Public awareness, knowledge, and attitude regarding proper disposal of unused medicines and associated factors in Gondar city, northwest Ethiopia.

Background: Proper disposal of unwanted medicines, in addition to reducing wastage, has a positive impact on the environment and public health. Improper disposal of medications increases the risk of accidental poisonings, particularly among children. This study aimed to assess the level of knowledge, attitudes, and awareness regarding the proper disposal of unused medicines in Gondar city, northwest Ethiopia. Method: From 30 July to 30 August 2023, a community-based cross-sectional study was conducted among the public in Gondar city. The data were gathered using the Kobo toolbox, exported into an Excel sheet, and then analyzed using SPSS version 27. Multivariate and bivariate binary logistic regressions were performed. A p-value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance. Result: From 786 study participants, the overall knowledge and attitude of the community toward the proper disposal of unused medicines were 42.6 and 42.9%, respectively. Factors identified in this study included ages between 19 and 25 [AOR = 6.91, 95% CI: (3.45, 13.84); education level: secondary [AOR = 11.82, 95% CI: (1.01, 3.29)] and college and above [AOR = 5.68, 95% CI: (2.25, 14.30)]; prior information [AOR = 6.41; 95% CI: (4.02, 10.22)]; and good attitudes [AOR = 2.11; 95% CI: (1.47, 3.02)]] as factors associated with good knowledge toward proper disposal of unused medicines. In addition, receiving information [AOR = 1.86 95% CI: (1.22, 2.86)], taking medication in the past 6 months [AOR = 1.61, 95% CI: (1.09, 2.38)], and being knowledgeable [AOR = 2.07 95% CI: (1.46, 2.94)] were factors contributing to positive attitudes toward the disposal of unused medicines among the general public. Furthermore, approximately 369 participants (46.9%) in our study lacked awareness about the harmful effects of disposing of unused medicine in regular waste. Conclusion: A relatively low level of knowledge and attitudes about the proper disposal of unused medications is present in the community. In this regard, a well-coordinated and methodical public awareness campaign is recommended to disseminate information and promote the appropriate disposal of unused medications.

Unused, expired pharmaceuticals and their disposal practices among the general public in Burdur-Türkiye: a cross-sectional study.

BACKGROUND: Unused pharmaceuticals are currently a public health problem. This study aimed to identify unused pharmaceuticals, research practices about the disposal methods, classify the medicines according to Anatomical Therapeutic Chemical codes (ATC) and, to determine the number of unused medicines. METHODS: The study was designed as a cross-sectional study. Data were collected between April and August 2023 in Burdur-Türkiye by non-probability sampling technique (convenience method). Pharmaceuticals were classified according to ATC. Statistical Package for Social Science SPSS (V.24) package program was used for data analysis. RESULTS: A total of 1120 people, 1005 in the first sample group and 115 in the second sample group, participated in the study. Findings of first sample group: A total of 4097 boxes of unused pharmaceuticals (4.7 ± 4.3 boxes/per capita) were detected. It was found that pharmaceuticals were stored in areas such as kitchens (59.1%) and refrigerators (38.6%), the reason for keeping them was reuse (41%), and the disposal practice was household garbage (81%). Paracetamol (648 boxes), Other cold preparation (303 boxes), Dexketoprofen (239 boxes), Diclofenac (218 boxes), Amoxicillin and beta-lactamase inhibitor (190 boxes) were found to be the most frequently unused pharmaceuticals. Using the unused medicines at home without consulting a physician was 94.1% (self-medication). Findings of second sample group: Of the 6189 dosage forms in 265 boxes pharmaceutical, 3132(50.6%) dosage forms were used and 3057(49.4%) were found to be unused. CONCLUSION: There is a significant amount and number of unused medicines in households, and self-medication is common. Medicines are not properly disposed of and some of them expire. Public information is needed. A "drug take-back system" for unused medicines can be useful in solving this problem.

Impacts of regional socioeconomic statuses and global events on solid waste research reflected in six waste-focused journals.

