Real World Health Care Blog

Tag Archives: nutrition

The Hospital Fast Food Debate: How a Simple, Low-cost Idea can Improve What People in Hospitals Eat

Back in April 2012, nearly two dozen hospitals that host fast food restaurant chains received a letter from an advocacy group asking them to evict their fast food tenants and to “stop fostering a food environment that promotes harm, not health.” But as it turns out, many of these outlets offer options that are nutritious in addition to unhealthy options, and the same can be said about many hospital-owned cafeterias.  In fact, a review by the Physicians Committee for Responsible Medicine (PCRM) found that some hospitals with fast food vendors also had their own cafeterias with equally unhealthy options.

David Sheon

David Sheon

Meanwhile, some fast food companies, such as McDonalds, have worked hard to improve nutritious options. Others, such as Burger King, should be acknowledged for adding veggie burgers.

Perhaps the debate over having these chains located in hospitals is misplaced. Perhaps the more important factor in helping customers make healthy decisions is labeling nutritious food in an easy to understand manner.

Hospitals appear to be able to convince cafeteria customers to buy healthier food by adjusting item displays to have traffic light-style green, yellow and red labels based on their level of nutrition.

According to a recent report by HealthDay News:

“Our current results show that the significant changes in the purchase patterns … did not fade away as cafeteria patrons became used to them,” study lead author Dr. Anne Thorndike, of the division of general medicine at Massachusetts General Hospital in Boston, said in a hospital news release. “This is good evidence that these changes in healthy choices persist over time.”

As part of the study, labels — green, yellow or red — appeared on all foods in the main hospital cafeteria. Fruits, vegetables and lean sources of protein got green labels, while red ones appeared on junk food.

The cafeteria also underwent a redesign to display healthier food products in locations — such as at eye level — that were more likely to draw the attention of customers.

The study showed that the changes appeared to produce more purchases of healthy items and fewer of unhealthy items — especially beverages. Green-labeled items sold at a 12 percent higher rate compared to before the program, and sales of red-labeled items dropped by 20 percent during the two-year study. Sales of the unhealthiest beverages fell by 39 percent.

“These findings are the most important of our research thus far because they show a food-labeling and product-placement intervention can promote healthy choices that persist over the long term, with no evidence of ‘label fatigue,'” said Thorndike, an assistant professor of medicine at Harvard Medical School.

Perhaps we should worry less about whether food vendors in hospitals are fast food chains, and more about labelling nutritious choices and positioning them to encourage healthy eating. What do you think? Would clear labelling of healthy choices affect the way you eat at hospitals? Would this translate outside of the hospital setting?

Categories: General

What You Can Do To Strengthen Health Care Delivery for MLK Day

Nathan Sheon Head Shot to Use

Nathan Sheon

The Rev. Dr. Martin Luther King Jr. (MLK) Day of Service will be recognized in communities across America on Monday, Jan. 20 as part of UnitedWe Serve – the President’s annual national call to service initiative. A powerful catalyst that organizes and promotes local volunteer programs to benefit diverse populations, it “empowers individuals, strengthens communities, bridges barriers, creates solutions to social problems, and moves us closer to Dr. King’s vision of a ‘Beloved Community.’”

Recognized as a “day on, not a day off” since 1994, the MLK Day of Service is the only federal holiday observed as a national day of service. The campaign’s programs address a wide range of issues that include poverty, education and access to food, in addition to sponsoring numerous initiatives that intersect with health care. This year, the MLK Day of Service aims to empower people to advocate for and educate their communities about how to live healthfully, from working out to making better eating choices and obtaining the latest information on implications of the Affordable Care Act (ACA).

Some of the ways you can help raise awareness about health interventions that will help your volunteering to last beyond one day, include:

  •  Organizing a local fitness event
  •  Informing people in your local community about how the new health care law effects them
  • Teaching a class on healthful cooking and eating
  •  Educating low- and middle-income families on opportunities to access affordable health care for their children

The MLK Day of Service website also includes a multitude of communications tools, such as:

But why serve on MLK Day and join the movement to help transform communities and improve health care delivery?

