Donuts as “Dienuts”: 60 Years of Data Demand Banning Sweets from Hospitals and Home

The status of hospital food in most medical centers is intolerable. We have been dulled to seeing disease-causing crap in health centers dedicated to healing and we must wake up and shout “No mas” as this is an outrage. It may be the few remaining fast food outlets, like the Wendy’s at Harper University Hospital where I am on staff that serves Baconator burgers and fries to patients, staff and guests daily, an offense must be terminated by the Detroit Medical Center and Tenet Healthcare. The ubiquitous presence of bacon, a food designated a Class 1 carcinogen by the World Health Organization, defies sensibility in hospitals operating on and providing radiation and chemotherapy treatments to patients with colorectal cancer a few floors above the cafeteria. Today let’s focus on the universal presence of donuts and other baked pastry sweets. In my other hospital, William Beaumont Hospital in Royal Oak and Troy, the “holy” donut is the first food spotted on entering the valet entrance and it is seen again at conferences packed with doctors in training, at celebrations of employees retiring, and throughout the cafeterias. Similar morsels are found in the showcase of the ever present Starbucks in the hospital lobby with a line usually out the door. I just returned from an international conference of the worlds’ leading interventional cardiologists and the breakfast served was donuts and orange juice. Pass me my insulin please. So what is so bad about donuts?

I am serious student of nutrition and the science that guides dietary recommendation. One of the most important but also controversial long term studies of nutrition is the Seven Countries Studies, begun in 1958 and now providing a full 50 years of prospective nutrition analysis and follow up. This landmark and massive undertaking has come under fire since the death of lead investigator Ancel Keys, Ph.D. but the noise has been a heap of lies and more lies from journalists doing shoddy research as I have written on before.

The major finding of the Seven Countries Studies was the strong association between dietary saturated fat, serum cholesterol levels, and the development of coronary heart disease (heart attacks, bypass surgery, heart deaths and such). In an interesting follow-up report of the 25-year mortality in subjects followed in this study, whole foods associated with coronary heart disease (CHD) were determined. As expected, animal food-groups were directly correlated with developing CHD deaths while vegetable food-groups were inversely correlated. The strongest individual food correlates with CHD deaths were butter (R=0.887), pastries (R=0.752), and milk (R=0.600). The combination of butter, lard, margarine of the era, and meat produced a very powerful predictive correlation of 0.922. We can return to butter, lard, and margarine of that era (rich in trans-fats) on another day, but ponder the strong correlation between pastries and CHD death. Donuts and most other baked goods are a perfect storm of refined grains, fats as butter or cheap oils, and added sugar. Are donuts in any manner part of a healthy dietary pattern as should be demonstrated and taught at medical centers? I think we can all join in a resounding HELL NO and the day they should be banned was long ago. The same can be said for the Starbucks baked goods and the carrot cake bearing my hospital’s name, The Beaumont Carrot Cake. Shameful and inexcusable.

This matter is timely as new data this month has been published by the Harvard School of Public Health on the quality of foods selected for a predominantly plant based diet. In this study, researchers presented data from over 200,000 health professionals without heart disease followed for over 25 years. They filled out repeated food questionnaires. A dietary pattern called healthful plant-based diet index (hPDI) was defined as those eating whole grains, fruits and vegetables, nuts, legumes, teas, coffee, and vegetable oils (as compared with butter and lard). Another dietary pattern called an unhealthful PDI (uPDI) was defined as one with increases in juices, sweetened beverages, grains, sweets, fried potatoes. During the study, 8,631 subjects developed coronary heart disease (CHD) like a heart attack. For subjects following the hDPI the risk of developing CHD was slashed by 25%. This is a huge lesson for medical centers and their food services to note and model dietary selections after. On the other hand, those followed the uPDI pattern actually were observed to develop more CHD, perhaps as much as a 30% increase in the risk! Once again, sweets were the bullseye of increased heart risk, that combination of excess fat, refined grains and oils or added sugars perfectly formed as a donut.

Both the data from the Seven Countries Study and the Harvard publication make the obvious a proven fact, sweets as found in pastries and donuts, are strongly associated with the number killer in the Western world, CHD. This is true for patients, guests of health facilities, employees, and administrators that make hospital food policy. While there are many battles to fight to reverse the trend towards worsening health in the USA and other countries, demanding that medical centers stand up and do the right thing is imperative as an example to the public. Hospitals need to ban processed meats, an action long overdue since the World Health Organization pronouncement in 2015 and now also ban donuts and pastry sweets. They need to substitute the healthy eating pattern in the Harvard study by serving abundant presence of fruits, vegetables, legumes, whole grains and nuts. We must not remain silent. Email or call a hospital administrator, post pictures on social media of substandard hospital food, and follow my Facebook page dedicated to stopping these abusive and intolerable practices. In the words of Margaret Mead, “a small group of thoughtful people could change the world. Indeed, it’s the only thing that ever has.”

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