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Home Science & Environment Climate Change

NYC hospitals are nudging patients toward plant-based…

April 16, 2025
in Climate Change
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He doesn’t serve Impossible or Beyond burgers — not because he thinks there’s anything wrong with fake meat, just because he wants to serve more natural and recognizable vegetarian dishes.

“It’s gotta be authentic, and it’s gotta have flavor — not ​‘hospital food,’ just good food,” DeMaiolo said. ​“Then you gotta advertise it right, and do some education.”

There’s behavioral science behind the advertising, too; studies show that calling dishes ​“vegan” or ​“vegetarian” is a turnoff to omnivores, while adjectives like ​“zesty” or ​“hearty” are much more enticing than ​“healthy” or ​“sustainable.” Even though plant-based meals are almost always better for the climate than chicken or pork, and dramatically better than beef or lamb, describing their climate benefits is apparently counterproductive. Most people prefer to associate food with comfort, joy, and their grandmother’s kitchen, not the boiling of the planet. In general, it helps to focus on the appeal of the meals, rather than their lack of meat; people want to feel like they’re getting something, not being denied something.

Chef Phil DeMaiolo with his hospital meal plans. (Michael Grunwald)

DeMaiolo says the education component is even more important to the program’s success. He began by taking field trips to all 11 hospitals, providing samples to CEOs, doctors, nurses, and janitors, getting their input as well as their buy-in. Then the real education is done by trained food service associates who not only recommend plant-based options to the patients but let them know about the nutritional benefits of each dish and eventually send them home with green and healthy recipes they can cook themselves.

At Kings County Hospital, a nearly 200-year-old institution in the East Flatbush neighborhood of Brooklyn, a Moroccan-born food service associate named Hassan Ouhassi took his iPad to Sumlin-Gambil’s bed to make sure she had liked her mushroom stroganoff. She had; she said it tasted just like beef. He agreed; he tries every dish himself.

“I tell them it’s healthy food, I tell them they’ll like it, and they do!” Ouhassi said. ​“They clean their plates. Sometimes they ask for meat, which is fine. Not usually, though.”

A woman lies in a hospital bed. Standing next to her is a man wearing a surgical mask and a shirt, vest, and tie.
Hassan Ouhassi, right, a food service associate, follows up to find out what Pamela Sumlin-Gambil thought of her plant-based meal. (Michael Grunwald)

This is the power of defaults: We’re much more likely to register to vote, sign up to be an organ donor, or renew our Netflix subscription when we have to opt out rather than opt in. Changing behaviors is hard, and we’ll have to change quite a few to maintain a habitable planet, so New York’s nudges could be a powerful model.

“This is something uncontroversial that actually works”

Mayor Adams embarked on his plant-based journey for health reasons, after he went nearly blind in one eye and his doctors told him he’d need diabetes drugs the rest of his life, so hospitals were the perfect venue to try to deploy his plant-based vision. But his food policy team is just as focused on climate. It’s set a goal of reducing the city’s food-related emissions by one-third by 2030, and shifting from meat to plants is the best way to do that. The team is expanding plant-based meals in schools and other city-run institutions while securing commitments from private institutions like Columbia University, the Bronx Zoo, and The Rockefeller Foundation to reduce their own food-related emissions by one-fourth.

MacKenzie, the director of the food policy office, says her strategy is simple: Buy less beef, offer more plants, focus on taste, and don’t guilt anyone. The city government’s emissions from food purchases are down 29%. That’s quite an achievement, because global food emissions are rising fast, mainly because global meat consumption rises just about every year.

To meet the 2050 emissions targets in the Paris climate accord, consumers in rich countries will have to reduce their consumption of meat, especially ruminant meats like beef and lamb, by about half. The problem is, our ancestors began eating meat 2 million years ago, and it literally helped make us who we are; we evolved bigger brains to help us find meat, and smaller stomachs because we didn’t need to digest as many plants. Animal flesh will be an extremely hard habit to break, which is why the default strategy that relies on our mindless willingness to outsource our dietary choices holds such promise.

“People are overwhelmed, there’s a cacophony of information thrown at them, they’ve got too many decisions to make — sometimes they just want to be told what to do,” said Eve Turow-Paul, executive director of the nonprofit Food for Climate League, which helped design the messaging for the default program. ​“If you can make the good choice the easy choice, without getting into the political bickering of ​‘you’re taking away my burger,’ you can help people and the planet.”

Four people in uniforms smiling and holding iPads.
Food service associates offer patients plant-based meals, but they’re not pushy about it. (NYC Health + Hospitals)

The animal rights movement has tried to turn Americans against meat by exposing the cruelty of factory farms, throwing blood at models wearing fur, and holding a lot of noisy demonstrations. Biotech startups like Beyond Meat and Impossible Foods have tried to stop the expansion of animal agriculture by offering meat substitutes that tasted, smelled, and seared like the real thing. But if anything, Americans are even more committed to eating animals, as ​“meatfluencers” get rich on the internet and ​“carnivore diets” trend on Instagram.

There are plenty of exciting potential food and climate solutions, but none of them are reducing many emissions yet. My family no longer wastes food at home, because we’ve got a food waste dehydrator that converts our kitchen scraps into chicken feed, but less than 0.1% of American households have one. Pongamia trees produce more food than soybean plants on much worse land, but so far they’ve only been planted on about 0.01% of American farmland.

But plant-based defaults seem easy to implement, easy to scale, and remarkably effective. And unlike Meatless Mondays or plastic-straw bans, they don’t seem to induce defensiveness or hostility.

“We’re living in such depressing and polarizing times,” said Cantrell, the Greener by Default cofounder. ​“Well, this is something uncontroversial that actually works!”

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