WORKBOOK. This workbook enables you to ... Task 2 : Use Nutrimen to look up
the iron content of Shreddies, Weetabix and Special K. Complete this table: .....
Thiamin (B1) ..... B. Very close to the EAR – suggesting he's maintaining his
weight.
WORKBOOK
professional dietary analysis
wherever you have internet access
This workbook enables you to explore the key functions of Nutrimen dietary analysis software. p2-5
Unit 1 – Quick Look ups Explore foods from the McCance and Widdowson database – no more green book
p6-12
Unit 2 – Analysing a food diary See for yourself why data entry takes only 25% of the time compared to other packages
Compare to relevant dietary reference values
Gain skills in portion size estimates along the way
p13-16
Unit 3 – Recipe analysis Easily add a recipe and see at a glance how it compares to traffic light food labels
Export tables and charts to Word, Excel or SPSS -
Unit 4 – Adding custom foods
p17-20
Use manufacturers information to add in your own foods which can then be added to food diaries and recipes
Unit 5 – Putting it all together
p21-27
Build confidence with your Nutrimen skills by entering a more complex two day food, including custom foods and recipes.
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Unit 1 – Quick look ups Unit 1 enables you to: • Use Nutrimen to access data from McCance and Widdowson’s database together with Food Portion Sizes
• Select appropriate alternatives for foods which are not found in the McCance and Widdowson dataset
• Use the data to inform dietary advice in given scenarios
We all know that a plate of fried chips contains more calories than a jacket potato but where does that data come from?
Back in the 1940s, Dr McCance and Dr Widdowson were the first to conduct detailed laboratory analysis on foods and drinks typically consumed in the UK. Their analysis tables have been updated and developed ever since and today are widely used by Dietitians and Nutritionists across the UK. Knowing which nutrients are in foods and drinks is the basis of much of our dietary advice.
Scenario 1 Trevor’s Taxis are worried about the health of their employees, many of whom are overweight. They are looking to improve the healthiness of their café food; of which deep fried crinkle cut chips are their best sellers.
Task 1 - Use Nutrimen to compare different types of chips; 1. On any PC, laptop or tablet visit www.nutrimen.co.uk
2. Search for chips
Note that as you type, Nutrimen guesses what you’re looking for. 3. In second column, use the drop down menu to find crinkle cut chips, fried in corn oil.
Note the extra information from the McCance book; the code 13-024 in the top right corner and the footnotes at the bottom: “10 samples, 10 brands. Deep fried 3-6 minutes” 4. Select large portion size.
Note Nutrimen contains data from Food Portion Sizes (FSA, 2005) together with some manufacturers estimates. 5. The third column tells us that a large portion (240g) of crinkle cut chips contains 696kcal and 40g total fat. Knowing Trevor’s taxi drivers often have chips with a large pastie or sausage roll, it looks like there is potential for finding some lower calorie chips.
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6. Use Nutrimen to compare this value with other types of chips. Complete this table:
Food description
McCance code
Portion Energy (kcal/ size portion size)
Crinkle cut chips, 13-024 fried in corn oil
240g (large)
Straight cut chips, frozen, fried in blended oil
50-681
240g (large)
Oven chips, baked
13-029
240g (large)
Total fat (g/ portion size)
696
Tick chips you’d recommend 40
Nutrimen contains 3,423 foods from the Royal Society of Chemistry COFIDS database. This is significantly more than is in the McCance and Widdowson book.
Scenario 2 Sue is vegetarian and has Iron Deficiency Anaemia. She currently has cornflakes for breakfast but asks you to recommend a breakfast cereal which would be higher in iron.
Task 2 : Use Nutrimen to look up the iron content of Shreddies, Weetabix and Special K. Complete this table:
Food description
McCance code
Portion size
Iron (mg/ portion size)
Cornflakes
11-490
30g medium portion
2.37
Shreddies
11-500
45g average portion
Weetabix
11-505
20g x 2 bisc
Special K
11-501
30g medium portion
Tick the breakfast cereal you’d recommend
Note: To enter a portion size of 2 weetabix, you select the 20g bisc portion size, then x2.
Scenario 3 Broadlands Nursing Home is reviewing their menu which has been found to be low in vitamin C. Residents currently enjoy tinned apricots in syrup as their favourite pudding. How could this be adapted to increase how much vitamin C it provides?
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Task 3 : Use Nutrimen to complete this table: Food description
McCance code
Portion size
Vitamin C (mg/ portion size)
Apricots, canned in syrup
14-290
140g
7.0mg
Apricots, canned in juice
14-302
140g
Apricots, stewed with sugar
14-027
110g
Tick the apricots you’d recommend
Note, to date there is no published typical portion size for stewed apricots. Instead Nutrimen suggests the closest equivalent; stewed apples. Use your knowledge of food to decide whether to accept the suggestion or use it to form the basis of your own portion size estimate.
Are all supermarket foods in Nutrimen? A trip round the supermarket and we see far more products than are in the McCance and Widdowson dataset. For example McCance and Widdowson analyse just one type of fresh filled pasta; Cheese and vegetable stuffed, cooked pasta (11-451), whereas a typical supermarket sells a dozen types; beef and red wine ravioli, chicken and bacon tortellini, spinach and ricotta tortellini to name a few. A key difference between professional Nutrimen and consumer apps such as MyFitnessPal or MyDietCoach is the breadth and depth of foods analysed. Consumer apps include more foods with typically only the energy value of each. In comparison Nutrimen uses McCance and Widdowson data contains a smaller number of foods but many, many more nutrients for each.
