Farm to Patient
THINK FRESH, NUTRITIOUS cuisine. Then think hospital food. Let's face it, the all-too-common vision of a tray of bland mystery meat, overcooked vegetables and canned gravy punctuated with a side of Jell-O rarely evokes descriptors such as wholesome or nourishing.
-But that's changing.
A growing awareness that links good health to good food is prodding hospitals across the country to hire nutritionists, upgrade their menus with more fresh fruits and vegetables, and tweak hospital fare with flavorful herbs and spices. Facing a national epidemic of chronic heart disease and juvenile obesity, one Hudson Valley hospital has developed a multi-focused program that links hospital cuisine to patient care.
"The long-term benefit of maintaining the health of our community and steering our patients to a much healthier way of living is our primary concern."
Hudson Valley Hospital Center established its "Harvest for Health" program not only to reinforce the value of fresh, healthful food for patients, but also to extend the scope to include community education and involvement. The comprehensive approach includes an organic garden tended by volunteers from the hospital's staff, a twice-monthly farmers' market at the entrance to the center's Cortlandt Manor campus, a state-of-the-art demonstration and teaching kitchen, and education programs for the public, patients and hospital staff. "It's an exciting development," affirms Hudson Valley Hospital Center President John Federspiel."The long-term benefit of maintaining the health of our community and steering our patients to a much healthier way of living is our primary concern."
In May, the hospital partnered with Pittsburgh-based Cura Hospitality, a food-service company known for sourcing local and sustainable produce for distribution to colleges, senior residencies and hospitals. Jamie Moore, Cura's Director of Sourcing and Sustainability, says the marriage with Hudson Valley Hospital Center is a good one because both programs focus on avoiding foods with antibiotics, hormones, trans fats, high fructose and corn syrup. "We don't have a hospital client that nears what [HVHC is] doing," he says. "They have a direction that is aggressive."
Matthew Croussouloudis, a CIA graduate and chef who has worked in the institutional food industry for 17 years, is Cura General Manager at the hospital. "We don't buy frozen entrees—everything is done on site," he explains. "Currently, we get produce from Red Barn Produce Distributors, but we're also looking for a local coffee roaster and a local dairy co-op. We've redesigned the cafeteria and changed the whole focus and perspective about food—we are engaged in a forward-moving impetus that seems to be unstoppable."
For patients undergoing radiation or chemotherapy, or for those with heart disease or diabetes who are on a restricted diet, trying new and different food can be especially tricky, admits Meredith Sobel, the hospital's clinical nutritionist. "We're always looking for new ways to introduce patients to new foods," she says. "It's a balancing act between what the doctor orders and what we feel is good nutrition." On the daily menu, traditional items such as tuna bow tie casserole, hamburgers and beef Burgundy are offered side-by-side with tofu stir-fry and vegetarian chili. "We want to change the perception of vegetables—that they can taste good," Sobel says. "If we serve meatloaf, we might add a few more carrots or more spinach and veggies. If a patient orders a hamburger, they will get a tasting cup of vegetarian chili or a tofu burger on the side."
The revamped hospital menu also feeds some 1,200 employees, 350 physicians and 300 volunteers in the hospital's cafeteria. All this falls under the apron of Chef Noah Sheetz, a CIA graduate and former executive chef to New York Governor George Pataki. Sheetz prepares 100,000 meals annually for the patients at the hospital (when he's not flipping black-bean burgers at the farmers' market, that is).
At the entrance to the hospital is a list of local farms providing fresh fruits and vegetables for the hospital menu. The list included strawberries and raspberries from Wright's Farm, as well as wild clover honey from Widmark Farms.
The farm-to-plate service doesn't stop at the bedside table or in the warmly lit cafeteria. An important component of Harvest for Health is the new "Chef Peter X. Kelly Teaching Kitchen," honoring Peter Kelly, owner of Xaviar's Restaurant Group, who was instrumental in developing the kitchen and its teaching programs. "When John Federspiel asked if I would help develop this program, I saw a great opportunity for promoting the Hudson Valley and what we do here," Kelly says. "We are essentially taking a community hospital and giving it a national footprint. My hope is that this local initiative will become a national model."
Kelly's concept was to create a training space that could accommodate a wide variety of students—nurses, doctors, staff, patients, and even local middle- and high-school students. "We can bring in patients suffering from diseases like diabetes, or those dealing with coronary issues, and teach them how to cook better," Kelly notes. "We can also [accommodate] about 15 kids from ages 7 to 12. We can greet them with a healthy snack and teach them how to make it; we can introduce them to a farmer or hold a class with a chef; we can show them how to dig a carrot out of the ground, clean it, peel it, cook it." The education component can be easily linked to one of Federspiel's major concerns—adolescent obesity. "We want to teach them that chickens don't have fingers and buffalo don't have wings," Federspiel says.
