Calorie Posting for Catering Staff Health Service Executive

Background FSAI (2012) What people need to know about calories Strategic focus-HI FSAI (2012) What people need to know about calories on menus in Ireland

Healthy Ireland Framework 2013– 2025 A Framework for improved health and wellbeing 2013 - 2025

Healthy Ireland

Framework for Improved Health & Wellbeing Healthy Ireland (Hi) 2013-2025 Vision Where everyone can enjoy physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility.

Government Plan = Healthy Ireland (Hi) 2013-2025 ‘Everyone can play their part in achieving a healthy Ireland’ Provide the information to help others make the healthy choice The government has a new plan called Healthy Ireland (Hi) 2013-2025. Hi says that we should ‘Create an environment where every sector of society can play their part in achieving a healthy Ireland’. Everyone has a role and ours is to provide healthy options and the information for everyone to make the healthy choice. 6 6 6 6 6

Healthy Ireland in The Health Service-National Implementation Plan 2015-2017 The HSE has published ‘Healthy Ireland in the Health Services’ – an implementation plan for the Healthy Ireland Framework specifically focuses on the HSE, our workforce, our services and the people we care for.  ‘Healthy Ireland in the Health Services’ has identified three clear strategic priorities for action, because in one way or another, every part of the health service is engaged in improving health and wellbeing. The plan outlines a sector-wide focus on System Reform - ensuring that we deliver the significant reforms which are underway to support a better health system Reducing Chronic Disease - the biggest risk to our population’s health and our services Staff Health and Wellbeing  - ensuring we have a resilient and healthy workforce 7

HI in the Health Services – National Implementation Priorities 2015 Calorie Posting National Physical Activity Plan + Obesity Policy Major Public Health Bills (Alcohol, Standardised Packaging and Licensing of Sale of Tobacco) Enactment of Bill for Healthy Workplace

Calorie Posting in the Health Services Catering, facilities & Dietetics Who Providing calorie counts on food and drinks What HSE Staff, and Visitors For Help everyone make healthier choices Why We all know how important food is to our health. In our role within the HSE, in either catering or dietetics, we are connected to the food provided for ourselves, the HSE staff and the visitors to our premises as well as to the patients in our care. Our role of providing nourishment is important in helping all these groups of people to stay healthy. 9 9 9 9 9

The purpose of the calorie posting policy is to… Encourage increased uptake of healthy food and beverage options at HSE premises Ensure that the organisation reflects best practice in relation to healthy eating Use calorie posting to promote and provide health education What is the purpose of the HSE Policy on Calorie Posting? 10

Why Calories Count? 2,500= Average number of calorie burned per day by a healthy male with normal levels of activity I think we need to specify the age range of the healthy male here?? Full referencing needed for this too??

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Calories on menus – does it work? Research in US shows that, when calories are on the menu beside the price, people eat: 152 calories less at Hamburger joints with each purchase 73 calories less at sandwich bars with each purchase 6% calories less overall each day If calorie intake is reduced by this much in Ireland, it will have a major effect on our obesity problem. (FSAI 2012) Full reference in referencing list?? This could be split into 2 text boxes maybe?

Foods Eaten Away from Home Account for about 25% + of daily calories Research shows we underestimate calories Sometimes no healthy options available The food we eat while we are away from home can make up ?? more than 25% of our daily food eaten. We tend to underestimate the calories in food eaten away from home so it is important that we are able to access healthy foods while we are out and about. For many HSE workers much of the time spent away from home will be at work. That makes it important that our colleagues and ourselves have low-calorie healthy food choices to eat while they are at work. In addition, visitors to the HSE need to have healthy choices when using the food outlets in our service. Putting calories on our menus allows co-workers, visitors, and ourselves to make that healthy choice when using our food outlets. 14

The calorie posting policy says that… Calorie information should be displayed a) On all food and drink items sold b) Based on a standard portion c) At ‘point of choice’ d) Per portion or per meal With daily needs per person so the information makes sense

