WILTSHIRE FARM FOODS

WILTSHIRE FARM FOODS NACC South West Specialised Nutrition Presentation December 2018

What is IDDSI? Why IDDSI? What does it mean? Nutrition Labels Timescales WILTSHIRE Agenda FARM FOODS Diabetes COPD CKD

WILTSHIRE FARM FOODS Introduction to IDDSI

WILTSHIRE FARM FOODS What is IDDSI? An international collaboration of dietitians, SLTs, food scientists, physicians, OTs, engineers, nurses and industry professionals. The objective was to review existing dysphagia standards and create a global standard for categorising texture modified foods and liquids for people with dysphagia. The aim is to have a common language that can be used for technical, cultural, professional and non-professional uses.

WILTSHIRE THE IDDSI FRAMEWORK FARM FOODS A continuum of 8 levels (0-7) including both foods and drinks Drinks are measured from levels 0-4 Foods are measured from levels 3-7 Cross-over in the middle

WILTSHIRE WHY IDDSI? FARM FOODS Specific standards for each level Clear characteristics and specifications Additional testing methods specific to each level Levels are defined by measurement Patient safety is key!

IS WILTSHIRE EVERYONE FARM ON BOARD? FOODS Endorsed by: IDDSI is supported by a variety of industry sponsors

WILTSHIRE SO WHAT? FARM FOODS apetito/wff is part of the IDDSI UK Expert Reference group and has been sponsoring this initiative since 2014 as has The NACC WFF adopted in 2010 with launch of our current Softer Foods range

NATIONAL WILTSHIRE DESCRIPTORS FARM FOODS vs IDDSI

WILTSHIRE CATEGORY FARM C vs LEVEL FOODS 4

WILTSHIRE CATEGORY FARM C vs LEVEL FOODS 4 National Dysphagia Descriptor- Category C Food has been puréed or has purée texture It is a thick puree Fluid in or on the food has not thinned out or separated off Hold its shape on the a plate or when scooped Can be eaten with a fork because it does not drop through the prongs The prongs of a fork make a clear pattern on the surface It can be piped, layered or moulded IDDSI level 4 Usually eaten with a spoon Fall off a spoon in a single spoonful when tilted and continues to hold shape on a plate Liquid must not separate from solid Show some slow movement under gravity but cannot be poured Cannot be drunk from a cup Not sticky Not lumps

WILTSHIRE CATEGORY FARM D vs LEVEL FOODS 5

WILTSHIRE CATEGORY FARM D vs LEVEL FOODS 5 National Dysphagia Descriptor- Category D Food is soft, tender and moist It has been mashed up with a fork before serving Any fluid in or on the food is very thick No hard, tough, chewy, fibrous, crunchy or crumbly bits Biting is not required Can be eaten with a fork IDDSI level 5 Can be scooped and shaped on a plate Soft and moist with no separate liquid Small lumps visible within the food Adult: 4mm lump size Lumps are easy to squash with tongue

WILTSHIRE CATEGORY FARM E vs LEVEL FOODS 6

WILTSHIRE CATEGORY FARM E vs LEVEL FOODS 6 National Dysphagia Descriptor- Category E Food is soft, tender and moist but needs some chewing It can be mashed with a fork it usually required a thick, smooth sauce No hard, though, chewy crunchy or crumbly bits No sticky food Pieces of soft tender meat must be served no bigger than 15mm IDDSI level 6 Can be eaten with a fork or spoon Can be mashed/ broken down with pressure from fork, spoon or chopsticks Chewing is required before swallowing Soft, tender and moist throughout but with no separate thin liquid Bite-sized pieces as appropriate for size and oral processing skills Adult: 15mm pieces

IMPACT ON WILTSHIRE WFF RANGE FARM C FOODS & D/Level 4 & 5 Product redevelopment required to ensure compliance Some changes phased in from September 2018 Meals started to become IDDSI compliant from September IDDSI compliant meals will still be compliant with old descriptors (C & D) Consumers unlikely to notice many major changes e.g. thickened sauces New labels on IDDSI compliant meals as phased in dual labelling New label = IDDSI compliant Fully compliant by March 2019

CATEGORY WILTSHIRE E/EXTRA FARM TENDER/Level FOODS 6 Key change All pieces 15mm or less (not just meat) Minor changes e.g. moving from slice to diced carrot phasing in from December Dual Purpose products: 1. Extra Tender: Targeted to those who want an easier to eat meal (protect sales & opportunity to improve in future) 2. Level 6 Soft and Bite Sized : TM range for those with dysphagia Many products shared between ranges Small number of standalone SKUs Working to minimise SKU count impact Further communication to be issued

NUTRITIONAL WILTSHIRE CONSIDERATIONS FARM FOODS Aims/considerations Aim to maintain or improve position where possible Dietary codes and allergens to consider Traffic Lights to consider Product development ongoing

WILTSHIRE LABELLING FARM FOODS Three levels of identification Numbers Name descriptions Colour Codes Interim dual labelling approach 6 12 months Our approach has been researched with customers

