90% of Patients Satisfied with NYC’s Plant-Based Hospital Meals Scheme

New York City’s Health + Hospitals scheme for plant-based meals has received overwhelming support from patients and led to reduced food costs and emissions.

Half of all patients in New York City’s public hospitals chose to eat vegan meals since Mayor Eric Adams’s ‘plant-based by default’ scheme was launched in 2022, and almost all of them were satisfied with the food.

Based on research proving the efficacy of plant-based diets and treating, preventing, and even reversing chronic diseases, the programme has served over 1.2 million vegan meals, from black bean burgers and orange cauliflower to sloppy does and Sicilian pizzas with non-dairy mozzarella.

Carried out in partnership with catering giant Sodexo, the scheme has received overwhelming support, with 90% of patients satisfied with their choice of eating plant-based, and just 5% requesting an alternative meal, according to a study published in the American Journal of Lifestyle Medicine.

“We put patient health first by putting plant-based meals first,” says co-author Samantha Morgenstern, a dietitian with Sodexo who worked on the scheme’s implementation. “We proved that when given the choice, patients opt for and prefer nutritious and delicious plant-based meals.”

How New York City’s hospitals promote plant-based meals

NYC Health + Hospitals began the development of the plant-based default programme for lunches in 2021, with the aim of making vegan food the preexisting option at all its 11 hospitals. Patients and their families are provided with nutrition information aimed at encouraging them to make healthier dietary choices both in the hospital and after discharge.

The programme now includes meals at dinners as well. And in addition to the 11 hospitals, vegan entrées have been rolled out in all five post-acute care facilities.

Building on the research the programme is based on, hospital staff are educated about the health benefits of vegan diets and nutrition, while all stakeholders – like administrators, nursing staff and patients – are kept engaged to ensure a common understanding of the scheme’s goals.

Meanwhile, the culinary team was trained in “fundamental techniques” of plant-based cooking and recipe design. Today, the menu comprises over 20 plant-based dishes from a variety of cuisines, and those have evolved over time.

For example, the Garden Bolognese was first made with soy crumbles, but the team has since replaced it with mushrooms as the high-protein ingredient to “reduce reliance on processed foods”.

Regardless of a patient’s therapeutic diet order, plant-based items are available and adjusted as needed. Foodservice associates visit the patient rooms and announce the featured meals every day, placing the meal orders on an iPad.

The first meal offered is the chef’s recommendation, and is always plant-based. If this isn’t accepted, patients are presented with an alternative vegan option. If that is also rejected, many other dishes are available to patients. “While the goal is to offer the most healthful meal first, patients are not restricted in their options,” the study notes.

Plant-based saves costs, both for the wallet and the planet

Last year alone, New York City’s public hospitals served over 780,000 vegan meals to patients. To nudge them towards choosing plant-based, NYC Health + Hospitals is employing several on-site promotion activities.

At admission, patients receive branded educational material with information about the meals, which contains a QR code for recipes and an FAQ section. On all hospital computers and TVs, screensavers include an appealing image of vegan food with text highlighting its health benefits.

Moreover, tray carts pushed through hospital halls are wrapped in imagery that promotes plant-based meals, and foodservice staffers wear pins that read: “Ask me about plant-based menus.” When being discharged, patients also receive a vegan recipe book collected from hospital staff submissions.

A resolution signed by 1,400 US mayors last year promoted a shift to plant-based diets across the country, taking inspiration from Adams’ hospital campaign (the New York City mayor himself follows a plant-forward diet). “Patients have experienced significant improvement in their cardiometabolic health, including weight loss, improved blood sugar, and reduction of other risk factors,” the document said of the city’s plant-based by default programme.

Apart from health, gains were also made in terms of finances and sustainability. The scheme led to a 36% reduction in carbon emissions from all meals served, with plant-based entrées nearly 60 cents cheaper on average. For instance, meat-based chili costs roughly $1.38 per serving, while a vegan version is priced at around 47 cents.

These cost savings come from the fact that the programme focuses on whole foods over meat analogues, which are 38% more expensive in the foodservice channel. Overall, the programme reduced food costs by $318,000 in 2023, and these savings are expected to improve.

“The proven success of New York City Health + Hospitals’ plant-based meals programs should inspire hospitals across the country to implement similar programs,” said co-author Anna Herby. “Hospitals that offer patients plant-based meals provide a teachable moment on how to prevent or reverse obesity, heart disease, type 2 diabetes, and other diet-related conditions that are so often the cause of hospitalisation.”

NYC Health + Hospitals is now also considering expanding the programme to patients not included in the initial rollout (like behavioural health patients). This would help cut emissions even further – food makes up a fifth of the city’s, which is why the local government is working to reduce emissions by a third by 2030.

Adams also launched the Plant-Powered Carbon Challenge earlier this year, with non-profit Greener by Default helping partners track emissions and share best practices on designing plant-forward menus. It has been taken up by Columbia University, The Rockefeller Foundation, catering giant Aramark, and the US Open, among others.