High Calorie Foods Lower Calorie Foods Mainly with fat and sugar and of little nutritional value Often highly processed & high in salt High Calorie Foods More vitamins, minerals and fibre More natural state and more variety All food groups included Lower Calorie Foods Energy or calories do not tell us about the nutrition contained in our food. However, high calorie foods tend to have lots of sugar and/or fat in them, neither of which gives us a lot of nutrition. So it is best to choose lower calorie foods with lots of nutrition as our main calorie intake for the day. 16

The Policy includes… Instructions for providers of food, snacks and drinks to staff, visitors and patients(not in-patients) Outlines where and how to post calories, how to tell people about it and how to make sure the system works

Other Reasons to Calorie Post Happy Heart at Work Award HIQA Audits Calorie posting will now also be part of the Happy Heart at Work Award : To achieve the Silver award you will need to have calorie posting for lunchtime meals To achieve the Gold award you will need to be have calorie posting for all meals. In the coming months audits on nutrition and hydration will become mandatory for HIQA Will need to have all patient meals and snacks analysed for nutritional content 18

What about inpatient meals? Calorie posting not required for inpatient meals Specialised Menus needed for very sick inpatients Liaise with the hospital dietitian Calorie posting is not required for inpatient meals Inpatients who are acutely unwell need specialised menus that this policy doesn’t apply to Please liaise with your hospital dietitian is there are any changes that impact on inpatient menus 19

HSE -Calorie Posting Policy The policy states that for calorie posting to work these steps must be followed in all HSE facilities In place for all food and drink items on sale Shown clearly at ’point of choice’ for the customer Shown per standard portion or per meal Available on the daily needs for an average person to help the customer to understand Calorie information must be I don’t think the last sentence re the ‘daily needs’ flows very well…any suggestions

‘Point of Choice’ Calorie Posting At ‘Point of Choice’ calorie informati on must be clearly presente d and beside the price. If there is more than one ‘Point of Choice’, calories must be posted at each point. Typical ‘Point of Choice’ locations include: Printed menus Menu boards Chalk boards Shelf edging Counter display tags Table centres Flyer-style menus

Implementation of Calorie Posting Gain buy in/ support/commitment from hospital management and set up a Working Group Build awareness of calorie posting - Inform all stakeholders at the start including staff, service users, and visitors of plan and the date calorie posting starts Allow sufficient resources/time Train staff & encourage staff buy-in Again, Fiona maybe 2 boxes??

Implementation of Calorie Posting Set up software package for inputting recipes, standardising recipes & source calorie information Standardise portions Monitor progress & outcomes before during and after Maintain the implementation of the policy Again maybe split into a couple of text boxes?

References Food Safety Authority of Ireland (2012) What people need to know about calories on menus in Ireland. http://www.fsai.ie/WorkArea/DownloadAsset.aspx?id=11419 DOH (2013) Healthy Ireland Framework for improved health and wellbeing 2013 – 2025 http://health.gov.ie/blog/publications/healthy-ireland-a-framework-for-improved-health-and-wellbeing-2013-2025/ FSAI (2013) Menucal Calorie Calculator http://www.fsai.ie/food_businesses/menucal.html Food Safety Authority of Ireland (2012) Calories on Menus in Ireland – a Report on a National Consultation June 2012 http://www.fsai.ie/WorkArea/DownloadAsset.aspx?id=11419

References cont Irish Universities Nutrition Alliance (IUNA) (2011) National Adult Nutrition Survey-Summary Report http://www.ucd.ie/t4cms/IUNA%20summaryreport_final.pdf TILDA (2014) Obesity in an Ageing Society http://tilda.tcd.ie/assets/pdf/Obesity_in_an_Ageing_Society_Report.pdf Heinen, M., et al. (2014) The Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland: Findings from 2008, 2010 and 2012 [Online]. Available from: http://www.thehealthwell.info/node/746606   Growing Up in Ireland (GUI) Infant Cohort At 3 years Dec.2011 www.growingup.ie Growing Up in Ireland (GUI) Cohort study at 9 years (2008) www.growingup.ie

Compiled by…. Christine Gurnett, Senior Health Promotion Dietitian Fiona Finneran, Hospital Dietitian Gwen Rice, Senior Community Dietitian Laura Molloy, National Health Promoting Health Services Coordinator