The research pertaining to solid waste is undergoing extensive advancement, thereby necessitating a consolidation and analysis of its research trajectories. The existing biblio-studies on solid waste research (SWR) lack thorough analyses of the factors influencing its trends. This article presents an innovative categorization framework that categorizes publications from six SWR journals utilizing Source Latent Dirichlet Allocation. First analyse changes in publication numbers across main categories, subcategories, journals, and regions, providing a macro-level study of SWR. Temporal analysis of keywords supplements a micro-level study of SWR, which highlights that emerging technologies with low Technology Readiness Level receive significant attention, while studies on widespread technologies are diminishing. Additionally, this study demonstrates the substantial influence of socioeconomic factors and previous SWR publications on current and future SWR trends. Finally, the article confirms the impact of global events on SWR trends by examining the structural breakpoints of SWR and their correlation with global events.

Exploring rural inhabitants' perceptions towards food wastage during COVID-19 lockdowns: Implications for food security in Pakistan.

The lessening of food wastage, specifically among nations where about half of its worldwide quantity is produced, has turned to be a mammoth challenge for environmental, social and economic sustainability, and represents one of the seventeen Sustainable Development Goals (SDG) within the Agenda 2030. The quantity of food being thrown away in spite of being in an edible condition has become alarming in middle and high income countries. The COVID-19 lockdown strategy, both at local and international levels, has expressively altered work, life and food consumption behaviors globally, directing to food wastage as a multi sectoral issue. Pakistan has no exception to such manifestations. The main objective of this study is to analyze the perceptions of rural people of Pakistan regarding food wastage during the COVID-19 pandemic. To evaluate whether behavior about food wastage among rural households varied or not during the pandemic, a descriptive survey was carried out using a self-administered questionnaire and 963 responses were selected for further empirical investigations. The findings of the study reveal that food waste actually decreased in spite of an increased amount of purchased food during the lockdown. Our results highlight that the effect of the pandemic has led to reduction in food wastage among rural respondents, an increased consciousness for the morals of food waste, and awareness of environmental impacts of food wastage. The conclusions of this study highlight that rural consumers of Pakistan are emerging with a new level of responsiveness about food wastage with possible positive impact on the environment in terms of decreased greenhouse gas (GHG) emission and other pollutants. The study findings imply that this pandemic time provides a suitable window to raise awareness about food wastage among rural as well as urban households while contemplating effective strategies to overcome the issue of food wastage in the country.

COVID-19 affected the food behavior of different age groups in Chinese households.

The COVID-19 pandemic brought profound changes to all corners of society and affected people in every aspect of their lives. This survey-based study investigated how household food related matters such as food sourcing and consumption behaviors of 2,126 Chinese consumers in different age groups changed approximately two months into the COVID-19 quarantine. A new food sourcing mechanism, community-based online group grocery-ordering (CoGGO), was widely adopted by households, particularly among the youngest group studied (18-24 years of age). The same group showed a higher confidence in the food supply system during the quarantine and a greater propensity for weight gain while staying-at-home. The more mature age group (≥35 years of age) showed heightened vigilance and awareness, with fewer grocery-shopping trips, a higher tendency for purchasing extra food, and less tendency to waste food. Survey findings of the new food-sourcing mechanism, attitudes to food, and changes in behavior among different age groups provide valuable insights to guide policies and management interventions to address matters pertaining to food supply and distribution, food access and household food security, and food waste reduction.

Food Waste and Its Association with Diet Quality of Foods Purchased in South Florida.

The objective of this study was to explore the associations between food waste and the diet quality of foods purchased and with grocery purchasing behaviors. This was a cross-sectional study among 109 primary household food providers conducting primary shopping. Participants were recruited outside of local grocery stores and were asked to complete a survey assessing amounts of avoidable food waste and grocery purchasing behaviors. The diet quality of the foods purchased was assessed from grocery receipts using the Grocery Purchase Quality Index-2016 (GPQI-2016). Variables were associated using linear regression, analysis of covariance, and point biserial correlations. We found that fresh fruits (63%) and leafy greens (70%) were the foods that were the most wasted. The GPQI-2016 total score was significantly inversely associated with the total amount of food wasted (ß = -0.63; 95% CI: -1.14,-0.12) after adjusting for important confounders. The reason "food past the date printed on the package" was directly correlated with food wasted (r = 0.40; p < 0.01) but inversely correlated with GPQI-2016 score (r = -0.21; p = 0.04). Food wasted, but not the GPQI-2016 score, was significantly higher among those who grocery shop 2-4 times per week compared to 1 time every 1-2 weeks (p = 0.02). In conclusion, food waste is inversely associated with diet quality and directly associated with grocery purchasing frequency.

