Trump Administration Pushes Hospitals to Offer Healthier Food

HHS officials launched their “Make Hospital Food Healthier” Pledge campaign Wednesday, saying that the program will promote long-term wellness.

“Patients recovering from serious medical conditions deserve better than ultra-processed and deep-fried junk foods,” HHS Secretary Robert F. Kennedy Jr. said in a press release. “Today, we’re challenging hospitals across the country to lead by example by serving nutritious, minimally processed meals that help patients heal, reduce chronic disease, and help make America healthy again.”

Mehmet Oz, MD, MBA, administrator of the Centers for Medicare & Medicaid Services (CMS), noted that “when it comes to managing chronic disease, reducing comorbidities like obesity, and shortening recovery times, a healthy diet can make all the difference.”

“Hospitals should nourish patients with the same commitment they bring to every other aspect of care,” he added. “That’s why we’re challenging hospitals to limit ultra-processed foods, feature nutritious meals that promote healing, and lead the way in delivering prevention-first, whole-person care.”

The voluntary Make Hospital Food Healthier Pledge includes commitments to:

• Limit ultra-processed foods and sugar-sweetened beverages
• Use baked, broiled, roasted, stir-fried, or grilled cooking methods instead of deep frying
• Limit processed meats and foods high in added sugars, sodium, and artificial additives
• Emphasize whole grains over refined grains
• Prioritize minimally processed proteins, including plant-based options

Wednesday’s announcement follows a special alert that CMS sent hospitals at the end of March, reminding them that they are obligated to meet their patients’ nutritional needs and limit their serving of ultra-processed foods and sugary beverages to chronically ill patients.

“It makes no sense that 90% of pediatric wards in America, which are treating children with prediabetes and obesity, have full-sugar soda machines,” Calley Means, senior advisor to Kennedy, said at a press conference at the time. “[It] makes absolutely no sense that hospitals are serving sugary drinks and inflammatory processed food to their patients, 90% of whom are dealing with chronic conditions … This memorandum from CMS is saying hospitals treating patients with chronic diseases should not be serving sugary drinks, should not be serving refined carbohydrates, and should not be serving ultra-processed food.”

In January, the Trump administration released new dietary guidelines that emphasized consumption of fresh vegetables, whole grains, and dairy products, long advised as part of a healthy eating plan. But the new guidelines also take a new stance on “highly processed” foods and refined carbohydrates, urging consumers to avoid “packaged, prepared, ready-to-eat, or other foods that are salty or sweet, such as chips, cookies, and candy.”

Ultra-processed foods make up more than half of the calories in the U.S. diet and have been linked to chronic diseases such as diabetes and obesity.

The new guidance backed away from revoking longstanding advice to limit saturated fats, despite signals from Kennedy and then-FDA commissioner Marty Makary, MD, MPH, that the administration would push for more consumption of animal fats to end the “war” on saturated fats.

The American Hospital Association (AHA) is already on board with the idea behind the campaign, according to its President and CEO Rick Pollack. “The AHA supports the administration’s continued focus on meeting patients’ nutritional needs that promotes healing, recovery, and patient health,” he said in an email. “Hospitals across the country work closely with registered dieticians and clinical staff to provide patients with high-quality, nutritious meals that embrace the notion that ‘food is medicine.’ We are committed to helping hospitals — as clinically appropriate and feasible — ensure that patients have access to nourishing meals, including by sharing this voluntary pledge with the hospital field and encouraging them to review it and give it serious consideration.”

But the idea also has its critics. “In the rationale laid out in the [special alert], CMS cites prospective cohort studies that detail the association between self-reported dietary intakes in the general population and risk of chronic disease,” Kevin Klatt, PhD, RD, associate editor of the American Journal of Clinical Nutrition, wrote in an op-ed for MedPage Today. “This type of evidence can inform clinical nutrition guidance, but often is inappropriate for the unique nutritional considerations and goals of the inpatient setting.”

“The acute inpatient clinical nutrition setting can present with myriad clinical scenarios: stroke patients who struggle to swallow; chemo and radiation patients who exhibit nausea; and patients recovering from gastrointestinal surgery with high energy and protein requirements but limited digestive capacity and a need for low-residue (e.g., low-fiber) diets,” wrote Klatt, who is also an assistant professor of nutritional sciences at the University of Toronto. “These are just a handful of examples of patients who have altered nutritional requirements and unique barriers to intake.”

“As nutrition advocates, we should question whether this memo is really a nutrition ‘win’ and critically examine the (lack of) serious policies and proposals that this administration has for addressing our current food system, which promotes nutrition-related chronic disease,” Klatt concluded. “To the extent that hospital nutrition needs improvements, it is a symptom of the broader food environment that we’ve seen no plan for tackling from this administration.”

In an email to MedPage Today Wednesday, Klatt noted that some of the language in the pledge has “softened” compared with the special alert — for instance, rather than urging hospitals to “eliminate refined grains,” it now urges them to emphasize whole grains over refined grains. “This doesn’t change too much but I think the softening of tone is probably related to pushback,” he wrote.

On the other hand, “there is also still no clear split between the hospital food service/patient menu and the retail food environment present in many hospitals,” Klatt pointed out. “The pledge could have been much more effective if they encouraged hospitals to not sign contracts with companies for their retail food space who largely serve options that are predominantly misaligned” with the dietary guidelines.

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