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Hospital food - is anything being done?

  • c

I recently spent a lot of time visiting the hospital where a friend of mine was very, very sick. This was a good hospital, one of the best in the country (Mass General). But the food was appalling. Cheap, greasy, and most definitely not health-promoting. There were some decent alternatives, like a fruit plate with yogurt, but mostly there was a heck of a lot of white flour and sugar, and sandwiches made with Kraft singles, and highly questionable hamburger - the sort of food you could get a Big Boy restaurant or maybe a Denny's. I don't eat this sort of stuff when I'm well because it makes me feel gross. She had to eat this stuff three meals a day for two months.

I'm frustrated and angry that we feed sick people food that is so lacking in nourishment. I've searched the internet unsuccessfully for any U.S. programs designed to improve the quality of hospital food. (There is an initiative in the U.K. in which a group of organic farmers and hospital nutritionists are working together to improve food in a few hospitals.) There are several programs aimed at improving the food in schools, but as far as I can tell, none aimed at hospitals. Does anyone know of anything? If no programs like this exist, could anyone suggest a larger group, like SlowFood, that might be interested in working on this issue? I would like to volunteer my time to such a program, would even go so far as to spearhead an effort, but I don't know where to start.

Link: http://seasonalcook.blogspot.com

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  1. Interesting. Our Slow Food Convivium has discussed this as an opportunity for our involvement and we plan to look into it at our local hospital. Last weekend there was an article about the school food in Berkeley where despite Alice Waters' efforts, it was still pretty bad so her foundation hired a chef for 3 years to improve the lunch program. One of the difficulties was that by law they have to use commodity foods which can not be sold, returned, or given away! Also, all the recipes need to be approved by the FDA for nutritional content! She is making progress but it is slow going. Given choices, the kids seem to be learning to make good ones.

    Anyway, it made me wonder if hospitals are bound by the same rules and purchasing orders. It might not be so bad for a patient who is in for a few days, but when someone has a long stay poor food certainly can't help their recovery.

    I'll raise this issue again at our next mmeting and see if anyone has started on it and what we can find out locally and also email you so we can be in touch that way.

    Link: http://www.sfgate.com/cgi-bin/article...

    1 Reply
    1. re: suzannapilaf

      As an administrator for one of the largest food programs in the US I would be inclined to agree that the hospitals are most likely regulated by US Health and Human Services and that the meals must meet certain dietary guidelines. These guidelines would limit salt and fats and refined sugar and increase things like fiber. This does not sound like it is happening though.

      I have worked in a couple of hospitals and I would guess that good food is the first thing out the window in the face of budget concerns because of the perceived expense of providing good, healthy and innovative menus. And if you have not noticed before, healthcare workers have some of the worst diets and a disproportionate number is in fact, over-weight.

      Doctors have their own lounges and pharmaceutical companies bring in only the best of the very best for the docs to eat. At the risk of sounding very bitter I think these pharmaceutical companies should show that they have some heart or soul and either provide these delicious meals to patients or perhaps cough up some dough and provide some grant opportunities to improve hospital food!

      A good jumping off point would be attaining a grant to do a pilot with some well defined outcomes and some rigorous methodologies so that the meal program could be replicated in other hospitals. If anyone can do this I know for a fact that not only will the patients love you but the families, doctors, nurses, support staff, and administrators will as well! You might even score an invite to the White House for a congressional medal of honor- who knows?

      I know that some grant money was given to a mid-western school to start a school lunch program that was extremely innovative. As I recall a chef was brought in and organic food was used and some really great menus were developed. It tuned out that these menus were not only healthier but also cost less than the contracted vendors that the school had previously used. If anyone can recall the program, the school, or the source of the funding then that would be a good start. Any grant writing hounds out there with some time on their hands that want to do some research?

      What a fantastic topic!!!!

    2. It is truly a sorry state of affairs – glad you brought it up. I am a former hospital dietitian and the food was an embarrassment in both of the hospitals I worked at. Thankfully in the newborn intensive care unit where I worked there wasn’t any food to be served, of course, save breastmilk and formula.

      Western medicine is focused on medication and procedures, not on holistic treatment which would include decent, nourishing food. The hospitals where I have worked emphasize “comfort food” rather than trying to make sick people eat something they aren’t familiar with, but that gets distorted into Denny’s-style food. Processed food is cheaper - in the short-term.

