The headlines started appearing in early December in newspapers, on blogs and on TV. And they kept coming, dozens of them:
Food Served in Children's Hospitals Rated Largely Unhealthy
California children's hospitals rarely offer healthy food, study finds
California Children's Hospitals Offer Few Healthy Food Choices
All were based on a release out of UCLA's PR “newsroom,” one that did a poor job summarizing a serious study by UCLA researchers and published in the Journal of Academic Pediatrics.
It's probable that few in the media bothered to obtain or read the original research. But they clearly read and picked up the sensationalized headline from the news release, with its misleading summary of the findings.
Had they gone to the trouble to read the actual study, they would have found a carefully defined (if strict) methodology that is clearly explained. But much of that detail is overlooked or ignored in the promotional material.
In my mind, this did a real injustice to the school, the Journal and the Robert Wood Johnson Foundation which funded the research. It's also an example of how otherwise serious research can be caricatured by those with agendas and who would prefer to use it for biased effect.
Just for starters, the release's headline failed to make clear that the study wasn't evaluating children's patient menus.
In fact, the researchers were evaluating cafeteria fare consumed mostly by hospital employees and visitors, often in facilities where the children's hospital was only an adjunct unit of a larger facility. The criteria to determine what offerings were “healthy” was developed by the researchers' own committee. And to be so rated, offerings not only had to meet the criteria, but also had to be prominently labeled as a healthy choice or have nutritional information posted at the venue.
The study stated: “Entrees that have no nutritional information or heathy choice labeling were not considered to qualify as healthy meals even if indeed they were….” (Further, nutrition information provided by handouts or to emplyees via hospital intranet postings, was “disregarded.”)
UCLA's news release failed to mention such “minor” factors. It also neglected to mention that the study gave a cafeteria demerits for offering any kind of discounted “combo” meals; demerits if healthy entrees cost more than competing entrees (we assume, even if their ingredients cost more); and more demerits if it offered any high-calorie items near checkout lanes.
The study's claim that half the hospitals visited offered no healthy entrees is one that is likely true only in the “structured” context of these details.
I understand that purist nutrition advocates would like to see healthier cafeteria items priced as loss leaders. To see nutrition information provided more aggressively. And that healthy choice items completely dominate the options available to customers. However, saying that by not operating in this fashion hospital cafeterias are unhealthy places to eat is another thing entirely.
A close read of the Journal article suggests the authors' goal was less to determine whether healthy food choices were available in hospital cafeterias and more to promote the idea that these operations should aggressively seek to change customer eating behavior for the better.
That is a laudable and idealistic point of view. But it ignores the reality that most or all of these facilities are not financially subsidized, have to appeal to a wide range of customers in order to break even and that many of those customers want offerings that do not fit the study's strict criteria. Hospital cafeteria offerings simply reflect the everyday choices customers make in the real world every day. But the healthy choices are always there.
A more accurate news release headline might have read, “Study Suggests California Hospital Cafeterias Could Do a Better Job of Promoting Healthy Food.” That, on the other hand, would not have generated the same kind of attention or media feeding-frenzy this one did. And perhaps that was the idea.
Dan Henroid, foodservice director at UC-San Francisco Medical Center (one of the hospitals studied) has suggested that AHF (the Association for Healthcare Foodservice) establish a consensus-based, best-practice set of criteria for what reasonably constitutes a healthy hospital cafeteria operation. In my mind, that would be a very sound way for the healthcare foodservice community to respond to these kinds of criticisms.
Going one step further, perhaps UCLA could establish some equally credible standards for its public relations “newsroom.” In my view, we don't need feeding frenzies among journalists, academics or nutrition advocates any more than we need them from cafeteria customers.