Hospital food often gets a bad rap—most people think of bland mashed potatoes, jello and mystery meat when they picture a patient’s food tray. While that reputation may have been grounded in reality at one time, today’s hospitals and healthcare systems are making a conscious effort to implement guidelines, programs and initiatives to ensure the food they serve patients, visitors and employees is much more nutritious than past offerings.
Food Labels & Certifications
Meat and poultry that have been produced without the
routine or non-therapeutic use of antibiotics carry one or more of the following labels or claims:
- USDA Organic
- American Grassfed Association
- Animal Welfare Approved
- Certified Humane Raised & Handled
- Food Alliance Certified
- Global Animal Partnership
- USDA Processed Verified Program shield along with labels such as “Raised Without Antibiotics,” “No Antibiotics Added” or “Never Ever 3”
Check to make sure the certification has:
- Clearly stated principles and criteria
- Measurable and transparent (publicly available) standards
- Third-party verification
- Improvements to standards as science, technology and
Seafood that has been raised or caught sustainably will carry one or more of the following labels:
- Farmed Responsibly Certified (Aquaculture Stewardship Council)
- Best Aquaculture Practices Certified
- Friend of the Sea
- Certified Sustainable Seafood (Marine Stewardship Council)
“Healthy food,” according to Health Care Without Harm (HCWH), “cannot be defined by nutritional quality alone. It is the end result of a food system that conserves and renews natural resources, advances social justice and animal welfare, builds community wealth, and fulfills the food and nutrition needs of all eaters now and into the future.” As such, it promotes “environmental nutrition.” Hospitals have a unique opportunity and what many see as a responsibility to lead the charge by using food to prevent disease and improve the general well-being of people in the communities they serve.
However, many agricultural practices can negate food’s nutritional value. To determine if food is truly healthy, it is necessary to consider how it was produced, processed and distributed. For example:
- More than 20 million pounds of antibiotics are used in agriculture every year, according to the Food and Drug Administration. The majority of these antibiotics serve to promote growth rather than treat disease. Routinely giving them to healthy animals raised for human consumption increases the prevalence of infection-causing, antibiotic-resistant bacteria.
- Animals in concentrated animal feeding operations (aka CAFOs) live in cramped conditions with no access to pasture, fresh air or light, thereby impacting their overall health.
- The widespread use of pesticides on the farms where animals live and breed also contributes to air pollution, putting livestock producers at risk of chronic health problems.
- Agricultural pesticides, plastics with chemicals (i.e., bisphenol A and persistent bioaccumulative and toxic substances, including methylmercury) are some of the many chemicals of concern touching today’s food supply.
“HealthTrust food contracts offer cage-free eggs, antibiotic-free poultry, beef and pork products, as well as wild-caught fish products,” says Sam Potter, senior director of food and nutrition procurement services at HealthTrust. Companies such as Dannon are even moving product lines toward clean-label, non-GMO and nonsynthetic selections.
Fostering a Sustainable Food System
Local foods have been linked to several government priorities—including enhancing the rural economy, the environment, food access and nutrition, and supporting agricultural producers. In response to rising consumer demand for locally sourced products, many states have mandated a certain percentage of food be purchased locally as part of the 2014 Farm Bill.
In 2011, the Michigan Health & Hospital Association (MHA) asked nearly 150 hospitals across the state to sign and adopt the tenets of the Healthy Food in Healthcare Pledge, part of HCWH’s initiative to help Michigan citizens combat the obesity epidemic. The MHA suggested hospitals commit at least 20 percent of their purchasing to Michigan-grown and sustainably produced food products. Hospitals in the Livonia, Michigan-based Trinity Health system complied, says Joyce Hagen-Flint, system director of food and nutrition services.
Offering Healthy Options On-site
Promote healthy choices by making these changes in the cafeteria at your hospital or corporate office:
- Place signage or labels near better-for-you choices. Use a “traffic light” system and put green labels near healthy choices, yellow near “in moderation” options, and red near non-healthy options.
- Ensure healthy choices are not more expensive than unhealthy choices.
- Don’t offer free refills on sodas or carbonated beverages, a practice which helps cut back on the overconsumption of sugar.
- Provide a salad bar with fresh ingredients and healthy vinaigrette dressings and toppings.