      Registered dietitians (who generally head hospital foodservice) are well trained in chemistry, anatomy, physiology, and food science. We are more than qualified to analyze food and diets for fat, carbs, protein, vitamins and minerals. We are the best people to recommend supplements or intravenous nutrition. But our schooling does not necessarily include food, cooking, or cuisine. It does not include the cultural, psychological and spiritual implications of food and how food is eaten, particularly when one is sick in the hospital. I currently train dietetic interns and half of them can’t follow a simple recipe and aren’t familiar with ingredients or cooking terms. It has become my personal mission to educate the six I get each year. Otherwise, what dietitians know about food often comes from food processors and manufacturers. Or from USDA. Also, a significant percentage of dietitians get into nutrition as an attempt to solve their own disordered eating.

      Most hospital foodservice is run by foodservice corporations like Sodexho and Morrison whose interests are not in patient care or patient health, and certainly not in food. Plus, the powerful supplement corps. (Nestle, Ross, etc) lobby dietitians heavily so we recommend a can of Ensure instead of a wholesome snack of real food. The American Dietetic Association annual meeting is a frightening melee of dietitians stuffing bags with samples of Splenda.

      What’s being done? Sadly, I don’t see much coming from dietitians with the exception of Field to Plate, which trains dietitians and food service people www.fieldtoplate.com

      These organizations need to hear from all of us:
      American Dietetic Association www.eatright.org
      ADA Food and Culinary Professionals www.foodculinaryprofs.org/

      1. My understanding is that, at least for some hospitals, the continuation of the use of unappetizing food is encouraged by the desire to get patients out quickly. I thought this was urban myth, but I've had more than one medical person tell me tales to make me reconsider.

        1. I'm gonna have to post this info again, aren't I?

          Maybe in a "hospital food" thread people won't go "yuck."

          See what Britain's up to: www.betterhospitalfood.com

          Let me again particularly recommend

          See their "flexi menu", their wide array of choices, their ideas for 24-hour catering, and more.

          I can also say, about American hospitals, that my 2-week stay 5 years ago offered tasty and balanced meals, plus snacks, and I still lost weight (a good thing for me) without feeling hungry. And I ate every darned thing on every plate. Maybe I "lucked out", I know hospitals vary widely. But I went to visit a friend 6 months ago and found the "run of the mill" hospital I knew at that address modernized, every room private, food anytime you wanted, and it was good.

          HOWEVER, aside from the food, the hospital I was in years ago had changed in one respect: I attribute it entirely to financial concerns that the nursing staff gave me a very poor impression - I wouldn'tr want to be stuck there these days for fear of my life.

          2 Replies
          1. re: Wayne Keyser
            janet of reno

            I recently had the misfortune of spending the night in a hospital far from home (with no one to bring me goodies...). Because surgery was a possibility when I was admitted, I wasn't allowed any food that night. the next day breakfast was adequate and reasonably healthy...probably my biggest complaint was that the oatmeal was a little cold...but I got them to heat it up in the microwave. I had oatmeal, wheat toast, scrambled eggs, bacon, coffee, and a half grapefruit. Not a bad breakfast. Oh, and a non-food observation: the ER that night was packed. A total zoo. But the hospital floor was empty. Thirty beds and three people. I think that the insurance companies are all encouraging the docs to see the patients in ER and send them home.....

            1. re: Wayne Keyser

              Thank you. I had seen a reference to this in the article about the organic farmers/nutritionists initiative in Britain, but I appreciate the chance to look in-depth at this program. I was hoping perhaps that something was being done in the U.S.

            2. It is my understanding that hospital food is Rocco's next calling.

              1. My son just spent a week in MGH - this time no dietary restrictions - when he's back in August (for open heart surgery) it will be a different story.

                Simple solution: first night, stopped by Kotobukiya - Cafe Mami and brought in katsu curry with a side of sushi. Second night, made his favorite salisbury steak w/mashed & gravy & greens and brought that in. Third night, spring rolls and a large pho from our favorite Vietnamese place... etcetc...

                I just don't expect hospitals to provide our "normal" menu. Even if they did serve nutritionally correct food, why should anyone have to put up with food that doesn't meet their everyday standards? The answer, of course, is that they don't - that's what friends and family are for. I just don't look at it as the institution's responsibility.

