Sustainability & Organics in Healthcare

FoodservicesMo CastenMS Nutrition and Wellness

Changing the

Stereotype of “Bad Hospital Food”

2 (Infographic created by Jorge Bach, CSPII)

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Are organic foods safer or healthier than

conventional alternatives?

A systematic review(Smith-Spangler et al,

2012)

The Organic -vs-

Conventional Foods Debate

Rages On

4 (Thalheimer, 2013)

“At this point there’s no conclusive scientific evidence

that shows that organically produced foods are healthier.”

-Vandana Sheth RDN, CDE Spokesperson for the Academy of Nutrition and Dietetics

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A plant’s nutrient profile is dependent upon:

• Species

• Variety

• Growing Season

• Weather & Climate

• Soil Makeup

• Region

• & More

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Nutritional quality of organic versus conventional fruits, vegetables, and grains

(Worthington, 2001)

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Agrosystem management and nutritional quality of plant foods: The case of organic

fruits and vegetablesOBJECTIVE: To assess the (potential) effect on consumer health of differences in composition between organic and conventional plant foods.

DESIGN: A meta-analysis of experimental studies reporting original data of comparisons of vitamins or secondary metabolites of fruits, herbs, and vegetables grown using organic and conventional methods for the period Jan 1992 - Oct 2009.

METHODS: The criteria of inclusion of included: appropriate experimental treatments; relevance of the organic/conventional practices used: that the same varieties were used in both systems; and that the products from both production systems were grown in (approximately) the same location. Each pair of values was used to calculate the ratio, as the content in the organic sample in % of the content in the conventional sample. Significance and magnitude of differences in contents of the compounds was calculated using techniques of In-transformed, resampling and back-transformation.

RESULTS: The content of secondary metabolites is approximately 12% higher than in corresponding conventional samples. p<0.0001

CONCLUSION: The 12% increase caused by switching to organic fruits and vegetables would correspond to an increase in life expectancy of, on average, 17 days for women and 25 days for men.

(Brandt et al. 2011)

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the environment

farmers & farm workers

animals

consumers

healthy / ‘hel-thē /adjective

Image from www.caglecartoons.com

Beyond Nutrient Content

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It’s a dangerous job-but someone has to do it!

• 1 of the most hazardous industries

• Work-related lung and skin diseases and certain cancers associated with chemical use

• Farmer’s families at risk for illness and death

(CDC, 2013) photography credit to: http://cdn2.ewg.org/sites/default/files/styles/medium/public/blog/pesticidespraying.jpg?itok=Tf6QO3d2

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Pesticides• 2 billion pounds used in the US annually

• 20,110 reported cases of acute poisoning

• Elevated risk for cancer, Parkinson Disease, Alzheimer’s & other disruptions of the reproductive, immune, endocrine and nervous system

(CDC) (Betarbet et al, 2000) (Horrigan et al, 2002) image source: website: The University of Reading, ECIFM, pesticides

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GHG Emissions• Agriculture alone accounts for 10-12% of green

house gas emissions

• 50% increase expected by 2030

• 40% of agriculture’s direct GHG emissions comes from soil management

nitrogen input = soil-born GHG

(Friel et al, 2009) (Skinner et al , 2009) (graphic from EPA)

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Livestock production produces 18% of GHG emissions

1/5

(Pryor, 2014) Photograph: EPA

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(CDC, 2014)

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Farm to….Hospital??• Group Purchasing Organizations

• Contracted and non-contracted vendors

• Reliance on ordering and delivery

• Billing efficiency

• Skilled staff

• Budget constraints!

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“My job is to not create new patients for my hospital”

-Chris Linaman, executive chef and F&B manager Overlake Hospital and Medical Center in Bellevue

(Pryor, 2013)

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• Henry Ford West Bloomfield Hospital (Detroit-area, MI)

• All patient food prepared in the hospital kitchen• All food sourced from on-site organic greenhouse or other

local sustainable producers

• Fletcher Allen Health Care (Burlington, VT)• $1.5 million spent on products made in VT• 42% of all purchases were sustainable• Purchasing directly from farms• 50% of meat and poultry antibiotic free• 70% of dairy purchases are rBGH free

• Dominican Hospital (Santa Cruz, CA)• on-site vegetable garden

July 22, 2012

(Brown, 2012) (Conis, 2009) (UHC)

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Three Bay Area Hospitals (CA)

1,440 lbs of local stone fruits

3,830 lbs of local green beans

7,210 lbs of local

organic strawberries

(Seacrest, 2012)