Eating Habits during the COVID-19 Lockdown in Italy: The Nutritional and Lifestyle Side Effects of the Pandemic.

To limit the spread of coronavirus SARS-CoV-2, a nationwide lockdown started in Italy in March 2020. In this unpredictable situation, a cross-sectional study using an online questionnaire was carried out by the Observatory on Food Surplus, Recovery and Waste of CREA Food and Nutrition Centre. The aim of this work was to evaluate how Italian habits changed during this period, the determinants of changes, and the effect on food waste prevention. In a sample of 2678 respondents, 62% showed low Adherence to the Mediterranean Diet (AMD). During lockdown many of participants improved the quality of their diet, increasing their consumption of fruit (24.4%), vegetables (28.5%), legumes (22.1%), nuts (12%), and fish or shellfish (14%). Unfavorable changes were observed with the excessive consumption of sweets or pastries (36.9%) and comfort foods (22.7%), and a lack of physical activity (37.2%). The main novelty of this study was the examination of dietary changes identified by a cluster analysis. Respondents with generally high AMD improved their eating habits, while the habits of the respondents with generally low AMD remained unchanged. In addition, nearly 80% of respondents were sensitive to food waste. The study provides a useful contribution to the debate on nutritional recommendations in case of further lockdown.

Post-consumer food waste generation while dining out: A close-up view.

Food loss and food waste occur along the food supply chain, negatively impacting the environment, global economy, and food security. There is a growing global interest in tackling this issue to mitigate or handle the waste generated and limit its repercussions, as one in eight people suffer from undernourishment worldwide. In the Arab world, where there is a high dependency on imports and limited potential of increasing local food production, addressing food loss and waste becomes substantial. Research has mainly been focused on household food waste generation, while data on post-consumer plate food waste in the foodservice sector remains scarce. In this study, managers from a representative sample of 222 restaurants located in Municipal Beirut, Lebanon, were surveyed about food waste generation. Plate food waste was measured to establish baseline information. Multiple Tobit regression analyses were performed to explore the determinants for plate food waste generation. Plate waste generation was also compared between Lebanese and non-Lebanese cuisine restaurants. Results revealed that 1,620 tons of plate food waste are generated per year in Beirut, equivalent to 0.15% of Lebanon's total organic waste. Furthermore, Lebanese cuisine restaurants serving Mediterranean Mezze were found to generate 34 kg of organic waste per day more than restaurants that serve international non-Lebanese cuisine. The type of cuisine, kind of service, and menu planning were significantly associated with post-consumer food waste generation. This study revealed an increasing concern towards the amount of plate waste generated in Beirut, and thereby further research is needed to create baseline information at the national level.

Conceptual Behaviour Underpinning the Occurrence of Nonfaecal Matter in Faecal Sludge in Some Urban Communities, Ghana.

Faecal sludge (FS) management is pertinent to the achievement of sustainable development goal 6.2 around the world; yet it is constrained by urbanisation challenges, waste management complexities, and defective attitudes. These deny communities of the plausible supply of resources from FS. This paper assesses the perception underpinning the occurrence of nonfaecal matter in FS in Ghana. Primary data were obtained from 400 respondents in four communities in Brong Ahafo and Greater Accra Regions of Ghana, using a structured questionnaire. Data were analysed by using STATA software version 15. Chi-square test and multiple logistic regression were conducted on all independent variables and statistical significance was accepted at p < 0.05. The study identified the following as the most perceived frequently disposed nonfaecal matter into FS: sanitary pads and diapers (38.5%), fabrics/rags (23.2%), toilet rolls (20.8%), razor/shaving sticks (10.3%), and others (7.2%). Gender, state of toilet facility (roof or unroofed), presence of container for collecting other types of waste in the toilet room, and state of container in toilet room either covered or uncovered were the factors found to be significantly associated with the disposal of solid waste (SW) into FS at 95% confidence level. The fear of exposing used sanitary materials for rituals, the use of fabric as an alternative to toilet rolls, and the desire to conceal aborted pregnancies from the public were some of the reasons alluded to the disposal acts. Education and awareness campaigns on proper SW disposal practices, appropriate use of toilet facilities, and the resource potentials of FS were found to be the best way forward to discourage indiscriminate disposal of SW into FS.

