any decision regarding the use of a feeding tube be based on the resident’s clinical condition and wishes, as well as applicable federal and state laws and regulations for decision making about life-sustaining treatments. Considerations Regarding the Use of Feeding Tubes: The regulations at §483.25(g) require that the resident’s clinical condition demonstrates the use of a feeding tube to be unavoidable. A feed- ing tube may be considered unavoidable only if no other viable alternative to maintain adequate nutrition and/or hydration is possible, and the use of the feeding tube is consistent with the clinical ob- jective of trying to maintain or improve nutritional and hydration parameters. The interdisciplinary team, with support and guid- ance from the physician, is responsible for assuring the ongoing review, evaluation and decision-mak- ing regarding the continuation or discontinuation of all treatments, devices, or approaches implement- ed to care for the resident. Involving the resident, family, and/or the resident’s legal representative in discussions about the indications, use, potential benefits and risks of tube feeding, types of approach- es, and alternatives helps support the resident’s right to make an informed decision to use or not use arti- ficial nutrition and hydration. In the Dining Practice Standards released in 2011 from the Pioneer Network, relevant research trends include: • Feeding tubes have not been shown to reduce the risk of aspiration or prolong survival in residents with end-stage dementia. • Oral
secretions
and/or
gastric
content
are
often the source of aspiration pneumonia or pneumonitis and thus will not be resolved with the placing of a tube. • Studies in the elderly with dementia have shown little to no improvement in weight. In situations when there was improvement in weight, there was no improve- ment in clinical outcome for residents. Enteral feeding is also considered for wound care as a means to improve
  • 27. Nutrition & Foodservice Edge | June 2015 25 Continued on page 26 wound healing, however data over a six month follow up has shown no impact on pressure ulcers or on infections such as cellulitis associated with wounds. • Percutaneous
endoscopic
gastrostomy
(PEG) and percutaneous
endoscopic
jejunostomy
(PEJ) tubes do not improve
a
resident’s
quality
of
life. Placing a PEG tube
in
residents with
advanced dementia
should
be strongly
discouraged. So why is it still so hard for healthcare providers to have conversations about ANH with clients and families? Is it lack of knowledge on the part of clients and families? Is it lack of knowledge of interdisciplinary healthcare providers about the evidence-based research regarding provision of ANH to seriously ill frail elders? Is it because of unrealistic expectations of what can be accomplished by ANH on the part of clients, families, and clinicians? Some say that clients and families have unrealistic expec- tations and demand unreasonable interventions for their loved ones. Yet, research indicates that when presented with all the relevant facts, clients and families generally opt to forgo more aggressive interventions when benefits are marginal. Conversations are important! CO N S I D E R ATI O N S FO R FAC I L IT Y “ CO N V E R SATI O N P L A N ” It is critical to have an overall facility plan that addresses how “conversations” about ANH will be administered. The following areas are some factors to consider with the over- all plan. (See Table 3.) • Develop a facility program that identifies overall planning for “having the conversation.” Determine how to incor- porate information and “conversations” with Admissions, Nutrition Risk Programs, Physician Involvement, Interdis- ciplinary Team (IDT), Dining Programs, Care Planning, etc. Be sure training occurs throughout the facility for proper implementation. • Develop a resource folder or notebook that includes client education brochures, research, and resources for helping clients and families make decisions about use of artificial nutrition and hydration. Make the information readily available. • When having conversations be sure to determine an ap- propriate setting: These important conversations should occur with the client and/or authorized decision-maker in a private setting that is conducive to comfortable and intimate communication. There should be no interrup- tions, and the overall tone should be respectful and car- ing. • During conversations it is important to listen. The clinician should determine what the client and family understand about the disease, and listen to what is important overall to the client and family. • Use conversation to impart knowledge to the client and family, while clarifying any misconceptions and present- ing alternative interventions that can realistically achieve client-specific goals of care, along with known possible harms and benefits of each. • Allow the client and family to express emotions, while empathizing, and assuring the client and family that support will be there for them. • Once emotions have settled, have a joint discussion with the client and family about the next steps, and then fol- low facility protocols to honor their decisions. • The facility should follow up periodically to determine whether and how client goals are being met by the interventions, and adjust the treatment plan together accordingly. • Documentation in the medical record should clearly reflect the conversations, nutrition interventions, and ongoing care and services honoring informed choice. Table 3: ANH Plan
