Hospital Food Gets a Makeover

by Sarah Henry on August 13, 2010 · 46 comments

in berkeley bites,civil eats,food events,hospital food

Unfortunately I can report from recent personal experience that in some facilities hospital food remains truly awful. If you’ve been in a hospital this will likely not be news to you. A couple of in-patient visits over the past few months have given me an up-close view of what gets served to the sick during a hospital stay, which averages around three days for most folks dealing with an acute health problem.

It’s not pretty, people. By that I mean the food looks bland and unappetizing. The eggs are gray and watery. The vegetables limp and tired. There’s the ubiquitous Jell-O cups. At one hospital I was in the meals came served on sickly salmon-colored trays. Don’t get me started on the odor.

I took one look at what was on offer (as an E.R. admission, I hadn’t had a chance to choose my own food) and pushed it away. So while it looked and smelled terrible, I can’t tell you how it tasted because I couldn’t bring myself to bring the food to my lips.

It wasn’t that I wasn’t hungry. I knew good grub was on its way.

My friends didn’t disappoint. Lucia showed up around breakfast time showered, though not well rested, since she’d been sitting in the E.R. all night with a certain someone. And she’d still managed to bring savory scones that I nibbled on with a cup of tea and orange juice. Margaret swung by a little later with lunch: Creamy quiche from a local cafe we frequent, along with a side of spring greens. It was the kind of food that said: “eat me.”

Okay, I know, I’m spoiled. Sometimes when you’re sick though — hell, I’d venture to say especially when you’re not well — having something healthy, comforting, and aesthetically pleasing to eat is critical.

Why is it then that most hospital food is bad, in the way that prison, airline, and school food — basically any meals made on an epic scale in an industrial setting — typically suck?

It’s crazy when you think about it: Hospitals, the very places we go to to cure what ails us, should be the beacon of wholesome eats. Yeah, I know, dream on.

But wait, in pockets of the country hospital food is getting a complete makeover. Once I started to heal my friend Lucia encouraged me to give hospital food another chance and check out the improvements made by leaders in the hospital food movement who want to feed sick people and hospital employees well.

That’s because aside from being a good friend and E.R. companion, Lucia Sayre co-directs the San Francisco Bay Area Chapter of Physicians for Social Responsibility. A big part of Lucia’s job (read more about her in this week’s Berkeley Bites post), is to work with local hospitals to source, prepare, and serve better food to patients and staff.

Lucia’s not one to seek the public eye or boast about her success. She just told me to go meet her hospital food buddies.  Since I trust the girl, I did.

Alison Negrin turns out to be a powerhouse in a growing movement to give hospital food a complete makeover. The tiny dynamo, who reminds me some of another institutional food advocate, Ann Cooper (aka The Renegade Lunch Lady), works as the executive chef for John Muir Health, which has campuses in Walnut Creek and Concord, east of San Francisco.

That’s right: Some hospitals — not very many mind — actually employ chefs. And Negrin comes with a culinary rockstar pedigree: She did a stint at Chez Panisse before she went on to open Bridges, a Japanese-influenced restaurant in the East Bay town of Danville, lauded by local restaurant critics. She followed that success with a turn at the stoves at a fusion bistro in Berkeley called Ginger Island.

But she tired of the demands of being a fine-dining chef and started to explore the concept of food as a healing tool. She studied alternative therapies, taught cooking skills to at-risk teens, and attended Bauman College in Berkeley, a learning center with a holistic approach to nutrition. When the hospital chef gig came her way about 10 years ago, she jumped at the challenge.

In the past decade she’s brought about a slew of improvements to the food that gets dished up at John Muir.  More local produce sourcing, smaller batch cooking, an emphasis on whole grains, and sustainable meats — not to mention a chef’s eye for plating and a total menu overhaul.

But unlike in her own restaurant kitchen where she could mix things up on a moment’s notice, change moves very slowly in a hospital setting. She has to deal with dietary restrictions and purchasing contracts. It can take three years, as one writer noted, to alter a soup recipe. (For an excellent analysis of the challenges faced by the folks who want to fix hospital food, I recommend readers take a gander at this story by John Birdsall in the East Bay Express.)

I met with Negrin a couple of weeks ago in the Concord medical center’s Diablo Cafe for hospital staff (the word cafeteria seems out of vogue). She invited me to join her for lunch with her colleagues, including Sandi Rigney, the hospital’s food service director, and Patty Campbell, the lead dietician there.

Despite having unpleasant hospital flashbacks once employees in scrubs started piling into the place, I agreed to eat with the trio, who proved perfectly pleasant lunch companions.

