Deadly Hospital Food?

Patients have been saying it for years: Hospital food is wretchedly prepared and totally lacking in flavor. Now a noted nutritionist adds a more serious complaint. Dr. Charles E. Butterworth Jr., director of the nutrition program at the University of Alabama in Birmingham and chairman of the A.M.A.'s Council on Foods and Nutrition, charges that hospital diets are often inadequate to maintain a patient's health--and sometimes so bad as to actually worsen it. "I suspect," writes Butterworth in Nutrition Today, "that one of the largest pockets of unrecognized malnutrition in America exists not in rural slums or urban ghettos, but in the private rooms and wards of our big city hospitals."

The evidence for Butterworth's accusation was gathered on visits to a number of hospitals and from a more intensive study in one of the institutions associated with the University of Alabama's medical center. He found that hospitals and doctors frequently slight nutritional needs. Some institutions allow surgery to be performed without first building patients up for the ordeal, then compound the error after the operation by ignoring good nutrition and relying solely on antibiotics to guard against infection. All too often, the postoperative neglect continues until the patient reaches an advanced state of malnutrition. Of 80 patients studied at the University of Alabama, 14 were hospitalized for more than three weeks without receiving vitamin supplements, although their symptoms suggested that they might have been undernourished.

One surgery patient in Butterworth's study grew steadily weaker, languishing in a hospital for 50 days until the doctors realized that he was suffering from a severe protein deficiency and scurvy; only then did they begin giving him the extra nutrients he needed to recover. He was more fortunate than another patient who received no vitamin supplements during 35 days in the intensive-care unit after open-heart surgery. He lost more than 30 lbs., developed irreversible malnutrition and died.

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