Canadian Hospital Food Service Practices to Prevent Malnutrition.

Purpose: The study aimed to determine current practice, barriers, and enablers of foodservices in Canadian hospitals relative to guiding principles for best practice to prevent malnutrition.Methods: Foodservice managers completed a 55-item cross-sectional, online survey (closed- and open-ended questions).Results: Survey responses (n = 286) were from diverse hospitals in all Canadian regions; 56% acute care; 13% had foodservices contracted out; and 60% had a reporting structure combined with clinical nutrition. Predominantly, foodservice systems were 43% in-house versus 41% pre-prepared, 46% cook-serve food production, 64% meals assembled centrally (on-site), and 40% non-selective menus with limited opportunities for patient choice in advance or at meals. The "regular menu" (44%) was most commonly served as 3 meals, no snacks at specific times. Energy and protein-dense menus were available, but not widespread (9%). Daily energy targets ranged from 1200 to 2400 kcal and 32% of respondents viewed protein targets as important. The number of therapeutic diets varied from 2 to 150.Conclusions: Although hospital foodservice practices vary across Canada, the survey results demonstrate gaps in national evidence-based practices and an opportunity to formalize guiding principles. This work highlights the need for standards to improve practice through patient-centered, foodservice practices focused on addressing malnutrition.

Successes and Challenges Implementing a "Fresh from the Farm" Fundraising Program in Schools.

In 2013, 4 partner organizations: Dietitians of Canada (DC); Ontario Fruit and Vegetable Growers Association; Ontario Ministry of Agriculture, Food and Rural Affairs; and Ontario Ministry of Education created "Fresh from the Farm" (FFF), a healthy fundraiser for Ontario Schools. FFF was designed to support the Ontario government's School Food and Beverage Policy and Local Food Act and to provide a feasible alternative for less healthy fundraising options. This paper outlines the program successes and challenges over the 6 years of DC's involvement. After 6 years, over 1700 schools successfully participated in FFF and over $2 million has been paid to Ontario farmers for product and distribution. The average participating school has generated $2040 in sales towards their fundraising efforts, equating to 770 kg (1700 lbs) of fresh produce per school. Schools reported high satisfaction with FFF, with over 90% of participating schools enrolling in subsequent years. The main reasons for satisfaction included: easy to implement, profitable, offers a healthy alternative to "traditional" fundraising programs, and provides great value for cost. The main challenges were logistics of sourcing and delivery, higher than anticipated costs that made the financial model less feasible than predicted, and competition from other fundraisers.