Greener Allied Health Professional Hub: Food & Nutrition (NHS, UK)

The UK National Health Service (NHS) has the third largest clinical workforce in the NHS. Allied Health Professionals (AHPs) play an important role in Delivering a Net Zero NHS, which is the overarching framework.

The “Greener Allied Health Professional (AHP) Hub” aims to provide:

  • Information on the importance of environmental sustainability for both population health and the health of the environment to provide clear actionable steps which AHPs can take to improve their own environmental sustainability.
  • Examples of the ways in which AHPs are already doing things which improve environmental sustainability to include ‘what good looks like’ for individual AHPs and their teams as well as wider examples demonstrating how AHPs can lead this work in their organisations.
  • Suggestions of how AHPs can contribute in relation to environmentally sustainable practice, digital, food and diet, use of equipment and public health and prevention.

Food & Nutrition is one of the focus areas for the Greener AHP Hub. As a food and nutrition professional, this NHS resource outlines key areas where you can make a difference in reducing the carbon footprint of healthcare food systems. It highlights your role in reducing food waste through optimizing mealtime support, promoting best practices, and utilizing technology for ordering and monitoring.

By advocating for healthy, low-carbon diets and minimizing packaging waste, you can address the broader impacts of food systems. This resource will help you implement strategies such as conducting waste audits, supporting patients in adopting better eating habits, and promoting the importance of nutrition and hydration among food service staff. Ultimately, this page equips you to link food, health, and climate change initiatives within the NHS, driving sustainable practices and better patient outcomes.

An example is the “Sustainability in Healthcare: Mildmay’s Low-Carbon Menu Transforms Patient Care“. Mildmay Hospital’s dietetics and catering teams, in collaboration with the NHS and dietetics students, developed a low-carbon menu tailored to vulnerable patients using recipes from the NHS England recipe bank. After iterative development and feedback, the winter menu achieved an 18% carbon footprint reduction and minimized food waste to 10% of portions served, while patient input led to further improvements like diverse recipes and a weekly cooked breakfast option for summer.



Next-generation solutions to address adaptive challenges in dietetics practice: the I+PSE conceptual framework for action (2022)

Tagtow A, Herman D, Cunningham-Sabo L. Next-generation solutions to address adaptive challenges in dietetics practice: the I+PSE conceptual framework for action. J Acad Nutr Diet. 2022; 122(1): 15-24.

This article focuses on Applications for Professional Practice. The following is taken from the introduction to the article:

“It describes the Individual plus Policy, System, and Environmental (I+PSE) Conceptual Framework for Action (known as the “Framework”) as a roadmap for RDNs across all areas of practice (eg, research, education, clinical, community, and management) to better address adaptive challenges and to formulate multidimensional strategies for optimal impact. The Framework has cross-cutting practice implications for all areas of dietetics practice and can lead to the next generation of solutions to tackle adaptive challenges that better support nutrition and health.

The I+PSE Conceptual Framework for Action (see Figure) is a blueprint for RDNs and their partners to develop and implement multidimensional strategies using a systems orientation to achieve greater responsiveness to adaptive challenges and realize greater impacts.

  • Phase 1 –
    • Once an adaptive challenge is identified, RDNs can apply a determinants of health lens (Figure, phase 1) to closely examine nutrition and health problems and better identify why problems are worsening despite best efforts to solve them. The result of this focused assessment is a stronger diagnosis of the root causes that supports strategic decision-making in phase 2.
  • Phase 2 –
    • Is the formation of coordinated multidimensional strategies that produce a sustainable and synergistic effect.
  • Phase 3 –
    • Is the evaluation of outcomes and impacts of the suite of strategies and the degree to which change has occurred at the individual, practice, program, organizational, policy, and population levels. Encircling the Framework is systems thinking and reflection to support an iterative cycle of robust assessment, planning, implementation, and impact evaluation. The Framework is versatile and can be adapted to a wide range of nutrition issues, areas of dietetics practice, and diverse partnerships.”

Sustainable Food Systems Network (EUFIC)

European Food Information Council (EUFIC)‘s Global Sustainable Food Systems Network facilitates communication and collaboration amongst stakeholders in sustainable food systems (SFS) across the globe. In this community, you will find policy makers, business professionals, civil society organizations, researchers, NGOs/non-profit organizations, funding agencies and interested citizens. The network allows members to:

  • Add to and use the resources section
  • Reach out to members through the chat in a field/topic you are interested in. Network, ask questions, build bridges. Chat conversations are private and confidential!
  • Publish about events you are organizing regarding SFS (on average, 30-120 members attend events shared in the feed!)
  • Peruse the calendar of events shared by other members.
  • Share calls, documents, reports, papers, etc. that you think are interesting for the whole community.
  • Ask the community for feedback and start a conversation, e.g. by creating a poll!
  • Share job openings as “opportunities”. The network currently spans 2000+ people, and their personal networks spread much further.

