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La dieta de textura modificada supone una importante pérdida de las cualidades organolépticas de la alimentación, por lo que suele asociarse a una ingesta subóptima y puede aumentar el riego de desnutrición en personas con dificultades de masticación o deglución. Es conocido que estas dietas basadas en los tradicionales triturados, presentan una suficiencia nutricional variable. La aparición de numerosos productos comerciales deshidratados o listos para su consumo, con una amplia variedad nutricional, según sea la gama y receta de que se trate, suponen un importante avance en la normalización del valor nutricional y en la garantía de la alimentación de personas con disfagia. En esta revisión se comentan sus posibles ventajas o inconvenientes, frente a los tradicionales triturados, así como las posibilidades de su incorporación en el menú de hospitales y residencias.

Introduction: The type of service offered by the nutrition and dietetics service (NDS) of a hospital has a direct impact on food waste.Objective: To evaluate waste in the transition from a simple to a mixed cafeteria service.Methodology: The study was carried out in a NDS of a University Hospital during 60 days (30 days for each type of service). The meals prepared and distributed and the leftovers of lunch and dinner were weighed.Results: Per capita values of non-usable leftovers were below the acceptable range (7-25 g), not varying with the service transition (p = 0.3) at lunch. At dinner, on the contrary, values were above the acceptable range, with a median of 190 g and 202 g, also showing no difference with the service modification (p = 0.5). At lunch, with the transition, there was a reduction in the plate waste-ingestion (p < 0.0001), percentage of plate waste-ingestion (p < 0.0001) and percentage of non-usable foods (p = 0.007). At dinner, there was a reduction in the plate waste-ingestion (p < 0.0001) and in the percentage of plate waste-ingestion (p = 0.0001).Conclusion: The modification of the service type was effective in reducing the plate waste-ingestion, but did not lead to operational modifications of the service, since the amount of non-usable leftovers remained high at dinner. Greater control of the production and distribution of meals is suggested, as well as training of food handlers and supervisors, implementation of standardized operating procedures and cost control in order to reduce waste, which has an economic, social and political impact. [ABSTRACT FROM AUTHOR]

Introduction: The school canteen provides a substantial proportion of the daily nutritional intake for many children. There are nutritional standards for school meals, however, it is still difficult to assess the dietary quality. Aims: To design a questionnaire for assessing the dietary quality of school meals, quickly and easily. Methods: A dietary questionnaire (COMES) was designed on the basis of the current recommendations. COMES consist of 15 items related to the foodfrequency and to other characteristics of school meals. Then, a longitudinal prospective study was performed in order to analyze, with COMES, 36 school meals of 4 catering companies from Castilla y León during the academic years 2006-2007 to 2010-2011. Differences in dietary quality menus according to the management system of catering companies (in situ vs. transported) were analyzed by using the Mann-Whitney and the Kruskal-Wallis tests. The significance was reached at p <0,05. Results: The frequency intake of meat, dairy and prepared products was higher to the recommended in 97,2%, 94,4% and 27,8% of the analyzed menus, respectively. By contrast, the frequency intake of fish, fruit, legume, and vegetable garnishes were lower to the recommended in 83,3%, 94,4%, 91,7% and 75% of menus, respectively. Nevertheless, recommendations established by our consensus document for school meals are complied for all food groups, except for dairy and fruits. The variety of foods and culinary techniques were appropriate. No significant differences were found in the COMES score according to the management system (p=0,87), although catering system provides higher dietary quality. Conclusions: A new tool to assess quickly and easily the nutritional quality of school meals has been proposed. The assessment of the frequency intake of the most problematic foods for schoolchildren with this scale is much more demanding than the current recommendations. Even so, menus analyzed showed an acceptable quality in terms of variety of foods and culinary techniques, although milk frequency in the menus was excessive at the expense of fresh fruit. On the other hand, the transported system (i.e. catering, both hot and cold-holding) provides menus more consistent with the dietary recommendations. [ABSTRACT FROM AUTHOR]