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Healthcare Caterer

The Official Publication of Healthcare Caterers International

Vol 1 · Issue 1 · Winter 2005

Regular Features

Chairman's Message HCI News Review Education Association News Association Profile Cover Story Product News Diary Dates HCI Resources HCI Contacts

Published by: In Association with:

Healthcare Issues

A Global View

La Is un su c e! h


Healthcare Caterers International (HCI) 406 Surrey Woods Drive St. Charles IL 60174-2386 USA Tel: (001) 630-587-6336 Healthcare Caterer is published by: Complete Media & Marketing Ltd 6 Harforde Court, John Tate Road, Foxholes Business Park, Hertford SG13 7NW. UK. Tel: +44 (0)1992 538001 Fax: +44 (0)1992 538002 Email: [email protected] Website: All rights reserved. No part of Healthcare Caterer may be reproduced without the written consent of Healthcare Caterers International. Opinions expressed in articles do not necessarily represent those of Healthcare Caterers International or Complete Media & Marketing Limited. The publishers cannot accept responsibility for claims made by contributors, manufacturers, advertisers or readers.

Regular Features

Click on the links below for direct access

Cover Story

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Chairman's Message 2 HCI News Review Education Page Association News Association Profile Cover Story Product News Diary Dates HCI Resources HCI Contacts

10 13 13 14 15

10 Healthcare Issues

Colleen Zenk provides an overview of the discussions from the `Novartis International Symposium on Nutrition Care', which took place in Washington DC, USA.

Editor's word

It is with great pleasure that we launch this first issue of the HCI newsletter in its on-line format. One of the major goals of HCI was to network with those who are employed in the same arena worldwide and to share information on relevant topics. This newsletter is our attempt to do just that. I have been amazed to see how fast HCI has grown and how quickly some of our ideas have come to fruition. We are truly in a "fast-forward" mode. The pace is exciting and challenging at the same time. It is our aim to provide our readers with the latest in news about HCI and the issues that are affecting us in all parts of the globe. So here we go! Each issue will have a feature article and we begin with "Healthcare Issues ­ A Global View", which recaps the topics discussed at the First Annual Nutrition Symposium sponsored by Novartis Nutrition. The Symposium was held in Washington, DC, USA in July of 2005 and brought together the HCI board members in a panel format. With the panel moderated by Dan McHugh, President of MacAoda Concepts and a consultant to HCI, members spoke out about the common issues faced by the Healthcare Caterers in their countries. What a group it was ­ not only were they knowledgeable and articulate about the issues; they were a lively and entertaining group as well. Each issue will have several features such as a Chairman's message, news from each member association, educational resources, and a calendar of related events in each country. We will also do a profile of one of the member associations. The newest member of HCI has been chosen to be featured in this inaugural issue ­ the Swedish Association of Dietitians. I had the chance to spend some time with Birgit Josefson and her husband, Stephan, during their visit to Washington this summer. We welcome them to HCI and I am sure you will find the profile interesting. I want to offer my thanks to Complete Media & Marketing for their assistance in this venture. Mike Fryer and Faye Eagle have been invaluable in pulling all of this together. I would also like to thank Tetra Pak who has generously agreed to help sponsor this newsletter and to Novartis Nutrition who has made the operation of HCI a reality. I welcome any comments and suggestions as we go forward. You can contact me at [email protected] Colleen Zenk, HCI Editor

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Chairman's Message

It is a real pleasure to be writing the first Chairman's Message of the Healthcare Caterers International publication. Now into its second year, Healthcare Caterers International is a rapidly expanding collaboration of national healthcare catering and foodservice associations across the globe, which enables `global knowledge' to be shared locally. "In order to solve problems, information has to be shared: and not only information, but doubts, fears and questions." I hope you agree that the formation of HCI gives each and everyone of us the vehicle to solve problems, ask questions and share doubts and fears as they arise. It's amazing how far HCI has moved forward and developed in such a short period of time. The HCI board is made up of dedicated, like-minded people with years of experience, and this is reflected in the progress made to date. At the end of the day, every one of the 25,000 individual members has common goals, issues and interests. As Chair my core aim is to further enhance the sharing of knowledge and experience between each one of you as members through the tools that we've already set up like, and now through the development of this e-publication. Following the successful inaugural `Novartis International Symposium on Nutrition Care', which was held in Washington DC this year in conjunction with the Dietary Managers Association Annual Conference, plans are now developing to host the next Symposium, which will run along side the third HCI Annual Board Meeting and the Hospital Caterers Association National Conference in April 2006, Birmingham, England. I would like to extend a very warm welcome to those of you who will be able to attend. As we are approaching the festive season I would like to leave you with some Christmas gift suggestions: · To your enemy - forgiveness · To your opponent - tolerance · To a friend - your heart · To a customer - service · To all - charity · To a child - a good example · To yourself - respect That concludes my first column and I hope you enjoy the rest of the newsletter. Alison McCree, HCI Chairman

HCI News Review

HCI Travels the World

HCI continues to seek out new members by making contacts with interested associations or catering managers throughout the world. In August, Colleen Zenk, former chair of HCI and current HCI secretary, traveled to Singapore to meet with interested parties in that region.