“Dr. King devoted his life to advancing equality, social justice, and economic opportunity for all, and taught us that everyone has a role to play in making America what it ought to be,” Robert Velasco II, acting CEO of the Corporation for National and Community Service, said in a statement. “Now more than ever, we need to take heed of Dr. King’s teachings and work together to achieve his dream. Volunteer service is a powerful way to strengthen economic opportunity. And when better to start than on the day we honor Dr. King?”

Organizers of the MLK Day of Service hope that by giving advocates and allies the tools and information to make their projects newsworthy, word of the initiative will spread – along with the success of new and innovative service projects. The event provides volunteers with the critical resources they need to establish grassroots campaigns and service projects that they believe will empower individuals and local communities to make more informed choices across the spectrum of health.

Now share your story. Are you participating in the MLK Day of Service, and if so, tell us why. Have you – or someone you know – volunteered in one or more programs? What impact did it have in your local community?

Categories: Access to Care

Turning DASH Strategy into Reality for Improved Cardio Wellness Outcomes: Part II

As part of their health & wellness program, the largest health insurer sent me a refrigerator magnet highlighting the National Institutes of Health’s (NIH) Dietary Approach to Stop Hypertension Diet (DASH).  In their accompanying letter, the company stated that the refrigerator magnet is a “tool to help you manage your blood pressure.”

Shawn J. Green

Shawn J. Green

The DASH Eating Plan refrigerator magnet was a nice gesture to remind clients to consume less sodium and incorporate more vegetables and fruits into their diet to lower blood pressure.  However, is this the most effective wellness tool to engage and motivate individuals to change their eating habits?

As we learned in last week’s post, plant-based diets – especially those rich in leafy greens, such as spinach and arugula – elevate cardio-protective nitric oxide.  For many pre-hypertensive individuals, staying with a plant-based diet is a critical driver to prevent elevated blood pressure and the diseases associated with hypertension.

Yet many Americans continue to fall far short of eating recommended daily servings of vegetables that elevate natural nitric oxide levels in our body.

A new model is needed to drive behavioral change. So how do we consistently integrate cardio-protective plant-based diets into our daily dietary lifestyle?

Berkeley Test may be a start.

Berkeley Test’s Saliva Nitric Oxide Test Strips and its iPhone Cardio Diet Tracker are designed to break bad habits and empower folks from various walks of life to incorporate plant-based foods into their daily diets.  These engaging tools provide a model to influence dietary change on a personal level that supports lasting compliance with measurable outcomes.

Designed to detect nitric oxide status in the body throughout the day, Berkeley Test developed the next generation proprietary nitric oxide test strip; for less than 70-cents, an easy-to-use, 1-minute saliva test strip enables consumers to make immediate and real-time dietary lifestyle adjustments.

Once users finish the strip test, they can use Berkeley Test’s Cardio Diet Tracker App to compare their results to a color-coded indicator showing whether nitric oxide levels are on target. After 2-3 hours, the user is alerted to check their nitric oxide status.  Users can leverage the Cardio Diet Tracker App to more effectively adhere to plant-based diets by tracking nitric oxide status in conjunction with the type, frequency, and amount of nitric oxide-potent foods eaten to sustain their levels.

Michael Greger, M.D., of NutritionFacts.org, suggests that Berkeley Test may offer hope by bringing plant-based foods into our dietary lifestyle in an engaging fashion. At the very least, it will remind us to eat our greens on a more frequent basis, he says.

Berkeley’s strip-app bundled technologies demonstrate that self-assessing, analyzing, and fine-tuning wellness outcomes with a shared, open, interactive community can be a catalyst to sustain plant-based cardio-protective diets in our daily lifestyle. The value of Berkeley Test’s model is not only demonstrated in how it equips consumers to make healthier dietary choices, but also in its ability to connect users by allowing them to share dietary successes with their Facebook friends.  In today’s society, wellness outcomes and fitness is highly social and valued.

Individuals – who range from Olympians seeking to boost their physical endurance to baby boomers looking for an easier way to eat healthfully and prevent high blood pressure – are embracing these innovations.  As more people turn to Berkeley’s strip and mobile App to improve adherence to plant-based diets, such as DASH and Ornish, natural communities of mutual support are growing.  These networks offer a unique venue to share experiences, provide strategies for success and a forum to discuss common challenges, refine approaches and achieve desired outcomes.

