Eat what I say, not what I do.

September 8, 2006 5:47 PM

Paging Dr. Ronald McDonald and Dr. Pepper. To Cardiology ... stat.Despite the innumerable reports demonstrating an sharp rise in childhood obesity and type 2 diabetes in children, many children's hospitals continue to provide a plethora of unwholesome food and beverage choices. Moreover, these choices often contribute to revenue in most of these hospitals. This has been well-documented in community and academic [BugMeNot] hospitals. Different children's hospitals are awfully good at handing out advice to families. Maybe the hospitals should look in the mirror [note: links to .pdf of study].
posted by scblackman (44 comments total)

posted by scblackman at 5:53 PM on September 8, 2006

So embarassing.
But some good news: McDonalds is getting the boot from Jacobi Hospital in the Bronx. (the 'well-documented' link)
The squeaky wheel got the grease out, as it were.
But in reality, I have no good ideas for what should replace it.
posted by Corpus Callosum at 5:59 PM on September 8, 2006

That picture is... Well it's something.

Also, how much time do kids spend in the hospital? Unless they're really screwed not too much. I would imagine getting candy when going to the hospital can help turn a frightening visit into something a little pleasant and help to make kids feel a little better about being there. The last thing a kid wants after being stuck with needles and shit is a whole-wheat bread spinach sandwich.
posted by delmoi at 6:17 PM on September 8, 2006 [1 favorite has favorites]

man, i fucking love dr. pepper
posted by radiosig at 6:20 PM on September 8, 2006

yeah, dr. pepper is awesome
posted by tumult at 6:52 PM on September 8, 2006

My friends down at the commune
They think I'm pretty neat
Oh, I don't know nothing about arts and crafts
But I give 'em all something to eat
I'm a friend to old Euell Gibbons
And I only eat home grown spice
I got a John Keats autographed Grecian urn
Filled up with my brown rice
Yes, I do

Oh, folks but lately I hae been spotted
With a Big Mac on my breath
Stumbling into a Colonel Sanders
With a face as white as death
I'm aftraid someday they'll find me
Just stretched out on my bed
With a handful of Pringles potato chips
And a Ding Dong by my head

They are all just Junk Food Junkies
posted by caddis at 6:55 PM on September 8, 2006

man, i fucking love dr. pepper

My father's almost 90 and the only thing that really gives him pleasure now is Dr. Pepper. He goes on and on about how great it is.
posted by StickyCarpet at 7:01 PM on September 8, 2006

I agree with delmoi. These are people in a hospital, probably in one of their most vulnerable life-moments. So what if there's junk food in hospitals; obviously someone has to make a profit from the sale of whatever--that's commerce.

When people are down, they want to get back up. I doubt the majority of patients in any given hospital are there because of a deficieny of nutrients. Sometimes, a crappy hamburger and/or candy and/or soda pop can help to ground people.

There are so many bigger problems in the world than this. Food available at public schools, for example.
posted by unwordy at 7:04 PM on September 8, 2006

er, i meant to spell "deficiency". i should have checked my preview before i posted--snap!
posted by unwordy at 7:06 PM on September 8, 2006

I work at a pediatric hospital and while I can see the whole 'hospitals are scary and candy helps make it better' rationale, I'd really appreciate having the option of sustaining myself on something a little healthier than Pizza Hut or Dairy Queen during a 12+ hour shift. Also, quite a few of our kids are here for months at a time, and I feel sorry for the family members that are given little option but to eat vastly overpriced fast food for weeks on end. At least I can brown-bag my meals from home.
posted by makonan at 7:39 PM on September 8, 2006

The focus of the paper (which is entitled, "Nutrition and Exercise Environment Available to Outpatients, Visitors, and Staff in Children's Hospitals in Canada and the United States"), is food availability for outpatients, families/visitors, and staff.

I agree - it would be draconian to deny a kid some chicken nuggets and fries after they had their broken arm fixed. But as many children's hospitals are the focus of primary care and subspecialty clinics for surrounding communities, they can be very busy places with lots of staff and visitors.