As a guest speaker for the International Healthcare Facilities Conference, she generated interest from Thailand, India and Malaysia. Since the topic for her presentation was "Improving Hospital Food" she piqued the interest of hospital administrators attending the conference. The dialog has begun and hopefully HCI can add at least one member from Asia and/or the Far East to the association by the time the board meets in the spring. Colleen was accompanied by Robin Gaines, chair of DMA's Certifying Board. She was able to provide insight into DMA's certification program for several interested conference attendees. Colleen and Robin travelled onto Sydney, Australia where they were both guest speakers for the IHHC. They were joined by Alison McCree, current Chair of HCI, who was also a guest speaker at their conference. Alison and Angelo Mignanelli, Chair of IHHC, gave a presentation on HCI to the Australian group. Support for HCI among their members has been terrific as well. One of the goals of HCI is to assist interested healthcare caterers form associations in countries where there are none. Great interest has been shown for an association in the Middle East. Mohammed Misbahuddin, HCI board member from Saudi Arabia, met with Dan McHugh and Bill St. John while in Washington DC in an effort to move forward. The association has been tentatively called MEDA (Middle Eastern Dietary Association) and they are working through the process of receiving official status within countries in that region. Meanwhile, Executive Director, Bill St. John traveled to MOWAA in Richmond, Virginia and spoke to their group on leadership development. He then traveled to Dublin to meet with Mike Fryer, and they met up with Mary Moriarty and the CMAI Secretary. They were able to update her on what she missed in Washington DC. Bill also attended the NACC meeting and was impressed with Roger Kellow's promotion of HCI to their members. As Bill stated "the members totally get it!!" While Bill was in Blackpool, he had the chance to meet with Carolyn Robinson who is coordinating the HCA hosting of HCI next April. The best news is that Tetra Pak (thanks to Colleen's efforts) has agreed to sponsor the HCI publication to the tune of $12,000. The association is thrilled with this sponsorship and hope that it will spark advertising and sponsorship interest from other vendors.

HCI Expanding to Middle East

Mr. Mohammed Misbahuddin, a Food & Beverages Manager has taken on the challenging initiative of expanding HCI to the Middle East by establishing a new dietary association ­ Middle East Dietary Association (MEDA). Many fellow professionals and prominent personalities from the region are coming forward to assist with this venture. Mr. Khaled Haddad, a Nutritionist and prominent businessman from Saudi Arabia will act as President until the MEDA board is formed. Please look for updates on HCI's website.

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Importance of Taste in Clinical Nutrition

Consumers choose taste over nutrition We all know the importance of taste to nutritional products. If the product does not taste good, patients will drink less. This is critical, because if patients drink less, they will not receive the nutrition they need and their recovery is likely to be compromised. Recent market research shows general consumers are looking for good tasting beverages more than ever. Obviously, taste is important for compromised patients as well. A 2004 packaging study shows that packaging makes a significant difference in the taste profile of beverages, which may improve the likelihood that patients will consume more of the nutritional drinks served to them. In a study conducted by Health Focus International in 2004, only 33% of consumers who are primary shoppers said that "healthy foods taste good". Additionally, 43% of consumers said that they would rarely or never give up taste for health benefits, up 10 percentage points since 1990! Another study conducted for Tetra Pak by the research firm DDW shows that taste is the number one consideration when purchasing a nutritional beverage such as a meal replacement beverage, ranking higher than nutritional efficacy and convenience.

Nutrition 39% Convenience 13% Taste 49%

Taste even more important for patients? If this is the feedback that consumers are giving us about retail nutritional products, what would they say about institutional ones? The research was conducted with healthy consumers; would less healthy consumers be even less likely to give up appealing taste for nutrition? Many of you have several stories of patient complaints with the taste of nutritional products. So what can you do? As a health care professional, you are charged with not only improving patient nutrition, but also tightly managing costs. Packaging affects taste Packaging does make a difference in flavour and palatability of products. Recent research on packaging suggests metallic and vitamin off- flavours in a meal replacement beverage are more pronounced when packed in a can than in an aseptic shelf-stable carton. In a 2004 study, identical vitamin-fortified formulations were processed and packaged two ways: retorted in lacquer-lined steel cans or aseptically processed into Tetra Pak carton packs. The beverages from both package types were compared and rated by a trained sensory test panel through 12 months in a blind taste test.1 To ensure

Aseptic cartons have a more pleasing aromatic profile over same products in cans

Blind Taste Test Panel Sensory Results Lacquer-lined steel can vs. Tetra Prisma Aseptic

Can has 30% more "metallic" smell/flavour

Lacquer-lined steel can vs. Tetra Prisma Aseptic

Can has 23% more "vitamin" flavour

Summary of 12 months testing. Identical fortified meal replacement beverage tested in both package types

Summary of 12 months testing. Identical fortified meal replacement beverage tested in both package types

consistency, the same formula was used for all processes and packages. Both cans and Tetra Brik Aseptic cartons have a long shelf life but with each there is a unique method of heat treating the beverage inside. Beverages in the aseptic carton box are flash heated for less than 6 seconds before filling into a sterilised carton. Meanwhile beverages inside cans are often boiled and sterilised for at least 10 minutes. The gentle aseptic processing of carton-packed supplements may account for the flavour improvement and fresher taste seen over canned supplements. The differences in heat treatment yielded two significant taste benefits: · The canned beverage contained higher vitamin off-flavours than the beverage in a carton. · The canned beverage contained higher iron and metallic off-flavours. Additionally the functional benefits of aseptic cartons make the packages easy to serve patients in an environment where staffing continues to be challenging: · If desired, straws can be placed on the package for immediate use. · The packages are also easy for a patient to hold and drink from. · For patients in bed, the package is less likely to spill. · The packages also take up less room on storeroom shelves. · Disposal is easy. · If larger, multi-serve carton packages are desired, a recloseable or resealeable opening is available. What are the costs for such benefits? Actually, the costs of aseptic cartons are slightly less than cans, allowing your suppliers to supply better tasting products at competitive prices. If you are not using nutritional products in aseptic carton packages, contact your supplier and test them. We think you'll see the benefits in patient acceptance immediately!

References: 1. Tetra Pak Inc. sponsored study, 2004.

