Nourishing Patients and the Planet: The Role of Hospital Food Service in Climate Leadership

Food-Climate Leaders at the University of Washington Medical Center.

In honor of Earth Day, Health Care Without Harm wants to celebrate healthcare food leaders, and the impact that they are having beyond hospital cafeterias.

Food is the best medicine. It’s why foodservice professionals work tirelessly to ensure their facilities purchase the freshest food to serve patients, staff, and visitors. They have even broadened the scope of “healthy” food, taking into consideration where it comes from, and how it’s grown or raised. They strive to provide the people who eat at their facilities with organic, local and sustainable products. In the work that they’re doing every day to make food healthier, they’re also helping to lead the charge against climate change, the greatest public health threat — -and opportunity — of the 21st century.

University of Washington Medical Center Chef preparing locally-sourced food.

When considering what it means to grow and produce sustainable food, climate change may not be the first thing that comes to mind. Yet industrial agriculture is one of the biggest contributors of carbon emissions. The Intergovernmental Panel on Climate Change estimates that agriculture and associated land use changes are responsible for 24% of global emissions — greater than emissions from industry and greater than the combined emissions of transportation and buildings.

If food procurement remains entangled in industrial agriculture, this is in direct contradiction to health care’s healing mission. The healthcare sector can use its annual buying power of $12 billion (in the United States alone) to reduce the climate impact from agriculture by purchasing and serving foods that are protective of the climate.


Food Leaders are De Facto Climate Leaders

Hundreds of hospitals across the United States are changing their purchasing practices to take into account these critical issues — having completely transformed their food services or starting to take steps along that trajectory.

Serving over three million customers per year combined on opposite coasts, the University of Washington Medical Center (UWMC) and the University of Vermont Medical Center (UVM) purchase, produce and serve an enormous amount of food — and as a result have a significant environmental impact. That impact is a positive one thanks to decisive ecologically-informed interventions throughout their food service such as meat and food waste reductions, and local and sustainable food purchasing practices. These two facilities demonstrate how foodservice work can lead to reduced greenhouse gas (GHG) emissions — a definitive step towards reducing a facility’s footprint and mitigating climate change.

Less Meat, Less Emissions

Data from the Environmental Working Group

Reducing the amount of meat and cheese that is served is one of the most powerful measures foodservice departments can take to reduce climate impact. Livestock production contributes 18% of the world’s GHG emissions. Beef and cheese have the highest climate impact of all foods because cows consume more feed, and their digestive system produces more methane (a GHG 72 times more powerful than Carbon Dioxide [CO2]) than other livestock. Eliminating meat for one day per week, for example, could reduce emissions by an estimated 1.0 Gt. to 1.3 Gt. per year, the equivalent to taking 273 million cars off the road.

Learn More

The University of Vermont Medical Center has worked hard to balance its menus, reducing the amounts and portions sizes of red meats and poultry and enriching its plates with ample portions of fruits, vegetables, legumes and whole grains. Protein portions are now 1–2 oz. lighter and are often the least prominent ingredient in a meal. The majority of meals do not include beef at all.

The University of Washington Medical Center has used several strategies to reduce the amount of meat they serve including hosting Meatless Mondays, increasing vegetarian options, decreasing meat portion sizes, and focusing more on vegetables and other forms of protein such as fish and beans. The facility’s efforts to reduce the amount of meat purchased and served have led to a reduction in overall GHG emissions of 11.8%. That is the equivalent amount of GHG produced by 211 cars.

“Eating a more plant-based diet not only decreases risk of several chronic diseases such as heart disease, obesity, and certain cancers, but also significantly reduces our carbon footprint.” — Charlotte Furman, Technology and Wellness Manager at the University of Washington Medical Center

Wasted Food is Wasted Greenhouse Gas Savings

Preventing food waste and diverting unused food from landfills is another powerful way to reduce climate impact. Globally, about 30% of food is wasted.

“If all the world’s food losses and waste…were represented as a country, it would be the third highest GHG emitter, after China and the U.S.” -Johns Hopkins Center for a Livable Future

When food is discarded, the waste embodies all the associated emissions from its production, and when decomposing in landfills, generates significant quantities of methane. Halving global wasted food by 2050 could reduce emissions by an estimated 4.5 Gt.

Engaging employees in food waste reduction at the University of Vermont Medical Center.

