 Hospital food needs a revolution. I was surprised to find out that most inpatient meals served in hospitals are not required to meet any sort of national nutrition standards for a healthy diet. And indeed, analysis on the nutritional value of food served to patients and teaching hospitals found that many did not meet dietary recommendations. Warning! Read the headlines, Hospital Food Bad for Health. A registered dietitian wrote in to defend the hospital, saying, at least over half the hospitals met at least over half the guidelines, and, hey, they're so stringent anyway, little eggs and dairy, you can blow through your limits. The provocative conclusions of their analysis only lead the media and the public to conclude that we're a bunch of dunces who have no understanding of the relation between nutrition and disease prevention. Well, if the white coat fits… Look, we spend a fortune on training doctors. You'd think we could follow through on some of the simplest things like food. A good diet is as necessary to the recovery of health as anything else, and it's folly to pretend that it's beyond the power of our profession to change this, a line written 75 years ago, and still there's pushback. Or perhaps we should question whether a healthy diet, given to a helpless patient during a two- to ten-day hospital state benefits anyone or anything other than the dietitian sense of doing good, responded one doctor. Always bothered when patients are deprived of a desired morning egg because a healthy diet has been ordered. I mean, what's a few days of a little heart-unfriendly diet in the scheme of things? But it's the message we're sending, where the presence of foods in the hospital transcends a message to patients as to what's healthy and acceptable for them to eat, responded the researchers that did the hospital foods analysis. We still can think of no better place or opportunity to set an example of good nutrition than when patients are in hospitals. After all, public schools in California have banned the sale of soda for over a decade. Why not children's hospitals? In a study of California healthcare facilities serving children, three-quarters of foods and drinks wouldn't have been allowed in schools. We're talking soda, candy, having unhealthy items in healthcare facilities and seeing staff consume these products contradicts the hypercritical nutrition and health messages children may get from healthcare providers. On adult menus, nearly all meals contained excess salt with 100% of daily menus exceeding the American Heart Association's recommendation for staying under 1,500 milligrams of sodium a day. This means meals offered to patients may actually contribute to the exacerbation of the very conditions that may have led them to the hospitalization. But if hospitals stuck to the recommended limits of salt, the food wouldn't taste as good, responded an executive from the Salt Institute, to which the researchers replied, taste is good. We're talking about hospital food, right? It doesn't taste good, no matter how much salt you put on it. In the very least, we should prepare all meals low sodium, and then look, if they want to add salt, it's their choice, right? They want to get someone to wheel them out in the parking lot and smoke? That's their business, but we shouldn't be blowing cigarette smoke in people's rooms three times a day, whether they want it or not. Interestingly, studies suggest that when individuals are allowed to salt food to taste, they rarely add as much as often it becomes prepackaged within the food. Check it out. Switch people to low sodium diet. And sure, they use their salt shakers more, but overall, their salt intake dips way down. And the study subject said it tasted just as salty, right? Because salt added to the surface of foods makes it taste saltier. When a hospital meal comes to you pre-salted to the hilt, inpatients may not even have the option to consume healthier levels. In defense of their unhealthy food, one hospital food service provider explained that they're just giving people what they want. Are we really going to deny people who are going through difficult times any small comfort they can get? That's one of the reasons why this clinical director sends candy bars and ice cream to cancer patients. You know what else might help take the edge off? A nice long drag on a cigarette. Here you go, Timmy, try this. Hospitals used to sell cigarettes primarily for patient convenience. I don't think I could deny a paying patient the right to smoke a cigarette, said one administrator. I'll have to insist we have cigarette machines in the hospital as a service to the patient. But some made the radical suggestion that tobacco products should not be sold in the hospital. This wasn't from the 1950s, but from the 1980s. Yet the irony of hospitals allowing the sale of a major cause of preventable illness and death in this country had really been discussed in the medical literature. And especially ironic, the smoking was, of course, permitted in the doctor's lounges. To their credit, though, US hospitals underwent the first industry-wide ban on smoking in the workplace by the mid-90s. Well, now hospitals again have the opportunity to take the lead and create food environments that are consistent with their mission to cure the sick and to promote health. Though the simple act of serving food that meets national nutritional standards, our hospitals will act in the best health interests of their patients and their staff, and will undoubtedly, again, be leaders in our ongoing dialogue on how to improve the food supply, which in turn will improve the health of us all. You know, strict anti-smoking regulations were often criticized as being too harsh, as if disease and premature death brought on by smoking were any easier. Think my smoking diet parallel is hyperbole? Well, guess what? Today, the major cause of preventable illness and death in this country is no longer tobacco. The leading cause of death in America is now the American diet. Hospitals in the United States serve millions of patient meals each day and are optimally positioned to model a healthy diet.