Metallic/Iron Aromatics

Vitamin Aromatics

Sensory Results from TIAX

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HCI around the world

Canadian Society of Nutrition Management

Dean Cox, President of CSNM Greetings from Canada and the 2300 members of the Canadian Society of Nutrition Management (CSNM). As healthcare is constantly evolving in our country, CSNM has constantly strived to adapt and ensure our members current and relevant knowledge in our profession. We continue to host two yearly conferences across the country as well as several provincial seminars hosted by local provincial chapters. We have just recently updated our computer system with a new data bank system, which should greatly improve office efficiency. Other projects currently under way include, revision of Bylaws, Accreditation Standards for all CSNM accredited teaching facilities, Website Redevelopment, Continuing Education System for Members and Strategic/Future Planning. We are continually updating our policies and procedures to ensure a well organised Society. CSNM is proud to announce that we have just agreed to sign a new one year contract with Complete Media & Marketing who has been publishing our Magazine for the past nine months. We hope to increase revenue through advertising and be able to move towards a more educational publication, which will soon be available in both English and French through a member's only online access. Our next conference will be held on 3rd-6th May, 2006 in Chatham Ontario. We look forward to hosting the CSNM/HCI Conference in May 2007 in Toronto. Full details will be made available in April 2006.

Dietary Managers Association

Bill St. John, President and CEO of DMA Dietary Managers Association (DMA) currently has just over 15,000 members, of which approximately 75% are Certified Dietary Managers. Following a very busy, but successful, annual meeting in Washington DC this past summer, much of the staff time at DMA turns to membership dues collection and administration of the annual credentialing exam. While the last couple of years have not really seen much growth in membership numbers, we have been able to hold retention at a strong level. The annual credentialing exam was held on 29th October in 50 different locations across the United States. Approximately 1200 people took the exam and we are hopeful that all of those who pass will become new CDMs. Planning is already underway for the 2006 Annual Meeting & Expo, which will take place on 16th-20th July in Milwaukee, Wisconsin. We anticipate over (100) exhibition stands and (700) attendees. Magazine advertising is another area that requires constant attention and DMA has been holding steady, running just about even with last year. DMA staff and elected leadership are working very hard to develop long lasting relationships with our industry partners. We are also in the midst of planning a makeover for our magazine, Dietary Manager. While the magazine is very well received by our membership, the board and staff feel that it may be looking tired and could use a facelift. The board and support groups will be working on this key initiative over the next several months, and we plan to launch the new magazine in July at the annual meeting. Publication sales have been very strong this year and we will be launching several new titles in 2006 as we strive to further build this excellent source of nondues revenue. In addition to new books this year, an ad hoc task force on education will meet in late November to examine the future of education within DMA and what we need to do to continue forward into the next 5-10 years. We are also working hard to influence government on the importance of Certified Dietary Managers in health care facilities. Keeping current with technology is always important and we continue to work hard to improve the DMA website for the benefit of members. New additions to the site have allowed the members to become more interactive, and our site has been receiving close to one million hits per month. The most popular reason for visiting our website continues to be job searching. This trend indicates that services such as I Entrée should become very popular within HCI. The future is very bright for catering management in the healthcare arena, and DMA is proud to be affiliated with HCI as we move forward.

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HCI around the world

Meals on Wheels Association of America

Sister Alice Marie Quinn, Chairman of MOWAA

The Meals On Wheels Association of America (MOWAA) has had an exciting year. We were awarded a 1.6 million dollar federal grant seeking to connect social services programs and health care systems. Our emphasis has been on older adults who live alone and who are discharged from the hospital. If provided with proper nutrition and other services, we hope to demonstrate that these seniors will have a faster recovery and will avoid frequent and future hospitalisations. Along with our CEO and the directors of other Meals On Wheels programs, Sister Alice Marie Quinn will represent MOWAA at the December 2005 White House Conference on Aging. Such conferences occur only once every decade, and Sister Alice Marie Quinn looks forward to helping make a contribution to the proceedings. Our annual conference took place in September. About 400 members attended and participated in the many seminars, discussion, and panels that we offer. 2005 was also the launch date for our new Meals On Wheels Association of America Foundation. Another project on the horizon is the establishment of the creation of our National Center for Nutrition Leadership, which will offer educational programs of many aspects of non-profit management for those involved in the areas of nutrition. The growth occurring within MOWAA is an exciting indication of the potential for growth among individual senior meal programs. The coming demographic bulge among retirees is one reason for the increasing need for our services. MOWAA's growth is not only encouraging, but essential.

Hospital Caterers Association

Alison McCree, Chairman of HCA

The Hospital Caterers Association is in the process of planning the Associations National Conference, which will be held on the 27th-28th April 2006 at the Hilton Birmingham Metropole hotel, England. Themed `Communicate, Motivate, Innovate', this conference will take the art of sharing best practice to new heights. It will provide delegates with: · An invaluable opportunity to learn from fellow practitioners · Offer a networking experience second to none · Enable the exchange of ideas with catering, facilities and other healthcare professionals. The National Chairman has been invited by the Mayor of the 2nd Arrondissement Borough of Paris to participate in a meeting on the 2nd December 2005, which will be discussing the proposals for the Food for Health Living and Livelihoods project ­ F4H. The purpose of the meeting is to enable various associations to work together to create changes in food and agricultural policy and practice that will make genuinely sustainable public food systems the norm not the exception and help create a new sustainable European model of food based proximity, co-operation and health. The National Chairman will be speaking at the Westminster Food & Health Forum on 8th December 2005 to give a presentation on Nutrition in Hospitals - The way forward for policy. The key message will be that no food is nutritious unless it is consumed and no food will be consumed unless it is tasty, well presented and good standards of food service exist at ward level.

