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WILTSHIRE FARM FOODS

WILTSHIRE FARM FOODS NACC South West Specialised Nutrition Presentation December 2018

WILTSHIRE FARM FOODS

• What is IDDSI?
• Why IDDSI?
• What does it mean?
• Nutrition
• Labels
• Timescales
• Diabetes
• COPD
• CKD

Agenda

WILTSHIRE FARM FOODS

Introduction to IDDSI

WILTSHIRE FARM FOODS What is IDDSI?

• An international collaboration of dietitians, SLTs, food scientists, physicians, OTs,

engineers, nurses and industry professionals.

• The objective was to review existing dysphagia standards and create a global

standard for categorising texture modified foods and liquids for people with dysphagia.

• The aim is to have a common language that can be used for technical, cultural,

professional and non-professional uses.

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• A continuum of 8 levels (0-7)

including both foods and drinks

• Drinks are measured from levels 0-4
• Foods are measured from levels 3-7
• Cross-over in the middle

THE IDDSI FRAMEWORK

WILTSHIRE FARM FOODS WHY IDDSI?

• Specific standards for each level
• Clear characteristics and specifications
• Additional testing methods specific to

each level

• Levels are defined by measurement

Patient safety is key!

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Endorsed by:

IS EVERYONE ON BOARD?

IDDSI is supported by a variety of industry sponsors

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apetito/WFF is part of the IDDSI UK Expert Reference group and has been sponsoring this initiative since 2014 as has The NACC

SO WHAT?

• WFF adopted in 2010 with

launch of our current Softer Foods range

WILTSHIRE FARM FOODS NATIONAL DESCRIPTORS vs IDDSI

WILTSHIRE FARM FOODS CATEGORY C vs LEVEL 4

WILTSHIRE FARM FOODS CATEGORY C vs LEVEL 4

National Dysphagia Descriptor- Category C IDDSI level 4

Food has been puréed or has purée texture Usually eaten with a spoon It is a thick puree Fall off a spoon in a single spoonful when tilted and continues to hold shape on a plate Fluid in or on the food has not thinned out or separated off Liquid must not separate from solid Hold its shape on the a plate or when scooped Show some slow movement under gravity but cannot be poured Can be eaten with a fork because it does not drop through the prongs Cannot be drunk from a cup The prongs of a fork make a clear pattern on the surface Not sticky It can be piped, layered or moulded Not lumps

WILTSHIRE FARM FOODS CATEGORY D vs LEVEL 5

WILTSHIRE FARM FOODS CATEGORY D vs LEVEL 5

National Dysphagia Descriptor- Category D IDDSI level 5

Food is soft, tender and moist Can be eaten with a fork It has been mashed up with a fork before serving Can be scooped and shaped on a plate Any fluid in or on the food is very thick Soft and moist with no separate liquid No hard, tough, chewy, fibrous, crunchy or crumbly bits Small lumps visible within the food Adult: 4mm lump size Biting is not required Lumps are easy to squash with tongue

WILTSHIRE FARM FOODS CATEGORY E vs LEVEL 6

WILTSHIRE FARM FOODS CATEGORY E vs LEVEL 6

National Dysphagia Descriptor- Category E IDDSI level 6

Food is soft, tender and moist but needs some chewing Can be eaten with a fork or spoon It can be mashed with a fork it usually required a thick, smooth sauce Can be mashed/ broken down with pressure from fork, spoon or chopsticks No hard, though, chewy crunchy or crumbly bits Chewing is required before swallowing No sticky food Soft, tender and moist throughout but with no separate thin liquid Pieces of soft tender meat must be served no bigger than 15mm ‘Bite-sized’ pieces as appropriate for size and oral processing skills Adult: 15mm pieces

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• Product redevelopment required to ensure compliance
• Some changes phased in from September 2018
• Meals started to become IDDSI compliant from September
• IDDSI compliant meals will still be compliant with old descriptors (C & D)
• Consumers unlikely to notice many major changes – e.g. thickened sauces
• New labels on IDDSI compliant meals as phased in – dual labelling
• New label = IDDSI compliant
• Fully compliant by March 2019

IMPACT ON WFF RANGE – C & D/Level 4 & 5

WILTSHIRE FARM FOODS CATEGORY E/EXTRA TENDER/Level 6

• Key change – All pieces 15mm or less (not just meat)
• Minor changes e.g. moving from slice to diced carrot phasing in from December
• Dual Purpose products:
• 1. Extra Tender: Targeted to those who want an easier to eat meal (protect sales &
• pportunity to improve in future)
• 2. Level 6 ‘Soft and Bite Sized’: TM range for those with dysphagia
• Many products shared between ranges
• Small number of standalone SKUs
• Working to minimise SKU count impact
• Further communication to be issued

WILTSHIRE FARM FOODS NUTRITIONAL CONSIDERATIONS

• Aims/considerations
• Aim to maintain or improve position where possible
• Dietary codes and allergens to consider
• Traffic Lights to consider
• Product development ongoing

WILTSHIRE FARM FOODS LABELLING

• Three levels of identification
• Numbers
• Name descriptions
• Colour Codes
• Interim dual labelling approach 6 – 12

months

• Our approach has been researched with

customers

WILTSHIRE FARM FOODS IDDSI TIMESCALE

WILTSHIRE FARM FOODS WFF TIMESCALE

September 2018

SOME new IDDSI compliant products and labels begin to filter in to range (Level 4

• nly)

Intro to IDDSI in brochures IDDSI eLearning module for WFF teams

Autumn/Winter 2018

Further IDDSI training at regional meetings More Level 4/5/6 IDDSI compliant products filter in Standalone IDDSI explanation - consumer flyer

March 2019

WFF fully compliant with IDDSI Cat C,D,E terminology no longer in use SS19 Literature/comms full IDDSI explanation/terminology

• 1st products with IDDSI label from September

2018 – limited numbers/customer impact

• September 2018 – March 2019: Transition

period ‘old’ descriptors C,D,E still in place

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• Diabetes
• COPD
• CKD

SPECIALISED NUTRITION

WILTSHIRE FARM FOODS DIABETES

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Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. Type 1 – where the body's immune system attacks and destroys the cells that produce insulin Type 2 – where the body doesn't produce enough insulin or the body's cells don't react to insulin

DIABETES – WHAT IS IT?