Full length features not trailers It can be helpful to think of consumer apps like MyFitnessPal or MyDietCoach as a library full of film trailers – you get only the headline energy values for each food. In comparison Nutrimen is a smaller library but of entire films, you get much more than just the trailer with analysis of not just energy but a wide range of macro and micronutrients.
Scenario 4 Supermarkets typically sell a large number of different types of yoghurts, far more than has been analysed in the McCance and Widdowson dataset. As a Nutritionist/Dietitian you need to find the closest equivalent for each type, based on your practical food knowledge of typical portion sizes and yoghurt types.
Task 4 : Use your judgement to find the closest equivalent for each type of yoghurt. Without using Nutrimen, just based on your knowledge of different types of yoghurt sold in the UK, draw a link between the first and second column as per example below;
Type of yoghurt the client usually chooses;
Type of yoghurt analysed in McCance and Widdowson dataset
Petit filous
Virtually fat free fruit
Muller corner – strawberry flavour
Infant, fruit flavour
Supermarket own brand low fat raspberry
Twinpot thick and creamy with fruit
Shape peach
Whole milk, plain
Yeo valley plain
Low fat fruit Page 4
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Task 5 We eat more biscuits in the UK than any other country in Europe. Some of these are easy to find eg Jaffa cake, digestive biscuit. Others you’ll need to use your judgement to find the closest equivalent. It can be useful to look at the grey footnotes in the second column of Nutrimen for more information about the foods analysed. As before draw a link between the first and second column for each biscuit;
Type of biscuit the client usually chooses
Type of biscuits analysed in McCance and Widdowson dataset
Hob Nob
Sandwich biscuit – cream filled
Custard cream
Oat based biscuit
Jammy dodger
Crunch biscuits – cream filled
Rich tea
Sandwich biscuit – jam filled
Golden crunch
Semi-sweet biscuit (look in footnotes)
Task 6 When finding closest equivalent foods, it can also be useful to think about the characteristics of the food. For example blueberries have not yet been analysed in McCance and Widdowson, but searching for berries shows some potential alternatives include raspberries, cranberries or gooseberries.
You know that blueberries are sweet like raspberries and yet small in size like cranberries. All berries are likely to be similar in terms of water content but different in terms of vitamin C. Look at the data in the data from Nutrimen in the table below and decide which you’d choose as the closest equivalent to blueberries;
Type of berry
Water content ml per 100g
Vitamin C
(mg per 100g)
Total sugars
(g per 100g)
Tastes sweet?
Blueberries
unknown
unknown
unknown
Yes
Raspberries
87
32
4.6
Yes
Cranberries
87
13
3.4
No
Gooseberries
90
14
3.0
No
Tick the closest match for blueberries
Task 6 completes Unit 1. You should now be able to: • Use Nutrimen to access data from McCance and Widdowson’s database together with Food Portion Sizes
• Select appropriate alternatives for foods which are not found in the McCance and Widdowson dataset
• Use the data to inform dietary advice in given scenarios.
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Unit 2 – Entering and analysing a basic food diary Unit 2 enables you to: • Use Nutrimen to input a straightforward one day food diary
• Select appropriate portion sizes from available options
• Use the data to inform dietary advice for a given case study
Scenario 5 Kate is 35 with a BMI of 27 and a strong family history of osteoporosis. She has been referred to you for weight reduction advice but is also keen to reduce her risk of osteoporosis.
Start by looking at Kate’s food diary below:
Kate’s food diary Breakfast Weetabix x2 with semi-skimmed milk Sugar, 1 teasp Mug of tea with semi-skimmed milk Apple juice Mid-morning snack Kitkat (4 bar) Mug of tea with semi-skimmed milk Lunch Wholemeal bread (2 slices) Flora (70% fat spread) Cheddar Pickle Ready salted crisps Banana Mid-afternoon snack Mullercorner yoghurt Cola Evening meal Lasagne homemade Garlic bread (3 slices) Coleslaw Sponge cake, jam filling Evening Red wine, 2 glasses
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Task 7 Before we do the full analysis, take a moment to estimate by eye the energy and calcium content of Kate’s diet. From what she normally eats, do you think that she eats too many or too few calories? Does she get enough calcium already or is there room for improvement? Use your estimate to answer the multiple choice questions below;
7.1
Kate’s food diary suggests her energy intake is;
A. Low enough to help with weight reduction, around 80% of the EAR
B. Above the EAR and contributing to small weight gain, around 120% of the EAR
C. High above the EAR and contributing to relatively fast weight gain, around 150% of the EAR
7.2
Which of the following best describes Kate’s calcium intake?
