While multitudes of people around the world face food insecurity, a whopping third of food is lost or wasted. This equates to more than a billion tonnes of food valued at nearly $940 billion every year.
Australia is a part of the problem: five million tonnes of food reach landfill annually, which would fill 9,000 Olympic sized swimming pools, according to OzHarvest. This comes at no small cost – wasted food costs the Australian economy around $20 billion a year.
Apart from the financial cost, food waste impacts the environment. Precious resources such as water and energy are used to grow, transport and sell food. And every tonne of food that ends up in landfill results in 750kg of carbon dioxide being released into an already overloaded atmosphere.
Every business, school and household needs to pull their weight to address the problem. But health care facilities face unique challenges in dealing with their contribution.
Food surplus accounts for half of all waste generated by the health system, squandering resources, labour and finances.
In 2015, an Australian audit found that 200 grams of food was wasted, on average, per bed each day in hospitals and aged care facilities. Most of this came from uneaten food on patient trays. Other sources are hospital kitchens and cafeterias, according to a US survey.
In hospitals, food service revolves around health care procedures, generating several different routes for food waste. These include bulk cooking, long delays between ordering and serving, and missed meals due to hospital procedures, fasting, test scheduling, and patients being checked out.
Patients and older adults are more likely to have poor appetite and treatments and conditions that limit eating through symptoms like pain and nausea.
Palatability of hospital food is a key issue, as well as packaged food that is unopened and thrown away or half-eaten – which also contributes to plastic pollution.
These issues not only have implications for food waste, but also for patients’ nutrition intake.
Methods for serving patient meals have not changed in 30 years. Improved technologies offer several ways in which the issue of food waste – and associated problems like surplus food costs and malnutrition – can be addressed.
A study by HealthShare NSW reformed hospital food delivery using improved workflow processes and menus, staff training and technology. The project aimed to decrease the time lag between ordering and getting meals to four hours or less, improve food quality and nutrition and increase patient choice.
As a result, improvements were made at various stages of the process, reducing patient food waste by half. Patients’ food intake also increased considerably.
Other health care facilities have switched to a room service model for feeding patients. This personalised approach results in better patient satisfaction, in turn improving nutrition intake and reducing food waste.
Melbourne’s health department joined other organisations to trial recycling organics, finding it a viable way to divert wasted food from landfill.
In all, combining streamlined technologies and procedures for storing, ordering, delivering and disposing of food with improved patient choice, food quality and dining environments can improve nutrition intake and reduce food waste – a win-win on all counts.
Recognition of links between diet and mental health has snowballed in recent years. This includes the impact of nutrition on risk of dementia and Alzheimer’s disease.
Some individual nutrients have been singled out, such as vitamin B6 and omega-3. While these are important, by themselves they are no replacement for healthy dietary patterns.
In particular, the Mediterranean diet has been showered with accolades for its physical and mental health benefits.
Most people won’t argue with the fact that a healthy diet can ward off heart disease, diabetes, obesity and other chronic lifestyle ailments.
Not so many connect diet with mental health. But the brain is an organ, just like the heart, the liver and the pancreas.
It’s not just any organ. Although the brain accounts for only 2-2.7% of the body’s weight, it uses up 25% of the body’s glucose supply at rest – and this increases to 50% when it’s active.
As such, the brain is highly dependent on a regular supply of energy and nutrients from food. This fuels its structure and function, keeping us sharp and happy.
Not only does the brain need nutrients to work properly and create the neurotransmitters that keep it ticking over, it is directly influenced by signals from the gut through pathways known as the ‘gut-brain axis’.
These pathways are hormonal, neuronal and immunological. And there are trillions of little workers that help or hinder gut-brain messages: microscopic bacteria that dwell in the intestines.
These microbial communities are impacted by several factors including antibiotics, stress and excessive hygiene. They are also influenced by the food we eat.
Specifically, a diet high in sugar and processed food breeds less healthy bacteria while the beneficial microbes munch and proliferate on a whole food, high fibre diet.
There isn’t just one Mediterranean diet. Likewise, populations that live long healthy lives – with miniscule risk of dementia – have variations in their diets.
But there is no need for confusion; some basic underlying dietary principles are simple to follow.
The driving tenet is eating plenty of plant foods: fruit, vegetables, legumes, nuts, seeds and wholegrains. These are teeming with nutrients, antioxidants and fibre that promote a healthy gut and brain.
Fats are also important. In particular, extra virgin olive oil – a healthy monounsaturated fat – has numerous benefits attributed to its antioxidant properties. This oil has a high smoke point so can be used liberally for cooking as well as salads.
The diet typically includes moderate intakes of fish, which is associated with reduced risk of dementia, fermented dairy and red wine with meals. Importantly, it is low in sugar, processed foods and meat.
Nurturing a healthy lifestyle not only includes following these dietary principles; engaging in regular physical activity is also robustly linked to better physical and cognitive outcomes with aging.
