Just What the Patient Ordered

Philip Prince sent his spaghetti dinner back almost untouched. It’s not that he wasn’t hungry during his recent hospital stay. It’s just that he didn’t find an ice-cream-scoop-shaped blob of red-colored spaghetti mush terribly appetizing.

“I ate a few of the noodles, but I just couldn’t hang with it,” he says. “I ate my salad, but that was just a bunch of cut-up lettuce and packaged dressing.”

Instead, Prince had his mother smuggle fajitas and a milkshake into his Dallas-area hospital room to keep him fortified.

“I never ate any of the [hospital] food,” he says. “It was too disgusting.”

And that’s pretty true to the rep--or rap--hospital food has gathered for itself: gray meat, limp salad and Jell-O.

Not only that, but in a recent letter to the New England Journal of Medicine, a group of researchers contends that hospital food is not particularly healthful either. Led by Dr. Adam Singer of the State University of New York at Stony Brook, the researchers compiled nutritional breakdowns of meals offered patients with no dietary restrictions in 57 university hospitals. Fifty-three of the menus failed to meet all the U.S. Public Health Service’s dietary guidelines.

Shocking?

“I wasn’t surprised because I’d eaten in hospitals all my life,” says Singer, who specializes in emergency medicine at the University Medical Center in Stony Brook.

What this seems to mean is you have sick people being served bad-tasting, non-nutritious food.

Not surprisingly, the health care food industry bristles at the research. Sue Taub, a registered dietitian and president of the American Society of Health Care Food Service, points out that the study was done in 1994, shortly after the dietary guidelines were released and before hospitals had time to rethink and react.

And individual hospital recipes were not analyzed in the study. For example, says Mary Kimbrough, director of nutrition services at Zale Lipshy University Hospital at Southwestern Medical Center in Dallas, mashed potatoes made the traditional way might be a serious artery attack, but they’re not nearly so bad when made with buttermilk, instead of cream, as they are at Zale Lipshy.

Industry people point out that guidelines are designed to be met over a period of time--not every meal must meet every guideline to be healthy. And, they say, even if they provide healthy options on the menu, it is up to the patients to choose them.

On the other hand, it is hard to defend some of what has been passing for food in hospital rooms.

Placing trained chefs in hospital kitchens is one of the most promising developments in hospital food. When the art of cooking meets the science of nutrition, meals are tastier, prettier and healthier.

Dan Stewart, executive chef at Irving Health Care Systems in Irving, Texas, finds the challenges of hospital cooking exciting.

“I had to learn to make something someone likes to eat, no matter what kind of diet they’re on.”

Hospital dietitians know that people who are sick and scared don’t necessarily want a pretty little plate of squab and baby Brussels sprouts. They are more likely to crave comfort foods--fried chicken, mashed potatoes, cheeseburgers. These cravings can’t be ignored in favor of steamed vegetables.

Just as exercise professionals are turning away from the adage “no pain, no gain,” so are dietitians trying to get across the message that there are no “bad” foods. A burger and fries now and then aren’t going to kill anyone, and if that’s what cheers you up in the hospital, your hospital dietitian won’t scold.

When Stewart started working at Irving Health Care Systems two years ago, his first task was to retrain his staff, some of whom had been there 20 years. Stewart, who recently placed third in the American Culinary Federation’s national championships, places the emphasis on cooking technique.

“Food has its own natural flavor within it,” he says. “You have to bring it out.”

When he saw cooks tossing raw onions into soups, for example, he taught them instead to “sweat” (saute lightly) the onions first to enhance the flavor, while adding minimal fat.

Improving the overall quality and nutritional content of hospital food may also help keep health care costs down. By making standard menus heart-healthy, hospitals can cut down the number of special meals they must prepare for patients on restricted diets. This means less work and less waste of food purchased in smaller quantities for special diets.

Zale Lipshy, a small (only 150 beds) “high-amenities” facility, has taken a strong stand on better dining for patients. If you find yourself in a hospital bed there, you might dine on Thai barbecued pork chops or roasted Cornish game hen with wild rice and asparagus.

And the hospital offers cooking classes, a cooking video and gourmet takeout meals on Friday nights, called Friday Night Feasts. This allows hospital chef Anthony Griffin to stretch creatively. In addition, it brings in money and helps educate the public, another facet of the new approach to hospital food service.

“We should use hospitals as an educational opportunity to teach people how to eat correctly,” Singer says. “During hospitalization, people are more susceptible to change their habits.”