A. too low, around 80% of the RNI, increasing her osteoporosis risk
B. comfortably above the RNI, around 130% of the RNI
C. very comfortably above the RNI, around 200% of the RNI
Task 8 Sign in to Nutrimen so you can use all the features
Quick look ups are freely available to everyone. Sign up to analyse food diaries, enter recipes and custom foods;
1. Visit: www.nutrimen.co.uk.
2. Select the green Sign Up button. Enter your email address and decide on your own password.
Note if you are a University student looking to try the free academic trial, use your University .ac.uk email address. 3. The first time you sign up, you’ll need to confirm your registration. Do this by clicking Confirm in your registration email sent to the email address you provided.
4. You’ll now be able to use all the functions of Nutrimen.
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Task 9 : Start new diary 1. Ensure you are signed in to be able to enter food diaries
2. From the Nutrimen home page, find Diaries and select Start new diary
3. Enter the demographics of your client, in this case;
Title
Kate Smith
Start date
Date of food diary – defaults to todays date.
Click in the box to select date from calendar
D.O.B.
Unknown date of birth? Leave blank and skip to age.
Age
35 years
Gender
Female
Pregnant
If female selected above, additional options for pregnancy and breastfeeding appear. Kate is neither so stick with the default settings
Breastfeeding Nutrients analysed Choose how many nutrients you’d like analysed. The default main list of 31 is plenty for most purposes 4. Click Create once finished.
Adding in these details now saves you time later as it will enable Nutrimen to compare your food diary to the right dietary reference values for Kate’s age and gender.
Task 10 : Enter the foods Kate ate; You’ll are now in Data Entry for Kate Smith
Note the blue tabs at the very top; Diaries – Kate Smith – Diary Entry 1. For breakfast, Kate ate 2 weetabix. Use the top right search box to find Weetabix.
In the second column the suggested portion size is 20g (1 bisk), select, then x2, then Add to diary. You’ll notice that 40g of Weetabix are now in Kate’s diary. 2. Semi-skimmed milk – 100g with cereals, average portion – Add to diary.
3. Sugar. Note white sugar is selected by default. If you wanted to choose a different type of sugar, use the drop down menu under the McCance code. 1 heaped teaspoon. Add to diary.
4. Tea – select appropriate type using the drop down menu – average mug portion size – Add to diary.
5. Tea is a Favourite - Kate drinks lots of tea during the day to it’s worth copying the mug of tea you’ve just entered into the 4th Favourites column so you can quickly add it again later. Hover over Tea in the diary, click on the heart symbol and it’ll copy across to the Favourites column. Try adding another mug of tea now by hovering over the Tea in Favourites column and click the left arrow.
6. Too much tea? - if you make a mistake, hover over the food you want to delete and click the red cross.
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7. Apple juice – Kate’s food diary doesn’t specify the portion size. Here you’ll need to use your judgement on which of the suggested portion sizes is most appropriate. You might look at the size of other drinks in Kate’s day, what you know about typical eating habits of UK women in their 30s or if unsure select an average glass size.
Hint - You’ll notice portion sizes for drinks are typically in grams rather than mls. Typically in food and nutrition, 1g is approximated to be comparable to 1ml. This assumption is appropriate when talking about the food and drink people typically consume because however hard you try it’s rarely a precise measure. If you weigh your cheese sandwich to be 150g and then eat it all – you won’t have eaten all 150g because they’ll be some crumbs left behind on the plate. Similarly a glass of 160ml apple juice won’t all be drunk as some will stick to the sides of the glass and be left in the base of the glass. 8. Kitkat - 4 finger bar – Add to diary.
9. Add another mug of tea from favourites
10. Wholemeal bread – 2 medium slices from a normal large loaf; 36g x 2
11. Flora (70% polyunsaturated fat spread) - add enough to put on 2 slices of bread ie 7g x 2
12. Cheddar – add enough for a sandwich.
Hint: if you prefer you can use Nutrimen using only the keyboard rather than mouse – just tab from box to box. 13. Pickle – add enough for a 2 slice sandwich
14. Crisps – ready salted, individual packet
15. Banana – medium
16. Yoghurt, Muller corner – use the drop down menu to find twinpot, thick and creamy with fruit.
17. Cola – 500ml – the default is diet, so use the drop down menu to select standard.
Hint: Nutrimen lists foods in popularity order. For example, when you search for milk, semi-skimmed milk comes up first and you have to scroll down for human breast milk. Setting the defaults to be the most popular options, means you spend less time scrolling up and down for the food you need, making food entry is quicker. 18. Lasagne, homemade – typical portion – Add to diary
Note: McCance and Widdowson use Lasagne (with an e at the end) to describe the recipe of beef, pasta sheets, tomato sauce, cheese sauce etc. In contrast they use Lasagna (with an a at the end) refers to dried lasagne sheets by themselves. 19. Garlic bread – 3 slices ie 20g slice x 3
20. Coleslaw – 2 tablespoons
21. Sponge cake with jam filling
22. Red wine – 2 average glasses
You’ve now entered all the food and drink from Kate’s food diary.
More than 1 day? If you wanted to add in day 2, go to the top blue Day 1 tab and click on the drop down arrow, select Add day. Unit 5 explores this in more detail.
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Pinpoint accuracy or broad household portion size estimates? Remember the portion sizes are household measures rather than exact to the nearest mg. Consider Kate’s mug of tea for which we used the standard mug of 260g. Take a look at people’s tea mugs around you, even the average looking ones vary in size and then often some tea is left in the bottom of the mug or spilt. It’s highly unlikely that all of Kate’s mugs of tea were exactly 260g.
