Food First

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

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 general community.

We offer a unique training and audit programme that teaches care home staff how to use the ‘Malnutrition Universal Screening Tool’ (‘MUST’) and how to manage malnutrition using a food based approach where appropriate. The team supports all older people care homes (with more than 10 beds) across Luton, South Bedfordshire, West Mid Bedfordshire and Hertfordshire Valley with training and auditing. The team also provides one to one clinical dietetic support where indicated to residents in older people care homes (Luton and South Beds).


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 particular common amongst older people and people admitted to hospital.

How to spot malnutrition?

Someone may be malnourished if they have 3:

  • A body mass index (BMI) under 18.5kg/m 2
  • 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

Consequences of malnutrition:

  • Increase risk of infections (e.g. chest infections)
  • Increased risk of pressure ulcers
  • Slower wound healing
  • Low mood
  • Increased risk of falls
  • Reduced energy levels and fatigue
  • Muscle weakness and reduce strength
  • Increased hospital admissions
  • Increased length of hospital stay


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 4 (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.

How to access the service

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.