Modern times have seen a resurgence in paleolithic diets – for better or worse – as people turn to hunter gatherers for lessons on lifestyle and health.
But we haven’t embraced paleo levels of exercise – and researchers suggest we should pay considerably more attention to our ancestors’ physical activity habits.
Historical records estimate that hunter gatherers, whose survival and transport relied on doing everything manually, accrued more than double, and even triple, the number of daily steps of modern US adults.
In fact, most urban people are less active now than ever before in history.
Whether stone age people were healthier remains debatable because they tended to die young. But they were more likely to be killed by wild beasts and falling rocks than the chronic metabolic diseases that plague modern humans.
Non-communicable diseases are the modern world’s biggest health problem, responsible for substantial limitations in daily activities and 70 percent of all deaths in the US.
Advances in technology have resulted in less physically active lifestyles along with increased sedentary behaviour – and these are not necessarily mirror images of each other.
In other words, many of the ways in which inactivity leads to chronic disease are not the same means by which being active can prevent those diseases – these have different mechanisms of action in the body.
So avoiding sedentary behaviours and engaging in physical activity each have their own distinct benefits.
Broadly, nutrition and exercise physiology expert Frank Booth and colleagues define physical inactivity as “physical activity levels less than those required for optimal health and prevention of premature death”.
Booth and co-authors argue that low activity levels are a primary culprit for most chronic diseases. In fact, they present evidence that being active could prevent at least 35 different conditions ranging from obesity and diabetes to heart disease and depression.
Hippocrates is famously quoted as saying that food is medicine. He also recognised the importance of physical activity.
On the whole, our ancestors’ physical activity levels approximate guidelines set by the World Health Organisation.
For older adults aged 65 and above, WHO recommends at least 150 minutes of moderate-intensity physical activity throughout the week in bouts of at least 10 minutes – and up to 300 minutes for additional health benefits.
There is a lot of confusion about the paleo diet, and experts point out it is not just one diet: they say there are many different variants.
By and large, paleo diet enthusiasts embrace it as an excuse to eat lots of meat. But Dr Kim Lloyd, CEO of the Paleo Society, told NutritionInsight it’s not a meat-based diet.
“True paleo means eating approximately 75 percent plant-based food, non-starchy vegetables, fruit, seeds and tree nuts with the addition of compassionately reared, free range meat, fish and eggs,” she explained.
Many nutrition experts say the diet’s health benefits are attributed to eating fresh foods and avoiding processed meats and other packaged foods. But they caution against omitting whole food groups like dairy, grains and legumes as suggested by many proponents of the diet.
Combined with regular physical activity, this broad dietary approach – a cornerstone of most traditional diets – is surely a wholesome recipe for longevity and good health.
Many older adults don’t eat enough to meet their nutritional needs, and this can impact their healing and recovery from injury.
In support of this, a 2-year pilot study has shown that giving one extra meal a day to older adults who were hospitalised with hip fractures halved their risk of dying.
The study, conducted by the NHS in the UK, was instigated after staff noticed that patients with hip fractures struggled to get enough nutrients. In the program, nutrition advisors across six sites brought food from the hospital’s canteen and sat with patients as they ate their extra meal.
As a result, mortality rates fell from 11 to 5.5 percent, and medical authorities are considering whether it should be introduced countrywide.
Often, busy staff overlook patients’ food intake, noted chief orthopaedic surgeon Dominic Inman. Commenting on the findings to The Telegraph, he said, “If you look upon food as a very, very cheap drug, that’s extremely powerful.”
Hip fractures are the most common, and most serious type of fracture in Australia, with new fractures resulting in 50,900 hospitalisations and 579,000 bed days throughout 2015-16.
The health of adults over 50 often rapidly declines after a hip fracture, exacerbating poor outcomes. For three months after fracturing a hip, older adults are at five to eight times greater risk of dying, and one in three adults over 50 dies within 12 months.
Aside from that, a hip fracture can sorely impact mobility, independence and quality of life, and many patients are transferred to another facility for ongoing care.
Falls can be prevented by maintaining good muscle mass and strength. Failing that, patient outcomes after a fall can be improved with rehabilitation aimed at getting them moving as soon as possible, and with good nutrition.
Malnutrition, although widespread, is often overlooked, so it is important to be aware of the signs.
Addressing this, Queensland researchers have tested a patient-centred food service model in a public hospital setting and showed that it increased patients’ energy and protein intake – key requirements for healing and preventing malnourishment.
The model has been used in private acute care settings for 15 years. It revolves around providing room service to patients on demand – so they get to choose what they eat and when. (Who wants dinner at 5pm if you’re not ready for it?)
This food revolution was led by Sally McCray, who says, “This innovate model demonstrates the importance of patients being able to order flexibly, both in terms of the type of food items that patients feel like eating, as well as ordering food at a time of day that they feel like eating.”
The researchers showed that, not only can it improve nutrition intake, it also results in happier patients and reduced food waste.