If Kate had completed a weighed food intake, we would have more precise portion sizes. Instead from just her food diary, we’ve had to make assumptions about her portion sizes. The more assumptions we’ve made, the less accurate the final analysis will be.
Task 11 : Discover how the food diary compares to relevant Dietary Reference Values Now that you’ve entered all the foods and drinks that Kate ate yesterday, we can compare it to the relevant Dietary Reference Values.
You are currently in Data Entry for Kate Smith
Note the tabs at the very top: Diaries – Kate Smith – Diary Entry 1. Move to Analysis
Note the tabs at the very top; Diaries – Kate Smith – Analysis 2. Look at the top left hand corner to identify the DRV tab within Analysis. This summarises nutrient intake, expressed both as g/mg and as a percentage of the Dietary Reference Values for Kate (age 35, female, not pregnant or breastfeeding)
3. You can copy the tables and graphs into Excel/Word or SPSS to use in your own reports. Simply click Download in the top right hand corner and select Excel, SPSS or image.
4. Test your understanding of the analysis of Kate’s diet by revisiting the following multiple choice questions from task 7.
11.1 Kate’s food diary suggests her energy intake is: A. Low enough to help with weight reduction, around 80% of the EAR
B. Above the EAR and contributing to small weight gain, around 120% of the EAR
C. High above the EAR and contributing to modest weight gain, around 150% of the EAR
11.2 Which of the following best describes Kate’s calcium intake? A. too low, around 80% of the RNI, increasing her osteoporosis risk
B. comfortably above the RNI, around 130% of the RNI
C. very comfortably above the RNI, around 200% of the RNI
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Task 12 : Explore which foods provided which nutrients. This is useful to know in order to form the basis of your dietary advice. For example if all the calcium came from milk and dairy foods – it suggests these are foods Kate likes and could potentially eat larger portions / more often.
1. Select the Contributing Foods tab within Analysis. Select the nutrient you’re interested in using the drop down menu. Then hover over the rainbow wheel to explore which foods were good sources.
Note you can download data into Excel or SPSS using the Download Data. Similarly you can download the graph to put into your own report/assignment using Download Graph. 2. Test your understanding of the analysis of Kate’s diet by answering the following multiple choice questions;
12.1 Which of the following foods provided the greatest amount of energy in Kate’s diet? A. Cola, cheese, sponge cake and crisps
B. Lasagne, kitkat, coleslaw and garlic bread
C. Yoghurt, wholemeal bread and Weetabix
12.2 Which of the following foods provided the greatest amount of calcium in Kate’s diet? A. Kit kat, red wine, sponge cake
B. Wholemeal bread, cola, coleslaw
C. Lasagne, cheese, yoghurt
4. Select the Data tab within Analysis. It is like a receipt showing all the food and drink entered, complete with McCance code and portion size. This can be useful for concisely recording which foods you entered into Nutrimen, for example for assignments and case studies.
Task 13 : Use the analysis to consider the overall composition of Kate’s diet Click on Energy within the Analysis tab
Consider how does Kate’s overall diet compare to the DRV that diets should contain 15-30% of energy from total fat?
13.1 Which of the following is correct; A. Kate’s diet contains too little energy from fat
B. Kate’s diet contains about the right amount of energy from fat
C. Kate’s diet contains too much energy from fat?
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Task 14 : Use the analysis findings to inform your dietary advice for Kate How well can you translate the analysis of Kate’s diet into practical dietary advice? Try the following multiple choice questions;
14.1 Which of the following pieces of dietary advice would lead to the greatest weight loss? A. Swapping from standard to diet cola?
B. Halving the amount of cheese in her sandwich?
C. Swapping from sugar to sweetener in her tea?
14.2 Look at Kate’s NSP intake and identify which foods provide the NSP. Which of the following pieces of dietary advice would be the easiest way for Kate to meet the RNI for NSP? A. Eat bigger portions of Weetabix and wholemeal bread?
B. Eat bigger portions bananas and fruit juice?
C. Eat bigger portions of crisps and coleslaw?
Now you’ve reached the end of Unit 2 you should feel confident to: • Use Nutrimen to input a food diary
• Select appropriate portion sizes
• Use the data to inform dietary advice for a given case study
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Unit 3 – Entering and analysing a recipe Unit 3 enables you to: • Use Nutrimen to devise a recipe
• Analyse the recipe and create a corresponding traffic light food label
• Add your recipe to an existing food diary
• Use the data to inform dietary advice for a given scenario
Scenario 6 You are working in Public Health and are working with TL Industries to help improve the healthiness of their work canteen food. The canteen cook Tina loves making teabread which is popular with employees and she asks you whether it’s a healthy dish or not?
