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Issue Date: September 2008

Health Mood

Lynne Thompson
Junk-food junkies who work at the Cleveland Clinic are having a harder time finding a fix these days. The medical institution’s more than 100 vending machines, along with those at its regional hospitals and health centers, have undergone an extreme makeover.

Greasy chips and cheese curls have been replaced with lower-fat baked items, and pita chips now reside where the snack cakes once did.

The nutritional upgrade is part of the Clinic’s continuing effort to offer better food choices, according to chief wellness officer Dr. Michael Roizen, who calls the typical vending machine’s selections “atrocious.”

“Employees get hungry in the late afternoon, and they make a bad food choice because the vending machines have only bad food choices in them,” he says.

Clinic guidelines now stipulate that snacks in its machines should have fewer than 250 calories, no more than 25 percent of which are contributed by added sugars, less than 35 percent fat (unless they’re heart-healthful monounsaturated fats), under 10 percent saturated fat, no trans fat and fewer than 200 milligrams of sodium.

Not all options are as healthful as Roizen would like. Some don’t even meet all Clinic guidelines. The exceptions are what Roizen calls “best of class” alternatives stocked at the request of employees. Even with the compromises, sales are down 30 percent, and Roizen doesn’t mind at all.
Junk Food
Healthier Alternative
Roizen’s Take
Lay’s Classic Potato Chips
Calories: 230; Fat: 15g;
Sodium: 270mg;
Sugars: 0g
Nature’s Select Barbecue Toasted Soycrisp
Calories: 115;
Fat: 3g; Sodium: 220mg;
Sugars: 1g
Yes, he’ll actually eat these. “It has fiber and protein, and it tastes good.”
Calories: 320; Fat: 20g;
Sodium: 590mg;
Sugars: 2g
Pepperidge Farm Goldfish Crackers
Calories: 200; Fat 7g;
Sodium: 360mg; Sugars:
less than 1g
Better for you than Cheetos, but still above Clinic guidelines. “They have almost twice the sodium.”
Calories: 280; Fat: 14g;
Sodium: 140mg;
Sugars: 30g
Kashi Cherry Dark Chocolate Granola Bar
Calories: 120; Fat: 2g;
Sodium: 75mg; Sugars: 8g
At 8 grams of sugar, it’s still too sweet for Roizen’s taste. “Really, we try and stay under 4 grams.”
Planters Dry Roasted Peanuts
Calories: 320; Fat: 28g;
Sodium: 190mg;
Sugars: 2g
Blue Diamond Whole Natural Almonds
Calories: 250; Fat: 22g; Sodium: 0mg; Sugars: 2g
It’s the most healthful snack in the machine. “They don’t have anything added.”
Thursday, October 02, 2008 3:00:52 PM by Anonymous
While it is great to offere a choice of healthy alternatives, what kind of "choice" are you offering if you take away all the "bad" things? We are adults and should be able to make a decision for ourselves and have both healthy and "non-healthy" choices available
Thursday, October 02, 2008 3:09:17 PM by Anonymous
Everything in moderation, except at the Cleveland Clinic. They won't allow for moderation.
Thursday, October 02, 2008 3:13:44 PM by Anonymous
I appreciate that the Clinic is utilizing a "practice what you preach" method to prevention. As adults, its not difficult to bring in our own food if we don't like what the Clinic has to offer.
Thursday, October 02, 2008 4:00:19 PM by Anonymous
I applaud this effort. Unfettered access to unhealthy food choices is a major contributor to the obesity epidemic.
Thursday, October 02, 2008 4:14:54 PM by Anonymous
It makes sense to me that if you are a healthcare provider and you are telling your patients to eat less sugar, fat, and sodium, then you would not sell them items like snickers and potato chips! The temptation to buy junk food is everywhere, but it does not belong in a hospital.
Friday, October 03, 2008 2:32:25 PM by Anonymous
It's an interesting idea, good in principle. I don't normally buy candy bars but 4 or 5 times a year. My only source is (was) vending machines. Now each time I go to Sam's Club I think, "Mmmm. 1 gross of Snickers...." If I bring 'em home, my family will devour them, and if I bring 'em into work, my coworkers will devour them.