Moreover, a great many underserved, poor families get their pediatrics care at urban hospital primary care clinics. The presence of fast-food outlets or poor nutritional choices opposes the message that I and many other pediatricians try to relate as we provide health care to overweight children and families: watch what you eat, make healthful food choices, minimize processed/fast-foods (oh, and ignore the big McDonalds in the food court).
posted by scblackman at 7:51 PM on September 8, 2006

give people choices. make everything available and let THEM choose.
posted by brandz at 7:56 PM on September 8, 2006

dudes my wife is a pediatric endocrinologist and this thing is out of control. loads and loads of obese children with type 2 diabetes. this was unheard of 50 years ago.

its an insult to have this kind of crappy non-food in a hospital. havent you guys read fast food nation or seen super size me? this stuff is bad news for kids.
posted by joeblough at 8:54 PM on September 8, 2006

I revise my previous statement. There should be at least some sort of choice concerning the availability of hospital food, especially because long-term patients and their family are stuck in the hospitals.

It's good to have fast available when it's desired, but there should also always be a somewhat healthy array of nutritious foods available at hospitals for people with special needs.

A vegetarian shouldn't be punished because their friend/family- member is sick for a period of time. Hospitals make a ton of money.There's no reason they can't employ a few different companies for food.
posted by unwordy at 8:59 PM on September 8, 2006

Wow, I'm really of two minds here. On the one hand delmoi makes a great point:

I would imagine getting candy when going to the hospital can help turn a frightening visit into something a little pleasant

Maybe it's just cause I got done with re-reading Snow Crash, but there is some honesty here. When you are injured or scared, something patiently familiar is like a life-raft, something that is the same no matter where you go. Something recognizable. People are creatures of habit after all.

On the other hand, scblackman makes an excellent observation as well:

The presence of fast-food outlets or poor nutritional choices opposes the message that I and many other pediatricians try to relate as we provide health care to overweight children and families: watch what you eat, make healthful food choices, minimize processed/fast-foods (oh, and ignore the big McDonalds in the food court).

I guess the real science here is which is more important, the psychological aid of having something familiar, or the benefit of having something healthy?

All thoughts of profit making aside, which is better for the patient?
posted by quin at 10:02 PM on September 8, 2006

Well crap, I guess unwordy made my point quite a bit ago. Choice is the answer:

It's good to have fast available when it's desired, but there should also always be a somewhat healthy array of nutritious foods available at hospitals for people with special needs.

So the real question is, is this economically feasible for the hospitals, and if not, what would it take to make it?
posted by quin at 10:15 PM on September 8, 2006

I have recently taken to buying McDonalds' fruit & walnut salad and yogurt parfait and mix them together and call that breakfast, with a large diet coke. This is in my futile effort to simulate the Peter Jackson "mostly yogurt and muesli diet"

I'm beginning to wonder if I've been eating yogurt or just frosting-flavored condensed sugar. And I don't think their salads are any healthier than a Big Mac, but I guess what they're selling is the illusion that you're eating right.

Screw it. When I get my heart attack and stroke and diabetes I'll be thankful to die, because then I won't have to diet no more.
posted by ZachsMind at 10:19 PM on September 8, 2006

Two things: 1. It's actually Dr Pepper. Also, Diet Dr Pepper. No period. Look at a can.

2. Junk food is comfort food. People in hospitals have lots on their mind.

And really, what better time for a doctor to say, "I hope you're not eating like that every day," rather than saying, "Aren't these rice cakes GREAT!?" while you're spending hours in the waiting room.

Sure, ultimately I agree that hospitals should be a healthy place. But people are under enormous stress. Cut 'em some slack, I guess.
posted by sdrawkcab at 10:27 PM on September 8, 2006

When I have been hospitalized, the food has been appalling. Grey overcooked veggies that may have once been canned peas, grey, unidentified meat, lots of mashed potatoes and salty gravy, with a dessert of greasy cake with greasy icing. Oh yeah, don't forget salad - jello with a few bits of fruit cocktail.

I like fresh, nutritious food, and so do a lot of people of all ages. Allowing egregiously non-nutritious foods in a hospital is stupid. Hospital nutritionists can and should provide quality, good-tasting food. There's plenty of comfort food that tastes good and is nutritious, or at least not horribly bad for you. Read Fast Food Nation, and it'll be a long time before you eat ground beef that was not ground locally.

