Culinary Healing

By Carol Neshevich

Picture this: you’re in the hospital, recovering from surgery or perhaps trying to regain strength after a lengthy illness. The nurse brings you a plate of rubbery meat, a small portion of wilted vegetables and some tasteless mashed potatoes. Do you gobble it up with enthusiasm? Not likely. Historically, this has been the stereotypical meal that many imagine when they think of hospital food. But as Canada’s population ages, and we learn more about the role of nutrition in the healing process, healthcare institution food is slowly but surely evolving to meet the demands and requirements of today’s patients.

“You really need tasty food, food that patients will eat,” asserts Winnie Chiu, director of the Food Innovation & Research Studio at Toronto’s George Brown College. “Because if it’s not enticing, they just won’t eat it.” And if patients don’t eat, they simply won’t recover as quickly. “High-quality food can be an important part of healing,” says Chiu.

According to Peter Todd, business development manager at Brampton, Ont.-based apetito Canada (which primarily produces food for the healthcare and homecare markets), a food’s visual appearance and plate presentation go a long way toward stimulating appetite. “Plate presentation is something that we’re focusing on at apetito, so we can help [healthcare facilities] deliver something that is eye-catching to look at, but also tasty as well,” he says. “We develop a lot of puréed food for hospitals and long-term care,” explains Todd. “When you attempt to make your own purées for those on a specialized diet, there’s a definite risk that you won’t get the consistency that is safe for someone on that diet, either because it’s too thick, or too thin, or a combination of both, or because you’re using equipment that doesn’t actually allow you to remove all the particles, which can cause a choking hazard. So a lot of people will turn to our product range of purées because we have the right equipment and we are a federally inspected facility, which allows us to guarantee the safety of our product.”

On the taste side, it’s also becoming more evident that patients want the type of food they’re used to eating at home — and increasingly that includes ethnic fare, from Thai to Japanese to Indian. “Baby boomers are more demanding than any generation in the past and expect variety. They are also well travelled and like experimenting with different ethnic flavours. Senior living homes will be looking for multiple menu ideas to ensure more variety can be offered on their menu without necessarily increasing their inventory or product mix,” explains Denise Paul, a registered dietician and the director of Healthcare at Maple Leaf Foodservice. To help its healthcare clients with these evolving demands, “Maple Leaf Foodservice has developed the Menu MAXimizer recipe program, which teaches our clients how to use our products in a variety of delicious and innovative applications, as well as create culturally diverse menu options.”

The aging boomer generation is, in fact, part of what spurred Maple Leaf to increase its focus on the healthcare market about a decade ago “after a market assessment revealed the immense size of the market and its growth potential, driven by the exploding senior living market,” says Paul. When it comes to the needs of seniors’ homes, “seniors are living longer with chronic diseases such as diabetes, hypertension, heart disease and renal disease. In the past, long-term care homes simply focused on ensuring that the seniors ate a nutritious meal that followed Canada’s Food Guide. But with more and more seniors having special diet restrictions, homes are demanding products that are lower in sodium and contain more natural ingredients,” says Paul. Similarly, regular hospitals are also looking for foods that can easily satisfy specific dietary requirements. “Hospitals seek products with a very strict nutritional profile so that one product can be served across various diet types such as healthy heart, renal and diabetic diets. Our Healthy Selections line was designed specifically for hospital patient feeding. All nine products [in the line] are low in sodium, low in fat, high in protein and contain few to no allergens,” says Paul, noting that the most popular products in the line are the Grilled Chicken Thighs and the Sliced Roast Pork Loin.

According to Paul, the biggest “hot button” in healthcare food right now is sodium. “Maple Leaf has reduced the sodium in more than 30 foodservice products in the past five years to better meet the needs of the healthcare market,” she says. “Our goal is to reduce sodium as much as possible while ensuring that the product still tastes delicious and is produced safely [since salt is used as a food preservative]. As an example, we reduced the sodium in our Schneider’s Fully Cooked Pulled Pork by 58 per cent to only 212 mg per 60-g serving.”

Creating and delivering the ideal meal for a hospital patient or seniors’ home resident is easier said than done, however, as the task is complicated by very restrictive financial concerns. Budgets remain the most difficult challenge for those in charge of healthcare institution food. With an allotment of less than $8 per day per patient (which must cover breakfast, lunch, dinner and snacks) at most Canadian healthcare facilities, it certainly isn’t easy to ensure that meals fulfill all the nutritional requirements while also being tasty and enticing.

“As healthcare costs continuously rise, budgets at healthcare institutions are being pinched. This can present a challenge as nutrition and food budgets are often cut,” explains Alison McLean, vice-president, Nestlé Health Science (a wholly owned subsidiary of Nestlé, created in January 2011.) “This financial challenge reinforces the importance of working with healthcare providers to increase awareness of the therapeutic value of nutrition in improving patient outcomes. Therapeutic nutrition products must be prioritized into non-negotiable budget cuts, in order to provide the clinical nutrition therapy patients require.” Nestlé is taking a very scientific approach to its offerings in this area, as McLean explains: “A recent focus has been on the nutritional management of those assessed as being malnourished or at risk of malnutrition. This could include the use of food enhanced with protein or calories, oral nutritional supplements, or in a more severe state, tube feedings may be the preferred choice. Nestlé Health Science offers a variety of products to help with nutritional management for those with various medical conditions, including oral nutrition supplements like BOOST and Resource 2.0, and tube feeding solutions including Peptamen and Isosource.”

But while large companies like Nestlé and Maple Leaf now have a fairly solid foothold in the healthcare sector, and more specialized companies like apetito have also found their niche, is there a place for small- to medium-size food companies to break into today’s healthcare food market? Kevin Stemmler believes there can be. His company, Stemmler’s Meat & Cheese in Heidelberg, Ont., has been working on a pilot project to get its products into healthcare institutions for the past four years. Stemmler believes one of the great strengths of a smaller company like his is that it can offer good local food products to satisfy the increasing desire to serve local fare — a popular trend in all foodservice markets today, including healthcare. “Local food is really big right now; I can’t see that changing. Larger manufacturers don’t really have the same ability to provide that as we do,” he says. Stemmler also thinks his ability to offer more flexibility in the ordering process, in terms of both frequency and volume, could be a plus for some institutions.

Overall, “I don’t want to compete against the big guys, because we’ll lose,” admits Stemmler. “We want to complement them. I really think the fact that small- to medium-size companies like Stemmler Meats have some unique products, very different products, funky products — I think that’s where we’ll be able to offer some interesting menu items.” Stemmler is optimistic about his company’s emerging role as a healthcare food supplier, and he views it as an important role: “Part of healing is sitting down to a meal, talking about what’s gone on in your day — that’s what people really have to look forward to. So we have to give [healthcare patients] things that they really enjoy and want to have in their life, and that includes a good meal.”