Balancing Patients' Eating Habits with Planetary Health-Pilot Study to Decrease Food Waste with Vegetarian Lunches using a Quality Improvement Approach.

Abstract

Background: Patient health is greatly impacted by increased likelihood of malnutrition if food is not consumed. Food waste also contributes to greenhouse gas emissions and may be possibly reduced by offering vegetarian food options. Therefore, a Plan-Do-Study-Act intervention of "Vegetarian Week" was conducted in an urban geriatric rehabilitation unit.

Method: Food waste was measured using the Visual Estimation Method, and the proportion of waste before and after the intervention was compared using a two-tailed z-test. Surveys assessed patients' attitudes towards vegetarian meals.

Results: Study population was of 54 (2022) and 65 (2023) patients with the majority being male (62.5%), average age 74.5 years, average length of stay 33 days. Comparing pre- and post-intervention periods, overall food wastage increased at: breakfast (22% to 32%), lunch (22% to 32%), and dinner (20% to 25%) with p values <.001. Considering lunch entrées only, wastage increased from 17% to 38%, with vegetarian entrees wasted (46%) more than non-vegetarian ones (34%). Vegetarian patients wasted (37%) as much as non-vegetarians (39%). Survey response rate pre-PDSA was 45%, with most patients (76%) reporting eating an omnivorous diet, a prior awareness of personal and planetary health benefits of vegetarian diets (59%), and previously trying vegetarian dishes (62%). Post-PDSA survey response rate was lower (22%) with 57% not willing to try vegetarian dishes again.

Conclusion: Through evaluation of the patient food experience with Visual Estimation Method and surveys, the very complex issue of food satisfaction was explored in older adults. Although food waste was not decreased during this "Vegetarian Week" pilot, improving patient and planetary health requires ongoing efforts.