- Skip fried foods and instead offer steamed, baked or grilled options.
- Offer alternatives to cream-based soups and fried vegetables.
- Provide a “healthy meal” discount (such as 10 percent off) to customers who choose more nutritious options.
According to Hagen-Flint, the requirement for those signing the MHA pledge is to “buy local”—meaning products grown, manufactured or distributed by a local supplier. Trinity Health turned to Gordon Food Services, a HealthTrust-contracted supplier.
“Not only is Gordon a Michigan-based distributor, but it has a ‘Near Here’ program that promotes locally sourced products, many of which are contracted through HealthTrust agreements,” Hagen-Flint explains. “This partnership is helping Trinity Health achieve the 20 percent goal that was established for Michigan hospitals.”
Hospital Sisters Health System (HSHS) is committed to offering locally produced foods and beverages at its 15 hospitals across the Midwest, says Rick Beckler, director of environment at HSHS. “Our food department contracts specify that a minimum of 15 percent of our total spend has to be local. We’re able to buy meat, bread, dairy and community favorites, such as coffee, from local farms. In the last six years, approximately 20 percent of our food spending has been locally sourced.”
Each of those suppliers are within 150 miles of any HSHS hospital, in stark contrast to the average 1,500 miles that food is typically transported to reach its destination. Buying local not only supports the nearby economy and ecologies, but also helps reduce air pollution caused by carbon monoxide emissions from food trucks, which can lead to asthma and other chronic respiratory illnesses.
“We feel a responsibility to provide healthy, sustainable foods,” Beckler says. “We want to ensure the food we’re offering patients or selling to staff and visitors is following the highest standards for health, wellness and the treatment of animals. There are no hormones in our chicken, and our meats are Grade A.”
HSHS is also dedicated to working with food suppliers adhering to guidelines of the 5-Step Animal Welfare Rating Program, developed by the Global Animal Partnership to promote continuous improvement in animal agriculture and farming practices that are friendly to animal welfare, and the Monterey Bay Aquarium’s Seafood Watch program, which facilitates the purchase of ocean-friendly seafood.
In the Northeast, Boston Medical Center is taking “local food” to a new level. Earlier this year, the hospital’s first rooftop farm opened at the facility’s power plant building. The farm is expected to produce almost 15,000 pounds of produce in 2017, most of which will go directly to hospital patients and their families, while reducing greenhouse gas emissions.
“From farm to fork, we know what’s touching these crops,” says David Maffeo, senior director of support services at Boston Medical Center. “We’re planting in organic soil and washing the produce ourselves. We know there are no pesticides touching these products. Plus, we’re growing food literally 1,000 feet from where we’re serving it, so we’re reducing greenhouse gas emissions. That’s both healthy and sustainable.”
According to Potter, “Our food program through Entegra—along with its regional partners throughout the country—offers our member facilities a variety of healthy and sustainable choices.” Programs include a farmers market, where customers can purchase fresh and organic produce right at their hospitals. Facility or health system food service directors can set up the program according to their volume needs. Contact Sam Potter (firstname.lastname@example.org) for more information on these and other healthier food options available through HealthTrust contracted suppliers.
Healthy Snacks & Beverages Initiative
Research shows that sugar-sweetened beverages—including sodas, energy and sports drinks, and some fruit drinks and teas—are related to obesity as well as chronic diseases associated with weight gain. In addition, the production and waste associated with sugar-sweetened and bottled beverages have negative consequences for the environment. That’s why Health Care Without Harm is challenging hospitals and health systems to participate in the Healthy Beverages Initiative, which aims to reduce the amount of unhealthy drinks on hospital grounds and encourages visitors, patients and staff to choose non-sugar sweetened drinks, with an emphasis on consuming water.
HealthTrust is helping member hospitals achieve these goals. “Our clients are seeking a balanced approach to wellness with simple ingredients that are lower in calories and sugar,” explains Sam Potter, senior director of food and nutrition procurement services at HealthTrust.
One option is the Evive Wellness Station, a beverage kiosk that cleans, sanitizes and refills a reusable bottle with purified or flavored water. Facilities can choose an employee payment plan or subsidize all or a portion of the cost for their employees. Facility employees receive an Evive reusable bottle that is embedded with an RFID tag that unlocks their member profile, which tracks personal hydration goals, monitors results via wearable technology, and encourages competition with colleagues.