What surprised me was the food. A fresh spring salad mix with dried cranberries, cheese, and nuts. Sweet potato fries with grilled Mahi Mahi served with a mango salsa. Vital Vittles whole grain rolls. Here was some hospital food I could happily eat.

Don’t get me wrong, the cafeteria still serves pizza, coke, and other food you don’t expect to find in a facility treating people with heart, kidney, and other health problems. Change comes very slowly, even in institutions allegedly built to keep us well. But I was heartened to find that people could make healthy choices — and plenty of them for lunch or dinner.

And I had the opportunity to watch in-patient food going out on trays. There was nice attention to detail: One worker served up small batches of striped ravioli with a tomato sauce; sprigs of watercress and a mix of cheese and herbs would also wind up on the plate. But in another area a kitchen worker opened a massive bag of pre-cut green beans that could hardly compete with what’s on offer at local farmers’ markets right now. Clearly, there are limitations on what hospitals can do in food service.

But that doesn’t mean Negrin isn’t going to try.  She’s introduced no-fry Mondays in the cafe and employees can now pick up a weekly CSA box of produce. She sources some produce from the local community. She’s slowly but surely revamping every hospital menu. Three days of the regular patient menu have been completely overhauled, the remainder of the days are expected to undergo scrutiny before the end of the year.

I left the building feeling hopeful that a revolution in hospital food is possible and that bodes well for sick people and those who take care of them.

Negrin is part of a panel discussion tonight on rethinking hospital food service at the John Muir Medical Center’s Concord campus. The event is co-sponsored by the John Muir Health Green Team, along with East Bay and Delta Diablo Slow Food Chapters. A kitchen tour begins at 5:30, discussion starts at 6:15, find more details here.

Update: While Negrin would be the first to concede that there are limitations to what a chef can do when it comes to hospital food, she wrote an email to let me know this: “FYI our green beans (and all vegetables) come in bags after being cleaned and cut for us.  They are still sourced locally and picked fresh — just packed that way.”

[Photo of Alison Negrin: © Akim Aginsky 2008]

This post also appears on Civil Eats.

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{ 35 comments… read them below or add one }

Sodium Girl August 13, 2010 at 12:52 pm

Great article and such an important topic. I have to keep a very strict low sodium diet due to Lupus-related kidney failure and I find that the most difficult place for me to eat is actually at the hospital! The “low sodium” diet food is way beyond what I can eat and there seems to be some major misunderstanding over not only what low sodium food is, but more importantly, how to make it taste good!

Thanks again.

SG

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Sarah Henry August 13, 2010 at 7:10 pm

Hi Sodium Girl,

Nice to see you here and thanks for weighing in with your perspective.

How ironic that the most difficult place for you to eat with your condition is the hospital.

Do you have your own tips on how to make low sodium food taste good that you care to share with the hospital food folk?

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Sodium Girl August 14, 2010 at 11:57 am

Before I start, I just want to say I love the site and am so glad I found it. As for how to fix the high-salt problem in the low-sodium hospital food, the first place to start is cutting prepared or canned items from the low salt menu. Seems obvious, but I can’t tell you how many times I’ve received pasta or soup that has ingredients (like diced tomatoes or broth) from a can. Which means high in sodium. After taking that step, I would caution people to be aware that many times, whether it is a restaurant or a hospital, that grains (like pasta and rice) and veggies are usually blanched in salt water. Which again, not great for a low sodium diet, and should be made from scratch (time intensive, yes, but better for probably everyone in a hospital with or without renal insufficiency).

So now that I’ve pretty much said “no” to the mainstays of what is served in hospitals, here is what does works: 1) Roast fresh vegetables and use those (like beets and kale) that naturally have a lot of flavor on their own. As another reader already pointed out, roasting gives great flavor to a simple plate of produce and a lot of vegetables carry an intense amount of sweetness and spice without any additional work; 2) Use vinegars, oils, citrus, herbs, pepper, garlic, and onions to flavor food. In a hospital, you aren’t going for four-star seasoning anyways and most likely, your tummy can’t handle too much spice, so just a simple spritz of lemon goes a long way; 3) Use products like coconut milk, mascarpone, and ricotta to replace sodium-heavy dairy ingredients; and 4) Add texture – most of low sodium cooking is about surprising your taste buds. A simple, unexpected element, like pine nuts or a crunchy cucumber, to offset the rest of the plate will go a long way in providing low sodium satisfaction to your mouth and belly.

I know ingredients are limited due to budget and time efficiency in the kitchen, but hopefully this is helpful in terms of adjusting one’s approach to low sodium cooking.

