Lead by example
Protected meal times are routine on hospital wards, but have we lost sight of what we are protecting? Surely the setting aside of time without “unnecessary interruption” for eating is supposed to ensure that all patients receive three well balanced and nutritious meals every day—a vital part of their treatment. But, after seeing the food served on a cardiology ward in a UK hospital, I have started to question if this is the case.
For example, during the morning ward round, patients with coronary artery disease were given lifestyle advice to help reduce their risk of further ischaemic events. One of the key messages is that they should optimise their weight, by monitoring the nutritional content of foods. At 11 am patients were offered biscuits. Lunch arrived with a selection of high calorie and fat content meals with optional extra potatoes, followed by a hot or cold dessert. Some patients would try their best to make healthy choices by plumping for one of the three salad options—although 40 hot meal options were available—but I doubt that a “pork pie salad” is low in fat or calories.
Yet the hospital wanted patients to make informed choices. Each menu had a key that stated which meals were “high calorie” and “healthy” options. However, vagueness surrounds the term healthy as neither the number of calories nor the fat content for these options was specified. Can creamed potatoes or a cheese and potato pie be regarded as healthy options as the key suggested? Moreover, the dinner menu consisted of double the number of “high calorie” options compared with the number of “healthy” ones. Patient choice is a fundamental part of the NHS, but why make it so easy for patients to make decisions that could be detrimental to their health? It seems only natural that a patient could think that the type of food they are given in hospital is acceptable to eat as part of a healthy diet once they leave. Of course, some patients require meals with higher calorie contents, for example postoperative patients. Perhaps the composition and calorie content of the meals offered should be tailored to each patient’s needs, such as those designed for patients at risk of refeeding syndrome.
It isn’t only patients making unhealthy choices. I had a look in the hospital canteen, used by staff and patients, to see if healthier options could be found. Having walked past the chocolate shop on the way, I then faced chips galore in the canteen accompanied by various high fat content items. Salad boxes, laden with mayonnaise and cheese were available, but were more costly than a large portion of chips. While queuing to pay, I was overwhelmed with a plethora of muffins and doughnuts. If patients see their doctors, who have just emphasised the importance of a healthy diet, eating these types of high calorie, high fat content foods, can we blame them for copying?
I believe that we should seize the opportunity to encourage good eating habits while patients are in hospital by providing patient specific, healthy meal options; and lead by example by choosing the healthy food options for ourselves.Victoria Grey, , Fifth year medical student,
1University of Birmingham
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
- National Patient Safety Agency. Protected meal times review: findings and recommendation report, 2007.
Cite this as: Student BMJ 2013;21:f6354