I suggest a little middle ground: 2 or 3 candy bar choices among the healthy ones.
Monday, October 06, 2008 7:54:09 AM by Anonymous
I hope Roizen doesn't start dictating color coordinating choices for clothes too.
Tuesday, October 07, 2008 4:32:34 PM by Anonymous
It's not a choice when you only have what healthy cardboard like snacks to eat
Tuesday, October 07, 2008 4:37:41 PM by Anonymous
I thank Dr. Roizen for all that he is doing at the Clinic. As an employee we should be practicing what we preach to our patients. Personally I would feel like a hypocrite if I was trying to tell a patient they needed to lose weight and eat healthy and there I am 20lbs overweight doing nothing to try to better myself. What kind of example are we setting for our patients?? Dr. Roizen has the right idea and I hope people can open their eyes and see the big picture!
Tuesday, October 07, 2008 4:38:12 PM by Anonymous
What is next? Only organic choices from our food service vendors? While I think that these are valid ideas coming from the Clinic in promoting healthy food choices, I also think that it is exerting a little too much control over the employees (overweight or not) and catering to the choices and wants of the few. We also need to keep in mind food allergies and other such medical needs when stocking any food for sale. Will the Clinic start telling employees that they cannot bring these "banned" snacks to work? No parties & such because celebration cakes are a bad food choice? We'll be fine if we keep it all sensible.
Tuesday, October 07, 2008 5:01:17 PM by Anonymous
Maybe if they posted the nutritional value for their cafeteria food, that would help people make a more informed decision as well. The vending machines are a jokehalf the stuff in there is not as healthy as some of the things they took out.
Tuesday, October 07, 2008 7:01:32 PM by Anonymous
I am an employee however I do not work in direct patient care. I myself, along with others I know are not fans of the healthy vending machine choices. There are people who would like to gain weight and we should have the right to eat unhealthy if we want to. Like other commenters have written, we are adults and should be able to make the choice whether or not we want to eat healthy or junk food. I feel that taking junk food away completely is unfair. It's bad enough that the cafeteria food is extremely tasteless and limited, but now you're taking away the only hope that was left within the vending machines. I hope that you will reconsider and leave well enough alone.
Wednesday, October 08, 2008 7:06:02 AM by Anne Jolly
What is the clinic doing about employees, patients, visitors who have special diet needs, such as diabetes and celiac disease? For those of us with these diet restrictions, the vending machines are next to useless.
Anne Jolly
Wednesday, October 08, 2008 7:39:36 AM by Anonymous
I work at the CBO and think it is a great idea to make healthy choices in the vending machines. We have a café here that I hope one day will give us better and healthier choices. I know that a group of us here would also love a place to work out as well and eat right. More and more people are opting for weight loss surgery as an easy way out and as everyone knows as long as you diet and exercise you can lose weight. It just means making the right choices. So I applaud Dr Roizen for what he is doing.
Wednesday, October 08, 2008 8:13:34 AM by Anonymous
While the vending machines may be healthy, I had a catered lunch here at the Clinic the other day and the baked beans had bacon on them. I wish I could get bacon out of the vending machine
Wednesday, October 08, 2008 8:14:25 AM by Marcie Wright
I'd like to thank you for taking my health and better eating habits of interest. But as a woman I would like some chocolate. Esspeically when mother nature comes.And I need to calm those hormonal craves.So PLEASE think about this little pleasures when removing all the junk food.
Wednesday, October 08, 2008 9:01:04 AM by Anonymous
Healthy options are a wonderful idea and I applaud the effort. But, I am in total agreement with Marcie. Some of us just need that “little something” late in the day. My department proudly displays several candy jars throughout and it’s amazing how much faster the candy is disappearing now that there are no other options available. I think people are grabbing a piece of candy on their way by because they know they may not be able to get it later when they actually want it. I used to purchase a bag of peanut M&Ms maybe once every 2 weeks. Now I keep a bag in my drawer and find that I’m eating them every day!!! If only they were hidden away in the vending machine, for emergencies, like they used to be!!!
Wednesday, October 08, 2008 10:16:28 AM by Anonymous
What a bunch of cry babies you all are! As one said above you are ALL adults. Stop complaining about food you can't get. You here to work not eat. And maybe some don't need to snack during the day. If your not "adult" enough to bring in your own food and eat it in balance, I don't think the vending machine will solve your problem. GROW UP PEOPLE. Oh one other thing. Think of all the children starving everywhere. Some are eating mud pie's to stay alive, maybe we should put some of those in the vending machine?
Thursday, October 09, 2008 3:53:53 AM by Anonymous
Friday, October 10, 2008 2:12:59 AM by Anonymous
The Clinic has never subcribed to the theory that happy employees make happy workers. they prefer to rule by intimidation. Eat this, wear this, say this, and dont get sick in the midst of all these germs. They dont' practice at all what they preach about . and 3.99 for a "healthy candy bar"!!! the clinic dosen't pay enough foryou to afford it.!!!!!!!!!
Friday, October 10, 2008 4:18:39 PM by Anonymous
Might not help me to live longer but it sure will seem like it.

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