                I made lunches for all my kids all throughout school - same reason. I simply did not expect my tax dollars to be paying for lunches that met our standards.

                Over the eight months that I went in for my chemo treatments at the Lowell GH cancer center, I grew to the point of being totally disgusted with their food. I avoided bringing in any outside food in case I would begin to associate it with the nausea. It worked. Now I still really like all my favorite foods, but I get nauseous just thinking about hospital food! And as far as I'm concerned, that's exactly its purpose!

                In August, as soon as my son is off bouillon, he's getting a nice beef curry!

                12 Replies
                1. re: applehome

                  I'm sorry, I just can't agree. My friend was in the hospital for a total of 2 1/2 months. She was lucky enough to have friends and family by her side as much as possible, but providing three meals a day far from your home kitchen is a huge undertaking, not to mention an expensive one during a time when hospital expenses are challenging enough. And during the time she was in the MICU, she was usually the youngest person there by at least thirty years. Many of the older patients had no one to visit them - why should they have to eat substandard food just because they lack social supports? I also know that I was frequently nervous about bringing food for fear that there were certain dietary requirements I was unaware of (her condition changed from one day to the next) and she might not be able to eat what I brought her.

                  I'm not expecting gourmet food - I am expecting nutritious, reasonable food. I believe it is the responsibility of an institution committed to healing to provide food that assists in that process, rather than hampers it.

                  1. re: curiousbaker

                    Did she ask to talk to the nutritionist? Just like a hotel, a hospital should have a nutritionist and food service staff member available to visit the patient in her room and discuss her dining requirements. She could also get a doctor to order her special healthy meals. Its terrible that they serve unhealthy unappetizing food but maybe it will help if enough patients send it back and request something else. Failing that I would suggest a hunger strike and calling the local TV station to cover it.

                    1. re: Marie

                      Hospitals employ Registered Dieticians not nutritionists. The RDs have degrees in food and nutrition and dietary science. Very few so called nutritionists do.

                  2. re: applehome

                    Best of luck to your son, I'm sorry he has to go through all of that. You are a good mom making sure that he has food that will please him. I wish him well.
                    It is pretty unpleasant to be ill and be presented with substandard food. I was in our local hospital some years ago and dinner was so awful that they ran out of antacids that night. Everyone who ate was miserable with indigestion that night.

                    Something I have discovered this spring when I have been going through a bunch of pain and nausea is that a bit of really dark chocolate can help you feel better while waiting for pain medication to kick in. I see a neurosurgeon tomorrow and will finally find out what is next with what has finally been diagnosed as a large herniated disc in my lower back. If this turns out to need surgery I have already told my husband he will be bringing me dinner.

                    1. re: Candy

                      Thanks, but it's Dad, not Mom. This is my youngest son's 4th open heart - we've spent many, many months at the hospital - my wife and I have always taken turns bringing him food, usually just dinners, and not necessarily every night, but certainly the great majority. It's been a long time since the last one.

                      One medical/food related story is that in between the 2nd and 3rd surgeries, he had to take some very strong regulating drugs to control his arrhythmia (tachycardia, where his heart would just start racing away). This drug (I have long since forgotten which one it was) made everything incredibly bland tasting - so here was this 4 year old, demanding the spiciest food you could imagine. He went through bottles of tabasco and he ate beni shoga (the tangy red pickled ginger) and kim-chi with everything. They gave him a pacemaker with his 3rd operation (along with a prosthetic valve, which is now being replaced) which precluded the need for the drug and he quickly went back to more normal tastes - but not completely - he is still the family hot-head - completely outdoes me on anything with heat.

                      Back problems are hell. I hope things work out for the best for you.

                      1. re: applehome

                        Sorry about the gender mistake. Some of our "names" on this board leave no clue.

                        I saw my neurosurgeon this AM and that herniated disc will be a thing of the past in a little over 3 weeks. Thanks for the good wishes.

                    2. re: applehome

                      OK, so you have a wonderful arrangement, congratulations to you and thrice hooray. But what about the people who do not have relatives or friends to do this for them? Who might be in hospitals hundreds of miles from where they live, or who are old and lonely, or whose family just can't afford to visit them? It's OK to have them eat disgusting crap because that's all "our tax dollars" are good for and they should have arranged things otherwise before they got sick?

