Serving sustainable food to patients at Seattle Children’s

What do you think of when someone says, “hospital food” — green Jell-O anyone?

You probably don't think of create-your-own omelets, barbecued chicken salads, street tacos or hand-tossed pizzas.

Hospital food has traditionally gotten a bad rap - and for many years it was deserved.

When Gina Sadowski, director of Nutrition, Culinary and Retail, started at Seattle Children's more than 15 years ago, the food options in the hospital industry left something to be desired.

"Hospitals had very basic menus, heavily reliant on processed and convenience foods," she said. "It was literally open a box, heat, serve."

Since then, it has been Sadowski's goal to change that at Seattle Children's.

Making the transition

From the start, Sadowski knew that quality food was essential to the successful recovery and health of our patients.

Initially, our main goal was the reduction of sodium. Because we were reliant on processed foods at the time, our biggest focus was bringing down the sodium on the patient menu and aligning it more closely with the daily recommended intake."

Gina Sadowski, director of Nutrition, Culinary and Retail, Seattle Children's

After successfully "desalinating" the patient menu, the team started looking at other ways to improve nutrition, which included getting rid of deep-fat fryers and removing sugar-sweetened beverages throughout the hospital.

"The opportunity to completely reinvent the menu really came with the design of a new kitchen on the hospital campus," Sadowski said. "Thanks to hospital support and the right staff, we were able to pull it off. Now, nearly everything on our patient and family room service menu is made from scratch. The food is restaurant quality."

As the healthy food initiative within Seattle Children's grows, so does the hospital's impact on the greater community.

"Hospitals are huge purchasers of food, and a large portion of that is animal protein," said Dr. Scott Weissman, an infectious disease physician at Seattle Children's. "The healthcare sector -; as a purchaser of food -; has a lot of influence in the marketplace to demand a different kind of product."

That's why, in recent years, Weissman and his colleagues have collaborated with Health Care Without Harm, an organization working to transform the environmental footprint of healthcare organizations.

"People who care about antibiotic overuse and antibiotic resistance have an incredibly powerful role to play," Weissman said. "Healthcare institutions as purchasers, presenters and vendors of food can provide that food with a message."

Gobble, gobble

During the past holiday season, Seattle Children's served meals that included free-range turkey raised without antibiotics.

While it's nice to think about turkeys enjoying their lives, pecking at seeds on the open range, there's a lot more that goes in to the decision of where to source the poultry, meat and fish served.
One way to think about sustainable nutrition is food products produced in a way that promotes well-being without harming the environment, humans or animals.

Sadowski's team -; including Chef Ryan Garcia and Michael Shelton, nutrition buyer supervisor -; look for local, sustainable sources of food, as well as antibiotic-free meat and poultry. They regularly collaborate with Colleen Groll, manager of Seattle Children's Sustainability Programs, to ensure the products actually meet the guidelines for sustainability.

According to the Centers for Disease Control and Prevention (CDC), more than 2.8 million people become infected with antibiotic-resistant bacteria each year; approximately 35,000 of them die from the infection.

For the last decade, there's been a growing awareness about the overuse of antibiotics in healthcare. What many people may not realize is the kind of meat, poultry and seafood you choose can also impact antibiotic resistance.

The concern is not that those antibiotics are in the meat. According to Weissman, regulations require a "wash-out period" where antibiotics cannot be used in the feed during the weeks before the animals are culled.

The problem is the enormous amount of run-off and waste generated from the meat production process. This waste can contaminate the ground and the groundwater, and sometimes it's collected and used as fertilizer on crops.

"When antibiotics are routinely used in raising the animals -; on that kind of an industrial scale -; it leads to environmental distribution of antibiotics," Weissman said. "When we talk about antibiotics in food, it's really antibiotics in the production of food. There are a number of sizeable impacts we don't fully understand."

Another concern is that antibiotic-resistant bacteria can remain in the meat of animals that were routinely fed antibiotics. These bacteria can then contaminate the meat during the culling process and become part of the final packaged product.

Neither Weissman nor the CDC are saying that we need to cease all use of antibiotics.

"No one wants to see a sick animal suffer or go untreated," Weissman said. "This is about routine use of antibiotics in feed that allows farmers to create industrial density. This is not good for the quality of life for the animals, and in turn may not be good for the quality of the meat that is produced."

Sustainability at Seattle Children's

Last year, Seattle Children's signed the Cool Food Pledge, agreeing to "provide delicious food that is better for the planet" and committing to help reduce the greenhouse gas emissions associated with the food we provide.

"We don't want to be the food police," Sadowski said, "but we do want to be advocates for children's health and good role models."

And like all areas of Seattle Children's, the Nutrition team wants to be inclusive. A lot of an individual's "food culture" comes from how they eat with their family at home, so diversity on the hospital's menus means patients, families and workforce members can choose food that is right for them.

"As Bill Taylor, our manager of Retail Operations says: 'Everyone's welcome at our table,'" Sadowski said. "We really do have something for everyone."