A dynamically open community to share new knowledge about wellness and create a model for achieving and maintaining healthy living and eating is what we hope Berkeley’s ‘health biomarker’ test strips (such as nitric oxide and mobile App combo) provides.

So, what is your nitric oxide level, today?

More Patients DASH to New Solution to Reduce High Blood Pressure: Part I

Shawn_J_Green

Shawn J. Green

What’s the solution to reversing the tide of hypertension, the most commonly diagnosed condition in the United States?  More evidence indicates that the answer begins with the food choices we make every day.

An underlying cause of heart attacks, strokes and kidney disease, one in three American adults now experiences high blood pressure – the single-largest contributor to death worldwide. It is also becoming more resistant to the pharmaceutical drugs used to lower it. In fact, blood pressure remains elevated in nearly one-third of all treated hypertensive patients on pharmaceutical drugs.

Instead of relying on prescriptions, more patients are turning to a healthier eating approach: Keeping sodium intake low and making consumption of nitric oxide-rich vegetables and leafy greens high. This cardio-protective daily diet, known as the DASH (Dietary Approach to Stop Hypertension) Eating Plan, is emerging as an effective way to delay or prevent high blood pressure altogether.

The value of nitric oxide was spotlighted when the Nobel Prize was awarded in 1998 for discovery of this naturally produced cardio-protective factor. A string of clinical studies underscored that vegetables (like red beet roots) and leafy greens (such as spinach and arugula) are replete with nitric oxide.

Diets known for promoting heart health and lowering rates of diabetes and obesity – like Japanese diets, Mediterranean diets and plant-based diets, such as DASH, among others including TLC, Ornish, and Pritikin – incorporate these natural whole foods. The need to consume more nitric oxide-potent vegetables and leafy greens becomes even more critical as we age because our bodies are less able to synthesize this natural hypertensive-fighting factor.

Reducing hypertension would not only improve health outcomes for individual patients, but would also benefit the health system as a whole. Although the percentage of resistance to antihypertensive drugs is relatively lower in the U.S., elevated blood pressure among a rapidly growing number of baby boomers will mean more challenges for health care in the long run unless we identify tools that work and make them as accessible and user-friendly to the public as possible.

DASH holds great promise to fuel compliance – a critical driver to prevent elevated blood pressure – among those living with hypertension. But a healthful eating strategy alone will not mean better outcomes for patients without a model to help them break bad habits and support dietary changes on a personal level, one day at a time.

So how do we get there?

Join us here next Thursday for the second post in our two-part series. Discover what innovative tools can empower patients to make the DASH Diet a part of their arsenal in the fight against hypertension.

Good for Your Body and Your Budget

Does stocking your shelves with nutritious foods always mean breaking your budget at the grocery store or local market? You probably think the answer is yes, but what we found might shock you.

Paul DeMiglio

Paul DeMiglio

Dawn Undurraga, a consulting nutritionist for the Environmental Working Group (EWG) and registered dietitian, tells a different story: Purchasing healthy foods and saving money can go hand in hand.

“Maintaining a delicious diet that’s good for you and the planet doesn’t have to be expensive,” she says. “You can eat 5-9 servings of fruits and vegetables for less than the cost of a bus ride, for example. But people need the tools to help make this happen.”

And that’s exactly what the EWG “Good Food on a Tight Budget” free shopping guide provides, to help people eat cheap, clean, green and healthy.

“We focused on the things that you can do and the changes you can make to save money,” Undurraga says, based on recent data from the U.S. Department of Agriculture (USDA) as well as feedback from groups that have on-the-ground expertise empowering consumers to navigate through the issues surrounding tight budgets, like Feeding America and Share Our Strength.

This guide includes lists that open the door to purchasing foods with the most nutritional value for the lowest price, including 15 practical recipes that on average cost less than $1.

Tips enable shoppers to spend their dollars smartly, specifying which items are best to purchase frozen (like corn) or fresh (like lima beans), as well as how to prepare dishes at home and how to make your foods last longer.

One key recommendation for saving money on a nutritious eating regimen is to plan meals ahead, budget your time while shopping and to know what you want at the store beforehand.