Culinary Nutrition Coordinator Michael Bulger, who created a Young Chefs program (just awarded $20,000 by the Newman's Own Foundation), says he hopes the popularity of MasterChef Junior, a new television culinary competition for kids 8 to 13, will help spur students to value and enjoy cooking up good, healthful meals. "Now there's this 'cool' factor about cooking—we want to build cooking skills and reinforce those skills with a nutritional message," Bulger says. "We can show them that instead of slathering a steak with Cheetos, it's so much cooler to sear a fish."
Patients, too, will have the opportunity to learn new ways of preparing foods recommended by their doctors. Classes will involve hospital dieticians and nutritionists who target new mothers; patients dealing with heart disease, cancer or diabetes; the elderly; and those on limited budgets. "It's one thing to tell patients to eat more fruits and vegetables, but it may be a monumental task for someone to slice an onion," Bulger stresses. "We want to give people confidence and a sense of accomplishment in the kitchen. Hopefully, if cooking is less scary and more enjoyable, they [will be] able to eat better."
Bulger and Federspiel are developing a program to track the impact a modified diet has on patients. "About 25 percent of heart attack patients return to the emergency room—that statistic is a real eye opener," Federspiel notes. "We have to change the lifestyle of these patients—and nutrition has to be brought into the equation."
The Organic Garden for Healing, built in 2012, was designed to be a place of respite for recovering patients who are encouraged to venture in among the flowers and vegetables for quiet contemplation. They also are encouraged to help pick tomatoes, beans, kale, spinach, basil and other vegetables and herbs. "The garden is great for the employees and for patients," says Melissa Frissora, administration coordinator at the Cheryl R. Lindenbaum Cancer Center. "We bring the produce from the garden into the cancer center for patients to try. There are dietitians working with patients on nutrition, and [visiting the garden] helps if [the patients] are sometimes apprehensive about new foods. For patients who want to work in the garden, it keeps their mind off their [medical] situation."
Deborah Lynch, medical coder in the health information management department, confirms the positive effect the garden can have. "If you see oncology patients, it can break your heart," she says. "But when we bring them out to the garden and they see the beautiful flowers, it really makes them smile." Patient access coordinator Deborah Glatz, of the center's radiology department, says her experience working in the garden has been very fulfilling. "We all share the work and help promote the garden and the farmers'' market—it all reinforces the message about eating healthy."
Each year, about 715,000 Americans have a heart attack, according to the Centers for Disease Control and Prevention (CDC). Coronary heart disease, the most common type of heart disease, kills more than 600,000 in the United States annually—1 in every 4 deaths. According to The $11 Trillion Reward: How Simple Dietary Changes Can Save lives and Money, and How We Get There, a 2013 report by the Union of Concerned Scientists, increasing our consumption of fruits and vegetables could save more than 100,000 lives and $17 billion in health care costs related to heart disease each year. The report postulates that if Americans ate one additional serving of fruits or vegetables per day, the change would save more than 30,000 lives and $5 billion in medical costs each year and that the resulting increased longevity would be worth $11 trillion.
Approximately 17 percent (12.5 million) of children and adolescents aged 2 to 19 in the U.S. are clinically obese. The CDC says that since 1980, obesity prevalence among children and adolescents has almost tripled. According to the Mayo Clinic, some cases of childhood and juvenile obesity occur because of genetic diseases and hormonal disorders, but most are a result of poor diet and lack of exercise. A typical diet for an obese child/teen includes sodas high in sugar; sweetened fruit drinks and sports drinks; and pre-packaged snack foods high in fat and sugar. This population eats one of every three meals outside of the home at restaurants and fast-food establishments where portions tend to be large.
Hudson Valley Hospital Center
Hudson Valley Hospital Center's geographic service area includes Northern Westchester County, Putnam County and Southern Dutchess County. The service area encompasses a total population of 320,000. According to 2010 census data, the primary service area population is 22 percent Hispanic and 9.3 percent Black. The median family household income is $85,500 with a median unemployment rate of 6 percent within the primary service area. Since 2005, more than 450 hospitals and food service management companies in the United States have committed to implementing strategies to improve their hospital food and beverage environments by signing Health Care Without Harm's Healthy Food in Health Care Pledge. Hudson Valley Hospital Center also signed the pledge.