Spring 2007

Healthcare foodservice operators start a crusade against trans fats

AN FSE SPECIAL REPORT

Hospitals are moving rapidly these days to be on the front lines of the battle to ban trans fats from the menu. As foodservice operators across every segment of the industry scurry to meet city and state deadlines to remove the man-made substances found to cause heart disease, healthcare foodservice operators find themselves with a special mission.

From large metropolitan medical facilities to small town hospitals, the push is on to ban trans fats.

At one small 82-bed hospital in a former coal-mining center in Pennsylvania, Chief Execu- tive Offi cer Nick Jacobs puts it this way: “I wanted to start a crusade,” he says. Wind- ber Medical Center sought to be one of the fi rst, if not the fi rst, medical facility to make the move, he recalls, because “serving hospital meals that contribute to heart disease is akin to putting cigarette ma- chines in a cancer center.”

Mort Cohan, director of food and nutrition services at the Cambridge, MA 200-bed Mount Auburn Hospital, sees the move as one of many trends in today’s foodservice. “In this industry, this is the ‘hot’ thing now,” he says. The hospital has removed 99 percent of menu items containing trans fats and now has a list of trans fat-free foods.

Similarly, on Long Island, the nation’s third largest non-profit, secular healthcare system, North Shore-Long Island Jewish Health Care, takes its role as the region’s largest healthcare provider very seriously, noting that “with more than 35,000 people eating at our facilities on a daily basis, we recognize how important it is for us to institute a zero trans fat rule system- wide. We have an obligation to serve the healthiest meals possible.”

While a number of consumers are seeking alternatives to trans fats as a result of the spate of media attention to the issue, many remain unclear about the reasons for banning trans fats or even about what trans fats do.

“Everybody is taking trans fats out of their food,” says Technomic Vice President Joe Pawlak, “but a lot of consumers still don’t understand why. The industry has a huge opportunity to explain why it’s important.”

For healthcare foodservice operators, taking the helm in that effort is part and parcel of protecting their customers’ health as well as improving the image of hospital food.

“The hospital segment has become very competitive,” says Mount Auburn Hospital’s Mort Cohan. “Consumers today are more aware and expect more of foodservice. We went from the ‘open the can’ approach to doing everything from scratch here. We do hotel style room serve and the food is served on china. You don’t go to the hospital for the food but the experience has you coming back. We want it to be a positive experience and we compete with the guys in the city.”

At Mount Auburn, he says, his staff has backgrounds in fine dining and hotel foodservice. “It’s a tough business today,” Cohan continues. “Quality and service can’t be stressed enough. In our cafeterias we have increased sales by 16 percent from putting on fresh items, We never serve the ‘same old thing’ all the time.”

After years of downsizing, he adds, healthcare is coming back. “We’re building an $80 million addition that will increase our bed count. Our occupancy is going up as the baby boomers age.”

At Windber in Pennsylvania, Jacobs, whose background as a professional musician, teacher and convention bureau executive made him a “non-traditional hospital COO,” the decision to remove trans fats was made with the hospital’s dining services provider, Cura Hospitality, based in Allentown, PA which has been at the forefront of removing trans fats, switching from traditional cooking oils to canola oil at many of its sites in the Mid-Atlantic.

“We share a common philosophy of caring for others,” Jacobs emphasizes. The goals of the new program are to eliminate a known health hazard from meals served by the hospital; to raise awareness of the dangers of trans fats in both the hospital and the community, and to encourage patients, families and employees to eliminate trans fats from their diets at home.”

A survey by the National Society for Healthcare Foodservice Management found that more than 75 percent of its 2,000-plus member facilities in North America have switched to trans fat-free cooking oils in their retail foodservice operations.

At Windber, Jacobs points out, “we removed trans fats starting with patients and the goal was extending that to all meals served. We’ve been working with a lipid specialist and switched to a Canola oil with rapeseed. This cost Cura $150,000 to implement,” he adds, and it took longer than he anticipated. “From my perspective, we should be setting the pace. Trans fats are in everything–they don’t break down and wind up causing blockages.”

Trans fats are formed when liquid vegetable oils are put through a process called hydrogenation that adds hydrogen to make the oils more solid. Some trans fats occur naturally in various meat and dairy products although the majority are in shortenings, hard (stick) margarine, cookies, crackers, fried foods, baked goods and processed items made or fried in partially hydrogenated oils, says a spokesman at North Shore-Long Island Jewish Health System.

Consuming trans fatty acids leads to higher levels of LDL or “bad” cholesterol and lowers “HDL” known as “good” cholesterol. As a result, arteries become clogged and the risk of developing heart disease and stroke is increased.

At the Harvard School of Public Health, estimates place the annual number of deaths caused by trans fats at 30,000 a year in the US.

One expert on fats, oils and nutrition, Dr. Gerald McNeill, director of research and development and marketing at Loders Croklaan, a producer of oils and fats for more than 100 years, points out that as a result of hydrogenating unstable polyunsaturated fats to keep them from becoming rancid, trans fats, synthetic substances, are produced.

When non-hydrogenated oils are used in deep fat frying, they produce free radicals or breakdown products that build up in the fryer and can damage human DNA and protein and lead to “aging diseases” such as arthritis and heart disease.

“The key for foodservice operators in switching to trans fat-free oils,” says Dr. McNeill, is the inherent stability of the oil. You need to avoid the build-up process in the fryer from breakdown of polyunsaturated fats. The overall stability of the oil is increased when you reduce polyunsaturated fats.”

Shifting from polyunsaturates to saturated fats is healthier. “Sticking with something natural means you have no unforeseen consequences,” he adds, pointing out that saturates “neither raise nor lower the risk of heart disease. They play an essential role in the body providing cell structure and an energy source. Saturated fats are not as bad for us as people have been making them out to be.”

For operators, the hardest part of eliminating trans fats, as Mort Cohan at Mount Auburn Hospital, says, can be determining what foods contain them. He sees the healthcare foodservice segment moving rapidly to take a leadership role in the ban.

In New York City, Sharon Cox, director of food and nutrition services at the 425-bed Memorial Sloan Kettering Cancer Center, used a computerized back-of-the-house system to check the ingredients in each recipe so staffers would know “what the food we’re serving contains and if something has partially hydrogenated fats.”

The hospital was among the first to “jump on the bandwagon,” she says. “We’re a “made from scratch, fresh facility,” Cox declares. “We do room service and prepare food a la carte so we don’t use a lot of frozen products.” She substituted grilled chicken strips for fried chicken fingers, she adds, and has found trans fat-free products to be “plentiful.”

The changeover in eliminating trans fats, she says, was virtually “seamless.” “We take pride in our meals and our patient satisfaction scores are in the 90th percentile.”