  • 28. Nutrition & Foodservice Edge | June 201526 S U M M A RY Discussions about use of ANH in elderly clients with advanced chronic illness should be held with clients and their families considering the client’s overall values and goals, as well as the specific goals for ANH, the current clinical status, and likely course with and without ANH, and guided by the current evidence-based research of known benefits and harms of intervention. This role of the CDM is reflected in the Association of Nutrition & Foodservice Professionals’ Position Paper: The Role of the Certified Dietary Manager in Person-Directed Dining, stating the CDM who works in long-term care is expected to seek continuing education and informa- tion in order to implement the best practices and recog- nized standards of practice for elder nutrition care and person-directed dining. The Certified Dietary Manager, in collaboration with the dietitian and the interdisciplin- ary team, has an essential role both in facilitating this process, as well as in monitoring it for desired outcomes. Continued from page 25 Brenda Richardson, MA, RDN, LD, CD, FAND is a lecturer, author, and consultant. She works with Dietary Consultants Inc. in business relations and development, and is president/ owner of Brenda Richardson Associ- ates, Inc. brendar10@juno.com REFERENCES i • O’Sullivan Maillet J, Baird Schwarz D, Posthauer ME; Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: ethical and legal issues in feeding and hydration. J Acad Nutr Diet. 2013;113(6):828-833. • State Operations Manual: Appendix PP—Guidance to surveyors for long term care facilities. Revised February 6, 2015. Centers for Medicare and Medicaid Services Website: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/ CMS1201984.html (Accessed April 28, 2015) • Association of Nutrition & Foodservice Professionals (formerly Dietary Managers Association), The Role of the Certified Dietary Manager in Person-Directed Dining—April 2011 http://anfponline.org/Resources/position_papers.shtml (Accessed April 28, 2015) • Association of Nutrition & Foodservice Professionals, Code of Ethics for the Certified Dietary Manager, http://anfponline.org/About/CDM_ CFPP_credential.shtml (Accessed April 29, 2015) ADDITIONAL RESOURCES: • ALS Association: Information About Feeding Tubes Website: http://www.alsa.org/als-care/resources/publications-videos/factsheets/ feeding-tubes.html • American Hospice Foundation: Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful? Website: http://americanhospice. org/caregiving/artificial-nutrition-and-hydration-at-the-end-of-life-beneficial-or-harmful/ • WebMD: Questions and Answers: Artificial Nutrition and Hydration and End of Life Decision Making Website: http://www.webmd.com/ balance/faqs-artificial-nutrition-hydration-end-of-life-decision-making-medref • Nutrition411: Facts About Tube Feeding Website: http://www.nutrition411.com/content/facts-about-tube-feeding • Nutrition 411: Interdisciplinary Nutrition Care Plan: Tube Feeding Website: http://www.nutrition411.com/content/interdisciplinary-nutrition- care-plan-tube-feeding • The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines and Standards Library Website: http://www. nutritioncare.org/Library.aspx Healthcare professionals must recognize the importance of establishing nutrition treatment goals that are resident centered, and that respect the unique values and personal decisions of the older adult. Section 2 of the Code of Eth- ics for the Certified Dietary Manager, Principle #10 states, “The Certified Dietary Manager provides sufficient in- formation to enable clients to make their own informed decisions.” Having conversations about ANH with clients and families is vital for informed choice, resident-centered care decisions, and quality of life. E
  • 29. Nutrition & Foodservice Edge | June 2015 27 Take your credential and GO FURTHER. Certificate of Advanced Learning: Healthcare Foodservice Finance - Beyond the Basics As a seasoned Healthcare Foodservice Director, how are your financial skills? Finance control is the core to a successful operation. This advanced online course will provide participants with a better understanding of the financial process and tools to manage them successfully. *Prerequisite: Minimum CDM certification one year prior to enrollment. Start today at www.ANFPonline.org/market • Define the key factors that influence Foodservice Financial Performance • Explain the role of the MENU in financial accountability. • Identify the opportunity for profit and/or loss in the retail/revenue services. • Develop a dashboard with relevant Key Performance Indicators (KPI) 30 CE hours | $250 ANFP Members | $270 Non-Members CE 30 HOURS CBDM Approved 1. Artificial nutrition is: A. Oral feeding using artificial flavors B. A new fasting program that is supported by best practice C. Non-oral, mechanical feeding by intravenous or enteral route 2. Artificial hydration is: A. Administration of fluid through non oral means B. Hydration using artificial or alternative sweeteners C. Serving liquids in a frozen state such as popsicles, etc. 3. The Centers for Medicare and Medicaid Services State Operations Manual Appendix PP states that: A. Decisions to use a feeding tube should be made strictly on the resident’s clinical condition B. A decision to use a feeding tube has a major impact on a resident and his or her quality of life C. The resident and family should not be included in discussions and information regarding use of a tube feeding 4. Conversations with residents and families should include: A. Being held in a private setting with no interruptions B. “Listening” with opportunities to inform and share knowledge C. Both A and B Reading Artificial Nutrition and Hydration (ANH): Conversations with Clients and Families and successfully completing these questions online has been approved for 1 hour of CE for CDM, CFPPs. CE credit is available ONLINE ONLY. To earn 1 CE hour, purchase the online CE quiz in the ANFP Marketplace. Visit www.ANFPonline.org/market, select “Publication,” then select “CE article” at left, then search the title “Artificial Nutrition and Hydration (ANH): Conversations with Clients and Families” and purchase the article. NUTRITION CONNECTIONReview Questions 5. Many medical and advocacy organizations have position statements on the provision of ANH that stress: A. ANH always has positive benefits B. The importance of informing residents and families of alternative treatments and interventions C. The ultimate decision is always made by the physician 6. The CDM is expected, in collaboration with the dietitian and the interdisciplinary team, to provide sufficient information to enable residents to make their own informed decisions as seen in the: A. Association of Nutrition & Foodservice Professionals’ Code of Ethics Principle #10 B. Association of Nutrition & Foodservice Professionals’ Position Paper: The Role of the Certified Dietary Manager in Person- Directed Dining C. Both A and B 7. Having conversations about use of ANH is vital for: A. Informed choice, resident-centered care, and quality of life B. Residents with end stage diseases only C. Establishment of supplies needed M A K E YO U R C E H O U R S AU D I T P R O O F Attention CDMs! Purchase your online CE products in the ANFP Marketplace and your completed CE hours will be automatically reported in your continuing education record. This includes all ANFP online courses, archived webinars, and CE online articles.