Swedish Association of Dietitians

Birgit Josefson, International Delegate of SAD

The Swedish Association of Dietitians (SAD) held its National Conference in April 2005, Stockholm, and it was then Karin Lidén took over as the new President of the Association. At the same time SAD also changed its Swedish name to be " Kost och Näring- en branschförening inom Ledarna" and we think that one of our most important challenges at present is to market our new name and our profile. We have also refreshed and renewed the name and appearance of our magazine and we hope that old and new members will find it attractive and worth reading. SAD is currently taking an active part in some very interesting and important working groups. One is to provide a national basic data formula in order to calculate all the costs involved of providing meals served in schools, nursing homes and hospitals. In May SAD had a meeting with the Swedish Minister for Schools and Adult Education in order to launch the new guidelines for meals in schools. Another reference group has started work to secure the quality of meals served in nursing homes and hospitals. In June SAD became a member of the HCI and the international representative Birgit Josefson visited the HCI board meeting in Washington DC. Birgit was able to meet the representatives of the other Associations who make up the HCI. It was really interesting to find that our working conditions are comparable in so many ways, even though we are living in so many different parts of the world. SAD is looking forward to future international global cooperation with all HCI members! Please visit our website at:

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HCI around the world

National Association of Care Catering

Sue Hawkins, Chairman of NACC Sue Hawkins has over as taken chairman of the National Association of Care Catering (NACC) from Roger Kellow, who has stepped down after four years in the role. At last month's annual conference in Blackpool he handed over to Hawkins, who also heads the organisation's South West of England region. As the assistant transport and catering manager with Dorset County Council, her responsibilities include, managing the catering services, overseeing the refit of kitchens, setting up of contracts and overseeing the Meals on Wheels service. Her involvement with the organisation began in 1991 when it was the Advisory Body for Social Services Catering and she started work in Dorset. NACC and Sustain work on Sustainable Food Procurement Project for Care Catering. This project seeks to explore the opportunities for sustainable food procurement in care catering and take first steps to increase the amount of sustainable food procured. The work will be carried out by the NACC and Sustain, the alliance for better food and farming. The Commission for Social Care Inspection (CSCI) and the NACC continue their collaboration to provide documentation to support the inspection process for The National Minimum Standards ­ Care Homes for Older People. The full range of NACC Documents are now available to purchase via the HCI website,

Institute of Hospitality in Health Care

Angelo Mignanelli, National President of IHHC The Institute of Hospitality in Health Care (IHHC) recently held a National Conference in conjunction with Fine Food at the Sydney Conference and Exhibition Centre, Darling Harbour on 11th-14th September 2005. As this was the first conference run at a leading exhibition centre, it was an unknown quantity when it came to response and sponsorship. Despite chewed nails, sleepless nights and concerns regarding sponsorship, the risk paid off with one of the best responses received in the history of the IHHC. The great venue, comprehensive program and special interest days proved a great inducement, and the following results were recorded: · 280 delegates over 3 days · 36 speakers · 38 supporters The program covered `Breaking News' and all speakers were either directly from industry or linked - with none requesting payment for presentations! The news was relevant and the international perspective certainly allowed a great insight into opportunities for consideration! A special thanks to Alison McCree from the UK, Colleen Zenk and Robin Gaines from the US, Nicky Moore and Heather Spence from NZ for making the trip down under! General interest groups included, `Snapshots from Abroad'- a view of overseas experiences from our members, benchmarking, best practice and Reflections on the Tsunami. All food for thought! (Note these are available for viewing on the IHHC website). Two other networking events were incorporated, which included a Trivia Night and a Mad Dinner. This required a number of leaders to be put forward and make a bid for the 2010 Olympics - the photos have to be seen to be believed. Two well-known members of HCI were last seen in a sari made of yellow contaminated waste bags and a cymbal of aluminium pie containers. All the poise and supposed reserve goes out the window when some of our members go overseas! With some of the New South Wales Committee responsible for planning the National Conference they will now be moving onto new frontiers in their careers following this conference. It was a great buzz to know we had done the best we could with what funds and speakers we had available! Without the committee members, and especially those that put their heart and soul into such organisations, conferences like this do not happen! It was encouraging to read positive comments from the conference surveys. One of the most rewarding areas was the response from the Aged Care community. Their interest is certainly in new membership and educational opportunities, using the IHHC as an educational provider and information update! We wish you well and invite you to come to Tasmania next year! Adieu.

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HCI around the world

Catering Management Association of Ireland

Mary Moriarty, President of CMAI The National Task Force on Obesity was launched on March 10th 2004 by the Minister for Health and Children, a national strategy aiming to halt the rise, and reversed the prevalence of, obesity in Irish children and adults. The Catering Management Association of Ireland (CMAI) was asked to submit a document expressing their views on how best to create the social and physical environments that make it easier for children and adults to eat healthily and regularly partake in physical activities. A representative from the CMAI is on the Food Safety Authority of Ireland Food Service Forum. This group represents different areas within the catering and food services sector. The CMAI acted as advisors from Industry in the development of Guidance Note 15, which updated the cook chill guidelines. At present the CMAI are also involved with the Food Service Authority of Ireland (FSAI) in developing a Guidance Note for the Determination of Produce Use-ByDate, which will assess scope and limitations of product development processes. FSAI requested that the CMAI work with them on salt reduction programmes. We sent our written proposals and promised to promote this initiative over the next few years, helping the FSAI to achieve the 6g/day population target, which they are hoping to reach by 2010. The CMAI are committed to Environmental Waste Management and, last April, we held a seminar ­ Waste Not Want Not ­ which was a great success with our members. Speakers included Fr. Sean McDonagh, who is the author of many well-known books on the subject. The CMAI had input in developing the North/South Health Services Partnership Ethnic Catering in our Hospitals guideline, aiming to raise the profile of Hospital Catering, and providing menus suited to patients and staff from multi-ethnic and multi-racial backgrounds. This booklet/ guideline was launched at "The Best of Health Conference", which took place at Hotel Europa, Belfast, on 15th November 2005. At present we are creating our own website. This will be up and running before Christmas and will be formerly launched in 2006. The website address is

