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Surveys (2008-2018) carried out by the Local Health Agency of Trieste (ASUITS) in local collective catering (CC) services of schools, hospitals, nursing homes, and workplaces (25.000 daily meals) have shown some non - adherence to healthier food choices, food standards, procedures and green and social procurement as recommended by the WHO, FAO, UE, Ministry of Health and of Environment. The purpose of this project is to support local public and private organizations in transforming the national and regional catering services food standards related to health, nutrition, environment and social criteria into food procurement and food contracts specifications. This has been done by compiling the major obstacles to improved standards observed during surveys, and by sharing critical and relevant examples with major public contractors across local, regional and national level. The guidelines (GL) for public procurement of CC consist of five chapters: the elaboration of specifications; a response module to present the offer of services; selection and award criteria, an evaluation system of offers, and the technical specifications attached. Technical information fixes the constituent elements of the service in order to have similar and directly comparable offers. GL cover both the purchasing of food and the contracting of catering services. In this way public or private institutions are able to prepare tender documents suitable to respond to health, economic needs and Sustainable Development Goals (SDGs). The development of the GL has increased the awareness and real potential that local organizations have in enhancing the strategic use of purchasers to boost food qualification, jobs, growth and investment. As well as to create a more innovative economy, to be resource and energy efficient, and to be socially-inclusive. To meet population nutrient intake goals and SDGs it is necessary to increase co-operation and the sharing of the objectives of ’Health in All Policies’. Key messages Contractors need practical tools to apply sustainable development goals criteria in collective catering. The integrated collective catering guide is a key to improving capacity building in institutions.

According to the literature the prevalence of the risk of malnutrition o hospitalized people exceeds 25% of patients, this evidence is also related to low meal satisfaction. To reduce hospital malnutrition it is also important to improve the consumption of meals by implementing organoleptic and nutritional quality (O&NQ). The Local Health Agency of Trieste (ASUITS) has conducted surveys to find out how to evaluate and improve the procurement qualifications of hospital catering systems (HCS) and how to implement O&NQ. The production processes of meals served in two clinics using Cook Chill (CC) and Cook/Fresh - Hot Hold (CFHH) production process, respectively, were evaluated from 2017 - 2019. The Nutrient Analysis Critical Control Point process was applied for the evaluation of two catering systems. In addition, the antiradicalic power (ARP) of 120 samples of meals by the University of Trieste was analysed. In 2019 an investigation was conducted to compare the satisfaction and ARP content of meals served to patients in two hospital wards (N = 60). The meals to patients of two wards respectively with CC Cold Plating Retherm (PR) and CC Hot PR were served. Meals produced by the CC production process highlight the average loss of 50% of ARP compared to the CFHH. Meals produced by the CC Cold PR method limit the loss of ARP by 15-40% less compared to the CC Hot PR method. The satisfaction of patients who have consumed meals produced by the CC Cold PR method is double compared to that of patients who have consumed meals produced by the CC Hot PR method. The surveys have produced significant evidence to evaluate hospital meal production processes and to improve O&NQ. The results were used to develop recommendations for the drafting of tender specifications capable of also protecting nutritional variables. The evaluation of the O&NQ of HCS represents a central determinant of food safety and nutrition security and must be taken into consideration in the procurements procedure. Key messages Hospital catering contracts must evaluate and guarantee organoleptic and nutritional quality. Integrated evaluation of organoleptic and nutritional quality is an integral part of hospital meals.

This chapter presents an overview of conditions that are identified to be caused by alcohol use. Some pathological states are briefly reviewed—such as those relating to the liver, the cardiovascular system, the neurological, endocrine systems, and a range of other conditions. The evidence reviewed indicates that if an individual has reasons for being a nondrinker, it is recommended that he or she refrain from drinking to prevent disease, for example, coronary heart disease. It is now fully recognized and accepted that drinking alcohol regularly for years is toxic to almost every tissue of the body. Alcohol's capacity to cause biological damage and, therefore disease has been widely demonstrated through biochemical studies, both experimental and epidemiological. Various meta-analyses have established alcohol's role in a wide range of physical, mental and social harms, with practically no organ in the body immune from alcohol-related harm. The WHO (1999) states that there is sufficient evidence to indicate that alcohol is a significant threat to world health and that 60% of the alcohol worldwide disability adjusted life years (DALYs) come from the years of disabled life.