Proposal to Primary Children’s Hospital

Our nation is currently experiencing an obesity crisis of epic proportions. For the first time in history, the current generation of American children is not expected to out-live their parents. (Bost, 2004)

Fast food restaurants are on every corner, and it seems like over 90% of the goods sold in any given local grocery store are processed and packaged convenience foods. As frozen and “all in a box” meals grow in popularity, more and more busy Americans are favoring the quick and easy aspect of convenience food, rather than taking the time to prepare nutritious wholesome meals from whole food ingredients.

If this trend continues, it is unlikely that the current generation of children will grow up knowing how to cook anything more complicated than macaroni & cheese!  Dinner has become all about satisfying hunger, rather than about providing enough adequate nutrition to facilitate healthy growth. This new “culture” of eating is literally killing us.

It doesn’t have to be this way. We can reverse this trend, one step at a time. It seems obvious to me that a logical first step would be with the healing institutions of our country.

Hospitals are in the business of restoring the sick and infirm to full health.  Shouldn’t they then also be a role model for how to maintain that state of health? If rehab clinics sent recovering addicts out into the world after becoming clean; without the support to maintain that status, is it likely that they would succeed? By the same token, how does it make sense to treat a type II diabetic or heart disease patient, and then provide them meals that are known to cause those diseases?

Shouldn’t prevention also be promoted, instead of simply curing the current illness and sending them on their way? It seems to be a shocking contradiction, and a hypocrisy of ginormous proportions.

“…the food in many hospitals is no better, and in some cases worse, than what you would find in a fast food restaurant” (Lesser).

Let me take you back with me to my last experience dining at the Primary Children’s Hospital cafeteria.

My 5-year-old son was undergoing an endoscopy (his 6th in 3 years) to assess the level of his disease; and as it was lunch time, my husband and I went to the cafeteria for something to eat. As I glanced around the dining room before entering the cafeteria, I noticed that a good amount diners, both parents and doctors alike, were overweight, and many of them could have been considered obese.  (I noticed, because I’m always surprised to see  overweight medical professionals)

As I grabbed a tray and joined the line of hungry patrons, I scanned the room, seeking something appealing and nutritious. Although there were a number of meal options, the healthy choices were very scant. Front and center as I walked into the room was the “Grill”. I was immediately bombarded with the heady scent of deep-fried onions, french fries, and chicken fingers. The sizzle and pop of juicy burgers searing on the grill caused my mouth to water and my cravings to kick into high gear.

It was difficult, but I was able to tear myself away from the rather long line for the grill, and make my way over to the hot food counter. I was sure that I would be able to find something there that would both satisfy and be easy on my waistline, but I was again disappointed.

The menu options available that day were: chicken enchiladas smothered in cheese, chicken cordon bleu (deep-fried, of course), battered and fried white fish, or thick slices of ham with side options of  instant mashed potatoes and gravy, and mixed vegetables drowning in butter.

Disappointed, I turned around and bumped into what appeared to be a rather large and impressive salad bar. However, 2/3 of the bar was taken up with cheeses, sliced fruit drowning in heavy syrup, and high-fat salad dressings.

I left the cafeteria that day with a salad that consisted of rather wilted greens topped with various veggies, lemon juice, and sliced almonds. Yum. My husband, who wasn’t nearly as discerning, walked out with a tray piled high with the chicken cordon bleu, mashed potatoes and gravy, and a white dinner roll.

Needless to say, our dining experience was a bit different. I ate my salad in misery; wishing it not only tasted better– but was more filling, while my husband ate his meal with guiltless abandon.  I remember leaving the cafeteria not only hungry and mildly depressed, but also angry at the injustice.