Middle East Dietary Association

Khalid Haddad, President of MEDA I would like to congratulate all the health food service providers and their for associations their invaluable contribution to the patient community and send my thanks and appreciation to all those involved in HCI's success. I am sure that this initiative will be a unique and valuable networking and brainstorming opportunity for industry professionals around the world. The role of a Dietary Manager does not end by serving just the patient community. I think our main challenge as a dietary association is to educate people and develop awareness of the importance of healthy diets. This will be a non-ending mission and someone will have to carry this responsibility. As such, our strategy needs to be "Promoting basic education and food knowledge for every one". In recent years, the Middle Eastern market has seen significant nutrition and health problems. With cultural diversity changing regional dietary habits, the incidence of diabetes, obesity and other public health issues are on the rise, as they are in other parts of the world. These are big issues impacting on the current population and the days are not so far away when we will have a very sick population. The increasing trend in worldwide medical tourism is demanding hospital caterers to review global dietary standards. The provision of food needs to be more flexible and individualised, with a strong emphasis on patient choice and nutritional outcomes. In order to meet such demands and to keep pace with global trends, many industry professionals from the Middle East are coming forward, creating a regional platform. This enables hospital caterers to interact with each other to share best practices, learn and apply successful approaches for providing an integrated and comprehensive nutrition education, along with managing food safety issues, current and emerging operational initiatives. It can also serve as a premier resource centre for present and aspiring professionals in food and nutrition management. Tentatively, this platform has been named MEDA (Middle East Dietary Association). As an initial step, we are in the process of creating a website where members can register themselves and start interaction with each other for professional development, and at the same time gain an official status. The website address will be and information on joining MEDA and using its website will be made available shortly. I welcome any comments and suggestion as we go forward. [email protected]; [email protected]

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Association Profile

Swedish Association of Dietitians

The Swedish Association of Dietitians (in swedish ­ Kost och Näring - en branschförening inom Ledarna) was in 1921 and has founded approximately 1000 members. The association is connected with the trade union Ledarna and has 20 regional subdivisions all over the country. Most members are administrative dietitians with a focus on food service management with the responsibility for feeding groups of people in health and disease within an institution or the community. The working areas of the health care field are: hospitals, nursing homes and primary health care. Administrative dietitians also work as staff in school and military restaurants, catering companies and as community advisers. In Sweden every child in elementary school (age 6 to 15 years old) is served a free nutritional, warm meal in school and this is an important working field for many administrative dietitians. Since 1972 SAD has been a member of the Europeen Federation of the Associations of Dietitians (EFAD). Every year the representatives have a meeting where guidelines for the future European work of dietitians are drawn up. At present very important and interesting work is happening on the European Dietetic Benchmark Statement. Other international organisations which SAD are a member of is the International Confederation of Dietetic Organisation (ICDA) and also, since June 2005, the HCI. These international professional contacts are very important for our members and therefore SAD is really looking forward to networking with other colleagues working in the same area in other countries! SAD has a website: and a journal ­ Dietisten ( the Dietitian ) with 6 issues every year. Every second year the Swedish Association of Dietitians arrange study days and the next event will take place on 27th ­ 28th September 2006, in Gothenburg. More details about the study days will be available on the website in February 2006. 2006 Board Meetings will be held on: · 13th January · 4th March · 17th March · 5th May · 26th ­ 27th August · 29th September · 18th November For further information contact: Karin Lidén President The Swedish Association of Dietitians Email: [email protected] Annika Larsson Vice President The Swedish Association of Dietitians Email: [email protected] Birgit Josefson International Delegate The Swedish Association of Dietitians Email: [email protected] Email: [email protected]

The aims of SAD are: · To promote professional, economical and social interests of its members · To promote the development of the dietetic profession · To promote training, education and the work of dietitians · To promote international professional contacts Education programmes for dietitians in Sweden include: · Three universities in Gothenburg, Uppsala and Umeå · Basic course, 3 years leads to a BSc in Catering or Dietetics · A fourth year leads to a MSc in Catering or Dietetics

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Healthcare Issues

A Global View

by Colleen Zenk, MS, CDM, CFPP


Have you ever wondered if the issues you are facing as a healthcare caterer are unique? Or does everyone else struggle with the same concerns? Those were the questions that were the foundation of the first annual "Novartis International Symposium on Nutrition Care" held in Washington, DC on July 24, 2005. The chairpersons of the nine national associations that make up HCI came together as an "expert panel" to compare, contrast and discuss healthcare foodservice challenges, trends and initiatives. Moderated by Dan McHugh, President of MacAoda Concepts and Consultant to HCI, the Symposium enabled the audience to hear and relate to experiences of like-minded colleagues from regions as diverse as the USA, Australia, UK, Canada, the Middle East and Sweden.

"Finding enough funding to provide adequate healthcare for the elderly was a common issue regardless of whether the healthcare system was financed by the government or private industry."

