Hospital Food You Can Get Excited About

https://www.nytimes.com/2018/09/20/well/eat/hospital-food-you-can-get-excited-about.html

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On a Tuesday morning in March, chef Bruno Tison presided over a frenzied cook-off between teams from 16 health care facilities at Glen Cove Hospital on Long Island. Mr. Tison was hired last September by the nonprofit network Northwell Health to help transform the food service at the company’s 23 New York-area hospitals.

Teams of cooks in towering chef caps, together with white-suited dietitians, had 45 minutes to transform a cornucopia of fruits, vegetables and meats piled on a table at the center of the auditorium into four-course meals of their own devising. Their creations not only had to meet restrictions for salt and calories, but were judged according to criteria not usually applied to hospital food like palatability, plate appearance and skill in cooking.

Chef Tison says that the bland, institutionalized fare typical of the health system lacks not just culinary distinction but often nutritional quality. For many patients, the lackluster food is just one more drawback of being in the hospital.

That’s a squandered opportunity, says Mr. Tison. The Michelin-starred chef argues that good food can offer a welcome break from the enforced monotony of a hospital stay, potentially boosting patient morale and speeding recovery.

“Many hospital chefs don’t have any culinary experience,” Mr. Tison said. “My job is to give them some guidance so that they can flourish in their position and really enjoy what they are doing.”

Thomas Mencaccini, who cooks at Long Island Jewish Hospital in Valley Stream, is among the chefs getting culinary tips from Mr. Tison. He was hurrying to complete his team’s seared scallops with roasted leeks and a citrus salad before the closing bell. “It’s bringing me back to that rush of cooking in a restaurant, getting things ready in time, hitting the ground running,” he said after spooning the browned scallops from the skillet.

The competitive pressures that drive restaurant chefs to excel have typically not existed in health care facilities, where the bar has been set uninspiringly low, Mr. Mencaccini said. Moreover, hospital chefs often have to function with meager food budgets. They also have to produce a variety of clinically appropriate meals for people suffering from different illnesses.

In the past, Mr. Mencaccini notes, the job of a hospital chef used to be more about heating pre-made mixes than actual cooking. Frozen burgers and chicken wings were deep fried, and foods in cans and sacks were reconstituted for hastily prepared meals. Now, they’ve scrapped the deep-fryer at LIJ, and they make all their meals from scratch with fresh, often organic, ingredients. “We want to give people the comforting experience of a home-cooked meal,” Mr. Mencaccini said.

This approach has made a big difference at Plainview Hospital too, says chef Carol Hilly. “People come down to the kitchen for recipes,” said Ms. Hilly, a 35-year hospital cooking veteran. “A lot of heart goes into the food now. I feel better about my work, and I eat a lot better myself.”

While the pleasures of a good meal are gratifying, the real reason hospitals should offer better food is that nutrition is a pillar of good health, says Dr. David Eisenberg of the Harvard T.H. Chan School of Public Health.

Dr. Eisenberg says the jury is no longer out on the benefits of eating a more plant-based diet with less refined foods, sugar and red meat. A study published last year in JAMA estimated that nearly half of the deaths from heart disease, stroke and Type 2 diabetes are caused by poor diet.

Dr. Eisenberg laments that only 27 percent of American medical schools teach the recommended 25 hours of nutrition, and even then the content is mostly biochemistry rather than “practical” advice about diet. As a rule, doctors are trained in “pathogenesis,” the origin of disease, rather than “salutogenesis,” the creation of health, Dr. Eisenberg said. He has been on a mission to boost “culinary literacy” by helping to develop teaching kitchens in hospitals throughout the United States.

“No hospital should be discharging a patient without giving them the tools they need to be successful, so that they don’t get readmitted” said Eric Sieden, director of food and nutritional services for Plainview and Syosset hospitals on Long Island. They now teach people things like what exactly a carb serving is, how to read food labels and the difference between high-fructose corn syrup and sugar.

The responsibility of a hospital does not end when a patient is discharged, said Stephen Bello, executive director of LIJ Valley Stream. In addition to running a community teaching kitchen, his hospital is the first in the Northwell system to start a “food pharmacy,” which provides bags of groceries based on a prescription that a physician writes when a person is discharged. Low-income patients who are deemed to be “food insecure” can come in weekly to receive free food to help them stay on diets designed to control chronic diseases.

While providing quality food can be costly, advocates like Mr. Bello say they save money in the long run by helping to cut health care expenditures. Since the health system started providing fresh unprocessed food, there has been a lot less waste, because patients are more satisfied and rarely request another meal. In the past, nearly 19 percent of all meals were returned and had to be replaced.

Still, challenges remain. Hospital kitchens are often antiquated and falling apart, Chef Tison said. Staff members are often leery of the changes in their accustomed cooking routines.

“I came here four months ago and they looked at me like I was the devil — the corporate chef is coming, what is he going to do to us,” said Mr. Tison as he stirred fresh-herbed chicken broth in a huge stainless steel pot in LIJ’s basement kitchen. “Now when I leave, they ask me when I am coming back. They say, ‘Chef, taste my mashed potatoes. What do you think?’”

But not everyone is on board. “There are still a lot of people in the health care system who believe that a hospital doesn’t need to have good food, doctors who feel that people come to get treatment, not great food,” the chef observed. “It will take time, but we will get there.”