  • 30. Nutrition & Foodservice Edge | June 201528 FOODSERVICE IDEAS As a post-graduate student, I took a course in marketing which used the now out-of-print book The Hid- den Persuaders, by Vance Packard. Mr. Packard provided many examples of the importance of marketing. One such example has remained with me throughout my career, and I’ve paraphrased it below. A large soap manufacturer spent millions of dollars on research to make the most perfect face soap. The com- pany packaged the soap, promoted it, and distributed it to various markets. The soap didn’t sell. The company was forced to recall the entire product and conduct more research. They looked at the target audiences, previous distribution channels, promotional efforts, price, and packaging of the soap. Their research indicated the need for a new plan as the soap was not the problem; it was the marketing and packaging that needed an overhaul. The company developed a new package design to gain the at- tention of the intended audience—women. Distribution was now to a more upscale audience, and at an increase in price. The new (old) soap sold out in six months, and within two years the company was making a profit on the sale of the product to their target market of women. It turns out the soap was indeed excellent, but the company initially failed to follow basic marketing principles. Foodservice Marketing by Ruby Puckett, MA, FFCSI Success Strategies
  • 31. Nutrition & Foodservice Edge | June 2015 29 U N D E R S TA N D TA R G E T M A R K E TI N G A target market is a subgroup within the population rather than the population as a whole. This market segment is where the company or organization should direct its pro- motional efforts. For example, the southern states would be a primary target market for grits and biscuits, because these items tend to be more popular menu options in the South. How can you use target marketing in your facility to pro- mote your food service, as well as market yourself and the profession? To answer this, we must know our customer base, understand their needs, and then develop goods and services to meet those needs. It’s necessary to determine such things as the culture, religion, language, gender, eco- nomic status, generation, preferences (local, organic, etc.), and special needs (vegan, gluten-free, etc.) of our audi- ence. This is called market segmentation. The above list contains both large and small market subsegments. Select the largest group and strive to meet their needs first. This large group is your primary target market. And as resourc- es permit, try to meet the smaller group’s needs. I D E N TI F Y YO U R P R O D U C T M IX Next, identify all the products offered for sale by your department, such as grab-and-go or take-out items that can be eaten elsewhere in the facility or brought home. Products may include food for a variety of customers that is purchased in the cafeteria, c-store, vending machines, food court, guest meals, or catering—anything that will satisfy the needs and demands of your customer groups. “Products” can also be services, places, ideas, or even people. Service encompasses education of employees, clients, and the community, and may include such things as providing nutrition information, weight loss classes, one-on-one counseling, and printed materials. Ideas are a valuable service and include brainstorming, providing suggestions for foodservice initiatives, partici- pating in the department’s strategic planning process, and more. Ideas for improving safety and sanitation, and meet- ing survey agency standards are ideas that will promote the efficiency and effectiveness of the department. Em- ployees may have many excellent suggestions and should be encouraged to share their ideas. Marketing is a management tool that focuses on identify- ing the needs, wants, and demands of customers to obtain products and services of quality and value in their target market. A major objective of marketing is to focus on customers’ needs. The needs of the customer are “things” required for a state of well-being, both physical (food, safety and shelter) and mental (belonging, affection, and self-expression). Refer to Maslow’s hierarchy of needs for more on this. All customers have wants, as well. The cus- tomer may desire something but not need it. Demands are wants that are supported by resources that allow the wants to be fulfilled. HOW TO USE TAR GET MARKETING TO PRO MOTE YOUR FOOD SERVICE Continued on page 30
  • 32. Nutrition & Foodservice Edge | June 201530 People are also a service, such as the maintenance engi- neers that maintain the foodservice equipment, external company representatives that introduce new products and services, and any employee within the organization that provides service to the department—such as the safety of- ficer that teaches fire safety. Many departments inside the organization, as well as external people, provide services to the food and nutrition department. D E T E R M I N E D I S T R I B U TI O N C H A N N E L S Identifying product distribution channels may be simple or complex. Distribution channels are the routes that products follow from field to fork. These routes may be direct from the manufacturer to the department, or to the middleman (such as a vendor) and then to your depart- ment. In a foodservice operation, distribution includes delivering food to the client’s bedside via tray service, wait staff serving menu items in the dining room, customers enjoying a self-serve buffet, and staff delivering customer selections through 24-hour room service. Food may also be distributed off site for catered events. E S TA B L I S H E F F E C TI V E P R I C I N G Pricing is a component of marketing. Price is the cost of the product to the customer and is linked to revenue and profit goals. Accurate cost information is critical to effec- tive pricing. Also, knowing what the competition charges in your geographic area can help you determine your