The Shame of School and Hospital Food

Of all institutions, these places should be feeding their charges well. Why aren't most of them, and what can we do about it?
Hospital Food


Hospital food as it is in the United States today may actually hinder the ability of a patient to recover.

This is one in a series of articles. For more on this subject visit The Daily Meal Special Report: Is Our Food Killing Us? Diet, Nutrition, and Health in 21st Century America.

Airline food may have improved in the past few years, at least in business class and above (some airline food has leapt from stand-up comic bait to being – well, if not excellent, actually palatable), but the same has yet to have happened for most hospital menus and school lunch programs. And the problem with these institutional food programs isn’t just flavor — although that’s certainly an issue — it’s how these foods are affecting Americans’ health.

Americans are plagued with high rates of heart disease, high blood pressure, and diabetes, all issues grounded in diet. So in our institutions where health matters most — our schools and hospitals — the food offered should logically be at its healthiest: Fresh fruits and vegetables, whole grains, and lean proteins should be at the fore. But all too often, these organizations are exactly where we are failing ourselves, serving meals that are frequently deep-fried, packed with sugar, and nutritionally void.

According to the Center for Disease Control and Prevention, a surprising number of U.S. hospitals are guilty of serving food that is poor in nutrients, overly caloric, and too high in sodium.

“A 2005 survey of 17 hospital entrées reported as healthiest found the sodium content per serving varied greatly from 61 milligrams (mg) to 1,450 mg… [these] meals also were exceedingly high in fat, saturated fat, and cholesterol and low in fiber” the CDC reports.

McDonald’s and other fast food chains, many of which have had contracts in hospitals since the 1980s and ‘90s are starting to be ejected by many hospitals nationwide. The idea of peddling food and drinks that are packed with saturated fat, corn syrup, and empty carbohydrates does not seem to fit, for many people, into an institution that tries to embody and promote a culture of wellness. But the option of a McDonald’s in the foyer may be less insidious than the unhealthiness of the meals that are actually served to patients in their beds.

“Hospital food as it is in the United States today, with high amounts of preservatives, additives, and sodium, may actually hinder the ability of a patient to recover,” says Deepa Verma, M.D., of Synergistiq Integrative Health, a holistic health provider. “Many hospitals contract their food plans with companies that also make food for schools and prisons so their focus is high volume with lowest cost as possible. This is known as institutional food.

“Bulk food costs are utilized and negotiated by government agencies like the U.S. Department of Agriculture,” Verma explained. “Fresh fruits and vegetables are not really used as much due to their higher cost relative to cheaper ingredients like wheat, GMO corn, and low-quality cuts of meat.”

What is to blame for this oversight? Partially, it’s that regulations tend to only be put in place when the federal government's Centers for Medicare and Medicaid Services, or CMS, is involved, and the CMS has yet to focus on this issue because Medicare does not reimburse for food. This isn’t the case in every country.
“The U.K.'s hospital food is closely monitored because it's a part of their national  healthcare system, which is run by the government," Business Insider reports. "In the U.S., hospital food is determined by individual institutions.”While some U.S. hospitals provide their patients with excellent quality, healthy food, many others don't, and there is no nationwide oversight or regulation for quality.

This means that while some U.S. hospitals provide their patients with excellent quality, healthy food, many others don't, and there is no nationwide oversight or regulation for quality.

There have been some efforts to improve food on a hospital-by-hospital level, however. The Health Hospital Food Initiative of New York City has been effective: Over half the city’s hospitals have taken the pledge to make the food they serve healthier, and have seen positive results as a consequence, not just in patients, but in hospital staff.

"We've reduced the salt," Nancy Gruber, director of food services at Montefiore Medical Center in the Bronx told NY Channel 1."[We] took away our “munchie bar,” which was popular at the time. It was fried Buffalo wings, fried potato skins, you know, a lot of fried food, and we've introduced a vegetable bar.”

And while Medicare may not be involved in regulating the quality of food in hospitals, it has started to alter its pay structure based partially on patient satisfaction — leading to an uptick in the quality of food at places like Rex Hospital in Raleigh, N.C., where the menu includes such items as Caribbean grilled chicken salad, lime- and ginger-glazed salmon, and baked potato wedges.

School lunches, meanwhile, are almost iconically disgusting, often resembling carnival fare more than anything students should actually be consuming on any kind of a regular basis. Classic school foods include such “mystery meat” as corn dogs and chicken nuggets (which National Public Radio recently reported sometimes don’t even really contain much in the way of chicken), and of course loads of French fries.

Aside from school food being generally icky, basic food safety problems are more common in school cafeterias than we’d like to think. When Dateline NBC did a nationwide report on school food safety issues, the results were shocking: In schools across the country, food was being held at improper temperatures (resulting in bacteria growth) and cooked at unreasonably low temperatures, there were fly infestations, and in some schools, cafeteria workers even lacked access to a sink with soap and running water. As Jennifer Berg, director of New York University’s food studies program, told Dateline, “That’s Russian roulette with kids’ health and lives.”

Schools often explain or excuse the poor quality of the food they serve by mentioning budget. The popular wisdom is that cheap, processed foods are, well, cheap, and they’re also the only foods kids will pay for. If cafeterias stop supplying this low-cost, low-quality food in favor of fresh ingredients, it is said, they’ll lose money. It’s an objection that should be taken into consideration — except that it turns out not to be true.

Dana Woldow, a San Francisco mom turned school food advocate, did an analysis of food costs at her children’s' school. Instead of potato chips and soda (which the cafeteria was losing money on anyway), the school started serving fresh foods like salads, sandwiches, and soups.

"Three months after we started our pilot project, the cafeteria was breaking even," Woldow told CNN. "Six months into it, our cafeteria was one of two in the school district that turned a profit. So much for the idea that you will lose money if you stop selling junk food in your cafeteria.”


According to a study that took place in four schools in the Boston area, kids really are eating more fruits and vegetables, thanks to new standards went into effect in 2012, a product of Michelle Obama’s Let’s Move campaign.