1. Calorie Posting in Letterkenny General Hospital Pilot Study

2. Background  Research indicates that Calorie Posting can bring modest behaviour changes.  HSE Policy  National Expert Group  2 Calorie Posting Pilot Sites

3.  Support from hospital management  Established a working group  Identified a project Manager  Identified a project Lead

4. Calorie Posting Group at LGH  Peter Byrne (Facilities Manager)  Marie Mc Kervey (Deputy Catering Manager)  Rita Mc Elhinney (Production Manager)  Christine Wallace (Dining Room Supervisor)  Sharon Patton (Dietitian) Two Nutritional students joined the LGH Calorie Posting Implementation Team to support role out of pilot.  Gillian O Brien (Bsc Health Science & Nutrition, 4 th year student at AIT)  Holly Courtney (Bsc Health Science & Nutrition, 4 th year student at AIT)

5. Objective of the Working Group The working group was established to provide guidance and support to the implementation of Calorie Posting within LGH.

6. Function of Working Group  Set timeframes and goals.  Presentation given to all catering staff on calorie posting.  Built awareness of calorie posting.  Allowed sufficient resources.  Trained staff and encouraged staff buy in.  Communication with visitors.

7. Calorie Posting  Dietitian Manager trained AIT students on menucal.  Production Manager provided recipes.  Suppliers contacted to source information on calories. A good response from suppliers.  Students assessed recipes and ingredients and input data.  Recipes checked for yield, portion size and calorie value of each portion.

8. Monitor Progress & Outcomes  Monitored purchasing trends both before and during the pilot.  Till adjusted to reflect what people were purchasing.  Volume of sales pre calorie posting.  Volume of sales post calorie posting.  Survey with visitors and staff to ask feed back on pilot.

9. Staff Awareness  Staff received training on standardising portions and using correct utensils for correct portion.  Calorie information displayed clearly, per portion or meal, at the ‘point of choice’ for the customer.  Recommended daily calories for men, women and children displayed in the restaurant.

10. Our Role in the Calorie Posting Pilot  Carried out an Evaluation of the Breakfast Calorie Posting Pilot.  Our objective: To observe the effect of calorie posting on consumer behaviour.  Focused on Mondays (Beginning of the week) and Fridays (Busiest day in the dining room).  Became members of Hospital Implementation Team.

11. Method of Evaluation  Analysed daily till receipts.  Collected data for each breakfast food item purchased. i.e. Amount of sausages sold  Produced individual reports for each food group showing their trends from pre-calorie posting to post-calorie posting.  October’s receipts represented the baseline turnover.

12. Graph 1 Low Fat Yoghurts

13. Graph 2 Cheese slice

14. Graph 3 Bacon

15. High Level Outcomes  The calorie posting of the breakfast foods had only shown a change on consumer purchasing for the first week of calorie posting.  The longer term behavioural change becomes more diluted as the pilot moves from its implementation date.  Fridays primarily showed the most changes in particular the cooked breakfast foods.  Seasonal and holiday periods affected the sales of breakfast foods. The decrease in food sales was not as a result of the calorie posting but rather a decrease in the volume of customers in the dining room.

16. Recommendations For Next Phase Lunch & Tea Calorie Posting  Extend the baseline audit from one month to three months.  Standardised data collection; individualise each food item on till for data collection consistency.  Attempt to record the number of people entering the dining room.  Choose appropriate time of year that avoids long holiday periods.