Should patients be fed ultra processed foods in hospitals?
I had this discussion yesterday with a peer who I deeply admire, and was surprised that we presented different opinions. And I swayed a bit…
I came to the conversation with a relatively militant stance. In a word, “no.” Now, my pre-standing position is more nuanced. For example, I wouldn’t issue a hard “no,” and have myself been know to “treat” some patients with “unhealthy” foods in special circumstances. For example, I made a patient transitioning to hospice care homemade ice cream, or brought a ‘metabolically healthy’ little child who loved blue foods blue skittles one day and blue Lindt Truffles another
But, as a rule of thumb, I would say cake 🍰 , apple pie 🥧 , muffins, etc are not just ‘sub-ideal’ choices, but in the context of a patient population overflowing with #obesity, MetS, and #diabetes, these choices can be harmful. Why harmful? Well, if poorly managed they can lead to negative acute outcomes, although this is less likely in an in-patient setting. However, they are certainly harmful over the long-term; and doesn’t a patient’s experience in the hospital setting and with the medical system set an expectation and ‘tone?’ In other words, what are we messaging when we say, “here’s a menu… if you want mashed potatoes and chocolate cake, it’s your choice. You’re an adult.”
Would we do the same for ‘acute’ use of cigarettes or alcohol? Do we…?
Well… that was my position. Now, I’m not entirely sure, and here’s why.
1/ We all have rebellious teenagers inside us. If we’re told “we can’t” - the forbidden fruit becomes all the more desired
2/ Before we can ‘preach,’ we should practice. IMHO (still) we should have a better choice ecosystem for patients.
However, were we to restrict choices and continue - ourselves - to “indulge” openly, the perceived (or evident?) hypocrisy could further undermine credibility.
3/ Consider the “starting point.” Okay, yes… I still would love to see patients being provided with better options - and to have the “standard” current food options 🍩🍪🥯🥨🥐🧇🥞 struck off as the defaults. But without first investing in education (which can start at the bedside), choice restriction in the hospital is unlikely to have much of an impact.
It’s a hand to play… but maybe not yet… maybe better played when we have a “fuller” hand, so to speak
Now, a question from me to me: if I could change 1 thing — JUST 1 — about nutrition & food in the hospital what would it be?
👉 Honestly, I don’t know what would be most impactful. But I don’t think I would choose “do cake 🍰 or donuts 🍩” as a hard rule… I think there are more strategic and effective options
That said, there will be no 🍰 🍩 for me 😉
A laser scan shows a plant root, in blue, enveloped by a mycorrhizal fungus, in red
Mycorrhizal fungi provide plants with nutrients, water and defense from pathogens in exchange for sugars
This image beautifully displays an ancient symbiosis where fungus and root become one
Each of us exists (in part) in the minds of other people, both as ideas and as memories. Human civilization is deeply connected in this way. Our intelligence is a collective intelligence. Our consciousness is a collective consciousness.
A list of useful stretches for those who sit all day.
Do this routine before bed to calm your body and still your mind.
This first one is usually the most painful yet relieving because the front of the leg/hip is a sitting tension hot spot.
Hold for 30-60s per leg, repeat 3x.
Stock-to-flow is really not looking good now.
I know it's impolite to gloat and all that, but I think financial models that give people a false sense of certainty and predestination that number-will-go-up are harmful and deserve all the mockery they get.