The Five Worst Hospital Food Environments

The Physicians Committee

The Five Worst Hospital Food Environments

A Physicians Committee for Responsible Medicine Report
Winter 2011

Hospitals have an obligation to provide a healthy environment. But when it comes to the food served to patients, staff, and visitors, many health care facilities offer high-fat, high-cholesterol fare that contributes to the very medical problems that land many patients in the hospital. To determine which hospital food environments are increasing the risk of diet-related diseases, dietitians with the Physicians Committee for Responsible Medicine (PCRM) analyzed food served at more than 110 hospitals in all 50 states and the District of Columbia, and identified five institutions serving the most unhealthful food.


PCRM dietitians found that some hospitals house as many as five fast-food outlets. Many hospital cafeterias and patient menus are dominated by foods high in fat, cholesterol, calories, sugar, and sodium. But these five institutions offer an especially unhealthful food environment:

The Five Worst Hospital Food Environments
Institution Nutrition Shocker
St. Luke’s Episcopal Hospital/Texas Heart Institute/Texas Children’s Hospital Complex (Houston, Texas) 4 fast-food outlets and fried-chicken bar in the cafeteria
Medical University of South Carolina University Hospital Complex (Charleston, S.C.) 5 fast-food outlets and a cafeteria serving country-fried steak and other high-fat fare
Naval Medical Center San Diego Hospital Facility Complex (San Diego, Calif.) 3 fast-food outlets; patients order from menu featuring pork chops, meatball sandwiches, and other high-cholesterol fare
Duke University Hospital Complex (Durham, N.C.) 3 fast-food outlets; patients order from cafeteria menu featuring spicy pork loin and other high-fat items
Children’s Memorial Hospital Complex (Chicago, Ill.) 1 fast-food outlet; patients’ menu has chicken wings, quesadillas with bacon, and grilled hot dogs


Many physicians and patients are increasingly concerned about the foods served in hospitals. These concerned observers point to the many fast-food outlets now located in hospitals, the high-fat, meat-heavy menus offered by many hospital cafeterias, and the unhealthful food often served to patients.

Fast-food outlets are especially troubling because their menus tend to be dominated by foods that are extraordinarily high in saturated fat, cholesterol, sodium, and sugar. Several of the hospitals surveyed host McDonald’s restaurants including Children’s Hospital Los Angeles, Ben Taub General Hospital, Northside Hospital Atlanta, St Luke’s Episcopal Hospital, Naval Medical Center San Diego, and Children’s Memorial Hospital in Chicago. McDonald’s serves a long list of high-fat, high-cholesterol items and offers almost no healthful choices, according to an analysis by PCRM dietitians. Even many McDonald’s items that consumers may believe are healthful—salads and children’s meals—are generally high in calories, fat, and sodium.

But the food served to patients and in many hospital cafeterias is often not much better. These menus tend to be full of meatball sandwiches, roasted pork loin, and other high-fat, high-cholesterol foods. They also often feature hot dogs, bacon, and other processed meats—which have been conclusively linked by the American Institute for Cancer Research to increased risk of colorectal cancer. Healthful meals rich in fruits, vegetables, and whole grains can be much harder for patients, visitors, and hospital staff to find.

At the Cleveland Clinic in Florida, for instance, a patient in the cardiac ICU was served fatty chunks of meat floating in lukewarm, congealed gravy. At St. Joseph’s Hospital in Tampa, Fla., a hospital employee recounted a breakfast that included two kinds of processed meat. Repeated requests for vegan soups were ignored. At the University of Chicago Medical Center, a participant in a sleep study was shocked when she was served a meal that included several fried items, a cookie, a soda, and milk. She sent photographs of the unhealthful food items to PCRM.

Obesity and diabetes rates in the United States have hit an all-time high. About 27 percent of young adults are now too overweight to qualify for military service, and an estimated one in three children born in 2000 will develop diabetes. Other diet-related diseases also take a serious toll on America’s health: More than half of all adult deaths are caused by cardiovascular disease.

Healthy eating habits, on the other hand, are increasingly acknowledged to play a critical role in preventing chronic disease. The 2010 Dietary Guidelines for Americans, for example, point out that low-fat, plant-based diets rich in fruits and vegetables provide nutritional advantages and reduce the risk of obesity, diabetes, and heart disease. Hospitals should lead the way in encouraging such healthful eating habits.

Review Process

In May 2011, PCRM dietitians began examining foods served by U.S. hospitals across the country to patients, visitors, and staff. Dietitians obtained information about available foods by gathering reports from patients and calling and visiting more than 110 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 Hospital Food Environments

St. Luke’s Episcopal Hospital/Texas Heart Institute/Texas Children’s Hospital Complex
Houston, Texas

The Texas Medical Center’s St. Luke’s Episcopal Hospital building, which also houses the Texas Heart Institute and the Texas Children’s Hospital, plays host to four fast-food outlets, including a McDonald’s and a Chick-fil-A. St. Luke’s is renowned as a pioneer in the area of cardiovascular surgery, but the hospital’s cafeteria menu is dominated by heart-unfriendly, high-fat foods, including a fried-chicken bar. Patient food features high-fat, high-cholesterol items such as chicken Florentine and grilled hamburgers.

Medical University of South Carolina University Hospital Complex
Charleston, S.C.

This hospital hosts a whopping five fast-food outlets, including Chick-fil-A. Unhealthful food is pervasive in the cafeteria, which offers fried steak and other high-cholesterol options. The patient menu includes hot dogs, barbeque chicken, meat loaf, and grilled cheese with ham.

Naval Medical Center San Diego Hospital Facility Complex
San Diego, Calif.

This hospital has three fast-food outlets, including a McDonald’s. Not only do high-fat options such as pork chops and meatball sandwiches dominate the cafeteria offerings, but patients order from a menu featuring the same unhealthful foods.

Duke University Hospital Complex
Durham, N.C.

This hospital houses three fast-food outlets, including Chick-fil-A, and unhealthful items such as spicy pork loin, sweet-and-sour pork, chicken wings, and lasagna abound on the cafeteria menu. Patients can order from that unhealthful cafeteria menu.

Children’s Memorial Hospital Complex
Chicago, Ill.

There is a McDonald’s on the hospital’s basement level. The menu choices offered to patients include unhealthy, high-fat fare like chicken wings, quesadillas with bacon, and grilled hot dogs.