An Investigation into Food Offered in a Children's Hospital: A Pilot Study

Introduction and background: The importance of a healthy diet has long been recognised as a cornerstone in achieving and maintaining physical and psychological health. The millions of meals served daily to patients, staff, and visitors in children’s hospitals could play a vital role in improving the health of children and their families (Rabbitt and Coyne 2012). However, the often poor quality of hospital food has gained increasing media and news coverage over recent years. In addition, parents have been shown to often underestimate their child’s weight, and not recognise if their child is an unhealthy weight.  

In Ireland, one in five 5-12 year olds is considered to be either overweight or obese (Irish Heart Foundation 2010). The association of obesity with the incidence of acute and chronic diseases, combined with its effects on general development and wellbeing presents a massive economic burden for the Irish healthcare system (Waters et al 2011). Additionally, it has been reported that overweight and obese children have slower healing times and longer hospital stays (Groleau et al 2014).

Parents are failing to recognise when their child is overweight or obese, thus not seeking help to address this situation (Flinn et al 2012). There exists the belief in Ireland and elsewhere that an overweight child is healthy and well-nourished and that they will grow out of their ‘baby weight’ as they age (Stankiewics et al 2014). Unfortunately, this is not the case, as evidence has shown that an overweight child is likely to become an overweight adult and face serious health consequences (Waters et al 2011; Watson et al 2015).

Methods: A cross-sectional study of children admitted to a busy city hospital in Ireland was conducted. Parents/primary carers were asked to complete a previously validated questionnaire with regard to their child, using opportunistic sampling.

Results: Of the 69 participants eligible for inclusion, 44 returned completed surveys, a response rate of 63%. Approximately 86.7% of parents reported that the food served in hospital was similar to the food served at home. Parents reported that they would like to see more wholegrain bread, fresh fruits and vegetables, dairy products such a yogurt and cheese, less sauces with meals, less ‘heavy’ foods such as potatoes, and less fried/greasy food offered to the children. 4% of parents however, reported that they would like to see more fried foods on offer at meal times. Up to 20% (n=9) of children were overweight or obese, and of these, only one parent correctly classified their child as overweight. 7 of these parents believed that their child was a healthy weight, and 1 parent was unsure of their child’s weight status.

Conclusion: This study shows that food served to children in hospital can be improved by offering more healthy options, wholegrain bread, and fresh fruit and vegetables. Parents are failing to recognise when their child’s weight is no longer healthy.

Limitations of the study: As a pilot study building on the results of Flinn et al (2012)’s cross-sectional study of diet and weight of children in an Irish hospital, the present study was limited by the sample size. There was a relatively short period of time during which data collection was carried out (4 weeks) and there was a limited amount of patient turnover in the chosen hospital. Furthermore, the fact that the survey consisted of a written questionnaire limited the study findings. The researchers believe that given more time, the utilisation of a focus group with a small number of parents would have greatly helped in generating richer ideas and comments on the food in hospital and perceptions of a healthy diet. Face-to-face interviews could also have been of benefit in encouraging a more in-depth response from participants.