- Sodium Girl

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sarah henry August 14, 2010 at 7:21 pm

Thanks for sharing some seemingly simple cooking tips for people who need to keep a close eye on their sodium consumption (these ideas sound good even for folks who don’t have to watch the salt so closely.)

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CS August 13, 2010 at 12:52 pm

Wow, this is so necessary. Washington Hospital in Fremont did a great job in many ways, but the food….well. My fork bounced off the gravy, it was so congealed and rubbery. And I know that many hospitals default to high-carb, salt-free, no-pepper meals because that way they can avoid exacerbating the problems of people with high blood pressure and gastric problems, but a) that’s probably outdated thinking when it comes to blood pressure, and b) you can make low-sodium meals that don’t taste like glue. I’ve done it! (Roasting rather than steaming sure helps…) It was among the worst food I’ve eaten in my life–even worse than what I remember from elementary school–and certainly didn’t make me want to eat enough to keep my strength up. I expect it leads to cheating (sneaking food in that patients shouldn’t actually eat–which can be dangerous), as well.

This summer, I visited a hospital in the southern part of the US. Their meals for patients were similar to the ones at Washington Hospital, and their cafeteria was dreadful. Buying a plate of high-fat, high-cholesterol, high-calorie biscuits and sausage gravy for breakfast cost about 1/5 as much as buying a fruit/yogurt/granola parfait. I was appalled.

I also accompanied a vegetarian friend to a hospital once. Despite having filled out meal forms in advance requesting vegetarian food, her first meal centered around … chicken broth. Their reasoning? It didn’t have *meat* in it. She had difficulty not going hungry.

I know it’s challenging to serve meals to so many people with so many needs, but I am sure that hospitals can do better. (Based on my experiences so far, I’m wondering how they could do worse. Even though it doesn’t look all that great, I would have done anything for the food this blogger got at her hospital in France: http://www.justhungry.com/stuck-french-hospital )

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Sarah Henry August 13, 2010 at 7:14 pm

Hi CS, Good to see you here and thanks for your long comment, which raises many interesting points.

Yes, roasting versus steaming is a great way to serve veggies that taste good, something that Negrin and her team do often.

The notion that people in hospital may well “cheat” isn’t something that occurred to me — my condition didn’t require any dietary restrictions. But you may well be onto something there.

Thanks for the link to the French hospital food post, I’m curious to learn about cross-cultural differences in dishes served to the sick.

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Frugal Kiwi August 13, 2010 at 1:02 pm

Great article. I wish that the District Health Boards in New Zealand would read this. The food I’ve experienced in hospitals in NZ was nothing sort of vile.
Frugal Kiwi´s last [type] ..Artisan Felt Handbag Giveaway

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Sarah Henry August 13, 2010 at 7:16 pm

Really, Frugal Kiwi? Somehow I thought that in a country like New Zealand with a smaller population base you might actually get dished up something decent to eat in hospital.

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Frugal Kiwi August 14, 2010 at 12:20 am

Sadly, no. Terrible, yucky and not healthy food.
Frugal Kiwi´s last [type] ..Artisan Felt Handbag Giveaway

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shilpa August 13, 2010 at 2:58 pm

Really great to read. I wish this slow, but steady movement would spread the world over. Take note Canada! Thanks for the post.

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Sarah Henry August 13, 2010 at 7:21 pm

Okay, we’ve got folks chiming in from around the globe with uniformally dismal hospital food experiences. I wonder if any other countries are adopting the kind of changes Negrin and co. are implementing.

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Sheryl August 13, 2010 at 5:27 pm

I so hope that this will start a (much-needed) movement in improving hospital food. Why, when you are already feeling so lousy, so in need of some TLC, do you have to feel so dejected with an awful, tasteless, ugly meal?

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Sarah Henry August 13, 2010 at 7:22 pm

I couldn’t agree more, Sheryl. Food can provide comfort — as well as nourishment. Alas, a lot of hospital food does neither of these things.

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Meredith August 13, 2010 at 5:44 pm

Very interesting. When my husband was hospitalized for an appendectomy we were amazed (in a bad way) at how un-good the food was. And salty! This is good news, a hospital-food makeover.
Meredith´s last [type] ..How about writing a manuscript in 1 month- 4 days

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Sarah Henry August 13, 2010 at 7:25 pm

You’re the second reader, Meredith, to comment about salty hospital food, which surprises me, since so many heart and renal patients likely need low sodium foods.

What’s with that?

