Much of the food served in California’s children’s hospitals is unhealthy and some of about the same or worse than fast food, according to a study.

Researchers from UCLA and the RAND Corporation studied how healthy the food was at children’s hospitals.

But when the researchers assessed 14 food venues at the state's 12 major children's hospitals, they found that there was “a lot of room for improvement in their offerings and practices.”

"As health professionals, we understand the connection between healthy eating and good health, and our hospitals should be role models in this regard," said Dr. Lenard Lesser, primary investigator and a physician in the Robert Wood Johnson Foundation Clinical Scholars Program in the Department of Family Medicine, David Geffen School of Medicine at UCLA.

"Unfortunately, the food in many hospitals is no better – and in some cases worse – than what you would find in a fast food restaurant,” he said.

Developing a modified version of the Nutrition Environment Measures Scale for Restaurants (NEMS-R) and using it as an assessment tool for rating the food offerings in hospital cafeterias, researchers found that only 7 percent of the total entrees were classified as healthy.

They took pricing, availability of vegetables, nutrition labeling, combo promotions, and healthy beverages into account and came to the conclusion that improvements were needed to help patients maintain a healthy diet.

Out of a range from 0-37, 0 being the least healthy and 37 being the healthiest, the overall average score for the 14 hospital food venues was 19.1.

According to the NEMS criteria only 7 percent of the total 359 entrees that hospitals served were healthy meals.

Nearly all the hospitals offered a healthy alternative such as fruits. However less than one-third had nutrition information at the point of sale or signs to promote healthy eating.

The researchers outlined the key findings.

  • All 16 food venues offered low-fat or skim milk and diet soda
  • 81 percent offered high-calorie, high-sugar items such as cookies and ice cream near the cash register.
  • 25 percent sold whole wheat bread.
  • Half the hospitals did not provide any indication that they carried healthy entrees.
  • 44 percent did not have low calorie salad dressings.

Researchers provided hospital administrators with their scores to encourage them to improve their choice of foods.

Since the start of the study, in July 2010, some of the surveyed hospitals have taken steps to improve and/or reduce unhealthy offerings, by eliminating fried food, lowering the price of salads, and increasing the price of sugary beverages or eliminating them altogether.

"The steps some hospitals are already taking to improve nutrition and reduce junk food are encouraging," Lesser said.

"We plan to make this nutritional quality measurement tool available to hospitals around the country to help them assess and improve their food offerings."

The researchers advise that hospitals improve the health of their food offerings by providing more fruits, vegetables, whole grains and smaller portions.

They said hospitals can “shrink the amount of low-nutrient choices, and utilize low-cost options to promote healthy eating such as signage and keeping unhealthy impulse items away from the checkout stand.”

"If we can't improve the food environment in our hospitals, how do we expect to improve the health of food in our community?" Lesser said.

"By serving as role models for healthy eating, we can make a small step toward helping children prevent the onset of dietary-related chronic diseases."