8/09/2011

Dining at Duke Med Center: a chicken wrap with 1554 mg of salt. Roasted veggies with 2381 mg. Ugh! For many people, daily intake should total 1500

Posted at 12:10 AM Tuesday

✔ Fact Checker here. Probative, provocative, pro-Duke. Good day!

FC gets a continuing flow of tips from Loyal Readers, and one who eats regularly in the Medical Center's restaurants for ambulatory patients, visitors and employees is responsible for this post. He told us about salt, salt and more salt in the food, and a Deputy Fact Checker found the statistics to confirm his taste buds.

Please note: this essay does not cover food served to patients admitted to Duke Hospital. And we did not compare the Medical Center's restaurants with others off campus, which may be just as bad.

We will get to why salt is bad for you in a moment. Let's first look at the recommended daily intake:

American Heart Association recommends for healthy adults less than 2,300 milligrams. And on the website of the Mayo Clinic, there is a recommendation for a 1500 mg a day limit "if you're age 51 or older, or if you are black, or if you have high blood pressure, diabetes or chronic kidney disease."

OK fellow Dukies, let's look at some of the food that is being dished up right in the middle of the campus facilities dedicated to preserving and restoring health.

This food is prepared and served in the Atrium Cafe under a contract with Aramark, which we thought had been banished after a revolt in 2007 -- everything short of a food riot -- against the most awful gruel and mystery meat which was served in a monopoly of East and West Campus student dining. It turns out Aramark survives in the Medical Center.

The information about salt is provided by Aramark itself.

The appetizers on Sunday -- you missed it -- included chili-cheese potato soup, which, not surprisingly, contains 1285 mg of salt. (Remember, a total of 2300 mg a day if you are healthy, 1500 if you are over 51, or black, or have health problems.) Next week's crabby Swiss soup (which apparently the restaurants in Switzerland were sold out of since FC did not encounter this on three visits) is 829 but that's for an 8 ounce cup.

The vegetables on Wednesday include diced roasted vegetables, which sounds pretty healthy until you find out a portion contains 2381 mg of salt. No typo. Figures from Aramark. 2381 mg. Even aloo gobi (which turns out to be potatoes and cauliflower mashed together, for those not familiar with Indian and Pakistani food) available on Thursday contains 565 mg. (It must be the cauliflower, for mashed potatoes are only 157.)

You are better off with the french fries, which have 435 mg before you add ketchup or your own salt. Even the Mediterranean salad which sounds so healthy with its crisp greens, cucumbers, tomatoes, peppers, onions and olives, and feta cheese, comes in at 621.

The meats on Monday included something called a hot dog expo, with 1,063 mg of salt, but at least the words hot dog, unlike the words diced roasted vegetables, should set off an alarm. Other entrees later this week -- Jamaican smoked pork chop and smoked St. Louis ribs -- contain 742 and 751 mg.

Perhaps you'd like to risk a grilled Angus burger, available every day, good for 1083 mg. The garden burger is not much better, 912.

Ah hah you may say, hot dogs, beef, you know they are bad for you. Go for the grilled chicken sandwich. Alas, 1401 mg. Yes, 1401. Even lemon roasted chicken has 799 mg. Next week's chicken cordon bleu on a hot ciabatta (spelled wrong on the menu) has 1041.

A slice of pizza has 935, the pepperoni pizza is good for 1130. There are no current values available for manicotti, ravioli or lasagna, but previous recipes, which may have been changed, made them disasters. Sample: manicotti 1068.

And to cap it all off, next week the featured honey ham sandwich has 1538 mg; the corned beef Reuben has 1948 mg, including a side of German potato salad. Yummy.

It's no better in other Aramack facilities. The Commons: yesterday "creative corn relish avocado soup" 900 mg. Chicken wrap 1554 mg.

To eat healthy in any of these facilities, you have to be keenly alert. That should not be the case.

✔ So Loyal Readers, you undoubtedly have this figured out. One meal as a guest of Aramark, and you are very likely to go over your entire quota for salt in a day. Yes, this is in the same Medical Center that looks out for you, properly, by prohibiting smoking everywhere, even on its sidewalks and in its parking decks.

This is also the same Medical Center that harbors Dr. Larry Goldstein, professor of neurology and head of Duke's Stroke Policy Program. In case you think salt is benign, or leads only to high blood pressure, listen: "The data behind sodium consumption (leading to strokes) are pretty strong and persuasive... People need to read the labels (or read Fact Checker) of the food they are eating and see what their salt consumption is and at least try to reduce it toward the levels that are currently being recommended."

Data? The risk of stroke increased 16% for every 500 mg/day of sodium consumed after adjustment for age, sex, race and ethnicity, education, alcohol use, exercise, daily caloric intake, smoking, diabetes, cholesterol, blood pressure, and previous heart disease.

And listen, please, to Michael Jacobson, executive director for Center for Science in the Public Interest in Washington: Salt “is the single most harmful element in the food supply, even worse than saturated fat and trans fat, or food additives and pesticides.”

✔ Duke's relationship with Aramark has always been curious. After all, the student food was so bad, it was so expensive, and the corporation was draining profits away from its Duke operations instead of reinvesting them as promised. All this despite a heavy presence of Dukies in the top leadership. These included John R. Donovan, Jr. '80, the president, and Executive Vice President and Group Executive L. Frederick Sutherland '73. Duke Trustee emeritus Karl VonDer Hayden '63 (of Perkins Pavilion fame) was on the board of directors, and the question has always been whether he was the rabbi who kept Aramark's grip on Duke alive.

Typical lunch experience, recounted in the 2006 Chronicle: Sophomore Tom Engquist said his request for a burrito with half-chicken and half-carnitas was rejected even though both items cost the same amount.

"Not only can she not do it, but she rolls her eyes at me," he recalled.

Engquist opted for a regular carnitas burrito, and said he found it bland and flavorless. "And I'm Mexican, so I know good carnitas," he said, adding that the only acceptable part of his meal was his bottled water.

Aramark is not only a food company, it is a service company, with total employment of 225,000 world wide.

In 2004, an employee of the Automatic Elevator Company did routine maintenance on elevators in many Duke facilities. He drained dirty, used hydraulic fluid and put into recycled containers labeled detergent.

Cardinal Medical Services was supposed to cart the containers away -- but somehow they got re-delivered to Duke facilities. Aramark -- not its food division, obviously -- was under contract to provide maintenance and other services for the Duke Health System's surgical instrument washing system.

Surgeons kept on complaining of greasy, slippery instruments -- but still they operated on 3,648 patients at Durham Regional Hospital and Duke Health Raleigh Hospital; the main Duke Hospital was not involved.

Whoops, the dirty hydraulic fluid was used instead of detergent. For months. Aramark inspected and re-inspected, or so it claimed, and found nothing wrong. Some inspection: the proper detergent was milky white, the used hydraulic fluid looked like maple syrup.

Numerous patients said they suffered injury and sued for malpractice.

In a statement, Duke was as cold as could be. Look at the first sentence: "We appreciate and understand that some of the plaintiffs may have physical problems for any number of reasons, including the fact that they had adverse health conditions necessitating surgical procedures to begin with."

Duke kept the lid on the scandal by reaching secret private settlements with the plaintiffs, and went to private arbitration with Aramark to recoup.

FC would like to start a regular dining column. To cover how it tastes, how much it costs, how good it is for you, on campus and off. When we get our new website in the next month or so, the column may run as a contribution by a Deputy Fact Checker, or perhaps a signed essay. No, we won't pay for your food. Interested? Write Duke.Fact.Checker@gmail.com



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