I read an article yesterday from the Ottawa Citizen, titled Hospitals battle ‘deep-fried hypocrisy’, push junk food out the door. The gist of the article describes the changes that are (slowly) being made to reduce the presence of fast food restaurants (Tim Hortons®, Burger King® etc) in hospitals, or at least change the offerings of these restaurants to healthier options. While this is a great idea (in theory), there are a few points to consider:
The Tim Hortons® near my hospital really makes my job challenging. Many of my clients are hooked on caffeine and sugar, therefore they frequent Tim Hortons® daily, or multiple times per day. The article in the Ottawa Citizen states “Hospitals in central Nova Scotia introduced a similar program about five years ago and Tim Hortons® now serve muffins, tea biscuits and trail mix cookies, instead of doughnuts, at hospitals there”. Ok.. but look at the nutritionals for a Tim Horton’s chocolate-dipped doughnut compared to a chocolate chip muffin (found on Tim Hortons® website):
- Doughnut: 190 calories, 6g fat, 10g sugar
- Muffin: 420 calories, 16g fat, 35g sugar
Yes, the doughnut is deep-fried, but you tell me what the better choice is. I would down a 190 calorie doughnut over a 420 calorie fat bomb muffin any day! I commend the hospitals for trying to encourage healthier choices at a fast food outlet, but they are missing the point between foods that are actually healthy, versus foods that are “health washed” (aka muffins, cookies with healthy-sounding names etc).
Are they even good for hospital business? Maybe not. A 2012 article published in the Windsor Star reports the Tim Hortons® kiosk in the Windsor Regional Hospital sets the hospital back about $265,000 per year. How? Labour costs. The Tim Hortons® franchise workers at this particular hospital are unionized (CAW) and they are paid DOUBLE what franchise workers in the community are paid. This is not the case for every hospital (many hospitals actually make quite a profit from these franchises), however it all depends on the collective agreement the hospital has with their union(s) in relation to contracting out work. So if the franchise is causing the hospital to bleed money, why not get rid of it? Well, the Windsor Star article reports there would be an “uproar from patients, staff and families” who purchase from the kiosk every day. Clearly a Tim Hortons® in and/or near a hospital is good business regardless.
So it looks like these types of establishments aren’t going anywhere. But how can we actually make it work out in the best interests of 1) customers and 2) healthcare workers who want these franchises to have their products align with healthy eating messages? Here are my ideas:
- Make the healthy choice the default choice. Marion Nestle said it best: “Plenty of research shows that although customers can request other options, most take the default. So the default is what counts”. So make some small changes here and there so customers almost always pick the healthier option (by default). For example: a “double double” is 2 creams, 2 sugars. By making the default “double double” 2 MILKS, 2 sugars, you automatically save 54 calories and 6g of fat with a medium coffee. For combo meals, make the default side a piece of fruit (instead of a cookie/doughnut), and the beverage a small.
- Portions are more important than “healthy-sounding” alternatives. As evidenced by my doughnut to muffin comparison, customers are often duped into purchasing health-washed foods, thinking they are making a better choice. So instead of continuing to promote these foods as “healthy”, what about reducing the portion size of gigantic muffins and bagels (both which have the carbohydrate equivalent to 4 slices of bread)? What about eliminating the largest sizes of the sugar-sweetened Iced Cappuccinos, fruit smoothies and frozen lemonades? All of these ideas sound great to a health professional, however it probably would spark customer outrage, who often look at “value for money”. A girl can dream though 🙂