10 · Healthcare Caterer · Winter2005



Healthcare Issues A Global View

The Symposium was introduced by Mr. Kerry Hurff, Director of Marketing ­ Longterm care, Novartis Nutrition Corporation, USA, who represented the sponsor; and was followed by an introduction given by each panel member and the moderator. Predefined questions were posed to the panel, who were given the opportunity to answer individually and on behalf of their respective national association. Issues and topics raised within the questions covered a broad spectrum of relative healthcare foodservice topics. The first question that the panel members responded to was "What is the most pressing issue that you see facing the elderly in your country and how is the issue being addressed?" It was within this very first question that panel members and the nearly 300 people that attended the symposium saw the common threads that face all nations. Finding enough funding to provide adequate healthcare for the elderly was a common issue regardless of whether the healthcare system was financed by the government or private industry. Costs for healthcare have risen in every country, and the need to provide adequate healthcare in economically stretched times was a concern among all panel members. Everyone sees the need but no one seems to have a great solution for finding the monies for a rapidly expanding population in need of care. The expanding population in need of good healthcare was identified as the growing aging population. In the US, the aging population is expected to double between now and 2030. Other countries are experiencing similar changing demographics. Most elderly people still live within their communities and not in institutions. Brigit Josefson (Sweden) noted that communities don't have enough resources to provide adequately for the elderly, resulting in malnutrition among this group. Roger Kellow (UK) noted that there is a great need to reduce hospitalisations among the elderly and that community services need to focus on preventative care. Sister Alice Marie Quinn (USA ­ MOWAA) discussed how hunger among the elderly is a huge problem as many seniors do not have the income to purchase adequate and nutritious foods. They often face a choice between buying food or the medications that are necessary for their health. Trends in therapeutic diets were a lively topic for the panel members. In general most countries seem to have liberalised diets for their senior population. In the US, as noted by Colleen Zenk (DMA) the trend is toward less emphasis on calorie controlled diets with more attention on the consistency of the diet. A national dysphagia diet has been developed that many facilities are following. Angelo Mignanelli (Australia) indicated that only in the last 3-4 years has Australia begun to employ dietitians and speech pathologists to better assess diet needs in the elderly population. Birgit Josefson indicated that Sweden has developed new recommendations for senior diets that are more liberal and focused on addressing malnutrition and underweight patients. Diets offered in common were regular, diabetic, texture modified with thickened fluids, low-fat and low salt. In counties such as the UK and Saudi Arabia, the list of diets was much longer. The hospital trust (corporation) where Alison McCree is employed offers a wide range of ethnic diets. The list includes Kosher, Afro-Caribbean, Urdu, Hindi, Punjabi, Gujarati, and Bengali. The mobility of the world's population and the increasing immigrant populations that many countries are absorbing has influenced the menus in many hospitals and aged care facilities, particularly those in metropolitan areas. Diets that address food intolerances and allergies have become a regular part of the healthcare caterer's responsibility to implement. This includes vegetarian diets, gluten-free diets, and those that address lactose intolerance. All participants indicated that the requests for these diets are on the increase. It was evident that even though the diets healthcare caterers implement in the various countries are similar, there is often a different terminology used. Angelo Mignanelli (Australia) humorously enlightened the audience on the meaning of "vitamizing" ­ the Australian term for pureed or minced diets.

"In the US, the aging population is expected to double between now and 2030."

"Diets that address food intolerances and allergies have become a regular part of the healthcare caterer's responsibility to implement."

11 · Healthcare Caterer · Winter2005



Healthcare Issues A Global View

The increasing incidence of obesity is not a problem unique to the United States according to the panel members. Colleen Zenk (USA) stated that she is seeing more demand for renal diets as facilities are treating patients with renal failure due to diabetes and obesity. Hospitals are doing an increasing number of Bariatric surgeries (for weight loss), which is creating a new focus for dietitians and healthcare caterers in the area of diet management. Patients who have undergone this surgery are also being admitted to aged care facilities. Healthcare workers in these settings may have little knowledge of nutrition care or the long range outcomes for such a patient. All panel participants indicated that malnutrition, diabetes and obesity are issues in their countries that the healthcare system is trying to address. They also felt that this trend would increase and present challenges to the healthcare professionals of the future. Alison McCree (UK) indicated that 40% of the patients admitted to hospitals in the UK are suffering from malnutrition and that the emphasis is on improving their nutritional status. The UK has initiated the Better Hospital Food Project, which has developed new minimum nutritional standards and is actively tackling this issue. Angelo Mignanelli (Australia) indicated that diabetes in Australia has increased by approximately 50% in the last 5 years and that aged care organisations are reporting that approximately 17% of their clients are diabetic. Improving the food experience (and the perception of hospital food) in healthcare settings was a challenge all healthcare caterers seem to face. A pertinent example came from Alison McCree, Chair of the Hospital Caterers Association in the UK, who informed the audience about the `Protected Mealtimes Initiative', which is currently being introduced in her country and aims to improve mealtimes for patients in care settings by ensuring a controlled environment around mealtimes. This is an initiative that other panel members felt would work well in their respective countries and it will be discussed further at future HCI meetings. Colleen Zenk (USA) also mentioned the hot trend in the USA of offering "room service" on demand. Food in hospitals and nursing homes has become about patient choice and lots of it and facilities are developing different strategies to provide it. All agreed that the healthcare consumer of the future will be more demanding and informed than ever before. Keeping the elderly in their own homes as long as possible seemed to be a common goal of the healthcare systems in the countries represented. All panel participants agreed that finding and funding the support services that senior populations need is a challenge. Sister Alice Marie Quinn (USA) talked at length about the program for the poor and the elderly she runs in urban Los Angeles. She said that there just isn't enough money for all the programs and that some of the programs aren't able to cover weekend meals, holidays and special diets. Colleen Zenk (USA) talked about the gaps in the programs provided, such as that many elderly are not reached by these programs, either due to where they live (rural America), their unwillingness to seek help, or the lack of volunteers able to deliver meals. Mohammed Misbahuddin (Saudi Arabia) indicated that programs to assist the senior population do not exist in the Middle East. Elderly citizens remain with extended family until the end of life, or if they need treatment they are referred to geriatric care centers within hospitals. Doctors and therapists can be arranged to provide care within the home if needed. Staffing healthcare facilities with competent, well-trained employees was another area of great concern. Many countries are experiencing a great shortage of healthcare workers, especially nurses. This is creating a strain on all aspects of the healthcare system. Discussion ensued about the training of catering employees in each country and the respective wages of varying positions. Alison McCree (UK) indicated that the National Health System in the UK will need to recruit 1 of every 2 high school students in order to sustain the NHS in the future. They are working with schools to promote career opportunities within the NHS and to get the message across that there are many careers besides being a doctor or a nurse within the NHS. Consensus was that wages in general are not high enough to attract employees. The Symposium delegates had the opportunity to learn not only from the experiences of their own representing association, but also from similar associations worldwide. The panel discussions focused on improving healthcare foodservice provision around the world and ultimately the provision of good nutrition and nutrition care to patients. As a result of the discussions that took place during the symposium, agreement was reached amongst the panel to initiate key follow-on projects, with the aim of building an international understanding of issues that span healthcare foodservice settings worldwide. Two projects were sited and will be initiated by each panel member in their respective country. The first will examine healthcare foodservice salaries globally, and the second will look at PPD (per patient day) budgets and how they compare in each country. The panel believes that projects like these can only help to improve healthcare foodservice provision around the world and ultimately the provision of good nutrition and nutrition care to patients. Look for more information in upcoming issues of this publication. The next Novartis Nutrition Symposium will be held in conjunction with the Hospital Caterers Association meeting, Birmingham, England in April 2006. The Canadian Society of Nutrition Management will host HCI in Toronto, 2007.