                      I am sorry but this kind of smugness really gets my goat. It's totally the 'let them eat cake' attitude.

                      1. re: Sir Gawain

                        A private institution like MGH doesn't live on tax dollars - so the question is whether or not they're giving you the bang for buck based on what you have paid, or through an insurance system, have had the insurer (could be the government) pay for you.

                        I would expect that the real bang for buck we want, comes from the primary purpose of the institution - that of specialized medical care - not the ancillary products, like food.

                        The expectations for ancillary services ought to be minimal, albeit adequate, especially in terms of health. The OP's point was that MGH's food service was not adequate. I did not disagree (although she did with me). I simply said that my needs (my family's needs) were higher than that, and that I would not expect any institution that wasn't specifically there to provide me with the service of food, should have to provide me with a level of food service to meet my requirements.

                        Perhaps that sounds hoity-toity. But consider this. This site is about extraordinary food, extraordinary people looking for, making, sharing information about extraordinary food. So a comment on my part, saying that my solution for months and months of my son's staying at a hospital over many years was to provide the level of food he had grown to expect, by our own effort (and $$$), is not, IMHO, out of line.

                        I feel that that the addressing of institutional food service needs through chowhoundie ways (Wayne's link, or Alice Water's Edible Schoolyards projects) is an excellent topic of discussion here. And certainly, anybody asking about bad institutional food might benefit from discussions of chowhoundish solutions.

                        In any case, thank you for hooraying me thrice. You know, we could save a lot of bandwidth here if you published your email, or simply emailed me at my published address. Your indignation certainly rings untrue, when you lack the courage to do anything but take potshots from behind the wall of anonymity. Of course, we would rob our respective readership (of whatever proportion) of their cheering/jeering activities - but none of this actually ever helps anyone looking for food information.

                        1. re: applehome

                          You're a lawyer, right?

                          1. re: applehome

                            In fairness, you were the one who brought up "tax dollars", albeit in the context of school lunches--it wasn't entirely clear that you were drawing a distinction between the types of funding for school lunches and hospital meals. To the extent that hospital costs are often funded by insurers, whether government-sponsored or not, we are, for the most part, paying those premiums in any case, whether directly or through payroll deductions.

                            I do take your point about keeping expectations for hospital food at a reasonable level--however, it is easy to see how it could be misconstrued, given that the OP's original point had been about the absence of food that was "health-promoting" and "decent", not food that was "normal" and up to her friend's "every day" eating standards. The OP gave, as an example of a "decent" option, a fruit and yogurt plate. This was not a cry for specialized, gourmet items, or even items of home-cooked or restaurant quality (for which, I agree, a patient's best bet is still going to be a home-cooked or restaurant-delivered meal), but rather for food that wasn't ultra-processed and actively unhealthy.

                            While your particular situation with your son is terrible and, given his age, less likely to be food-related (I have no idea), I think it's disingenuous to call food an "ancillary" item in hospitals. Food and food-related health issues (such as obesity and cholesterol), are at the very least a contributing factor to why many people end up in the hospital in the first place. The food that the OP was describing sounded health-deterrent, in both a physical and a mental sense. That, to me, is a hospital abdicating its responsibility to do no harm.

                            Health-promoting food options (not gourmet, not sprinkled with a mother's love, just not disgusting or all-fried-all-preservatives-all-the-time) are not ancillary to those of a hospital's goals that concern a patient's actual health, whether short- or long-term, and not just the cheapest, most efficient way to prevent a mass of patients from starving to death while preparing for or recovering from whatever brought them to the hospital in the first place.

                            1. re: applehome

                              I don't think that hospitals are obliged to serve gourmet food, but they certainly should be serving nutritious and safe food. The last time I was in the hospital -- about three years ago -- most of the food was highly processed (canned veggies, canned gravy, etc.) and most of it arrived about room temperature. The health department in my town cites restaurants for not keeping food at the proper temperature. This is considered a "critical violation". Hospitals should be held to the same standard.

                              Simple food decently prepared is surely within the grasp of any institution that cares about its patients and employees.

