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Plant-Based Offerings Heat Up in Health Care
By Sharon Palmer, MSFS, RDN, and Ally Mirin
As dietitians know full well, plant-based eating is a hot trend among consumers. According to a recent report, nearly 40% of Americans are trying to incorporate more plant-based foods into their diet. And with good reason. The evidence supporting a plant-based diet to help prevent, treat, and manage some of the most prevalent diseases in the nation is growing. So, it’s only natural that health care facilities of all types would be interested in adding plant-based offerings to their menus. Some states are even mandating that these options be made available. Here’s a look at what’s going on with plant-based options in health care.
Why Put Plants on the Health Care Menu?
In the United States, CVD is the leading cause of hospitalization and is the cause of 1 in 3 deaths. Obesity, type 2 diabetes, hypertension, cancer, and high cholesterol also contribute to a significant amount of hospital stays and are leading causes of mortality in the country.1 One commonality among these illnesses is that they all have modifiable risk factors, which include diet. Many studies have shown that following a plant-based diet is associated with lower risks of heart disease, obesity, hypertension, type 2 diabetes, and certain types of cancer.2 Yet many hospitals have offered unhealthful food choices that contradict the healing environment that health care providers work so hard to foster. This concept is changing, as more hospitals desire to become leaders of change in the community, both for health and environmental footprint. The nonprofit organization Health Care Without Harm reports that the health care sector’s climate footprint contributes to 4.4% of global emissions—nearly 75% comes from the health care supply chain, including food and agricultural products.3
Legislation is catching up with the times. In 2018, California passed Senate Bill 1138, requiring hospitals to make plant-based meals that don’t include any animal products available to all patients.4 New York passed a similar bill in February 2019, mandating that hospitals offer plant-based meals and snacks to patients upon request at no additional cost.5 More states may follow in New York and California’s footsteps, making plant-based foods a required option for patients across the nation.
Plant-Forward Trends in Health Care Food Service
What’s encouraging is that many hospitals around the nation are looking to put more healthful plant-based options on their menus. In 2017, the American Medical Association created the Healthy Food Options in Hospitals resolution, pushing healthful, reasonably priced, and accessible food choices to become available on hospital premises, as well as calling on US hospitals to improve the health of their patients, staff, and visitors by providing more plant-based, low-fat, low-sodium, and low-sugar foods, eliminating processed meat, and promoting healthful beverages.6 The American College of Cardiology put forth similar guidelines in Planting a Seed: Heart-Healthy Food Recommendations for Hospitals, which recommends hospitals offer at least one plant-based entrée that’s low in fat, sodium, and sugar at every meal, as well as a minimum of three fruit and/or vegetable options at every meal, and the elimination of trans fats and processed meats.7
Health Care Without Harm has made strides to improve the quality of food offered in hospitals across the country. It developed the Healthy Food in Health Care Pledge, which is a framework that describes steps to improve food production and distribution, for both the bettering of the planet and patient health. As part of their pledge, hospitals commit to taking specific actions such as working with local farmers, increasing fruit and vegetable offerings, and minimizing food waste.8 At press time, a total of 596 hospitals had taken the Healthy Food Pledge.
How to Green the Health Care Menu
Resources are becoming more available to help health care facilities offer more plant-based meal options. Oldways Plant Forward Plates Healthcare Toolkit is an excellent resource for introducing and integrating 100% plant-based meals into hospitals and health care foodservice settings. The toolkit offers a turnkey solution for implementing a plant-based menu in health care foodservice settings, including menu plans for therapeutic diets, scalable recipes, and ordering guides to aid clinical dietitians, foodservice directors, chefs, dining managers, and administrators in implementing a plant-based, dietitian-developed menu program.
The Physicians Committee for Responsible Medicine also provides a Nutrition Guide for Clinicians, designed for health care professionals, as well as a 21-day Vegan Kickstart and a Vegetarian Starter Kit for anyone who’s looking to begin a plant-based lifestyle in other walks of life.
Many hospitals have fully embraced the push for plant-based meal offerings, including Bellevue Hospital in New York City, where they’ve established The Plant-Based Lifestyle Medicine Program, designed to help people improve their health by transitioning to a plant-based diet and active lifestyle.9 Adults with diabetes, CVD, hypertension, high cholesterol, or obesity are eligible to work with a team of doctors, RDs, and health coaches who will establish individualized plans to achieve health goals through a healthful, plant-based diet.
Foodservice contracts for health care also are shifting their focus to plants. According to Aramark, 60% of consumers want to reduce their meat consumption. The company recently launched a plant-forward initiative, which introduced more than 200 new plant-based recipes, set a standard of 30% of menu offerings to be vegan or vegetarian, and trained more than 1,200 chefs in plant-based culinary innovation. It’s currently developing a gumbo bowl for hospital patient menus that uses the popular Beyond Meat Sausage.10
Another program working to promote plant-based meals in hospitals around the country is Meatless Monday. It offers a complete implementation guide that explains the benefits of introducing the plant-based program, provides specific strategies for success, and offers other invaluable tips on how to get the program going. Several hospitals have launched Meatless Monday with great results, including NewYork-Presbyterian in New York City.
