Meals4Life. Dr. Bent Egberg Mikkelsen, professor, Aalborg University Copenhagen, Denmark

Transcription

1 Meals4Life From treatment to health promotion the changing face of food at hospital food Bent Egberg Mikkelsen Fudan University Shanghai Food4Growth Seminar, April, 25, 2014 Dr. Bent Egberg Mikkelsen, professor, Aalborg University Copenhagen, Denmark Abstract: Modern lifestyle and the co existence of chronic diet related diseases and disorders coexist with undernutrition and infectious diseases is a challenge to both developed and developing economies. This calls for action among a broad range of societal actors including the clinical nutrition and public health nutrition community. This paper argues for a new role for nutrition researchers engaged in hospital nutrition. It argues that clinical nutrition has a role to play not only frontstage at bedside but also in relation to the backstage perspective and that it needs to reach out to local communities. It uses the idea of New Public Health to frame the idea. The paper uses the 2 cases of Bornholm and Aalborg hospitals as examples of approaches where a holistic foodscape based approach has been used. The paper give a brief account of the 3 projects Sol, FoodServInspire and Foodtura to makes its case

2 Clinical nutrition vs public health nutrition Nutrition of patients in health care individual focus Nutrition in a population based perspective focus on groups Hospital Local community Barcelona declaration, 2006 the promotion and maintenance of nutrition related health and wellbeing of populations through the organised efforts and informed choices of society.

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4 A rights based perspective

5 Rethinking food at hospital

6 From Aalborg to Bornholm

7 Case of Sol Bornholm

8 Why Sol Bornholm Self perception Eating healthy or very healthy Being in perfect, very good or good state of health Objective measures Having an unhealthy eating pattern (uhei) Having a healthy eating pattern (HEI) Capital region Bornholm 46,4 42,0 86,3 82,0 9,8 13,3 28,1 24,1

9 SoL high impact intervention sites

10 dk/programmer/bare lidtsundere.aspx?videoid=32 365&vidLoc=NewDB SoL supersetting

11 Expected outcomes Increase 15 % retail sale of F&V and whole grain compared to control 25 % intake of F&V and whole grain among 220 intervention families compared to control Significant difference in knowledge (cultural capital) and attitude among intervention families compared to control Decrease 15 % of intake of candy and soft drinks compared to control TV viewing of ½ hour among children in intervention families

12 Choice architecturing the supermarket Nudging, spacemanagement Healthy foods visibility Price regulation Co location of healthy choices

13 Local Community Foodscapes Assessment Tool (LC FAT)

14 929 beds admissions/year ambulatory visits 6500 employees Aalborg University Hospital Centre for Nutrition and Bowel Diseases CET

15 The Foodtura project To develop a mobile device for transfer of food data, thus linking the patient with the hospital kitchen in order to: Provide more personalised nutrition; Monitor the patient s nutritional intake; Improve the patient s condition from better nutrition Facilitate data transfer and thus reduce work loads; Reduce food waste;

16 Big hospital food data Improving the menuplanning system Better data about patients Improving the menu planning system in hospital kitchens based on better understanding of the users needs and demands. Integration of data about the patient s nutritional condition with data about food intake. The screening and monitoring procedure. Improved nutrition Development of a method to collect data about food intake; Development of a prototype mobile device to be used for data collection and communication betwteen ward and kitchen

17 Protocol: datacollection Interviews with primary users in hospital kitchens based on semi structured questionnaires; Interviews with secondary users in regional governments; On site visit to Aalborg Hospital s kitchen; Reviewing of literature; Workshop at Alborg University and discussions with the participants => engaging with a wider user group; The report: The Users demands for data and functions in a modern menu planning system

18 Who are the Users of the menu Primary Production: Users Hospital kitchens, canteens and other large scale food service operations (public and private) Other Users: Food producers and food whole salers planning system? Menu planning system: database about food items; calculation of nutrional values; recipes; and production planning Nutrition: Secondary Users Dieticians and personnel at the wards Food procurement: Regional governments Other Users 18

19 Dismantling the Menu Plannning Functions, that are used on a daily basis: Finding information about food products Calculation of recipes and nutritional values of the meal Production planning Ordering of meals from the wards Calculation of prices for the meals Printing of labels for packaged food (relevant for canteens and meetings) Shopping lists Data on sales and production Functions that are used on a regular basis: Development of menus (e.g. by every 3rd week or by season) Calculation of prices for menus Functions that are used occasionally: Calculation of diets 19

20 Integrated Food Studies:

21 Measuring behavior intake AND waste DIMS 1 dietary intake monitoring system Served = eaten + left over Ofei, KT; Holst, M; Rasmussen,HH; Mikkelsen, BE: How practice contributes to trolley food waste: A qualitative study among staff involved in serving meals to hospital patients, Submitted for Appetite 2014 Ofei KT; Dobroczynksi; Holst M; Rasmussen HH & Mikkelsen BE The Dietary Intake Monitoring System (DIMS) an innovative tool to measure patient s food choice, intake and plate waste in a hospital setting, submitted for Journal of Human Nutrition and Dietetics, 2014

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24 The Intelligent Buffet (IB)

25 The Intelligent Buffet (IB)

26 VIFOR virtual food reality urtesy of: Dennis Godtfredsen, Philip Brisson, Martin Rene Andersen and Patrick Lehmann Hald, Project Group Create kl14ml601

27 A 3D look at the dairy cold cabinet Courtesy of: Dennis Godtfredsen, Philip Brisson, Martin Rene Andersen and Patrick Lehmann Hald, Project Group Create kl14ml601

28 FoodX Lab A new lab facility for the advancement of research in captive foodscapes at Aalborg University Hospital Building on experiences from FoodScape Lab Offering assistance to local food sector Connecting with leading foodlabs in Europe, Brazil.. and China?

29 Density of groceries Geodata in nutrition related research Anders Lyseen

30 Distance to supermarkets & discount

31 Conclusion New roles for the hospital outreach to local community hospital as a mega consumer hospital as a driver for localising the food system hospital to drive smart procurement hospital as a learning environment hospital as a healthy workplace campus as healthy university