The SFSN Community leaders send a biweekly newsletter with featured shared events, opportunities, posts, and new members for further dissemination.

If you have any feedback, questions or would like to get more involved, email sfsn@eufic.org or contact us directly through the chat (search Community Managers).

Aquatic Foods Toolkit (2023)

A World of Aquatic Foods Resources: Open-access resources designed to empower chefs, foodservice, consumer packaged goods entrepreneurs, healthcare professionals, and other aquatic food advocates in promoting bivalves and sea vegetables.

🌐 You’ll get: Free, open-access toolkits, packed with evidence-based resources, eater insights, tested messaging, nutritional guidance, and inspiring recipes. Access to an interactive Aquatic Foods Ecosystem Map, so you can connect with others creating impact through sea vegetables and bivalves.

Aquatic foods—foods derived from aquatic animals, plants, or algae—have long been enjoyed traditionally by many cultures through the centuries. They have been highlighted in recent landmark reports for their ability to help build a healthy, diversified, equitable, and sustainable food future. Few topics today at the intersection of food, cuisine, health, and sustainability are more exciting than the vast potential of foods from the sea.

For this project, Food for Climate League joined forces with Food + Planet (F+P) and set out to develop narratives that can equip foodservice, CPG, retail, and nutrition professionals to market and promote sustainable aquatic foods successfully. With funding from Builders Initiative, they developed evidence-based health and wellness messaging and narratives for sustainable and nutritious aquatic foods, namely bivalves and sea vegetables.

🪸 The research outlined in the toolkits is a mix of qualitative and quantitative work conducted in 2022 to understand the aquatic foods landscape, including current and potential focus points and narratives around sustainable aquatic foods.

Pollinator Friendly Cookbook

Use this cookbook by Pollinator Partnership to create culinary masterpieces that honor pollinators and the work that they do.

Food is a basic human need, and without pollinators, humans would go hungry! 🦅 🦇 🐝 🦋 🪲 🪰 Birds, bats, bees, butterflies, beetles, flies, and small animals that pollinate plants are responsible for bringing us one out of every three bites of food. More than 200,000 species of pollinators are critical to the stability of our food supply.

In your search for ingredients, we encourage you to support local farmers that practice pollinator-friendly management techniques. Learn more at the Pollinator Partnership website.

‘It’s a constant changing environment, and we’re just playing catch up’: Hospital food services, food waste, and COVID-19 (2022 Jun)

(available for download at the bottom)

Cook N, Goodwin D,Collins J, Porter J.‘It’s a constant changingenvironment, and we’re just playing catch up’:Hospital food services, food waste, and COVID-19.Nutrition & Dietetics. 2022;1‐10. doi:10.1111/1747-0080.12762

Open access link to article: 

https://onlinelibrary.wiley.com/doi/epdf/10.1111/1747-0080.12762

Relevant to: 

Foodservice dietitians

Question: 

The research wanted to understand the impacts of COVID-19 on hospital foodservice practices. Specifically, how COVID-19 impacted the completion of food waste audits and the generation of food waste in hospital foodservice.

Bottom line for nutrition practice: 

  • Foodservice staff are a resilient workforce group
  • Forced changes in resource allocation and usage allowed foodservices to adapt and learn to work with COVID-19 restrictions, potentially beginning the path to post-pandemic services.
  • This stage of the ‘green recovery’ can be led by dietitians and may incorporate food waste audits as a higher priority.
  • The success of electronic menu management tools during this period to combat contact restrictions may see them remain as ‘standard procedure’ for food waste data collection and be selected for uptake in additional hospitals who do not have this technology currently.

