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The Five Worst Children’s Hospital Food Environments

A Physicians Committee for Responsible Medicine Report
Autumn 2012

Children’s hospitals are supposed to help fight disease. But many also host fast-food restaurants and cafeterias that seem to go against the hospital’s mission to keep kids healthy. Patient menus feature high-fat, meat-heavy items that put children at risk for obesity, diabetes, heart disease, and other chronic diseases now and into adulthood. Dietitians with the nonprofit Physicians Committee for Responsible Medicine (PCRM) recently analyzed children’s hospitals in all 50 states and the District of Columbia, and identified five serving the most unhealthful food. One of the hospitals on the list, in Gainesville, Fla., hosts at least five fast-food outlets.


PCRM dietitians found that many hospital cafeterias and patient menus are dominated by foods high in fat, cholesterol, calories, sugar, and sodium. Processed meats, such as bacon, sausage, and hot dogs, are also common and increase cancer and diabetes risk.

These five hospitals offer an especially unhealthful food environment for children and their families:

The Five Worst Children's Hospital Food Environments
Institution Nutrition Shocker
Shands Hospital for Children at University of Florida
Gainesville, Fla.
At least 5 fast-food outlets, including Wendy's; patient menu includes a ham-and-cheese croissant, barbecue chicken, and meatloaf with beef gravy
Monroe Carell Jr. Children's Hospital at Vanderbilt
Nashville, Tenn.
4 fast-food outlets, including Taco Bell/Pizza Hut Express; cafeteria features barbecue chicken, cheesesteak wrap, and chicken-fried steak with cream gravy
St. Louis Children's Hospital-Washington University
St. Louis, Mo.
2 fast-food outlets, including Pizza Hut; patient menu includes sausage, bacon, ham, grilled chicken, and roast beef with gravy
Children's Hospital Los Angeles
Los Angeles, Calif.
McDonald's on first floor of hospital; patient menu features pizza and hot dogs
Riley Hospital for Children-Indiana University Health
Indianapolis, Ind.
McDonald's in hospital next to cafeteria; patient menu features sausage, bacon, and corn dogs


Promoting unhealthful foods to adolescent patients and visitors is dangerous at a time when obesity and diabetes rates among children in the United States are skyrocketing. More than 12 million children and adolescents are obese. And a recent study found that nearly one in four American adolescents could have diabetes or prediabetes.

Even Disney has recognized the influence fast food has on children and will soon ban ads for junk food on its TV channels, radio stations, and websites. But a study of California’s children’s hospitals published in Academic Pediatrics found that almost 40 percent had signs encouraging unhealthy eating.

Pediatrics experts warn that the availability of unhealthful foods in children’s hospitals contradicts positive nutrition and health messages physicians and nurses give children.

A study in the journal Pediatrics found that the presence of a McDonald’s restaurant in a children’s hospital increased the purchase of food at the on-site McDonald’s. The location of a McDonald’s inside a hospital was also associated with a more positive perception of the healthfulness of its food.

McDonald’s says it has restaurants in 27 U.S. hospitals. Children's Hospital Los Angeles and Riley Hospital for Children, both on our list, host McDonald’s. Other children's hospitals with McDonald’s include Children's Minneapolis, Kosair Children's Hospital in Louisville, Ky., Joe DiMaggio Children’s Hospital in Hollywood, Fla., and Rady's Children's Hospital San Diego.

Even hospitals that made it into the U.S. News & World Report’s Best Children’s Hospitals house fast-food chains and cafeterias with menus dominated by foods that are high in saturated fat, cholesterol, sodium, and sugar.

Healthful plant-based options are available at some hospitals. Shands Hospital has veggie burgers and a hummus and vegetable plate. St. Louis Children's Hospital has a vegetable bar and a salad bar. The Monroe Carell Jr. Children's Hospital website suggests that the menu is labeled for vegetarian and vegan items, but none are currently indicated.

Instead of promoting fast food and junk food, hospitals should lead the way in encouraging children to develop healthful eating habits early on. Meals rich in fruits, vegetables, and whole grains can help them establish eating patterns now that can result in decreased risk for heart disease, cancer, and other diet-related conditions later in life.

Review Process

In spring and summer 2012, PCRM dietitians reviewed foods served by U.S. children’s hospitals. PCRM obtained information by calling and visiting hospitals located in major cities in 50 states and the District of Columbia. They evaluated each hospital food environment based on the number of fast-food outlets in the hospital and the healthfulness of options offered on cafeteria and patient menus.

Detailed Results: The Five Worst Children’s Hospital Food Environments

Shands Hospital for Children at University of Florida
Gainesville, Fla.
Shands Hospital was listed on U.S. News & World Report’s Best Children's Hospitals: Cardiology & Heart Surgery. But the hospital has at least five fast-food outlets serving heart-stopping, artery-clogging fare—including Wendy’s and Umberto’s Pizza. There is a Chik-fil-A located on the Sun Terrace, an outside patio. Foods in the cafeteria are no healthier: meatloaf, fried chicken, and macaroni and cheese. The patient menu includes high-fat, high-cholesterol items such as a ham-and-cheese croissant, beef lasagna, barbecue chicken, and meatloaf.

Monroe Carell Jr. Children's Hospital at Vanderbilt
Nashville, Tenn.

This hospital houses four fast-food restaurants. Among the worst offenders in the Children's Way Café are Taco Bell/Pizza Hut Express and Ben & Jerry’s. The cafeteria features strip steak, barbecue chicken, a cheesesteak wrap, chicken-fried steak with cream gravy, and meatloaf. The patient menu includes bacon, omelets, sausage, hamburgers, and grilled cheese.

St. Louis Children's Hospital-Washington University
St. Louis, Mo.

Pizza Hut and Dairy Queen, the two fast-food outlets in this hospital, prominently feature high-cholesterol dairy products including pizza and ice cream. Sausage, bacon, ham, grilled chicken, and roast beef with gravy are just a few of the unhealthful patient menu options.

Children's Hospital Los Angeles
Los Angeles, Calif.

Children’s Hospital Los Angeles made the U.S. News & World Report’s Best Children's Hospitals: The Honor Roll. But it gets an F for its fast food and fatty cafeteria and patient menus. The hospital houses a McDonald’s with typical high-fat burgers and junk food. Pizza and rotisserie meats are regularly served in the hospital cafeteria, and the patient menu features hot dogs, chicken, and eggs.

Riley Hospital for Children-Indiana University Health
Indianapolis, Ind.

McDonald’s is also on the premises of Riley Hospital for Children. Pork loin and deli sandwiches are served in the cafeteria, and processed meats such as sausage, bacon, and corn dogs dominate the patient menu.


The McDonald’s at the Children’s Hospital of Philadelphia recently closed after 34 years. And when Chicago’s Children’s Memorial Hospital relocated this year and became the Ann & Robert Lurie Children's Hospital of Chicago, it didn’t bring along its former tenant McDonald’s. Children’s hospitals nationwide would make a wise choice by following suit. Hospitals that eliminate fast-food chains and serve more low-fat, healthful options go a long way toward improving the health prognosis of both patients and visitors.


Worst Children's Hospital Food

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