# Alignment of menu items offered in Canadian long-term care homes with Canada’s food guide and the Diabetes Canada Clinical Practice Guidelines

## TL;DR

This study evaluates how well food items in Canadian long-term care menus align with national dietary guidelines and finds room for improvement in nutritional quality.

## Contribution

The study introduces a method to assess menu alignment with dietary guidelines using nutrient profile models for long-term care settings.

## Key findings

- 52.8% of menu items were rated as 'good' or 'excellent' by the Canadian Foods Scoring System.
- Afternoon snacks had the highest proportion of least healthy items.
- Legumes and vegetables were the healthiest food categories, while sugars and sweets were the least healthy.

## Abstract

Many residents in long-term care (LTC) homes face the risk of malnutrition and non-communicable diseases like diabetes, underscoring the crucial role of menu planning. In most provinces, menu items offered in LTC homes must adhere to Canada’s food guide (CFG). Other dietary guidelines, like those in Diabetes Canada Clinical Practice Guidelines (DCCP), provide recommendations for managing chronic disease; however, the alignment of individual menu items with CFG and DCCP is unknown. The objective was to assess the alignment of menu items offered in LTC homes with CFG and DCCP.

Using a four-week menu cycle designed for LTC, menu items (n = 1,365) were assessed using two nutrient profile models based on CFG and the DCCP. The Canadian Foods Scoring System (CFSS) categorized items as “very poor” to “excellent” choices according to CFG, and the DCCP nutrient profile model classified items as “least” to “mostly aligned” with DCCP. Descriptive statistics summarized menu items by CFSS and DCCP nutrient profile model categories across meal occasions and food categories.

Overall, 52.8% of menu items served in LTC homes were rated “good” or “excellent” choices by CFSS, and 50.8% were classified as “most aligned” with the DCCP nutrient profile model. Afternoon Snacks had the highest proportion of the least healthy items. Legumes and Vegetables were the healthiest categories, and Sugars & Sweets, along with Combination Dishes, ranked as the least healthy.

While about one-half of LTC menu items align with CFG and DCCP, opportunities remain to enhance their nutritional quality. Developing a translational tool based on nutrient profile models could simplify the application of food-based dietary guidelines, supporting more effective and aligned LTC menu planning.