It All Adds Up: Nutrition Analysis Software Can Open the Door to Professional Opportunities

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eut fnThru11BtiopovedaresresortryrandaHostaingannaturontioAforregfinthefroter(wprofinfabcalhothehisTHSELAchefooconprtricomanbeavHoadwiNtiobaingananforhapeticMhafunsetrectoforasanpoimportant attributes of nutrient anal-ysis software.Depending on work setting, Marrinventory control, and othersor in-formation technology standards, suchas client-server, Web-based, portabil-RDsof Df Ip Aqe Itkd Dcmm Hvawsuis dtofea Ft N N R Mc Dt F Fa Smartphone compatibilityPersonal selection criteria may in-CostCost is frequently a factor when pur-chasing any type of product, evenfrom something as simple as a pack-This article was written by KarenSTeMtSTATEMENT OF POTENTIALCONFLICT OF INTEREST: Seepage S34.dFollowing are some questions an age of ballpoint pens to something asoi: 10.1016/j.jada.2011.03.0052011 by the American Dietetic Association Supplement to the Journal of the AMERICAN DIETETIC ASSOCIATION S31ity, security, and so forth.says, considerations may include in-tegration into a larger platform withadditional functionssuch as menucosting, medical nutrition therapy,clude factors such as cost, user friend-liness, and product quality:tein, MFA, a freelance writer inraverse City, MI, consultantditor for the Nutrition Careanual, and a former editor athe Journal.practicIt All Adds Up: Ntheis article is reprinted from the Feb-ary 2011 issue of the Journal (2011;1:214-218).ecause HR 3590, the PatientProtection and Affordable CareAct, includes a mandate (Sec-n 4205) that calorie information bested at the point of purchase fornding machine snacks and stan-rd menu items at certain types oftaurants (1)specifically, chaintaurants with at least 20 machinesestablishments across the coun-the nutrient values of restau-t offerings and how they affect theily diet are back in the spotlight.wever, at these early legislativeges, this attention is mostly com-from government officials, healthd nutrition professionals, and jour-lists, with the ultimate goal of cap-ing the attention of consumersce these provisions are put into ac-n.s a result of this impending needaccurate nutrient information,istered dietitians (RDs) may soond themselves asked to providese data in a number of contexts,m the restaurant that seeks to de-mine calculations for its menuhether by mandate or choice) to theivate client seeking to make sensethis information. Provision of suchormation requires access to a reli-le, robust, and accurate nutrientculation software program. Butw does an RD go about selectingapplicrition Analysis SoDoor to Professiosoftware program that best suitsor her professional needs?E COMPLICATED TASK OF SOFTWAREECTIONcording to Liz Marr, MS, RDwhoads Liz Marr and Associates LLC, ad and nutrition communicationssultancy outside Boulder, CO, andovides recipe development and nu-tion analysis information to foodpanies and restaurantschoosingy type of software can be dauntingcause of the number and variety ofailable platforms (see the Figure).wever, conducting the research invance will lead to more satisfactionth the purchased product.ote that many nutrient calcula-n software packages have the samesic features and functions, includ-intake analysis, recipe creationd analysis, client data tracking,d report generation (2). It is there-e necessary for potential users tove a strong sense of how they ex-ct to use the software in their prac-e.arr says that it is important tove a clear idea of the most crucialctions for ones particular practiceting before shopping around. Sheommends creating a spreadsheetrate the functions of various plat-ms.If you think about the end-productthe services you are providing asRD, Marr says, accuracy and re-rting capabilities are the two mostationsBUSINESS OF DIETETICStware Can Openal Opportunitiesmight consider when evaluatingtware packages (3):oes the database contain all theoods and nutrients of interest?s the database complete for thesearticular nutrients?re the foods in the database ade-uately specific for accurate nutri-nt assessment?s the nutrient database main-ained for accuracy based on mar-etplace and data-availability up-ates?oes the software manufacturerommunicate regularly with foodanufacturers for updated infor-ation?ow is accuracy ensured?Although database currency is aluable requirement, be aware thatith 800 new products hitting thepermarket shelves every month, itifficult for software manufacturersbe fully updated at all times (4).Selection criteria based on softwaretures may include the following:oodservice management capabili-iesutrition assessment capabilitiesutrient analysis capabilitieseferenceenu production and managementapabilitiesata regarding specialty popula-ionsitness programming capabilitiesunctionality on a portable digitalssistantFigBUSINESS OF DIETETICSS32ure. Information on nutrition software manufacturers and their products applications. Adapted from reference (5).May 2011 Suppl 1 Volume 111 Number 5comNucaimpranaswhbaifcatuthwhwaseaSQtriforif hintavfooanloatrigrawawiofmituonwicapaticutrywiYnevicUseEasofthoqupeforusit isomuslowtioarthreflbaartricaalsturtacforquintansuacsencernowiniephoncapeforwopuconmaregpapowhwawaenothcomanWeinfmeProRDofseacontotomsiocontheabtioHoplimaRDexaprimesuwowhucdefol