How Hospital Food Can Fuel Sustainability Efforts

NYC Health + Hospitals, the country’s largest municipal health system, recently announced that it has reduced food-related carbon emissions by 36% only one year after making plant-based food the default for inpatient meals. What’s more, the patient satisfaction rating of the health system’s revamped menu soared to more than 90%. And switching from animal products to plant-based food resulted in an initial cost savings of 59 cents per tray.

Plant-based meals are gaining popularity at many health care facilities, transforming hospital food from a punch line into a driver for getting patients to embrace more healthful food choices while improving sustainability and patient satisfaction.

Plant-based Menus Take Center Stage

In 2017, when the American Medical Association adopted a resolution calling on hospitals to provide healthful plant-based meals and eliminate processed meats, few hospitals offered a plant-forward menu. Since then, increased public demand for meatless foods coupled with advocacy by organizations like the Coalition for Plant-based Foods in Hospitals and mounting evidence on the benefits of a plant-based diet have led some hospitals to be more proactive by offering meatless options on their menus.

Plant-based diets are associated with a “significantly reduced risk of negative health outcomes,” according to an expansive study published in Missouri Medicine, the journal of the Missouri State Medical Association.

NYC Health + Hospitals made the shift to a plant-based default menu gradually to ensure that the move had the highest chance of acceptance and success. In 2019, they introduced Meatless Monday, a program launched by the Johns Hopkins Center for a Livable Future, which encourages people to skip meat once a week and has been adopted by hospitals in 40 countries. Then, in March 2022, it piloted plant-based lunches by default, extending to plant-based dinners in September 2022.

“This is really, truly a historic win. As far as we know, it is unprecedented for a health care facility to implement a plant-based default, let alone the biggest hospital system in the United States,” said Katie Cantrell, CEO of Greener By Default, a nongovernmental organization that helps hospitals and others adopt plant-based food plans and assisted NYC Health + Hospitals in implementing its program. “We’re now trying to build on this progress and make sure that this amazing example is taken up by other health care systems.”

NYC Health + Hospitals serves approximately 3 million meals a year and expects around 850,000 of those meals to be plant-based in 2023. Since introducing the plant-based default menu, nearly 60% of patients continue with the vegetarian option after their first meal. “Our goal is to flip the norm to make plant-based [meals] the default but give people the choice to opt into meat and dairy if they want to. That freedom of choice is critical because people don’t like having options removed or having a choice forced on them,” said Samantha Morgenstern, senior director of nutrition services for acute care at Sodexo, a food services and facilities management company.

Patients are offered a variety of meatless options including meals with global flavors to appeal to a diverse population. Popular choices are Moroccan vegetable tagine, Spanish vegetable paella, garden Bolognese with rigatoni and a pad thai noodle bowl.

The long-term goal is not just to encourage patients to eat plant-based meals during their hospital stays, but to educate them about how to make changes to their diet post-discharge, including what less meat means for their health and how it can make a positive impact regarding climate change.

Meatless Helps Meet Sustainability Goals

The move toward plant-based meals is helping hospitals meet sustainability goals. A 2023 study from Oxford University reported that plant-based diets account for 75% less in greenhouse gas emissions than diets that include 3.5 ounces of meat a day, and the United Nations estimates that about 10% of global greenhouse gas emissions are caused by food loss and food waste.

More than 100 hospitals have signed the Coolfood Pledge, an international effort to achieve a science-based collective target of reducing emissions from food by 25% by 2030. Participating hospitals receive technical assistance and support from Health Care Without Harm and Practice Greenhealth as they implement plant-forward strategies to meet the pledge goal.

University of California San Francisco Health (UCSF Health), a Coolfood Pledge participant, began to increase plant-forward menu items about five years ago. From 2017 to 2020, its plant-forward efforts reduced the climate impact of the food they serve by 12.5% overall. This was driven by a 28% reduction of beef, a 13% increase in legumes and an almost 70% increase of plant-based milk. Three initiatives helped UCSF Health achieve this result:

• Replacing its 100% beef burger with 70/30 mushroom-blended burger.
• Reducing the number of beef items on the patient menu from 20 in 2017 to just three by 2020.
• Launching a “roots and shoots” menu concept that puts plant proteins at the center of the plate.

“We also reduced our CO2 emissions and made our customers happy,” said UCSF Health’s Food Service Director Dan Henroid.

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Need Help Meeting Your Sustainability Goals?

An upcoming AHA Leadership Scan episode will explore how some hospitals and health systems have developed more resilient and proactive approaches to identifying, vetting and purchasing sustainable products. Join the virtual panel discussion, “Supply Chain Success Stories: Optimizing Sustainability Performance,” at noon CT, Wednesday, Oct. 11. Register today!