                          2. re: applehome

                            Sounds like you know good food and how important it is to the soul. So many people are all alone in the world - curiousbaker made a good point about that. I used to volunteer with Hospice, making meals for patients and families. Now I do this on occasion for Ronald McDonald House. It is very gratifying to make a special request for a patient or exhausted caregivers. I suggest this activity to any hound, especially those that are truly concerned for those that are alone or in a lonely and stressful situation.

                            My thoughts are with you and your family - I can understand how stressful this is for you.

                          3. recently i had to spend 4 days at cedars sinai hospital in los angeles and i must say i was pleasantly surprised by the food. there were a large number of choices for appetizers, mains, sides, desserts, and beverages, making it possible to eat extremely healthily (which is what i did for the most part) or unhealthily depending on what one chose. actually, i didn't have much of an appetite most of the time i was there, and the quantity of food was more than i would eat when i'm feeling well - i thought that maybe they offered so many items in each meal in hopes of stimulating people like me to eat something. but anyway, for the most part i found the food to be fresh and tasty - i picked things like oatmeal for breakfast, turkey on wheat for lunch and baked chicken for dinner, plus lots of fruits and vegetables. but i guess the key is that that's what i picked. i could also have had bacon, french toast, pizza, enchiladas, potato chips and cookies.

                            1. I doubt it is any worse than the crap that American kids eat at school for thirteen years of their lives...

                              1. I recently spent a week in Emerson Hospital (Concord, Mass.) and must say the food there was very good. Tasty, healthy, reasonable size portions, wide range of choices. No, not particularly chowish, but do you really want that in a hospital?

                                1. My fiance was at Penn Hospital in Philadelphia today, and was surprised to find that they have a sushi chef. He said the sushi was not bad at all--your basic takeout-type.

                                  1. s
                                    sally from LA

                                    The hospital my mother was admitted to had taken a lot of trouble to vary the menu with dishes of various ethnicities, such as Thai,Chinese, French and Italian. The only problem was that they had forgotten to cater to simpler tastes - none of these foods appealed to an 80+ old lady, who had to survive on bread rolls and cheese for the duration of her stay.

                                    1. The food at our hospital, Rogue Valley Memorial, is really very good and they offer quite a variety. My only complaint, during a three-night stay last year, was that my coffee always arrived too cold and too weak. I should have been born on the Right Coast, where you can stand your spoon up in the coffee...tee hee.

                                      1. i totally agree, especially the part about the holistic approach to healing and health.

                                        so did anyone mention that kaiser (aren'th they the biggest hmo in the country?) is hosting the 'thrive' campaign, along with farmer's mkts AT the hospitals?

                                        that is certainly a good step, but i would also consider setting up a delivery system, where the nutritionist pre-selects entrees from local restos and patients can order them (for a fee, if necessary). let the professional food preparers feed people, not hmo's.

                                        1. I was recently in a Newport Beach, California hospital for a three day hospital stay.

                                          I was on liquids the entire visit.

                                          The first meal was so salty, I left nearly all of it. Not a good start when you're supposed to be 'recovering'. The dietician came in to see me, and I told her everything was way too salty for me. My next meal reflected my concerns, along with a slip that had all my 'no-no's'.

                                          This meal consisted of a very delicious spicy tortilla soup, that sadly was only 4 oz. I coulda used more.

                                          1. A Bob's Big Boy burger is not a "highly questionable hamburger."

                                            1. Mme ZoeZ was hospitalized for a 23 hour day at Century City Hospital in Los Angeles a few months ago. The hospital hired the Puck Organization to put together a menu but the beauty of the whole operation is that food is on demand and from a menu. Fast service with a waitperson dressed in white shirt/tie/apron bringing the food freshly made. I was waiting in the room and asked for a cup of coffee and it arrived within minutes (person came back to ask if I wanted a refill). Good soups, salads, desserts and "sicky food for sickies like applesauce and oatmeal". Had a omelet too which was excellent. They will have a Puck restaurant instead of a cafeteria shortly.

                                              1. There are some efforts to bring organic, seasonal, sustainable food to hospitals in California at least. I helped to organize a roundtable on this issue and we had approximately 60 people from several hospitals in the San Francisco Bay Area come to the presentations and break up into discussion groups. It's slow going especially since most of these hospitals do have those dietary restrictions and have to purchase their supplies through group purchasing organizations but I have heard of several hospitals that have been able to make small changes and also some small hospitals that have been able to switch to made to order meals.