Wvs Ha AW Fpm HrbadeitysobasagratiobasadifmatridaevliesofanmoinfwhplainfisSOPRAsdiebytioMaingBUSINESS OF DIETETICSplex as an insurance package.trient calculation software costsn run from close to $100 to approx-ately $700, and frequently theseices are for access for a single userd dont include additional fees suchfor updates and upgrades. Butile it may be tempting to purchasesed on savings, like most products,fewer dollars are paid for nutrientlculation software, then fewer fea-res are offered. For example, al-ough an RD may feel sticker shocken considering the higher-end soft-re packages such as ESHA Re-rchs (Salem, OR) Food ProcessorL, CyberSofts (Phoenix, AZ) Nu-Base 7, and Axxya Systems (Staf-d, TX) Nutritionist Pro 4, it is beste or she also takes practice needso account: the pricier bundles onerage profess a greater number ofds in the database and nutrientsalyzed and availability of a down-dable trial (5). However, not all nu-tion professionals will need a pro-m as robust as these.Marr advises RDs to factor the soft-re costs into the annual budgetth the understanding that becauseongoing database and program-ng updates (a highly desirable fea-re), the software is not going to be ae-time expense but rather a licenseth periodic charges.For that reason, RDs should bereful not to overbuy a softwareckage beyond the needs of the prac-e; however, by that same token,nderbuying a software package oring to make do with free softwarell not have a successful outcome.ou get what you pay for, and youed to be able to stand by your ser-es, Marr says.r Friendlinessse of use is a frequent criterion fortware selection of any kind. Al-ugh new software applications fre-ently take some getting used to, es-cially if one is accustomed to anothermat, manufacturers demos are veryeful in determining how comfortables to work in a given program. Whilee manufacturers provide would-beers a mini-tour, other companies al-full access to the programs func-ns for a restricted time period (2).Keep in mind, however, that demose frequently abbreviated versions ofe software and may not accurately theect the extensiveness of the data-se; therefore, would-be purchaserse encouraged to look beyond theal versions for assessing databasepabilities (3).However, user friendliness mayo refer to how helpful the manufac-er is if problems should arise. Con-ting a software manufacturers in-mation line with pre-purchaseestions will provide a useful glimpseo the quality of its customer serviced indicate whether it provides clearpport or is unhelpful (2).While considering the actual inter-tion with customer support repre-tatives, if there are budgetary con-ns, it is also worthwhile to makete of any additional costs that cometh customer supportsome compa-s may opt to not provide a toll-freeone number, and some might offerly a limited number of free helplinells before charges are imposed (2).RDs who use a Mac (Apple Inc, Cu-rtino, CA) should note that optionsMac users are limited (6); however,rkarounds, such as personal com-ter emulators, are available (7).Whether via their Web site or uponsumer request, many softwarenufacturers provide informationarding recent updates, softwaretches (to fix glitches), and other im-rtant software-related news.Also important is the venue inich the RD seeks to use the soft-re. Marr notes that several soft-re packages are available in a cli-t-server configuration, whereasers are designed for standaloneputers that are not networked,d yet others are available via theb; thus, the RDs practice need willorm which version or installationthod is most suitable.duct Qualitys may learn a lot about the qualitya given software package by re-rching the available programs ortacting the manufacturers directlyask product-related queries of cus-er service. For example, the profes-nal background of the individualssulting on product creation gets atcredibility and potentially the reli-ility of the data as well as the func-nality of the software, says Marr.wever, the softwares intended ap-cation will determine who best servesproduct development team. Whereas cluMay 2011 Supplement to the Journal ony software products might haves or food scientists on the team, formple, For software systems gearedmarily toward foodservice, involve-nt of individuals in other disciplines,ch as chefs and operations managers,uld be important.For RDs unsure of what to asken attempting to discern a prod-ts quality via a customer servicepartment, Marr recommends thelowing questions:hat type of training do you pro-ide initially and, if there are per-onnel changes, in the future?ow often do you provide databasend program updates?re software updates available foreb-based downloads?or larger operations and softwarelatforms, what level of onsite or re-ote software support do you offer?ow do you address database er-ors reported by customers?The number of items in the data-se itself may not be a useful tool fortermining the comprehensive qual-of a software package, becauseme systems include separate data-se entries for different forms of theme food (eg, solid, cubed, andted cheeses), for different prepara-ns of the same food (eg, fried,ked, or breaded chicken), or for theme food with amounts