Abstract: 

  • Aims: Hospital food service operations have been affected by the COVID-19pandemic, particularly resulting in increased waste. The aim of this research was to explore the impact of the COVID-19 pandemic on hospital food ser-vices, particularly on food waste and the completion of food waste audits.
  • Methods: A qualitative interview research design was used. Semi-structured interviews were completed and recorded via Zoom, focusing on the barriers and enablers towards the completion of hospital food waste audits. Twenty-one participants were interviewed from 12 hospitals. No questions were related o the COVID-19 pandemic and its impact on hospital food services, however this issue frequently emerged during interviews. Data were coded following inductive thematic analysis.
  • Results: Five themes were generated from the interviews related to COVID-19and hospital food services; impacts on practice, labour, change, technology and post-pandemic expectations. Participants reported COVID-19 negatively affected food service operations. Changes included increased food waste, con-tact restrictions, and labour shortages. Nonetheless, hospitals embraced the challenge and created new positions, trialled different food waste data collection methods, and utilised technology to support food service operations around COVID-19 restrictions.
  • Conclusions: Despite the impact COVID-19 had on hospital food services, including their ability to audit food waste and increased food waste generation, the response from food services has demonstrated their adaptability to change. Sustainable healthcare, including the aggregate measuring and reduction of food waste in hospital food services, is an essential transition post-pandemic, and may be facilitated through the operational changes forced by COVID-19.

Details of results: 

Five themes were generated from the data after inductive coding was completed: these are below in dot point format with some of the dominant responses presented.

  1. Impacts on practice
    • Infection prevention led to increased pre-packaged single serve food, utensils, crockery and their waste
    • The re-use, storage, or donation of used items was prohibited
    • Waste disposed of in patient rooms
    • Forecasting was impacted by COVID peaks
  2. Change
    • Some changes occurred immediately, others took time
    • Reduction in hospital catering services
    • COVID-19 as an excuse to trialing new practice
    • Ingredients inaccessible and out of stock
  3. Technology
    • Room service was recommended to forecast meal numbers and support food service delivery
    • Electronic menu management systems with waste measurement capabilities were supportive in plate waste data collection but not available at all sites due to cost, equipment, and manual data collection still being part of standard practice
  4. Labour
    • Higher than usual sick leave
    • Failure to hire new staff (>300 interviews completed at one site)
    • Individuals forced to step in to new and unfamiliar roles (e.g. manager to chef)
    • Cumulative pressure on staff throughout COVID including vaccine mandate in Victoria which resulted in loss of staff
    • Nutrition students unavailable to hospitals for placement
  5. Post Pandemic expectations
    • Hope for practice to return to normal as soon as possible or when the pandemic is ‘over’
    • Planning for future emergencies already to counteract drastic changes in service and practice

Of additional interest: 

Editor’s comment:  

@nathan_cook includes the audit tool with descriptions for you available at this link in the side bar.

Conflict of interest/ Funding:  

One author of the research is an editor at the journal, however the journal undergoes a blinded peer review process. Funding was received by Nathan Cook in the form of a scholarship from the King and Amy O’Malley Trust Scholarship and the Department of Nutrition, Dietetics and Food at Monash University as part of his PhD.

External relevant links:  

A blog describing the research article – http://monashnutrition.blogspot.com/2022/09/hospitals-covid-food-waste-dilemma.html

Corresponding author: 

Nathan Cook, @nathan_cook, PhD candidate, nathan.cook@monash.edu

Delivering community benefit: Healthy food playbook (tool)

The “Delivering community benefit: Healthy food playbook” is a suite of resources to support hospital community benefit professionals and community partners in developing community health interventions that promote healthy food access and healthier food environments.

If a facility has identified obesity, food access, or diet-related health conditions among the priority health needs in its community health needs assessment (CHNA), then initiatives to promote healthy food access and increased consumption of fruits and vegetables can be important components of an implementation strategy to address these needs.

The playbook has several sections with resources to support different stages of the community benefit or community health planning process. Each resource provides examples and links to learn more. These resources will inspire and strengthen your efforts to promote healthy and vibrant communities with healthy, sustainable, and equitable community food systems.

Inspired by a commitment to respond to community health needs, Health Care Without Harm’s Healthy Food in Health Care program carried out a national research project to support hospital community benefit professionals and community partners in developing initiatives that promote healthy food access and healthier food environments. The project was supported by a grant from the Robert Wood Johnson Foundation

Healthy Food in Health Care Pledge (Tool)

You can encourage your Health Care institution to sign the Healthy Food in Health Care Pledge below, which is a framework by Health Care Without Harm US & Canada that outlines steps to improve the health of patients, communities, and the environment.

In addition to encouraging your Health Care systems to sign, implement, and report on this pledge, you could adapt this pledge to other situations – schools, churches, or other groups or institutions you are working with to signal to the marketplace about their interest in local, nutritious, sustainable food. Share back with us if you do this, and we will encourage others to sign!

