Hospitals Look at Food to Strengthen Patient Health, Support Local Farmers and Tackle Climate Change

Not so long ago, bad hospital food was a given. Patients could expect industrially-produced meals that lacked flavor as well as nutritional value. Not only did this food make hospital stays all the more unpleasant for patients and their families, but it also fundamentally failed to support the mission at hand: wellness.

Thankfully, change is underway. Patients and staff in hospitals around the country can now find a variety of nutritious and flavorful food options. Hospitals are also paying attention to how they source their food, purchasing from local farmers, growing produce and herbs on rooftop gardens or eliminating meat raised with antibiotics and hormones. Many of these changes and the evolution of understanding can be attributed to an organization called Health Care Without Harm (HCWH).

A Holistic Understanding of Healthy Food

For HCWH, the foundational medical principle of “do no harm” extends far beyond the individual patient. HCWH looks at the impact of the health care sector on the community, economy and environment and works with hospitals to adopt more sustainable practices – everything from building construction to waste disposal. The organization promotes a holistic understanding of healthy food that goes beyond just the health of patients and the food they eat. It takes into account the broader food systems in which hospitals participate, working from the belief that a healthy food system leads to healthy people. “Health care can invest in the health of the community by supporting regional food systems that are equitable and resilient – that take into account all actors and don’t compromise our ability to produce healthy food in the future,” says John Stoddard, National Program Director. “We have always taken a multi-sector approach.”

Just as the national conversation has heightened around climate change, HCWH has also sharpened its focus on combatting climate change across all program areas, including food. Food offers a clear opportunity for hospitals to decrease their carbon footprint and support climate-resilient systems, while furthering patient health. Their Healthy Food in Health Care program focuses on increasing plant-forward meals and expanding local and sustainable food purchasing.

Plant-Forward Meals

A growing body of research has demonstrated that reduced consumption of animal-based foods and increased consumption of plant-based foods is critical for both human and environmental health. Livestock, in particular, accounts for a significant portion of greenhouse gas emissions and requires more land and water than plant-based proteins. So, HCWH and its membership-based sister organization Practice Greenhealth are providing a variety of resources to support hospitals that want to introduce more plant-forward options into their food service programs, which include patient dining, cafeterias and retail.

The Cool Food Pledge

One of those resources is the Cool Food Pledge. In 2018, the global research non-profit World Resources Institute launched the Cool Food Pledge to help large institutions reduce their food-based contributions to climate change. It starts with a simple premise: food production accounts for 25 percent of the world’s greenhouse gas emissions. And so the initiative works with hotels, hospitals, universities, restaurants and corporations with dining facilities to collectively reduce their food-related greenhouse gas emissions by 25 percent by 2030. This target is in keeping with the Paris Agreement climate goals, which require a 67 percent reduction in agricultural emissions by 2050.

So far, in the United States, 30 health care institutions have taken the pledge.

Institutions who sign on begin by establishing a baseline for their current purchasing data in order to set targets and then confidentially report data on an annual basis. The Cool Food Calculator allows them to input their purchasing data by weight and receive estimates for key metrics such as food-related greenhouse gas emissions, food-related land use and food-related carbon opportunity costs (the amount of carbon that could be stored were it not for the production of that food). The World Resources Institute continuously updates the science-based calculator to ensure that it reflects the latest data and research, producing more accurate estimates. Health care signatories in the United States also receive individualized reporting and support from Practice Greenhealth.

Targeted support for Cool Food pledge-takers allows them to track their progress over time, as well as estimate the impact of the potential menu and sourcing changes  – such as the greenhouse gas reductions achieved through meatless Mondays. “This is helpful for looking at our total impact, but also thinking about tradeoffs,” says Dan Henroid, Director of Nutrition and Food Service at University of California-San Francisco (UCSF).  “Especially with meat, we can now see what happens if we replace beef with another kind of animal protein.” Henroid hopes to get as close as possible to real-time data analytics to better understand their impact and inform decision-making at every juncture.

While the Cool Food Pledge aims to achieve a collective goal of a 25 percent absolute decrease in food-related greenhouse gas emissions by 2030, individual institutions are also expected to hold themselves to this number. “Our mindset is to definitely meet the twenty-five percent goal, but hopefully surpass it,” says Henroid.

Why Not Say “Vegetarian?”

So what does “plant-forward” mean exactly? HCWH is very deliberate in its messaging and generally prefers “plant-rich” and “plant-forward” over “vegetarian” and “vegan.” Their goal is not to eliminate meat wholesale, but to reduce meat consumption overall through individual and institutional changes. And they see serving good food – with an emphasis on taste, quality and customer satisfaction – as the best way to get there. While this messaging might sound like an attempt to downplay the importance of climate change, the organization finds that it’s just what is most effective.

“People get upset if you tell them what they can and cannot eat,” explains Kyle Tafuri, Director of Sustainability at Hackensack-Meridien Health. Tafuri favors marketing foods for what they have, instead of what they lack. “Especially in a health care setting, we can talk about certain foods in terms of personal health and wellness, as well as clinical and population health.”

For Dan Henroid at UCSF, it’s simple: “We work every day to put the best products on the plate that look great, taste great and have a great value for price point.” This approach also makes good business sense. Health care foodservice operations generally include patient meals, cafeterias, retail and catering. When hospitals offer quality meals and snacks, sales go up. Henroid pioneered the first blended burger (70% grass-fed beef and 30% mushrooms) in health care, but notes that the burger was so good, and so well-received, that his beef sales actually went up. He’s interested in developing other, equally delicious blended burgers, but with turkey meat or a plant-based protein.