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Five Questions for: Dianne Moore

FoodService Director - Five Questions for Dianne MooreLast week, the Women's Health & Environmental Network (WHEN) launched a pilot called the Balanced Menus project. The project is a commitment by healthcare facilities to reduce their environmental impact and, at the same time, increase the health and wellness of their customers. FSD talked with Dianne Moore, manager of Healthy Food in Health Care for WHEN, about the pilot.

What is the Balanced Menus project?

Balanced Menus project is a voluntary commitment by healthcare institutions to reduce their meat offerings in patient meals and hospital cafeterias by 20% in 12 months. Balanced Menus is a climate change reduction strategy that also protects the effectiveness of antibiotics and promotes good nutrition. Fourteen hospitals are already participating in the national Balanced Menus Challenge. In the Philadelphia region, Cooper University Hospital in Camden, N.J., and Thomas Jefferson University Hospital in Philadelphia have signed on to reduce their meat purchases by 20% in 12 months.  

Why was this project created?

The USDA recommends 5 to 6 ounces of meat/fish/poultry/beans per day, yet for meat alone, Americans on average eat 8 ounces daily. Hospital foodservice operations often mirror this trend, offering sizable servings of meat several meals per day. High consumption of conventionally produced meat and processed meat contributes to an increased risk of cardiovascular disease, obesity, diabetes, metabolic syndrome, dementia and some kinds of cancer. Over-consumption of meat contributes to the overwhelming cost of the U.S. health system-estimated to be $147 billion as a result of obesity management alone-as well as environmental damage such as climate change, water and air pollution.

Most hospitals buy substantial amounts of meat, typically through large distributors who source from the U.S. commodity beef, pork and poultry markets. U.S. food production relies heavily on fossil fuels, and red meat production is particularly energy intensive as it requires significant inputs of synthetic fertilizers and pesticides to grow crops for feed. The food system accounts for more than 10% of overall energy use in the United States. Globally, livestock for meat and dairy production accounts for 18% of greenhouse gases, more than all of Earth's cars, trains and planes combined.

One of the goals of the project is to reduce meat purchases by 20% within the next year. What have participating hospitals done to achieve this goal?

The Balanced Menus project challenges hospitals, as large purchasers, to make a reduction in animal protein, especially beef, by creating menus that rely more on vegetables. Building on the foundation of preventive health, these hospitals are serving as exemplary models of healthier food for patients, visitors and staff, as well as their surrounding urban communities, while saving costs. By reducing the role of meat served in healing institutions, hospitals are supporting a more sustainable food system for the benefit of all.  

Jefferson and Cooper have been working with WHEN, a member organization of Health Care Without Harm, to institute sustainable food purchasing and practices. Both hospitals joined a regional effort coordinated by WHEN earlier this year to serve meatless meals on Earth Day, demonstrating that healthcare can be at the forefront of preventive health. In addition, both hospitals have expressed interest in purchasing more sustainably produced meats, such as grass-fed, pasture-raised beef or cattle not given non-therapeutic antibiotics. The Balanced Menus challenge will continue for the next 12 months. Hospitals that have taken the Balanced Menus Challenge are collecting data that will be reported.

Directors often say cost is a major hindrance to going "green." What are some ways foodservice directors can implement some of the initiatives of the Balanced Menus project without incurring significant expenses?


Reducing the role of meat in menu offerings and replacing meat with plant-based protein can result in significant savings or be cost-neutral, especially when the non-meat item tastes great, is nutritious and sells out. Cooper University Hospital overhauled its menu with the goal of serving the healthiest and most sustainably produced meals available. Cooper has looked for plant-based protein alternatives to enhance its entrées as well as more seasonal produce and local fish. Cooper introduced tofu and other non-meat protein sources and routinely finds these vegetarian meals are big sellers. Cooper also increased its purchase of locally grown produce by replacing out-of-season tomatoes, strawberries and melons with roasted red peppers, locally grown seasonal produce and mushrooms. Located in a distressed urban city, Cooper has committed to a more balanced menu that is healthier for people and the environment.

Thomas Jefferson University Hospital has a successful weekly farmers' market on its campus, which features fruits, vegetables, whole-grain breads, local honey and more. In addition, its cafeteria offers rBGH-free milk and yogurt, vegetarian options, fair-trade coffee, caged-free eggs and more.  

As more hospital cafeterias become dining destinations in some communities, there is an opportunity to support a healthier lifestyle that consumers want to pay for.

Operators can make these changes, but none of that matters if customers don't change their eating habits. What kind of consumer education is being done with the Balanced Menus project?

WHEN's Sustainable Food Cook Training, in which five Philadelphia region hospitals participated including Jefferson and Cooper, demonstrated preparing meatless meals and organic products. The recipes are posted when.org/documents/SustainableRecipesFinal.pdf.

The Web site for the national project-noharm.org/us_canada/issues/food/menus.php-also offers recipes and materials for hospitals to share with and educate consumers. Participating hospitals are posting signage, highlighting featured items on menu boards, posting information online and creating table tents.

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