expressed inferent units (3).Food manufacturers avail softwarenufacturers of their products nu-ent data for incorporation into thetabase. Yet, despite the continuousolution of these productsin ear-r iterations of nutrition calculationtware, for example, ethnic foodsd vegetarian options were less com-nly included in the databases (3)ormation gaps do still exist. Thatsere an RDs knowledge comes intoy, says Marr. Being able to makeormed judgments for substitutionsimportant.FTWARE PACKAGES FOR DIFFERENTACTICE TYPESnoted previously, different types oftetics practice will be best serveddifferent types of nutrient calcula-n software programs. According torr, examples of practices benefit-from specific types of software in-de the following:f the AMERICAN DIETETIC ASSOCIATION S33 FspMwf Sswttsampitebmvia(sfCr StcsaFFtrGsm PrwianhiPsrfptscRl(sgcs BcicpcappDbittetmotriwoCONustabeingavsofbaMaofwabaincincuentofunuemahadasuseaMabaaptrasetSTFLconauRe1.2.3.4.5.6.7.avnaph2&0&idBUSINESS OF DIETETICSS34or RDs who plan menus forchools participating in the US De-artment of Agriculture Schooleals program, only certain soft-are programs have been approvedor such use.*ome nutrient information analysisoftware is part of a broader soft-are platform that allows integra-ion of data, which have applica-ions in larger food and/or nutritionervices systems. The software mayllow for medical nutrition therapyanagement, diet planning, menulanning, recipe development, andndexing as well as nutrient informa-ion analysis of menu items; how-ver, the programs may also includeusiness planning and operationsanagement components such as in-entory control, purchasing, order-ng, sales, menu and recipe costingnd pricing, and so on. ComputritionChatsworth, CA) is an example ofuch a program with applicationsor health care settings, whereashefTec (Boulder, CO) is used forestaurants and foodservice systems.ome software is designed to meethe food labeling regulations andreate food labels, whereas someoftware is primarily for nutrientnalysis of consumers food intake.or example, ESHA Researchsood Processor is primarily for nu-rition and fitness but includes aecipe analysis component, whereasenesis R&D, also from ESHA Re-earch, is used for product develop-ent and menu labeling.rivate practice RDs working di-ectly with consumers may use soft-are for nutrient and physical activ-ty tracking, diet and physicalctivity goal setting, and menu plan-ing. Some software packages mayave more detailed options for phys-cal activity, diabetes exchanges, My-yramid servings, and so on. RDshould consider which analysis andeporting options are most importantor the types of clients in particularractice settings. Behavior modifica-ion approaches may incorporate*The list of approved programs isailable at: http://healthymeals.l.usda.gov/nal_display/index.p?info_center14&tax_leveltax_subject234&level3_idlevel4_id0&level5_id0&topic_in2689&&placement_default0.May 2011 Suppl 1 Volume 111 Number 5elf-assessment tools, such as havinglients monitor their own food intake.Ds may want to explore the variousow-cost personal digital assistantPDA) applications available to con-umers as well as Web-based pro-rams that may be integrated with orompletely separate from profes-ional software packages.ecause of the legal implicationsreated by Section 4205, RDs work-ng with restaurants on nutrientalculations will likely need toainstakingly document how theyomputed these values. Just aboutll nutrient calculation softwareackages are based on the US De-artment of Agricultures Nutrientatabase for Standard Reference,ut RDs working in the menu label-ng context may require softwarehat also provides source informa-ion, sample count, and standardrror of the mean for all items inhe database (4).See the textbox on page S35 forre detailed information about nu-ent calculation software for RDsrking with restaurants.NTINUED PRODUCT EVOLUTIONtrient calculation software is con-ntly evolving. In the mid-1980s,fore widespread computer network-or Internet capabilities wereailable, the nutrient calculationtware was disk operating systemsed and for standalone PCs, notesrr, who adds previous versioningthe software that was being testeds not computerized. Rather, it wassed on hand-calculations. Since itseption, the software has evolvedmany ways, from search and cal-lation speed to database size, to cli-t-server, to cloud-based, to PDAs,integration with other food-relatedctions, and the innovation contin-s, Marr says. But one thing re-ins constant: the importance ofving reliable food and nutrientta, which goes back to continuedpport for food composition re-rch.As far as future applications, saysrr, Expect to see growth in cloud-sed (Web-based) and portable deviceplications; incorporation of nu-genomics into programs for clinicaltings; and continued improvementsspeed, functionality, and reporting.ATEMENT OF POTENTIAL CON-ICT OF INTEREST: No potentialflict of interest was reported by thethor.ferencesLibrary of Congress. Bill Summary & Status:H.R. 3590, Patient Protection and AffordableCare Act. http://thomas.loc.gov/cgi-bin/bdquery/z?d111:H.R.3590:. Accessed October 4, 2010.Prestwood E. Shopping for nutrition soft-ware. Todays Dietitian. 