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Susan August 14, 2010 at 7:31 am

Hope you’ve recovered from your hospital stay, Sarah! I applaud you for turning it into a blog post. I’m fortunate that I’ve never been a hospital patient (aside from when I was born and when I cut myself slicing veggies and needed stitches, but I wasn’t there long enough to eat anything), so I had no idea it was so bad. Sounds like airplane food awhile back!

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sarah henry August 14, 2010 at 7:23 pm

Hey Susan, Not sure what airline you’re flying, but last I looked, the food isn’t too fabulous — if it’s even on offer — for those of us in cattle class.
sarah henry´s last [type] ..Hospital Food Gets a Makeover

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Alisa August 14, 2010 at 11:00 am

I love the banana photo. And praise Lucia. Can you ship her to PA? We could use her help here!
Alisa´s last [type] ..The Heavenly Art of Manscaping

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Sarah Henry August 14, 2010 at 7:29 pm

It’s an apt image, isn’t it, Alisa? Judging by previous comments, sounds like people like Lucia Sayre and Alison Negrin are needed in many parts of the country.

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Lisa August 14, 2010 at 8:49 pm

Very interesting article Sarah. I remember when visiting my dad at the Mayo clinic in Arizona, the vistor/staff cafe had very good food – salad bar, sandwich bar, and lots of vegetarian options. The food given to the patients however, was pretty vile. We bought him food from the cafe instead.

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Sarah Henry August 15, 2010 at 9:05 pm

Smart move, Lisa. I wonder how many other family members wise up to where to find food a sick loved one might want to eat.

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Kerry August 15, 2010 at 1:47 pm

Sarah,
clearly there’s a need for leadership and ideas here…maybe your next book?
Kerry´s last [type] ..an Irish blessing

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Sarah Henry August 15, 2010 at 9:06 pm

Kerry, I think folks in Northern California are leading the way, but I hear that there are other champions for change scattered around the country.

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Ruth Pennebaker August 15, 2010 at 3:43 pm

What a brilliant and important idea for a subject; I’m just sorry you had to get inspired the hard way.
Ruth Pennebaker´s last [type] ..Why Didn’t I Jump

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Sarah Henry August 15, 2010 at 9:10 pm

Well, Ruth, as you know since you’re an accomplished writer, it all winds up being creative fodder — whether in realistic fiction, personal essays, feature stories, or, in this case, blog posts.

Truth is, the topic may not have occurred to me — or held my interest — if I hadn’t had personal experience to draw upon.

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Jennifer Margulis August 16, 2010 at 7:50 am

So many thoughts. First of all, I’m so sorry that YOU were in the hospital and were getting poisoned by the food. But I’m so delighted to hear that there is a trend in a different (healthier, fresher) direction. It’s time for the “food” to be food and for the medical establishment to understand that the quality of food we put in our bodies–whether in the hospital or having a meal at home–is a really important key to good health.
Jennifer Margulis´s last [type] ..So You Want to be on TV

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Sarah Henry August 16, 2010 at 1:49 pm

Well put, Jennifer.

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Ruth August 16, 2010 at 11:13 am

It’s only too true that most hospital food is bland, overcooked past it’s prime or unappetizing.

That’s why I chose the hospital where my newest baby was born for the food(!). The hospital allows three meals per day at your convenience (not a scheduled hour). Patients order from a room service style menu with guidelines for those on restricted diets. The food is cooked to order, fresh colorful and sooo good.

I even called the hospital after my stay to request a recipe.

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Sarah Henry August 16, 2010 at 1:57 pm

Wow, Ruth, that’s an endorsement of hospital food if ever I’ve heard one. Care to tell us where you were so fortunate to have your latest baby?

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Melanie Haiken August 16, 2010 at 11:01 pm

So interesting to ask ourselves why, of all places, hospitals are slow to adopt healthy practices! I think there are some east coast hospitals that have also revamped their approach to food, but like so many things it’s probably a movement that’s mainly on the coasts right now.

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Sarah Henry August 17, 2010 at 7:55 am

Yes, Melanie, I’ve heard rumblings about some innovative folks making changes in Vermont and Boston.

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ler August 17, 2010 at 8:05 am

I have to eat low sodium because of health problems I have been having. I get a lot of specialty food online at healthy heart market. But I didn’t even think about if I was in a hospital I couldn’t get low sodium food very easily.

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Sarah Henry September 12, 2010 at 2:42 pm

I hope you never have to find out, but if you do wind up in hospital, ler, now you’ll know to check about the sodium content of the food that’s served.

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Donna Hull August 17, 2010 at 7:11 pm

I hope this starts a nationwide trend. Hospital food is the worst, in my experience.

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Sarah Henry September 12, 2010 at 2:42 pm

You’re not alone, Donna.

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