The overlap of health care and food systems is multifaceted. Nourish convened 22 leaders from across healthcare, government, food systems and philanthropy together for a four day retreat on Wasan Island in order to explore the opportunities around environmental nutrition in health care. Environmental nutrition (2014), a concept coined by Health Care Without Harm, reframes healthy food as contributing beyond individual well-being towards a collective social responsibility for creating healthy communities and a sustainable food system.
By Allison Gacad, Loran Scholar and Nourish Researcher and Annie Marquez, Nourish Innovator
A meal at a healthcare system is a juggling act of numerous priorities: is it nutritionally adequate for the patient? Does it fit within the allocated budget? Are there a variety of colours and textures on the plate? Among these questions, a new priority is beginning to emerge: how sustainable is this meal?
The most powerful path to being sustainable as a healthcare institution isn’t through turning off the lights or unplugging electronics – it’s in changing the way that patients eat. From the production of the ingredients to the processing at a factory, to the transportation required to bring the food to the plate, the creation of a meal radiates social, economic, and environmental effects well beyond the person who is eating it. When we amplify this by the thousands of meals prepared, served, and consumed daily in healthcare institutions across Canada, the impact is monumental.
The choices that food service managers make about what is served on the plate ultimately influence global systemic issues of climate change and public health. Despite this immense opportunity for proactive change, not all food service managers are equipped with the knowledge and tools to act in the interest of environmental sustainability.
Nourish Healthcare’s Sustainable Menus collaborative working group is a team of healthcare leaders looking to address this knowledge gap and transition food in healthcare towards sustainability. Through the creation of a practical and user-friendly sustainable menu guide for food service managers, the group is looking to mobilize sustainable food choices in healthcare and the reduction of greenhouse gas emissions. Below are some of the pathways towards sustainability presented in the guide:
Moving towards plant-based proteins
Agriculture — the system that powers the production of our food — accounts for nearly 24% of global greenhouse gas emissions. However, the production of certain types of foods are more resource intensive than others. Livestock — including red meats, pork, and poultry — contribute to 18% of global greenhouse gas emissions. Large volumes of water are needed for livestock to drink and maintain hygiene. Vast amounts of land are used to produce their feed and even their natural digestive processes directly contribute to the greenhouse gases in our atmosphere.
In contrast, plant-based proteins such as legumes benefit soil ecosystems rather than impair them. Legumes are recognized as “soil building crops” thanks to their properties which improve soil structure, reduce erosion, and increase organic content.
For most healthcare facilities, traditional protein is animal-based and is usually in the form of beef or pork. Transitioning into plant-based proteins can be challenging, but even small efforts can have massive impacts. According to Healthcare Without Harm, “Eliminating meat for one day per week, for example, could reduce emissions by an estimated 1.0 gigatons (Gt) to 1.3 Gt. per year, the equivalent to taking 273 million cars off the road.” Plant-based proteins are also substantially cheaper than their animal protein equivalents, in fact being approximately 4 times less expensive per gram of protein.
Less processing, more whole foods
Chicken nuggets, bags of chips, and microwavable meals: ultra-processed foods have little resemblance to whole foods. They are better described as formulations of industrial ingredients and other substances derived from foods and additives. Not only are these foods full of calories and have limited nutritional value, but the energy and water required for their production is extensive. Processed foods are also a source of ample plastic waste due to the packaging of the products to optimize transportability.
The convenience of ultra-processed foods is attractive in healthcare settings. Pre-packaged portions make it easy to serve clients – but at a cost to nutrition, sustainability, and sometimes even budgets. Instead, looking to whole foods or minimally processed foods such as raw fruits and vegetables or simple baked goods can be beneficial for patients and the planet.
Local food, local economies
Prioritizing the procurement of local foods is path that can help meet priorities around creating delicious, sustainable and cost-efficient meals.
In a recent article in Food Service and Nutrition Magazine, Jennifer Reynolds of Food Secure Canada describes the following 5 reasons for buying local food:
Reducing food miles: The smaller the distance food needs to travel, the smaller the environmental impact.
