Evaluation of the Balanced Menus Challenge: a healthy food and sustainability programme in hospitals in Maryland

Abstract

Objective: The Balanced Menus Challenge (BMC) is a national effort to bring the healthiest, most sustainably produced meat available into health-care settings to preserve antibiotic effectiveness and promote good nutrition. The present study evaluated the outcomes of the BMC in the Maryland/Washington, DC region. Design: The BMC is a cost-effective programme whereby participating hospitals reduce meat purchases by 20 % of their budget, then invest the savings into purchasing sustainably produced meat. A mixed-methods retrospective assessment was conducted to assess (i) utilization of the BMC 'implementation toolkit' and (ii) achievement of the 20 % reduction in meat purchases. Previous survey data were reviewed and semi-structured interviews were conducted. Setting: Hospitals located in the Maryland/Washington, DC region, USA, that adopted the BMC. Subjects: Twelve hospitals signed the BMC in the Maryland/Washington, DC region and six were available for interview. Results: Three hospitals in the Maryland/Washington, DC region that signed the BMC tracked their progress and two achieved a reduction in meat procurement by ≥20 %. One hospital demonstrated that the final outcome goal of switching to a local and sustainable source for meat is possible to achieve, at least for a portion of the meal budget. The three hospitals that reduced meat purchases also received and used the highest number of BMC implementation tools. There was a positive correlation between receipt and usage of implementation tools (r = 0·93, P = 0·005). Conclusions: The study demonstrates that hospitals in the Maryland/Washington, DC region that sign the BMC can increase the amount of sustainably produced meat purchased and served.

Sustainable Supply Chain Management Practices and Sustainable Performance in Hospitals: A Systematic Review and Integrative Framework

“…High-fat processed food, the use of non-nutritive additives, meat produced using antibiotics and hormones, obesity, antibiotic resistance, diabetes, cancer, food waste, and pollution caused by food transport are among the problems that current food systems face [88,89,91,92]. Hospitals have the potential to impact sustainability by addressing food issues, given their role as intermediaries in the market, their buying power, their responsibility for the promotion of proper nutritional habits, and the large number of people who frequent these organizations, between patients, visitors, employees, and the community [93].…”

“…Reference [93] identifies 12 opportunities through which food practices may be addressed: procurement, catering contracts, menu development, pricing, waste management, infrastructure, staff training, information, education, communication and feedback, partnerships, and special events. Similarly, Reference [91] suggests practices that range from the participative design of new options with staff and customers to behavioral initiatives that encourage the consumption of healthier food, while Reference [92] shows that reducing meat consumption by up to 20% and substituting it for vegetarian or alternative proteins from local sources is feasible for hospitals, without a detriment to budgetary increases.…”

“…Analogously, general metrics intended to reflect outcomes of the entire hospital, such as profitability, cost of services, and return on investment, are included in financial metrics. Moreover, environmental performance is sometimes converted into financial terms by quantifying actual and potential savings due to efficiency and conservation improvements in energy, water, travel, food, and waste [19,50,58,59,86,88,91,92,98], while social investment volume is used to economically measure social performance [72].…”

Food for Life: evaluation of the impact of the Hospital Food Programme in England using a case study approach

“…Although this centralised model provides opportunities for change at scale, and advantages in terms of food quality, consistency, choice and reduction in waste, identifying the key levers may be difficult for single organisations. For example, replication of the Balanced Menus Challenge, a US-based effort to bring sustainably produced meat available into healthcare settings whereby participating hospitals reduce meat purchases by 20% of their budget, then invest the savings into purchasing sustainably produced meat, 27 could be effectively implemented at scale should the right drivers be identified. One respondent suggested that local place-based central meal preparation facilities working across sectors might be a way forward.…”

Public health nutrition and sustainability

“…Physical environments In the context of this special issue, the physical environments level of analysis grouped those papers that investigated the changing of practices in hospital, public kitchen and educational institutional settings, as well as community-based interventions. Ranke et al evaluated the outcomes of the Balanced Menus Challenge in which participating US hospitals reduce meat purchases by 20 %, then invest the savings into purchasing sustainably produced meat (17) . The study demonstrates that hospitals in the Maryland/Washington, DC region can reduce meat purchasing and increase the amount of sustainably produced meat purchased and served.…”