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From farms to Northern California hospitals: Healthier food for healthier patients

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By April Dembosky

Nothing spells patient satisfaction like free-range roast chicken after triple bypass surgery.

Throw some organic potatoes mashed with hormone-free milk and locally grown arugula salad onto the tray and hospital food may soon escape the culinary sneers it usually shares with TV dinners and airline meals.

Such bedside menus may not be far off for Northern California hospitals that are harnessing their buying power to demand changes in how food is grown and distributed. They're part of a growing alliance of doctors and food advocates who say organic, fresh food is healthier, and local, sustainable food practices reduce pollution and contamination, which will ultimately lead to fewer health problems.

"What people eat is one of the most important determinants of their health," said Dr. Preston Maring, an obstetrician at Kaiser Permanente who started the movement to put farmers markets outside the hospitals.

Throughout the region, chefs are planting gardens outside the ERs, hospital administrators are hanging out with farmers, and nutritionists are lobbying to overhaul cafeteria contracts to favor organic food.

"The food system promotes high pesticides and overuse of antibiotics, which all health care organizations are saying we have to stop because it's promoting antibiotic resistance," said Jamie Harvie, the food coordinator for Health Care Without Harm, a national advocacy organization.

Kaiser now has 30 farmers markets at its hospitals, including San Jose, Santa Clara, Redwood City and Fremont. Medical centers that don't have such markets instead have programs where boxes of fresh produce are delivered weekly to employees' desks.

Patients' meals

The HMO is now tackling inpatient food. Last year, it bought 74 tons of produce from local small and mid-size farmers to cut down on the environmental impact of shipping products from halfway across the world. It's looking for new beef and poultry suppliers, based on principles of a pilot program in San Francisco. The Balanced Menus campaign asks hospitals to reduce their overall meat purchases by 20 percent, then use the cost savings to buy only free-range, hormone-free meat from local ranches.

Most hospitals interested in the movement are going slowly, starting first in the staff cafeteria before tinkering with inpatient meals.

At Dominican Hospital in Santa Cruz, a row of trays rolls down a lunch assembly line. Four people alternately add fruit cups then penne to each tray, sprinkle Parmesan cheese, pour coffee, then slip the tray into a metal cart that swoops out to make its deliveries. Parent company Catholic Healthcare West is at the first stages of shifting its inpatient food system, looking for alternatives to genetically modified sugar and meat products made from animal clones.

Chef Deane Bussiere buys about $500 worth of organic vegetables from a local nonprofit every week. But the company is still bound to mostly conventional ingredients provided by its distributors and vendors. So patient meals like pasta bolognese generally win average taste rankings among the system's 41 hospitals.

It's a different story in the hospital's cafeteria, where Bussiere uses free-range chicken in his fajitas and organic cucumbers and radishes from the hospital's own garden to feed hospital staff and visitors.

"A lot more hospitals across the nation are hiring a lot more professional chefs to improve the food service," Bussiere said. "Nothing tastes as good as a carrot right out of the ground."

The hospital started the garden in 2004 when grill master Jaime Ortiz wanted to plant some herbs for meat rubs and marinades. Now, 30 beds brim with green beans, tomatoes, radishes, squash, beets, rosemary and parsley. Sunflowers flank every crop to distract bugs from the veggies without pesticide.

'Healthy environment'

"We want to make sure what comes in the front door is as healthy and green as possible," said Sister Mary Ellen Leciejewski, the ecology program coordinator for Catholic Healthcare West. "If we don't have a healthy environment, we won't have a healthy human being."

Not all Bay Area advocates agree on how best to change hospitals' food practices.

"Take the word organic out of this," said Jack Olsen, executive administrator for the San Mateo County Farm Bureau. Local farmers want to find local buyers for their produce before tackling the complicated process of organic certification.

Most of the food grown in San Mateo County is shipped to Europe, partly because locals simply can't eat that many artichokes and Brussels sprouts. But the main reason, Olsen said, is that there aren't enough large local buyers to encourage farmers to grow more diverse crops.

"A farmer doesn't like the risk of planting something and not knowing if he can sell it," he said. "If a hospital will buy 500 crates a week, that's a strong incentive for the farmer to plant that crop."

The county's Food System Alliance recently hosted a "speed dating" event recently where farmers and hospital staff had five minutes to talk. Farmers told hospitals what they grew; hospitals told farmers what they wanted to buy. The group will check next month to see if any of the connections grew to full romances.

There are several obstacles that stand between farmers and hospitals, including restrictive vendor contracts, tight food-safety standards, the often higher cost of organic products, and the enormous labor required to chop tons of fresh vegetables instead of opening a can.

But advocates say there could be huge cost savings to the health care system if diseases like obesity, diabetes and other environmentally related health conditions could be addressed through the food system. Kaiser's Maring calls farmers markets and new purchasing programs imperatives, not luxuries.

"It's a symbol of good health," he said. "It's a symbol of what we need to do in the country to even have the health care system survive over time."

Contact April Dembosky at 408-920-5064.

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