WILTSHIRE IDDSI TIMESCALE FARM FOODS

WILTSHIRE WFF TIMESCALE FARM FOODS September 2018 SOME new IDDSI compliant products and labels begin to filter in to range (Level 4 only) Intro to IDDSI in brochures IDDSI elearning module for WFF teams Autumn/Winter 2018 Further IDDSI training at regional meetings More Level 4/5/6 IDDSI compliant products filter in Standalone IDDSI explanation - consumer flyer March 2019 WFF fully compliant with IDDSI Cat C,D,E terminology no longer in use SS19 Literature/comms full IDDSI explanation/terminology 1 st products with IDDSI label from September 2018 limited numbers/customer impact September 2018 March 2019: Transition period old descriptors C,D,E still in place

WILTSHIRE SPECIALISED FARM NUTRITION FOODS Diabetes COPD CKD

WILTSHIRE DIABETES FARM FOODS

WILTSHIRE DIABETES FARM WHAT FOODS IS IT? Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. Type 1 where the body's immune system attacks and destroys the cells that produce insulin Type 2 where the body doesn't produce enough insulin or the body's cells don't react to insulin

WILTSHIRE DIABETES FARM WHAT FOODS IS IT?

DIABETES WILTSHIRE WHY SHOULD FARM FOODS WE WORRY?

DIABETES WILTSHIRE WHAT ARE FARM THE FOODS SYMPTOMS? Complications: Over a long period of time, high glucose levels in the blood can seriously damage the heart, eyes, feet and kidneys

WILTSHIRE DIABETES TREATMENT FARM FOODS Type 1 Type 2 Always Insulin Healthy Eating Heathy Weight Regular Exercise Medication may be or become necessary

WILTSHIRE Type 2 diabetes FARM and FOODS diet 90% of people with Diabetes have type 2 diabetes Type 2 is more common as you get older Therefore WFF focus will be on type 2 diabetes

What is recommended in the Long Term? WILTSHIRE DIABETES FARM AND FOODS A healthy, balanced diet: Eating regular meals Plenty of fruit and vegetables Eating less saturated fat, sugar, salt and starchy high fibre carbohydrates Following a healthy, balanced diet will help to control blood glucose, blood fats and blood pressure, as well as helping to maintain a healthy weight

TYPE WILTSHIRE 2 DIABETES FARM AND FOODS DIET

WILTSHIRE DIABETIC FARM FOODS FOODS It is not true that if you have diabetes you will need to eat a special diet. You should eat a healthy diet high in fibre, fruit and vegetables and low in fat, salt and sugar Since healthy eating advice is the same for people with diabetes as it is for other people, the idea of special diabetic foods is out of date

WILTSHIRE COPD FARM FOODS

WILTSHIRE COPD WHAT FARM IS FOODS IT? The name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease

COPD WILTSHIRE WHAT ARE FARM THE FOODS SYMPTOMS? People with COPD have difficulties breathing, primarily due to the narrowing of their airways. Typical symptoms of COPD include: Increased breathlessness when active A persistent cough with phlegm Frequent chest infections

WILTSHIRE COPD TREATMENT FARM FOODS Treatments include: stopping smoking the most important action inhalers and medications to help make breathing easier pulmonary rehabilitation a specialised programme of exercise and education surgery or a lung transplant although this is only an option for a very small number of people

COPD WILTSHIRE AND ISSUES FARM WITH FOODS EATING Breathlessnessa symptom of COPD that can make eating effortful Weight changes- Due to either poor appetite or sedentary lifestyle Poor appetite- Due to struggling with breathing Taste changes- Caused by a dry mouth or medication Dry mouth- Caused by inhalers and using oxygen Bloating- Air gulping while eating due to breathlessness

Take into account: SIGNPOSTING WILTSHIRE TO FARM A GOOD FOODS DIET Low Appetite and/or Loss of Weight Chewing/Swallowing difficulties Healthy & Nutritious

SIGNPOSTING WILTSHIRE TO FARM A GOOD FOODS DIET

CHRONIC WILTSHIRE KIDNEY FARM DISEASE FOODS

WILTSHIRE CKD WHAT FARM IS FOODS IT? Chronic kidney disease (CKD) is a long-term condition where the kidneys don't work as well as they should Common causes include: Ageing Ethnicity High blood pressure Diabetes High cholesterol Kidney infections (and other kidney conditions) Long-term, regular use of certain medicines

CKD WILTSHIRE WHAT ARE FARM THE SYMPTOMS? FOODS Symptom free to start with but as CKD progresses: weight loss poor appetite water retention shortness of breath tiredness blood in urine frequent urination

CKD WILTSHIRE HOW IS FARM IT TREATED? FOODS The main treatments are: lifestyle changes, including diet medication dialysis kidney transplant

WILTSHIRE CKD AND FARM DIET FOODS Kidneys remove the left-over waste products from the blood. Depending on the person s condition, making dietary changes can: Help a person feel better Affect the medication they need Influence the need for dialysis CKD is classified as Stage 1-5 with 5 being the most advanced The severity of the disease determines the dietary restrictions

CKD AND WILTSHIRE NUTRITIONAL FARM CONSIDERATIONS FOODS CKD 1-3 The main focus is to try and reduce the risk of cardiovascular disease A healthy diet and keeping weight within a healthy range is the focus

CKD AND WILTSHIRE NUTRITIONAL FARM CONSIDERATIONS FOODS CKD 4 5 Patients with this level of kidney disease are usually referred to a specialist Renal Centre with regard to; Salt Potassium Phosphate Protein Poor appetite Fluid

SIGNPOSTING WILTSHIRE TO FARM A GOOD FOODS DIET

Thank you WILTSHIRE FARM FOODS