And the health care system profiting from selling you unhealthy food is hypocritical and unethical.
posted by theora55 at 7:24 AM on September 9, 2006

Junk food has as much of a place in hospitals as cigarrettes. I smoke and would expect to be kicked out if I tried to light up. Same for crap "food" (how McDonalds and all can be called food is beyond me. I'd probably get as much nutrition from a plate of dog shit)
posted by twistedonion at 8:09 AM on September 9, 2006

And the health care system profiting from selling you unhealthy food is hypocritical and unethical.

Absolutely
posted by twistedonion at 8:11 AM on September 9, 2006

A grammatical aside, but I'm puzzled as to why, as some of the links do, medical writeups use the phrase "obesity and overweight" as opposed to "obesity and *the state of being* overweight," ignoring that the latter word is an adjective.

I've also seen "headaches" and "migraines" referred to as "headache" and "migraine."

Are there other examples of this usage, and what's going on here?
posted by Gordion Knott at 8:18 AM on September 9, 2006

twistedonion : "how McDonalds and all can be called food is beyond me. I'd probably get as much nutrition from a plate of dog shit"

McDonald's isn't the most nutritious food out there, but it has some nutritive value, and is "food" by pretty much any definition you can think of, unless you define "food" as "what I like, and not what I don't like!". In which case, as of today, broccoli is no longer food, and neither is rice pudding.
posted by Bugbread at 8:36 AM on September 9, 2006

Rewarding kids for getting better (or for being wsick in the first place) with candy and junk food is part and parcel of our society's terrible relationship with food. We feel guilty if we eat too much, or badly, and say things like, "I was bad; I ate a twinkie" or, "I was good; I had the broccoli." The whole idea that nutritious food is an onerous duty is just wrong. There's no reason why hospitals can't teach by example, by providing nutritious, healthy, tasty foods.
posted by joannemerriam at 8:57 AM on September 9, 2006

joannemerriam : "There's no reason why hospitals can't teach by example, by providing nutritious, healthy, tasty foods."

There's only one problem with that: the reason junk food is such a problem is because it's tasty. The reason people don't eat much healthy food is because it isn't as tasty. If healthy, nutritious food were so goddamn tasty, we wouldn't be having the problems we're having.

No, eating healthy shouldn't be some sort of onerous job, but it's a bit disingenuous to pretend that healthy food tastes every bit as good and that it's an easy job to whip up some healthy competition to fast food. Don't get me wrong, there's some good, good healthy food out there, but I've yet to find the good tasty food that can compete with the flavour of chocolate.
posted by Bugbread at 9:39 AM on September 9, 2006

Coming late to this thread. Unless you're going to have a cafeteria open 24-7, you *have* to have vending machines in hospitals. Not so much for patients but for staff and for those of us visiting critically ill family members, doing the late-night hospital vigil thing. This whole "war on obesity" thing has started to take on a moralistic/evangelical tone.
posted by ClaudiaCenter at 10:06 AM on September 9, 2006

ClaudiaCenter : "This whole 'war on obesity' thing has started to take on a moralistic/evangelical tone."

I think that's just a function of Metafilter. We do outrage well.
posted by Bugbread at 10:14 AM on September 9, 2006

posted by scblackman at 10:17 AM on September 9, 2006

This whole "war on obesity" thing has started to take on a moralistic/evangelical tone.

Too many of the kids in children's hospitals don't know what a normal, healthy meal is. Their parents are too busy or broke to prepare healthy food and the schools are too busy or broke to provide them. This isn't about a child getting a shake to comfort them after breaking their arm, this is about the hospitals being too busy or broke to provide reasonable, healthy food. And the tragic thing is that these kids are going to go home reinforced with the idea that a Big Mac is a normal, every day, kind of lunch.
posted by Slarty Bartfast at 10:40 AM on September 9, 2006

I'm 90% with joeblough's thoughts on this. Ah, hell. Make it 100% as my SO works for a hospital in its pediatric nephrology dept.

I'm going to take the radical position that hospitals should provide healthy food and discourage bad eating habits. But McDonalds is in the fat and sugar delivery business -- even their salads are unhealthy: an entire Quarter Pounder has the same total fat content as a packet of McDonald’s Creamy Caesar salad dressing.

