Environmental impacts of the menu patterns of a university hospital in Uruguay
DOI:
https://doi.org/10.21527/2176-7114.2024.48.14133Keywords:
hospital feeding, greenhouse gases, water footprint, nutritionAbstract
Introduction: in hospital care, the provision of meals integrates the recovery process of patients. The foods that are used can affect the environment. Objective: to identify the characteristics of the different diet patterns, as well as the environmental impacts of the foods used in the menus of a Public University Hospital (PUH) in Uruguay. Methods: retrospective study using secondary data. The period investigated was 2021 and the first half of 2022. The prescriptions of total oral diets (OD) and supplemental diets (SD) were evaluated. The following variables were analyzed: a) energy value in kilocalories (kcal), b) water footprint (WF) - for OD; and for the inputs used in SD: c) energy value, and d) generation of greenhouse gases (GHG). Results: The PUH served 317,380 meals during the three semesters. Of the 24 options for prescribing OD, 13 types represented more than 93% of the total number of consultations. As for the 21 types of foods used in dietary prescriptions, 6 were of animal origin. In the environmental impact assessment, a difference of up to 51% in WF was identified between the types of OD. In SD, the group of enteral formulas for adults represented 88.37% of total consumption. The group of infant formulas had the greatest impact on GHG emissions. Conclusions: in addition to attention to dietary care, hospital food services should consider the environmental impacts in the provision of their meals.
References
Abreu ES, Spinelli MGN. A unidade de alimentação e nutrição. En: Abreu ES, Spinelli MGN, Pinto AMS. Gestão de unidades de alimentação e nutrição: um modo de fazer. Fifth edition. São Paulo, Brasil: Metha; 2016.
Simzari, K., Vahabzadeh, D., Saeidlou, S. N., et al. (2017). Food intake, plate waste and its association with malnutrition in hospitalized patients. Nutr hosp 2017;34(5):1.376-1.381. DOI: 10.20960/nh.1102
Fonseca KZ, Santana GR. de. Guia prático para gerenciamento de unidades de alimentação e nutrição. Cruz das Almas, Brasil: Universidade Federal do Recôncavo da Bahia; 2012. Disponible en: http://www.repositorio.ufrb.edu.br/bitstream/123456789/804/1/guia%20pratico%20de%20unidade%20de%20alimantacao%20e%20nutricao%281%29.pdf
Oliveira DA, Oliveira JL, Pereira KN, Análise dos principais fatores de desperdício em uma Unidade de Alimentação e Nutrição – UAN. South American Journal of Basic Education, Technical and technological. 2017;1(1):234-239.
de Araújo IS, Alves de Macedo M. Manual de Dietas Hospitalares HU-UNIVASF. Petrolina, 2020. Disponible en: http://www.univasf.edu.br/~tcc/000018/000018ef.pdf]
CFN. Conselho Federal de Nutricionistas. Resolução CFN nº 600, de 25 de fevereiro de 2018. Disponible en: https://www.cfn.org.br/wp-content/uploads/resolucoes/Res_600_2018.html
Weir SBS, AkhondI H. Bland Diet. National Library of Medicine [Internet] 2022. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK538142/
Feil AA, Schreiber D. Sustentabilidade e desenvolvimento sustentável: desvendando as sobreposições e alcances de seus significados. Cadernos EBAPE.BR 2017;15(3):667-681.
