The Importance of Dietary Services in a Hospital; Can We Integrate Whole-food Plant-based Dietary Services in Hospitals as a New Standard of Care?

Diet services play a crucial role in hospital management system. Diet and hospital food supply is related with recovery, rehabilitation and overall well-being of a patient. The government of India has launched “Ayushman Bharat” scheme under which wellness part of health is given utmost importance at all health and wellness centers of the country. Diet is a part of holistic care which has preventive and promotive aspects along with therapeutic benefits.[1] Hospitals deal with sick people as it involves complex issues in relation of providing diet which has to be nutritious, tasty, and hygienic to a population whose appetite may not be optimal and require special restricted diet. Thus, it is a great challenging issue not only for the caregivers but also for the hospital management. The current issue of the Journal of Integrated Health Sciences deals with a cross-sectional study on patient satisfaction in relation to dietary services in one of the tertiary care hospital of the Malwa region of Punjab.[2] High level of satisfaction is one of the aims of every hospital establishment as they would be ambassadors of reputations of any hospital. Hospital food should not only be a specialized diet designed by team of doctors and clinical nutritionists but should also be served to patients timely with compassion, serenity, and love. The feedback received from the patients as obtained in this cross-sectional study is of great importance and it is recommended to be a part of hospital audit at all healthcare establishments. The palatable food for various patients with different ailments and disease conditions is difficult to list down. Vegetable soups, fruit juices, raw fruits like banana, apple, tofu paneer, spinach sabji, green smoothie, sandwiches, and dairy made products like tea coffee are commonly served in hospitals. “Whole food plant based (WFPB)” improves healing process and improves resilience as well as immunity.[3] After COVID-19, evidence have mounted in favor of “WFPB” as one of the ways of healthy lifestyle.[3,4] The WHO has included fruits, vegetables, legumes (e.g., lentils and beans), nuts, and whole grains as one of the healthy diet options.[5] This is one such diet plan which can be suitable to all patients having communicable as well as noncommunicable diseases. It includes infective disorders, diabetes, obesity, ischemic heart disease, malignancy as well as pre- and postoperative patients. There are several evidence of its beneficial effect and there are several hospitals worldwide which incorporates WFPB diet in their daily patient dietary services.[6–10] New York City Health + Hospitals, the largest public healthcare system in the U. S., has implemented a WFPB diet system across all of its public hospitals [Table 1].[7]Table 1: Hospitals which incorporates “Whole food, plant based” diet in their dietary services[ 6–10 ]Loma Linda University of Health has included an innovative diet plan which has a therapeutic menu development initiative, offering WFPB dining choices to certain inpatients. This innovative therapeutic menu included items like whole grain sandwiches having tomatoes, bean chilli, roasted sweet potatoes, chickpeas with cashew cream sauce. It also included combination of oats, chia seeds, farro, spinach, and tofu scramble.[8] University of Florida’s Academic Hospital has introduced a fully WFPB menu for its inpatient population, making it one of the first to make this institutional change.[9] Hayek Hospital, Lebanon is the world’s first hospital to implement a fully plant based, vegan menu. The hospital transitioned to a 100% plant-based menu on March 1, 2021, replacing all animal-based food with plant-based alternatives. This move was not just about dietary changes; it was a statement about ethical and health concerns, aligning with the principles of a WFPB diet.[10] As the healthcare industry continues to evolve, it is imperative that hospitals prioritize evidence-based nutrition to promote patient well-being. WFPB dietary services offer a promising solution, focusing on minimally processed plant foods to prevent and manage chronic diseases. Research demonstrates that WFPB diets can reduce inflammation, improve cardiovascular health, and even reverse certain disease processes.[11,12] One such example of beneficiary of WFPB diet was Mayor of New York city who reversed his diabetes by switching his diet to WFPB diet.[13] By incorporating WFPB options into hospital menus, patients can benefit by reduced risk of chronic diseases, improved nutritional outcomes, enhanced recovery rates, and increased patient satisfaction.[14] Implementing WFPB dietary services requires a multidisciplinary approach, involving culinary staff, dieticians, and healthcare providers including doctors. Hospitals can start by: offering plant-based meal options, providing nutrition education and counseling, and collaborating with registered dietitians to develop WFPB menu. By adopting WFPB dietary services, hospitals can demonstrate a commitment to patient-centered care, improve health outcomes, and set a new standard for nutrition in healthcare. It is time for hospitals to harness the power of plant-based nutrition to transform patient care and promote a culture of wellness. Dhiraj Hospital (teaching hospital to SBKS Medical College), Sumandeep Vidyapeeth, is transitioning toward WFPB meals for its patients. Being run by a Jain charitable trust, the food served is already vegetarian. Hence, the main challenge was replacing dairy products and avoiding or minimizing oil. At first, we started with replacing paneer with tofu. At first, we started with replacing paneer with tofu which was tested by doctors as well as hospital staff, and most of them could not make out the difference. Second was replacing curd with soya curd. The most important barrier was availability in the market and its transportation which added to the cost. Finally, we still have to experiment replacing dairy milk with soy milk for tea, milk, and coffee served to patients. I am sure after the initial teething problems we shall be able to do that as well. Retraining our chefs for making oil-free dals and vegetable curries through food demonstrations is an ongoing process. The other welcome addition was introducing delicious healthy green smoothies (which has ingredients pulpy seasonal fruits such as banana, apple, pineapple, mango, and guava; green leafy vegetables such as spinach, mint, and coriander, and omega 3 sources such as flax seeds or chia seeds) and different salads (millets and pulses along with vegetables) at the hospital cafe. This ensured the intake of raw greens and salads, which replace sugar-sweetened beverages and packets of ultra-processed chips or other unhealthy junk food. Although the sales are not that great, the authorities are encouraging to start healthy alternatives that are tasty and affordable. We strongly believe that a hospital is a place for reclaiming your/one’s health and this health center should be promoting WFPB meals, snacks, and drinks. It should be the torchbearer of health which should loudly promote healthy food choices and provide those to patients to arrest this fast-growing pandemic of chronic diseases. In conclusion, we wish that hospitals should adopt “Whole Food, Plant based” dietary system as a new paradigm or standard of care. Health managers and administrators should do advocacy in this regard. Idea of writing this article is to emphasize the philosophy of Hippocrates as considering “food as medicine.” Doctors in charge of patients may be more confident about drug prescription rather than the prescription of diet and nutrition.[15] This should change and importance to diet and nutrition with wellness of patients should be given due sincere thoughts. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.