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Serving Up Good Health

Maryland hospitals take pledge for healthier food

Monday August 25, 2008
Mercy Medical Center executive chef Anthony Cover inspects lettuce from a local farm.
Mercy Medical Center executive chef Anthony Cover inspects lettuce from a local farm.
(Photo by Kevin Parks)
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Patients, nurses, and visitors at four Maryland hospitals are eating more locally grown foods, milk without synthetic growth hormones, and products grown with fewer pesticides and antibiotics as part of the Healthy Food in Health Care Initiative.

"We are in an environment of healing, and what better place to have food without processing?" asks Charlotte Wallace, RN, a pediatric nurse and chairperson of the green team at Anne Arundel Medical Center in Annapolis, one of 128 hospitals nationwide that have signed the Arlington, Va.-based Health Care Without Harm's Healthy Food in Health Care Pledge.

The Maryland Hospitals for a Healthy Environment (Maryland H2E) Initiative, coordinated by the University of Maryland School of Nursing in Baltimore, launched the program. Nicole Killion, RN, BSN, a nursing outreach coordinator at Maryland H2E, educates nurses about healthy foods and the creation of more sustainable environments. She finds most nurses receptive to, and interested in, these issues.

"Some nurses are seeing opportunities around environmental stewardship, and they're finding new ways to do things that are healthier for our patients, staff, and environment," says Barbara Sattler, RN, DrPh, FAAN, professor and director of the Environmental Health Education Center at the University of Maryland School of Nursing. "It's back to basics, giving patients enough light, dark, quiet, and healthy food."

The issues

The initiative promotes serving environmentally sustainable, economically viable, and socially responsible food choices. It encourages hospitals to provide foods that reduce or eliminate public health effects of food production and distribution, such as purchasing locally grown and organic foods, selling fair trade coffee, serving beef and poultry raised without routine antibiotic use, and using milk without recombinant bovine growth hormone (rBGH).

Locally grown food is typically fresher because it doesn't require extensive transporting, thus cutting down on air pollution and carbon emissions. The produce may be grown with fewer pesticides and herbicides, so there is less toxic residue, says Louise Mitchell, project coordinator for the University of Maryland School of Nursing. Fair trade coffee growers work in safer conditions and get fair wages.

Beef and poultry producers frequently feed antibiotics to their animals to help them grow faster and to compensate for confined conditions. However, agricultural use of these drugs contributes to antibiotic-resistant bacteria.

"As nurses, we deal with patients that carry antibiotic-resistant organisms every day," Killion says. "It's more work for nurses, more expensive for the hospital, and patients have worse outcomes."

Up to 20% of U.S. dairy farmers give cows rBGH to increase milk production. These cows frequently develop mastitis and require treatment with antibiotics, increasing the likelihood of antibiotic-resistant bacteria in the food chain. Also, use of rBGH increases insulin-like growth factor (IGF-1) in cows' milk. IGF-1 has been associated with increased rates of breast, colon, and prostate cancers in humans, says Killion, adding rBGH-free milk costs about the same as milk produced with synthetic hormones. The American Nurses Association's House of Delegates has passed a resolution calling for healthier food in health care, which includes educating nurses about projected harmful effects of the use of food additives, rBGH and other hormones, and antibiotics in milk and dairy production and in agriculture.

Maryland hospitals sign on

Wallace spearheaded green efforts at her facility. Anne Arundel Medical Center has begun serving healthy meals made with local produce and handing out cards with the recipes on the first Thursday of every month. It sells fair trade coffee and rBGH-free milk, encourages drinking water from reusable bottles, and stocks a fruit station. "Nurses, as a whole, are very caring individuals and believe in the power of prevention and education of patients," Wallace says.

Mercy Medical Center, Baltimore, is buying food from local farmers, focusing on quality and organically grown produce. "Nutrition is important for a goal of overall health," says Sheila Matlak, RN, CD, CPT, a nurse in Mercy's Diabetes Center.

Sinai Hospital of Baltimore serves local produce, rBGH-free milk, organic yogurt, and fair trade coffee.

"It's a great boon to educate patients and model it in the hospital," says Kathleen Cox, RN, MS, ACNP, an advanced practice nurse at Sinai. She coaches bedside nurses about the importance of teaching patients to eat right to stay healthy.

Carroll Hospital Center in Westminster partners with local farms to bring fresh foods to the hospital and serves rBGH-free milk and local beef free of nontherapeutic antibiotics and hormones.

"It's really important for hospitals to set a good example," says Melissa Murdock, RN, BSN, community educator at Carroll Hospital. "It's important for nurses to support what is good for the environment because that is healthier for all of us."

Next steps

As more hospitals sign the pledge and begin demanding more sustainably produced foods, Mitchell says, it will influence the marketplace, and wholesome food will become more readily available at a lower cost.

"We are starting to see the supply chain respond," says Jamie Harvie, executive director of the Institute for a Sustainable Future and coordinator of the national Healthy Food in Health Care Initiative.

Cox hopes more nurses will learn about nutrition and become aware of how foods are produced and grown so they can educate their patients.

"Patients listen to us and trust us," Cox says. "We should be equipped with accurate information."

Debra Anscombe Wood, RN, is a freelance writer.

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