By Linda Shiue
originally posted in http://www.culinate.com/articles/features/medical_awareness_nutrition
July 30, 2013

While some medical students and doctors are becoming more savvy about nutrition, health, and cooking, the options for patients can still be generally summed up with the dismissive phrase “hospital food.” It’s not just the unpalatable Jell-O cups; nutrition is often ignored, too.

At the well-regarded academic medical center where I trained, my postpartum lunch tray included a plastic-wrapped, highly processed PB&J sandwich. And this type of offering is the norm. Vending machines in hospitals sell soda and candy, just as they do anywhere else, while hospitals that ban fast-food chains make headlines.

Over the past few years, however, a few hospitals have overhauled their food services to address both nutrition and taste. One of those is New Milford Hospital in Connecticut, which adopted a seasonal, plant-based menu (think portobello burgers and quinoa as entrées). The hospital also developed a program called Plow to Plate, connecting local farmers and fishermen with hospitals, physicians, chefs, and community members.

Marydale DeBor, New Milford Hospital’s former VP of external relations, has launched a New Haven-based consulting firm called Fresh Advantage. With the slogan “Food is Primary Care,” the firm aims to guide other hospitals in transforming their “ancillary institutional food service to health-promoting food care — without increasing costs.”

The Affordable Care Act, DeBor says, has tightened requirements for not-for-profit hospitals to justify their tax status via community benefit. Promoting healthier eating and providing healthier food to patients, she feels, is a highly appropriate way to serve the community.

Meanwhile, other programs are tackling the hospital-food problem. Health Care Without Harm, for example, is an international coalition of hospitals, health-care systems, medical professionals, and community and environmental groups. The coalition, which began in 1996 after the Environmental Protection Agency identified the incineration of medical waste as the leading source of dioxin, now includes 480 organizations and lists reforming the food system as one of its goals.

In 2005, Health Care Without Harm began its Health Food in Health Care Initiative to inspire the health-care industry to “become leaders in shaping a food system that supports prevention-based health care.” This includes coordinating the Healthier Food Challenge of the Healthier Hospitals Initiative, whose pledge to “provide local, nutritious and sustainable food” has been signed by more than 500 hospitals around the country. A 2012 downloadable report on the latter initiative showed that participating hospitals were serving 10 percent less meat, that hospital spending on healthier beverage choices had increased from 10 percent to over 60 percent, and that hospitals were obtaining 4 percent of their food from local and/or sustainable sources.

A similar program was launched in 2012 by the Partnership for a Healthier America, of which First Lady Michelle Obama is the honorary chairwoman. Hospitals participating in the PHA’s Hospital Healthy Food Initiative program pledge to offer lower-calorie meals with an emphasis on plant-based foods. Hospitals in the program need to meet specific food and nutrition standards. They also can no longer offer deep-fried food and must offer only healthy foods near cash registers, which means no more candy bars and chips. Sixteen private-sector health systems, which include more than 150 hospitals, have signed onto the program.

That’s a lot of hospitals, and a lot of pledges to focus on prevention through applied nutrition education at every level. But will all these good intentions bear fruit — such as fresh sandwiches instead of processed PB&J on hospital trays?

Next time you see your physician, ask what she’s cooking for dinner. You might get her recipe for a favorite kale salad instead of a prescription for cholesterol-lowering medication. Or you might just send her home with something new to chew over: the back-to-basics concept of food education.

Dr. Linda Shiue is an internal-medicine physician at the Palo Alto Medical Foundation in the San Francisco Bay Area. She teaches healthy-cooking classes to patients and community groups and writes about food on her blog, Spicebox Travels. Follow her on Twitter: @spiceboxtravels.