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.

Introducción: el tipo de servicio ofrecido por el servicio de nutrición y dietética (SND) de un hospital tiene un impacto directo en el desperdicio de alimentos. Objetivo: evaluar el desperdicio en la transición de un servicio de cafetería simple a uno combinado. Metodología: el estudio fue llevado a cabo en el SND de un hospital universitario durante 60 días (30 días para cada tipo de servicio). Las comidas preparadas, distribuidas y las sobras del almuerzo y cena fueron pesadas. Resultados: los valores per cápita de las sobras no aprovechables estuvieron por debajo del rango aceptable (7-25 g), sin que variaran con la transición del servicio (p = 0,3) en el almuerzo. En la cena, por el contrario, los valores estuvieron por encima del rango aceptable, con una mediana de 190 g y 202 g, y sin mostrar tampoco una diferencia significativa con la modificación del servicio (p = 0,5). En el almuerzo, con la transición, hubo una reducción en el desperdicio de alimento-ingesta (p < 0,0001), porcentaje del desperdicio de alimento-ingesta (p < 0,0001) y porcentaje de comidas no utilizables (p = 0,007). En la cena, hubo una reducción en el desperdicio de alimento-ingesta (p < 0,0001) y en el porcentaje desperdicio-ingestión (p = 0,0001). Conclusión: la modificación del tipo de servicio fue efectiva a la hora de reducir el desperdicio de alimento-ingesta, pero no condujo a modificaciones operativas en el servicio ya que la cantidad de sobras no utilizables era mayor en la cena. Se sugiere un mayor control de la producción y distribución de las comidas, así como la formación de responsables y supervisores de comida, la implementación de procedimientos operativos estandarizados y el control del coste para reducir el desperdicio, que tiene un impacto económico, social y político.

INTRODUÇÃO: A diarréia associada ao uso de antimicrobiano (DAA) é um importante efeito colateral dessa classe de fármacos. O objetivo do presente trabalho é investigar o efeito do uso de probióticos no tratamento da DAA. MÉTODOS: Pacientes hospitalizados em um hospital universitário com diarréia, que se desenvolveu durante o uso ou até sete dias após a suspensão de antimicrobianos, foram randomizados, de forma cega, para receberem dieta padronizada associada, três vezes ao dia, ao uso de probiótico (Lactobacillus casei e Bifidobacterium breve) ou placebo. RESULTADOS: Foram estudados um total de setenta pacientes. Para o grupo experimento (n=35) e controle (n=35), respectivamente, o tempo médio de tratamento foi de 5,06 ± 2,18 e 5,49 ± 3,17dias (p=0,95) e o tempo médio de duração da diarréia, entre aqueles que se curaram, foi de 4,87 ± 2,13 e 4,52 ± 2,55 dias (p=0,36). Quatro (11,4%) pacientes que receberam probióticos e dez (28,6%) que receberam placebo não foram curados (p=0,13) e a frequência de recidiva foi similar entre os grupos. Sete pacientes de cada grupo, além da diarréia, apresentaram distensão e/ou cólica abdominal e/ou vômito (p=1,00). CONCLUSÕES: L. casei associado a B. breve, na dosagem e frequência administradas, não demonstraram qualquer efeito no tratamento da diarréia associada a antimicrobiano. Estudos similares merecem ser realizados com doses maiores destes ou de outros probióticos.

INTRODUCTION: Antibiotic-associated diarrhea (AAD) is an important side effect of this specific class of drugs. The objective of this study was to investigate the effect of the use of probiotics in the treatment of AAD. METHODS: A group of hospitalized patients, who contracted diarrhea during or after 7 days of suspension of antimicrobial medication, was blindly randomized to receive a standardized diet associated with the use of the probiotics (Lactobacillus casei and Bifidobacterium breve) or its corresponding placebo, three times a day. RESULTS: Seventy patients were studied. For the experimental (n=35) and control (n=35) groups, respectively, the average time of treatment was 5.06±2.18 and 5.49±3.17 days (p=0.95), and the average duration of diarrhea, among those who were healed, was 4.87±2.13 and 4.52±2.55 days (p=0.36). Four (11.4%) patients who received probiotics and ten (28.6%) who received the placebo were not cured (p=0.13), and relapse rates were similar between both groups. Seven patients from each group, in addition to diarrhea, presented cases of bloating and/or abdominal cramps and/or vomiting (p=1.00). CONCLUSIONS: In this light, it is concluded that L. casei associated with B. breve, in the administered dosage and frequency, has no effect on the antibiotic-associated diarrhea. Similar studies need to be conducted with higher doses of these or other probiotics.