The issue of providing "mental comfort" to hospitalized kids is worth pursuing. But, IMO, we should try to do that without poisoning them or reinforcing poor nutrition. This also raises a more interesting point: Why is McDonalds/Junk Food considered a "positive"? Yeah, fat tastes good. But, I would rather give my kid some ice cream or cookies as a treat than a load of empty carbs as a meal. If I remember correctly, Fast Food Nation had a good description of the "Playland effect". My altavistaing is failing, but it was something along the lines of poor kids/no day care/McD's playland/bright colors/happy memories/I WANT A BIG MAC, MOMMY!

OK, that was almost worth $5. (I.e., first time commenter. Have mercy.)
posted by bodega at 12:00 PM on September 9, 2006

Joeblough, I would love to hear what a pediatric endocrinologist thinks is going on with all that type II diabetes.
posted by jamjam at 12:46 PM on September 9, 2006

well she had to go to the store so i cant ask her this instant, but dollars to donuts she's going to say poor nutrition/fast food/lack of exercise which leads to obesity, and then to diabetes.

as you can see from my profile we live in the biggedy O and there's a lot of low-income people here who arent particuarly well-educated about food/nutrition, and tend to eat a lot of fast foods.

it's one thing to say "give people a choice" but if they are uninformed about their choices, then they dont even know they are making a bad one.
posted by joeblough at 1:05 PM on September 9, 2006

bodega : "But, I would rather give my kid some ice cream or cookies as a treat than a load of empty carbs as a meal."

Good point, I hadn't really considered that aspect. Either way, the kid is getting bad nutrition, but one way it's a bad nutritional item in addition to (presumably) a good nutritional meal. The other way, it's a bad nutritional item instead of a (presumably) good nutritional meal.
posted by Bugbread at 1:25 PM on September 9, 2006

Swear to god - my cardiologist is named Dr. Gregory Pepper. Even funnier, I met him when I had taken myself to the hospital after having some chest pains while shopping... and purchasing a twelve pack of Diet Dr Pepper, which was in my rucksack next to me while they admitted me. (Everyting fine, btw - just a temporary arrythmia.)

I just barely managed to stifle myself from making some joke that I expect he had heard ad nauseam long since. And I have to say, he has been a super super doctor. If you ever find yourself clutching your chest in Southwest Houston, I ..erm.. heartily recommend you look him up.
posted by John Smallberries at 4:18 PM on September 9, 2006

joeblough writes "its an insult to have this kind of crappy non-food in a hospital. havent you guys read fast food nation or seen super size me? this stuff is bad news for kids."


Supersize me increasingly looks, retrospectively, as some kind of marketing FOR McDonalds rather then against it. I definitely love investigative reporting and similar kinds of inyourface-unconvenient journalism, but supersizeme left me wondering

Let' consider NOT only the quality, but also the quantity of food one eat in a day ; a fault in supersize me was, imho, the fact that the dude gulped comparatively large servings of mc products on a dailly basis. I picked this factoid from wiki

His diet was also between two and three times the Recommended Dietary Allowance of 2000 to 2500 calories (8,400 to 10,500 kilojoules)

While I question the veracity of this statement, if true then it wouldn't suprise me he had a lot of health problems ; yet where they caused my McFood (quality) , by quantity or by both ?

If anything ssme shows that commodity food, easily and quickly obtained can become a bad habit, because avaiabilty is a precondition for consumption and gluttony needs avaiability : you can't eat a bucketful of anything if you don't have it.
posted by elpapacito at 6:04 PM on September 9, 2006

yes i see what you are saying, when something like ssme is done sloppily or to excess then it gives the target of the documentary an out. and it did feel a bit hipster/smug.

but in the end he wanted to see if mcdonald's claim that their food was appropriate for all 3 daily meals was true. since one of their meals apparently contains a full day's supply of calories, then it follows that it is not a good idea to eat 3 mcdonalds meals per day.

also what struck me is that his doctors didnt forsee the insane bloodwork he had by the 3rd week. somehow i doubt that you would see such out of whack numbers from simply overeating.

anyway i asked my wife and she also said that when pregnant women have a history of diabetes then their children are apparently at greater risk for diabetes. so it seems to be self-reinforcing, and this effect is probably partially to blame for the increase in the number of obese/diabetic kids these days.
posted by joeblough at 7:21 PM on September 9, 2006

joeblough writes "but in the end he wanted to see if mcdonald's claim that their food was appropriate for all 3 daily meals was true. since one of their meals apparently contains a full day's supply of calories, then it follows that it is not a good idea to eat 3 mcdonalds meals per day."