product pricing. Calculating the cost of a product is important. Actual Cost is one method used and represents the total expenditures required to create the product, including the money paid for raw materials, labor, rent, utilities, insurance, and so forth. Another method of pricing is Food Cost Basis to determine the selling prices. Frequently, the prices are determined by using one cost—usually the raw materi- als—as the basis for establishing the selling price. A for- mula is used to calculate the relationship of the food cost to the selling cost. Most foodservice departments use this method to price items in the cafeteria and in c-stores. The formula is 40 percent for food cost and 60 percent for la- bor, other expenses, and profit. So, if a small orange juice costs 40 cents, it would sell for $1.00. Another method is Fixed Pricing, where a standard price for a product or an event has been determined in advance for various menus or menu items. Continued from page 29 Pricing varies from one geographic area to another, due to cost of living factors. Pricing should also take into ac- count the quality of the product. When quality increases, cost should lower through increased efficiency. A continu- ous quality improvement (CQI) program allows the food service to provide increased and better service to meet customer needs. C H O O S E E F F E C TI V E P R O M OTI O N S Promotions are methods used to convey information about products or services to customers. A number of techniques can be used to promote products including ad- vertising, personal selling, public relations, and merchan- dising. Other techniques include newspaper ads, Internet specials, personal phone calls, and catalogs. Foodservice department promotions might include post- ing menus with price and nutritive value for each food item, using the Internet and social media to advertise specials, providing discount coupons and meal deals as appropriate, and preparing a department newsletter to distribute in the cafeteria and on client meal trays. Use your imagination to determine other ways to market your products and services. Personal selling means marketing by word of mouth. If the foodservice department produces quality food at a competitive price served by friendly personnel in a sanitary environment with pleasant ambience, customers will tell others, including prospective patrons. Sales promotions are another way to publicize new items. Provide a sales promotion for a new product or service, such as an ice cream shop or a coffee kiosk. These promo- tions are typically short in duration to generate interest and create a sense of urgency for buyers. Public relations is an important promotional tool. Become friends with the local newspaper editor. Promote a new menu item that is being served to customers by providing the food editor with the recipe, a color photo of the item, and nutrition information. During Pride in Foodservice Week, spotlight the department by introducing personnel at a coffee, hosting a trivia contest, or distributing informa- tion on a hot topic in nutrition. Promote new better-for-you foods in the cafeteria that have reduced fat, sugar, and salt content. Continued on page 32
  • 33. Nutrition & Foodservice Edge | June 2015 31 10 Quick Tips for Marketing Your Food Service 1. Celebrate cultural diversity. Designate one or more days each week to highlight the foods of a particular ethnic group. Develop menu items that give patrons an opportunity to savor the unique spices, aromas, and tastes of fare from other lands. 2. Promote daily specials. Reduce pricing on select menu items each day. Advertise daily specials in employee newsletters, on signage, on tent cards, and anywhere else that will attract the attention of potential customers. Give them another reason to dine with you. 3. Sample products. If it’s for free, it’s for me. Who doesn’t like going to big box stores and sampling savory new spreads, meat on toothpicks, and cool beverages in mini paper cups? Try this approach in your food service. 4. Enhance the atmosphere. Boost the appeal of your cafeteria with attractive table decorations, a pleasant color scheme, and friendly staff that’s customer focused. Make guests feel welcome and cared for while dining. 5. Offer coupon savings. Put a $1 off coupon incentive in the staff newsletter to attract facility employees to your food service and keep them on the property at mealtime. Fast food restaurants make liberal use of savings cou- pons, why shouldn’t you? 6. Make a wrong right. If a customer has gotten less than stellar service, provide an apology and a savings coupon to help smooth things over. Righting a wrong will ease the sting of a bad customer service experience. 7. Offer a money back guarantee. Let’s face it. Many people don’t think of the hospi- tal cafeteria as a quality culinary experience. Allow them to give your food service a try without risk. If you’re confident in the quality of your menu items, offer customers a money back guarantee if they’re unhappy with their order. 8. Expand your coffee program. The popularity of coffee products and novelty hot beverages has exploded in recent years. Save employees and facility guests a trip to the drive- through on their way to work, and make your food service a coffee destination. Sales of bagels, muf- fins, and other breakfast fare will improve if they are marketed on your coffee menu. 9. Promote choice. People love to have choices. Empower them to make decisions about their menu selections. Yel- low mustard, brown mustard or Dijon mustard? Tabasco, sriracha, or chipotle? Without over- whelming them with too many offerings, give them options to make their meal just the way they like it. 10. Consider customer comments. Requesting feedback makes customers feel like their opinion matters. Seek their input. If you see a pattern when it comes to customer complaints, you need to act. Minimize your weaknesses and capitalize on your strengths!