The pledge

As a responsible provider of health care services, we are committed to the health of our patients, our staff and the local and global community. We are aware that food production and distribution methods can have adverse impacts on public environmental health. As a result, we recognize that for the consumers who eat it, the workers who produce it and the ecosystems that sustain us, healthy food must be defined not only by nutritional quality, but equally by a food system that is economically viable, environmentally sustainable, and supportive of human dignity and justice. We are committed to the goal of providing local, nutritious and sustainable food. This Healthy Food in Health Care Pledge is a framework that outlines steps to be taken by the health care industry to improve the health of patients, communities and the environment.

Specifically, we are committed to the following healthy food in health care measures for our institution.

We pledge to:

  • Work with local farmers, community-based organizations and food suppliers to increase the availability of locally-sourced food.
  • Encourage our vendors and/or food-management companies to supply us with food that is, among other attributes, produced without synthetic pesticides and hormones or antibiotics given to animals in the absence of diagnosed disease and which supports farmer health and welfare, and ecologically protective and restorative agriculture.
  • Increase our offering of fruit and vegetables, nutritionally-dense and minimally processed, unrefined foods and reduce unhealthy (trans and saturated) fats and sweetened foods.
  • Implement a stepwise program to identify and adopt sustainable food procurement. Begin where fewer barriers exist and immediate steps can be taken. For example, the adoption of rBGH free milk, fair trade coffee, or the introduction of organic fresh produce in the cafeteria.
  • Communicate to our Group Purchasing Organizations our interest in foods that are identified as local and/or third-party certified.
  • Educate and communicate within our system and to our patients and community about our nutritious, socially just and ecological sustainable food healthy food practices and procedures.
  • Minimize or beneficially reuse food waste and support the use of food packaging and products which are ecologically protective.
  • Develop a program to promote and source from producers and processors which uphold the dignity of family, farmers, workers and their communities and support sustainable and humane agriculture systems.
  • Report annually on the implementation of this pledge. 

StratKIT Platform – Sustainable public procurement and catering network & Sustainable Public Meal Toolkit (website)

StratKIT Platform sustainable public procurement and catering network offers open knowledge resources on sustainable public procurement and catering services. The details are in the StratKIT report.

The Sustainable Public Meal Toolkit provides experience-based advice on how to set up innovative strategies and activities for sustainable public procurement and catering services. The toolkit was developed in the Baltic Sea Region countries but can be used in many more places due to the generic descriptions in the tools. Start the change in your municipality, your company, your school, your hospital, or elsewhere! The tools, collected during the Interreg-BSR project StratKIT, range from strategic approaches to concrete activities in public catering facilities.

More than fifty tools are available for stakeholders involved in the provision of public meals, whether they be policymakers, procurers, caterers, producers, suppliers, consumers, or other public and private bodies. While all tools originated from BSR countries, some have been developed and piloted within the StratKIT project. Each tool is presented as a step-by-step procedure. To find tools suitable for your situation, you can either browse them all or find collections of tools for different topics in the thematic gateways. Add the most suitable tools to your own collection to download and print.

NDA Sustainability Grants

12 Nutrition/Dietetic Associations (NDAs) were awarded Sustainable Food Systems (SFS) Toolkit grants from 2022-24. See below for their progress/results.

Overall the grants aim to:
➛ Increase diversity of perspectives, languages, and cultures in the ICDA SFS Toolkit
➛ Spread sustainability (see SFS Learning Modules)
➛ Maximise participation and learning among your NDA members
➛ Produce new tools and/or learning from the ICDA SFS Toolkit
➛ Increase sharing of solutions and practical implementation for a wide variety of Dietitian-Nutritionists

The grants are now closed, but these are the criteria and application forms that were filled. They were also available in Korean and Spanish.

2024 March – 5 grants

🇦🇺 Dietitians Australia (DA)

DA is developing Information, Education and Communication Materials for Dietitians for the Pathway to Planetary Health, which was developed with six guiding principles (see the photo) and consideration of First Nations allyship and leadership in pro-environmental change. 

They aim to empower dietitians and dietetic students to undertake pro-environmental change in their personal and professional lives and foster positive behaviour change through evidence-based education, information, and communication strategies. 