Social vulnerabilities of female waste pickers in Brasília, Brazil.

Worldwide, waste pickers are exposed to adverse health effects resulting from hazards at work. This study aimed to identify possible gender disparities among waste pickers. A quantitative cross-sectional epidemiological study, using semi-structured data was conducted in Estrutural's dumpsite, Brasília, Brazil. It included 1,025 waste pickers, with 67% being female. Most of them lived without partners (73.7%), have 3 to 4 children (47.8%), and have a lower monthly income (62.6%

Determinants of Household Solid Waste Generation and Composition in Homs City, Syria.

The absence of accurate information on the state of waste is a challenge to the solid waste management system in Syria. The local authorities commonly estimate the quantity of waste produced and its characterisation, which is the starting point for solid waste management planning. So, this paper aims to evaluate the generation and composition of household solid waste in Homs city, Syria. Also, the study presents factors influencing the waste generation rate and the waste composition. The study was carried out in 300 families from four zones in Homs city, and three sampling stages were conducted during the study duration, which started in July 2017 and ended in February 2019. The outcomes show that an average of 0.68 kg/per/day solid waste generated was calculated for the entire study area in Homs city. Also, the data analysis presents that organic waste constitutes the largest component in the waste mixture (69.1%) followed by plastic (10.6%), inert materials (8.7%), paper (4.6%), textile (2.5%), metal (1.2%), glass (1.1%), wood (0.6%), and hazardous materials (1.6%). The multiple linear regression results showed that the adjusted R 2 value was found to be 0.557, 0.839, and 0.709 for the waste generation per capita, the daily household organic waste generation, and the daily household packaging waste generation, respectively. Also, according to Pearson's coefficient values, a positive correlation was found between household waste generation and monthly income (r = 0.626), household size (r = 0.37), and age of the household head (r = 0.517), whereas a negative correlation was found between household waste generation and the education level of the household head (r = -0.649).

Selection, intake, and plate waste patterns of leftover food items among U.S. consumers: A pilot study.

Many campaigns promote the preservation and consumption of leftover food items as a critical household strategy to accomplish national consumer food waste reduction goals. We fill a gap in knowledge about the consumption and creation of leftovers in the United States by analyzing data from a pilot study in which 18 subjects tracked food selection, intake, and plate waste across all eating occasions for about one week. Subjects noted which items selected for consumption were leftovers, i.e., previously prepared but uneaten items that were stored for future consumption, and which unfinished items were saved to become leftovers. We found that 12% of items selected for consumption were leftovers while 24% of selected items that were not fully consumed were kept to become a leftover. Leftovers were most frequently vegetables, cheeses, and meats, and most frequently selected on Mondays and for lunch. Regression analyses isolate significant dining patterns with respect to leftovers, including evidence that leftovers were less likely to be fully consumed than non-leftover items, and that larger meals led to more uneaten food. This suggests that strategies to reduce meal size may be most effective in reducing food waste by limiting the creation of leftovers in the first place. Strategies to make leftovers more attractive and appealing may also reduce food waste.

Controlled substances in hospices after patient death: a cross-sectional survey of Ontario hospices.

