2026年4月30日 美国东部时间早上5:00 / KFF健康新闻
对医院餐食的抱怨早已不是新鲜事，果冻和果汁更是常被拿来当相关笑话的笑柄。但特朗普政府近期加码了这一议题。
该政府正敦促公众举报供应含糖饮料、营养奶昔或其所称不符合农业部去年制定的饮食指南的医院和疗养院，官员们誓言，若出现违规行为，将截留数百万美元的联邦拨款。
卫生与公众服务部部长小罗伯特·F·肯尼迪发起的这项倡议，引发了一些医生和医疗服务提供者的强烈反对，他们称该举措未考虑患者的特殊饮食需求，同时也触怒了长期秉持反监管立场的共和党人。
律师和营养师表示，目前也不清楚卫生与公众服务部是否拥有无需经过正式规则制定程序就能执行其威胁的监管权限。
“这其中大部分都是政治作秀。卫生与公众服务部并没有多少实权，”多伦多大学助理教授、营养师兼研究科学家凯文·克拉特说道，“再者，如果到了要管控人们选择的地步，那看起来可有点法西斯主义那味儿了。”
肯尼迪在3月30日的新闻发布会上表示，该机构已向医院发送通知，要求其食品采购符合政府2025至2030年的饮食指南，以确保其继续有资格获得医疗补助和医疗保险拨款。
“我们将让全国所有医院都遵循健康饮食标准，”他称这些指示“本质上是一项联邦强制要求”。
但当被问及该指导方针时，卫生与公众服务部发言人安德鲁·尼克松在一份声明中表示，它“并未制定新的强制要求、改变医疗保险参与条件，也未为医院或疗养院设置任何新处罚”。
“该指导方针并未对执法、调查或认证流程做出任何调整，”他补充道。相反，他将这份通知描述为基于“长期以来的期望”，即医疗机构将满足患者的营养需求作为“安全、高质量、以患者为中心的护理的一部分”。
尼克松还淡化了肯尼迪高级顾问卡利·米恩斯发出的威胁。米恩斯曾呼吁公众举报不遵守该指导方针的医院。
“如果医院向患者提供含糖饮料，那么它们就不符合政府标准，其报销资格也将面临风险，”米恩斯在X平台上发帖称，“如果你看到患者被提供含糖饮料，请在下方发布相关信息，或告知医疗保险和医疗补助服务中心。”
该评论附带了一个指向卫生与公众服务部网页的链接，页面上有一个通常用于医疗账单投诉的免费举报电话。截留医院的联邦拨款是监管机构可用的最极端执法手段之一，医疗保险和医疗补助服务中心很少动用这一手段。
米恩斯警告称，即便向患者提供像安素这样的液态营养产品，也可能让医院陷入风险。“它们需要做出改变，否则就会失去报销资格。如果你看到这种情况，请举报它们，”他在回复一名X平台用户时说道。
医疗保险和医疗补助是医院支出的最大支付方，二者合计占比极高。
尼克松在声明中并未点名米恩斯，而是表示“提及外部网站或热线与本指导方针无关，也不代表卫生与公众服务部或医疗保险和医疗补助服务中心的政策。这项工作体现了我们致力于为提供者提供清晰、基于证据的信息，以帮助他们持续改善患者治疗效果”。
米恩斯并未直接回应KFF健康新闻的置评请求，而是在被联系后不久在X平台上发帖称：“‘特朗普精神错乱综合征’导致民主党人捍卫向美国患者大规模供应苏打水和垃圾食品的医疗重要性。”在发给KFF健康新闻的短信中，他说道：“这句话可以引用。我没有其他评论。”
尽管如此，一些政府官员明确表示，他们不会回避停止联邦拨款这一手段——这一极少采取的步骤可能会危及医院的运营能力。
胡萝卜加大棒
卫生与公众服务部可以在医院违反该机构制定的强制性最低健康和安全标准时截留或以威胁截留联邦拨款。例如，这些标准规定医院必须保护患者隐私并落实感染防控措施。
这些标准确实涉及医院餐食，但并未明确提及农业部2025至2030年的饮食指南。
相反，标准要求“必须按照公认的饮食惯例满足患者的个体营养需求”，并列出了医院的其他要求，例如配备合格的营养师。
“医疗保险和医疗补助服务中心此前从未将这一要求解读为强制遵守任何一套饮食指南，”奥云、古普、斯特劳斯、豪尔&费尔德律师事务所4月13日的一份简报写道。
根据该简报，医疗保险和医疗补助服务中心的备忘录显示，该机构正在采取“显著举措”，在未制定新规则的情况下将饮食指南“纳入医院监管框架”。
一些律师表示，医院很可能会遵守规定，因为它们不愿与联邦政府作对，也希望避免与肯尼迪产生法律纠纷或面临执法行动。
“他并没有法律依据这么做，但医院和疗养院根本不敢完全忽视这一点，因为这可能预示着潜在的执法行动，”密歇根大学法学院教授尼古拉斯·巴格利说道。
如果联邦拨款被截留，医院随时可以提起诉讼，挑战卫生与公众服务部的权限。
“当机构对医院说‘我们要因此收回你们的拨款’时，医院可以起诉并辩称‘看，没有任何规定要求我们用牛油炸薯条’或者类似的事情，”巴格利说道。
对于希望遵守规定的医院，该机构的备忘录提供了患者餐食的推荐和禁止示例。
食物即良药
该指导方针中的“禁止项”包括：含糖饮料或果汁。“推荐项”则包括：水、无糖茶、牛奶或咖啡。备忘录中建议的餐食包括烤三文鱼配藜麦，或以豆类为主食搭配绿叶蔬菜。
一些营养师对关注患者医院餐食的举措表示欢迎。公共卫生倡导者、分子生物学家玛丽昂·内斯特尔在其4月8日的博客《食品政治》中称赞该倡议称，“听起来棒极了！”
其他医疗领袖和医生则提出反对，指出住院患者往往有更个性化的营养需求，可能不符合联邦饮食建议。
“对于刚中风后吞咽困难的患者来说，三文鱼和藜麦是最糟糕的食物。他们可能会因此误吸，”多伦多大学的营养师克拉特说道。
未能提供特定护理标准的医院，例如提供蛋白质奶昔治疗营养不良或不健康体重下降，可能会面临法律责任。发表在同行评审科学期刊《医院营养学》上的一项临床试验结果显示，80%的营养不良老年患者通过安素等营养补充剂增加了体重并改善了肌肉质量。