The outputs will be produced and embedded within the existing PlanEATary Quest and Toolkit and include a user-friendly, professional PowerPoint slide deck and a 30-minute recorded webinar, with accompanying materials; an online participatory webinar or face-to-face workshop; and a case-study summary submitted to the Focus on Health Professional Education Journal.


🇭🇺 Hungarian Dietetic Association

They are working on supporting Hungarian dietitians in using the ICDA-SFS Toolkit. This project will raise the awareness of the Hungarian dietitians towards including the aspect of sustainability in their practice, regardless of the working fields. The Hungarian Dietetic Association has 712 members but can potentially reach 2,100 colleagues with the newsletter, and there are 32,000 followers in their social media accounts.

English is a serious barrier for more than two-thirds of the dietitians, therefore, they will translate and adapt tools. They will provide these tools and education opportunities to academic colleagues, as well as to those working in the clinical field, food service, or public health. 

The outputs of the project are underway, and the first one is already achieved:
1) Printable Glossary for Hungarian dietitians (click the link for “2025.02 glossaryready hivatkozva”)

The other 2 are still underway:
2) Three printable infographics for Hungarian dietitians
3) Translated and adapted materials for Hungarian dietitians

As materials are released, social media posts about the #ICDAsfsToolkit and adapted materials will be circulated. When all materials are complete, a workshop will be held about the ICDA SFS Toolkit, and the adapted materials will be used during the Annual Congress of the Hungarian Dietetic Association.


🇮🇹 The Scientific Association for Food, Nutrition, and Dietetics (ASAND)

The Foodservice Study Group is conducting Technical Tests of Counseling in School Foodservice. The project aims to research and adopt sustainable policies in school canteens with a network of Italian municipalities. The program is progressing positively, with the confirmed participation of 11 municipalities in 3 Provinces.

There are three objectives in this project:
1 – Development of a climate-friendly menu based on the seasonality of food products, through the adoption of local recipes with lower carbon ingredients to reduce the overall carbon footprints.
2 – Nutritional counselling to spread knowledge of the importance of sustainable nutrition among users, parents, and teachers, increasing awareness of food sustainability and the skills necessary to make autonomous choices regarding environmentally friendly food (empowerment).
3 – Proposing a sustainable school food service model to ASAND members and other ICDA NDA members.

The work done so far mainly focuses on three key areas of the project:
1 – planning activities in co-design with users,
2 – implementing experimental initiatives, and
3 – interacting with the involved municipalities.

Following the initial meetings and online discussions, we have decided to organize and start the following “challenges”:

1 – Climate-Friendly Menus: research and introduction of local and sustainable recipes to be included in the school menu. The experimentation phase continues with the monitoring of student satisfaction and further evaluations.

2 – Educational Workshops: the activation of a nutritional education path through practical workshops on healthy eating. The content is tailored to the specific needs of each school, with active student involvement and consistent support from the school staff.

3 – Food Waste Recording System: implementation of a system to monitor meal consumption by creating a standardized model to reduce food waste in school canteen.

4 – Counselling Service: activation of a Dietitian’s Help Desk for parents, teachers, and all interested citizens. The response has been positive so far, with growing interest and an increase in requests for information.


🇹🇹 Trinidad and Tobago Association of Nutritionists and Dietitians

They are developing an introduction to Sustainability for Nutrition Professionals to increase knowledge and awareness of sustainable food systems and sustainability in practice for nutritionists and dietitians in Trinidad and Tobago through workshops based on the Sustainability in Nutrition learning modules.

They will encourage networking and exchange of information with regional and international nutrition and dietetic practitioners in the area of sustainability by engaging three guest lecturers to present at workshops.

The outputs of the project will be a series of workshops (three workshops, one per module) that introduce the topic to local NDA members/external nutritionists and dietitians using the Learning Modules material from the ICDA Sustainability in Nutrition website along with a resource package of workshop materials


🇨🇭Schweizerischer Verband der Ernährungsberater/innen, ‘SVDE’

SVDE is co-creating a position paper “Sustainable food systems and the role of dieticians in Switzerland”. The position paper directs the professional development of Swiss dietitians in terms of sustainable diets from SFS. This requires an evidence- and value-based vision and concrete, action-based measures on three levels:

  1. positioning Dietitian’s existing professional skills in SFS; opening up new fields of activity and development opportunities for dietitians
  2. defining sustainable nutrition and nutritional advice in SFS in the curricula of dietitians; strengthening training and further education on SFS
  3. positioning dietitians as an important professional voice in political discussions and decisions on SFS

The position paper is an instrument that serves to communicate ‘internally’ so that dietitians can use it as a guide. Furthermore, it empowers dietitians to position themselves ‘externally’ towards other actors in the field of the food system in terms of strategy, expertise and politics.