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Health Care Without Harm

“to transform the health sector worldwide, without compromising patient safety or care, so that is

becomes ecologically sustainable and a leading advocate for environmental

health and justice”

Noharm.org

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Balanced Menus: A pilot evaluation of implementation in four San Francisco

Bay Area Hospitals

• Santa Rosa Memorial Hospital, San Francisco VA Medical Center, John Muir Medical Center + one anonymous hospital

• Results:•Reduced meat purchasing by 28%•Savings of $400,000 on meat purchases in a year•Savings of 1,004 ton/year meat related GHG

(Lagasse, 2010)

Beyond our Patients

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The average U.S hospital serves one million meals per year

$5 billion in food

expenditures

(Pryor, 2014)

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Helpful Resources:• https://noharm-uscanada.org

• http://www.hendpg.org

• http://vndpg.org

• http://www.chicagogreenhc.org

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References:

Betarbet R, Sherer TB, MacKenzie G, Garcia-Osuna M, Panov AV, Greenamyre JT. Chronic systemic pesticide exposure reproduces features of Parkinson's disease. Nature Neuroscience. 2000; 3(12): 1301-1306.

Brandt K, Leifert R, Sanderson R, Seal CJ. Agrosystem management and nutritional quality of plant foods: The case of organic fruits and vegetables. CRC Crit Rev Plant Sci. 2011;30(1-2):177-197.

Brown SA. Henry Ford West Bloomfield Hospital opens organic greenhouse. Henry Ford Health Systems. http://www.henryford.com/body.cfm?id=46335&action=detail&ref=1713. Published September 13, 2012. Accessed April 21, 2014.

Centers for Disease Control and Prevention. Agriculture. Centers for Disease Control and Prevention. http://www.cdc.gov/niosh/topics/agriculture/. Last updated December 9, 2013. Accessed April 21, 2014.

Centers for Disease Control and Prevention. Threat report 2013. Centers for Disease Control and Prevention. http://www.cdc.gov/drugresistance/threat-report-2013/ Last updated March 10, 2014. Accessed April 21, 2014.

Centers for Disease Control and Prevention. Pesticides. Centers for Disease Control and Prevention. http://www.cdc.gov/nceh/hsb/pesticides/pdfs/activities.pdf Published June 2004. Accessed April 21, 2014.

Conis E. Hospitals adding fresh, organic food to the menu. Los Angelos Times. http://articles.latimes.com/2009/apr/27/health/he-nutrition27 Published April 27, 2009. Accessed April 21, 2014.

Friel S, Dangour AD, Garnett T, Lock K, Chalabi Z, Roberts I. Public health benefits of strategies to reduce greenhouse-gas emissions: food and agriculture. The Lancet. 2009; 374(9706): 2016-2025. doi:10.1016/S0140-6736(09)61753-0

Health Care Without Harm. Integrating sustainability requirements into health care food service contracting. Health Care Without Harm. http://noharm.org/lib/downloads/food/Integrating_Sustainability_FoodService.pdf Accessed April 21, 2014.

Horrigan L, Lawrence RS, Walker P. How sustainable agriculture can address the environmental and human health harms of industrial agriculture. Environ Health Perspect. 2002;110(5):445

Lagasse L, Neff R. Balanced Menus: A pilot evaluation of implementation in four San Francisco Bay Area hospitals. John Hopkins School of Public Health. http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-a-livable-future/_pdf/research/clf_reports/BMC_Report_Final.pdf. Published April 12, 2010. Accessed April 21, 2014.

Pryor K. Hospitals go farm-fresh. Sound Consumer. http://www.pccnaturalmarkets.com/sc/1308/hospital_food_local_sustainable.html Published August 2013. Accessed May 3, 2014.

Pryor K. The Food Climate Connection [Webinar]. January 30, 2014. https://eatright.webex.com/eatright/ldr.php?RCID=fa7a4df3e82997d27f6ffa8edf9cc000 Accessed May 3, 2014.

Secrest E. Bay Area hospitals aggregate demand to push the market for local and organic produce from family farms. http://noharm-uscanada.org/articles/news/us-canada/bay-area-hospitals-aggregate-demand-push-market-local-and-organic-produce Published October 23,2012. Accessed April 21, 2014.

 

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References continued:

UHC. Fletcher Allen Health Care sets industry standard with award-winning sustainable food program. http://www.fletcherallen.org/upload/photos/4709Case_Study_UHC.pdf. Published July, 2012. Accessed April 21, 2014.

Worthington V. Nutritional quality of organic versus conventional fruits, vegetables, and grains. J Altern Complement Med. 2001;7(2):161-173.