Strasburg VJ, Jahno VD. Paradigmas das práticas de gestão ambiental no segmento de produção de refeições no Brasil. Engenharia Sanitaria e Ambiental. 2017;22:3-12. DOI:10.1590/s1413-41522017155538
Hoekstra AY, Chapagain AK, Aldaya MM, Mekonen MM. Water Footprint Manual: State of the Art. Water Footprint Network, Ensched, The Netherlands. Nov. 2009. Disponible en: https://waterfootprint.org/media/downloads/WaterFootprintManual2009.pdf
Carbon trust. Carbon footprinting guide [Internet] 2021. Disponible en: https://www.carbontrust.com/resources/guides/carbon-footprinting-and-reporting/carbon-footprinting/
Caiado RGG, Dias RF, Mattos LV, Quelhas OLG, Leal Filho W. Towards sustainable development through the perspective of eco-efficiency: a systematic literature review. J. Clean. Prod 2017;165:890-904. DOI: 10.1016/j.jclepro.2017.07.166
Ritchie H, Roser M. Our World in Data [Internet] 2020. Environmental Impacts of Food Production. Disponible en: https://ourworldindata.org/environmental-impacts-of-food
Dados mundiais. Uruguai. [Internet] 2022. Disponible en: https://www.dadosmundiais.com/america/uruguai/index.php
Hospital de Clínicas Dr. Manuel Quintela. El Hospital. [Internet] 2022. Disponible en: https://www.hc.edu.uy/index.php/el-hospital
Prodanov CC, Freitas EC. Metodologia do trabalho científico: métodos e técnicas da pesquisa e do trabalho acadêmico. Novo Hamburgo, Brasil: Feevale. 2013. Disponible en: http://www.feevale.br/Comum/midias/8807f05a-14d0-4d5b-b1ad-1538f3aef538/E-book%20Metodologia%20do%20Trabalho%20Cientifico.pdf
Strasburg VJ, Jahno VD. Application of eco-efficiency in the assessment of raw materials consumed by university restaurants in Brazil: A case study. J. Clean. prod 2017;161:78-187. DOI: 10.1016/j.jclepro.2017.05.089
NEPA. Núcleo de Estudos e Pesquisas em Alimentação. Tabela Brasileira de Composição de Alimentos – TACO. Campinas, SP, Brasil: Universidade Estadual de Campinas; 2011. Disponible en: http://www.unicamp.br/nepa/taco/
Mekonnen MM, Hoekstra AY. The green, blue and grey water footprint of crops and derived crop Products. Hydrology and earth system sciences. 2011;15:1.577-1.600. DOI: 10.5194/hess-15-1577-2011
Mekonnen MM, Hoekstra AYA. Global assessment of the water footprint of farm animal products. Ecosystems. 2012;15(3):401-415. DOI: 10.1007/s10021-011-9517-8
Pahlow M, van Oel PR, Mekonnen MM, Hoekstra AY. Increasing pressure on fresh water resources due to terrestrial feed ingredients for aquaculture production. Sci. total environ. 2015;536:847-857. DOI: 10.1016/j.scitotenv.2015.07.124
Wepoke. Distância entre cidades. [Internet] 2022. Disponible en: http://www.distanciasentrecidades.com/
DECC. Department of Energy & Climate Change. Greenhouse gas reporting – Conversion factors. 2020. [Internet]. 2022. Disponible en: https://www.gov.uk/government/publications/greenhouse-gas-reporting-conversion-factors-2020
Normando PG, Araujo-Filho JA, Fonseca GA, Rodrigues REF, Oliveira VA, Hajjar LA, et al. Redução na hospitalização e aumento na mortalidade por doenças cardiovasculares durante a pandemia da Covid-19 no Brasil. Arq bras cardiol. 2021;116(3):371-380. DOI: 10.36660/abc.20200821
Nourazari S, Davis SR, Granovsky R, Austin R, Straff DJ, Joseph JW, Sanchez LD. Decreased hospital admissions through emergency departments during the COVID-19 pandemic, The American Journal of emergency medicine. 2021;42:203-210. DOI: 10.1016/j.ajem.2020.11.029
Mariet A-S, Giroud M, Benzenine E, Cottenet J, Roussot A, Aho-Glélé LS, et al. Hospitalizations for stroke in France during the COVID-19 pandemic before, during, and after the national lockdown. Stroke 2021;52(4):1.362-1.369. DOI: 10.1161/STROKEAHA.120.032312