Background Practices related to the handling of controlled substances (CS) in Ontario hospices have not been previously published and therefore, are unknown. Objective The objective of this study was to determine current practices, and policies, standard operating procedures (SOPs) and guidelines related to handling and disposal of CS at hospices across Ontario. Setting This study was a cross-sectional survey of hospices in Ontario. Method A list of all hospices in Ontario, 39 in total, was obtained from Hospice and Palliative Care Ontario. The Director at each hospice was contacted to request contact information on the person most likely to be knowledgeable about handling procedures related to CS. All participants who provided consent were asked to complete a telephone survey composed of 32 questions: 20 multiple-choice and 12 open-ended. Of the 20 multiple-choice, eight requested demographics of the hospice, nine were related to disposal and documentation practices. Main outcome measure Demographic information, disposal practices and patterns of care were summarized and presented as frequencies or means. Responses to open-ended questions were analyzed qualitatively to identify themes related to the handling and disposal of controlled substances in hospices. Results Twelve hospices (12/39; 31%) participated in the survey, 25 did not, and two were ineligible. Two (2/12, 17%) hospices served both pediatric and adult patients while 10 (83%) served adults only; 100% indicated that 76-100% of their patients were on CS at time of death. Eight (67%) had a policy for controlled substances handling, two had policy and SOPs and two had no policies, guidelines or SOPs. Qualitative analysis indicated variability in procedures for obtaining CS (patient's own supply, other patient's supply, hospice associated pharmacy), storage and dispensation of CS (location, secure lock, dispensing by staff or family), documentation (dispensing records, double signature, tracking returns and disposal), and disposal of CS (return to pharmacy, disposal at hospice, return to families). Conclusion Although most of the hospices have a policy, guideline or SOP on the handling of CS, there is considerable variation in practice of dispensing CS to patients, documentation and disposal of CS, which may provide an avenue for inappropriate use, abuse or diversion of CS.

Prevalence and Practice of Unused and Expired Medicine-A Community-Based Study among Saudi Adults in Riyadh, Saudi Arabia.

PURPOSE: The objective of the current study was to determine the prevalence and practice of unused and expired medicine among Saudi adults. Subjects and Methods. The study used cross-sectional web-based design to collect the data, over a period of 4 months among people who are living in Riyadh, Saudi Arabia. RESULTS: A total of 337 questionnaires were obtained during the study period. The majority of respondents were university graduates n = 251 (74.7%). The prevalence of unused medicine was n = 301 (89.3%). The most commonly used drugs were nonsteroidal anti-inflammatory drugs n = 272 (80.7%) and antibiotics n = 164 (48.7%). Of the participants, 186 (55.2%) checked the expiry date of the medicine before they purchase. Most of them n = 305 (90.5%) obtained medicine through prescription. About n = 219 (65%) of them keep the medicine until it expired; 48.1% throw away in the household garbage while only 18 (5.4%) of the respondents said to give it back to the medical store. CONCLUSION: The study revealed a high prevalence of unused medications among Saudi community. However, the disposable practice among the Saudi community was inadequate. Increasing awareness through education programs about proper disposable guidelines is necessary for controlling the medication wastage.

Plate Waste Generated by Spanish Households and Out-of-Home Consumption: Results from the ANIBES Study.

Food waste is a major environmental issue that must be tackled in order to achieve a sustainable food supply chain. Currently, in Spain there are no studies that examine the amounts and sources of plate waste (PW) produced by both household and out-of-home consumption. The present study aims to provide this information from a representative sample from the Spanish population. A total of 2009 individuals aged 9-75 years, from the ANIBES study ("anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain"), completed a three-day dietary record, collected by a tablet device. Photographs of all foods and beverages consumed both at home and outside were taken before and after meals. Median PW across the total population was 7.3 (0.0-37.3) g/day and was significantly higher in females than males (p < 0.05) and in children vs. adolescents, adults, and elderly (p < 0.01). Regarding meals, PW across all age groups was higher at lunch (40%), dinner (27%), and breakfast (11%). The highest PW was observed for bread (25%) main courses (16%), first and second courses (15%), vegetables and fruits (12%), ready-to-eat meals (10%), cereals and grains (10%), oils and fats (10%), pulses (10%), meat products (8%), sauces and condiments (8%), and starters (8%). Our results reinforce the need for new strategies to focus on reducing plate leftovers, which are crucial from a nutritional, economic, and environmental point of view. Additionally, this evidence is important for relying on more accurate information on actual intakes when using dietary surveys.

