Walking through the hospital atrium at the end of my shift, my attention was caught by a vending machine. I was surprised to see that it was filled not with chocolate and fizzy drinks, but exclusively with a range of healthier options including dried fruit and unsalted nuts. A few paces on, I spotted a sign for the weekly fresh produce stall – which sells fruit, vegetables, bread and local produce just inside the hospital main entrance. Of course, I also walked past food and drink outlets which displayed a high proportion of unhealthy food and drink options, but crucially there was choice.
A study which I was involved with in 2016-2017 found that all shops and cafes within 2 NHS hospitals prioritised display of unhealthy options and that neither hospital met NICE Guidelines relating to displaying nutritional information on menus (https://bmjopen.bmj.com/content/7/11/e018214) . Additionally, 63% of hospital vending machines exclusively displayed unhealthy options (https://bmjopen.bmj.com/content/7/11/e018214) . Hospitals and the health care professionals working within them are regarded as promotors of healthfulness and NHS venues are also an important setting in which to implement childhood obesity prevention strategies (https://www.nice.org.uk/guidance/qs94) , yet the consumer nutritional environment provided within hospitals has been shown to fall short of the standards expected of them (https://bmjopen.bmj.com/content/7/11/e018214). Furthermore, research has showed that providing healthy options does create a shift in purchasing behaviour towards healthier food and drink (https://www.gov.uk/government/publications/hospital-vending-machines-helping-people-make-healthier-choices ) – demonstrating that the demand is there for these items.
Nutritank have excelled in their mission to highlight the importance of improving teaching for medical students about nutrition and lifestyle medicine. In order to empower patients to make healthier food choices, we must in turn equip health care professionals -whom many patients will turn to for guidance relating to lifestyle changes – with the knowledge to advise patients. In addition, hospitals, must keep their eyes on their own plates by ensuring that they optimise the consumer nutritional environment for the health and wellbeing not only for patients, but for staff members, visitors, medical students and other trainees. The Nutritank community and other lifestyle medicine advocates have a role in highlighting examples of good practice as well as holding to account hospitals who fail to get the balance right.