March 28

Hospital food is supposed to be good for you. But can it ever be "good"?

INTELIHEALTH FEATURE -

Does nutritionally sound food have to taste bad? Not if you follow the advice of a hospital that has people clamoring for its recipes.

Cookbook titles you won't find at Amazon.com:

"Delicious Recipes from Community General Hospital"
"Smallville Medical Center's Most Requested Meals"
"Dishes to Make Your Mouth Water: From the Food Service Staff at St. Mary's"

Grumblings about hospital food are well known, and, in most cases, well founded. A 1999 study of food served in British hospitals, for example, noted that the meals were so unpalatable that many patients felt even worse than when they were admitted to the hospital and had even lost weight by the time of their discharge. Granted, we’re talking about a country where dishes like bubble and squeak pass for haute cuisine, but the situation here in the colonies is often no better.

Most mass-produced institutional meals sometimes lack not only pizzazz but also basic taste. In their defense, hospital cooks face hurdles that Julia and Emeril never have to consider — keeping fat below 30 percent of total calories, reducing salt and avoiding overly spicy ingredients. They also make sure every meal meets the basic nutritional requirements outlined in the USDA's Food Guide Pyramid. The result? Patients receive well-balanced meals, but they usually have a hard time getting the stuff down. If only there were a way to combine the nutritional value of hospital food with the good taste of restaurant food.

There Is. Consider This Example:
In Fairfax, Va., there's a day care center called A Child's Place where kids enjoy great-tasting hot lunches every day. The food so impresses the kids that they rave about it to their parents. In addition to being the sort of stuff kids like to eat, everything on Junior’s menu follows the tenets of the Food Guide Pyramid . Where do these "miracle" meals come from? Nearby INOVA Fairfax Hospital and INOVA Fairfax Hospital For Children.

"Parents call about the day care meals and want me to fax them recipes — for our vegetable lasagna, for example — because their children like them so much," says Vernon Rhea, food service director for the hospital. In addition to serving A Child's Place, Rhea says INOVA Fairfax Hospital provides meals for four area day care centers (supplying nearly 10,000 meals per month); 25 Meals-On-Wheels routes; the 656-bed hospital population; and the hospital cafeteria, where people from the community come to eat even if they don't have someone in the hospital to visit. This is not a place that generates bad-food jokes.

For most hospitals, meeting the nutritional guidelines outlined in the Food Guide Pyramid is the easy part. Food service directors work with their chefs and dietitians to plan menus full of variety and nutritional value.

Jeanette Jordan, a registered dietitian and spokesperson for the American Dietetic Association, was involved for 15 years in planning patient menus, including both regular meals (those with no restrictions) and special diets. "We followed the standard guideline about fat — no more than 30 percent of total calories from fat," she says. "For the average person, that might be less than what they normally consume." She also says hospitals stress variety to a greater degree than many folks do at home. "We make sure patients get fruit at every meal," says Jordan. For the consumer, the greatest benefit of following a hospital-style meal plan is that it's based squarely on following the Food Guide Pyramid, which highlights eating a variety of foods to get all the nutrients people need to be healthy.

But What About Taste?
OK. You're convinced that planning your home meals the way a hospital does — based on the Food Guide Pyramid — is a good idea. But what about flavor? How does INOVA Fairfax Hospital earn accolades from its community about the quality of its food and avoid the hospital food jokes so many other centers rightfully deserve?

According to Joe Teta, INOVA Fairfax Hospital chef, the answer boils down to two guiding principles:

• Be creative in your use of spices (to cut down on the need for fat and salt to add flavor).
• Make as much as you can from scratch (to control the fat and salt content).

"A lot of hospitals use all convenience items on their menus, such as the frozen entrees you can buy in supermarkets," Teta says. "We use some of those products, but we also make a lot of stuff from scratch. When we make items from scratch, we can drain the fat off and control the salt content. A lot of those packaged foods are very salty."

As for the spices he uses in his meals, Teta says you can find them at your local market. "These new spices are very versatile," he says. "They can be used on poultry and fish. They add flavor without adding salt."

Another simple trick Teta uses to retain flavor while cutting down on fat is to use low-fat versions of ingredients. "Many people will say that soups made with cream will taste better, but I use 2 percent milk and think the soup comes out just as good," Teta says, "though you might need to add a little more flour or cornstarch to thicken the soup."

One Of A Kind?
Is the food at Fairfax a pleasant aberration or part of a larger trend toward better tasting hospital dishes? Eliana Schultz, R.D., director of food and nutrition services of San Mateo County, Calif., and a spokesperson for the American Society For Healthcare Food Administrators, says a few changes bode well for the palates of people eating hospital food.

"We're seeing a lot more menus that are ethnically diverse," she says. "Asian and Mexican dishes in particular rely more on fresher foods, which contributes to a healthful menu."

Another recent change is that more hospital chefs have formal educations in the culinary arts, and instead of going into the restaurant business, many chefs use their skills in hospital kitchens.

The last change isn't in the food, but in the delivery. "The industry has looked hard at delivering food in a timely fashion," says Schultz. A perfectly good meal doesn't taste good if it isn't served hot. Possible solutions include using galley-type kitchens on patient floors to prepare or heat up meals.

Related Reading
Nutrition Guide

Digestion

Weight Center