Guidance for Healthy and More Climate-Friendly Diets in Nursing Homes—Scenario Analysis Based on a Municipality’s Food Procurement

Reducing the climate impact of food provided for residents in nursing homes is challenging, as the diets for older, frail adults must be high in protein content and energy density while at the same time ensuring that the meals are palatable and recognizable. This study aimed at providing guidance on healthy and more climate-friendly diets for nursing homes in the City of Copenhagen. The goal was to decrease greenhouse gas emissions (GHGE) by at least 25% while at the same time providing nutritionally adequate and recognizable menus. First, food purchase data were compiled with datasets matching each food item to a proxy food item and then to databases containing GHGE and nutrient information. Secondly, two diet scenarios were modelled based on current procurement practices, i.e., an energy- and protein-dense diet and a standard protein-dense diet, and converted into guidelines for menu planning. The diets contained less total meat, especially beef, and significantly more pulses, nuts and seeds in order to increase protein content according to recommendations for older adults. Finally, a combined scenario was calculated to reflect the joint climate impact reduction. This kind of innovation in food procurement is required in order to achieve the necessary transition to a sustainable food system.

Penyelenggaraan Makanan Pasien Di Instalasinya Gizi RSIA Eria Bunda Pekanbaru Tahun 2020

Penyelenggaraan makanan di instalasi gizi RSIA Eria Bunda belum berjalan dengan baik, pada perencanaan menu belum berjalan optimal. Untuk pengantaran bahan makanan yang dilakukan vendor tidak tepat waktu. Rasa dan tekstur makanan masih kurang. Bahan yang diterima tidak sesuai. Untuk tempat penyimpanan bahan makanan belum memenuhi standar. Tujuan penelitian ini untuk mengetahui perencanaan menu, pengadaan bahan makanan, penerimaan bahan makanan, penyimpanan bahan makanan dan pengolahan bahan makanan di Instalasi Gizi RSIA Eria Bunda Pekanbaru. Penelitian ini dilakukan dengan menggunakan rancangan penelitian deskriptif dengan pendekatan kualitatif. Informan penelitian berjumlah 5 orang yaitu Informan Utama terdiri dari Kepala Instalasi Gizi dan Penanggung Jawab Juru Masak, dan Informan Penunjang terdiri dari Pramusaji. Kesimpulan dari penelitian bahwa penyelenggaraan makanan di Instalasi Gizi masih belum sesuai dengan langkah-langkah atau pedoman yang dikeluarkan Kemenkes RI (2013), masih ada kendala dalam penyelenggaraan makanan pasien, untuk itu disarankan bagi Instalasi Gizi lebih memperhatikan dan lebih teliti lagi dalam memperhatikan proses penyelenggaraan makanan agar mendapatkan hasil yang bagus dan kualitas makanan pasien yang lebih terjamin. Food delivery at the nutrition installation of RSIA Eria Bunda has not been going well and the menu planning has not been optimal. The vendor did not deliver food on time. The taste and texture of the food are still lacking. Ingredient received is not suitable. For food storage, it does not meet the standart. The purpose of this study was to determine menu planning, procurement of foodstuff, receipt of foodstuff, storage of foodstuff and processing of food ingredient at the nutrition installation of RSIA Eria Bunda Pekanbaru. This research was conducted using a descriptive research design with a qualitative approach. The number of informants in the study were 5 poeple, namely the main informants consisting of the head of the nutrition installation, the person in charge of the cook and the supporting informants consisting of the waiters. The conclusion from the research is that the implementation of food at the nutrition installation is still not in accordance with the step or guideline issued by the Indonesian Ministry of Health (2013), there are still obstacles in the administration of patient food, for that is recommended that the Nutrition Installation pay more attention and be more careful in paying attention to the food handing process in order to get good result and the quality of the patient’s food more guaranteed.

