Although the Health Ministry has instructed all hospitals to serve patients and sell to staff and visitors only whole-grain bread and products low in fat, salt and sugar, it has done nothing to reduce the prices at least to the level of white-flour and other heavily processed products.
In addition, it has asked all public and private hospitals to change their menus and what is sold in hospital cafeterias and kiosks “from now on.” However, the cafeteria that the ministry’s headquarters shares in Jerusalem’s Romema neighborhood with another ministry, serving hundreds of meals daily does not follow the Health Ministry’s own guidelines.
“You’re right. You’re absolutely right,” Prof. Arnon Afek, the ministry’s director of health administration who is in charge of supervising the hospitals, told The Jerusalem Post on Tuesday.
“Nothing is perfect. Wholegrained bread, whose flour is merely ground up, should not cost more than white flour, although it does because only the white flour is price controlled by the government.”
It was suggested that Health Minister Yael German should have first reached an agreement with her Yesh Atid colleague, Finance Minister Yair Lapid, on price controls that would equalize the costs of whole-grained, healthful products to the processed, unhealthful items.
Lapid said: “That is not my job. I should be given credit for issuing circulars that require the hospitals to change their food.”
As for the fact that the ministry’s own cafeteria sells white bread, soft drinks, salty and sweet snacks, hot dogs, white rice and pasta and other foods ruled out in the hospital guidelines, Afek said he would raise the issue internally.
“If we demand this of the hospitals, we certainly should be observing the rules ourselves,” he said.
The ministry spokeswoman’s office previously told the Post that meals and other food sold in the cafeteria were approved by Dr. Ziva Stahl, director of the ministry’s nutrition department.
Asked about enforcement, Afek said his office will supervise to ensure that general, geriatric and psychiatric hospitals, both public and private, observe the rules.
“We are not there yet. If we find they do not implement them, we will consider actual enforcement,” he said. “An information campaign is needed.”
He could not say how much more it would cost hospitals to implement the changes.
In January 2013, the Medical Administration first handed down guidelines to all the hospitals on food for patients in a detailed, 16-page directive.
Only whole-grained bread (with at least 80 percent whole grains) would be served, it said, and the amount of sodium, sugar, fat and trans-fat would be reduced to a minimum, it said. The document even included suggested menus for a whole week. Hospital dietary chiefs must save and register the menus for two years, including a list of the nutrients in the food served.
However, it continued, patients who require special diets due to their medical condition (including allergies) could still receive food otherwise prohibited on the menus.
The directives issued on Monday relate to all food sold in hospitals – including staff and visitors’ cafeterias and commercial kiosks. Only bread and rolls with at least 80% whole grains may be sold. As for salt, it must not exceed 400 milligrams per 100 grams of prepared food; this reduction would be accomplished by minimizing salt in cooking and in prepared sauces, herb mixtures and soup powders, the document said.
Milk, chicken, fish and meat must have less than 5% fat. The sale of burekas, which are made from margarine, is barred, along with fatty cakes, hot dogs, hamburgers, malawah (oily Yemenite-style dough), salty or sweet snacks and kebabs.
Only unsaturated oils from olives, canola, avocados, tehina, walnuts, sesame and sunflower seeds and peanuts may be used. Soy oil, which is considerably less expensive, is not mentioned. And much fiber from vegetables, fruits and pulses should be served, the directive says. Fish that grow in salt water should be preferred.
Baking, roasting and other cooking methods using less oil are preferred over frying.
Sugared soft drinks, including cola, are prohibited for sale anywhere in the hospitals.
Water and diet drinks and healthful cakes such as those made from carrots or apples are permitted.
The ministry has not yet issued any directive to supermarkets and groceries on the content, or the labels of ingredients, of unwrapped bread and rolls.