Key takeaways:

• An HHS/CMS initiative asks hospitals to commit to serving more nutritious meals.
• The voluntary pledge calls for limiting processed meats, emphasizing fruit and vegetables, and choosing healthier cooking methods.

HHS and CMS today launched a nationwide initiative that invites hospitals to commit to serving more nutritious meals.

The voluntary Make Hospital Food Heathier Pledge encourages hospitals to take multiple actions to ensure the food they offer aligns with current Dietary Guidelines for Americans when feasible and clinically appropriate.

“Our entire health care system — not just hospitals — tends to focus on medications and symptom management. We haven’t thought as much about prevention or the role food and lifestyle decisions play in the development of chronic diseases like obesity, heart disease and diabetes,” Anna Herby, DHSc, RD, CDCES, a nutrition education specialist with Physicians Committee for Responsible Medicine, told Healio. “If we can change the way we approach health care, it could be very impactful. This initiative to incentivize improving hospital food brings the issue to the forefront of people’s minds and it is a step in the right direction.”

The Make Hospital Food Healthier Pledge encourages hospitals to implement several practices that reinforce the importance of nutrition in patients’ health, recovery and long-term wellness. These actions include:

• limiting ultra-processed foods, processed meats and sugar-sweetened beverages;
• emphasizing fruits and vegetables, legumes, seafood, nuts, seeds and healthy fats;
• prioritizing minimally processed proteins, including plant-based options;
• emphasizing whole grains instead of refined grains;
• using baked, broiled, grilled, roasted or stir-fried preparation methods rather than deep frying foods; and
• limiting use of foods high in added sugars, sodium and artificial additives.

“Patients recovering from serious medical conditions deserve better than ultra-processed and deep-fried junk foods,” HHS Secretary Robert F. Kennedy Jr. said in an agency-issued press release. “We’re challenging hospitals across the country to lead by example by serving nutritious, minimally processed meals that help patients heal, reduce chronic disease and help make America healthy again.”

The time and effort required to implement each objective likely will vary, according to Herby, whose organization promotes preventive medicine and the need for higher standards in research.

“Hospitals want to provide healthy food — and they are providing some — but each one faces different challenges and taking it to that next step might be a challenge,” Herby said. “One of the main barriers is how hospital kitchens are set up. Some may have a lot of the food shipped in that they can simply heat, like instant mashed potatoes. Some may not have enough staff to chop fresh vegetables or the refrigerator space to store them. There also is a lot of staff turnover within food service at hospitals. A lot of reeducating and retraining needs to be done, and that takes time. Hopefully funding, resources or other support can be provided to help make all of this happen.”

CMS announced its intention to launch the Make Hospital Food Healthier Pledge in April.

At that time, Rick Pollack, president and CEO of the American Hospital Association, issued a statement saying the organization supports the administration’s focus on meeting patients' nutritional needs to promote recovery, healing and overall health.

“Hospitals across the country work closely with registered dietitians and clinical staff to provide patients with highquality, nutritious meals that embrace the notion that ‘food is medicine,’” Pollack said in the statement. “We are committed to helping hospitals — as clinically appropriate and feasible — ensure that patients have access to nourishing meals, including by sharing this voluntary pledge with the hospital field and encouraging them to review it and give it serious consideration.”

The U.S. spends approximately $5 trillion annually on health care, according to CMS. About 90% of the expenditures are allocated to people with chronic disease.

The Make Hospital Food Heathier Pledge is an important step in delivering “prevention-first, whole-person care,” according to CMS Administrator Mehmet Oz, MD.

“When it comes to managing chronic disease, reducing comorbidities like obesity and shortening recovery times, a healthy diet can make all the difference,” Oz said in the release. “Hospitals should nourish patients with the same commitment they bring to every other aspect of care.”

An HHS webpage that provides an overview of the initiative lists four “foundational pillars” for the effort. One underscores the importance of nutrition education so patients have the knowledge and resources to maintain healthy eating habits after they are discharged. Another emphasizes the need for nutrition initiatives to be extended beyond the hospital to support healthier communities.

“I don’t think you can do one without the other,” Herby said. “Many patients are scared when they are in the hospital. They want to know what they can do to avoid getting into a situation where they need to be hospitalized again. It is a real turning point for people and we need to take advantage of that moment.

“Providing them with healthy food while they are in the hospital — and educating them while they are motivated — can help ensure they keep that change going once they leave,” she added. “Outpatient programs, cooking classes, referrals to dietitians and general community support can then keep this going. That is what it will take to help people make long-term changes.”

Dietitians can speak with patients in the hospital and offer handouts with tips or easy-to-make healthy recipes. Nurses can support that effort to reach more patients.

However, members of the clinical community who practice outside of a hospital setting also play an important role, Herby said.

Earlier this year, the Trump administration launched its Nutrition Education Pledge, encouraging medical schools to commit to incorporate 40 hours of nutritional education or its competency equivalent into graduation requirements.

“Nutrition education is important for everyone who works in health care,” Herby said. “We spend a lot of money treating people who have preventable conditions, and our goal should be to see fewer patients in the hospital. By giving them a little bit of knowledge and helping them understand how to make a few changes in their lifestyle, we can empower people to take control of their health.

“There is a lot of misinformation, so if we can all promote the main messages — such as reducing saturated fat, avoiding processed meats and increasing our fiber intake — it can help ensure everyone is on the same page,” she added. “That will make a big difference.”

For more information:

Anna Herby, DHSc, RD, CDCES, can be reached at aherby@pcrm.org.