Saturday, September 23, 2006

Get Fast Food out of Hospitals

As a family doctor, one of my primary duties is to prevent my patients from suffering heart disease and cancer. I spend a lot of time counseling my patients to eat a healthy diet. I tell them to eat lots of fruits and vegetables, whole grains, and to limit sweets, soda, bad fats, and refined carbohydrates.

But then my patients walk through one of my affiliated hospitals, Tufts-New England Medical Center. There they can purchase a Dunkaccino with 11 grams of bad fat at Dunkin Donuts. Then they can head over to Pizza Hut and get pizza with 1240 milligrams of sodium. They can finish off with a Carrot Nut Muffin with 38 grams of sugar from Au Bon Pain. They can eat all of these without ever stepping foot outside the hospital.

I recently conducted a study with the American Medical Student Association, which looked at the prevalence of brand named fast food at academic-affiliated hospitals. The research, published in this month’s Journal of the American Board of Family Medicine ( reported that of the 234 hospitals surveyed, 42 percent were selling brand-name fast food on their campuses. These included Krispy Crème, Subway, McDonald’s, and Burger Kings.

But, brand named fast food is not the only problem. If you visit the Harvard hospitals in the Longwood area you can pick up a cheeseburger, fries, and soda. A few years ago, I worked at Children’s Hospital (which has one of the healthiest cafeterias). I wondered how the obese children would fare after we told them sugary drinks are bad, and then saw our cafeteria serving soda.

Hospitals should be promoting a healthy safe eating environment for the communities they serve. The food served should be representative of national dietary recommendations. Hospitals should help educate patients as to what a healthy dietary menu looks like. The best way they can do this is by setting a good example.

The first thing hospitals could do to take the lead would be to provide nutrition information that is easily available. The menu boards that show the price should also show the number of calories and/or amount of bad fats. For instance: Chocolate Frosted Donut, 200 cal, 9g Bad Fat, $0.59. Second, hospitals should make sure that food has no deadly hydrogenated oils.

The hospitals should then look at the food offerings as a whole. If the whole menu was analyzed by food group, would it adhere to national guidelines? Is the majority of the menu whole grains, fruits, and vegetables? If not, hospitals should pressure the food vendors to adopt their menu to be healthy. There is no problem with Dunkin Donuts offering their coffee to fatigued doctors, but why can’t we tell them to sell their donuts somewhere else?

If these franchises or cafeterias cannot change, they should be asked to leave the facility and contracts should end. With the large problem of poor nutrition, someone has to push for change. Hospitals not only have the power to control what food is served, they have the responsibility. Their mission is to improve health. They receive millions of dollars from Medicare to treat people with high blood pressure, high cholesterol, diabetes, and heart disease. Yet they also help create these problems by serving some of the very food that causes these conditions.

The medical profession needs to start practicing what it is preaching. Let’s put words to action and create healthy hospitals which educate patients on a healthy diet inside and outside the examination room.

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