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apetito Ltd. Canal Road, Trowbridge, Wiltshire, BA14 8RJ T. 01225 753 636 F. 01225 777084 www.apetito.co.uk To arrange a free tasting experience or to find out more, just get in touch. Call 01225 569335 Specialist Diets This brochure is intended to provide general information about our products and services. You should always seek further advice on any particular issue or requirement you might have. Whilst we make every effort to ensure the accuracy of the information, we do not accept any responsibility for inaccuracies or errors which might be contained in this brochure.

Texture Modified Meals 2 Making mealtimes more manageable A great meal is much more than great food. At apetito, we believe that everyone should look forward to a great meal, no matter what. We understand the importance of providing a safe and nutritious meal, particularly for those with swallowing difficulties. We ve spent years understanding the needs of individuals with dysphagia and our mission from day one has been to create a range of Texture Modified meals that are not only delicious and safe, but are also full of nutrients to enhance health and wellbeing. We are proud of our multiple award-winning, specialist meals, which provide visually appealing, great tasting food, all in line with recommended guidelines. There are now over 100 meals for people with dysphagia and behind it all was the ethos; great cookery and really good ingredients. Phil Rimmer, apetito Head Chef

Texture Modified Meals 4 What the experts say Making food part of the solution Caroline Lecko, lead and co-author of the UK Dysphagia Diet Food Descriptors and committee member of the International Dysphagia Diet Standardisation Initiative (IDDSI). For many years a meal for someone with dysphagia consisted of simply puréed food served as one or if you were lucky three dollops on a plate. Hardly appetising or acceptable. However, preparing meals is time consuming, especially when trying to ensure that the correct consistency has been achieved every time. apetito recognises that catering professionals need to provide safe, tasty and appetising meals in order to reduce the risks of malnutrition and choking, whilst providing choice and a positive dining experience. Andy Jones Ex-Chair, HCA Dysphagia can be a serious threat to a person s health, due to a high risk of choking, dehydration, malnutrition and aspiration pneumonia. Studies suggest that the odds of being malnourished are increased in the presence of dysphagia. At apetito, we understand how vital a good meal is to a person s health and wellbeing. That s why we have created an extensive range of appetising and nutritious Texture Modified meals that help people with dysphagia sustain healthy, longer lives. 41% of sufferers experience anxiety or panic during mealtimes. 36% of sufferers avoid eating with others because of their dysphagia.* For many of us eating and drinking is an enjoyable, social experience and a time to look forward to, however this is not always the case for people suffering with dysphagia and in fact many live in trepidation of mealtimes. Having a well presented, nutritious and delicious meal at the right consistency is vital and I believe apetito have achieved all of this with their range of Texture Modified meals. *SOURCE: O.Ekberg et al.: Social and Psychological Burden of Dysphagia 2001 Category C / IDDSI Level 4 - Mixed Fruit Pie & Custard

Texture Modified Meals 6 Looks good, tastes good, does good Nothing should stand in the way of anyone getting a great meal. That s our mantra, and it s why we don t let a medical condition like dysphagia stop people from enjoying their meal times. It s common for people with dysphagia to struggle to eat a full meal. Those individuals are at a greater risk of malnutrition, which causes serious implications for their health. Helen Willis, apetito dietitian Category D / IDDSI Level 5 Pork Casserole

Texture Modified Meals 8 What is IDDSI? IDDSI is a new global standard that describes Texture Modified foods and thickened liquids. It is the result of a collaboration between expert dietitians, speech and language therapists, physicians, occupational therapists, engineers, nurses and industry professionals. The aim? To have a common language that can be used for technical, cultural, professional and non-professional uses. Category C / IDDSI Level 4 Steak & Chips New Texture Modified food standards As part of our dedication to developing Texture Modified meals that are not only safe but enjoyable, we are testing and improving all our Dysphagia products to comply with the new International Dysphagia Diet Standardisation Initiative (IDDSI) as well as delivering a tasty, appealing and nutritious meal. We have been part of the IDDSI UK Expert Reference Group since April 2014. The objective was to review existing dysphagia standards and create a global standard for categorising Texture Modified foods and liquids for people with dysphagia. Previously the guidelines used have been restricted to the UK and could be subjectively interpreted. The new guidelines will be rolled out internationally, providing a level playing field for all organisations who provide Texture Modified foods and liquids.

Texture Modified Meals 10 What will be changing? What will this mean for us and you? The IDDSI framework will ultimately replace the current National Descriptors that are used, which run from B E. The IDDSI framework consists of eight levels, ranging from zero to seven and is the first framework of its type to include drinks and foods together. FOODS REGULAR 7 We will be updating our labels to reflect both the National Descriptors and IDDSI levels to help you identify them more easily. Not only will the IDDSI framework make categorising meals more consistent, it will also provide new testing methods to help you ensure food is prepared and served to the correct texture for a person s specific needs. We have been working hard to ensure our meals fall within the new guidelines and will ensure all our meals are IDDSI compliant by April 2019. SOFT & BITE-SIZED MINCED & MOIST 5 6 NATIONAL DESCRIPTORS IDDSI LEVELS PURÉED 4 EXTREMELY THICK REGULAR 7 LIQUIDISED 3 MODERATELY THICK E FORK MASHABLE SOFT & BITE-SIZED 6 2 MILDLY THICK D PRE- MASHED MINCED & MOIST 5 1 SLIGHTLY THICK C THICK PURÉE PURÉED 4 0 THIN B THIN PURÉE LIQUIDISED 3 DRINKS

