Evaluation, recommendation and implementation of the local hospital catering system

According to the literature the prevalence of the risk of malnutrition o hospitalized people exceeds 25% of patients, this evidence is also related to low meal satisfaction. To reduce hospital malnutrition it is also important to improve the consumption of meals by implementing organoleptic and nutritional quality (O&NQ). The Local Health Agency of Trieste (ASUITS) has conducted surveys to find out how to evaluate and improve the procurement qualifications of hospital catering systems (HCS) and how to implement O&NQ. The production processes of meals served in two clinics using Cook Chill (CC) and Cook/Fresh - Hot Hold (CFHH) production process, respectively, were evaluated from 2017 - 2019. The Nutrient Analysis Critical Control Point process was applied for the evaluation of two catering systems. In addition, the antiradicalic power (ARP) of 120 samples of meals by the University of Trieste was analysed. In 2019 an investigation was conducted to compare the satisfaction and ARP content of meals served to patients in two hospital wards (N = 60). The meals to patients of two wards respectively with CC Cold Plating Retherm (PR) and CC Hot PR were served. Meals produced by the CC production process highlight the average loss of 50% of ARP compared to the CFHH. Meals produced by the CC Cold PR method limit the loss of ARP by 15-40% less compared to the CC Hot PR method. The satisfaction of patients who have consumed meals produced by the CC Cold PR method is double compared to that of patients who have consumed meals produced by the CC Hot PR method. The surveys have produced significant evidence to evaluate hospital meal production processes and to improve O&NQ. The results were used to develop recommendations for the drafting of tender specifications capable of also protecting nutritional variables. The evaluation of the O&NQ of HCS represents a central determinant of food safety and nutrition security and must be taken into consideration in the procurements procedure

Integrated guide for public procurement and private contracts of collective catering system and SDGs

Surveys (2008-2018) carried out by the Local Health Agency of Trieste (ASUITS) in local collective catering (CC) services of schools, hospitals, nursing homes, and workplaces (25.000 daily meals) have shown some non - adherence to healthier food choices, food standards, procedures and green and social procurement as recommended by the WHO, FAO, UE, Ministry of Health and of Environment. The purpose of this project is to support local public and private organizations in transforming the national and regional catering services food standards related to health, nutrition, environment and social criteria into food procurement and food contracts specifications. This has been done by compiling the major obstacles to improved standards observed during surveys, and by sharing critical and relevant examples with major public contractors across local, regional and national level. The guidelines (GL) for public procurement of CC consist of five chapters: the elaboration of specifications; a response module to present the offer of services; selection and award criteria, an evaluation system of offers, and the technical specifications attached. Technical information fixes the constituent elements of the service in order to have similar and directly comparable offers. GL cover both the purchasing of food and the contracting of catering services. In this way public or private institutions are able to prepare tender documents suitable to respond to health, economic needs and Sustainable Development Goals (SDGs). The development of the GL has increased the awareness and real potential that local organizations have in enhancing the strategic use of purchasers to boost food qualification, jobs, growth and investment. As well as to create a more innovative economy, to be resource and energy efficient, and to be socially-inclusive. To meet population nutrient intake goals and SDGs it is necessary to increase co-operation and the sharing of the objectives of ’Health in All Policies’

Recommendations and tools to implement food and nutrition policies for collective catering

Surveys (2015 – 2018) carried out by the local health agency of Trieste (LHATs) in a collective catering (CC) sample (nurseries, schools, university, hospitals, nursing homes, workplaces), with a total production of 20% of the meals served daily in the area, have shown some critical conditions. In some CC the following has been observed: noncompliance of food supply quality and quantity, loss of up to 80% of antiradicalic power (ARP) and poliphenol content of several vegetable dishes, increase of more than 50% of oxidized compounds in some fish and homogenized meat dishes, as demonstrated by the University of Trieste. This represents a triple burden for the community: consumption of non-protective meals from oxidative stress; fraud of product quality/quantity (equal to 2-4% of contract value); and failure of the challenges of Sustainable Development Goals (SDGs). It is also a serious problem for institutionalized and hospitalized people as, according to the literature, the prevalence of the risk of malnutrition in patients exceeds 50% and 25% respectively. In view of these findings, LHATs has developed recommendations and tools to improve the control capability of organizations that outsource the CC. These recommendations take into consideration: analysis of item costs, merceological food value, working conditions, and integrate the indications of the Ministry of Health for CC that provide: adoption of dietary guidelines, Nutrient Analysis Critical Control Points (NACCP) process and updated food composition. Tools recommended by LHATs permit monitoring and control food supply quality-quantity, NACCP process, ARP and other markers to detect the nutritional value of meals. The key process to developing actions to better apply food and nutrition policies and to contribute to SDGs in strategic local CC is the ability of the public health to analyze its context in a systemic view to innovative provision of improve sustainable healthy protective nutrition for communities

Nutritional critical points of the cook & chill system and development of corrective actions tools

Background. In Italy almost one in 10 people eat a meal in collective catering (CC) every day. The WHO and FAO emphasize the need to guarantee adequate amounts of antioxidants and protective phytochemicals, essential for the many metabolic functions, by intake of minimally processed foods. It is strategic to ensure protective meals for all CC users, especially hospital patients and the elderly. Recently the Public Procurement (PP) have more often chosen Cook & Chill (C&C) systems, characterized by the administration of meals stored between 0 and +3 C ° for 20 - 30 days. The aims of the project were to: evaluate the qualitative - quantitative profile of the effective protective molecules in C&C meals, determine any nutritional critical points (NCPs) - corrective actions (CAs) of C&C, identify rapid and cheap methods for monitoring the nutritional quality of meals and identify portable systems easy to use by non-professional operators in the chemical-analytical sector. Methods. The NACCP process indicated by the Ministry of Health has been applied. In 2019 over 120 foods collected at different stages of the production of a C&C were sampled. The University of Trieste has performed over 850 analyses. The outcomes were compared with the food composition database by the agency of the Ministry of Agriculture (MA). Results. The quantitative profile of the protective molecules present in C&C meals was in many cases reduced by 15 to 75% compared to the MA database. The protective capacity of some meals administered is comparable to that of ultra-processed food. The NCPs - CAs have been determined to ensure an adequate content of protective compounds in C&C meals. Rapid screening systems with chromatographic and optical techniques were identified. Portable systems with immediate analytical response will be developed. Conclusions. The results of the project can significantly orient PP towards choices that: adhere to the WHO recommendations and adopt nutritional quality monitoring tools. Key messages. Include nutritional quality criteria for choosing collective catering systems. Monitor the nutritional quality of collective catering through rapid screening systems

Geologia delle Prealpi Carniche

Carta Geologica 1:50.000 e sezioni con note illustrative di una vasta area di 850 km quadrati