生产安素的雅培公司发言人约翰·科瓦尔在一份声明中表示：“雅培生产一系列产品，包括为‘因化疗等医疗治疗而可能营养不良、因食欲不佳而无法获得足够热量’的人群提供的奶昔。”
“让人们吃饭总是很困难。在医院里体重下降会增加死亡风险，”睡眠医学专家玛丽·塔利·鲍登说道。她经常支持“让美国再次健康”运动，但批评政府呼吁在X平台上举报违规行为，发帖称：“得了吧，卡利。搞个举报医院供应苏打水的热线？”
“这有点专制，”她在采访中说道。
此次对医院餐食的关注是肯尼迪3月底推出的“让美国再次健康”倡议的一部分。在该倡议中，他大力宣传联邦饮食指南的调整，强调增加蛋白质和健康脂肪，避免加工食品。
肯尼迪一直大力倡导改变饮食习惯，这符合“让美国再次健康”运动的理念，也在民主党和共和党选民中都获得了不错的民意支持。Navigator Research 2025年9月发布的一项民调显示，86%的登记选民表示，应该让每个美国家庭都更容易获得新鲜水果和蔬菜。
_KFF健康新闻_是一家全国性新闻编辑部，专注于健康议题的深度报道，也是_KFF_——独立的健康政策研究、民调与新闻资讯来源——的核心运营项目之一。
RFK Jr.’s healthy food agenda puts hospitals on notice about patients’ meals
April 30, 2026 5:00 AM EDT / KFF Health News
Complaints about hospital food are certainly not new, and Jell-O and fruit juice are often the butt of related jokes. But the Trump administration has recently upped the ante.
It is urging the public to report hospitals and nursing homes that serve sugary drinks, nutrition shakes or meals that it says don’t meet dietary guidelines established last year by the Department of Agriculture, with officials vowing to withhold millions of dollars in federal funding if violations occur.
The initiative from Health and Human Services Secretary Robert F. Kennedy Jr. is spurring backlash from some doctors and medical providers who say it fails to account for patients’ unique dietary needs and is anathema to Republicans who have long embraced an anti-regulatory stance.
It’s also not clear that HHS has the regulatory authority to enforce its threat without going through a formal rulemaking process, lawyers and dietitians say.
“Most of this is political theater. HHS doesn’t have the power to do much,” said Kevin Klatt, a dietitian and research scientist who is an assistant professor at the University of Toronto. “Also, if it’s to the point that you’re trying to control people’s choices, well, you look a little fascist.”
The agency sent notices to hospitals asking them to align their food purchases with the administration’s 2025-30 dietary guidelines to ensure continued eligibility for Medicaid and Medicare payments, Kennedy said at a March 30 press event.
“We are going to bring all the hospitals in the country in line with good food,” he said, describing the instructions as “essentially a federal mandate.”
