Georgetown joins campaign to bring a healthier menu to nation's hospitals

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By Martha Thomas
Special to The Washington Post
Tuesday, March 23, 2010

At Georgetown University Hospital, the cafe's lunch specials have generally consisted of two meat dishes and one vegetarian offering. In the refrigerated case, sandwiches made with roast beef or ham and cheese were kept on shelves at eye level, for easy grabbing.

In early March, however, the cafe began offering more vegetarian specials, and the meat sandwiches were moved to the bottom shelf. On prominent display are pasta- and grain-based cold salads, vegetable wraps and fresh fruit. "It used to be that the meat sandwiches were the first thing people would see," said Leigh-Anne Wooten, the hospital's clinical nutrition manager. "We're experimenting to see if customers will try alternatives."

Georgetown is the first hospital in Washington to sign on to the Balanced Menus Challenge, an initiative of the advocacy group Health Care Without Harm that calls on health-care institutions to reduce meat purchases by 20 percent over a 12-month period.

Twenty-nine other health-care institutions in the United States have made that commitment, including eight in Maryland. The effort is part of the group's Healthy Food in Health Care campaign, in which close to 300 hospitals have agreed to incorporate sustainable foods into their menus.

Reducing meat consumption in hospitals, according to Health Care Without Harm -- a Reston-based coalition of about 500 organizations, including the American Hospital Association, the American Nurses Association and Physicians for Social Responsibility -- not only encourages better nutrition but also reduces exposure to the growth hormones and antibiotics routinely used in industrial meat production. In addition, hospitals "can substantially reduce their carbon footprints" by cutting back on meat and buying foods from local producers, said Anna Gilmore Hall, the group's executive director.

"It's about changing market dynamics through purchasing and procurement patterns," said Lena Brook, coordinator of the balanced-menu challenge. Hospitals are major players in the food service industry: Nationwide, they spend about $10 billion each year, with about 45 percent sold in cafeterias and 40 percent served on patient trays, according to the research firm Technomic. (Hospital catering and room service account for the balance.) Nearly half of hospitals contract with such companies as Aramark, Sodexo and Morrison Foods, which design menus and recipes at the corporate level.

Hospitals with independent food programs have more autonomy and make changes more quickly, noted Louise Mitchell of Maryland Hospitals for a Healthy Environment, a program of University of Maryland School of Nursing. "For those that contract out their food services, change can be much more challenging."

Chris DeRocco, a Morrison employee who manages food service at Baltimore's Good Samaritan Hospital, said Balanced Menus offerings at the 325-bed hospital "have gone over pretty well."

Patients, he said, are easier to convert than cafeteria customers, who still congregate around the burger grill. "But there are definitely those who say they like the idea of eating something that was dug up three days ago not far from here," he said. "More people these days are in tune with the local-food movement."

Along with the "flexitarian" -- semi-vegetarian -- menus that the company drew up last year, Morrison has begun "Ag in the Middle," a program to identify local farms large enough to supply the volumes that hospitals require. "At the peak of the season in D.C., we don't want our hospitals to be getting corn from California," said Marc Zammit, vice president of sustainability for Morrison's parent company, the Compass Group. "Our first choice would be to buy from local markets, but the infrastructure wasn't there."

Sodexo has contracts with 600 farmers across the country, mostly for produce, said Nita Gupta, a vice president for the company's health-care group. Menus are designed with seasonal produce in mind, she said, and food service managers can use the company's intranet to match recipes to what's available locally.

Some hospitals signing up for these programs are essentially affirming or expanding changes they were already making. "We've created a framework," said Jamie Harvie, a coordinator for Health Care Without Harm. "Hospitals were already working on improving the food, but mostly from a nutrition standpoint. Four or five years ago, hospitals weren't really demanding local produce."

Some criticism of the menu changes has come from meat producers. The National Cattlemen's Beef Association issued a statement warning that "the unintended consequences of eliminating high-quality animal protein, such as lean beef, from the diet can have a serious impact on public health." The National Pork Board reiterates that warning and challenges claims about the risks of antibiotic use in industrial meats. Its statement cites studies showing that "95 percent of antibiotic resistance concerns in human medicine are unrelated to animal uses of antibiotics."

Brook said the Balanced Menus Challenge is not an anti-meat campaign. "Nowhere does it say, 'Don't serve meat,' " she said. She says the challenge is intended "to bring healthier food into health-care institutions." In fact, the program grew from environmental concerns and efforts to support sustainable and grass-fed meat production in the San Francisco area, where Brook is on the staff of the local chapter of Physicians for Social Responsibility.

Brook has been tracking four Bay Area hospitals that reduced their meat purchases more than a year ago. Initial results show that the hospitals' combined contributions to greenhouse gas emissions dropped by nearly 85 tons per month, she said. Moreover, the hospitals saved an average of nearly $9,000 per month in food costs by buying less meat. Brook said that some of that money might be reinvested in sustainably produced meat, which is generally more expensive.

For Hall, an important result is the impact an in-hospital program can have on behavior outside the hospital. A former nurse, she recalls embracing the so-called "teachable moments," when she was able to talk with a patient or family about diet and nutrition. "As health-care workers, we don't always take advantage of the influence we have."

Thomas is a freelance writer.


© 2010 The Washington Post Company

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