The issue of food waste has garnered much attention globally due to its adverse impacts on the economy, food security, natural resources, the environment, and human health. Despite this, the academic literature lacks systematic, historical, and synthesising investigations on healthcare food waste. This bibliometrics analysis study aims to summarise the growing trends of food waste publications and highlight common and potential research topics of food waste in healthcare settings. The Scopus database analysed 193 journal articles published between 1952 and 2022. We identified several common and potential research topics for future research in the area, including food waste and malnutrition, related intervention strategies, the impact of healthcare food service systems on food waste, and their economic and environmental impact. Healthcare food waste research in developing nations is still limited. Thus, it is recommended that policymakers support its development as one of the steps to encounter food waste.

BACKGROUND/OBJECTIVES: Dietitians frequently use nutrition education tools to facilitate dietary counselling sessions. Nevertheless, these tools may require adaptation to keep pace with technological advancements. This study had a 2-fold purpose: first, to identify the types of nutrition education tools currently in use, identify their limitations, and explore dietitians’ perspectives on the importance of these tools; second, to investigate the features that dietitians prefer in digital nutrition education tools. SUBJECTS/METHODS: A semi-structured face-to-face interview was conducted among 15 dietitians from selected public hospitals, primary care clinics, and teaching hospitals in Malaysia.Inductive thematic analysis of the responses was conducted using NVivo version 12 software. RESULTS: Most dietitians used physical education tools including the healthy plate model, pamphlets, food models, and flip charts. These tools were perceived as important as they facilitate the nutrition assessment process, deliver nutrition intervention, and are time efficient. However, dietitians described the current educational tools as impersonal, outdated, limited in availability due to financial constraints, unhandy, and difficult to visualise. Alternatively, they strongly favoured digital education tools that provided instant feedback, utilised an automated system, included a local food database, were user-friendly, developed by experts in the field, and seamlessly integrated into the healthcare system. CONCLUSION Presently, although dietitians have a preference for digital educational tools, they heavily rely on physical nutrition education tools due to their availability despite the perception that these tools are outdated, impersonal, and inconvenient. Transitioning to digital dietary education tools could potentially address these issues.

Introduction: This methodological research study aimed to measure content validity and reliability of a newly developed questionnaire of knowledge, attitudes, and self-reported practices towards pureed diet preparation (KAP DYS Puree) among hospital food handlers for dysphagia management. Methods: The study was conducted through face validation, content validation, content reliability and construct validation. A cross-sectional design with convenience sampling was carried out involving 4 panels for face validation, 10 raters for content validity and 161 food handlers participated for Exploratory Factor Analysis (EFA), while 30 food handlers were involved for test-retest reliability. The questionnaire which consisted of 40 items distributed into 3 domains and was assessed and analyzed using modified kappa (k*) for reliability. Results: Content Validity Index revealed the following I-CVI values: knowledge = 0.915, attitudes = 0.922 and self-reported practices = 0.900 and modified kappa values (k*) knowledge = 0.983, attitudes = 0.9214 and self-reported practices = 0.899. The EFA was employed for two dimensions which were self-reported practices and attitudes based on principal axis of factoring with varimax rotation. The factor analysis yielded two factors with a total of 10 items in the attitudes domain and two factors with a total of 9 items in the self-reported practices domain that had satisfactory factor loading (> 0.3). The Kaiser-Meyer-Olkin (KMO) values for attitudes = 0.816 and self-reported practices = 0.776. Bartlett’s test of sphericity was significant at p < 0.0001 for attitudes and self-reported practices indicating the suitability of this data for factor analysis. Interclass Correlation Index (ICC) values for attitudes = 0.739 and self-reported practices = 0.789. Conclusion: This instrument can be used as a need assessment tool in the development of a comprehensive training module for pureed diet preparations in dysphagia management.

Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

BACKGROUND/OBJECTIVES: While plate waste has been widely investigated in hospitals, there have been minimal studies specific to the texture-modified diet (TMD). This study aims to determine the percentage of plate waste among patients prescribed with TMD and its contributory factors. SUBJECTS/METHODS: This was a single-centre study conducted in the university hospital on three types of TMD (blended diet, mixed porridge, minced diet) during lunch and dinner meals. Weighing method and visual estimation method assisted by digital photograph were adopted in this study. Face to face interview was carried out to investigate on 1) the food/ food service quality factors in terms of patients' satisfaction level towards sensorial quality of food and food services provided and 2) the clinical/external factors including appetite, the provision of oral nutrition support, time taking the diet, the need for feeding assistance and the length of hospital stay. RESULTS: The mean percentage of overall plate waste of 95 patients receiving TMD was high (47.5%). Blended diet was identified as the most wasted diet (65%) followed by minced diet (56%) and mixed porridge (35%). Satisfaction level among patients was moderate. Patients on TMD in general had higher satisfaction level on the aspect of food service as compared to food quality. Substantial association between sensorial qualities of food and plate waste were varied according to individual TMD type. A multiple linear regression showed that only the satisfaction level toward the aspects of appearance and variety of foods were the predictors of TMD plate waste (R 2 = 0.254, P < 0.05). CONCLUSIONS A significant relationship between the percentage of plate waste and the overall satisfaction level of patients receiving TMD suggests that vigorous strategies are needed to reduce the food waste of TMD which will lead to a better nutritional status and clinical outcomes among the patients.

