Real World Health Care Blog
Primary category:

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


  1. TD

    I’ve been eating in hospital cafeterias off and on for more than 25 years (sometimes it was the only way my wife, a hosptal-based physician, and I could see each other for a meal) and I can tell you they are rarely bastions of healthy eating. That always surprised me. The decision about where to eat has much to do with personal responsibility and some to do with economy. If more food is cheaper at a fast food franchise than at the cafeteria, people trying to control spending – or feed several kids – will probably opt for the fast food. Fast food franchises do offer some healthier options, but they were sort of forced into it.

    Here’s one other point that is perhaps trivial, but, I believe, real. People in hospitals who don’t work there, are probably there because they or someone close to them is ill. Being in a hospital is a high-stress situation for these people and I bet seeking easy, usually high-calorie, “comfort” food is also a motivating factor no matter how the food is positioned or labeled.

    I see no harm in labeling and positioning healthier food to promote better choices, but that assumes a willingness on the part of the food buyer to be educated and a desire to eat healthier food.


Leave a Reply

Your email address will not be published. Required fields are marked *