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Are you Meeting your Service Users’ Religious Dietary Needs?
The new CQC regulations, effective from April 2015, continue to emphasise the importance of nutrition and hydration needs. One of the key aspects is meeting service users’ dietary requirements arising from religious backgrounds, and so it seems timely to review this area.
Recognition of different religious dietary practices
The move towards inclusive provision for differing dietary requirements reflects the diversity of multi-faith Britain. People should be free, whatever their circumstances, to live out their personal beliefs including in matters of dietary practice. It is not appropriate for choices of food and drink to be imposed on people regardless of their religious, cultural, social or ethnic background. Sensitivity and care should therefore be exercised when catering for those who follow particular religious dietary practices, and this is particularly important where those being served are unable to eat elsewhere.
Although the majority, some 60 per cent, of the UK remains Christian, a wide range of religious beliefs and culturally diverse communities are now found, including Muslim (around 5 per cent), Hindu, Sikh, Jewish and Buddhist faiths, and this will be increasingly reflected in the religions of service users. Care staff, health professionals and caterers should recognise religious dietary needs, and these should be identified at admission, recorded in a care plan and met in food service provision. If there are any clinical contraindications or risks posed as a result of these requirements, including fast days, this must be discussed with the service user to allow them to make informed choices.
Catering for different religious dietary practices
When catering for people of faith, institutions need to be clear about any specific requirements their service users may have, so that they are aware of the full range of dietary practices with which they are working. It is recognised that catering for such a range can be complex. The most common dietary patterns to meet the religious and cultural needs of most people are vegetarian, halal and kosher diets. It is therefore good practice to have meat and vegetarian options (a full vegetarian main dish and not just vegetable side dishes), and, where required, correctly slaughtered meat. Vegan options should be readily available. Menu planning should not only consider religious needs but also the number of people requiring culturally adapted special diets like texture modified food, for example.
It is not only the food itself but the way it is prepared and served that may form an essential part of faith-based dietary practice. Institutions should be able, as necessary, to respond to queries about ingredients in food which may be inappropriate for some service users following faith-based dietary practices where specific items are not allowed. It is advisable to keep ingredients that some will not consume separate in storage, preparation, cooking and serving. Issues regarding potential cross contamination of certain foodstuffs may also need to be considered in relation to crockery and utensil provision. For example, strict practitioners of Hindu or Sikh vegetarian diets may require that equipment and utensils have not come into contact with meat, and for Muslims that these have not come into contact with pork, other non-halal meats or alcohol. During the preparation of kosher meals separate implements should be used for meat and dairy products.
Method of meat slaughter is important in some religions
The correct labelling of meat slaughtered in accordance with religious guidelines may be an important part of the religious practices for Jews (Kosher), Muslims (halal) and Sikhs (not halal or kosher) and care should be taken to source their meat and other foodstuffs accordingly, making sure that traceability of the origins of meat is available to ensure a defensible procurement procedure.
Good communication is key
Good cultural and religious care is based on good communication with the individual and their family by staff that can recognise possible issues and who are willing to ask the right questions and can communicate these well. Consideration needs to be given regarding communication of the menu, food service provision and feedback to those users from populations that may not speak or read English.
It is important not to assume an individual’s dietary practices just because they belong to a particular faith or religious group. Dietary practices between and within different groups can be quite diverse and it’s important to find out each individual’s dietary needs. Some older people will follow culturally defined practices, whereas others may have diets that are more Westernised. While in many faith communities the majority of observant members will follow the same practice, such as the consumption of ‘halal’ food by most Muslims, there are communities in which dietary practices may differ between followers of the same faith. For example, while most Hindus follow a vegetarian diet, a significant minority will eat meat, though all are likely to avoid beef because of respect in the Hindu faith for the cow.
Fasts and festivals
When catering for people of diverse faiths, caterers will find it helpful to be aware of whether members of particular faiths are marking festivals or fast days as faith-based dietary requirements can alter during periods of religious observance and celebration. This can involve changes to the times of meals: for example, Muslims must eat after sundown during Ramadan and any food that is consumed must be eaten between sunrise and sunset. Festivals can also change what is eaten: for example, during Passover observant Jewish people will avoid grains that have not been specially prepared. Other people of faith may also have special observances or observe more closely than usual their faith’s food laws during festival periods. For example, many Hindus will maintain a vegetarian diet during Diwali and Navratri even though they might eat some meat at other times. Sikhs who normally eat meat will not do so on festive occasions.
Minority ethnic groups dietary requirements
- A halal diet is followed by people of the Muslim faith typically originating from Pakistan, Bangladesh, Middle East, Malaysia, Indonesia, Sri Lanka and Africa.
- Unlawful foods for observant Muslims include: pork and pork products. meat not slaughtered by proper halal methods; foods containing ingredients or additives from a pig or non-halal meat; foods containing gelatine, animal fats or emulsifiers from animal derivatives; blood and its by-products and alcohol. The acceptance of shellfish varies by community.
- Queries about manufactured foods that have been certified as halal can be addressed to the Muslim Food Board UK: http://www.tmfb.net/home
- The Hindu diet is followed by people from the Gurajat and Punjab areas of India and also east Africa.
- Dietary practices and food restrictions of the Hindu diet vary depending on the individual. Many Hindus practice vegetarianism, eating largely plant-based foods - fruit, vegetables and pulses - and avoid all meat, poultry and seafood.
- Eggs are not usually eaten, but cakes or biscuits containing eggs are mostly considered acceptable.
- An increasing number of Hindus residing in the UK, particularly men, eat meat such as mutton lamb, chicken and fish. However, the cow is considered scared and consumption of beef is rare.
- Observant Jews never eat pork and pork products, and will only consume kosher meat, i.e. meats from ruminant animals with split hooves and which chew the cud (e.g. beef, lamb, mutton or goat), or poultry (chicken, duck, turkey and goose) that has been slaughtered according to religious guidelines.
- Only fish with scales and fins are eaten (not shellfish or eels).
- Dietary practice requires the separation of meat and milk products served at the same meal or cooked together.
- For Jewish clients who keep kosher, it is often advisable to purchase specially prepared and sealed kosher meals from a certified supplier to avoid complications. A food guide listing all foods certified as kosher is available from the London Beth Din: http://www.kosher.org.uk/
- Some Sikhs are vegetarians, and may avoid all meat fish and eggs.
- Other Sikhs may eat meat but will not eat meat slaughtered according to the guidelines of other religions (halal or kosher) and some do not eat beef or pork.
- Observant Sikhs will not consume alcohol.
- There are no set dietary laws and a great deal of diversity.
- Many Buddhists practice vegetarianism, on the basis of ‘do not harm’ and/or reincarnation principles. Some are vegan.
- Other groups, often from China or Vietnam, will not eat onion, garlic or leek (‘pungent spices’), and Tibetans will rarely eat fish and often avoid chicken.
Ayela Spiro, British Nutrition Foundation – QCS Expert Nutrition Contributor