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Food First

Food First

Sharing our specialist knowledge to empower others to make nutrition and hydration a priority

What we do

The Food First Team consists of Registered Dietitians, Assistant Practitioners and Support Workers striving to improve the identification and management of malnutrition and dehydration in older people care homes and in the wider community. 

The Food First Team aims to reduce the incidence of malnutrition and dehydration in Luton and South Bedfordshire by:

  • Taking a food based approach first line where appropriate for the management of malnutrition in older people.
  • Working in collaboration with primary care (e.g. GPs and District Nursing) to ensure the appropriate prescribing of oral nutritional supplements and specialist infant formulas. We also support with gluten free product prescribing in Luton only.
  • Working with older people care homes to support them with meeting the Care Quality Commission’s (CQC) Regulation 14: Meeting nutritional and hydration needs. The team provides interactive training that covers the identification of malnutrition risk using the ‘Malnutrition Universal Screening Tool’ (‘MUST’) and how to manage someone at risk of malnutrition using a food based approach first line, where appropriate. Following training the team support care homes to achieve and maintain high standards of nutritional care by auditing nutritional care plans. Where standards are met, a certificate is issued demonstrating good nutritional care (valid for one year).
  • Providing one to one clinical dietetic support to individuals in care homes who meet the service referral criteria.
  • Highlighting nutrition as a priority to all.

Food First resourcesMeet the team Information for health professionalsInformation for care homes

What is malnutrition?

Malnutrition is defined as a state in which a deficiency of nutrients such as energy, protein, vitamins and minerals results in measurable adverse effects on body composition, function or clinical outcome.1 Malnutrition can affect anyone; however it is particularly common among older people and people admitted to hospital.

Consequences of malnutrition include: increase risk of infections, increased risk of pressure ulcers, slower wound healing, low mood, increased risk of falls, reduced energy levels, increased chance of hospital admissions, longer hospital stay, muscle weakness and reduced strength.

How to spot malnutrition?

Someone may be malnourished if they have:

  • A body mass index (BMI) under 18.5kg/m2
  • Unintentionally lost >10% of their body weight within the last 6 months
  • A body mass index (BMI) under 20kg/m2 and lost 5-10% of their body weight within the last 6 months
  • Loose clothing, jewellery or dentures
  • Loss in muscle strength or functional ability


It is very important that everyone keeps hydrated, especially in hot weather or when you exercise. Everyone should aim to have at least 1.6 – 2 litres (around 6 – 8 glasses) of fluid per day to stay hydrated. Keeping hydrated can prevent or aid the treatment of constipation, low blood pressure, urinary tract infections (UTIs), pressure ulcers and falls. Keep an eye on the colour of your urine; if it is dark you probably need to drink more.

So whether you or someone you know is underweight, experiencing unintentional weight loss or struggling to stay hydrated, explore this website using the links below for further advice.

Food First advice

Where appropriate the team advises to use a food based approach as first line to manage those identified at risk of malnutrition. This approach consists of three key principles:

  1. Fortified diet: Adding extra energy and protein to meals/snacks without increasing the size of the meal/snack.
  2. High energy snacks: For a little and often approach and good for those with a small appetite.
  3. Nourishing drinks: A milk based drink which is a good source of energy and protein and can tailored to meet individual preferences.

For more details on the above and more advice sheets please see our resources page.

We are unable to accept self-referrals. If you or someone you know may require further dietetic support please discuss with your GP or other healthcare professional and if a resident in a care home with the care home staff.

Awards and recognition

The Food First Team are proud to have won or been nominated for many local and national awards for our outstanding work which aims to highlight nutrition as a priority. See our latest achievements below:

NICE Shared Learning Awards (2018) – Finalist for this award for the team is tackling malnutrition in care homes using a sustainable, non-medicalised approach.

Cambridgeshire Community Services NHS 70th Anniversary Exemplary Contribution (2018) – Awarded this for the team’s continued commitment to improving the identification and management of malnutrition and dehydration in the community.

Advancing Healthcare Awards: Improving Quality, Measuring and Demonstrating Impact (2018) – Finalist for this award for the work the Food First Project has accomplished when transferring the project into a new CCG.  

South Essex Partnership Trust: In Tune Award (November 2016) – Multiple members of the team were have been awarded this due to their achievements and provision of excellent customer service on a daily basis. 

Health Service Journal (HSJ): Value in Healthcare Award (2016) – The team was shortlisted for the Value and Improvement in Medicines Management category at national Health Science Journal ‘Value in Healthcare’ Awards.

Advancing Healthcare Awards: Improving Quality, Measuring and Demonstrating Impact (2016) – Finalist for this award for the work the Food First Project does in terms of demonstrating our impact and measuring outcomes.

Contact the Food First team

Dunstable Health Centre
Tel: 01582 707629

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The staff are wonderful; the receptionists were polite and efficient, the nurses I have seen, were incredible.