Just what the doctor ordered: Brazil’s drive to ditch UPFs from hospital menus

E very month a few dozen staff from some of São Paulo’s leading hospitals take time out of their busy schedules to visit food fairs where stallholders from more than 50 local farms display their produce. The aim is to strike deals that will supply the hospitals with organic vegetables, homemade bread and other locally made foods. Started in October 2023, the fairs are part of a revolutionary scheme in São Paulo state to phase out ultra-processed foods (UPFs) from hospital menus in favour of heal

“It’s not only cooks, nutritionists, meal planners and hospital management who attend the fairs but also nurses and doctors,” says Weruska Davi Barrios, a specialist in hospital nutrition at the University of São Paulo, the institution that has initiated the project. These events represent an opportunity for hospitals to fill their order books for vegetables, fruits, herbs and spices, and also to sample artisanal delicacies made from lesser-known plant species unique to Brazil’s remarkably diverse ecosystem. Many of them have been threatened by the degradation of rainforests and saved by the farmers. While Brazil’s hospitals have always attempted to use fresh vegetables and natural foods where possible, UPFs have increasingly worked their way into hospital menus in recent decades, despite accumulating evidence that they actively worsen health. One 2019 study estimated that 57,000 premature deaths in Brazil every year were being caused by UPFs . As well as selling fruit, vegetables and spices, the food fairs give hospital staff a chance to sample foods made from plant species unique to Brazil. “We’re using our money from the national health system to buy ultra-processed foods,” she says. “It shouldn’t be something that we accept.” Yet it’s also a complex problem to address. Transitioning to freshly grown foods requires building hospital kitchens, investing in cold storage, creating transportation networks to deliver the food from farms, and running educational programmes to explain the benefits to overworked staff and bemused patients. Some of this has already begun, but it remains a work in progress. “Change is gradual, and as more local foods become part of the purchasing plan, fewer ultra-processed foods will be needed to compose patients’ diets,” says Barrios. The idea has now gained political backing in other states.

Key points

• “It’s not only cooks, nutritionists, meal planners and hospital management who attend the fairs but also nurses and doctors,” says Weruska Davi Barrios, a specialist in hospital nutrition at the Un…
• These events represent an opportunity for hospitals to fill their order books for vegetables, fruits, herbs and spices, and also to sample artisanal delicacies made from lesser-known plant species…
• Many of them have been threatened by the degradation of rainforests and saved by the farmers.
• While Brazil’s hospitals have always attempted to use fresh vegetables and natural foods where possible, UPFs have increasingly worked their way into hospital menus in recent decades, despite accum…
• One 2019 study estimated that 57,000 premature deaths in Brazil every year were being caused by UPFs .