Hospital food isn’t known for tasting good or even being all that good for you. But some U.S. hospitals are teaming up with farms to change that.

You probably think of hospital food as premade, prepackaged, bland, and colorless — except for the Jell-O, of course. Maybe you’ve brought a friend or relative soup or a sandwich to their hospital room because the place where you most expect a healthy meal is one of the places you’re least likely to get it.

So you might be surprised to know that some hospitals are teaming up with local farms to offer healthier, tastier food. A few even have their own farm on campus.

“Good food is good medicine,” says Santana Diaz, executive chef of food and nutrition services of UC Davis Medical Center in Davis, CA, and the first U.S.-born person in his family of generations of Mexican farmers.

“Patients are at the center of everything we do,” Diaz says. “I know I’m not a doctor or a nurse standing next to the patient, but I want to give everyone in our care the healthiest choices possible.”

Diaz and others are proving it’s possible to provide healthy meals for patients and help local growers at the same time.

Diaz and his team serve 1,530 patient meals a day and more than 4,000 meals in retail spaces.

Diaz puts his “boots on the ground of every farm we buy from to make sure it’s a real place,” then uses a local distributor for pick up and delivery.

“We get two pallets of produce every day. That’s about 2,000 pounds, or 1 ton,” Diaz says. “When we say we go through a ton of produce a day, we literally mean a ton of produce a day.”

This translates to local tomatoes in salads, local peaches for dessert, and black beans that become a fiber-filled side for taco Tuesday, and a black bean vinaigrette that keeps sugar levels in salad dressing low but the flavor profile high.

It’s also good for the farmers. With a large-scale operation, Diaz can forecast with farmers what his yields and needs are for the year or even years ahead.

More than half of the produce that John Muir Medical Centers serves to patients and visitors — 60% — comes from California. And 50% of that comes from farms within a 150-mile radius.

That’s possible thanks to their partnership with Bay Cities Produce Co. While Joe LaVilla, the culinary operations manager of nutrition services for John Muir, focuses on the meals, Bay Cities vets and works with local farms to make sure the necessary but less sexy side of food procurement — federally regulated standards like food safety, fair trade and field, soil and water testing — is up to speed.

“Hospitals don’t want people getting sick,” says Steve del Masso, president of Bay Cities Produce Co. “John Muir has the desire to do the right thing with small farms, and they’re dedicated to keeping local going. At the same time, there are food safety concerns. I think we’re a good go-between.”

For patients, this means the stir-fried vegetables or carrots in the carrot-ginger soup come fresh from farms, not out of freezer bags.

“Our overnight oats for breakfast feature local blood oranges. We serve local squashes, Brentwood corn in season, and up to four special salads a day — all based on what’s fresh and local,” DaVilla says. “Our best seller is a steak salad with arugula, endive, peppers, frisee, and shaved onion.” 

Built on a former golf course, Lankenau Medical Center’s 98-acre campus includes a 2-acre farm right across the street from the emergency room.

Since 2016, the Deaver Wellness Farm has produced more than 13,000 pounds of onions, greens, tomatoes, melons, beans, and peas.

“Anything you can grow, we grow,” says Phil Robinson, president of Lankenau Medical Center.

Education is a big part of the programming. School children visit the farm to learn about food that doesn’t come out of a wrapper or bag. Patients with food insecurity — those who don’t have access to fresh fruits and vegetables — talk with a dietitian about produce and recipes. Then they get fresh fruits and vegetables delivered to their homes.

“If you just patch them up and send them back where they came from, you’re not doing a lot of good,” Robinson says. “If we’re really going to make a difference and improve our patients’ health status, it has to be outside the four walls of this hospital.”

All 3,000-plus pounds of produce harvested from The Sky Farm at Eskenazi Health every year make their way into free food and nutrition classes. This helps patients at all Eskenazi locations — especially those with diabetes, heart disease, and other chronic diseases — learn how to control and even reverse their conditions.

Class topics include “Lifestyle Medicine,” “Growing Strong: Cooking Matters,” “Fresh Veggie Fridays,” and “What Can I Eat?”

Squash, peppers, tomatoes, eggplant, cucumbers, radishes, and herbs are just a few of the crops that grow on Boston Medical Center’s rooftop farm every year.

More than 5,000 pounds of food from the farm is used in hospital cafeterias, patient meals, demonstration kitchens, and the center’s preventive food pantry, which supplies nutritious food to those who can’t afford it.

The micro-farm on the third floor deck of the Health Science Center at Stony Brook Medicine has more than 2,000 square feet of gardening space that yields fresh fruits and vegetables used in patient meals.

Their “farm-to-bedside” concept often includes a tent card on the tray to let patients know some of their meal was harvested at the farm.

Through a partnership with the Rodale Institute, St. Luke’s University Health Network has St. Luke’s-Rodale Institute Organic Farm, 8 acres of crops that supply all 12 hospitals in their network with 100 varieties of chemical-free, certified organic produce.

