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The Five Worst Heart Hospital Food Environments

A Physicians Committee for Responsible Medicine Report
February 2014

The Physicians Committee’s Five Worst Heart Hospital Food Environments report finds that fast-food outlets including McDonald’s and Chick-fil-A are present in many heart hospitals and that hospital cafeterias and patient menus promote double bacon cheeseburgers, macaroni and cheese, and other meat and dairy products that cause cardiovascular disease.

For its fourth report, Physicians Committee experts researched 775 heart hospitals. The hospitals were either eligible for the U.S. News & World Report’s “Top 50 Cardiology & Heart Surgery Hospitals 2013” or hospitals with heart transplant centers. From these, the researchers identified five hospitals dominated by cholesterol-laden, artery-clogging foods. Each of the five hosts two or more fast-food outlets.

Despite the pervasiveness of junk food in hospitals, the Physicians Committee’s hospital reports are beginning to influence improvements. Two hospitals featured in the 2012 Hospital Food Report have removed junk food: McDonald’s closed at Riley Hospital for Children and St. Louis Children’s Hospital no longer carries Dairy Queen products.

Findings

The Physicians Committee called and visited hospitals and reviewed hospital websites and found fast-food outlets, cafeterias, and patient menus dominated by foods high in fat and cholesterol. These five hospitals offer an especially unhealthful food environment for patients, visitors, and employees:

The Five Worst Heart Hospital Food Environments
Hospital Shocker
Virginia Commonwealth University Medical Center
Richmond, VA
Fast Food: Wendy's, Chick-fil-A, Subway, Einstein Bros Bagels, and Au Bon Pain
Cafeteria: Pork Cutlet
Patient Menu: Roast Beef
Greenville Memorial Hospital with Heart and Vascular Institute
Greenville, S.C.
Fast Food: Chick-fil-A, Subway, Au Bon Pain, and Starbucks
Cafeteria: Cajun Pork
Patient Menu: Hot Dogs
Broward General Medical Center with Heart Center of Excellence
Fort Lauderdale, Fla.
Fast Food: McDonald's, Subway, and Starbucks
Cafeteria: Double Bacon Cheeseburger
Patient Menu: Grilled Ham and Swiss
Tampa General Hospital
Tampa, Fla.
Fast Food: McDonald's and Starbucks
Cafeteria: Pork Loin
Patient Menu: Hamburger
Jackson-Madison County General Hospital
Jackson, Tenn.
McDonald's in hospital next to cafeteria; patient menu features sausage, bacon, and corn dogs

Background

An article published recently in the American Medical Association’s Virtual Mentor, says “given that many leading causes of preventable illness and premature death in the U.S.—obesity, diabetes, heart disease, cancer—are diet-related, it is logical that hospitals have a stake in providing health-promoting food.”

But hospitals across the country continue to serve patients meat and dairy products that exacerbate these diseases, despite evidence showing patients need—and want—more heart-healthy, antioxidant-rich fruits, vegetables, beans, and whole grains.
Patient menus that exclude meat are especially critical for cardiovascular patients.

  • A recent study in JAMA Internal Medicine found that people who improved their eating habits the most after a heart attack had a better chance of surviving. And a recent survey of 1,200 cancer patients found that most crave fruit and vegetables and more than half avoid greasy food.

The unhealthful foods served in fast-food outlets and cafeterias in hospitals are also dangerous for patients—as well as visitors and employees. But several recent studies show that hospital cafeterias that make simple changes help visitors make healthful choices.

  • A 2013 study examined the impact of nutrition information on menus in two hospital cafeterias. One cafeteria featured calorie, sodium, and fat content on digital menus, as well as a logo for “healthier” items. The other cafeteria provided limited nutrition information.

Significantly more people at the cafeteria that provided nutrition information consumed significantly fewer calories and less sodium, saturated fat, and total fat than customers at the cafeteria providing limited nutrition information.

  • Another study surveyed customers in a hospital cafeteria in Boston where cafeteria items were identified as red (unhealthy), yellow (less healthy), or green (healthy). The “traffic light” food labels prompted individuals to consider their health and to make healthier choices.

Healthful plant-based options, which have been shown to prevent and reverse many chronic diseases including heart disease, are available at some hospitals in this year’s report. At Virginia Commonwealth University Medical Center, vegetarian meals for patients are available upon request. But these meager offerings don’t counter the overwhelming number of unhealthful menu items.

Detailed Results: The Five Worst Heart Hospital Food Environments

Virginia Commonwealth University Medical Center | Richmond, Va.

The five fast-food restaurants at Virginia Commonwealth University Medical Center include Wendy’s and Einstein Bros Bagels on the ground floor of the Gateway building, Subway and Chick-fil-A on the first floor of the main hospital, and Au Bon Pain in the main hospital lobby. A crispy breaded pork cutlet and turkey with gravy are among the fatty options on the cafeteria menu. Meaty meals offered to patients include roast beef, hamburgers, hot dogs, and meatloaf.

Greenville Memorial Hospital with Heart and Vascular Institute | Greenville, S.C.

Greenville Memorial Hospital hosts the Heart and Vascular Institute—as well as four fast-food restaurants serving heart-clogging options. Chick-fil-A, Subway, Au Bon Pain, and Starbucks are all in the first floor cafeteria area. The cafeteria restaurants, which include the Terrace Café and Grille 7, are available to patients and serve Cajun pork, a turkey patty melt, shrimp jambalaya, baked chicken breast, hamburgers, hot dogs, and ice cream. Heartbreakers on the patient menu include chicken tenders, pizza, hot dogs, hamburgers, and cheesecake.

Broward General Medical Center with Heart Center of Excellence | Fort Lauderdale, Fla.

Broward General Medical Center is the home of the Heart Center of Excellence, as well McDonald’s, Subway, and Starbuck’s, which are all in the hospital’s main lobby. A site visit on Nov. 15, 2013, revealed that cafeteria breakfast options included scrambled eggs, corned beef hash, sausage, and bacon. The Grille Zone cafeteria menu obtained in November featured a section dedicated to burgers, including a cheeseburger, double cheeseburger, bacon cheeseburger, double bacon cheeseburger, and turkey burger. Equally unhealthful options included four-cheese grilled cheese, hot dogs, and chicken tenders. Even the vegetables are fried: shoestring fries, zucchini fries, sweet potato fries, and onion rings.

Tampa General Hospital | Tampa, Fla.

McDonald’s and Starbucks serve fatty, salty, and sugary foods in Tampa General Hospital’s first floor East Pavilion. Greasy meals in the hospital cafeteria located in the first floor West Pavilion include turkey and Swiss or ham and cheddar chef plates, a fried fish sandwich, and pork loin. Hot dogs, hamburgers, macaroni and cheese, and grilled cheese dominate the patient menu.

Jackson-Madison County General Hospital | Jackson, Tenn.

Chick-fil-A and Subway greet visitors on the lower level of Jackson-Madison County General Hospital. The cafeteria menu looks more like a sports bar’s menu: barbecue spare ribs and chicken wings. The patient menu features ham sandwiches, chicken noodle bake, and angel food cake.

Conclusion

Hospitals that continue to serve junk food counter their mission by endangering patients, visitors, and employees. But hospitals that curb fast food—like the three that have eliminated McDonald’s since the Physicians Committee’s 2011 report—and promote plant-based diets could reduce patient readmission rates for diet-related diseases, keep visitors from becoming future patients, and promote employee wellness.



Earlier Hospital Food Reports:

The Five Worst Children's Hospital Food Environments

The Five Worst Hospital Food Environments

PCRM's Healthy Hospital Food Initiative


   
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