An Integrated Model to Measure Service Management and Physical Constraints' Effect on Food Consumption in Assisted-Living Facilities

Something to Chew on; Plate-Waste at an Ontario Veteran's Centre

There is paucity of data assessing levels of food/beverage waste in long-term care (LTC) facilities, especially in Ontario. Observations in the Veteran's Centre (VC) at Sunnybrook Health Sciences Centre (Sunnybrook) indicated food/beverage waste may be high, potentially impacting sustainability efforts within our institution. Before proceeding with waste reduction efforts, we conducted a comprehensive 3-day waste-audit of food/beverage items provided to VC residents with the goal of understanding the extent of food/beverage waste at VC, items wasted, and any other factors that may inform future changes. Our results indicate that 28% of items served to residents were wasted. Lunch was the meal with greatest waste at 31% and waste of solid items was 12% higher than that of liquids. We observed a large variability in waste between residents and within each resident, with 15% of residents wasting >50% of items provided. This study provides a deeper insight into the magnitude of food/beverage waste in a LTC population and highlights the importance of considering individualized strategies to address waste to avoid negative impact on residents.

How to improve food waste management in hospitals through focussing on the four most common measures for reducing plate waste

Hospitals have a responsibility to link human health and the environment, but food waste in hospitals has traditionally been much higher than in other areas of food supply. The cause of this situation has many negative impacts on health, economy, society, and environment. As a result, food waste has become a topic of discussion in hospital food departments. Part of this problem is plate waste, the served food that remains uneaten by patients. Given the magnitude of the food problem, this systematic review is aimed to identify the most common measures used to reduce plate waste in hospitals. PubMed, Scopus, and Google Scholar databases were comprehensively searched to identify food waste studies worldwide using related search terms. Many approaches have been recommended to increase patient food intake and minimise plate waste in hospitals. Up to date, the four most common include flexible portion sizes, increased food choices through selective menus, additional nutritional support and a better ordering and delivery system. Among them, the most used and effective are flexible portion sizes which may increase the ability of patients choosing their menus and upgrade ordering and delivery system by electronic format. In most studies, plate waste covers the most significant percentage of food waste produced in hospitals, while more than one approach is recommended to minimise it. In this aspect, further well-design, multicenter, clinical studies are strongly required to highlight and establish novel and effective approaches for improving food waste management in hospitals by reducing plate waste.

The Feasibility of Using Computrition Software for Nutrition Research-A Pilot Study

We evaluated the feasibility of using Computrition to design and implement a low vs. typical sodium meal plan intervention for older adults. Dietitians used Computrition to design a 7-day meal plan with three caloric levels (≤1750, 2000, ≥2250 kcals/day) and two sodium densities (low = 0.9 mg/kcal; n = 11 or typical = 2 mg/kcal; n = 9). Feasibility was determined by post-hoc definitions of effectiveness, sodium compliance, palatability of diet, sustainability, and safety. Given the low number of participants in one of the three calorie groups, the higher calorie groups were combined. Thus, comparisons are between low vs. typical meal plans at two calorie levels (≤1750 or ≥2000 kcals/day). Overall, regardless of the calorie group, the meal plans created with Computrition were effective in reaching the targeted sodium density and were safe for participants. Furthermore, individuals appeared to be equally compliant and reported similar palatability across meal plans. However, one of the three criteria for the sustainability definition was not met. In conclusion, we successfully used Computrition to design low and typical sodium meal plans that were effective, compliable, and safe. Future studies of older adults in similar settings should focus on improving the palatability of the meal plans and scaling this protocol to larger studies in older adults.

Defining skilled nursing facility residents' dining style preferences

The desire of skilled nursing facilities to increase quality of service to meet changes in residents' expectations, improve marketability, and adhere to regulations warrant a new look at culture change and homelike dining as defined by residents in skilled nursing facilities (SNF). The objectives of this study were to determine residents' home dining practices, to define residents' desired dining style practices in the SNF, and to determine the relationship between home dining practices and dining preferences in SNF. One hundred and four residents in three SNF in the central Texas area who met the cognition criteria and consumed facility-provided food were engaged in a standardized interview using the Resident Dining Style Preferences Survey. Data were analyzed to determine the degree to which home practices determine SNF dining preferences. Our findings showed that the majority of the participants want hot, home cooked meals served in the dining room. They want to be seated at the table with friends and neighbors and served on every day plates in a quiet atmosphere, with food served restaurant or table service style. Length of stay and generational group were not significant predictors of dining style preferences. Study limitations included small sample size and lack of ethnic diversity. Our study results show that removing dining time restrictions may be the most valuable adaptation for a SNF looking to initiate culture change.

A study on the model of homebound senior's meal satisfaction related to the quality of life

This study was conducted to develop a construct model regarding the daily activities, emotional security provided by food, enjoyment of food, level of satisfaction with delivered food, and the quality of life of homebound seniors who benefitted from meal delivery programs. The data were analyzed by SAS 9.2 and the Structural Equation Model (SEM), which was created by Analysis of Moment Structure (AMOS) 5.0 packages. The reliability of the data was confirmed by an exploratory factor analysis and through a Cronbach's alpha coefficient, and the measurement model proved to be appropriate by a confirmatory factor analysis of the measurement model in conjunction with AMOS. The results of the correlations between all the variables showed significant positive correlations (P < 0.05). The path analysis demonstrated that the daily activities (P < 0.01) and the emotional security created by food (P < 0.05) had positive correlations with the foodservice satisfaction (P < 0.05), while the daily activities (P < 0.05), the sense of emotional security made by food (P < 0.05), and food enjoyment (P < 0.05) also presented significant positive correlations with the quality of life. However, the food service satisfaction was shown to directly, but not significantly, affect the quality of life. This revealed that the current meal delivery programs needed to be improved in several directions.