US hospital food is some of the worst stuff out there for you. And I’m not just talking about the taste or the cost. Studies have proven that ‘standard’ hospital meals actually increase mortality rates in patients recovering from heart failure.
In a place that’s supposed to heal and help, why is the food anything but healthy? How did we get to where we are today? And most importantly, what can we do about it?
Article overview
- Standard hospital food may increase the risk of death for patients recovering from heart conditions.
- Most hospital food is dictated by cost, availability, and some Federal guidelines. However, there is no true set standard for ‘healthy’ food in our systems.
- I’ve seen firsthand how much this can impact patients after major events such as heart surgery.
- While there are new guidelines in place supporting reforms in our hospitals, the best course of action is to make informed food decisions for yourself and your loved ones.
What’s the deal with hospital food?
The type of food that is served in hospitals is believed to be healthy by most. After all, since it’s a hospital setting, it’s probably designed to keep sick people healthier. Right?
Well, that depends on who you ask.
Hospital food in the US is generally determined based on two major factors: cost and availability.
First, the cost. Most hospitals have surprisingly tight margins to work with, and the cost to acquire, cook, and deliver food to patients can be surprisingly high. Case in point, this article from the Association of Nutrition and Foodservice Professionals argues that “raw food costs
come in second place” behind only the cost of labor. So it’s no surprise that many smaller systems must subcontract to cheaper providers with lower-quality food.
The second factor is availability. Food provided at a rural hospital setting will look very different from what you might find in a large city or major metro. Accessibility can also be a challenge, as you can see in this recent Bloomberg article.
This article also discusses the third and most important factor: the Federal influence on hospital food. US law 42 CFR §482.28 states that hospitals receiving Medicaid and Medicare must provide individualized nutrition that is consistent with “recognized dietary practices.” Here’s how the exact text reads:
§ 482.28 Condition of participation: Food and dietetic services.
The hospital must have organized dietary services that are directed and staffed by adequate qualified personnel. However, a hospital that has a contract with an outside food management company may be found to meet this Condition of participation if the company has a dietitian who serves the hospital on a full-time, part-time, or consultant basis, and if the company maintains at least the minimum standards specified in this section and provides for constant liaison with the hospital medical staff for recommendations on dietetic policies affecting patient treatment.
This tells us two things. First, that ‘recognized dietary practices’ could mean almost anything under the ambiguity of this messaging (the least of which may be a metabolically healthy diet). Second, that contracts with outside food management companies are perfectly fine so long as the hospital employs a dietitian. This doesn’t necessarily mean the food needs to be ‘healthy’ — just enough to meet the patient’s needs.
Interestingly, a study found that the nutrient profile of many hospital menus are not compatible with most dietary guidelines and can lead to “imbalances in nutrient intake.”
This means meals often served to patients can exacerbate conditions they are there to be treated for in the first place.
How hospital food worsens patient heart health
If you’ve ever been an in-patient in a hospital, you’ve no doubt been exposed to the food on the menu. In a worst-case scenario, it’s probably rich in sugar, seed oil, and processed food. None of these things bodes well for your metabolic health.
Highly processed foods, for example, are directly associated with inflammation and insulin resistance. Seed oil is also heavily implicated in the rise of US heart disease. The impact of sugar, of course, speaks for itself.
The result of this food is:
- High blood sugar
- High insulin
- Imbalanced omega 6 to 3
These can easily worsen chronic diseases, such as heart conditions.
I will routinely walk in, the morning after a heart surgery, only to see my patient sitting in a bed with a glass of orange juice and pancakes. And yet, they have an insulin IV running to their arm to ‘control their blood sugar.’
Why in the world do we do this to metabolically unhealthy people?
These are ‘low-fat,’ ‘ heart-healthy,’ and ‘carb-controlled,’ according to hospital standards.
The problem is, in my opinion, that the dieticians and nutritionists simply aren’t equipped with the knowledge that doing anything else is safe or even healthy for the patient. If we put fewer carbohydrates in, we’d also need to add less insulin to the patients as well.
This is simply a foreign concept for a medical system that has been focused on ‘low-fat and heart-healthy’ diets for nearly 50 years.
It’s no wonder that the sheer nutritional deficit of hospital food has entered the realm of public ridicule!
I realize most healthcare providers have no control over the food served to patients. But by not speaking out against it or discussing the problems with it, we are complicit in unintentionally harming many, many hearts.
I believe that we must advocate for our patients as much as possible. This includes providing information like this, as well as encouraging patients to adopt healthier habits.
What’s being done (and what can YOU do)?
It’s not all doom and gloom out there. There are many ways hospital dietary standards are starting to swing in the right direction, albeit slowly.
There are new US dietary guidelines, for example, and RFK Jr. recently issued a memo encouraging hospitals to adopt this new approach.
The CMS also announced a new voluntary pledge for hospitals to serve more whole, real foods to patients. This allows healthcare facilities across the nation to sign a virtual pledge to better serve their patients.
But again, no one will care as much about your heart health as you. So I highly recommend arming yourself with the right knowledge to make informed decisions while staying at the hospital — whether you are the patient or simply staying with one.
I recommend:
- Learning how to read an ingredient’s label.
- Requesting a low-carb diet during your stay, if possible. This could be something like a Mediterranean or Keto diet, although not all hospitals can or will make accommodations.
If no suitable food can be found, consider building an intermittent fasting routine.