Assessment of Knowledge, Attitude, and Disposal Practice of Unused and Expired Pharmaceuticals in Community of Adigrat City, Northern Ethiopia.

Background: Medicines have become part of our day-to-day life. Due to different reasons, patients may not use all the medications dispensed to them. The storage of drugs at home promotes self-medication, which results in variety of adverse consequences. Global growth in health-seeking awareness and behavior among people has resulted in increment of medicine consumption over years. However, Ethiopians have little awareness about proper disposal of unused and expired pharmaceuticals. Besides, large quantities remain unused or expired since not all medications given to the consumers are consumed. Hence, this study could serve as an indicator for the country policy makers concerning pharmaceutical waste management. Objective: To assess knowledge, attitude, and disposal practice of unused and expired pharmaceuticals in the community of Adigrat city, Tigray, Ethiopia, 2019. Methodology. A cross-sectional study was conducted among 359 respondents from the residents of Adigrat city. Semistructured questionnaires, which focused on knowledge, attitudes, and disposal practices for unused and expired medications, were used to collect data from respondents. Epi-data 3.0 suite and the statistical package for social sciences (SPSS) version 20 were used in data entry and analysis. Results: All of the 359 returned questionnaires were valid for data entry and analysis. Of the 359 respondents, 57.7% were men and the majority (93%) were Orthodox Christians. Almost half of the respondents (50.14%) have good knowledge concerning the disposal of unused and expired pharmaceuticals. Most (82.2%) of the respondents have a positive attitude towards the disposal of unused and expired pharmaceuticals. Around fifty-two (52.4) of the respondents had unused medicines stored at home, with analgesics being the most common (41.5%). Around three-quarters (75.2%) and 63% of the respondents discarded unused and expired medicines in the garbage bins, respectively. Conclusion: Although the majority of the respondents had a positive attitude towards the disposal of unused and expired medications, almost half of the sample population were unaware of proper disposal practices. Furthermore, less were inclined to practice proper disposal of unused and expired medications in the city. Therefore, we recommend further studies that focus on how the disposal attitude of the population can influence their knowledge and practice of the disposal of unused and expired medications.

Status of Household Solid Waste Management and Associated Factors in a Slum Community in Kampala, Uganda.

Background: Only a third of the total waste generated in slum communities in Kampala is collected and disposed of to the landfill every month. This study assessed the status of household solid waste management and associated factors in a slum community in Kampala, Uganda. Methods: We conducted a community-based cross-sectional study involving 395 households using a semistructured questionnaire and an observational checklist. Proper solid waste management was determined based on possession of waste collection and storage receptacle; collection receptacle ability to minimise nuisances (covered); segregation of waste; presence of flies and other vectors; and collection receptacle fill status. Prevalence rate ratios and their 95% confidence intervals were used as a measure of association. Results: Only, 41.3% (163/395) of the households exhibited proper waste management practices. The majority of the households 85.8% (339/395) owned solid waste storage receptacles, most of which were sacs 61.7% (209/339) and would minimise nuisances 72.9% (245/339). The main type of waste collected was biodegradable materials 56.7% (224/395). The majority of the households 78.7% (311/395) did not segregate their waste. Solid waste was mainly transported to the collection point by pulling the collecting sac 54.4% (215/395). The city authority 73.9% (292/395) and private companies 12.9% (51/395) were the major entities collecting waste. Factors associated with proper waste management were collecting waste in plastic containers (adjusted PR = 1.27, 95% CI (1.04-1.55)), polythene bags (adjusted PR = 0.26, 95% CI (0.14-0.47)), and paper bags or metallic bins (adjusted PR = 0.13, 95% CI (0.03-0.44)) as well as awareness of solid waste management laws (adjusted PR = 1.49, 95% CI (1.20-1.85)) and the dangers of improper solid waste management (adjusted PR = 2.15, 95% CI (1.51-3.06)). Conclusion: Solid waste management was generally poor. As such, a cascade of interventions that address knowledge, physical, and behavioural aspects of solid waste management is required to improve its management in slum communities.

