Unhealthy Hospital Food Gets a Healthy Makeover in Pennsylvania

The Shift Toward Healthier Snacks in Hospital Vending Machines

In recent years, there has been a noticeable shift in the types of snacks available in hospital vending machines. Nutritious options such as dried mango slices, roasted edamame beans, and sweet potato tortilla chips are now more readily available than traditional junk food items. This change is part of a broader initiative aimed at improving the quality of food served in hospitals across Pennsylvania.

At the Hospital of the University of Pennsylvania (HUP), these healthier choices are just one example of the 322 “healthier vending machines” that have been introduced as part of the Good Food, Healthy Hospitals initiative. This program, launched in 2014 by the Philadelphia Department of Public Health, seeks to address the paradox of hospitals serving unhealthy food despite their mission to promote health.

A Growing Movement for Healthier Hospital Food

The initiative highlights a long-standing issue: many hospitals serve meals and snacks that are high in calories, fat, sugar, cholesterol, and sodium. Research has shown that this problem is not isolated to one region. For instance, a study of children’s hospitals in California found that only 7% of 384 entrées were considered healthy according to a nutritional assessment tool.

To combat this, the Pennsylvania program collaborates with hospitals to improve food and beverage options. This includes adjusting what is offered on bedside trays, in cafeterias, and in vending machines. The goal is to reduce foods high in fat, sodium, and added sugar while promoting plant-based and whole grain alternatives.

Some hospitals have replaced traditional deep fryers with air fryers, while others have completely eliminated sugar-sweetened beverages from their menus. However, the transition is not always straightforward.

Balancing Health and Accessibility

Wayde Schallowitz, director of retail operations for HUP’s pavilion food court, emphasizes that the key to encouraging healthier choices is subtlety. “You can’t completely eliminate everything. While we try to be a leader because we are in a hospital, you still want to not force it on [people],” he said.

Participation in the program is voluntary, but it has grown significantly since its inception. In 2018, the effort expanded statewide through a partnership with the Pennsylvania Department of Health. Three years later, the Hospital and Healthsystem Association of Pennsylvania joined the initiative. As of last year, 63 hospitals across 27 counties are taking part.

In the Philadelphia region, participating hospitals include St. Christopher’s Hospital for Children and various facilities under Penn Medicine, Jefferson Health, Temple Health, Main Line Health, Trinity Health Mid-Atlantic, and St. Luke’s health systems.

Making Healthy Choices More Appealing

Inside HUP’s pavilion cafeteria, the approach to promoting healthier eating starts with how food is displayed. Unlike traditional stores that place junk food near the checkout, HUP stocks the checkout line with fruit, gluten-free items, and reduced-fat or baked chips. This subtle shift encourages people to make healthier choices without feeling restricted.

The cafeteria no longer serves regular candy, cakes, or snacks. Instead, they offer alternatives like gluten-free brownies and healthier versions of classic dishes. For example, pizza is still available, but it may come with a whole-wheat twist. Salads also feature chickpea salad, quinoa, couscous, and other protein-rich grains.

However, some healthier options, such as whole wheat pastas and vegan dishes, can be challenging to sell. Shelley Chamberlain, the Healthy Food in Healthcare Specialist for the initiative, advises hospitals to either remove these items or make them more appealing. “Don’t shove things down people’s throats. Try to improve the taste or the texture,” she said.

Marketing plays a crucial role in making healthy food more attractive. By giving a dish a name that sounds appetizing, people are more likely to try it. HUP used this strategy with gluten-free pasta dishes, naming them after restaurant-style options. Patients were surprised to learn these meals were healthy, and many ended up enjoying them.

What Makes a Vending Machine "Healthier"?

In HUP’s healthier vending machine, even popular snacks like Doritos are reduced in fat. To meet the program’s standards, 65% of items must be healthy—defined as having 250 calories or less and being low in fat, sodium, and sugar. The remaining 35% can include traditional chips and candy.

Beverages follow similar guidelines. Sixty-five percent of drinks should be water, seltzers, or sugar-free iced teas and sodas. HUP’s machine offers water bottles, Bubly sparkling water, unsweetened Pure Leaf tea, fruit juices, and diet sodas. The least healthy options, such as Celsius energy drinks and zero-sugar Gatorade, are placed on the bottom row.

Financial incentives also play a role. Water must be priced equal to or lower than any other beverage of the same volume. For example, an Aquafina water bottle costs $2.75, while a Celsius energy drink is priced at $3.50.

Adapting to Change

While introducing healthier options initially leads to a dip in vending sales, the trend often reverses after three months. Susanna Howard, a neurosurgery resident at Penn, appreciates the healthier trail mix choices now available in the vending machines. “Healthcare is not a 9-to-5 business, it’s 24/7. So it’s nice to have a vending machine that has better options,” she said.

Despite the availability of healthier choices, Howard still values the presence of classic sweet and savory snacks. “Sometimes you need the junk food,” she admitted.