Texture Modified Meals 12 What makes our Texture Modified meals better? Working towards full compliance with the International Dysphagia Diet Standardisation Initiative (IDDSI) Developed by experienced chefs alongside dedicated dietitians and nutritionist Food holds its shape after cooking, so looks appetising Every meal is nutritionally balanced No hidden lumps No bacterial risk from blending equipment and handling Reducing risk We ve developed consistent textures that reduce the risk of choking and aspiration pneumonia. Preventing malnutrition Our carefully devised menu means that everyone receives a great meal and the right nutrition too. Whetting the appetite Our meals have been created to both taste and look great, meaning that people look forward to mealtimes again. Individual portions to help cut food wastage Category C / IDDSI Level 4 Beans on Toast

Texture Modified Meals 14 apetito s meals have been used to create a benchmark for our national work to support patients with dysphagia. Rob Winfield, Head of Catering, Royal Derby Hospital Variety is the spice of life We believe that everyone should be able to enjoy mealtimes, whatever their circumstances. So it s really important to us that we offer a variety of safe, delicious and nutritious meals to meet any of their dietary needs and get their taste buds going. National Guidelines Category B - Soups We ve created a full and varied range of over 100 nutritionally balanced and visually appealing meals, desserts and sandwiches that cater for a wide range of dietary needs across the different texture categories. Our Texture Modified meals have always met the National Descriptors for categories B, C, D and E as developed by the industry experts, including NPSA. We are now developing our range to fall in line with international category standards, IDDSI. IDDSI Level 3 - Liquidised These great tasting, nutritious soups have a smooth, thin and uniform consistency. Our Puréed soups are a source of protein; containing more than 8g of protein and more than 230Kcal Carrot Soup

Texture Modified Meals 13 16 Category C - Purée Petite IDDSI Level 4 - Puréed With Purée Petite, individuals will receive all the nutrition and great taste of a classic size Category C / Level 4 meal in a more manageable portion size. So you can be sure those with smaller appetites get all the goodness they need to maintain good health. Our Purée Petite range is complaint with the IDDSI level 4 requirements and will be duallabelled from Sept 2018. Pork Sausages Category D - Pre-Mashed Meals IDDSI Level 5 - Minced & Moist Our Category D / Level 5 main meals are mashed to be tender and moist; the pieces are no larger than 4mm, they need very little chewing. Any gravy or sauce is of a similar consistency to the rest of the meal. Salmon Supreme Category C - Classic Puréed Meals IDDSI Level 4 - Puréed Our standard portion size Category C / Level 4 meals, desserts and sandwiches have a smooth texture and do not require any chewing. They are moulded to resemble the food they represent and hold their shape even after cooking. They are puréed and can be eaten with a fork. Category E - Fork Mashable Meals IDDSI Level 6 - Soft & Bite Sized Our Category E / Level 6 meals are soft and tender, though require some chewing. Food ingredients are cut into smaller pieces no larger than 15mm and can be mashed with a fork. Any gravy or sauce is of a thick consistency. We are always looking to innovate and are currently working hard to develop our Fork Mashable Meals range to make them Level 6 compliant. Helen Willis, apetito dietitian Cottage Pie

Texture Modified Meals 18 Smaller portion big nutrition 40% smaller portion sizes* 500+ calories per serving 15g+ protein per serving Our chefs, dietitian and registered nutritionist have spent three years developing Purée Petite, an innovative range of smaller, Texture Modified meals that deliver the same high nutritional content as a standard-sized dish. We ve worked hard to not only reduce the portion size but also to enhance the great flavours and quality ingredients that are so important. We ve created over 20 recipes, all designed to put nutritious, tasty food back on people s plates. Every mouthful matters Each of our 21 Purée Petite meals has been specially created to provide a nutritionally rich and energy-dense meal that everyone will look forward to. Full compliance with the International Dysphagia Diet Standardisation Initiative (IDDSI) 40% smaller* portions for more manageable mealtimes and reduced wastage Visually appealing meals that maintain their appearance after cooking Prevent menu fatigue with over 20 delicious options to choose from. Each meal provides a minimum of 500 kcal's and 15g-24g of protein to help sustain and nourish *When compared to existing apetito Category C / Level 4 Texture Modified meals Category C IDDSI Level 4 Fish & Chips

Mini Meals Extra 20 Mini Meals Extra When you need more but want less Our Mini Meals Extra dishes may be small but are energy dense, containing 500* calories and at least 20g of essential protein to help your patients and residents towards their nutritional needs and combat malnutrition. These energy dense meals can be cooked in multiple ways at any time of the day allowing you to offer a more flexible eating schedule to those that need it. By having an energy dense meal in a smaller portion, you eliminate the need to carve up larger meals or throw away uneaten food, helping to reduce waste. It s so important that meals are nutritious and safe to eat, but also look and taste great as well as being a manageable portion size. Kelly Fortune, apetito registered nutritionist *Range contains 501-522 calories and at least 20g of protein Ham & Leek Bake

Mini Meals Extra 22 Chicken Biryani The main contributing factors to malnutrition are poor or reduced diet. Malnutrition is a serious issue that impacts every aspect of a person s life, including overall sociability and mental wellbeing. Our energy dense range, Mini Meals Extra works towards combatting the effects of malnutrition to help meet the dietary requirements of those in need. 25-34% of patients admitted to hospital and... 1 in 10 older people are suffering from or are at risk of malnutrition. 30-42% of care home residents are considered malnourished. Malnutrition Task Force, 2013 The British Association for Parenteral and Enteral Nutrition (BAPEN), 2016