Thankfully, I’m not alone with my frustration at this broken system. The following was pulled from an article written by Andres Chavez, and published on Dec 1, 2011 in the San Fernando Valley Sun:

“As health professionals, we understand the connection between healthy eating and good health, and our hospitals should be role models in this regard,” said Dr. Lenard Lesser, primary investigator and a physician in the Robert Wood Johnson Foundation Clinical Scholars Program in the Department of Family Medicine, David Geffen School of Medicine at UCLA. “Unfortunately, the food in many hospitals is no better – and in some cases worse – than what you would find in a fast food restaurant” (Chavez, 2011).

Cafeterias that disregard healthy eating guidelines and serve food loaded in fat, sodium, and empty carbohydrates are, in essence, “thumbing their noses” at contemporary medical advice. How much worse, therefore, is it for doctors and other medical staff to be seen eating that unhealthy fare by the public? It undermines medical authority and creates a “do as I say, not as I do” situation.

In September of 2005, in response to the growing obesity epidemic, the Physicians Committee for Responsible Medicine (PRCM) came up with the “Healthy Hospital Food Initiative”. This initiative outlines 11 practical measures that hospitals can undertake to make their cafeterias and patient meals healthy and nutritious.

“If the food served in hospitals is to be part of the solution to the obesity crisis and the chronic disease epidemic in the United States, some upgrading of the foods served and the nutrition information provided by hospitals to their staff and visitors is needed….. The Healthy Hospital Initiative recommends that all hospitals adopt most or all of these recommendations on a regular basis” (PRCM, 2005).

Physicians Committee for Responsible Medicine

Eleven Recommended Guidlines

 

  1. Offer a daily salad bar. Make sure that there are plenty of fresh fruits and vegetables, and that there are several low-fat dressings available. Include beans and whole grains if possible.
  2. Remember: Fresh is best. Fresh fruits and vegetables offer far more nutrition than their canned counterparts. Try to buy local, organic produce as much as possible.
  3. Choose healthier versions of prepared food products.  Most prepared products are available with lower fat, sugar, and sodium options. Choose these instead.
  4. Make it vegetarian.  Substitute seitan or tofu for meat where ever possible. Offer veggie burgers, and beans and rice dishes.
  5. Serve a healthy, hearty vegetarian soup every day. There are hundreds of great vegetarian soup recipes to choose from, but some common favorites are: vegetable, black bean, and split pea.
  6. Offer soymilk or rice milk. Make cream sauces with plant-based milk, and have plant milks  available for your lactose-intolerant customers.
  7. Keep high-fat add-ons optional. Don’t automatically top dishes with fattening extras like cheese and sour cream. Offer those items as extras, and charge for them separately.
  8. Include beans on salad bars and offer a hot, healthy bean dish daily.
  9. Experiment with menu items from world cuisines. 
  10. Ask your customers. Conduct a survey, and ask your customers what types of food they would like to see on the menu.
  11. Offer nutrition information. 
“A menu that emphasizes plant-based foods over animal products and whole grains over refined grains has been repeatedly shown in scientific studies to provide the most disease-fighting protection of any dietary pattern. It is time to translate this scientific research into meals served in hospital cafeterias” (PRCM, 2005).

While the 11 recommendations presented by the PCRM are fantastic, I propose that you begin by adopting just two of them. This way, immediate impact can be made without as big of a hit on the operating budget.

Proposal #1  Offer more healthy entrees

Possible Hot Grill Items: Grilled Chicken Breast on Whole Wheat Bun, Grilled Veggie Burger on Whole Wheat Bun, Grilled Chicken wraps with Whole Wheat Pitas

Possible Hot Meal Items: Spaghetti with Whole Wheat Pasta, Chili Topped Potatoes, Black Beans and Rice with Steamed Veggies, Minestrone with Whole Wheat Roll, Veggie Stir Fry Over Brown Rice

Proposal #2  Place nutrition information labels by each menu option

By clearly labeling the nutritional information of each menu option, the diner is educated and empowered to make the right decisions for his or her self.

Both of my proposals are simple and cost-effective. In fact, in my experience, I have found that processed and packaged food costs considerably more than their whole grain counterparts.