Well, the obvious question is: does McDonald's claim that all of their food is appropriate for all 3 meals in a day?
posted by Bugbread at 7:29 PM on September 9, 2006

well, he didnt eat big macs for breakfast... he ate the breakfast food for breakfast. so i dont know if McD ever claimed that quarter-pounders with cheese are breakfast food, but they will certainly sell you one at 8am.
posted by joeblough at 9:13 PM on September 9, 2006

High fructose corn syrup and partially hydrogenated oil.... chow down, my friends!
posted by chef_boyardee at 11:54 PM on September 9, 2006

Sorry, when I say "all of their food" in reference to being appropriate for all 3 meals, I didn't mean "Do they say their evening menu is appropriate for breakfast", but "Do they say that you can order anything you want from the breakfast menu at breakfast, anything you want from the lunch menu at lunch, and anything you want from the dinner menu at dinner and have an acceptable diet, or do they say that there are certain combinations of items that can be eaten for breakfast, lunch, and dinner which are appropriate for all 3 meals in a day?".

Because if it's the former, to be honest, I can't think of any restaurant, anywhere, fast food or slow food, where it's true that ANY combination of their breakfasts, lunches, and dinners will be fine. There's always a bad choice somewhere on the menu, and if that's what you're picking, you're going to be screwed. Even at health food restaurants, unless they're vegan, they'll probably have a menu item with an egg in it, and if you choose that three times a day, you're going to get a solid packed artery. That doesn't mean that it's intrinsically unhealthy to eat at the health food restaurant three times a day, but that it's intrinsically unhealthy to eat certain combinations of dishes from the health food restaurant three times a day.

Not trying to defend McDonald's, because I really don't know what claim they're making, so I dunno if they're full of shit or not. If they're saying "Pick anything you want from our menu, for breakfast lunch and dinner, and you'll be fine" then they're full of shit. If they're saying "Use dietary sense when ordering from our menu for breakfast lunch and dinner, and you'll be fine", well, they might be full of shit and they might not (I dunno what McDonalds has on their menu in the US).
posted by Bugbread at 5:25 AM on September 10, 2006

If they're saying "Pick anything you want from our menu, for breakfast lunch and dinner, and you'll be fine" then they're full of shit.

Yes, which is why McDonald's definitely shouldn't be in hospitals. You should be able to eat just about any three meals a day at a hospital restaurant every day and know you're maintaining a healthy diet. Junk should be the exception (and labeled as such -- "Bad for your diet!" or "Once a month!" or the like), every item should have calories listed next to the price, and the total calories (and maybe other health info) should be printed on the receipt. Also, a nice touch would be a scale for people standing in line, and a big wall chart showing recommended weight ranges and daily calories.
posted by pracowity at 4:47 AM on September 11, 2006

Also, a nice touch would be a scale for people standing in line

Ahaha funny idea :) ...BLING * Sir in line 4, yeah you that broke the damn scale , hop down here get your BMac *
posted by elpapacito at 6:50 AM on September 11, 2006

pracowity writes "the total calories (and maybe other health info) should be printed on the receipt"

I dunno about McDonald's in America, but in McDonald's in Japan, the caloric info for everything on the menu (down to the mustard packets) is printed on the back of that paper placemat on the serving tray. Very handy.
posted by Bugbread at 9:45 AM on September 11, 2006

printed on the back of that paper placemat on the serving tray.

But that's too easy to ignore. It would be more effective to add it up for people: "You just bought X calories worth of food and drink." And have big wall charts (so you can read them from any table) showing how heavy you should be and how many calories you should have each day.

An electronic scale that also measures your height would be cool. Make it discreet (a printed result, not a flashing number) so people aren't ashamed to try it. Or link it to the cash register so you can get a full report.

It is a hospital, after all. The menu at a hospital restaurant should be a model of good nutrition, and the experience, unlike the Ronald and Chucky stuff, should be healthy nutrition (preventive medicine and health education) first and profits second.
posted by pracowity at 1:30 PM on September 11, 2006