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The Nutrition and Hydration Digest

1 CONTENTSThe Nutrition and Hydration Digest2nd EditionImproving outcomes through food and beverage services New IDDSI framework Easy to chew coding Neutropenic diets Renal diets UPDATED FOR 2019 The Nutrition and Hydration DigestProduced by The food Services Specialist Group in consultation with The British Dietetic Association 2017 BDA food Services Specialist Group2nd EditionDate of Issue: November 2017 Date of Review: November 2022 Version 4 (minor updates July 2019)3 CONTENTS3 ContentsExecutive Summary 16 Chapter 1: International, National and Local Influences 16 Chapter 2: Nutrition , Hydration , Eating and Drinking 16 Chapter 3: Catering for Staff and Visitors in the NHS 16 Chapter 4: The Role of the Dietitian in food Service 17 Chapter 5: food Service Delivery and Planning 17 Chapter 6: Catering Specifications and Contracts 18 Chapter 7: food Composition, Labelling and Recipe analysis 18 Chapter 8: Menu Design and Content 18 Chapter 9: Nutritional Standards; Day Parts Approach 19 Chapter 10: Analysing Menu Capacity 19 Chapter 11: Diets, Patient Groups and Menu Coding

Food Composition, Labelling and Recipe Analysis 101 Nutritional Content 104 Food Costs 104 Procurement of Food 104 Packaging 105 Food Labelling Legislation 105 Allergen Information 105 Nutrition Information 106 Nutritional Analysis 108 Recipe Analysis 111 Recipe Analysis Software 116 7 8 Menu Design and Content 121 Menu Design 124

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Transcription of The Nutrition and Hydration Digest

1 1 CONTENTSThe Nutrition and Hydration Digest2nd EditionImproving outcomes through food and beverage services New IDDSI framework Easy to chew coding Neutropenic diets Renal diets UPDATED FOR 2019 The Nutrition and Hydration DigestProduced by The food Services Specialist Group in consultation with The British Dietetic Association 2017 BDA food Services Specialist Group2nd EditionDate of Issue: November 2017 Date of Review: November 2022 Version 4 (minor updates July 2019)3 CONTENTS3 ContentsExecutive Summary 16 Chapter 1: International, National and Local Influences 16 Chapter 2: Nutrition , Hydration , Eating and Drinking 16 Chapter 3: Catering for Staff and Visitors in the NHS 16 Chapter 4: The Role of the Dietitian in food Service 17 Chapter 5: food Service Delivery and Planning 17 Chapter 6: Catering Specifications and Contracts 18 Chapter 7: food Composition, Labelling and Recipe analysis 18 Chapter 8: Menu Design and Content 18 Chapter 9: Nutritional Standards.

2 Day Parts Approach 19 Chapter 10: Analysing Menu Capacity 19 Chapter 11: Diets, Patient Groups and Menu Coding 201 International, National and Local Influences 21 International 24 National 24 Local 25 England 27 Northern Ireland 30 Scotland 31 Wales

3 31 Foreword 10 Introduction 11 Glossary 12 Clickable ContentsJump directly to sections and subsections by clicking belowThe Nutrition and Hydration DigestContents42 Nutrition and Hydration , Eating and Drinking 41 Causes and Effects of Malnutrition 46 Hydration 48 Catering for Staff and Visitors in the NHS 53 Introduction 57 Background 57 Health and Wellbeing Initiatives within the NHS 58 Health and Wellbeing in Scotland.

4 Wales and Northern Ireland 61 Health and Wellbeing for Patients 62 The Role of the Registered Dietitian 623 Role of the Dietitian in food Service 65 The Dietitian s Role 68 Dietetic Working in Partnership 69 Training for food Service Staff 70 Menu Planning 71 Service Provision 7145 CONTENTS55 food Service Delivery and Planning 75 Working Together - Power of 3 78 Protected Mealtimes: Provision of a Patient-focused Meal Service 79 food Service Systems 81 Control of food Service Delivery 84 food Waste 86 food Hygiene and Safety 90 Catering Specifications and Contracts 95 Barriers to Good Practice 98 Catering Specifications 98 Catering Contracts 996continues >The Nutrition and Hydration Digest6 food Composition, Labelling and Recipe analysis 101 Nutritional Content 104 food Costs 104 Procurement of food 104 Packaging 105 food Labelling Legislation 105 Allergen Information 105 Nutrition Information 106 Nutritional analysis 108 Recipe analysis 111 Recipe analysis Software 116 78 Menu Design and Content 121 Menu Design 124 Menu Structure 126 Menu Planning 128 Menu Content 129 Menu Based Guidance 133 Average Nutritional Content of Minimum Breakfast 134 Meal Starters Nutrition 13624 Hour Meal Provision 141 Beverages 141 Analysing the Menu 142 Menu Assessment Checklist 142 Contents7 CONTENTS79 Nutritional Standards.

