Burgers for the Health Professional
By MARC SANTORA
Published: October 26, 2004
Under the smiling clown-face of Ronald McDonald, a woman and her 5-year-old daughter had spread before them a burger, Chicken McNuggets and fries. Nearby, a young couple were enjoying two Quarter Pounders with cheese. A neurologist was downing some hot cakes.
Just a few of the billions served, as the company proudly proclaims beneath its golden arches.
What made the scene unusual was where these arches were located - at Elmhurst Hospital Center in Queens, one of the city's busiest places of healing.
As obesity and its consequences are increasingly taxing the health care system, the fact that a fast food place serves as a hospital's cafeteria strikes some as jarring. But Elmhurst Hospital is not alone. There are two other city-run hospitals with fast food outlets, Jacobi Medical Center and Coney Island Hospital. And in public and private hospitals across the country, fast food is not an uncommon sight, even at some of nation's premier institutions, like the Children's Hospital of Philadelphia.
It's hard to find a doctor who says that a steady diet of burgers and fries is healthy. But hospitals with fast food outlets say that these franchises were a good option - in some cases the only one - for their food services.
Saint Barnabas Medical Center in Livingston, N.J., opened its doors to McDonald's a decade ago. Robin Lally, a spokeswoman for Saint Barnabas, said the hospital still has a McDonald's, as well as another cafeteria offering a wider variety of healthier food selections. McDonald's filled a need for round-the-clock meals, she said.
While financial considerations were part of the equation (though hospitals would not say how much they earned from franchise contracts), Miriam Pappo, a registered dietitian and the clinical nutrition manager at Montefiore Medical Center in the Bronx, said a 10-year-old study in a New Jersey hospital found that children in pediatric units who ate a McDonald's meal once a week ate better the rest of the time than children who did not eat at McDonald's.
"When you are scared in the hospital you want something that brings back fun memories," she said. "This is where this started."
Ken Barun, a senior vice president of McDonald's, cited the company's experience at Texas Children's Hospital in Houston, where McDonald's has had a restaurant for 17 years.
"The doctors liked McDonald's because they could get something fast, and they said, 'Our sick kids will eat this food,' " Mr. Barun said. "Happy Meals provide kids with the nutrients they need," he said. "From the emotional side, it really does help them get better."
Menus at McDonald's include healthy items like salads, Mr. Barun says, and the company is always willing to make adjustments at hospitals, like offering soup on the side instead of fries. He also said the company gives generously to charities that benefit hospitals and, through the Ronald McDonald House program, provides 6,000 beds around the world every night for families with members staying in hospitals.
Kate McGrath, spokeswoman for the New York City Health and Hospital Corporation, which oversees Elmhurst, said that McDonald's was one of the few companies that bid for the right to run food service at the hospital, and that McDonald's has a "Made for You" option that enables customers to reduce the calories, fat or sodium of menu items. For example, omitting the mayonnaise on the Chicken McGrill sandwich eliminates 100 calories and reduces the fat content to 6 grams.
Nonetheless, Ms. McGrath said, when the McDonald's contract at Elmhurst is up in 2007, it will not be renewed. (She said that Jacobi and Coney Island hospitals, which are also run by the Health and Hospital Corporation, have not yet decided what they will do when their McDonald's contracts expire.)
Dietary concerns have changed in the years since fast food restaurants first appeared in hospitals in the metropolitan area.
From movies like "Super Size Me" to books like "Fast Food Nation" to a flood of studies showing the impact of obesity on countless things, from sperm counts to the cost of health care, the questions and issues surrounding fat are unavoidable.
The obesity rate among adults in New York State doubled between 1990 and 2002, according to the Centers for Disease Control and Prevention, whose data showed that about 57 percent of New Yorkers are overweight or obese.
As obesity has reached epidemic proportions in recent years, Ms. Pappo of Montefiore said, hospitals have begun to rethink the food they serve. Montefiore decided years ago to stay away from fast food establishments in favor of providing its own healthier choices.
"It's probably very similar to how schools would get revenue from Coca-Cola and they are now saying we are going to have to do without this because we have to send a good message," Ms. Pappo said.
For its part, McDonald's consistently says that its food is not unhealthy and that a host of other factors contribute to the widening of the American waistline - not the least of which is a lack of exercise.
"Fast food is not necessarily bad food," said Dr. Cathy Kapica, the global director of nutrition for McDonald's.
McDonald's restaurants make up only 2 percent of all the eating establishments in the United States, she said, so other dietary choices must be fueling America's weight problem. Most of the people grabbing a bite at the Elmhurst McDonald's said they thought the food they were eating was not very healthy.
"I know it is not good, but I like it," said Sandra Campbell, 26. She came to the hospital with her mother, who had an appointment. Ms. Campbell said she eats fast food nearly every day.
"I have my baby, and I work five days a week, and I have no money to make food," she said. "After I had the baby, I got fat. This doesn't help at all."
Bienviendo Medreno, 38, a social worker at the hospital, sat with his aunt and cousin as they ate. He abstained, saying he was not happy that McDonald's was the only food available where he works.
"I'm very against it, to be honest with you," he said.
A neurologist, who was sitting nearby disagreed.
"I am a surgeon, and the food we have here is the food I like," he said, while acknowledging that obesity is a significant health problem.
"It's not the fault of McDonald's,'' he said. "It's the fault of the people eating too much."
When asked his name, however, he would not give it, saying it would be embarrassing to be the brain surgeon in favor of fast food.