  • 34. Nutrition & Foodservice Edge | June 201532 Merchandising or displaying products is another promo- tion technique. Customers will purchase more of an item if it has visual appeal. Make up a sample plate. Combin- ing foods with attractive colors and varied textures on the plate will go a long way in creating meal appeal and marketing your menu. D O N ’ T FO R G E T TO M A R K E T YO U R S E L F Finally, it’s important to market yourself, your credentials, and your accomplishments. Make others aware of what your job entails, the education you have, and the skillset you bring to the job. Market the profession and its high standards, such as the requirement for certification or a degree, and the need for continuing education. Remember that marketing is a process to meet the wants, needs, and demands of the customer. The process includes knowledge of the target market and characteristics of the customers. Develop a marketing plan for your food service that includes product, placement, price, and promotion, and watch your satisfaction scores and profits soar. E rpuckett@dce.ufl.edu Ruby Puckett, MA, FFCSI is the director of dietary manager training at University of Florida, Division of Continuing Education, Gainesville, Fla. She’s a member of ANFP’s Editorial Advisory Board. Continued from page 30 Anum Ali Paulo Allarde Leticia Avelar Frankie Bailey Darnell Bartley Antonio Brown Michael Buck Rebecca Burch Claire Chrystal Doug Crisp Kimberly Densham Jennifer DeSander Cathy DeYoung Andrea Dildy Kay Douglas Cheryl Dowell Michelle Drouillard Jade Fagerland Tanya Florexile David Galvan Sandra Garcia Laurie Gattman Sheldon Giovanna Giancola Holly Gilbertson Gayle Gilchrist Susanna Gray-Proctor Robert Hatano Lakeisha Hawthorne Marcia Herceg Tracy Hockenberry Kyu Jang Valerie Kampf Karen Kay Garcia Brian Kice Neal Lavender Sau Lee The Certifying Board for Dietary Managers announces that 87 individuals passed the CDM Certification Exam in April. During that time, 82 individuals activated their credential and are now officially CDM, CFPPs. Congratulations to the following new CDMs: CDM Certified Dietary Manager Certified Food Protection Professional|CFPP® ® Mary Maples Rozell Marasigan Michael Marino LeeAnn Martin Nya McAlister Eric McClung Alicia McCole Steven McCoy Marcus McGrew James McKinney Curtis Mensch Wilfrido Mercado Tracey Miller Alberta Moore Jessica Morrison Bryan Mullet Jason Mullikin Clarence Nichols Tamra O’Neal Richard Page Joshua Posey Marsha Reynolds Ericka Rieckers Rebecca Riker Brent Russell Sharon Schmidt Kurt Seeger Julie Shelton Brenda Sluder Tami Stansbury Wanda Stone Stephanie Stratman Sheila Streider Cinda Strickler Iadanza Thomas Jeremy Tishler Maurice Tomat Chhayleng Touch Kyra Tyler Alyssa Van Peursem David Wall Rhonda Washington Wayne Webb Mary Weiser April Williams Augustine Wojcik
  • 35. Nutrition & Foodservice Edge | June 2015 33 MESSAGE FROM THE CHAIR The benefits I’ve experienced have been very rewarding. As a new member, I had the privilege of being mentored by long-time members that have been very successful. With this mentoring opportunity I saw the value of members gaining experience and knowledge in the industry. I have profited greatly from the wisdom of other nutrition and foodservice professionals, and I’ve been able to share my industry insights and experiences with peers over the years. This has provided a winning combination for all involved, and has afforded value both ways. One of the biggest advantages ANFP offers me is the opportunity to increase my knowledge in the profession through courses, seminars, workshops, publications, and other education avenues. This is invaluable in terms of personal and professional growth, and it’s also important to the facilities and clients we serve. Working together, we can raise awareness of ANFP standards and practices. The association can be shown in a positive light as members showcase what the group has to offer others in this career field. If members take the time to convey their needs, great value can be provided to the organiza- tion and, by extension, our members. The ability to contact and connect with our col- leagues may be the biggest membership value of all. There is really no substitute for peer-to-peer interaction. You can build valuable relationships with other members that can pay off when looking for a new job or when needing referrals or recommenda- tions on products and services. ANFP meetings, casual networking events, and our online member community—ANFPConnect—give you opportunities to meet and mingle with your peers. I know that dues and fees for professional organiza- tions can be a bit expensive. Yet, that money can provide great value to you in the future, and to the organization. Our dues dollars support a myriad of advocacy efforts and other initiatives that bring value to the profession and to our credential. I encourage you to get involved in ANFP and enjoy the benefits of being an active member of your professional association! E The Association of Nutrition & Foodservice Professionals has value for each member. I joined the organization in 1990 and have found that being involved enhances my professional success and personal confidence. I’ve been able to give to and receive from the association. ANFP has given me the ability to do both. Deborah McDonald, CDM, CFPP is the Program Administrator for Food Service at North Texas State Hospital, Wichita Falls Campus. She has worked in food service for 35 years. dmcdonald@anfponline.org by Deborah McDonald, CDM, CFPP The Value of Your ANFP Membership The ability to contact and connect with our colleagues may be the biggest membership value of all.