Sharma M, Lioutas V, Madsen T, et al. Decline in stroke alerts and hospitalisations during the COVID-19 pandemic. Stroke and vascular neurology. 2020;5. DOI: 10.1136/svn-2020-000441
Strasburg VJ, Fontoura LS, Bennedetti LV, Camargo EPL, Sousa BJ, Seabra LMJ. Environmental impacts of the water footprint and waste generation from inputs used in the meals of workers in a Brazilian public hospital. Research, society and development. 2021;10:1-16. DOI: 10.33448/rsd-v10i3.13129
Rigo A, Escobar M, Goularte JF, Jochims AMK, Strasburg VJ. Acceptability of diabetes mellitus dietetics and factors associated with the consumption in patients in a public university hospital. Demetra – alimentação, nutrição e saúde. 2020;15. DOI: 10.12957/demetra.2020.51595
do Rosario, V.A., Walton, K. Hospital Food Service. In: Meiselman, H. (eds) Handbook of Eating and Drinking. Springer; 2020. DOI: 10.1007/978-3-030-14504-0_74
Melo VTP, Strasburg VJ. Geração de resíduos na aquisição de vegetais in natura e minimamente processados por serviço de nutrição e dietética de um hospital público. Braz. J. food technol. 2020;23:e2019069. DOI: 10.1590/1981-6723.06919
Santos VS, Gontijo MCF, de Almeida MEF. Effect of gastronomy on the acceptability of hospital diets. Nutr. clín. diet. Hosp. 2017;37(3):17-22.
Strasburg VJ, Jahno VD. Sustentabilidade de cardápio: avaliação da pegada hídrica nas refeições de um restaurante universitário. Am agua interdiscip J appl sci. 2015;10:903-914.
Strasburg VJ, Prattes G, Acevedo B, Suárez C. Calidad nutricional e impacto en medio ambiente por los insumos de un comedor universitario en Uruguay. Archivos latinoamericanos de nutrición. 2023;73(2):90-101. DOI: 10.37527/2023.73.2.001
Hatjiathanassiadou M, de Souza SRG, Nogueira JP, Oliveira LM, Strasburg VJ, Rolim PM, Seabra LM J. Environmental impacts of university restaurant menus: a case study in Brazil. Sustainability. 2019;11:5157. DOI:10.3390/su11195157
Speck M, Bienge K, Wagner L, Engelmann T, Schuster S, Teitscheid P, Langen, N. Creating sustainable meals supported by the NAHGAST online tool-approach and effects on GHG emissions and use of natural resources. Sustainability. 2020;12(3). DOI: 10.3390/su12031136
Bengtsson J, Bullock JM, Egoh B, Everson C, Everson T, O’Connor, T. et al. Grasslands - more important for ecosystem services than you might think. Ecosphere. 2019;10:e02582, DOI: 10.1002/ecs2.2582
González-García S, González-García R, González Vázquez L, Moreira MT, Leis R. Tracking the environmental footprints of institutional restaurant service in nursery schools. Science of the total environment. 2020; 728. DOI: 10.1016/j.scitotenv.2020.138939
Ribeiro KRR, Rolim PM, Seabra LMJ, Strasburg VJ. Evaluation of the ecoefficiency of greenhouse gases generation in the provision of complementary meals in a public hospital. Research, society and development. 2021;10:e10110413995. DOI: 10.33448/rsd-v10i4.13995
De Laurentiis V, Hunt DVL, Lee SE, et al. EATS: a life cycle-based decision support tool for local authorities and school caterers. Int J life cycle assess. 2018;24(7):1.222-1.238. DOI: 10.1007/s11367-018-1460-x
Castro e Cardoso MG, Prates SMS, Anastácio LR. Fórmulas para nutrição enteral padrão e modificada disponíveis no Brasil: Levantamento e classificação. Braspen J. 2018;33(4):402-417. Disponible en: http://arquivos.braspen.org/journal/out-dez-2018/08formulas.pdf
Nogueira JP, Hatjiathanassiadou M, de Souza SRG, Strasburg VJ, Rolim PM, Seabra LMJ. Sustainable perspective in public educational institutions restaurants: from foodstuffs purchase to meal offer. Sustainability. 2020;12:4340. DOI: 10.3390/su12114340
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