Patients at MaineGeneral Medical Center in Augusta can recuperate with a freshly squeezed green juice for breakfast and later order a pizza with vegetarian sausage. The hospital’s menu for patients also includes steel-cut oats, vegan veggie burgers, a Super Antioxidant Salad, and a hummus and vegetable wrap.

Since moving into its new campus in 2013, MaineGeneral has added more fruit, vegetables and plant-based meals to the patient menu. The hospital has also removed ham from the menu and reduced its offerings of sugar-sweetened beverages, resulting in soda being yanked from the cafeteria and offered in a smaller size on the patient menu.

“In the cafeteria every day we have a vegetarian option,” said Shelley Goraj, food and nutrition director at MaineGeneral. “Some days it is vegan and some days it is not. On the deli line we’ve added hummus. On the salad bar, there’s a lot of bean dishes and grains such as kamut and quinoa.”

Hospitals across Maine have worked in recent years to better align their menus with their health-care missions, with some institutions like MaineGeneral ahead of the pack.

Such efforts got a significant nudge this summer when the American Medical Association, the largest physician organization in the country, adopted a resolution calling on hospitals to do three things: add plant-based meals to their menus, get rid of processed meats, and re-stock beverage coolers with more healthful drinks. The move by the AMA follows years of clinical studies linking diets high in animal products and sugar with chronic ailments, such as heart disease, stroke, cancer, obesity and diabetes.

In recent years, other doctors groups, ranging from the American College of Cardiology to the Physicians Committee for Responsible Medicine, have called upon hospitals to add plant-based meals and eliminate processed meats. These policy directives aren’t meant to cater to vegetarians and vegans, but to increase the overall nutrition of the menu by getting everyone to eat more plant-based food and less meat.

“It’s really exciting that there are resolutions coming out and more and more people are recognizing how important nutritious food is,” said Shelia Costello, nutrition services director at Waldo County General Hospital.

The Belfast hospital started making changes to its patient and cafeteria menus after Costello was hired five years ago. One of the first things she did was sign on to MaineHealth’s Hospital Healthy Food Initiative, which was launched in 2012.

While the initiative doesn’t call for adding plant-based meals or removing processed meats, it does focus on a long list of related concerns. Among its policy goals: reduce sodium and saturated fat; increase fruits and vegetables; remove deep fat fryers; add whole grains; and downplay soda. In an indirect way, these goals have resulted in changes to the meat served in some Maine hospitals.

“We know that processed meat is incredibly high in sodium,” said Emily Kain, MaineHealth wellness program manager who oversees the initiative. “We had a grant around sodium reduction, and processed meat was certainly a focus on that grant and finding ways to reduce it by making your own or replacing it with low sodium (meat brands).”

Waldo County is among a handful of hospitals that have gone beyond the baby step of replacing processed meat with slightly improved options and have instead begun to remove it from the menu altogether.

In the years since joining the effort, the Belfast hospital has nixed ham, bacon and sausage from its menus. Plant-based meals have been added to the patient menu (including a split pea soup, a pasta primavera and a hummus plate), and soda was axed.

Soda is also gone from the Waldo County General Hospital cafeteria, and more vegan meals are being served and eaten there too. Costello said roasted vegetables are particularly popular with hospital staff, as was a recent grab-and-go salad called the Super Vegan Salad that sold out swiftly.

The pace of change is slower at Southern Maine Health Care in Biddeford, but still visible. Soda is off the patient menu and relegated to the lower shelves in the cafeteria. Hot dogs are gone from the cafeteria, but other processed meats remain there and on the patient menu. The cafeteria offers vegetarian and some vegan dishes, while its salad bar features an expanded selection of plant-based proteins and whole grains. However, the patient menu offers no all plant-based entrees, since even the veggie burger is made with cheese.

Mike Sabo, hospitality director for Southern Maine Health Care, said while hospitals “need to model the proper diet,” the patient population must be considered. “We’re an acute care hospital,” he said, “and our folks here are very ill. Our primary concern is we need to get calories into them.”

At Maine Medical Center in Portland, where the menu is also evolving slowly, nutrition and food service director Kevin O’Connor echoed Sabo’s sentiment: “Our overarching goal is to nourish the patients,” he said.

The Maine Med patient menu was updated this November yet sausage, bacon, deli meats and even hot dogs remain. On the other hand, patients can order hummus and tabouli, rice and beans, and rotini with marinara sauce.

Like Southern Maine Health Care, the Maine Med veggie burger is made with cheese. But the Maine Medical Center menu surprises with soy milk and a vegan apple crisp. Soda is gone from the Maine Med patient menu, and moved to a less prominent spot in the cafeteria. As a result, soda sales have slumped and sales of bottled water and unsweetened seltzer have risen. O’Connor said an expanded salad bar also boosted sales, while admitting that the patient menu has been more difficult to change than the cafeteria offerings because of the “wide variety of patient diets and cultural differences we try to accommodate.”

Dr. Jeffrey Rosenblatt, a cardiologist who attends patients at Maine Medical Center, has long advocated for more plant-based choices on the patient menu. He is encouraged by the steps the hospital is taking, and hopes to soon vault the state’s largest hospital to the head of the pack in terms of cutting-edge patient menus. Rosenblatt and a group of cardiologists are in talks with Maine Medical Center’s administration to create a wellness program that adds new vegan dishes to the hospital’s patient menu and features a prescription for plant-based meals.

Doctors at the University of Toronto and the 39 hospitals in the Kaiser Permanente health network are among those already writing such plant-based prescriptions.

At the same time, Rosenblatt said the hospital should follow the lead of other Maine hospitals and eliminate all processed meats and sweetened beverages.

“Empty calories, red meat, processed food, sweetened fruits, dairy, highly processed breads and buns and other simple carbohydrates are of near zero nutritional value and in fact have all been scientifically proven to be a major cause of cardiovascular disease, including stroke and heart attack as well as diabetes and a slew of other common medical problems,” Rosenblatt emailed me from Qatar, where he is deployed as a flight surgeon with the Maine Air National Guard.

“Let’s not lose a precious opportunity to have an impact on our patients when we care for them and they are most open to change,” he wrote, referring to the postoperative period when patients are eating from the hospital menu.

“I now often joke with my colleagues that the patient is in need of an acute, aggressive intervention,” Rosenblatt wrote. “They start to get all excited and activate the cath lab to put in a stent. I calm them down and continue, ‘No, I’m talking about an acute aggressive dietary intervention.’ ”

In other words, eat two veggie burgers and call me in the morning. If the American Medical Association and doctors like Rosenblatt get their way, this will no longer be a joke but a standard treatment in Maine hospitals.

Avery Yale Kamila is a food writer who lives in Portland. She can be reached at:

avery.kamila@gmail.com

Twitter: AveryYaleKamila

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