Everything from salad greens, broccoli, and peppers to Swiss chard, garlic, beets, and herbs is incorporated into patient, visitor, and staff meals, and is available for purchase at on-site farmers markets at various hospital locations. 

If you’ve become a caregiver for a family member or friend with schizophrenia, it’s tough to go it alone. The demands on your psychological and physical well-being, and on your personal life and finances, can be heavy.

“A lot of caregivers experience uncertainty about what the future will look like, not just for their loved one but for themselves,” says Christine Crawford, MD, MPH, associate medical director at the National Alliance on Mental Illness (NAMI).

“All their expectations about holding a job and relationship kind of get shifted after the schizophrenia diagnosis. It’s a period of adjustment.”

But you can tap rich resources of information and support during this period of adjustment. You just need to be willing to ask and know where to look.

Education About Schizophrenia Caregiving

“It’s often difficult for caregivers to have a good appreciation of what the schizophrenia diagnosis is all about, to get past their own preconceived notions,” says Crawford, a Boston-based psychiatrist. “So it’s important to start off by educating yourself about the condition and what (caregiving) support is all about.”

You might start with a trip to a public or medical school library. Or visit the websites of mental health and caregiving advocacy groups. Some you might try:

• The Schizophrenia & Psychosis Action Alliance offers materials in print, video, and presentation formats about schizophrenia and psychosis. They even have a schizophrenia caregiver toolkit.
• NAMI has lots of videos and other materials on schizophrenia, an eight-session YouTube “NAMI Family-to-Family Program” that helps caregivers, a helpline, and online discussion groups. 
• The Family Caregiver Alliance has a page with resources on caregiving in general.

But don’t let your learning begin and end with what you read, Crawford urges. If your loved one agrees, go with them on some doctor visits. You can learn more about their treatment plan and develop a bond with their mental health provider.

And before you make assumptions, ask the person you’re helping about their symptoms, experiences, emotions, and ambitions, she says.

“Don’t challenge the loved one about the realities of their symptoms. Ask how they are experiencing schizophrenia and get to the emotional component,” Crawford says. “It can be more helpful for the caregiver to learn from the loved one than from a book.”

Getting Help From Family and Friends

Many primary schizophrenia caregivers feel guilty that they can’t handle the job alone. But if you can get past any mental blocks about seeking help, you may find valuable allies and a support system.

A few of the ways other friends and family members can help:

• “Respite care” — giving you time to recharge your batteries by going to the gym or a movie, a walk in the woods, or whatever helps
• Running errands like grocery shopping
• Driving your loved one to doctor’s appointments or picking up your kids from school
• Paying the household bills
• Doing online research into organizations that offer financial help to families with schizophrenia

“I recommend that caregivers write down a list of all the things that are hard for them to get done in a week and then ask if family and friends are willing to take them on,” Crawford says.

That said, be aware that it’s sometimes hard for friends and family members to be consistent through the worst of schizophrenia.

Find a Caregiver Support Group

Over time, Fabos became a volunteer and speaker for schizophrenia-related causes. She recently helped start a chapter for the Schizophrenia & Psychosis Action Alliance (S&PAA) in her home county. She also launched a caregiver support group called Families For Care that now boasts more than 800 members worldwide.

“Joining a support group is the biggest lesson I’ve learned,” she says. “You can get the resources you need in the right support group. There will be someone in the group where, if they haven’t been through the exact same situation you have, it’s close enough.”

In Fabos’s group, she says, caregivers not only get a sounding board, but often get help from nearby members with daily tasks.

Along with searching the internet and social media outlets, you can find a nearby support group by:

• Registering for one through S&PAA
• Using the NAMI Connection support group search engine
• Messaging through Mental Health America’s Inspire schizophrenia board

Crawford says it’s a good idea to join a schizophrenia or mental illness caregiver support group even if you enjoy a great support network of family and friends.

“If you encounter a bump in the road with your loved one, the support group can say, ‘I know it’s difficult now, but hang in there. It worked for me, and I strongly believe it can work for you,’” she says.

 “And if you go to a support group and it’s not a good fit, it’s OK to need to look for another. It’s not a one-size-fits-all approach.”

Feb. 22, 2024 — Injectable weight loss drugs like Wegovy, Saxenda, and Zepbound have been getting all the glory lately, but they’re not for everyone. If the inconvenience or cost of weight-loss drugs isn’t for you, another approach may be boosting your gut microbiome.

So how does one do that, and how does it work?

“There are a lot of different factors naturally in weight gain and weight loss, so the gut microbiome is certainly not the only thing,” said Chris Damman, MD, a gastroenterologist at the University of Washington. He studies how food and the microbiome affect your health. “With that caveat, it probably is playing an important role.”

Trillions of Microbes

The idea that your gut is home to an enormous range of tiny organisms — microbes — has existed for more than 100 years, but only in the 21st century have scientists had the ability to delve into specifics. 

We now know you want a robust assortment of microbes in your gut, especially in the lower gut, your colon. They feast on fiber from the food you eat and turn it into substances your body needs. Those substances send signals all over your body. 

