Hospital Food Short on More Than Flavor

Study finds it lacks many vitamins, minerals

TUESDAY, May 11, 2004 (HealthDayNews) -- If you're looking for a healthy meal while you're in the hospital, you might want to order out.

New research suggests hospital food, long the butt of jokes about its lack of flavor, isn't a nutritional gold mine, either -- especially when it's designed for elderly patients.

On the other hand, two nutrition experts and a hospital dietician said the findings aren't too worrisome, especially since doctors can easily make up for missing vitamins and minerals by handing out supplements.

Researchers from three universities -- the University of Arkansas, the University of Texas and the University of Oklahoma -- examined commonly prescribed meals for the elderly at two unnamed hospitals. One of the hospitals was a nonprofit, research-oriented medical center and the other was a Veterans Administration facility in a large metropolitan area.

The meals came in a variety of forms, including liquid, low-calorie and low-salt. The researchers looked at both the meals themselves and their ingredients. The two hospitals had thousands of recipes for their foods; one had more than 50 recipes alone for green beans.

The findings of the study appear in a research letter in the May 12 issue of the Journal of the American Medical Association.

Most of the meals supplied enough calories, protein and vitamin A for patients, but they were "generally deficient" in meeting daily requirements for many vitamins and minerals.

All the diets, for example, offered less vitamin C and Vitamin D -- in some cases less than half -- than some experts recommend for elderly patients. Many of the diets didn't meet government recommendations for daily consumption of zinc, folate and calcium.

The researchers, however, used a nontraditional measurement of how much vitamin C patients should get each day; most of the diets met the U.S. government's recommended daily allowance for that vitamin.

The study authors note nutritional problems could spell trouble for elderly patients, especially those hospitalized for long periods of time.

Ruth Kava, director of nutrition at the American Council on Science and Health, said the study results don't alarm her, although she thinks the hospitals could do a better job on the nutrition front.

Several of the diets, such as the liquid ones, aren't designed to be fully nutritional, she said. "It seems to me that if someone is getting a specialized diet, they should be getting some vitamin supplements."

Indeed, hospital dieticians are well aware of the limitations of specialized meals and make sure to encourage the use of supplements, said Eliana Schultz, a dietician in San Mateo County, Calif., and president-elect of the American Society for Healthcare Food Service Administrators. "A lot of this is stuff we knew, but we're glad that this information is there for [doctors] to think about."

How should patients and potential patients react to the findings? People "shouldn't slam hospital foods for their nutrient content," said Karen Chapman-Novakofski, an associate professor of nutrition at the University of Illinois at Urbana-Champaign. "They get slammed enough for how they taste."

Indeed, one of the biggest challenges for hospitals is getting patients to eat foods they don't like. Kava, who once worked in a hospital, remembered a patient who got so upset that he threatened to throw a peanut-butter-and-jelly sandwich at the staff.

The problem? It came on wheat bread, not white.

More information

The American Dietetic Association has more about proper diet.

SOURCES: Ruth Kava, R.D., Ph.D., director, nutrition, American Council on Science and Health, New York City; Karen Chapman-Novakofski, R.D., Ph.D., associate professor, nutrition, University of Illinois, Urbana-Champaign; Eliana Schultz, R.D., director, food and nutrition services, San Mateo County Health Services Agency, San Mateo, Calif., and president-elect, American Society for Healthcare Food Service Administrators; May 12, 2004, Journal of the American Medical Association
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