In addition to the Evive Wellness Station, HealthTrust offers Entegra’s Pepsi Right Fit program to hospitals wanting to supply healthier beverages and snacks within their facilities, Potter adds. The program offers water, Naked juices, Gatorade, SoBe LifeWater and Muscle Milk at prices comparable to that of the sodas and other sugar-added beverages they are replacing. Frito-Lay (a subsidiary of PepsiCo) pairs its healthier snack varieties—such as oven-baked chips and Smartfood Popcorn—with the Right Fit beverages. These, when retailed in hospital cafeterias, both offer customers healthier alternatives and generate additional revenues.
Promoting Healthier Choices
Healthcare professionals are consistently ranked as some of the most trusted authorities on health and wellness—and that means they have a responsibility to educate and motivate consumers to make food choices that are healthy for themselves and the environment. At Boston Medical Center, individuals with specific nutritional needs are referred to the hospital’s Preventive Food Pantry by primary care providers who write “prescriptions” for supplemental foods. There, patients and their families can stock up on perishable goods, such as fresh fruits and vegetables, which are grown on the rooftop farm.
“A large portion of our patient population is underserved,” Maffeo says. “About 7,000 patients and their family members visit the pantry each month.”
In addition to the Preventive Food Pantry, Boston Medical Center has a demonstration kitchen where it teaches pantry visitors how to cook the items they pick up and accommodate any dietary restrictions. The kitchen is open to anyone, including hospital employees, who want to learn the ins and outs of cooking healthy.
“Many people come to the hospital and learn they need to change their nutritional habits, but they don’t know where to start,” Maffeo says. “We’re able to teach people how to change their lifestyle by changing their diet.”
Hospitals don’t have to offer a food prescription program to promote healthy eating. Here are six ways they can encourage people to make smart food choices that benefit both their health and the environment:
- Make over the hospital menu. Replace canned and prepackaged foods, which are often riddled with sodium and sugar, with organic fruits and vegetables that are free of additives. Canned fruits and vegetables are banned from HSHS, where only fresh produce gets served, Beckler notes.
- Decrease the amount of meat purchased. On average, Americans eat about 56 pounds of red meat per year, according to the U.S. Department of Agriculture. High consumption of meat fats and processed meats is linked to an increased risk of obesity, diabetes and cardiovascular disease. Seek out companies that raise grass-fed beef and don’t routinely pump animals with antibiotics.
- Rethink your seafood options. The ocean’s fish population is declining, but the demand for seafood is growing rapidly. Today, over half the fish we eat comes from aquaculture, or fish farms, which are not without their faults. Fish farms are overpopulated, meaning fish—and their waste—are crowded together. Antibiotics, hormones and pesticides are required to avoid diseases caused by overcrowded conditions. Purchase seafood from environmentally responsible providers or farms. Boston Medical Center, for example, partners with the Gloucester Fishermen’s Wives Association to help preserve the Atlantic Ocean and bring fresh seafood into the hospital, Maffeo says.
- Banish fried foods. “We just opened a new hospital in Southern Illinois, and we didn’t include a deep fryer in the cafeteria,” Beckler says. “While people still want deep-fried food, we’re slowly moving them to healthier options. The food industry now offers many appetizing products that can be baked, grilled or steamed.”
- Offer community wide cooking and nutrition classes. “We do a lot of cooking classes both in the community and in our kitchens,” Beckler says. “Typically patients are educated on their prescribed diets. We share recipes featuring quality ingredients and, during the holidays, healthy options they can choose at parties and events.” If you offer classes to employees, consider advertising them in the hospital’s internal newsletter. Classes that are open to the larger community can be promoted by placing flyers around the hospital’s public areas, an ad in the local newspaper or posts on social media. Encourage attendees to share photos or post to social media on event day.
- Work with community-supported agriculture (CSA) groups and farmers markets. Help make fresh, healthy food more accessible by hosting farmers markets and CSAs on hospital grounds. Giving people the option to buy healthy foods on-site is a win-win—it helps support community farmers and also impacts the eating habits of patients, hospital employees and members of the community.