Daily cost of consumer food wasted, inedible, and consumed in the United States, 2001-2016.

BACKGROUND: Consumer food waste in the United States represents substantial amounts of wasted nutrients, as well as needless environmental impact from wasted agricultural inputs, energy use, and greenhouse gas emissions. Efforts to reduce food waste at the consumer level are urgently needed to address the most prominent nutrition and environmental sustainability issues we now face. Importantly, individuals report that saving money is a salient motivator for reducing food waste, yet contemporary evidence on the consumer cost of wasted food is lacking. The objectives of this study are to 1) estimate the daily per capita cost of food wasted, inedible, and consumed 2) at home and away from home, and 3) by food group. METHODS: This study utilizes cross-sectional, nationally-representative data on food intake from the National Health and Nutrition Examination Survey (2001-2016), linked with nationally representative data on food waste from published literature, as well as data on food prices and food price inflation from multiple publicly-available sources. Survey-weighted procedures estimated daily per capita expenditure on food waste for 39,758 adults aged ≥20 y. RESULTS: Total daily per capita food expenditure was $13.27, representing 27% wasted, 14% inedible, and 59% consumed. The greatest daily food waste expenditures were observed for meat and seafood purchased for consumption outside of the home ($0.94, 95% CI: $0.90-0.99), and fruits and vegetables purchased for consumption in the home ($0.68, $0.63-0.73). CONCLUSIONS: The most cost-effective ways to reduce food waste at the consumer level are to focus waste reduction efforts on meat and seafood purchased for consumption outside of the home and fruits and vegetables purchased for consumption in the home. A number of strategies are available to help consumers reduce their food waste, which can increase their financial flexibility to purchase more healthy foods while simultaneously reducing environmental impact.

Improved meals service and reduced food waste and costs in medical institutions resulting from employment of a food service dietitian - a case study.

BACKGROUND: A recurring problem in medical institutions is patients not always receiving food meeting their nutritional and medical needs. A proposed contributing factor is non- inclusion of dietitians in food service staff. Recently, positions for food service dietitians in hospitals were created. For the newly defined role of "Food Service Dietitian", comprehensive training courses were developed (70 dietitians participated). OBJECTIVE: To examine the impact of the addition of the role of a "Food Service Dietitian" in medical institutions on suitability of foods served, food costs and food waste. METHODS: A three years (2014-2017) national case study to examine the new role's impact was carried out, in 18 hospitals, nine of which employ a food service dietitian (intervention), and 9 without (control). The number of nutritional analyses of menus was checked, as was the extent of kitchen staff training, and how often night meals were served for all patients. Data were gathered regarding food costs and waste with respect to food distributed to staff and patients. Food costs savings and waste reduction were calculated, based on reduction in provision of unnecessary meals, at a cost of 18 NIS per day per meal. RESULTS: Kitchen staff training was carried out in all intervention institutions, and not in the controls. In most controls, nutritional analyses were not performed, whereas in the intervention hospitals, full analyses were performed and tailoring of menus to specific department requirements improved significantly. In most intervention hospitals, late night snacks were provided, this not being so in the controls. Total food cost savings of $229,569 per annum was seen in the six intervention hospitals, attributable to 4 factors: 1.Meals not delivered to fasting patients, or those receiving parenteral/enteral nutrition- cost savings of 328,500 NIS ($93,857)2.Better tailoring and monitoring of food delivered to the wards and staff (bread, cheese, milk etc)- annual cost savings of 235,000 NIS ($67,142) in the hospitals with a food service dietitian.3.Checking expiry dates of medical foods, and improved communication between the wards, the kitchen and the food distribution centers, has lessened food waste with savings of 5% from the medical food budget per annum of 40,000 NIS ($11,428).4.As a result of dietitian-performed nutritional analyses, tailoring of food provided according to the patient's medical and nutrition needs was improved. In one hospital, after re-evaluation of serve sizes in high protein diets, sizes were reduced while retaining adequacy, with immediate cost savings of 200,000 NIS ($57,142) per annum. CONCLUSIONS: Implementation of the new role of Food Service Dietitian led to cost savings and significant improvements in adherence to the nutritional care plan.