The Crestwood Nutrition and Wellness Initiative was started in May of 2013 under the direction of Margaret McDonald, Crestwood’s Director of Nutritional and Wellness Services. One of the initiative’s first goals was to provide Crestwood facilities with new menus and recipes based on government guidelines and the latest nutrition research, using whole foods, rather than processed foods.
In many of our Mental Health Recovery Centers (MHRCs), we have been able to greatly reduce or eliminate therapeutic diet orders because this diet is appropriate for the vast majority of our clients, including those with diabetes, high blood pressure, and high cholesterol. The diet is appropriate for diabetics because we keep each meal within a certain range of carbohydrates, and we offer very few concentrated sweets. We do most of our baking with whole wheat flour and serve real sugar in small portions. The diet is appropriate for those with high blood pressure and high cholesterol because we limit saturated fat by serving red meat only once a week and serving low-fat dairy products. We also use very little added salt, and few processed or canned goods. Dietary Directors have reported that the costs have been about the same or a bit lower than the old diet.
We offer two fish meals per week, three vegetarian meals per week, and limit red meat to one meal a week. Other meals provide lean proteins such as turkey and chicken. The diet is high in fiber with lots of whole grains, beans, lentils, and fresh fruits and vegetables. We include many plant sources of healthy fats such as oils, trans fat free margarines, nuts, and seeds. Whenever possible, we avoid products with trans fats, high fructose corn syrup, and artificial colorings and sweeteners, and we make as much as possible from scratch. We also offer meals from a variety of cultural backgrounds in order to appeal to our diverse client population.
We have been monitoring client weights, lipid profiles, and HGBA1Cs (a measure of blood sugar levels over time). In the facilities that have implemented our menus, we have seen a gradual weight loss in some of our overweight and obese clients, and an improvement in lipid profiles and a lowering of HGBA1Cs in some clients. Dr. Zhongshu Yang, M.D., PhD from the University of California, Davis was so impressed with the change in weights and lab results at Crestwood Sacramento Center, that she applied for a grant to do a research project on our diet. She and a graduate student, Jennifer Papac B.S., recently presented a poster on our diet at UC Davis Medical School, titled “Crestwood Nutrition and Wellness Initiative in Long-Term Psychiatric Patients.” They concluded that after implementing the diet, there was a reduction in the percentage of obese patients and an increase in the percentage of patients in the overweight and normal weight ranges. They also concluded that patients lost a significant amount of weight over the time period looked at, and that they showed a significant decrease in Body Mass Index (BMI) over that time period.
Lastly, we have received positive feedback from Dietary Directors, kitchen staff, and the clients themselves. Dietary Directors’ comments include, “There was some resistance at first from clients and staff, but they gradually accepted the changes and are getting excited about eating healthy”, “We are starting to see healthy weight loss and an overall change in clients’ attitudes toward making healthier choices”, and “Clients are enjoying the meals and we are getting positive feedback.” Clients also have their opinions about the new diet changes and made comments such as, “It’s like restaurant food”, “I feel better and it’s only been a week”, “I feel good, not so heavy”, and “I feel like I have more energy.”
Going forward, Margaret plans to develop more nutrition and exercise-related groups, for clients, as well as health related in-services for staff. Overall, Crestwood’s ultimate goal is to continue to improve the health and wellness of both our clients and staff through educating and serving them nutritious and delicious food that will make a difference in their recovery and lives. In the words of Hippocrates, “Our food should be our medicine and our medicine should be our food.”
Margaret McDonald, M.S.
Director of Nutritional and Wellness Services