  • 36. Nutrition & Foodservice Edge | June 201534 Meet Your Incoming 2015-2016 Officers and Directors ® 2015 -2016 BOARD CONGRATULATIONS to the following individuals, who will serve as national leaders on the ANFP Board of Directors and the Certifying Board for Dietary Managers in 2015-2016. The ANFP Leadership Development Committee recommended these individuals, and their names were distributed to mem- bers in late winter. The ANFP Board then approved this slate at their March 11 meeting. They will take office June 1, 2015. These incoming board members join current ANFP national leaders whose positions will change as follows on June 1. Deborah McDonald, CDM, CFPP ascends to the position of 2015-2016 ANFP Chair of the Board; Janice Hemel, CDM, CFPP becomes Chair Elect; Kathryn Massey, BA, CDM, CFPP becomes Immediate Past Chair; and Ken Hanson, CDM, CFPP moves from Treasurer Elect to Treasurer. Best wishes to all ANFP volunteer leaders in their new roles! O F F I C E R S Nurturing careers, Setting standards, Sharing best practices. ® 2 0 1 5 - 2 0 1 6 B O A R D O F D I R E C T O R S Chair Elect Janice Hemel, CDM, CFPP Dighton, KS Treasurer Elect Sharon Vermeer, CDM, CFPP Maurice, IA Immediate Past Chair Kathryn Massey, BA, CDM, CFPP Sioux City, IA Cindy Cothern, CDM, CFPP Mound Valley, KS John Hickson, CCA, FMP, CHESP, CDM, CFPP Slidell, LA Richard Hoelzel, CDM, CFPP, FMP Cabot, AR Larry J. Jackson, CDM, CFPP Americus, GA Richard “Nick” Nickless, CDM, CFPP Hanahan, SC Sherri Williams, CDM, CFPP Fayetteville, AR D I R E C T O R S AT L A R G E CDM, CFPPs Deb Dawson, CDM, CFPP Johnston, IA H C I L I A I S O N Amy B. Lewis, MBA SimplyThick, LLC Mystic, CT Carl Mulder Aladdin Temp-Rite Hendersonville, TN Corporate Partners Gary Blake Creative Solutions in Healthcare, Inc. Fort Worth, TX Jeff Patton Brookdale Senior Living, Inc. Brentwood, TN Joyce Gilbert, PhD, RDN St. Charles, IL Industry PartnersChair Deborah McDonald, CDM, CFPP Burkburnett, TX Treasurer Ken Hanson, CDM, CFPP Ankeny, IA A N F P P R E S I D E N T & C E O
  • 37. Nutrition & Foodservice Edge | June 2015 35 Continued on page 36 Janice Hemel, CDM, CFPP Dighton, KS Certified Dietary Manager, Lane County Hospital and Long-Term Care Years Worked in Food Service: 29 Years in ANFP: 23 Sharon Vermeer, CDM, CFPP Maurice, IA Food Services Manager, Orange City Area Health System Years Worked in Food Service: 19 Years in ANFP: 16 A N F P C H A I R E L E C T: A N F P T R E A S U R E R E L E C T: Notable Volunteer Activities ANFP Board Treasurer; ANFP Audit/Finance, Education Content, and Leadership Development Committees; Kansas ANFP Chapter President, School Liaison, Secretary, Treasurer, and several committees; Nutrition & Foodser- vice Education Foundation Board Member; President - Home Extension Service Why are you interested in serving ANFP at the national board level? I have enjoyed my experience on the board so far [most recently serving as treasurer] and feel I give a different out- look. I like to look at all sides of the picture when topics are being discussed to see what will be the best outcome for all CDMs. Increased communication from the board to the members is essential to work together on changes that are happening within the industry and organization. I live, eat and sleep ANFP, and I want to help make it the “go-to” association in the food industry. What do you think you’ll bring to the ANFP Board? I come from a small town in western Kansas. I have learned how to do more with less, think outside the box, and see the picture from all sides. I can use these talents to help ANFP move forward in the future to ensure our CDMs have the education and tools it takes to be successful members. This will help keep our association strong for many years to come. We need to be accessible to our members and to the foodservice industry to make the best better. Notable Volunteer Activities ANFP Board Director at Large; ANFP Chapter Leadership Team; CBDM Item Writer; Iowa ANFP Chapter President Why are you interested in serving ANFP at the national board level? I’ve really enjoyed the time I have already spent on the board [most recently serving as director at large]. There is so much more to learn about ANFP. It is an honor to volun- teer at the national level! As a CDM, our management skills and leadership are vital to a well-run kitchen. Because, let’s face it, that’s the one thing patients and residents can control. It’s something to look forward to: not just the food, but the fellowship. What we do creates that for them. What we do matters. As CDMs, we need to market ourselves to our CEOs and bosses, helping them to see the great value a well-run department affords them. I believe we can help CDMs do that by things we do as a national board. What do you think you’ll bring to the ANFP Board? I have a real passion for CDMs. One of the advantages of our board is that it is comprised of people from all dif- ferent areas of the country, which affords us many points of view. By working as a team, we can incorporate those views and do what is best for our organization and all of us as CDMs.
