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Leading US Hospitals Serving Fast Food Sends Mixed Message

It is deplorable for a doctor to lecture a patient on taking more careful precautions against heart disease, while there is McDonald’s in the hospital’s lobby serving a fried-food lunch.” US hospitals may be contributing to unhealthy lifestyle choices by housing fast-food establishments on their premises, according to the results of a survey by the American Medical Student Association (AMSA). The findings were published as a research letter in the September/October issue of the Journal of the American Board of Family Medicine.

"The medical community must practice what it’s preaching," lead author Lenard I. Lesser, MD, AMSA’s Healthy Hospitals Campaign coordinator and a family medicine resident at Tufts University in Malden, Massachusetts, says in a news release. "It is deplorable for a doctor to lecture a patient on taking more careful precautions against heart disease, while there is McDonald’s in the hospital’s lobby serving a fried-food lunch."

From January through October of 2005, students from all allopathic US medical schools were surveyed. One student at each medical school listed up to 5 of their main teaching hospitals/medical centers using a Web-based survey and identified which, if any, brand-name fast food (BNFF) was sold on the hospital campus. The response rate was 90% (113 of 125 medical schools surveyed), representing 233 affiliated hospitals/medical centers.

Of these 233 hospitals, 98 (42%) had at least 1 BNFF served on campus. Notably, these included The Children’s Hospital of Philadelphia at the University of Pennsylvania (McDonald’s); The Cleveland Clinic at Case Western Reserve University in Ohio (McDonald’s); The Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Tennessee (Taco Bell and Pizza Hut); Grady Memorial Hospital at Emory University in Georgia (McDonald’s); University of Michigan Hospital in Ann Arbor (Wendy’s); and Tufts-New England Medical Center in Boston (Pizza Hut and Dunkin Donuts).

There were a total of 163 occurrences of BNFF served on hospital grounds, because many hospitals had more than 1 type. When looking at the prevalence by medical school, 71 (63%) of 113 had at least 1 affiliated teaching hospital or medical center that served BNFF.

In contrast, Duke Children’s Hospital and Health Center at Duke University in Durham, North Carolina, and Barnes-Jewish Hospital at Washington University in St. Louis have removed fast-food vendors from their campuses. In 2005, AMSA began its "Healthy Foods in Hospitals" campaign to reform hospitals serving unhealthy fast food. AMSA notes that fast food has been correlated with poor diets and poor health outcomes in numerous studies. The group recommends removing nutritionally unsound food vendors from hospital premises, or at least requiring fast food franchises located on hospital grounds to post nutritional information on their menu boards. Hospitals should also stop serving foods prepared with partially hydrogenated oil, according to AMSA.

In light of publicity campaigns by leading hospitals to promote healthy diet and lifestyle, AMSA suggests that their survey results are disappointing. By releasing these findings, AMSA hopes to create greater public awareness of the unhealthy dining options available at many leading hospitals. The group recommends that future studies continue to characterize the types of food available in all venues on medical center campuses.

"With the obesity epidemic in America getting more attention every day, AMSA hopes administrators at teaching hospitals consider the results of this study and evaluate whether the food that is served on their campuses is truly consistent with the mission of improving the health of their communities," says AMSA president Jay Bhatt.

J Am Board Fam Med. 2006;19(5):526-527.

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