5 Day Parts Approach 145 Nutritional Targets 148 Menu Capacity 149 Day Parts Model 152 Analysing Menu Capacity 155 Methodology 158 Worked Example from Cycle Menu A 161 Worked Example from La Carte Menu B 165 Useful Documentation 167 10continues >The Nutrition and Hydration Digest8 Diets, Patient Groups and Menu Coding 169 Standard Diets 173 Healthier Eating 174 Higher Energy 175 Easy to Chew 176 Vegetarian 178 Religious, Cultural, Personal and Lifestyle Considerations 179 Halal 180 Kosher 182 Asian Vegetarian 184 Vegan 186 Therapeutic Diets 188 Modified Texture Diets 188 Finger Foods 191 Renal Suitable 192 Liver Disease (Decompensated)

6 195 food Allergy 196 Gluten Free 198 Low FODMAP 200 Neutropenic 201 Specific Patient Groups 204 Children 204 Critical Illness 207 Obesity 207 Older People 209 Dementia/Cognitive Impairment 209 Cancer 210 Mental Health 212 Test and Investigation Diets 21411 Contents9 CONTENTS9 Endorsements 225 Acknowledgements 227 Appendices 219 Appendix 1: Using food as Fortification Agents 221 Appendix 2: Example of Menu Assessment Checklist 222 Appendix 3.

7 Revised Population Estimated Average Requirement 225 (EAR) Values for Adults The Nutrition and Hydration DigestCONTENTSF oreword10 ForewordThe prevention and treatment of malnutrition in hospitals and within the community requires a multi-professional and multi-agency approach in order to achieve successful outcomes for the end-user. As Honorary Chairman of the British Dietetic Association (BDA) it is my privilege to welcome you to the second edition of this (in)credible evidence-based resource for dietitians, caterers, nurses and others working within health and social Nutrition and Hydration Digest is a fundamental resource for all involved in the provision of quality Nutrition and Hydration services and is framed within the fast evolving field of food and beverage services.

8 I am heartened to note that this edition retains its breadth and richness of content, complemented with updated referencing and reformatting for ease of access to would like to take this opportunity to congratulate the multi-professional working group for their attention to detail and hard work in revising and publishing this second edition. I would also like to thank all of you who work tirelessly within your practice to provide nutritious food and optimal Hydration for people within your care. Si n O Shea RD MSc FBDAH onorary Chairman BDA11 CONTENTSCONTENTS11 IntroductionIntroduction A group of Dietitians and representatives from the Hospital Caterers Association have been revising the Digest , which began with our launch event in November 2016.

9 To begin with we agreed to streamline the document and bring the reference deck up to date. However as we reviewed the chapters we felt that most of the information was still relevant and did not want to remove information that will be used by our colleagues on a regular major changes we have made to the document therefore include:re-ordering the chapters to support a logical flowreducing repetitionadding in new and current information, particularly relating to staff and visitor catering and therapeutic dietsrestructuring the chapter outlining therapeutic diets to ensure this is user friendly. Whilst the document is still long we understand that users will refer to the chapters that they need at a moment in time and it is designed to be used as a toolkit of information.

10 The group has worked tirelessly to provide an ongoing and up to date resource, which I hope will continue to be used for the next 5 years. Helen ReamChair Digest Review Working GroupCONTENTSG lossary12 GlossaryBBAPEN British Association for Parenteral and Enteral NutritionBDA British Dietetic AssociationBNF British Nutrition Foundation CCAMHS Child and Adolescent Mental Health ServicesCEO Chief Executive OfficerCIEH Chartered Institute of Environmental HealthCoE Council of EuropeCoFiDS Composition of Foods integrated Data SetCQC Care Quality CommissionCQUIN Commissioning for Quality and InnovationCWT Caroline Walker Trust DDH Department of HealthDEFRA Department for Environment, food and Rural AffairsDRV Dietary Reference ValuesDMS Delivered Meal SystemEE Menu code for higher energyEAR Estimated Average RequirementsEC European CommissionESPEN European Society for Clinical Nutrition and MetabolismEU European Union13 CONTENTSCONTENTS13 FFF menu code for finger foodsFIC food Information for ConsumersFIR food Information RegulationsFODMAP Fermentable Oligosaccharides Disaccharides Monosaccharides and PolyolsFoP Front of packFSA food Standards AuthorityGGF Menu code for gluten freeGBS Government Buying StandardsHH Menu code for healthier eatingHACCP Hazard analysis Critical Control PointsHCA Hospital Caterers AssociationHCPC Health and Care Professions CouncilHIS Healthcare Improvement ScotlandHLS


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