Simply doing these two things will set the tone for more positive changes to come. The health benefits are enormous, and Primary Children’s Hospital will finally be able to hold “it’s” head up and be proud of the food that it provides. Your community will thank you. I know that I will.

Works Cited

Chavez, A. (2011). Hospital Cafeteria Food Generally Unhealthy, According to Study. Retrieved on December 5, 2011 from: http://www.sanfernandosun.com/sanfernsun/news/7496-hospital-cafeteria-food-generally-unhealthy-according-to-study

PRCM. (2005). Retrieved on December 10, 2011 from: http://www.pcrm.org/health/reports/healthy-hospital-food-initiative-recommendations

Bost, E. (2004) USDA. Congressional Testimony. Retrieved on December 11, 2011 from: http://www.fns.usda.gov/cga/speeches/ct091504.html

Farris, J. Political Cartoon. Retrieved on December 2, 2011 from:http://www.cartoonstock.com/fullsearch.asp?ANDkeyword=obese+doctor&ORkeyword=&TITLEkeyword=&NOTkeyword=&performSearch=TRUE&mainArchive=mainArchive&MA_Artist=&MA_Category=&start=4

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3 responses »

  1. Jackie,

    I love this page! It really flows well from the first paragraph on. You do a great job of addressing the obesity issue in a way that doesn’t feel like I’ve already heard a million times, probably because of the way you start with the risk of our children dying before us. That definitely gets readers’ attention right away and makes this something crucial to read, and I love how smoothly you then go from that problem into starting where it makes sense: hospital cafeterias. Well done.

    So the only issue is that it doesn’t feel complete. How feasible is it for cafeterias to provide those options? Will it be a lot more expensive? Will they need new equipment? Are there suppliers out there who can provide hospitals with these nutritious options? And since you need more sources anyway, I would love for you to find examples of hospitals or other cafeterias, such as maybe school cafeteria pilot programs, that are already doing this. Thanks to Michelle Obama’s campaign, there have got to be cafeterias in this country that are on the right track! I love the imagery you’ve given me of what the cafeteria at Primary Children’s is like; now find a source that describes a healthy cafeteria and include it here so that I get a sense of how it might work. I love the menu ideas that you include, so keep those too, but I think that showing an example of cafeterias already doing this would better persuade me that it’s totally possible. In addition, I would love to hear short quotes from doctors and what they think about hospital cafeteria food or what they notice about the effects of nutrition on their patients.

    Your writing is fantastic; now it’s just a matter of pulling in more sources and adding more about feasibility, plus some kind of conclusion so that it’s not just dropping off like it is now. Also, see if you can work on leading into your sources more smoothly. The one you have now still feels choppy, which was an issue I noticed on your report too. Review the “Organization Review” document I put on Blackboard. You should find ways to lead into the evidence and then follow-up on the evidence. For example, instead of just saying, “The following is from an article written by so-and-so,” get me excited about the quote you’re about to include! Say something like, “Thankfully there are some doctors who agree, like Dr Lenard Lesser at UCLA, who says . . .” And then after the quote tell us what you think about it, like, “His comparison to fast food is appalling. Is that really the standard we want our hospitals measured against?”

    Keep that in mind as you add more sources: always comment about them before and after you include them. It’s been the only weakness I’ve noticed in your writing this semester, so if you learn that trick, you’ll be amazing! 😀

  2. bookworm21 says:

    I really love what you’ve written. I’m totally drawn in to it by the way you speak, I can totally relate to what you are saying, and the imagery is FANTASTIC!! So far, I can’t find anything that I would change.

  3. reginafarley says:

    jackie- Great job! I love how your proposal is really easy to read, lots of white space, and also the paragraphs are short. Maybe yopu could include a picture of an example of a food bar, with all of the ‘food’ avalable to people. I love how you provided an example of your own experience with hospital cafeterias, it really helped me understand and relate to the issue. I think you should keep up the really descriptive comments, like your second to last paragraph. Love that one 🙂 keep up the good work. Your blog looks fantastic!! Great work.

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