Goodbye, green Jell-O
Local healthcare professionals are bringing a more nutritious green hue to hospital food
By Helene Kremer
About this quilt: Jane Kelly, a Health Promotion Specialist at John Muir Medical Center is an avid food gardener, and passionate health enthusiast. She was inspired to make this quilt by the objectives of the Healthy Food Committee and her friendship with Alison Negrin. “If hospital visitors, patients, or employees happen to view the quilt and come away with a better understanding of good health, I’ve accomplished my goal.” Jane lives in Martinez and can be reached at email@example.com.
Dinner begins with organic spring greens and tomatoes in an olive oil dressing, followed by locally grown green beans steamed to perfection and a juicy piece of grass-fed roast beef. And no, we’re not at some trendy restaurant. This meal is being served to patients at John Muir Medical Center in Walnut Creek.
Gail Wadsworth, executive director of the California Institute for Rural Studies at Davis and author of the Slow Food Delta Diablo blog, calls it “a food revolution . . . in American hospitals.”
Wadsworth is the founder of Eat Outside the Box, a community-supported agriculture program that provides subscribers in central Contra Costa County with fresh fruits and vegetables grown in east Contra Costa County. In coordination with Eat Outside the Box, she also has a position on a leadership team at Kaiser Permanente that is working to implement the advancement toward sustainable meals for all patients.
“The prospect of hospitals sourcing locally is exciting for local farmers,” said Wadsworth in her blog. “Although many are not yet able to meet the needs of such large buyers, the buzz is getting out.”
At Kaiser Permanente
Almost a decade ago, Preston Maring, an OB/GYN at Kaiser Permanente in Oakland, started putting some serious thought to the connection between general health and nutrition. Looking at the jewelry and T-shirts for sale in the gift shop of his hospital, he had the striking vision that his patients could be buying fresh fruits and vegetables there instead.
“It was consistent with Kaiser’s mission to not just prevent disease, but to create good health,” he said. “I thought we could make buying fresh fruits and vegetables easy by just putting it there at the hospital.” And so in 2003, Kaiser Oakland became the first hospital in the United States to host a farmers market on its campus. There are now markets at 37 Kaiser Permanente hospitals around the country.
“The farmers markets at the hospitals is more of a community focus,” said Maring. “They don’t have as many moving parts or challenges as getting the sustainable foods into the hospitals.”
Getting healthy meals into the food service at Kaiser Permanente—where the Northern California hospitals and medical centers alone serve approximately 7,000 meals a day—would be the next step, but that challenge is considerable. Now working in an advisory role at Kaiser Permanente, Maring continues his efforts through sustainability events, recently moderating a nationally broadcast webinar entitled, “Antibiotics Overuse: Why Healthcare Should Care about Agriculture Use.”
At John Muir Medical Center
With a total of 640 beds spread over three Contra Costa campuses, John Muir Medical Center (JMMC) does not have quite the power for modeling change that Kaiser has, but its executive chef, Alison Negrin, has moved a small mountain of her own in re-envisioning her hospital’s food program. Her work, like Maring’s, has had some larger repercussions.
Trained at the Culinary Academy in San Francisco in the early 1980s, Negrin found a niche for herself in East Bay restaurants known for serving healthy, organic foods. She worked at Poulet and Chez Panisse and also helped open Bridges in Danville. It was in 2002, after going back to school full-time at Bauman College, a local culinary arts college with a holistic nutrition focus, that she took the job at JMMC.
Her new job presented challenges she hadn’t faced when cooking at the restaurants. Instead of sourcing small amounts of food from local farms, she now worked with such major purveyors as U.S. Foods and Sysco. The challenge was not simply how to feed her patients healthy foods, but also how to obtain those foods.
“I definitely wanted to bring healthier foods to the patients,” says Negrin. “[But] it was hard, because institutions are very slow to change.”
In addition, there was no real media attention to spur widespread change. “We weren’t really aware yet about the epidemic of obesity,” Negrin explains. “Also, there wasn’t the consciousness of carbon footprints and greenhouse gases.”
She looked for information online, but her searches for “healthy food” and “hospitals” came up short. That changed in 2005, however, when Negrin, with the support of her boss and fellow dietitians at JMMC, attended a conference called “FoodMed,” sponsored by HealthCare without Harm and Kaiser Permanente. Preston Maring was instrumental in the focus of that conference.
“The people [at the conference] were not just interested in healthy foods, but also sourcing,” she remembers. “Of course I wanted to get local produce because that’s what we did in all the restaurants, but I didn’t know how to approach that.”
An outcome of the 2005 conference was that Negrin joined the Bay Area Hospital Leadership Team, where members represent such groups as UCSF, Kaiser, Alta Bates, and Veterans Administration hospitals. She organized a healthy food committee where the hospitals could unite on the shared idea of influencing the source companies. “We use our group to leverage U.S. Foods to try to bring in more sustainable products,” she says.
Another important step Negrin took was to get involved in a pilot project called Balanced Menus, which was started by Healthcare without Harm and Physicians for Social Responsibility. “The idea is to reduce the amount of meat that you’re serving,” she says, explaining that reducing meat means a reduced contribution to greenhouse emissions as well as lowered cost per meal. “You’re hoping that by lowering the cost, you can afford the more expensive sustainably raised meats. I see that continuing, offering a healthier diet with smaller portions of meat and less of it. Hopefully it will spread to other hospitals that want to make these changes.”
Negrin’s work at finding solutions to the food issues at JMMC will be ongoing, and new solutions may come along as soon as next year’s crops. A local educational organization is attempting to form a collective with local organic farmers, whereby specific growers would commit to selling all of their produce directly to a specific hospital, which would lower the cost for both parties.
“The future seems clear for healthy foods in all local hospitals,” Negrin enthuses.
None of us wants to be in a position where we would have to take our meals at the hospital, but should it happen, perhaps we’ll find that the food being served is as it is meant to be—just what the doctor ordered.
Pictured here is a panel that spoke at “An Evening at the Hospital,” an event Slow Food Delta Diablo hosted at John Muir Medical Center’s Concord Campus last August. Panel members left to right are: Kathleen M. Reed, Sustainable Food Program Manager, Kaiser Permanente; Alison Negrin, Executive Chef, John Muir Health System; Lucia Sayre, Co-Executive Director, Physicians for Social Responsibility; Kristine Batten, MD, Cardiologist and Medical Director, Wellness Program and Women’s Heart Program John Muir Health; Patty Campbell, RD CNSD, Lead Clinical Dietitian at John Muir Concord. Also on the panel but not pictured was Temra Costa, author and sustainable food advocate.
Writer Helene Kremer is an East Bay–based freelance writer with a nearly completed B.A. in management and integrated marketing communications from Golden Gate University. Her frequent micro-blogs about local food and wine can be followed on Twitter at @hkremer or @edibleeastbay. She can be reached at firstname.lastname@example.org.