Wednesday, July 13, 2016

Hospital RDs Defend Patient Meals Containing Doritos and Oreos

On Monday I posted a picture sent to me of the meal provided to a patient in the Plano's Texas Health Presbyterian Hospital's ER. It consisted of a sandwich of some sort, a few tablespoons of mayonnaise, what appears to be a fruit cup, and then a bag of both Doritos and Oreos.

Over on my Facebook page, this post sparked a discussion, and included in that discussion were two RDs from the Texas hospital, Amber Murphy and Neva Cochran, who defended the meal.

Murphy defended it with by stating that it was alright for hospitals to be providing patients with junk food because the junk food was being provided to patients in the ER when the hospitals' kitchens were closed and before a formal diet order had been recorded,
"This is the after-hours stock sandwich meal that is typically served when the Room Service line is closed. It's what is available when they can't order something off of their designated menu and is typically served when pts are in the ER and diet orders aren't solidified yet."
Later she suggests that the alternative to handing out Doritos and Oreos would be an organic kale salad with quinoa (which would lead to rioting) and that cookies are comforting,
"I hear what you're saying and I don't expect to change your opinion on a FB rant; however, if our hospital offered something like an organic kale salad with a side of quinoa to some of our patients in the ER, there would be massive rioting. This is a well-portioned boxed meal, that is shelf-stable, a good source of protein and fiber, hospital budget-friendly and easily prepared by our limited kitchen staff. And I don't know about you, but if I'm a patient in the ER that just went thru a traumatic experience, a cookie might just make me feel a little bit better."
Cochran defended it on the basis that because it also has a sandwich and a fruit it's ok,
"There was more to the meal than Doritos. It had a sandwich and fruit but no one seems to notice that."
She then followed that up with the suggestion that the meal was ok because there was no such thing as junk foods and that a diet consisting wholly of broccoli would be bad for you,
"There are no junk foods, only junk diets. Doritos and Oreos can be eaten as part of a healthful diet. A diet of only doritos and oreos is not a healthful diet. Neither is a diet of only broccoli, which I assume no one is calling "junk" but eaten as your only food it does not provide for all necessary nutrients."
As I mentioned on Twitter, the issue of course isn't a single meal that includes Doritos and Oreos, it's that we have so normalized the provision of junk food that not only is there a hospital giving it out to sick patients in their emergency department, there are RDs who are comfortable defending that practice.

A hospital's default meal choice shouldn't be junk food. And it's worth asking whether or not those ER patients had other choices? Frankly I doubt it. I'm guessing their non-options would have included choosing to use hospital vending machines (that likely only contain junk food), or simply to go hungry.

And of course it's not just the ER. We've created a world where to make healthful choices you have to go out of your way to do so, sometimes far out of your way. This is true for adults and kids alike. While I think life does (and even should) include junk food, our crafted environment should require us to go out of our way to find it, not have to say no to it and go hungry in a hospital emergency department, or in a school, a summer camp, an arena, etc.

Recently I gave a talk for the Middlesex Community Healthy Kids Challenge. They kindly provided me with a copy to share. In it I highlight this crazy world we've built. Starting with our ill-advised practice of inviting the food industry to sit on governmental healthy living and eating advisory panels, and then following through with a tour of just some of the more inane examples of a world where junk food is definitely not, "just one", and where you can't possibly be expected to, "just say no".

And if you missed it, here's a video that they've produced demonstrating what responsible and thoughtful organizations can do to help.

And for more from one of their champions Nadine Devin, here's her guest post and call to action on this blog.

(And thanks too to Nadine Devin and Middlesex County for sharing the videos with me)