A multifaceted approach increased staff confidence to develop outside of school hours care as a health promoting setting

Background Outside-of-school-hours-care (OSHC) services are well positioned to influence the health behaviours of 489, 800 Australian children, and are an important setting for health promotion given the current rates of childhood overweight and obesity and associated health risks. OSHC Professionals are ideally placed to become positive influencers in this setting, although they may require training and support to confidently perform this role. This study piloted a multifaceted intervention strategy to increase OSHC Professional’s confidence and competencies, to support a health promoting OSHC environment with a nutrition and physical activity focus. Methods A mixed methods approach was used. Nineteen OSHC Professionals participated in the study, including a face-to-face workshop, supported by a closed Facebook group and website. Role adequacy (self-confidence) and legitimacy (professional responsibility) were measured pre and post workshop and evaluated using non-parametric statistics. Facebook interactions were monitored, and four participants undertook qualitative exit interviews to discuss their experiences with the intervention. Results Pre-workshop 68% of participants had not received any OSHC-specific health promotion training. Post-workshop significant improvements in confidence about menu planning, accessing nutrition information, activities and recipes was observed (P < 0.05 for all). A significant improvement was observed in role support and role related training (P < 0.05). A high level of support and interaction was observed between participants on Facebook and the website was reported a useful repository of information. Conclusions Health promotion training, combined with positive social connections, shared learning experiences, and a website improved OSHC Professionals confidence and capacity to provide a health promoting OSHC environment. Health promotion professional development for OSHC professionals should be mandated as a minimum requirement, and such learning opportunities should be scaffolded with support available through social media interactions and website access.

Building Theory From Practice: Mapping Executive Chefs’ Menu Planning Processes Using a Flowchart

The main purpose of this study is to build from practice to theory by developing a flow chart of menu planning based on the practices of a single successful executive chef and then testing the generality of the flow chart by assessing agreement with flows by 10 other executive chefs working in similar environments. This paper involves deep observation of real-life practices of one 5-star executive chef and his associates using. Observation is based on the 5W2H1E approach. A flowchart of the menu planning process is developed based on data from observing. The research uses degrees-of-freedom analysis of responses from ten chefs in assessing acceptance of the flowchart structure. It is concluded that the flow chart is meaningful in that it is generally acceptable. Ideas from the research contribute to theory and have practical implications. Contributions and practical implications are discussed.

Pre-Emptive and Non-Pre-Emptive Goal Programming Problems for Optimal Menu Planning in Diet Management of Indian Diabetes Mellitus Patients

Diet management or caloric restriction for diabetes mellitus patients is essential in order to reduce the disease’s burden. Mathematical programming problems can help in this regard; they have a central role in optimal diet management and in the nutritional balance of food recipes. The present study employed linear optimization models such as linear, pre-emptive, and non-pre-emptive goal programming problems (LPP, PGP and NPGP) to minimize the deviations of over and under achievements of specific nutrients for optimal selection of food menus with various energy (calories) levels. Sixty-two food recipes are considered, all selected because of being commonly available for the Indian population and developed dietary intake for meal planning through optimization models. The results suggest that a variety of Indian food recipes with low glycemic values can be chosen to assist the varying glucose levels (>200 mg/dL) of Indian diabetes patients.

Fruit and Vegetable Intake Among Korean Young Adults in Their 20s: Barriers to and Potential for Increasing Consumption

Objectives This study aimed to explore the perceived barriers to fruit and vegetable intake among Korean young adults in their 20s, and the potential to increase it. Methods An on-line survey was conducted from February 18th to 24th, 2020 to a total of 1, 277 Korean young adults in their 20s. An on-line survey questionnaire was developed to assess respondents’ preference, acceptance, perceived daily intake level of fruit and vegetables, and perceived barriers in each step from planning, purchasing, storing, to preparation/cooking. Descriptive statistics were calculated, and significant differences in fruit and vegetable consumption (i.e., preference, acceptance perceived daily intake level) were measured according to respondents’ socio-demographic characteristics (gender, education level. income level, and type of household) by using t-tests and ANOVA. Significant differences in perceived barriers were analyzed across three groups (low, medium, and high) based on perceived daily intake level of fruit and vegetables. Multiple linear regression analyses, adjusted for gender, income/education level and household type, were performed to examine the associations between barriers and perceived daily intake level of fruit and vegetables. Results On an average, preference and acceptance exceeded perceived daily intake level of both fruit and vegetables. The perceived daily intake level of both fruit and vegetables were significantly lower in female, low-income, and single-person household groups. The perceived barriers to each step from menu through preparation/cooking were rated significantly higher in low-intake groups of both fruit and vegetables. The results of multiple regression analyses revealed that menu planning was the major barrier to both fruit and vegetable consumption, followed by storing. Conclusions This study suggests that future interventions address perceived barriers associated with menu planning and storing of both fruit and vegetables to boost the consumption among Korean young adults. Special attention needs to be paid to those who are female, with lower incomes, and living in single-person households. Funding Sources This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT).