The American Diet Messes With Your Gut

If you’re a typical American, you eat a lot of ultra-processed foods — manufactured with a long ingredients list that includes additives or preservatives. According to one study, those foods make up 73% of our food supply. That can have a serious impact on gut health.

“When you process a food and mill it, it turns a whole food into tiny particles,” Damman said. “That makes the food highly digestible. But if you eat a stalk of broccoli, a large amount of that broccoli in the form of fiber and other things will make its way to your lower gut, where it will feed microbes.” 

With heavily processed foods, on the other hand, most of it gets digested before it can reach your lower gut, which leaves your microbes without the energy they need to survive. 

Rosa Krajmalnik-Brown, PhD, is director of the Biodesign Center for Health Through Microbiomes at Arizona State University. Her lab has done research into how microbes use the undigested food that reaches your gut. She describes the problem with processed foods this way: 

While the study wasn’t designed for weight loss, an interesting thing happened when researchers analyzed participants’ bowel movements.

“We found that when you feed subjects a diet designed to provide more energy to the microbes and not to the [body], our subjects lost a little weight,” Krajmalnik-Brown said. “It looks like by feeding your microbes, it seems to make people healthier and potentially even lose a little.”

Another possible mechanism involves the same hormone that powers those injectable weight loss drugs. The lower part of your gut makes hormones that tell the entire gut to slow down and also help orchestrate metabolism and appetite. Among them is GLP-1. The drugs use a synthetic version, semaglutide or tirzepatide, to trigger the same effect. 

According to Damman, you can stimulate your gut to make those helpful hormones with the food you eat — by giving your microbes the right fuel.

Eat to Feed Your Microbes

The foods you eat can affect your gut microbiome, and so your weight. But don’t go looking for that one perfect ingredient, experts warn. 

Eating for gut health isn’t a magic bullet in terms of weight loss. But the benefits of a healthy gut go far beyond shedding a few pounds.

“I think we need to strive for health, not weight loss.” Krajmalnik-Brown said. “Keep your gut healthy and your microbes healthy, and that should eventually lead to a healthy weight. You’ll make your microbes happy, and your microbes do a lot for your health.”

Feb. 23, 2024 – Is shorter better? Or just more practical? The CDC is reportedly going to cut its COVID-19 isolation recommendations down from 5 days to 24 hours starting in April. 

The agency appears to be walking a fine line between reducing COVID transmission, including the JN.1 variant, and the reality that many people struggle to forgo work or school for days at a time. 

The agency is expected to recommend 24 hours on two conditions: as long as a person remains fever-free for 24 hours and their symptoms are mild and improving. But where does this leave those at higher risk for more serious COVID outcomes? Why wait until April? And has the science around COVID changed, or just our behavior?

We turned to some experts for answers.

It remains to be seen if people are more likely to isolate for 24 hours or if that will send an unintended message about COVID severity. 

“That’s my worry, that people will no longer take isolation seriously if it’s so short,” said Purvi Parikh, MD, an immunologist with the Allergy & Asthma Network, a nonprofit advocacy group for people with these conditions based in Fairfax, VA. 

If the CDC does move forward with the recommendation, Bruce Farber, MD, chief public health and epidemiology officer at Northwell Health in New York, hopes they will stay flexible because COVID is unpredictable. “If the situation changes and there is a big peak in the fall … this should be rethought.”

The move “ignores the increased risk this change will have for the most vulnerable,” said Brian Koffman, MDCM. He was diagnosed with the blood cancer chronic lymphocytic leukemia (CLL) in 2005 and counts himself among the nearly 7% of people with impaired immunity.

“These changes will reinforce the need for me and others immunocompromised to continue avoiding crowds, mask indoors, and practice careful hand hygiene,” he said. “It will make restaurant visits and other indoor events even higher risk.”

“Many – myself included – will consider the risk prohibitive and choose to stay home.”

Shielding these higher-risk populations from COVID can help reduce the risk for the larger population, Koffman said. “We have clear evidence that it is often in the infected immunocompromised where new variants arise, so protecting them protects everyone.”

A Matter of Timing

With many people testing for COVID at home and not reporting their results, it’s more challenging to get overall case and transmission numbers. But of those who do get officially tested, just under 10% are positive, the latest CDC COVID Tracker numbers reveal.

COVID is also not the only virus out there during this winter respiratory season, as RSV and the flu continue to get people sick. 

The CDC may be pausing to get past any COVID surge associated with the winter months. “They’re waiting until April because the RSV season will be over, and more than likely the COVID numbers will be dramatically lower than during the winter months,” Farber said.

Also, the pandemic is not like it was 2 years ago, he said. “There is a lot of immunity out there to COVID.”

There is also the practical question of how many people with COVID symptoms or who test positive for COVID actually stay in isolation for 5 full days. Although “I don’t think anyone would argue that it’s not safer wearing a mask and being isolated for 5 days … the reality is most people are not following those rules,” Farber said.