  • 38. Nutrition & Foodservice Edge | June 201536 Cindy Cothern, CDM, CFPP Mound Valley, KS Dietary Manager, Montgomery Place Years Worked in Food Service: 25 Years in ANFP: 17 John Hickson, CCA, FMP, CHESP, CDM, CFPP Slidell, LA Independent Food Safety Auditor, Verify International Years Worked in Food Service: 28 Years in ANFP: 3 A N F P D I R E C TO R AT L A R G E : A N F P D I R E C TO R AT L A R G E : Notable Volunteer Activities ANFP Legislative Committee; Kansas ANFP Chapter Educa- tion Chair and Legislative Spokesperson Why are you interested in serving ANFP at the national board level? ANFP has been good to me through the years. The mem- bers have become like family to me, and I definitely have more time on my hands with the children moved out of the house. It is a perfect opportunity for me to give back to an organization that has supported me for many years. When I became active at the state level I was surprised to find that I have some talent working with government af- fairs! After doing some speaking with CDMs and members of Congress, I found I have a voice, and people want to hear it. It would be my pleasure to serve the members and help the organization that has helped me so much over the years. What do you think you’ll bring to the ANFP Board? I’ll bring dedication to our association and to our mem- bers, an enthusiastic attitude, and a willing spirit. I am excited to learn new ways to serve. I believe we have a bright and exciting future ahead of us, and I look forward to assisting our association in preparing for that future. Notable Volunteer Activities Louisiana ANFP Chapter President and Membership Chair; ANFP Professional Development Committee; Second Harvesters Volunteer Teaching Chef; National Restaurant Association Education Foundation Exam Item Writer for ServSafe and ManageFirst Programs Why are you interested in serving ANFP at the national board level? I was raised to always give back to my community in the best way possible. I would like to help my fellow CDMs achieve all they can, by expanding our education offerings to our members. I believe that with over 28 years of expe- rience within the foodservice industry it is time to share my education and experience with up and coming CDMs. What do you think you’ll bring to the ANFP Board? I will bring a wealth of industry knowledge to the board, along with my successful team building skills. I am an “at- tack the issue/problem” now and resolve it immediately type of person. I enjoy working with a diverse group of in- dividuals and working on common ground for the good of the whole association. I have a solid history of producing results within a limited budget. I have built and success- fully managed multiple foodservice operations; I deal ef- fectively with customers, executives, and stakeholders on a regular basis. All of these achievements are critical to the success of any organization. My educational background, experience, and skills are diverse, and I look forward to serving ANFP members. Continued from page 35
  • 39. Nutrition & Foodservice Edge | June 2015 37 Carl Mulder Hendersonville, TN Vice President of Sales and Marketing, Aladdin Temp-Rite Gary Blake Fort Worth, TX Owner & Founder, Creative Solutions in Healthcare, Inc. ANFP DIREC TOR AT L ARGE— CORPOR ATE PARTNER: ANFP DIREC TOR AT L ARGE— INDUSTRY PARTNER: Why are you interested in serving ANFP at the national board level? The Board of Directors is integral to the growth and suc- cess of ANFP. Because I recognize the importance of ANFP to the CDM community in food service and the positive impact its members have on the industry, I’ve personally been af- filiated with ANFP for many years; my company, Aladdin Temp-Rite, has supported ANFP for many more. Working with ANFP is an exciting opportunity to contrib- ute to the organization’s future by bringing value to its CDM members. Through mentoring, peer interactions and educational engagement programs that provide learning at every career stage, ANFP has so much to offer members and potential members. We will continue to build on that success. What do you