Don't call it 'vegan' and other tips from hospitals to get people to eat less meat

A table outside a Boston hospital cafeteria offers samples of a daily special: a soba noodle stir-fry with shiitake mushrooms and mixed vegetables. Andrea Venable, a parking services employee in a bright red uniform shirt, picks up a small plastic cup and peeks inside.

"Looks like noodles," says Venable. She shrugs. "I don't know. I guess I'll give it a try."

She likes the sample but she's not convinced by the cafeteria's efforts to introduce more plant-based dishes. "I think it's good for the people that eat, like, vegetarian," she says.

Venable is not one of them. She likes meat and isn't interested in eating less of it.

Therein lies the challenge for Brigham and Women's Faulkner Hospital leaders. It's hard to persuade people to cut back on meat. Faulkner started trying about 20 years ago for health reasons. "Meatless Mondays" generated a lot of complaints at the hospital. And don't even ask about the time they cut fries and chicken nuggets from the menu.

But hospital leaders say they've noticed a shift since at least 2020 when they began framing their efforts around climate change. Patients and employees who wouldn't adjust their diet to improve their own health are doing it for the greater good.

"It's a little bit more altruistic in that way," says Susan Langill, the hospital's director of food services, which are provided by the company Sodexo. "They are putting the earth and future generations before their own health."

Faulkner is one of 60 hospitals, universities, major corporations and cities that have signed an international pledge to reduce food-related greenhouse gas emissions 25% by 2030. The hospital is starting with the cafeteria and will expand to changing patient meals, too.

A key factor, possibly the key, will be serving less meat. The latest hospital data shows beef and the occasional order of lamb make up just 5% of its food purchases, but represent 56% of the hospital's food-related greenhouse gas emissions.

"Seeing that graph," says Langill, "was the game-changer for me.

Stealthy strategies to introduce plant-based foods

Langill says many diners need a nudge. The hospital's strategies, focused first on staff, are subtle, even a bit ... stealth. Here's one:

"Celebrate what's in the dish as opposed to what's been taken out of it," Langill says.

The strategy originates from a playbook of suggestions that comes with the climate emissions pledge.

Today's soba noodle special, for example, is meat-free. But elegant, descriptive signs on the tasting table don't say that. In fact the words "vegan" or "vegetarian" don't appear in the name of any dishes on the hospital cafeteria menu. The hospital has learned that dishes labeled vegan pretty much only attract, well, vegans.

"Lots of folks don't identify as vegan or vegetarian," Langill says. "So instead we're marketing dishes based on the flavor or cultural benefits and celebrations of that food."

Other strategies include putting plant-based or plant-rich foods at the front of the buffet line. There's often a meat-free option like eggplant parm next to chicken parm as a ready alternative.

And contests are popular, such as asking staff to try a different plant-based item from the menu every day for 30 days. The cafeteria staff offer cooking demonstrations with tofu and tempeh, and hand out recipe cards.

Dr. Len Lilly, a cardiologist who stops to grab a soba noodle sample, is pleased. He says a climate-friendly diet is also a healthier diet, because it includes less meat.

"There have been times I've come to this cafeteria and the choices have been between steak and hamburger," says Lilly. "That's not good."

Other hospital staff are on board with the gradual changes, too.

Matt Wilson, an operating room nurse, and his wife have started eating vegan once a week for dinner. They're getting used to friends' jokes.

"They always laugh at me when I tell them I eat vegan meals, but that's OK," says Wilson in between bites of soba noodles. "They'll convert. I got faith."

A shift to more sustainable foods

The next frontier for Faulkner and its larger affiliate Brigham and Women's Hospital is new patient menus. They will have more plant-based dishes where adding meat is an option, like tacos or a barbeque burger with a choice of patties: black bean, turkey, chicken or beef.

The hospital is already nudging patients with daily meat-free specials: a roasted edamame salad or a teriyaki tofu and grilled pineapple wrap, for example.

Food is likely a small part of most hospitals' greenhouse gas emissions, but advocates say it's a critical step in reducing emissions. And Health Care Without Harm, a group that helps the industry address climate change, says it's one that will have an impact.

The climate pledge includes using more sustainable foods such as those highlighted by the World Wildlife Fund's Future 50 Foods list. It includes fava beans, buckwheat and okra — foods that could help shift away from dependence on corn, rice and wheat.

Expanding the range of beans, grains and vegetables commonly eaten could help preserve biodiversity and help farmers deal with the impacts of climate change. These foods also can help diversify people's diets, increasing their intake of healthful fiber, vitamins and other micronutrients.

Faulkner's general manager for food services, Mike Hanley, says he adds something from the list to specials regularly. And the hospital serves local fish twice a week, often not the typical fare. Diners may see species like dogfish, cusk, bluefish, skate and monkfish.

"Anything that swims in our waters," says Mike Hanley, general manager for food services at Faulkner Hospital. "You name it, we've served it. And it's cheaper than beef."

A pledge to cut food-related emissions

The pledge to cut food-related greenhouse gas emissions is led by the World Resources Institute. It measures progress in two ways: emissions linked to the weight of food purchased, where the goal is a 25% cut, and emissions per calorie which need to drop 38%. Buying fewer pounds of beef as compared to food from plants is the fastest route.

The science of calculating emissions for individual foods is new, so estimates are rough. They're based on the type of food, the amount of land used, the agricultural supply chain and other factors.

As of 2021, the first 30 organizations to sign on cut food-related emissions per calorie by 21%.

"We hope we're showing that change is possible," says Richard Waite, senior research associate in food and climate programs at the World Resources Institute. "But we need many others to be making these same types of changes if we want to, as a world, get to where we need to be by 2030."

One year into the pledge, Faulkner is showing a 2.2% decrease in emissions per calorie. Brigham and Women's has cut emissions per calorie by 20%.

Langill says she's optimistic that both hospitals will hit the target. "As long as we continue to do things like this," she says, waving toward the tasting table, "and convince people to change their habits."

On cue, Andrea Venable, the enthusiastic meat eater, strolls past the tasting table, again.

"I gotta say it's good," she says, picking up another sample, "really good."