“When you do, you’ll find you waste less food. Not wasting food by having a good plan can save you money too. When you shop with a meal list and a timeline, you can get in and out of a store quickly,” without going outside your budget by getting distracted and purchasing less healthy foods you don’t want or need, Undurraga explains.

The EWG created “Good Food on a Tight Budget” based on specific measures to establish the amount of pesticides that the foods contain, also comparing and rating the foods to organize the guide on a balance of five factors.

  • Beneficial nutrients
  • Nutrients to minimize (i.e. sodium)
  • Price
  • Extent of processing
  • Harmful contaminants from environmental pollution and food packaging

The USDA also underscores that planning your meals for the week and doing an inventory of foods you already have before making a list are essential. They also encourage buying non-perishables in bulk during sales and to purchase foods in season to get the lowest prices while optimizing freshness.

Similar strategies for making healthy shopping choices on a budget can also be found herehere and here.

All the research, planning and preparation involved in being a selective shopper might seem daunting at first, but the payoff to your health and budget is worth the investment.

“There’s so many ways to put together a diet. The shoppers who often make the most of their budget are those already on a tight budget. It’s tough but possible,” when you incorporate approaches that work best for you, Undurraga says.

Have you used any of these tips when grocery shopping? Did they help make it easier to purchase healthy foods and stay within your financial means? Tell us why or why not.

Categories: Cost-Savings

Take a Vacation from Guilt with Practical Tips for Healthful Eating

Worried that your upcoming summer getaway will mean overindulgence and more hours on the treadmill? Well you might be relieved to find out that coming home from your next trip doesn’t have to mean running away from the scale.

Paul DeMiglio

Paul DeMiglio

Following a few simple, evidence-based eating strategies will equip you with the tools you need to make healthy choices, burn calories and still have a great time while you’re away.

And guess what? Keeping off the unwanted pounds doesn’t mean having to disrupt your vacation time by spending long hours at the gym. In fact, maintaining good eating habits can even open new doors to trying exciting foods with friends and family.

The Academy of Nutrition and Dietetics, the world’s largest organization of food and nutrition professionals, recommends integrating the following steps when taking trips near and far:

  • Enjoy high-calorie foods by sampling them in small amounts. 
  • Share large-portioned meals – which abound in places like restaurants – with your travel companions.
  • Break up your meals throughout the day.
  • Make physical activity part of your plans in simple ways, even if it just means walking to some of your favorite destinations instead of taking the car or using the stairs instead of the elevator at your hotel.

Sharing high-calorie foods is a tip that WebMD’s Expert Columnist Elaine Magee, MPH, RD also recommends when it comes to having dessert:

“Part of being on vacation is enjoying life, and part of enjoying life is ordering dessert when you really want to. If your meal has left you satisfied, you can take your dessert with you and enjoy it later when you are hungry again. You can also share your dessert with one or more dining partners, either at the table or later on.”

The American Diabetes Association (ADA) also agrees that spacing out your meals to several each day boosts weight management, often helping to decrease hunger and reduce the number of calories consumed each day.

If you’re going on a road trip, the Academy says to pack 100-percent fruit juice or bottled water along with easy snacks you can store in your cooler that include fresh fruits and vegetables, deli sandwiches, bean salad or pasta salad.

“When traveling, the key is to plan ahead,” said Angela Lemond, Registered Dietitian Nutritionist, Speaker, Wellness Coach and Spokesperson for the Academy of Nutrition and Dietetics. “Look at the day or week ahead of you, and see what the situation allows for you when it comes to eating right.  Plan for unexpected delays or changes in your schedule by packing plenty of snacks.  If you can keep your hunger level controlled, it is much easier to make the right food choices.”

Last week when I went to Rehoboth for a fun getaway with friends, I found that putting some of these tips into practice was easy to do while on the run.

Instead of driving to the beach, for example, we walked there and back as a group. When trying out area restaurants, we sampled desserts and ordered large dishes to share – which actually turned out to be more interesting because we could enjoy a wider selection of food with much less guilt.

So relax, enjoy yourself, and remember that cutting down on calories doesn’t have to mean cutting out the fun during your next excursion.