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Improving the food environment in Colorado hospitals: a case study
Reena Oza-Frank1, Ynke de Koe2, Amy Meyering2
1Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Frontiers in Public Health
|July 31, 2026
Summary
The Colorado Healthy Hospital Compact successfully improved hospital nutrition environments by implementing Food Service Guidelines (FSG). Hospitals increased healthy options and reduced unhealthy items, demonstrating a feasible approach to healthier hospital food.
Area of Science:
- Public Health Nutrition
- Health Services Research
- Behavioral Science
Background:
- Food Service Guidelines (FSG) implementation can enhance dietary quality and health outcomes.
- Hospital nutrition environments significantly influence patient and staff health behaviors.
- Statewide initiatives are crucial for promoting systemic changes in institutional food services.
Purpose of the Study:
- To evaluate the effectiveness of the Colorado Healthy Hospital Compact (the Compact) in improving hospital nutrition environments.
- To identify facilitators and barriers to implementing FSG within hospital settings.
- To assess the sustainability of changes in hospital food and beverage offerings.
Main Methods:
- A statewide initiative, the Colorado Healthy Hospital Compact, was developed and implemented by the Colorado Department of Public Health and Environment (CDPHE).
- Ten hospitals voluntarily participated, undergoing assessments to monitor changes in cafeteria nutrition and marketing.
- Interviews with key staff (food service directors, dietitians, wellness coordinators) were conducted to gather qualitative data on implementation experiences.
Main Results:
- Hospitals demonstrated significant improvements in meeting healthy standards for sides, entrees, snacks, desserts, and beverages from 2021 to 2023.
- Enhancements were observed in hospitals' pricing strategies and the availability of healthier product selections.
- Customer preference for specific foods was a key barrier, while existing health priorities and staff buy-in served as facilitators.
Conclusions:
- The Colorado Healthy Hospital Compact is a feasible and effective strategy for implementing healthier nutrition standards in hospitals.
- Sustaining interventions requires strong nutrition policies, effective communication, leadership support, and collaboration with food service vendors.
- The Compact model shows potential for broader adoption and implementation across diverse hospital settings.
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