Parents’ Knowledge and Perspectives About the New CACFP Meal Guidelines: A Qualitative Investigation

Objectives Child day care centers that serve low-income families may qualify to participate in the US Department of Agriculture Child and Adult Care Food Program (CACFP) and receive reimbursement for meals and snacks served. In 2017, day care sites were mandated to follow the new CACFP meal guidelines. The objective of this study was to assess knowledge and perspectives about the new CACFP meal guidelines among parents of children attending day care sites. Methods Individual interviews and focus groups with parents of children at CACFP day care sites in two Texas cities. Qualitative data were coded and analyzed using using a modified version of focused coding and grounded theory methods. Themes and sub-themes were identified. Quantitative data were analyzed for frequencies and descriptives. Results A total of 54 parents participated via 29 individual interviews and 7 focus groups and completed questionnaires. All participants were females; majority were Hispanics and with income &lt; $20,000, about 67% were aware of the new CACFP meal guidelines. Five major themes emerged: thoughts on menus and meals served at day care (sub-themes: overall menu, nutritional value, portion size, quality, variety of options), perceived child likability of foods served at day care, perceived child satiety, suggested changes to meals, and barriers to children eating meals at day care (sub-themes: time, child preferences). Conclusions This study helped identify thoughts and perceptions of parents of children attending CACFP day care. Issues identified should be systematically addressed and incorporated into CACFP menu planning at day care sites. Funding Sources NIH and USDA-ARS.

Scenario Analysis of a Municipality’s Food Purchase to Simultaneously Improve Nutritional Quality and Lower Carbon Emission for Child-Care Centers

Public procurement has been highlighted as an important strategic tool to drive sustainable development. The present study aimed at providing direction for decreasing greenhouse gas emissions (GHGE) by 25% for the food purchased by child-care centers in the City of Copenhagen while simultaneously providing nutritionally adequate, affordable and tasty menus. Baseline data were provided by compiling food purchase data with datasets matching each food item to a proxy food item and further with databases containing nutrient and GHGE information. For each food item, the edible amount was estimated in order to evaluate nutritional content and GHGE per 10 MJ. Two scenarios were modeled, i.e., a plant-rich diet and a lacto-ovo vegetarian diet directed at children two to five years old based on current purchase practice. Finally, the diets were translated into guidelines for menu planning. Amounts of pulses, nuts and seeds, as well as dark green vegetables and plant-based fats, were increased substantially in the two scenarios, while animal fat was decreased and the amount of meat was either reduced or eliminated in the plant-rich and lacto-ovo vegetarian diets, respectively. These kinds of changes in public food procurement have the power to significantly affect the transition toward a more healthy and sustainable food system.

Cluster randomised controlled trial of a menu box delivery service for Australian long day care services to improve menu guideline compliance: a study protocol

IntroductionGlobally, children are not meeting the recommended serves of the five food group foods, particularly vegetables. Childcare is an opportune setting to improve children’s diet quality. This study aims to assess the effectiveness of a menu box delivery service tailored to the long day care setting to improve menu compliance with recommendations and improve children’s food intake while in care.Methods and analysisThis study will employ a cluster randomised controlled trial and will recruit eight long day care centres, randomly allocated to the intervention or comparison groups. The intervention group will trial the delivery of a weekly menu box service that includes all ingredients and recipes required to provide morning snack, lunch and afternoon snack. The menu boxes are underpinned by a 4-week menu developed by dietitians and meet menu planning guidelines. The comparison group will receive access to online menu planning training and a menu assessment tool for cooks. The primary outcomes are child dietary intake and menu guideline compliance. Secondary outcomes include within-trial cost-effectiveness and process evaluation measures including intervention acceptability, usability and fidelity. If effective, the menu box delivery will provide an easy strategy for childcare cooks to implement a centre menu that meets menu planning guidelines and improves child intake of five food group foods, including vegetables.Ethics and disseminationThis study was approved by the Flinders University Social and Behavioural Research Ethics Committee. Study outcomes will be disseminated in peer-reviewed publications, via local, national and international presentations. Non-traditional outputs including evidence summaries and development of a business case will be used to disseminate study findings to relevant stakeholder groups. Data will be used in a doctoral thesis.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12620000296932).