Training Foodservice Culinarians
Even if hospitals want to move forward with plant-based options, how do they train their staffs? One solution comes from the Humane Society of the United States’ (HSUS) Food and Nutrition team, which works with hospitals and other institutions to make plant-based options more readily available. It has developed a comprehensive and revolutionary program called Forward Food Culinary Nutrition Training.
“This is a culinary nutrition workshop for nutrition and health professionals and culinary teams, examining the latest research on chronic disease prevention through plant-based diets,” explains Karla Dumas, RDN, LDN, director of food and nutrition at the Humane Society. “At this training, a registered dietitian, along with our chef, will work with foodservice and health professionals, reviewing the latest science behind plant-based dietary patterns and their role in disease prevention. The training also identifies strategies that empower clients to put more plants on their plate. Participants have the opportunity to prepare a variety of quick and delicious plant-based meals and receive continuing education credits. This training is available at relatively no cost to the hospitals, with a value of $1,500.” The program has completed nearly 500 trainings since 2015, and they’re projected to have taught more than 11,000 foodservice culinarians by the end of 2019.
One of the many successful trainings by the Forward Food team was done at The Valley Hospital in New Jersey. After working with HSUS, the hospital implemented Meatless Monday, and now more than 30% of its daily menu offerings are entirely plant-based. The Valley Hospital also has achieved an overall food cost savings of $130,000 annually. Its success has inspired several other hospitals to commit to integrating more plant-based meals, and it continues to work toward increasing its offerings to be 50% plant-based in the next few years.
Hospitals across the country are making inspiring strides towards a more plant-based future. Offering patients nourishing plant-focused meals will decrease costs to institutions, pave the way to a more sustainable planet, and encourage healing.
— Sharon Palmer, MSFS, RDN, The Plant-Powered Dietitian, serves as the nutrition editor of Today’s Dietitian. She works in plant-based and sustainable nutrition and is a nutrition consultant for Oldways.
— Ally Mirin is a senior dietetics student at Cornell University and intern with Sharon Palmer, MSFS, RDN. She’s based in Ithaca, New York.
References
1. Krishnamurthi N, Francis J, Fihn SD, Meyer CS, Whooley MA. Leading causes of cardiovascular hospitalization in 8.45 million US veterans. PLoS One. 2018;13(3):e0193996.
2. Craig WJ, Mangels AR; American Dietetic Association. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009;109(7):1266-1282.
3. Health care’s climate footprint: how the health sector contributes to the global climate crisis and opportunities for action. Health Care Without Harm website. https://noharm-global.org/sites/default/files/documents-files/5961/HealthCaresClimateFootprint_092319.pdf. Published September 2019.
4. Gov. Jerry Brown makes plant-based meals the law in California hospitals. Physicians Committee for Responsible Medicine website. https://www.pcrm.org/news/news-releases/gov-jerry-brown-makes-plant-based-meals-law-california-hospitals. Published September 18, 2018. Accessed September 29, 2019.
5. Bill no. A04072. New York State Assembly website. https://nyassembly.gov/leg/?default_fld=&leg_video=&bn=A04072&term=0&Summary=Y&Actions=Y&Committee%26nbspVotes=Y&Floor%26nbspVotes=Y&Memo=Y&Text=Y. Accessed September 29, 2019.
6. Healthy Food Options in Hospitals H-150.949. American Medical Association PolicyFinder website. https://policysearch.ama-assn.org/policyfinder/detail/Healthy%20Food%20Options%20in%20Hospitals%20H-150.949?uri=%2FAMADoc%2FHOD.xml-0-627.xml. Updated 2018. Accessed September 29, 2019.
7. Planting a seed: heart-healthy food recommendations for hospitals. American College of Cardiology website. https://www.acc.org/membership/sections-and-councils/prevention-of-cardiovascular-disease-section/about-us/section-sub-groups/features/hospital-food-program. Accessed September 29, 2019.
8. Healthy food in health care pledge. Health Care Without Harm website. https://noharm-uscanada.org/issues/us-canada/healthy-food-pledge. Accessed October 4, 2019.
9. Plant-based lifestyle medicine program. NYC Health + Hospitals Bellevue website. https://www.nychealthandhospitals.org/bellevue/health-care-services/plant-based-lifestyle-medicine-program/. Accessed September 29, 2019.
10. Plant-based Beyond Meat products help Aramark drive climate-healthy culinary innovation. Aramark website. https://www.aramark.com/about-us/news/aramark-general/beyond-meat-products-help-aramark-drive-innovation. Published August 12, 2019. Accessed September 29, 2019.