"Staffing healthcare facilities with competent, welltrained employees was another area of great concern"

12 · Healthcare Caterer · Winter2005



Product News

New Boost® Diabetic Nutritional Supplement Helps Patients Maintain Stable Blood Glucose Levels

Minneapolis, September 23, 2005 ­ The maker of BOOST nutritional energy drinks is introducing BOOST Diabetic Nutritional Supplement, a new beverage containing a slow-digesting carbohydrate that has been clinically shown to help maintain stable blood glucose levels and facilitate a balanced nutritional intake. Novartis Nutrition Corporation developed BOOST Diabetic Nutritional Supplement to support patients in alternate care facilities, hospitals and home care. BOOST Diabetic Nutritional Supplement contains many of the attributes that have made BOOST a leading product in the nutritional supplement industry, including its great taste. Available in strawberry, vanilla and chocolate, it contains 14g of protein, 20g of carbohydrates and 12g of fat to help individuals with diabetes better manage their diets and blood glucose. Designed to help minimise glycemic response, the new drink has a variety of health care applications. Practitioners can use it in the nutritional management of their patients' diabetes through blood glucose control. Good glycemic control can help to minimise diabetesassociated complications. BOOST Diabetic Nutritional Supplement will also benefit hospitalised individuals who need to consume an oral supplement to help improve their oral intake during an acute episode. For more information, contact: Novartis Customer Service at 1.800.333.3785 or visit the Web site at

Designed to help minimise glycemic response, provides nutritional balance and great taste

Diary Dates

CMAI ANNUAL DINNER Date: 2nd December 2005 Venue: Restaurant 1592 Trinity College, Dublin THE HOSPITAL CATERERS ASSOCIATION NATIONAL CONFERENCE Date: 27th ­ 28th April 2006 Venue: Hilton Birmingham Metropole, UK CSNM CONFERENCE Date: 3rd ­ 6th May 2006 Venue: Chatham, Ontario NATIONAL RESTAURANT SHOW Date: 20th ­ 23rd May 2006 Venue: McCormick Place, Chicago, IL UPCOMING DMA ANNUAL MEETINGS Date: 16th ­ 20th July 2006 Venue: Hilton Milwaukee City Center, Milwaukee, WI Date: 1st ­ 5th July 2007 Venue: Hyatt Regency, San Diego, CA Date: 27th ­ 31st July 2008 Venue: Wyndham Philadelphia, Philadelphia, PA Date: 9th ­ 13th August 2009 Venue: Hyatt Regency, Atlanta, GA "COMPARING APPLES WITH APPLES" The 25th National Conference IHHC Date: 30th August 2nd September 2006 Venue: Launceston Country Club Resort, Launceston, Tasmania For further Information: Conference Committee Email: [email protected] MOWAA ANNUAL CONFERENCE Date: 7th ­ 9th September 2006 Venue: Hilton, Minneapolis, MN AMERICAN DIETETIC ASSOCIATION FOOD AND NUTRITION CONFERENCE Date: 16th ­ 19th September 2006 Venue: Honolulu, Hawaii SWEDISH ASSOCIATION OF DIETITIANS STUDY DAYS Date: 27th ­ 28th September 2006 Venue: Gothenburg For further information: Email: [email protected] NACC CONFERENCE & EXHIBITION Date: 27th ­ 29th September 2006 Venue: Hinckley Island Hotel, Leicestershire. UK For further information: Email: [email protected] CMAI AGM Date: 26th January 2006 Venue: Failte Ireland, Amien Street, Dublin NUTRITION THROUGH LIFE PROFESSIONAL STUDY DAY Date: 26th April 2006 Venue: Royal College of Physicians, London, UK For further information visit

