The days of bland chicken, reconstituted potatoes, frozen peas and a side of syrupy, canned peaches appear to be coming to a close at a growing number of hospitals across the U.S.
Spurred by patient demand, concerns about setting a healthful example and a desire to make notoriously bad hospital food nutritious and appetizing, more hospitals are making strides in serving their patients fresh, organic and local produce alongside meats and dairy foods that are hormone- and antibiotic-free, as well as minimally processed.
Some hospitals have taken small steps -- eliminating trans fats from their menus or switching to dairy products free of the growth hormone rBGH. Others have taken on bigger overhauls: The chef at Dominican Hospital in Santa Cruz cooks with produce from the hospital's on-site vegetable garden; Chicago's Swedish Covenant Hospital is gradually moving toward meals that are entirely organic.
Hospitals are implementing the changes largely in response to consumer trends, says Joyce Hagen-Flint, director of food and nutrition services at Regional Medical Center Bayonet Point in Hudson, Fla.
"In the general population, people are becoming more conscious of what's in the food on their plate, where it came from and its overall impact from a financial, health and economic perspective," says Hagen-Flint, who is also on the board of directors of the Assn. of Healthcare Food Services.
But some of the changes are also prompted by a realization that hospitals can be a model of healthful eating, says Jamie Harvie, food coordinator for the Arlington, Va.-based advocacy group Health Care Without Harm. Some hospitals are eschewing antibiotic-treated meats over concerns that antibiotics given to livestock generate drug-resistant bacteria. Others are eliminating deep-fried foods and foods containing trans fats, which have been linked to heart disease.
At St. Luke's Hospital in Duluth, Minn., patients are now served locally raised bison, and at Good Shepherd Hospital in Hermiston, Ore., they're being offered grass-fed beef -- in part because both options are lower in overall fat than standard, grain-fed beef.
Those two hospitals are among nearly 250 nationwide that have signed a pledge, promoted by Health Care Without Harm, to serve more fresh fruits and vegetables, forgo heavily processed foods and trans fats, and provide patients hormone-free milk and organic produce when possible. In a 2008 survey of hospitals that have taken the pledge, 72% said they were buying local produce, 81% had switched to rBGH-free milk, and 44% were switching to antibiotic- and hormone-free meats.
Of course, these hospitals constitute a minority among the more than 7,500 in the U.S. But at national healthcare food industry meetings, more hospitals are expressing interest in following the trend, Hagen-Flint says.
A major barrier, however, is cost, she says: "Hospitals are interested, but they're not sure they can afford to do it."
Some cost-conscious hospitals are looking to Kaiser Permanente of Northern California as a model. It started hosting in-hospital farmers markets in 2003, and in 2006 began partnering with small, local farms to provide patients with organic strawberries in late spring, fresh cherry tomatoes in summer, and other produce items as they came into season.
To offset the sometimes pricier items, Kaiser is attempting to cut food production costs elsewhere, says Jan Sanders, Kaiser's director of national nutrition services. "Years ago, there would have been a dessert on every tray. Now patients get fresh, seasonal fruit" -- and dessert only if requested, Sanders says.
That may sound like a step toward more healthful hospital fare, but the direct health benefit of serving patients fresh, local foods is limited, says Dr. Preston Maring, associate physician in chief for Kaiser Permanente East Bay Medical Center in Oakland.
"The meals eaten during a three- to five-day hospital stay won't change patients' health, because it's not a long-term dietary change," Maring says. "But it is a consistent and visible reminder to everyone that what we eat is important for good health."
Fresh, whole foods also help create what Maring (who started Kaiser's first farmers market) refers to as a healing environment. "A perfectly ripe peach can be a great comfort for someone just coming out of surgery," he says.
Hospitals, of course, need to provide variety, if only to meet the needs of patients with diverse dietary restrictions and limitations. As a result, no matter how many hospitals buy vegetables or beef from local farmers, hospital food "can't ever be 100% fresh and local," Sanders says.
Nonetheless, the trend toward fresher and even more local and organic hospital food will likely continue -- if only because of patient demand.
"There's tremendous competition in healthcare," Harvie says. "It's a powerful driver for change."