Why are hospitals, the primary institutions of the so-called "health care industry," so generally myopic about the relationship between diet and health?

In the past two decades, a number of radical changes have begun taking place in the American diet. Some no doubt will eventually evaporate as fads, but, on balance, they are changes that signal the serious new attention now being given to the link between diet and health.

Yet the food that is being served up to patients and employes alike from hospital kitchens does not reflect discoveries about this relationship.

This troubling state of affairs came home to me in a very personal way last fall. I was attending my mother as she lay dying of cancer in a hospital in my home town of Portsmouth, Va.

With only days to live, struggling and hardly able to get sufficient air into her lungs even with oxygen support, she was routinely served cheeseburgers, fried liver, large pieces of beef and other such hearty entrees.

In her last days, meat was repulsive to her, so I asked the hospital dietitian if a vegetarian option was available. With suspicious eyes, she told me they offered a soft diet and a salt-free diet, but not a vegetarian one. The soft diet consisted of Jell-O (basically sugar and water), sickeningly sweet egg custard and beef bouillon.

One does not have to be a graduate dietitian to know that the traditional American diet has some basic flaws and that certain recent trends are probably quite beneficial to one's health. Few would dispute the emerging opinion that our diet has generally contained excessive amounts of red meat or that traditional amounts of red meat intake have contributed to certain diseases.

The typical hospital menu is too heavy on red meat and contains far too much animal fat. I have never seen honey or fructose available as sugar substitutes, though I have seen the dubious chemical sugar substitutes. Every hospital I have ever been in routinely overcooks vegetables.

Certainly all large hospitals have a dietitian, but either their hands are tied or they are not keeping up with the world around them.

However, a cursory glance at recent editions of the Journal of the American Dietetic Association suggests that dietitians might be too close to their microscopes to see what is happening in the world at large. And the valuable research that is under way does not nullify the fact that typical hospital food is prepared as if the entire health food movement were built on fallacious reasoning.

Indeed, a recent article in the ADA journal, "The Dietician Vs. Food Faddism," argues that: "Most health foods are no healthier than conventional foods."

The health food movement, however, is a broad and multi-faceted trend, a new direction, and should not be totally dismissed through a recounting of its errors. Professional nutritionists have every right, even an obligation, to debunk popular but incorrect assumptions in their field.

Yet a blanket, out of hand dismissal of so-called health foods is both irresponsible and unpersuasive. Nutritionists should be making allies in the health food movement and nurturing the more solidly based assumption of that trend, that better diet can mean better overall health.

I doubt anyone knows for sure whether a strict health food diet is the best road to optimum health, but the evidence is quite persuasive that the average person would get better health results from a diet of less animal and more vegetable protein. Furthermore, public consumption of less red meat would result in less stress on the environment and is therefore a moral issue as well as a dietary one.

A large hospital in New York recently added a salad bar for employes, a separate line from the main one in the cafeteria. Many employes applauded this innovation, a clear step in the direction of a healthier diet option for workers there.

But why are our pivotal health care institutions the last on the block to make such moves, and why do they act with so little enthusiasm? The fact is that the salad bar in this particular hospital, as welcomed as it is, is rather pathetic when compared with the one in the Korean produce store down the street, which serves far fewer customers.

Few would deny that the health food movement has yet to be fully tested. Many of its assumptions no doubt deserve debunking. But the basic thrust of the health food movement is incontrovertible: That the typical American should consume less red meat, fewer animal fats, more raw and lightly cooked vegetables, more sources of plant protein, less refined sugar and fewer chemical additives and contaminants. These discoveries have not yet found their way into the American hospital diet.

Perhaps the time has come to give more authority to the hospital dietitians. If it is not authority but vision they lack, I suggest an in-service education tour of a neighborhood produce market salad bar and health food store. Hospitals should be leading the way toward an improved, more healthful American diet instead of fighting a rear guard action as they seem to be doing at present.

Copyright (c) 1986, Words by Wire.