The outputs of the project will be:

  1. Consultation-workshop of the paper with dietitians at Switzerland’s NDA ‘SVDE’ annual meeting in spring 2025
  2. Publication of the reviewed paper in the SFS Toolkit in the summer of 2025
  3. Announcement of the paper as an online document for members of Switzerland’s NDA ‘SVDE’
  4. Distribution to Swiss dietitians in June 2025

2023 January – 3 Grants

🇳🇬 The Dietitians Association of Nigeria (DAN) 

DAN promoting Sustainable Nutrition.

DAN is increasing the knowledge of local dietitian-nutritionists about indigenous foods to promote consumption as part of a sustainable diet. The study was carried out in the six geo-political zones North Central, North East, North West, North South, South East South West and South South of Nigeria. The study highlights the available and diverse indigenous foods across the zones including fruits and leafy vegetables, cereals/grains, roots and tubers, and spices. It enumerates the importance of indigenous foods as well as current threats to local food systems and makes recommendations on how to preserve our food heritage. 

It was deduced that despite the differences in the types and varieties of indigenous foods found in different localities or cultures in Nigeria, only 8.4% of six hundred and five respondents had a high consumption of indigenous foods, 4.3% moderate, and 87.3% had low consumption of indigenous foods.

The benefits of producing and consuming indigenous foods have been shown in this work. Some of these local foods, however, are getting eroded due to various challenges. Consequently, the Dietitian-Nutritionists in Nigeria through this work are called to action to ensure that indigenous foods are consumed, as well as to achieve a sustainable, equitable food system for Nigerians. 

This link is for a 1-page flyer summarizing the study on Indigenous Foods in Nigeria.


Zeroing on Household Food Waste Infographic -Afrikaans and English

🇿🇦 Asssociation for Dietetics in South Africa (ADSA)

South Africa generates approximately 10 million tonnes of food waste throughout the supply chain each year. The project aimed to increase the knowledge and awareness of local nutritionists and dietitians on household and institutional food waste to promote literacy on food waste among consumers and institutional managers.

The Sustainable Development Goal 12.3 target is that by 2030 we should halve per capita global food waste at the retail and consumer levels and reduce food losses along production and supply chains, including post-harvest losses.

A symposium was held at the 2023 Nutrition Congress which 48 Nutritionists and Dietitians attended. Each received a multi-lingual food waste awareness infographic created by the project, which was also shared at a conference exhibition stand.

Dietitians and nutritionists can use the infographic with consumers to improve food literacy on household food waste that documents household food waste breakdown (amount, types of foods, cost and environmental impact) and how to reduce household food waste through cook smart tips, zero waste recipes, upcycling etc.

Participants were encouraged to complete the ICDA SFS online modules through a PowerPoint explaining how to navigate the toolkit.

The presenters also developed other tools, including plantable coasters with zero-food waste messages and a Compleating” (complete eating) zero-waste recipe book for consumers. These resources are shared here to further promote sustainable zero-waste food practices.


🇱🇰 Dietitians’ Association of Sri Lanka (DiASL)

DiASL reduced food waste and associated food costs in selected hospitals by 33% within 12 months through the development and introduction of a “Minimum food waste tool kit.”

Sri Lanka’s private hospitals are taking significant strides toward sustainability by introducing the Minimum Food Waste Toolkit, an innovative initiative designed to reduce food waste while improving patient satisfaction and nutrition. Spearheaded by the Dietitians Association of Sri Lanka and funded by ICDA-SFS, this initiative addresses the pressing issue of food waste, which constitutes 10-15% of hospital solid waste, contributing to environmental degradation and economic inefficiencies.

This is a summary of the full report. The full report will be shared shortly.

Key Features of the Toolkit:  The toolkit implements a patient-centered and sustainable food service approach by integrating nutritional science, operational efficiency, and real-time waste tracking. It focuses on key areas such as staff training, patient engagement, and individualized nutrition plans.