Task 15 : Look at Tina’s recipe for Teabread below and guess how it might compare to the FSA traffic light food labels, for example, tick low/green if you think it will be low for total fat; Tina’s Teabread (makes 14 slices) 350g raisins 175g brown sugar 300ml cold strong black tea 1 egg 225g plain flour 1 teasp baking powder 1 teasp cinnamon High
Medium
Low
Total fat Saturated fat Sugar Salt 1. Ensure you are signed in, so you can use the recipe function
2. From My Nutrimen home screen, Recipes, then select Create new recipe
3. Describe the main features of the recipe eg;
Title
Tina’s teabread (we’d recommend giving it a personal name (eg Tina’s) to help you find it later
Portions
14
Notes
From TL industries canteen (date)
Nutrients
Keep the default setting of Main (31 nutrients) – which is plenty for most purposes
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4. Click Create
5. You are now on the recipe screen, adding in the ingredients to Tina’s teabread.
the very top tabs read: Recipes – Tina’s teabread – Recipe Entry 6. Use the search box in the top left corner to search for all the ingredients as you did before; starting with raisins, 350g
7. Sugar, brown, 175g
8. Tea, black, 300ml – use the drop down menu to select a strong black tea infusion, without milk
9. Eggs, chickens, raw, 1
Note: there is no published portion size for a raw egg, therefore Nutrimen suggests the closest equivalent of a boiled egg= 50g. 10. Plain flour, 225g
11. Baking powder, 1 teaspoon
12. Cinnamon, 1 teasp
13. When you’ve finished entering all ingredients, click the green Publish to my list button in the 4th column to save as a recipe in your profile.
Note: the recipe ingredients are only saved once you have clicked Publish to my list.
Now when you go back to your diaries, Tina’s teabread recipe will be waiting for you to use. The recipe will be saved to your My profile rather than the central Nutrimen database.
Task 16 – Add a slice of Tina’s teabread to the existing food diary for Kate Smith; 1. Find the food diary you entered in tutorial 2 for Kate Smith
(from Home – Diaries – Kate Smith) 2. On Kate Smiths’ row – find the Actions column - click Diary Entry symbol (book page icon)
3. Search for Tina’s Teabread. Select
4. Nutrimen has worked out the weight of each slice from your recipe. So the 79g typical serving suggested is the weight of all the cake ingredients, divided by 14 slices. Select 79g, then Add to diary.
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Task 17 - Find out how the Tina’s teabread recipe compares to traffic light food labels. 1. Select the Recipes tab in the top blue bar
2. Find Tina’s teabread
3. On the Tina’s teabread row – go to Actions column – select recipe analysis icon (looks like a column chart)
4. View the traffic light label for Tina’s teabread; showing it provides an estimated 174kcal per slice and is low in fat, low in saturates, high in sugar and low in salt;
Turn back to your Task 15 answer – how accurate was your initial estimate?
Task 18 - Find out which foods provided the most sugar, calcium and NSP Click on Contributing foods and selecting the nutrients you are interested in from the drop down menu. Use your findings to answer the following;
18.1 Tina’s teabread was red/high for total sugars. Which foods provided most of the sugar? A. Brown sugar 57%, raisins 42%
B. Raisins 57%, brown sugar, 42%
18.2 A slice of Tina’s teabread provided 49mg calcium. Which food provided most of the calcium? A. flour
B. raisins
C. black tea
18.3 50% of the NSP was provided from the raisins, 50% from the flour. How much NSP does a single slice of Tina’s teabread provide; (Look in Nutrients tab next to ingredients) A. 3g a slice
B. 2g a slice
C. 1g a slice
As before, you can download data and graphs to Excel or SPSS for use in your own reports.
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Task 19 - Decide what would you say to the Tina about the healthiness of her Teabread. Choose one of the following: A. Your teabread is very high in sugar and therefore is definitely not a healthy food
B. Your teabread is much lower in fat than other cake and therefore is a relatively healthy cake option
C. Your teabread has an excellent nutritional profile and as such is an officially healthy option.
Now you’ve reached the end of Unit 3, you can: • Use Nutrimen to devise a recipe
• Analyse the recipe and create a corresponding traffic light food label
• Add your recipe to an existing food diary
• Use the data to inform dietary advice for a given scenario
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Unit 4 – Adding custom foods Unit 4 enables you to: • Use Nutrimen to enter a custom food and save to your profile
• Add your custom food to a food diary
• Use a previously added custom food as an ingredient in a recipe
• Apply findings to given scenario
Scenario 7 Kelloggs Rice Krispies Multigrain Shapes is a relatively new breakfast cereal aimed at children. It has yet to be analysed by McCance and Widdowson but core nutritional information is freely available from the manufacturer online.
Custom foods allows you to enter in the nutritional composition of your own foods. Custom foods are saved to your individual profile and will be available to you whenever you use Nutrimen. They cannot be seen by anyone else.
Task 20 – Add Rice Krispies Multigrain Shapes as a custom food. 1. From My Nutrimen home page, find My food, then Add custom food
2. You’ll need the nutritional breakdown in front of you to proceed. This could come from the manufacturers website or the food packaging eg;
Rice Krispies Multigrain Shapes Breakfast Cereal Nutritional Information
Suggested portion size 30g per 100g
per 100g
Energy
379kcal
Vitamin D
4.2μg
Total fat
2.5g
Thiamin (B1)
0.91mg
of which saturates
0.5g
Riboflavin (B2)
1.2mg
Total carbohydrate
77g
Niacin
13.3mg
of which sugars
18g
B6
1.2mg
Fibre
8g
Folic acid
166μg
Protein
8g
Vitamin B12
2.1μg
Salt
0.38g
Calcium
456mg
Sodium
152mg
Iron
8.0mg
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3. Add the broad details of your new food eg:
Title
Rice Krispies Multigrain Shapes
Subtitle
Breakfast cereal
Notes
Data from manufacturers website (date accessed)
4. Go to Nutrients at the bottom of the screen. With the food label infront of you, fill in the form for the nutrient content per 100g of food, leaving blank any information you don’t know.
