Nurse, I Need a Big Mac, Stat!

Survey finds leading hospitals now offer fast food

TUESDAY, June 11, 2002 (HealthDayNews) -- Would you like fries with that bypass?

Not that you should, but at many hospitals you could, according to a new study finding that a sizeable chunk of the nation's most highly regarded medical centers have fast food outlets on site.

That doesn't necessarily mean patients eat at these restaurants, because many patients are on restricted diets. But the presence of fast food in the very places that stress its dangers -- and often treat the consequences of its excesses -- is alarming, the researchers said.

"Hospitals need to be aware of the potential hypocrisy with what we're doing," said Dr. Peter Cram, a fellow at the University of Michigan and lead author of the study. "The research side says Americans are obese, have diabetes and heart disease related to the Western diet that's heavy in red meat and fat."

But by having such fare readily available in hospitals, he adds, "we're making it easier for people to eat these foods."

The study appears as a research letter in tomorrow's issue of the Journal of the American Medical Association.

Cram and his colleagues surveyed 16 hospitals named in U.S. News & World Report's 2001 "America's Best Hospitals" roundup.

Six of the hospitals (38 percent) reported having a fast food franchise on the grounds of their main medical facility. While the study did not name any of the hospitals, they do include Cram's own institution: The University of Michigan's Medical Center in Ann Arbor, which has a Wendy's outlet. Four of the six had two chains. A seventh hospital said it had a franchise but terminated the contract, only to open its own eatery with a similar menu.

To be sure, Cram said, most of the patrons of these restaurants are clinic employees, visitors and family members of patients -- not the patients themselves. But he said he and his colleagues have noticed fast food bags in the hands of people sitting in clinic waiting rooms and wandering the halls in hospital gowns.

"It may be that they are not suffering from any diseases or conditions that fast food is harmful for. It may be that the people with diabetes and heart disease don't go. But that's expecting a lot," he said.

Rick Wade, a spokesman for the American Hospital Association, said his group "would hope that hospitals would think through the perception implications of these things."

But, he added, "the problem with obesity is not that fast food restaurants exist. It's the choices people make" when they order and eat.

Food franchises are becoming more common as hospitals renovate aging physical plants and search for new streams of revenue, Wade said. However, he added, they're far more prevalent in large urban medical centers than in smaller hospitals, and the percentage nationally with fast food chains is "much less" than 38 percent.

Gary Stephenson, a spokesman for Johns Hopkins University in Baltimore, whose medical center topped the magazine's "honor roll" list, said patient demand prompted the hospital to contract with a Subway franchise and a Chinese restaurant.

"Each individual can choose the meal he or she wants," he said.

Bill Whitman, a spokesman for McDonald's Corp., in Oakbrook, Ill., said the chain has "a number" of restaurants in American hospitals, but he couldn't say how many.

He also disputed the notion that fast food is unhealthful. "The uninformed may come to that false premise. But the reality is all food can fit into a balanced diet. I certainly think that includes McDonald's," Whitehead said.

But Cram noted that the pairing of fast food chains with hospitals strikes an odd chord. And it does so at a time when hospitals are trying to increasingly present themselves as "medical centers" that promote overall patient welfare and the health of the communities they serve, he said.

A similar thing happened in the 1980s, when hospitals had to decide whether to allow smoking, the JAMA letter said.

"Ultimately, hospitals decided that the benefit of allowing individuals the freedom to smoke was outweighed by their responsibility for advocating health promotion," it said.

What To Do

For more on how to eat a healthful diet, try the American Dietetic Association or the Centers for Disease Control and Prevention.

And if you're interested to see whether your medical center is on the honor roll, here is the U.S. News & World Report's best hospitals list.

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