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Top Hospitals Dishing Out the Trans Fats

February 7, 2006

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Eighteen of the nation's top hospitals are unnecessarily harming their faculties and staffs, their visitors, and some patients by serving foods prepared with partially hydrogenated oil -- the biggest source of artery-clogging trans fat in the American diet, according to the Center for Science in the Public Interest (CSPI).

CSPI commissioned independent laboratory analyses of French fries from the hospitals' cafeterias in order to identify the oil they used for deep-frying.

While French fries will never be a health food, says CSPI, hospitals could at least make them safer for their patients' hearts and arteries by frying in canola, soy, peanut, or other heart-friendly oil.

"Partially hydrogenated oil has as much place in hospital cafeterias as ashtrays have in the operating rooms," said CSPI executive director Michael F. Jacobson. "Serving foods high in trans fat in a health-care setting violates the principle of 'first, do no harm.'"

CSPI tested French fries from 14 of the top 16 hospitals with Honor Roll status in U.S. News & World Report's rankings. (Two of the 16, Cleveland Clinic and Johns Hopkins do not sell any fried foods in their cafeterias, though the former sports a McDonald's on its campus).

CSPI also tested French fries from six top children's hospitals. The tests found trans fat in the fries at all 20 institutions.

Serving sizes at the hospitals varied widely, so to have an apples-to-apples comparison of trans-fat content, CSPI used a standardized serving size of 6 ounces -- the size of a large order of McDonald's fries and slightly less than the 6.3-ounce average of the samples CSPI weighed.

The French fries served at the Hospital of the University of Pennsylvania have the most trans fat, at 5.3 grams of trans per 6-ounce serving, followed by the University of Michigan Medical Center (4.9 g) and UCLA Medical Center (4.6 g).

Trans-fat levels in that range necessarily mean that the hospital is using partially hydrogenated oil in its deep-fryer. Amounts under 2 grams suggest that the institution is using a non-hydrogenated vegetable oil in its deep-fryer, but is using frozen French fries that had been par-fried in partially hydrogenated oil.

Among the children's hospitals, the French fries at Children's National Medical Center in Washington, D.C., had the most trans fat, at 4.1 grams per 6-ounces followed by St. Louis Children's Hospital (3.9 g) and Children's Medical Center Dallas (2.0 g).

CSPI says hospitals should know better than to use partially hydrogenated oil.

In 2003, the National Academies' Institute of Medicine concluded that Americans should eat as little trans fat as possible, and in 2004, the Dietary Guidelines Advisory Committee recommended that Americans consume less than 1 percent of their calories from trans fat-about 2 grams per day.

"Deep-fried foods probably shouldn't be served in hospitals in the first place, but foods high in trans fat should certainly be excluded," said Carlos Camargo, Associate Professor of Medicine and Epidemiology at Harvard Medical School, and a physician who practices at Massachusetts General Hospital in Boston. Dr. Camargo was a member of the federal government's most recent Dietary Guidelines Advisory Committee.

After being notified by Dr. Camargo that Massachusetts General Hospital's fries had the most trans fat of any hospital CSPI had tested, Susan Barraclough, the director of nutrition and food services at that hospital immediately switched to trans-fat-free frying oil.

One of the two varieties of fries that Massachusetts General sells is still par-fried in partially hydrogenated oil, but the hospital is considering switching to fries that are entirely trans-fat-free.

The Mayo Clinic in Rochester, Minn., told CSPI that its food-service program had independently switched to trans-free fries and oil shortly after CSPI's testing. For those reasons, neither institution is listed on CSPI's chart.

CSPI also tested French fries from several government cafeterias. The cafeterias at the National Institutes of Health in Bethesda, Md., and the Food and Drug Administration's headquarters in Rockville, Md., had negligible amounts (0.2 grams or less) of trans fat.

But the fries served at the main cafeteria at the U.S. Department of Agriculture -- the government's lead agency for nutrition education -- had a heart-stopping 5.8 grams of trans per 6-ounces.

Although small amounts of trans fat occur naturally in beef and dairy foods, about 80 percent of the trans fat in Americans' diets comes from factory-produced partially hydrogenated vegetable oil.

Partially hydrogenated oils were once thought to be harmless, but in the last 15 years, medical research has proven that trans fat is even more harmful than saturated fat.

While both saturated and trans fat raise LDL, or "bad" cholesterol, thereby raising risk of heart disease, only trans fat lowers HDL, the "good" cholesterol that helps guard against heart disease.

For that reason, Harvard School of Public Health professor Walter Willett calls trans fat a "metabolic poison" that is responsible for tens of thousands of premature heart attack deaths each year.

In 2004, CSPI formally petitioned the FDA to all but prohibit the use of partially hydrogenated oil in food manufacturing and to require restaurants and institutional food-service providers to disclose whether they use it.

New trans-fat labeling rules have encouraged many grocery manufacturers to reduce or eliminate partially hydrogenated oil in foods.

Restaurants and institutional food-service providers have been slower to act, even though trans-fat-free frying oils and trans-fat-free frozen French fries are readily available from several major suppliers.

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