think you’ll bring to the ANFP Board? As a member of the corporate foodservice supplier/partner community, I have a very diverse background in finding answers to challenges, and successfully resolving problems that arise in the foodservice industry. While serving as the Chair of the Industry Advisory Coun- cil this next year, it affords me the opportunity to liaise between ANFP’s corporate partners and the board. The ultimate goal is more CDM members and supplier partners that support the organization, leading to a stron- ger, more valuable ANFP. Notable Volunteer Activities Recipient of ANFP’s 2014 Leading Change Partnership Award; Member of Fort Worth Academy School Board Why are you interested in serving ANFP at the national board level? I value the services of nationally-certified dietary manag- ers, and I want to support their professional organization. As the leader of a large group of skilled nursing facilities, I have come to realize over the past 15 years the importance of having a well-qualified dietary manager at the helm of each of my dietary departments, and I see the benefits of having a strong professional organization to support the certified dietary manager. What do you think you’ll bring to the ANFP Board? I bring direct hands-on experience with the issues fac- ing dietary managers in long-term care every day. When founding Creative Solutions in Healthcare, one facility at a time, I realized first-hand the challenges and rewards that our dietary managers experience every day. I appreciate the range of decisions that a dietary manager must make, and how these decisions have a profound impact on the lives of our residents. I believe that this grassroots knowl- edge will serve me well when helping to make decisions about the future of ANFP. Continued on page 38
  • 40. Nutrition & Foodservice Edge | June 201538 Richard Hoelzel, CDM, CFPP, FMP Larry Jackson, CDM, CFPP Richard “Nick” Nickless, CDM, CFPP Sherri Williams, CDM, CFPP Amy Lewis, MBA, SimplyThick LLC (Corporate Partner) Jeff Patton, Brookdale Senior Living, Inc. (Industry Partner) Debra Dawson, CDM, CFPP (HCI Liaison) Thanks for Serving A N F P D I R E C TO R S AT L A R G E C E R TI F Y I N G B OA R D A N F P D I R E C TO R S AT L A R G E Theresa Fightmaster Yvonne Foyt, CDM, CFPP Kristin Klinefelter, RD Dana Moyers, NHA Barbara Thomsen, CDM, CFPP CarieAnn Williams, CDM, CFPP Terri Edens, CDM, CFPP, LNHA Kevin Loughran, Healthcare Services Group (Industry Partner) Beth Naber, MS, RD, US Foods (Corporate Partner) Sue Zins, CDM, CFPP, 2014-2015 CBDM Chair Paula Bradley, CDM, CFPP, 2014-2015 ANFP Immediate Past Chair The following individuals will continue serving ANFP or the CBDM in leadership roles in 2015-2016. We appreciate their ongoing commitment to serve! The following national leaders will complete their term of service on May 31, 2015. ANFP and the CBDM are grateful to them for their leadership. Timothy L. Bauman, DHCFA, CDM, CFPP Sylvania, OH President/Owner, BBSLLC Years Worked in Food Service: 41 Years in ANFP: 25 C E R TI F Y I N G B OA R D M E M B E R : Notable Volunteer Activities Ohio ANFP Chapter President and Webmaster; Fellow with the National Center for Nutrition Leadership; CBDM Item Writer; Board Member of three CDM certification pro- grams; Board Member of ASHFSA/AHF, MedAssets, HPS, NOSS, Wood County Health District, Food & Nutrition Advisory BGSU Why are you interested in serving on the Certifying Board for Dietary Managers? A chance to advance both the profession and the organiza- tion are top goals when I serve on the CBDM. Champion- ing education and getting greater national recognition for our credential and government advocacy activities are priorities. I work hard to get donations, vendor support, and work on behalf of the membership. Supporting certi- fication programs across the nation is an excellent way to increase the membership and visibility of the organization. What do you think you’ll bring to the CBDM? I look forward to giving back to something that has done so much for me through the years. I have served in the trenches as a member and enjoyed serving Ohio ANFP. I have produced many articles for the magazine and have served on several national ANFP committees including the CBDM Item Writers Committee. I attended the ANFP Leadership Institute and, as a result, was named a Fellow with the National Center for Nutrition with MOWAA. I served as a board member for three CDM course pro- grams and am a frequent speaker. Wherever I can pro- mote education, the organization and industry, I do. Continued from page 37 C E R TI F Y I N G B OA R D