  1. Staff Training: A comprehensive training program equipped food and beverage staff with skills in disease-specific diets, natural flavor enhancement, and standardized portion control. Ward coordinators and nursing staff were educated on effective communication and supporting patients’ nutritional needs, and chefs and kitchen helpers were guided in preparing visually appealing, disease-specific meals in correct portion sizes to suit patient requirements.
  2. Raising awareness:  A short video was displayed in the patient waiting area on the impact of edible food waste and the importance of sustainability.  Watch the video here.
  3. Screening and Monitoring Tools: The toolkit incorporated a validated Visual Analog Scale (VAS) appetite screening tool, aligned with the Functional Assessment of Cancer Therapy (FACT), to identify patients with reduced appetite. Combined with malnutrition screening, these tools facilitated the development of tailored dietary plans to address individual nutritional needs effectively. 
  4. Customized Nutrition Plans: Personalized meal plans were designed based on patient preferences, medical conditions, and appetite levels. The flexibility of portion sizes and meal options, along with adjustments in texture and flavor helped improve patient satisfaction and compliance with their dietary regimens.
  5. Real-Time Food Waste Monitoring: The toolkit used digital imaging and the modified Comstock method for accurate visual assessment of leftover food, providing insights into waste patterns. Weekly tracking of garbage bin usage further helped measure the impact of the toolkit, highlighting significant reductions in food waste.

Notable Outcomes

  • Waste Reduction: Implementation of the toolkit reduced the number of food waste bags used in a 100-bed hospital by 33%, from 60 to 40 bags weekly.
  • Improved Patient Compliance: Approximately 70% of patients with reduced appetite completed their meals, significantly decreasing waste.
  • Operational Efficiency: Enhanced meal preparation and delivery processes led to better alignment with patient needs and reduced waste.

Challenges and Future Directions: Despite the toolkit’s success, challenges persist, such as limited dietitian resources as personalized care requires significant time and effort. Proposed solutions include integrating AI-driven meal planning tools and increasing the dietitian workforce. Accurate waste segregation remains another hurdle, with issues stemming from non-edible waste and external food contributions, necessitating improved segregation systems and patient education. Future efforts will focus on adopting advanced technologies, expanding staff capacity, and refining food service systems to enable broader implementation across hospitals in Sri Lanka.

Conclusion: The Minimum Food Waste Toolkit sets a benchmark for sustainable healthcare practices, aligning with global efforts to minimize waste and enhance operational efficiency. By addressing environmental and nutritional concerns, this initiative demonstrates how Sri Lanka’s healthcare sector can lead by example, inspiring similar reforms across the country and beyond.

Submitted by Ms. F.A.Z. Firouse, President of the Dietitians’ Association of Sri Lanka. Contact: FirouseAmal@gmail.com

2022 September – 4 Grants

🇦🇺 Dietitians Australia (DA)

DA created PlanEATary Quest to promote planetary health, one bite at a time. The PlanEATary Quest encourages dietitians to choose their own adventure to modify your own diet-related practices in line with current evidence regarding planetary health outcomes. 

Visit the PlanEATary Quest Google site to take your own quest in 4 easy steps:

Step 1: Complete the quiz – Complete a 12-question PlanEATary Quiz to see where you’re kicking goals, and where you can improve.

Step 2: Design your Challenge – Select from over 100 tasks to design a challenge that will help you improve your score. We suggest choosing 3 – 10 tasks, focusing on the questions where you scored the lowest on the Quiz.

Step 3: Complete your Challenge – Time to get your hands dirty! Spend 2-3 weeks completing your chosen tasks. As you go, you may like to reflect on what helps or hinders your quest for planetary health.

Step 4: Repeat the Quiz – Repeat the PlanEATary Quiz to see whether you’ve improved your score, and are interacting with our food system in a more sustainable way.

This grant was managed by Dr Liza Barbour and Sandy Murray, both active members of Dietitians Australia’s Food and Environment Interest Group. They established a working group of 7 members and met monthly for the first 8 months of this project, during which time we reviewed the existing materials (the ‘Eco-Friendly Food Challenge) and based on our expertise in the field, developed an updated, evidence-based version.

The PlanEATary Quest was piloted with a group of practising dietitians and health promotion practitioners (n = 47) from Sept – Nov with a group of 5 Masters of Dietetics during their 8-week public health placement. They recruited PlanEATary Quest participants, monitored their level of engagement throughout the intervention, and followed up with a series of interviews and focus groups (n = 14). See the infographic of key findings from this pilot.

While their placement focused on more ‘process evaluation’ they will also be analysing and writing up further results for publication in 2024. A pilot with nutrition and dietetic students is planned for February – June 2024.