5. Click Add food to save to your profile.
Task 21 – Enter a portion of Rice Krispies Multigrain Shapes into a food diary. To make this easier, we’ll use our existing food diary from tutorial 2 for Kate Smith. 1. From My Nutrimen – Find Kate Smiths’ diary – Click on the Edit Diary icon (looks like a book page)
2. Search for Rice Krispies Multigrain Shapes
3. Notice how Nutrimen has allocated a unique code starting FDO… which appears in the top right corner where the McCance code would normally appear
4. Add in a 30g portion of Rice Krispies Multgrain Shapes cereal to Kate’s diet
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Scenario 8 You are working with nursery cooks at Woodcroft Primary School to devise a healthy pudding choice which be both easy for the cooks to prepare and popular with the children. They are keen to develop a variation on a chocolate rice krispie cake using a breakfast cereal which both contains wholegrains and iron. They plan to also include dried apricots to provide some fruit.
Task 22 - Enter a new recipe using the information below; Multigrain Rice Krispie Chocolate Crispie cakes (makes 140 slices) 1000g Rice Krispie Multigrain Shapes breakfast cereal 500g butter 800g milk chocolate 1 x 454g tin of golden syrup 500g dried apricots 1. From My Nutrimen – Recipes – Create New Recipe
2. Enter details of the recipe:
Title
Multigrain Rice Krispie chocolate crispy cakes
Portions
140
Notes
Proposed pudding for Woodcroft Primary
Nutrients
Main (31 nutrients)
3. Create
4. Use the table above, to add in all the ingredients. Remember to ‘publish to my list’
5. Analysis
Task 23 – Answer the following question about the Recipe analysis 20.1 Look at Contributing Foods – select Iron. Which of the following is true? A. 50% of the iron came from the multigrain shapes and 50% from the dried apricots
B. 70% of the iron came from the multigrain shapes and 20% from the dried apricots
C. 80% of the iron came from the multigrain shapes and 10% from the dried apricots
20.2 Look at Nutrients tab within Analysis. Which of the following is true about the energy and iron content of the crispy cakes? A. Each crispy cake contained 115kcal and 0.2mg iron
B. Each crispy cake contained 215kcal and 0.4mg iron
C. Each crispy cake contained 315kcal and 0.8mg iron
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Task 24 – In Recipe – Analysis, find out how much iron and total sugars would be provided by eating one chocolate crispie cake? Add the values to the first line of the table. Now go back to the Quick Look ups by clicking on Home at the top left hand corner. Look up the other 3 options being considered by the cooks; noting their iron and total sugar content in the table below.
Choose which pudding option you’d recommend to the school?
Pudding choice
Iron (mg/portion)
Energy (kcal/ portion)
Tick the pudding you’d recommend for the school to adopt
Rice Krispie Multigrain Shapes chocolate crispie cake, 23g Flapjack, 35g Cereal crunchy bar eg Tracker, 27g Fruit cake, 50g Write a sentence to explain your choice;
You’ve reached the end of unit 4 and can now:
• Use Nutrimen to enter a custom food and save to your profile
• Add your custom food to a food diary
• Use a previously added custom food as an ingredient in a recipe.
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Unit 5 – Putting it all together Unit 5 enables you to: • Use Nutrimen to input a more complex 2 day food diary
• Change portion sizes in a diary
• Move foods around within a day of a diary
• Interpret the Analysis in order to compare intakes to typical UK intakes and identify main contributing foods
• Experiment with changing foods in order to alter nutritional profile
Task 25 – Start new diary 1. Logon to Nutrimen.co.uk using your Cardiff Met email address and nominate password
2. From My Nutrimen, select Start new diary
3. Enter the demographics of your client, in this case;
Title
Mark Thomas
Start date
Date of food diary – defaults to todays date. Click in the box to select date from calendar
D.O.B
Unknown date of birth? Leave blank and skip to age
Age
58 years
Gender
Male
Nutrients analysed
Main (31 nutrients)
4. Click Create once finished.
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Scenario 9 Mark Thomas is a 58 year old plasterer who has both long standing obesity (BMI 41) and chronic constipation. He has been referred for dietary advice to reduce his energy intake and increase his fibre intake.
Start by taking a look at his 2 day food diary.