Fresher, more flavourful food: Local food is often harvested only hours before being sold – the freshness results in better taste.
Seasonal eating: When fruits and vegetables are in season, they are at peak flavour and ripeness.
Supporting local economies: Producers directly receive profits and consumers learn how their food is grown.
Transparency: Consumers gain a better awareness of what they’re buying.
Food waste leads to lost calories, money, and energy. In 2010, the annual value of food wasted in Canadian hospitals was about $45 million. This was the result of either kitchen food waste, where food may be overproduced or prepared inefficiently, or patient food waste, where food is left uneaten and remains on the plate. Hospital kitchens can use simple methods of reducing waste such as freezing leftover bread or pureeing proteins into soup in order to maximize use of the ingredients purchased.
Reducing food waste is a sustainable action that also meets needs around enhancing patient health and satisfaction. Observing how much and what foods are left on the patient plate can empower care providers to identify signs of malnourishment and support food service managers in identifying recipes that need to be improved.
There is no doubt that making sustainable food choices can nourish both patients and the wider environment. Health care facilities which elect to prioritize sustainability in their kitchens will emerge as leaders in public health. As climate change continues to aggravate existing global problems such as food security, infectious diseases and extreme weather patterns, making sustainable food choices is part of the public responsibility of hospitals to reduce the impact of a warming climate. Moving forward, it is vital that we see healthy food as synonymous with sustainable food, for the health of the patient, population and planet.
Summer 2017 Nourish e-newsletter featuring stories from innovators on how healthcare can curate value through local and sustainable food supply chains.
Dan Munshaw writes about the environmental and community benefits of strategic procurement for the City of Thunder Bay and how he’s modelling ways in which public institutions can reclaim ownership and power in supply chains when they demand local food.
Innovator Shelly Crack with her colleague, traditional Haida knowledge keeper Jenny Cross, are exploring opportunities to work with local and traditional harvesters to serve more culturally nourishing foods to the patients in 2 island hospitals.
In Ontario, Travis Durham is partnering with a local beekeeper to set up beehives at the long-term care home where he is the Food & Nutrition Manager.
Four innovators from Quebec, Anne Gignac, Claire Potvin, Josée Lavoie and Annie Marquez, in collaboration with Nourish advisor Carole Saint-Pierre, share how healthcare institutions in Quebec are defining sustainability in food purchasing.
Local food matters. The easiest way to convince people of this is to let them see it, hear about it and, most importantly, taste it. That’s the idea behind our Local Food Expo, which is a part of Local Food Week (June 4-10, 2017) in Ontario. Local food champions came together to share their knowledge, passion and food with patients, visitors, staff and volunteers at Oakville Trafalgar Memorial Hospital on June 8th. At this event, 10 of our partners spent the day with us serving up everything from herb and cheese appetizers to strawberry-rhubarb pie and sharing recipes and information to help people choose local.
The Expo is just the most visible part of our love of local food. Behind the scenes, our Food Services team, led by Manager Marianne Katusin, works to bring food from ‘farm to bedside” and creates their own recipes that use local ingredients. The result is tasty and nutritious meals that help our patients heal, while we also get the most value from our financial resources.
But we’re not stopping there. With a $51,000 grant from the Greenbelt Foundation (as part of Ontario’s Local Food Investment Fund), we’re launching phase two of our Good for You, Locally Grown initiative. We will continue to craft delicious meals that heal and help patients identify local food choices so they can enjoy the benefits of local at home.
Missed the Food Expo in June? See you in October as we celebrate Ontario Agriculture Week!
Located west of Toronto, Halton Healthcare encompasses Georgetown, Milton District and Oakville Trafalgar Hospitals. Our almost 5,600 physicians, staff and volunteers serve the healthcare needs of half a million residents. Last year we served approximately 575,000 nutritious and delicious meals to our patients.
The Nourish cohort has identified five key topics for work and learning for a Spring 2017 webinar series. The webinars will be designed with and for the cohort innovators–healthcare foodservice and procurement professionals–but are open to the public to share the thinking, tools, and strategies from the program with a broader audience.