Working together for meals that heal

Instead of a pill, hospital patients at San Francisco General Hospital (SFGH) might be handed a prescription for vegetables such as kale and beets.

And those prescriptions are filled and picked up on-site. The Therapeutic Food Pantry located at SFGH is one of a growing number of facilities swapping pills and supplements for fruits, veggies and proteins.  

The prescription food program enables doctors and healthcare providers to prescribe fresh fruits and vegetables along with other healthy items to patients as part of a road map to sustained health and wellness.  

The secret ingredient powering the trend? Foodservice directors who work in tandem with physicians and dietitians to prepare meals.

“I think it’s better to eat healthy, from-scratch and locally sourced food than rely on a pill,” says Ruth Argenta, director of foodservice at Ann & Robert H. Lurie Children's Hospital of Chicago, who is pictured above (at left) with chef Carolyn Brown. “We believe in the power of food.”

The 320-bed hospital isn’t equipped with a food pantry, but it’s still actively participating in a “medicinal” food approach. Argenta counts herself among a legion of FSDs aligning with physician and dietitian networks to adopt a precise, patient-specific meal regimen.

Others have followed suit. “I fully embrace the concept,” says Moe Memmolo, general manager for dining services at 350-resident Taylor Community, a senior living operation in Laconia, N.H. “We meet regularly with our dietitian to discuss staying current with the science of nutrition, adapting as science changes and discussing trends and how to incorporate them into our menu cycle. Our model is based on liberalizing diets.”

And while some directors respect the idea, they believe the terminology “food as medicine” doesn’t send the appropriate message.

“Our focus has been ‘food with purpose,’ as [food as medicine] can be polarizing depending on the context and group of individuals,” says Shawn Goldrick, senior director of patient support services at Boston Children’s Hospital. “Food with purpose answers the question of why we’re sourcing and using a certain product, such as antibiotic-free, humanely raised and locally sourced. These decisions are not so much clinical but based more on ‘better-for-you’ with an emphasis on ‘why.’”

Healing meals

One example of “food with purpose” at Boston Children’s is its proprietary Lemon Ginger Chicken Soup, which is prepared in place of traditional chicken noodle soup.

“We chose this knowing that lemon and ginger can be an appetite stimulant for cancer patients that have a challenge with taste during treatments,” Goldrick says. “By making these adjustments to our dishes, we are able to better serve our patients in a way that can be impactful.”

Argenta, a registered dietitian who sources 20% of Lurie’s food from local producers, says the overarching concept has staying power. Lurie “took a deeper dive into wellness” in 2014, she says, by aligning with the Partnership for a Healthier America (PHA) to address obesity in children.

Lurie’s endgame is serving wellness meals of 500 calories or fewer, with some examples being a PBJ sandwich with carrots and grapes; a chicken breast with whole grain, fruit and vegetable; and a hamburger on a whole-grain bun. To Argenta, two elements underpin the effort: healthy, from-scratch foods coupled with a cohesiveness between foodservice, physicians and dietitians.

Due in part to its PHA affiliation, Lurie Children’s developed a laser-focused team approach to serving medicinal-oriented food, with a key acknowledgement.

“The doctor is the captain of the ship,” Argenta says.

Deployment of intuitive software, diet manuals and the hospital call center are all integral to the execution, says Argenta, who’s employed by Aurora, Ill.-based Morrison Healthcare, Lurie’s third-party foodservice provider. There are a lot of moving pieces, as Lurie has a network of 32 clinical dietitians overseen by 10 team leaders, who all interact with Argenta’s program, which consists of 70 hourly cooks, servers, dishwashers and others.

Proprietary software integrates with patients’ medical records to obtain date of birth, diet history, allergens and more, Argenta says: “Let’s say a patient requires a clear liquid diet. One restriction might be serving broth due to fat content—something a doctor might forbid prior to surgery.”

Technology meets tradition

Traditional dialogue, particularly within the Lurie network of dietitians, coupled with electronic tools informs Argenta at every turn.

“We, like most hospitals, have established a diet manual that becomes the basis for nutrition,” she says. “My operation provides food consistent with the manual while doctors and dietitians prescribe the diets.”

At SFGH, patients get access to nutrition education programs relevant to certain diseases and health goals, along with food demonstrations hosted in its demonstration kitchen so people can learn how to prepare certain foods.

They are also given approximately 25 pounds of food per visit, which typically feeds a family of four for five days. Some receive “max assist” from the pantry, which means they can return every two weeks for as many refills as indicated by their provider, according to SFGH.

Outside the hospital setting, directors at senior living communities such as Taylor are adopting the concept to serve an aging clientele, with a medicinal twist enabled by seamless communication.

“The process should be collaborative with all parties—doctors, dietitians and directors—and that means getting each perspective to find accommodations as often as possible,” Memmolo says. “From a hospitality perspective, I want to say ‘yes’ to all requests while meeting mandates for the minimum daily dietary intake—and we want to exceed expectations whenever we can.”