Friday
Saturday
Breakfast Toast, 2 white slices with spreadable butter and marmalade
Coffee (cafetiere) with semi-skimmed milk
Breakfast - in cafe 1 fried egg
2 rashers fried back bacon
1 fried pork sausage
1 slice of fried white bread
½ large beef steak tomato, grilled
Baked beans
1 mushroom, fried
Coffee - as yesterday
Snack Real McCoys Crinkle cut crisps
Tea with semi-skimmed milk and 1 sugar Lunch Ham and tomato baguette
Muller light yoghurt
Mid-afternoon Innocent smoothie – strawberry and banana
Evening meal - in curry house Chicken and spinach curry
Half portion rice
Mini naan bread
Pistachio ice cream with wafer biscuit Lager, 4 pints
Evening meal Tuna pasta bake
Homemade apricot flapjack
Mug of tea, as yesterday Beer, bitter, 3 pints
Task 26 – Enter all the foods for day 1 above (Note: top tabs are; Diaries – Mark Thomas – Diary Entry) 1. Toast, white, 2 slices (27g x 2)
Was it 2 slices from a normal large loaf or a small loaf? If it’s unclear, you’ll need to make a best guess, which size of loaf is more typical? Add to diary. 2. Butter, spreadable on the toast (10g x 2)
3. Marmalade (15g x 2)
4. Search for coffee and see Nutrimen defaults to instant coffee. Use the drop down menu to try and find a better match. Coffee, infusion average would be closer to cafetiere coffee. There are several types of coffee infusion, plain, with whole milk or with semi-skimmed milk.
Would Mark have a mug or cup? Make your best guess, then Add to diary. 5. Mark will have more coffee tomorrow, so move a copy of his coffee across to favourites to save you time later (hoover over the entry in the diary, click on the heart).
6. Mid-morning, Mark ate half a packet of Real McCoys Crinkle cut crisps. Search for Crisps, then use the drop down menu to find an appropriate type of crisps. Find an appropriate portion size eg (40g x 0.5).
7. Add a mug of tea, with semi skimmed milk and 1 sugar. Also copy to favourites to use again later.
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Note: as this unit continues, you’ll find they’ll be less and less exact detail for each food. It’s an opportunity to practise skills of estimating and best guessing. 8. At lunchtime, Mark had a ham and tomato baguette. Search for baguette. The McCance database hasn’t analysed baguette yet so Nutrimen suggests the closest equivalent; white bread – French stick.
9. The suggested portion size for French stick is 6” slice being 120g. How big is a typical baguette? Decide on an appropriate portion size.
10. Mark’s baguette was spread with Clover spread. Search for Fat spread, then Blended spread. The grey McCance footnotes confirm Clover was part of the analysis. Decide on a suitable portion sizes.
11. Search for ham. Think about how much ham you would normally get a ham baguette from baguettes you’ve eaten yourself or seen sold in shops. Decide which type of ham to choose and a suitable portion size.
12. Search for tomato. Find raw, then think about how many slices of tomato you’d usually have in a ham and tomato baguette. Decide on an appropriate portion size.
13. Next Mark had a Muller Light virtually fat free yoghurt with his lunch. Search for yoghurt and use the drop down menu to find a suitable type and portion size of yoghurt. 150g
14. You remember that Muller Light yoghurts are typically bigger than normal. Check with the manufacturers website and you’ll find they are 175g. To amend a portion size, hoover over the entry on the food diary, then select the orange pencil icon. Watch as it jumps back to the 2nd column. Change the portion size, then Update diary entry.
15. For his evening meal, Mark went to a curry house for chicken and spinach curry with half portion of rice and a mini naan bread. Search for curry
16. You’ll see there is either a plain chicken curry or a beef and spinach curry. Think about the composition of each and decide which is closest to a typical chicken and spinach curry. Add an appropriate portion size.
17. Add half a portion of boiled rice and a mini naan.
18. Nutrimen and Food Portion Sizes book only contains the typical portion size of a full size naan bread. To find the portion size of a mini naan. In other words a naan the size of your fist, rather than the size of your outstretched hand. You could either estimate from your experience or use a commercial website to give you a portion size estimate;
From a supermarket website (eg Tesco, Sainsburys, Asda), a packet of 4 mini naan breads is 235g. Therefore 235g∕4 = 59g for 1 mini naan bread. 19. After his curry, Mark consumed 2 scoops of pistachio ice cream with a wafer biscuit. Find an appropriate type of ice cream, portion size and ice cream wafer fan.
20. Add lager, 4 pints
That completes day 1.
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Task 27 – Enter all the foods for day 2 (Note: top tabs are; Diaries – Mark Thomas – Diary Entry) 1. Look at the 3rd Diary column. Note the light blue drop down menu in the right hand corner which currently says Day 1. Drop down and select Add day then Save changes.
2. Reassure yourself that Day 1 is still there then go back to Day 2 where the diary column is now empty ready for you to enter day 2 foods in.
3. On day 2, Mark started the day with a full cooked breakfast. Find and enter the following:
• 1 fried egg
• 2 rashers fried back bacon
• 1 fried pork sausage
• 1 slice of fried white bread
• ½ large beef steak tomato, grilled
• Baked beans – (no portion size stated, you’ll need to estimate an appropriate portion)
• 1 mushroom, fried
4. Mid-afternoon, Mark had an Innocent Smoothie. Search for Smoothie.
5. No smoothies have analysed yet in the McCance and Widdowson database so you’ll need to add as a custom food. Start by finding publicly available nutrition information from the manufacturers website or the food packaging eg:
Innocent Smoothie – Strawberry and Banana Nutritional Information
Individual bottle 250g per 100g Energy
53kcal
Total fat
0.1g
of which saturates
0.1g
Total carbohydrate
12.1g
of which sugars
10.5g
Fibre
0.8g
Protein
0.6g
Salt
0.38g
Sodium
10mg
6. From My Nutrimen – My Custom Foods – Add new custom food
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7. Describe the custom food eg:
Title
Innocent Smoothie
Subtitle
Strawberry and Banana
Notes
Data from manufacturers website (date accessed)
8. Go to Nutrients at the bottom of the screen. With the food label in-front of you, fill in the form for the nutrient content per 100g of food, leaving blank any information you don’t know.
