Next to airplane food, the meals served at hospitals are probably the most frequently ridiculed on the planet. But while no one expects haute cuisine as an inpatient, you might expect the food to at least be healthy. After all, these are meals being served to people who are sick, or recovering from surgery. Surely the food is nutritious, if not altogether appetizing, right?
"We hear time and time again of somebody going to the hospital for a heart attack and the next day they're served bacon and eggs for breakfast," said Karen Smith, a registered dietician at Barnard Medical Center in Washington DC and an advisor at the nonprofit Physicians Committee for Responsible Medicine. "That is just not at all in line with what a patient who has just had a heart attack should be having."
The lack of healthy food served to hospital patients is an ongoing point of contention in the health community. Last week, obesity expert Dr. Yoni Freedhoff shared an image of a meal served to patients at a Texas emergency room, complete with a squeezable packet of full-fat mayonnaise to top a sandwich, a bag of Doritos, and Oreos:
Surprisingly, two dietitians from the hospital defended the meal on Facebook, telling Freedhoff that "if our hospital offered something like an organic kale salad with a side of quinoa to some of our patients in the ER, there would be massive rioting," and that the Oreos may be comforting to sick patients.
On Monday, a Canadian hospital announced it would be shaking up its menu after administrators ate the same food as their patients for a week. Though the Ottawa Hospital's director of food services told the Ottawa Citizen he was "confident" the food was nutritious, he said it sure didn't taste like it.
These two stories get at the heart of the debate: Is it possible to serve patients healthy, nutritious food, that tastes good, is comforting, and is cost effective? And if not, what should be prioritized?
"I don't think it's okay for them to say 'I don't feel well. I want an ice cream sundae,'" Smith told me over the phone. "It's not the hospital's responsibility to allow that indulgence. It's much more important for them to promote the best diet in terms of treatment and prevention of disease."
Considering the most common cause of hospitalization in the US (by quite a bit) is related to heart health—which is directly linked to diet and nutrition—inpatients ought to be eating healthy food. Yet the majority of North American hospitals still don't prioritize nutritious meals. A study published last year reviewing 84 menus from three Canadian hospitals found that not one menu consistently met standards laid out by Canada's Food Guide.
In fact, many hospitals are home to fast food chains like McDonald's. The idea of having a Big Mac the day after open heart surgery seems ludicrous, but the reality is many patients have the option to do so within the very same building where they're getting treatment.
Cost isn't a great excuse either, Smith said. Healthy food can often be more cost effective than processed meats and treats. A health system in Detroit saved more than $28,000 just by getting rid of its deep fryers and switching to healthier meals at its hospitals.
Part of the problem is that the doctors working in hospitals, who usually have very little nutrition training, have trouble quitting junk food themselves, Smith argued. Until doctors lead the way, change will be slow.
"There is a slow but gaining trend in hospitals providing more nutritious foods and plant-based options, but it certainly isn't the majority at the moment," Smith said. "You need to have physicians being the leaders in this."