BACKGROUND/OBJECTIVES: While plate waste has been widely investigated in hospitals, there have been minimal studies specific to the texture-modified diet (TMD). This study aims to determine the percentage of plate waste among patients prescribed with TMD and its contributory factors. SUBJECTS/METHODS: This was a single-centre study conducted in the university hospital on three types of TMD (blended diet, mixed porridge, minced diet) during lunch and dinner meals. Weighing method and visual estimation method assisted by digital photograph were adopted in this study. Face to face interview was carried out to investigate on 1) the food/ food service quality factors in terms of patients' satisfaction level towards sensorial quality of food and food services provided and 2) the clinical/external factors including appetite, the provision of oral nutrition support, time taking the diet, the need for feeding assistance and the length of hospital stay. RESULTS: The mean percentage of overall plate waste of 95 patients receiving TMD was high (47.5%). Blended diet was identified as the most wasted diet (65%) followed by minced diet (56%) and mixed porridge (35%). Satisfaction level among patients was moderate. Patients on TMD in general had higher satisfaction level on the aspect of food service as compared to food quality. Substantial association between sensorial qualities of food and plate waste were varied according to individual TMD type. A multiple linear regression showed that only the satisfaction level toward the aspects of appearance and variety of foods were the predictors of TMD plate waste (R 2 = 0.254, P < 0.05). CONCLUSIONS A significant relationship between the percentage of plate waste and the overall satisfaction level of patients receiving TMD suggests that vigorous strategies are needed to reduce the food waste of TMD which will lead to a better nutritional status and clinical outcomes among the patients.

Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

Introduction: Pressure ulcers (PUs) are a leading health problem among spinal cord injury(SCI) patients. Therefore, this comprehensive study was aimed at determining the association between potential factors and the occurrence of PUs among SCI adults in community settings. Methods: A cross-sectional study was conducted among adults with SCI aged 18 years and above from five selected locations in Kuala Lumpur, Malaysia. The study was carried out through interviews based on validated questionnaires such as the Dietary History Questionnaire (DHQ), Spinal Nutrition Screening Tool (SNST), Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), Barthel Index for Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). Estimated weight and height were obtained using recumbent formula. The stages of their PUs were assessed based on National Pressure Ulcer Advisory Panel (NPUAP) grading system. Results: A total of 40 subjects participated in the study, 25% of whom were having PUs. Their nutritional inadequacies were identified, whereby 90%, 70% and 85.5% of them were receiving below their daily requirement of energy, carbohydrate and protein, respectively. The fat and sodium intakes of 55% of them were above the Malaysian Recommended Nutrient Intakes(RNI). It was successfully found that physical activity could decrease the risk of PUs(R2=0.654, OR=0.310, p<0.05). Conclusion: Overall, 25% of the subjects had PUs that were associated with physical inactivity. The majority of the subjects did not meet their nutrient requirements. Therefore, there is a need for increased physical activity and improved nutrient intake in order to reduce the risk of pressure ulcers among SCI adults in communities.

Background/Aims: Ulcerative colitis (UC) is a chronic, relapsing and remitting inflammation of the gastrointestinal tract. Little is known about the link between dietary intake, food avoidance, and beliefs among UC patients of different disease severity. Therefore, this study aimed to assess the dietary intake, food avoidance, and beliefs among active and inactive UC patients. Methods: A cross-sectional study was conducted among UC patients from a tertiary medical center in Kuala Lumpur, Malaysia. Demographic, anthropometric, dietary intake, food avoidance and beliefs were assessed. Disease activity of UC patients was evaluated using the Powell Tuck Index. Results: UC patients were recruited (64.1% inactive UC and 35.9% active UC). As compared to inactive UC patients, active UC patients were likely to lose weight (75.0% vs. 0%), possess certain food beliefs (95.7% vs. 39.0%), and frequently practiced dietary avoidance (95.7% vs. 43.9%). The dietary intake among inactive UC patients was higher than active UC patients. However, neither of them met the standard nutrients recommendation for protein, calcium, iron, folate, zinc, vitamin D, vitamin B12, and vitamin E. Conclusions Active UC patients had poorer dietary intake, were more prone to practicing food avoidance and exhibited certain food beliefs as compared to inactive UC patients. Both macro- and micronutrients intakes were inadequate regardless of patient’s disease status. These findings emphasized the importance for patients to be provided with the nutrition-related knowledge as part of strategies to avoid nutritional inadequacies.

Introduction: Lack of healthy food choices at the worksite is associated with unhealthy eating habits and poor diet quality. This study aimed to conduct a two weeks pilot study to assess the diet quality of lunch-meals delivered to worksites. Methods: Using a crossover study design, a total of 50 adults were purposely recruited from among university and hospital staffs in Selangor. Participants were randomised into two groups, whereby in week one, Group A was provided with the study’s “healthy lunch-meals” (RD4U©) for 3 work days/week, while Group B consumed their usual lunch. In week two, the groups switched over with Group B receiving RD4U© lunch-meals for three days. Diet quality of the lunch meals was assessed using the Healthy Eating Index for Malaysian (HEI-M). Participant satisfaction for RD4U© service was determined using SERVQUAL. Results: Mean protein consumption was significantly higher (27±4 g/day) while fat consumption was significantly lower (18±5 g/day) for the RD4U© lunch-meals, compared to the respective levels (24±11 g/day; 22±12 g/day) for the usual lunch meals. Total HEI score of the RD4U© meals (61.9±9.2) was higher than that for the usual lunch meals (56.1±11.2). Nonetheless, the overall diet quality scores indicate that both RD4U© and usual lunch meals were in the “need improvement” category. Generally, participants were satisfied with the RD4U© lunch-meal service. Conclusion: The RD4U© lunch-meals showed potential in delivering healthy lunch to worksites, and feasibility studies to expand the RD4U© delivery service is recommended.