9. Click Add food to save to your profile.
Task 28 – Add in 2 more recipes In the evening, Mark has tuna pasta bake and a homemade apricot flapjack. There are tuna pasta and flapjack recipes in Nutrimen/McCance database using the standard recipes listed at the end of the McCance book. However when you check the recipes, you’ll find that what Mark ate was significantly different. Therefore you’ll need to add 2 new recipes; Mark’s Tuna Pasta Bake and Mark’s Apricot Flapjack.
Below is Mark’s Tuna Pasta Bake recipe:
Tuna pasta bake (serves 5) 600g fusilli 50g butter 50g plain flour 600ml semi-skimmed milk 200g cheddar, grated 100g tinned sweetcorn 100g peas 3 spring onions 2 x 185g tinned tuna in spring water 1. From the My Nutrimen home page, enter a New Recipe entitled ‘Mark’s Tuna Pasta Bake’ – which makes 5 portions
2. Enter all the ingredients starting with pasta. Surprisingly the pasta in McCance is filled pasta eg tortelli/ravioli. This recipe was dried pasta, the closest equivalent of which is spaghetti. As the recipe listed the white raw weight, ensure you select the same from the drop down menu.
3. Remember to Publish to my list when you have entered all the foods.
4. Go back to Mark’s diary. Select day 2, then enter a typical serving of Mark’s tuna pasta bake.
Note how Nutrimen calculates typical portion size by adding up the weight of all the ingredients you entered, the dividing by the number of portions you specified to estimate that a typical portion size of Marks Tuna pasta bake would be 420g. You may want to adjust this if you felt Mark would have eaten more or less than this, for example if the whole recipe was shared between 4 members of the household rather than 5
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5. Next add the final recipe for Mark’s apricot flapjacks as per recipe below:
Marks’ Apricot Flapjacks (makes 12 slices) Butter (not spreadable) 175g Golden syrup 175g Brown sugar 175g Oats 350g Dried apricots 140g 6. Remember to save the list as a recipe by clicking Publish to my list
7. Go back into diaries – Mark – day 2 and add a slice of Mark’s apricot flapjack
Note how Nutrimen calculates typical portion size by adding up the weight of all the ingriedents you entered, the dividing by the number of portions you specified to estimate that a typical portion size of Mark’s apricot flapjack would be 85g 1. Add a mug of tea from Favourites
2. Add beer, bitter, 3 pints
3. Look at the analysis of Mark’s diary. Nutrimen has averaged his intake over the 2 days to compare to daily DRVs.
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Task 29 - Demonstrate your understanding of the analysis by filling in the gaps in the following report on Mark’s intake. All the data you need can be found in the Nutrimen analysis you have just completed 26.1 The energy content of Mark’s diet is; A. A little below the EAR – suggesting he’s already losing weight
B. Very close to the EAR – suggesting he’s maintaining his weight
C. Above the EAR – suggesting gradual weight gain
26.2 The fibre content of Mark’s diet is; A. Below the RNI at around 15g each day
B. Around the RNI of 18g per day
C. Comfortably above the RNI at around 22g per day
Note: because you made some assumptions and estimates in Marks food diary, you’re analysis figures may vary from those shown here.
26.3 On which day was Mark’s diet highest in fibre (NSP)? A. day 1 at around 10g
B. day 2 at around 20g
C. both days were the same
26.4 Which foods provided the majority of the fibre? A. mushrooms, rice, marmalade
B. tomatoes, naan bread, potato crisps
C. flapjacks, pasta bake, baked beans
26.5 How was the energy distributed in his diet? (closest) (Analysis - Energy – All days – Show fat breakdown) A. Total carbohydrate 47%, protein 12%, saturated fat 10%
B. Total carbohydrate 40%, protein 14%, saturated fat 13%
C. Total carbohydrate 50%, protein 16%, saturated fat 18%
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26.6 What proportion of the energy in Mark’s diet comes from alcohol? (Analysis – Energy – All days) A. around 18%
B. around 10%
C. around 6%
26.7 How much selenium was there in Mark’s diet? A. around 43μg
B. around 73μg
C. around 103μg
26.8 Which one of the following changes would help Mark to lose weight effectively? A. Halve alcohol intake
B. Swap from fried breakfast to grilled/poached breakfast
C. Swap from butter to 60% fat spread
26.9 A portion of Mark’s tuna pasta bake currently provides 5.2g NSP. Try swapping the pasta from white to wholemeal, how much NSP does a portion now provide? A. around 8g
B. around 12g
C. around 18g
Now that you have completed Unit 5, you should feel confident to: • Enter a more complex 2 day food diary
• Make appropriate estimates when no standard portion size available
• Interpret Analysis to identify main contributing foods as the basis of dietary advice
• Experiment with changing foods in order to alter nutritional profile.
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