The University of Vermont Medical Center has been a compost champion since 1985, composting all food scraps. One of the hospital’s cafes is near to achieving the goal of zero waste — 90% of all waste is composted or recycled. In general the hospital has adapted the Environmental Protection Agency’s (EPA) Food Recovery Hierarchy to guide decision making around food waste protocol.

Learn more: https://www.epa.gov/sustainable-management-food

In addition to traditional approaches to ameliorating food waste such as composting, both facilities have have employed creative solutions that take into account all aspects of food use. Instead of set patient meal times, the hospitals allow patients to order the food they want on demand through their room service programs. In 2006, when UVM switched to this room service model, it saw an immediate 20% reduction in food waste.

At the University of Washington Medical Center, patients and cafeteria patrons alike have the option of half-sized portions. The facility consolidates ingredients through patient and retail operations to decrease spoilage. The composting program at UWMC is extensive and includes all pre- and post-consumer waste including plates and flatware, and cooking oil. The hospital estimates it is able to divert 12–15 tons of waste per month from landfills. From 2013–2014, nearly 200 tons of food waste was composted. That equates to about 30.23 metric tons per month of avoided GHG emissions or 78 less cars.


Sustainable Food Strategies for Climate Leadership

Fewer transport miles leads to fewer emissions. According to the Worldwatch Institute, in the United States, food travels an average of 1,500 miles from where it was grown to the plate and overall, transport accounts for about 11% of the food system’s emissions. Other factors contribute to the climate impact of long-distance food including distribution, storage and processing. A study of food miles in Canada estimated that replacing imported food with equivalent items locally grown in the Waterloo, Ontario region would save transport-related emissions equivalent to nearly 50,000 metric tons of CO2, or the equivalent of taking 16,191 cars off the road.

Data from the U.S. Energy Information Association

Preferential purchasing of organic and sustainably produced products results in additional GHG savings. The manufacture and use of nitrogen fertilizers is the second highest source of GHG from food production. Nitrous oxide (N2O), the resulting emission, is a GHG with 300 times the warming potential of CO2. Agriculture is responsible for 60% of global N2O emissions. Health care facilities can reduce their climate impact by purchasing sustainably grown foods. They should look for U.S. Department of Agriculture (USDA) Certified Organic and other sustainability labels that indicate production practices that reduce or eliminate the use of synthetic fertilizers.

By partnering with local farms and other producers, UWMC has been able to purchase a significant amount of local, sustainably produced and organic ingredients. Twenty percent of produce, 47% percent of poultry and 67% percent of dairy are purchased from local sources. The facility invested more than $1 million on local and sustainable foods.

Nearly half (40%) of UVM’s food budget is spent on local and/or sustainable foods, a total of $1.8 million. The hospital places a special focus on purchasing local (defined as grown or assembled in Vermont or within 30 miles of the state, and comprising 34% of the budget) and regional (defined as within 250 miles of the hospital, and comprising 5% of the budget) foods.

Of particular interest is the over $343,000 (7% of the budget) spent on direct purchases from local producers. This represents a valuable investment in the local economy and support for the local food system.

It doesn’t get more climate-friendly than on-site food production. There are three gardens at the UVM facility, all of which grow food that is eaten in the hospital cafes and food service. This is a climate positive endeavor: no transportation is needed, no fossil fuel fertilizer, and compost — made partially from hospital food scraps — adds carbon back into the soil instead of the atmosphere.

“We purchase our compost from the same company that takes away our [food waste] so I like to think that it completes the circle.” -Daria Holcomb, Manager of Nutrition Services at the University of Vermont Medical Center


Taking Ownership of Food-Climate Leadership

Being a champion for healthy food service in hospitals is fundamental to nourishing patients and staff — as well as the planet. From streamlining the food transportation and distribution network, to integrating energy reduction strategies and beyond, ensuring that food operations are sustainable is integral to climate change mitigation. Food systems work is climate work, and healthy food leaders are climate champions.

Consider this: the current global food system, propelled by an increasingly powerful transnational food industry, is responsible for around half of all human produced greenhouse gas emissions: anywhere between a low of 44% to a high of 57%. Experts suggest that keeping global warming below 2° C will require rapid and dramatic reductions in both meat and dairy intake and wasted food.

Intergovernmental Panel on Climate Change

In order to capitalize on this momentum, healthcare facilities can add climate messaging to their sustainability reporting in order to inspire others to mitigate climate change through food systems work. The healing mission of health care extends to food work, which in turn impacts the health of the planet. In committing to food procurement that is protective of the climate, food leaders are safeguarding a healthier future for everyone.


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