How Hospitals Can Improve Patient Nutrition and Promote Healthy Lifestyles

Hospitals can promote good nutrition and healthy lifestyles through many programs, including plant-based menus and educational efforts.

There are a growing number of successful nutrition and lifestyle initiatives at health systems and hospitals across the country, a recent journal article shows.

Largely due to poor dietary habits and sedentary lifestyle, the number of overweight Americans has reached pandemic proportions. More than two-thirds of Americans are overweight or obese, according to the National Health and Nutrition Examination Survey. Dietary risks are now a top cause of premature death.

The recent journal article, which was published in The American Journal of Medicine, says hospitals are well-positioned to have a positive impact on patient weight. "Acute care settings present an opportunity to improve nutrition and lifestyle of patients, especially because patients may be highly motivated to embrace these tools as part of the healing process," the co-authors wrote.

Boosting hospital nutrition

There are several examples of initiatives designed to improve the hospital food environment for inpatients, visitors, and employees, according to the journal article.

• Partnership for a Healthier America is a public-private program developed by former first lady Michelle Obama. "It encourages hospitals to offer lower-calorie meals, eliminate deep-fried products, increase fruit and vegetable offerings, promote healthful beverages, and keep unhealthy snack foods away from cash registers," the co-authors wrote.
   
• The American Medical Association has urged hospitals to implement three measures to improve hospital food: offering a range of healthy food such as plant-based meals and meals that are low in fat and added sugar; dropping processed meats from meals; and providing healthy drinks.
   
• At least five hospitals and health systems offer 100% plant-based meals to patients on a separate menu, give educational materials to inpatients on how diet impacts chronic disease, and include their plant-based menu in admission orders to require physicians to have diet-related conversations with inpatients: Tampa, Florida-based James A. Haley Veterans' Hospital; New York-based Lenox Hill Hospital; Bronx, New York-based Montefiore Health System; Denver, Colorado-based National Jewish Health/St. Joseph Hospital; and Gainesville, Florida-based UF Health Shands Hospital.

Outpatient initiatives

There also are several examples in the journal article of health systems that have nutrition and lifestyle programs for outpatients.

• New York-based NYC Health + Hospitals/Bellevue has implemented a pilot program that promotes plant-based nutrition and lifestyle changes to lower cardiometabolic risk. The program features a team with physicians, a dietitian, and a health coach.
   
• UF Health in Gainesville assesses diet and lifestyle in an outpatient prevention cardiology program, which includes hour-long meetings with a preventative cardiologist. Patients also meet with physician educators to promote plant-based meals and create an eating plan and grocery list.
   
• Since 2017, Manhattan, New York-based Northwell Health has launched three nutrition initiatives for outpatient settings: offering fresh products such as antibiotic-free chicken; reducing and eventually eliminating sugar-sweetened drinks in areas such as cafeterias and coffee shops; and eliminating fryers and pre-fried food.
   
• Beginning in 2003, Oakland, California-based Kaiser Permanente developed a network of more than 50 hospital- and clinic-related farmers markets.
   
• The Cardiology Division at Montefiore Health System has a plant-based prevention clinic that includes free Saturday morning sessions for patients with a physician and a registered dietitian to learn about plant-based nutrition.

Implementing nutrition initiatives

The lead author of the journal article told HealthLeaders there are key commonalities in hospital nutrition programs.

"All of the initiatives focus on adding more plants into the hospital foods, eliminating refined and simple sugars and processed foods, and offering more fiber-rich foods. We have a common focus, and everyone realizes that hospital food programs need improvement," said Monica Aggarwal, MD, an associate professor in the Division of Cardiology at the University of Florida in Gainesville, and director of integrative cardiology and prevention at UF Health Shands Hospital.

UF Health Shands Hospital has transitioned to healthy food and beverages without having a negative impact on patient satisfaction, she said.

"Patients are understanding the common goals. We have a lot of supportive education to explain why we want people to eat more plants. On our regular menu, we also have a lot of plant-based options, so that those who may be intimidated by the idea of plants can see it is an option. That has really helped—people often prefer plants and don't realize it."