2005;7:44.Buzzard IM, Price KS, Warren RA. Consider-ations for selecting nutrient-calculation soft-ware: Evaluation of the nutrient database.Am J Clin Nutr. 1991;54:7-9Nutrition software: 101 questions to ask be-fore you buy. Todays Dietitian. 2000;2(2).American Dietetic Association. Computer soft-ware resources by name. American Dietetic As-sociation Web site. http://www.eatright.org/Members/content.aspx?id6442452368. Ac-cessed December 8, 2010.Aronson D. Before you buy, get the lowdownon nutrition software. ADA Times. Mar/Apr2008.Axxya Systems. NutritionistPro Diet Analy-sis General Frequently Asked Questions.NutritionistPro.com Web site. http://www.nutritionistpro.com/dietanalysis_general_faq.php. Accessed December 8, 2010.NUTRIENT CALCULATION AND RESTAURANT MENU LABELING GUIDELINESLiz Marr, MS, RDSection 4205 of H.R. 3590 may lead to a windfall of career opportunitiesfor RDs, as smaller restaurants and vending machine operators seek toadhere to the rules regulating menu postings for calories and provision ofanAwrsinvtlamcnHrdacasmdiebcFdedCgAe1s(apngdaninhFBUSINESS OF DIETETICSdditional nutrient data upon requesta. But is it acceptable for RDs to useutrient calculation software to determine these values?Under the Patient Protection and Affordable Care Act (Affordable Carect), the analysis can be performed by nutrient information analysis soft-are rather than laboratory analysis. However, some regulatory detailsemain specific to the foodservice setting, including potential variation oferving size and menu item formulation, training of foodservice workers,gredient variation, and so on. Software with a large, reliable database isery important and so is being able to enter user-generated values, providedhe RD can obtain complete data for required nutrients.In response to the Patient Protection and Affordable Care Act signed intow in 2010, the US Food and Drug Association (FDA) solicited public com-ents regarding development of regulations for restaurant and vending ma-hine menu labeling.b Included in the request for information was determi-ation of calorie content of foods looking at issues such as the followingc: Information about standardization of recipes and methods of preparation Information about variation in serving size and formulation of menuitems The role of inadvertent human error Information about training of foodservice workers Information about variations in ingredients Any other relevant factors.So more specific guidance can be expected when the final rules are issued.owever, an FDA regulation in place since 1996 stipulates that, specific toestaurant menu labeling, nutrient levels may be determined by nutrientatabases, cookbooks, or analyses, or by other reasonable bases that providessurance that the food or meal meets the nutrient requirements for thelaim.d The Affordable Health Care Act refers to that regulatione.This applies particularly to restaurants that opt to voluntarily comply with the legislation andmaller chains and vending machine operators just at or over the threshold for 20 restaurants/achines. The larger national chains already have nutrient calculation software and staffetermining the nutrient values. Source: Stein K. Making wellness delicious: Building a Health-r Chicagos FIT City program. J Am Diet Assoc. 2010;110:1620-1625.The comment period closed October 12, 2010.ederal Register/Vol. 75, No. 129/Wednesday, July 7, 2010/Notices pg. 39028.Section 4205 [of the Affordable Health Care Act] states that a restaurant or similar retail foodstablishment shall have a reasonable basis for its nutrient content disclosures, including nutrientatabases, cookbooks, laboratory analyses, and other reasonable means, as described in Title 21ode of Federal Regulations, section 101.10. (Section 403(q)(5)(H)(iv) of FFDCA). http://www.po.gov/fdsys/pkg/CFR-2010-title21-vol2/xml/CFR-2010-title21-vol2-part101.xml#seqnum101.9.ccessed October 14, 2010.01.10 Nutrition labeling of restaurant foods: Nutrition labeling in accordance with 101.9hall be provided upon request for any restaurant food or meal for which a nutrient content claims defined in 101.13 or in subpart D of this part) or a health claim (as defined in 101.14 andermitted by a regulation in subpart E of this part) is made, except that information on theutrient amounts that are the basis for the claim (e.g., low fat, this meal provides less than 10rams of fat) may serve as the functional equivalent of complete nutrition information asescribed in 101.9. Nutrient levels may be determined by nutrient databases, cookbooks, ornalyses, or by other reasonable bases that provide assurance that the food or meal meets theutrient requirements for the claim. Presentation of nutrition labeling may be in various forms,cluding those provided in 101.45 and other reasonable means. [61 FR 40332, Aug. 2, 1996].ttp://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/oodLabelingNutrition/ucm223266.htm. Accessed October 14, 2010.May 2011 Supplement to the Journal of the AMERICAN DIETETIC ASSOCIATION S35It All Adds Up: Nutrition Analysis Software Can Open the Door to Professional OpportunitiesThe Complicated Task of Software SelectionCostUser FriendlinessProduct QualitySoftware Packages for Different Practice TypesContinued Product EvolutionReferences

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