13 · Healthcare Caterer · Winter2005



Internet Resources for HCI Members Where Job-Seekers and Employers Come Together

Employment openings . . . New career horizons . . . Whether you are exploring new jobs across the globe or in your own back yard, may be a worthwhile Web destination in your search. A benefit for members of Healthcare Caterers International (HCI), stands alone as the exclusive online employment resource for foodservice and catering managers working in healthcare settings. While it offers many of the features of mega-employment websites, it narrows the scope to include only catering/foodservice management positions in organisations such as nursing facilities, hospitals, and related operations. The razor-sharp focus of can save you time and help you target valuable career opportunities. A Member Benefit As a member of any of the participating organisations, you are automatically also a member of HCI. For a complete list of members, please visit the HCI website at What does your added membership deliver? You can post your resume to the system, and choose your options for making a match to employment opportunities as they enter the website: 1. Make your resume available to recruiters who may be looking for a candidate with exactly your skills. Already, key recruiters from healthcare chains are using the to find their next set of managers... AND/OR: 2. Keep your resume information confidential, but simply receive e-mail notification every time a job matching your search criteria enters the system. To access these members-only perks, go to and select Post/Edit Resume. Click the "More Information" link to view details about

HCI Global eLibrary

HCI members around the world are now enjoying a new electronic library from HCI, the HCI Global eLibrary, located on the Web at With the support of member organisations as well as Complete Media & Marketing of Hertford, England, the site provides a wealth of electronic resources in PDF (Adobe Acrobat) format. Featured are timely articles from member magazines and the Complete Nutrition magazine, which focuses on communicating nutrition from a new perspective. To use the eLibrary, simply select a topic area from among Nutrition and Medical Nutrition Therapy, Food Safety & Sanitation, Foodservice/Catering Management, or General Interest, and then browse the offerings. Click any article to view the full-text PDF file. This is an interactive way to explore global resources for the profession, from advice about professional roles to implementing 5-a-Day nutrition advice to managing pressure ulcers or renal diets. Articles also address service and delivery systems, quality management, technology, finance, marketing, managing change, HACCP, functional foods, food allergy, nutrition support, and much more. This is a great way to expand your own knowledge of the profession, and for HCI members to enjoy the synergy of professional expertise shared among member associations. No member login is required. Simply launch the website and enjoy!

login for your association, or contact the HCI webmaster for assistance: [email protected] Search Job Openings Even without using your login, you can check available job postings on any time. Simply choose "Search Jobs" and select your location and position type ­ or just click "GO" to see all openings. Recruitment Help If you are a manager responsible for recruiting catering or foodservice managers, can help you reach a targeted job market of more than 20,000 qualified professionals. For information about placing employment ads, please contact Lori Harr 817.840.9273 (US telephone), [email protected] or send an email to the HCI webmaster: [email protected]

14 · Healthcare Caterer · Winter2005



HCI Board of Directors


ALISON McCREE Hospital Caterers Association Associate Director of Estates & Facilities County Durham & Darlington Acute Hospitals, NHS Trust Darlington Memorial Hospital Hollyhurst Road Darlington DL3 OR2 ENGLAND UK Tel: +44 (0)1325 743022 E-Mail: [email protected] SERGE VAN DEN NIEUWENHOF Novartis Consumer Health Route de I'Etraz, 1260 Nyon SWITZERLAND Tel: +41 22 636 30 45 E-Mail: [email protected] ROGER KELLOW National Association of Care Catering Government Account Manager Hobart UK Unite 17, Ace Business Park Mackadown Lane, Kitts Green Birmingham, B330LD ENGLAND, UK Tel: +44 (0)121 7895326 E-Mail: [email protected] ANGELO MIGNANELLI Institute of Hospitality in Health Care Ltd PO Box 7193 Hutt Street Adelaide, South Australia 5001 AUSTRALIA Tel: +61(0) 882045141 E-Mail: [email protected] MARY MORIARTY Catering Management Association of Ireland Central Production Unit Midlands Regional Hospital Mullinger County Westmeath IRELAND Tel: +353 4440221 Ext. 9750 E-Mail: [email protected] BIRGIT JOSEFSON Swedish Association of Dietitians Kostutbildning, Brisvagen 8 24335 Hoor SWEDEN Tel: +46 41326272 E-Mail: [email protected] DAN MCHUGH MacAoda Concepts 1206 19th St. SW Austin, MN 55912 USA Tel: +1 507-433-2632 E-Mail: [email protected] MOHAMMED MISBAHUDDIN Middle East Dietary Association Food & Beverages Manager Abdul Latif Jameel Center for Rehabilitation and Healthcare PO Box 114869 Jeddah, Saudi Arabia 21381 SAUDI ARABIA Tel: +966 5079 18794 Email: [email protected]


WILLIAM ST. JOHN 406 Surrey Woods Drive St. Charles, IL 60174-2386 USA Tel: +1 630-587-6336 Ext. 113 E-Mail: [email protected]


MIKE FRYER Global Media Partner Director Complete Media & Marketing Limited 6 Harforde Court John Tate Road Hertford SG13 7NW ENGLAND UK Tel: +44 (0)1992 538001 E-Mail: [email protected] SUE GROSSBAUER, RD Global Web Partner Principal The Grossbauer Group P.O. Box 2001 Chesterton, IN 46304 USA Tel: +1 219-926-1000 Ext. 202 E-Mail: [email protected] BOB HERBOLSHEIMER HCI Council Attorney at Law Herbolsheimer Law Office 733 15th St. NW #1120 Washington, DC 20008 USA Tel: +1 202-628-9200 E-Mail: [email protected]


COLLEEN ZENK Dietary Managers Association 16579 Baywood Lane Eden Prairie, MN 55346 USA Tel: +1 952-934-4468 E-Mail: [email protected] DEAN COX Canadian Society of Nutrition Management Good Eats Catering 280 Deer Lane Nanaimo, British Columbia V9T4V2 CANADA Tel: +1 250-754-5458 E-Mail: [email protected] SISTER ALICE MARIE QUINN Meals on Wheels Association of America Program Director, St. Vincent Sr. Citizen Nutrition Program, Inc. 2131 W. 3rd Street Los Angeles, CA 90057 USA Tel: +1 213-484-7778 E-Mail: [email protected]

15 · Healthcare Caterer · Winter2005


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