WILTSHIRE FARM FOODS DIABETES – WHAT IS IT?

WILTSHIRE FARM FOODS DIABETES – WHY SHOULD WE WORRY?

WILTSHIRE FARM FOODS DIABETES – WHAT ARE THE SYMPTOMS?

Complications: Over a long period of time, high glucose levels in the blood can seriously damage the heart, eyes, feet and kidneys

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Type 1 Type 2

DIABETES TREATMENT

Always Insulin Healthy Eating Heathy Weight Regular Exercise Medication may be or become necessary

WILTSHIRE FARM FOODS Type 2 diabetes and diet

90% of people with Diabetes have type 2 diabetes Type 2 is more common as you get older Therefore WFF focus will be on type 2 diabetes

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What is recommended in the Long Term?

A healthy, balanced diet: Eating regular meals Plenty of fruit and vegetables Eating less saturated fat, sugar, salt and starchy high fibre carbohydrates Following a healthy, balanced diet will help to control blood glucose, blood fats and blood pressure, as well as helping to maintain a healthy weight

DIABETES AND FOOD

WILTSHIRE FARM FOODS TYPE 2 DIABETES AND DIET

WILTSHIRE FARM FOODS DIABETIC FOODS

It is not true that if you have diabetes you will need to eat a special diet. You should eat a healthy diet high in fibre, fruit and vegetables and low in fat, salt and sugar Since healthy eating advice is the same for people with diabetes as it is for other people, the idea of special ‘diabetic ‘ foods is out of date’

WILTSHIRE FARM FOODS COPD

WILTSHIRE FARM FOODS COPD – WHAT IS IT?

The name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease

WILTSHIRE FARM FOODS COPD – WHAT ARE THE SYMPTOMS?

People with COPD have difficulties breathing, primarily due to the narrowing of their airways. Typical symptoms of COPD include: Increased breathlessness when active A persistent cough with phlegm Frequent chest infections

WILTSHIRE FARM FOODS COPD TREATMENT

Treatments include:

• stopping smoking – the most important action
• inhalers and medications – to help make breathing easier
• pulmonary rehabilitation – a specialised programme of exercise and

education

• surgery or a lung transplant – although this is only an option for a very

small number of people

WILTSHIRE FARM FOODS COPD AND ISSUES WITH EATING

Breathlessness- a symptom of COPD that can make eating effortful Weight changes- Due to either poor appetite or sedentary lifestyle Poor appetite- Due to struggling with breathing Taste changes- Caused by a dry mouth or medication Dry mouth- Caused by inhalers and using

• xygen

Bloating- Air gulping while eating due to breathlessness

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Take into account:

• Low Appetite and/or Loss of Weight
• Chewing/Swallowing difficulties
• Healthy & Nutritious

SIGNPOSTING TO A GOOD DIET

WILTSHIRE FARM FOODS SIGNPOSTING TO A GOOD DIET

WILTSHIRE FARM FOODS SIGNPOSTING TO A GOOD DIET

WILTSHIRE FARM FOODS SIGNPOSTING TO A GOOD DIET

WILTSHIRE FARM FOODS CHRONIC KIDNEY DISEASE

WILTSHIRE FARM FOODS CKD – WHAT IS IT?

Chronic kidney disease (CKD) is a long-term condition where the kidneys don't work as well as they should Common causes include:

• Ageing
• Ethnicity
• High blood pressure
• Diabetes
• High cholesterol
• Kidney infections (and other kidney conditions)
• Long-term, regular use of certain medicines

WILTSHIRE FARM FOODS CKD – WHAT ARE THE SYMPTOMS?

Symptom free to start with but as CKD progresses:

• weight loss
• poor appetite
• water retention
• shortness of breath
• tiredness
• blood in urine
• frequent urination

WILTSHIRE FARM FOODS CKD – HOW IS IT TREATED?

The main treatments are:

• lifestyle changes, including diet
• medication
• dialysis
• kidney transplant

WILTSHIRE FARM FOODS CKD AND DIET

Kidneys remove the left-over waste products from the blood. Depending

• n the person’s condition, making dietary changes can:
• Help a person feel better
• Affect the medication they need
• Influence the need for dialysis
• CKD is classified as Stage 1-5 with 5 being the most advanced
• The severity of the disease determines the dietary restrictions

WILTSHIRE FARM FOODS CKD AND NUTRITIONAL CONSIDERATIONS

CKD 1 - 3 The main focus is to try and reduce the risk of cardiovascular disease A healthy diet and keeping weight within a healthy range is the focus

WILTSHIRE FARM FOODS CKD AND NUTRITIONAL CONSIDERATIONS

CKD 4 – 5 Patients with this level of kidney disease are usually referred to a specialist Renal Centre with regard to;

• Salt
• Potassium
• Phosphate
• Protein
• Poor appetite
• Fluid

WILTSHIRE FARM FOODS SIGNPOSTING TO A GOOD DIET

WILTSHIRE FARM FOODS SIGNPOSTING TO A GOOD DIET

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Thank you