Background: American diets today are heavily comprised of mass-produced foods that are high in calories, sodium, fat, and sugar, and low in nutrients recommended by the US Dietary Guidelines for Americans. Children and adults struggle with obesity and diabetes, and lack access to healthy foods. Vending machines often contain unhealthy food and beverage items, such as sugar-sweetened beverages and calorie-dense snacks that are low in essential nutrients. This is true in healthcare settings, and contradicts the messages that doctors are sending their patients about healthy diets. Methods: Twenty vending machines selling foods and beverages were evaluated at three hospitals throughout Rhode Island. The products were evaluated using the National Alliance for Nutrition and Activity (NANA) vending standards, which looks at product size and nutritional contents. The hospital-specific data was compared between and within each hospital for all vending products, separating foods from beverages. Analyses examine proportions of products that meet the various criteria and quantified overages for the criteria that are violated. Results: Overall, the majority of items vended across all three hospitals did not meet the NANA criteria. There were 266 total beverage slots and 371 total food slots across the three hospitals. Hospital A had 152 beverage and 229 food slots, Hospital B had 96 beverage and 105 food slots, and Hospital C had 18 beverage and 37 food slots. At Hospital A, 43% of the beverages vended met one or more of the NANA criteria, while only 20% of the food options met all of the NANA standards. At Hospital B, 75% of the beverages met the NANA standards, yet just 10.5% of the food options met all 7 NANA criteria. Hospital C had 44% of beverages that met one or more of the NANA criteria, but 0% of the food items met all of the NANA standards. Sodas comprised 26% of all slots across the three hospitals, and 58% of the not-approved slots. All beverages that did not meet the standards were sugar-sweetened beverages. The most common criterion not met for food were calories, percentage of calories from fat, and at least 1 of 4 ingredients listed by NANA. Discussion: Though there has been little research done evaluating vending machines in healthcare settings and in general, interventions that increase the number of healthy options have shown an increase in healthy options vended, a decrease in non-essential nutrients vended, and no revenue loss. There are rigorous standards and implementation practices in place for educational settings from which healthcare vending guidelines can be modeled. Conclusions: Further research evaluating the nutritional value of vending machines in healthcare settings is critical, as well as the development of vending standards specifically for healthcare settings. The messaging sent by hospital offerings should align with the dietary habits doctors recommend.
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Citation
Curhan, Talia,
"Project REACH: Redefining Eating Availability and Choices in Hospitals"
(2020).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/es3w-vd02
