It is natural to expect children's hospitals would serve as a role model for healthy eating, given the obesity epidemic among the young in the United States. But hospitals in California fall short, with only 7 percent of entrees classified as "healthy" according to a new study published in Academic Pediatrics.
Researchers from UCLA and the RAND Corporation assessed 14 food venues at the state's 12 major children's hospitals and found there was a lot of room for improvement in their offerings and practices.
"As health professionals, we understand the connection between healthy eating and good health, and our hospitals should be role models in this regard," said Dr. Lenard Lesser, primary investigator and a physician in the Robert Wood Johnson Foundation Clinical Scholars Program in the Department of Family Medicine, David Geffen School of Medicine at UCLA. "Unfortunately, the food in many hospitals is no better - and in some cases worse - than what you would find in a fast food restaurant."
The study authors developed a modified version of the Nutrition Environment Measures Scale for Restaurants (NEMS-R) as an assessment tool for rating the food offerings in hospital cafeterias. This measurement system takes into account pricing, availability of vegetables, nutrition labeling, combo promotions and healthy beverages.
Overall the average score for the 14 hospital food venues was 19.1, out of a range of 0 (least healthy) to 37 (most healthy). Of the total 359 entrees the hospitals served, only 7 percent were classified as healthy according to the NEMS criteria. And while nearly all the hospitals offered healthy alternatives such as fruit, less than one third had nutrition information at the point of sale or signs to promote healthy eating.
Among the other key findings:
- All 14 food venues offered low-fat or skim milk and diet soda
- 81 percent offered high-calorie, high-sugar items such as cookies and ice cream near the cash register
- 25 percent sold whole wheat bread
- Half the hospitals did not provide any indication that they carried healthy entrees
- 44 percent did not have low calorie salad dressings
Since no one has previously documented the health of food in these hospitals, researchers provided hospital administrators with their scores to encourage improvement. Since the study was conducted in July 2010, some of the hospitals surveyed have taken steps to either improve their fare and/or reduce unhealthy offerings. For example, some have eliminated fried food, lowered the price of salads, and increased the price of sugary beverages or eliminated them altogether from their cafeterias.
"The steps some hospitals are already taking to improve nutrition and reduce junk food are encouraging," Lesser said. "We plan to make this nutritional quality measurement tool available to hospitals around the country to help them assess and improve their food offerings."
Researchers said hospitals can improve the health of their food offerings by providing more fruits, vegetables, whole grains and smaller portions; shrink the amount of low-nutrient choices, and utilize low-cost options to promote healthy eating such as signage and keeping unhealthy impulse items away from the checkout stand.
"If we can't improve the food environment in our hospitals, how do we expect to improve the health of food in our community?" Lesser said. "By serving as role models for healthy eating, we can make a small step toward helping children prevent the onset of dietary-related chronic diseases."