Case Study Presentation: British Heart Foundation Social Cooking Project

Azmina Govindji RD

Member of Ethnic Strategy Advisory Committee, British Heart Foundation

Site Dietitian for The Ismaili Nutrition Centre (www.TheIsmaili.org/nutrition), Aga Khan

Health Board UKCampaign dietitian for Change4life BME

interventionswww.govindjinutrition.com

The menu…

• British Heart Foundation Social cooking intervention (2007-2009)– what we are doing with places of worship

• Brief insights:– The Ismaili Nutrition Centre website (2009)–

based on traditional recipes from relevant communities

– Change4life BME Campaign (2009-2010)

• Learnings and recipe for success

POCKETS OF SETTLEMENTS e.g.

• Brent, Harrow, Leicester - Gujarati Hindus

• Southall, Birmingham - Punjabi Sikhs

• Tower Hamlets, Bradford - Bangladeshi Muslims

EXT-E-ND-ED FAMILY

BHF Social Cooking

• Why we chose places of worship• How much salt reduction?• The intervention• Visuals & methods• What did we learn?• How to run a similar programme

Why salt reduction?

around 50% higher risk of dying prematurely from heart disease (1)

diastolic blood pressure significantly higher in Indian men 2)

Indian men higher rates of stroke (2)

adding salt during cooking almost universal (over 95%); 35%

of Indian men also added salt at the table (2)

6% knew the max recommended salt intake was 6g a day (3)

[1] BHF coronary heart disease statistics (2005). British Heart Foundation Health Promotion Research Group, Department of public Health, University of

Oxford

[ 2] Health Survey For England – The Health of Minority Ethnic Groups 1999, Department of Health, July 2000

[3] www.stroke.org.uk/media_centre/press_releases/south_asians.html

How salt reduction?

• Temples Gurdwaras

Rationale

Volunteer cooks in gurdwaras and temples prepare communal meals

for large numbers of people on a regular basis (social cooking).

Working with cooks allows us to demonstrate how salt reduction

needn’t impact taste

Enables learning to be transferred to the

home (word of mouth +++)

Focuses on what you can change

Talks to congregations

(importance of salt/fat reduction, advice, labels etc)

How much reduction?

What is practical, achievable, realistic?

Aim to reduce salt (& fat) by 5%

Educate the chefs and the head cook on healthy cooking and how to reduce salt & fat

Talk to volunteers & congregations - increasing awareness on the importance of salt reduction

The intervention – in the kitchen

• Each place of worship taking part in the project received four (or more) visits from a dietitian.

• 1st visit to measure baseline data• Cooks advised on salt and CVD, and raised incidence

amongst S Asians• Practical tips on using herbs and spices to ↓salt

Cooks corner…

Ghee makes you strong &

gives you strong bonesThe older generation used to have ghee with every thing and

they do not suffer from heart disease?People won’t eat the food if there is not enough

salt in itThe food will go off if a lot of oil is not added to the

food If food is not tasty, it will not be

eaten and will wasteIf you don’t add enough butter to

chapattis they will go rock hard

The intervention – the congregation

• Fun, interactive sessions• Displays, posters, handouts• Radio shows• Work with them, eat with them, play with

them…

So, what did we achieve?

• Original target: 5% salt reduction

Result: 5-10% achieved in all places of worship, 10% in most of them!!!!!

A recipe for success

• Preliminary visit before you even start• Work with the leader• Identify and influence the key decision maker (head

cook? person who adds seasoning?).• Discuss barriers: cultural, religious, political• Give out leaflets• Publicise – posters, radio • Explain the intervention.

A recipe for success 2

6. Timeline - in writing, get an agreement7. Take measurements - ‘muthi’ (fistful), spoon, glass,

grams. 8. Discuss the best methods with head cook.9. Measure on same measuring device every visit.10. Keep in touch with the head cook between visits.

Read all about it….

http://.wwwfoodvision.gov.uk/pages/reducing-salt-in-social-cooking-in-temples-and-gurdwaras

Local project with global impact

The Ismaili Nutrition Centre

• Launched by Aga Khan Health Board and DH on 18 June 2009

• Based on research at Kings, 2000• Supported by FSA, BDA, BHF, DUK, BNF, C4L• New website that promotes healthier eating,

emphasising the value of preserving traditional dishes

TheIsmaili.org/nutrition

DH Change4life BME initiative

Reaching the Community

• Stakeholder Conferences• Gatekeepers – cookery demos

• Family pressure to have ‘chubby’ children.• Children doubling up on meals.• Western food can often be consumed as snacks • Often unhealthy choices (chips, pizza and burgers)

Healthy Weight, Healthy Lives: Consumer Insight Story (2008)

A recipe for success

•Understand your audience•Use their language e.g. roti, dahl•Build rapport•Get the stakeholders involved•Use all levels of communication•Seek out the ring leader•Be aware of internal pressures•It takes time to create any change

•Cultural, social, religious factors•Notice what happens behind your back•Press the pause button!•Build on the good work

www.govindjinutrition.com