Authors (including presenting author) :
Lee H (1),(3), Luk S (2),(3), Wong A (2),(3), Diabetes and Endocrine team (3), Ching KM (1),(3), Chua YK (1),(4), Wong HY (1),(4)
Affiliation :
(1)Dietetic Department, (2)Food Services Department, (3)Ruttonjee & Tang Shiu Kin Hospitals, (4) Pamela Youde Nethersole Eastern Hospital
Introduction :
In Ruttonjee Hospital, in-patient with Diabetes Mellitus (DM patient) was routinely provided with alternate days of meat congee and plain oat at breakfast. DM patient’s glucose control will benefit from higher fiber provision and ingredients with a lower glycemic index. Congee’s fiber content is low and glycemic index is high and will raise blood glucose in DM patients quickly. Patients used to learn from meal pattern in hospital and it was not good to adopt congee as breakfast upon discharge. In July 2024, RTSKH Diabetes and Endocrine team took steps to improve on diabetes service. One of the agenda was to improve the meal provision for DM patient so as to improve their glycemic control and in the same time providing sufficient protein and tasty food to the in-patients.
Objectives :
1. Choose food ingredients with a lower glycemic index and a higher fiber content. 2. Provide sufficient protein content in meal.
Methodology :
Dietetic Department joined force with Food Services Department in July 2024. The modification of meal provision was divided into 2 phases. Phase 1 (since 12 Aug 2024): Reduce glycemic index and provide more fiber to meal. Stop serving apple juice. Serve orange and apple puree (exception: apple juice is served in fluid diet, clear fluid diet and low fiber diet) Serve plain Oat at breakfast (exception: patient is allergic to oat or chooses not to eat oat. Oat’s texture might induce swallowing risk.) Plain oat does not contain milk or other protein, 1 portion of plain oat weighs 550g, provides 175kcal, 7g Protein. The overall energy and protein provision was inadequate. However, there was no other higher energy and protein oat recipe in use in Hospital Authority(HA). Phase 2: Provide oat recipe with sufficient protein content. 1. Create nutritious and tasty oat recipes for patient consumption. 2. Food tasting and production feasibility test.
Result & Outcome :
After this meal improvement project, DM patient are served with nutritious oat which contains sufficient protein. By providing oat, orange and apple puree instead of congee and apple juice will ensure a lower glycemic index and sufficient fiber intake for DM in-patients. 1. 2 new recipes were created: Oat with chicken puree; 1 portion 550g contains 243kcal, 14g Protein Oat with pork puree; 1 portion 550g contains 256kcal, 14g Protein 2. Submit new recipes to HA Dietetic and Catering Management (DCMS) team for ingredient, nutrition and texture vetting. 3. New approved recipes adopted into HA DCMS food data bank. New recipes are shared to other HA hospitals. 4. Incorporate recipes in Ruttonjee Hospital’s menu cycle. 5. Start Date: 28 October 2024