🇩🇪 German Association of Dietitians (VDD)

Germany increased awareness for German-speaking dietitians in Germany, Austria, and Switzerland towards sustainable achievements in the field of nutrition and dietetics and how to present these within the ICDA SFS-Toolkit. (2022 Sept – 2023 Aug)

Manuela Thul led the project and produced several products in a participatory manner, and spread them via the toolkit and local structures such as Webinars, Social media, NDA congress, and reaching out to schools and universities.

Manuela promoted the grant and the #ICDAsfsToolkit on the Junior_Dietitian Instagram, on the digital chat at the 64th NDA congress 13.-14.05.2022, and in an article in the NDA Newsletter, and the Annual Business Report 2022 of the German Association of Dietitians. These are great ways to help your NDA to know the #ICDAsfsToolkit and the resources it contains.

Another result of this promotion is the #ICDAsfsToolkit Advisor for Germany, Elina Zwickert who was also highlighted in the March issue of GROW — we hope you are subscribed!


🇬🇷 Hellenic Association of Dietitians Nutritionists

Greece improved and spread the “Straight from Nature” YouTube Channel which teaches about foods as they comprehensively come from nature, aiming to support food sustainability.

Despina Varaklas created a YouTube channel by the name of Straight from Nature. The purpose of the channel is to create videos that talk about food products. Every video talks about a different product, e.g. olive oil, garlic, onions, cinnamon, etc. As dietitians, we learn about foods, nutritional values, etc… but often we don’t know enough details about each one, keeping our clients and patients short of valuable knowledge they can make for the benefit of their health. Using this channel, dietitians can learn about each product of nature, where it comes from, its health benefits, and how they can be easily incorporated into the diet.

The grant helped promote the channel through Social media, the dietetic association, webinars, interviews, workshops, and conferences and was able to assist in the tools needed to make the videos a reality. The subscribers and watch hours of the channel have increased, but mainly the feedback is joyfully positive.

Dietitians, and other health professionals, are advised to listen to these videos and make use of the content. Sharing the videos is a way of you contributing to the project as well.

You can also subscribe to a private Facebook group “Living Healthy: Learning how to balance Food, Thoughts, and Emotions” where safe conversations can take place with discussions and comments.


🇪🇸 Consejo General de Colegios Oficiales de Dietistas-Nutricionistas (El CGCODN)

Spain worked on a project titled “Transitioning to sustainable diets: a tool to identify people’s barriers and motivators for following a sustainable diet”.

Júlia Muñoz-Martínez led the development and validation of a questionnaire to identify the motivators and barriers to following a sustainable diet among Spanish citizens sensitive to socioeconomic differences.

The tool is called the SALSA questionnaire (Sustainability and Healthy Diets, as its acronym in Spanish) and intends to provide the means for dietitians, and other stakeholders involved in public health, for the development of interventions aiming to equitably promote healthy and sustainable diets.

The process was to identify all the barriers and facilitators for following a sustainable diet among different socioeconomic groups in Barcelona to develop a first draft of SALSA. This was administered to 9 Spanish experts in the fields of sustainability, nutrition (including a member from the Spanish NDA), psychology, and sociology to validate the content. By 2023 March, the survey pre-test was done with citizens from the city of Barcelona and its urban surroundings through 3 focus group discussions and 5 individual interviews.

Between April and June, they administered the online survey to a sample of more than 700 citizens across Spain.  They then conducted data cleaning and psychometric analysis (item reduction, extraction of factors, test of dimensionality, test of reliability, and test of validity).  Exploratory Factor Analysis revealed four final dimensions of the SALSA questionnaire, which corresponded to personal factors, external factors, sociocultural factors, and consumption of animal and plant-based protein. These dimensions were validated through Confirmatory Factor Analysis. 

The final SALSA questionnaire investigates the barriers and facilitators for people to adhere to a sustainable and healthy diet through a set of 27 questions, grouped into four dimensions (listed above). Respondents are asked to rate their level of agreement on a scale from 1 to 5, with 1 indicating ‘completely disagree’ and 5 indicating ‘completely agree.’ This tool is a step forward towards the promotion of SHD as it can be applied in multiple scenarios. It could be used in the planning and assessment of interventions with such aim, as well as by dietitians in one-to-one consultations at the individual level.


This Toolkit is made to be used & shared - feel free!
Please cite the authors of the resources (and the ICDA SFS Toolkit if you can).


Feedback? Questions? Ideas? Contact the ICDA SFS Coordinator:
ICDAsfs.coordinator@acadiau.ca