Asked later about the guidance, however, HHS spokesperson Andrew Nixon said in a statement that it “does not establish new mandates, change Medicare Conditions of Participation, or create any new penalties for hospitals or nursing homes.”
“There are no changes to enforcement, survey, or accreditation processes associated with this guidance,” he added. Instead, he described the notice as building on “long-standing expectations” that healthcare facilities meet patients’ nutritional needs “as part of safe, high-quality, patient-centered care.”
Nixon also downplayed a threat by a top Kennedy adviser, Calley Means, who called on the public to report hospitals that don’t comply with the guidance.
“If a hospital is serving patients sugary drinks, they are out of compliance with government standards and are putting their reimbursements in jeopardy,” Means posted on X. “If you see patients being served sugary drinks, please post information below or let CMS know.”
The comment included a link to an HHS webpage with a toll-free number for reporting complaints typically used for medical bills. Withholding federal funding from hospitals is one of the most extreme enforcement tools available to regulators, one the Centers for Medicare & Medicaid Services has seldom deployed.
Even serving liquid nutrition products like Ensure to patients could put hospitals in jeopardy, Means warned. “They need to change or lose reimbursement. Please report them if you see it,” he told an X user.
Medicare and Medicaid, combined, are the largest payers of hospital expenditures.
Without mentioning Means by name, Nixon said in his statement that “references to external websites or hotlines are not connected to this guidance and do not reflect HHS or CMS policy. This effort reflects a commitment to supporting providers with clear, evidence-informed information as they continue to improve patient outcomes.”
Means did not respond directly to requests for comment from KFF Health News, instead posting on X shortly after he was contacted: “‘Trump Derangement Syndrome’ has led Democrats to defend the medical importance of mass-serving soda and junk food to American patients.” In a text with KFF Health News, he said, “That’s to cite if you want. I don’t have a comment.”
Still, some administration officials have made it clear they will not shy away from halting federal funding, a rarely taken step that can imperil the ability of a hospital to remain open.
A carrot and a stick
HHS can withhold or threaten federal funding if hospitals violate mandatory minimum health and safety standards set by the agency. The standards stipulate that hospitals must protect patient privacy, for example, and uphold infection control.
The standards do address hospital food, but they don’t explicitly refer to the 2025-30 dietary guidelines established by the USDA.
Rather, the standards require that “individual patient nutritional needs must be met in accordance with recognized dietary practices,” and list other requirements for hospitals, such as having access to a qualified dietitian.
“CMS has never before interpreted this requirement as mandating adherence to any set of dietary guidelines,” according to an April 13 brief from law firm Akin Gump Strauss Hauer & Feld.
The CMS memo shows the agency is taking the “notable step” to incorporate the dietary guidelines “into the hospital regulatory framework without new rulemaking,” according to the brief.
Hospitals are likely to comply because they are loath to cross the federal government and want to avoid a legal tussle or enforcement action by Kennedy, some lawyers say.
“He doesn’t have a legal basis to do this, but hospitals and nursing homes can’t afford to ignore it altogether because of what it signals about potential enforcement action,” said Nicholas Bagley, a University of Michigan law professor.
If federal funding were withheld, hospitals could always sue to try and challenge HHS’ authority.
“When the agency goes to the hospital and says, We’re going to take away your money for this, the hospital can sue and say, Look, nothing requires us to fry our fries in beef tallow or whatever,” Bagley said.
For hospitals looking to comply, the agency’s memo provides examples of what should and shouldn’t be served to patients.
Food as medicine
What the guidance calls “don’ts”: sugar-sweetened beverages or juice. And “do’s”: water, unsweetened tea, milk, or coffee. Meals suggested in the memo include grilled salmon with quinoa or bean-based entrees with leafy greens.
Some nutritionists welcomed the focus on hospital food for patients. Marion Nestle, a public health advocate and molecular biologist, lauded the initiative, saying, “These sound terrific!” in an April 8 post on her blog, Food Politics.
Other health leaders and doctors pushed back, noting hospitalized patients often have more individualized nutrition needs that may not conform to federal dietary recommendations.
For “a patient struggling to swallow from just having a stroke, salmon and quinoa is the worst thing for them. They’re going to risk aspirating on it,” said Klatt, the University of Toronto dietitian.
Hospitals that neglect to provide certain standards of care, such as protein shakes to treat malnutrition or an unhealthy weight loss, could open themselves up to possible legal liability. Eighty percent of malnourished elderly patients gained weight and improved muscle mass on nutritional supplements such as Ensure, according to the results of a clinical trial published in Nutrición Hospitalaria, a peer-reviewed scientific journal.
Abbott, which manufactures Ensure, makes a range of products including shakes for people who “could be malnourished due to medical treatments, such as chemotherapy, and not be getting the calories they need because they don’t have much of an appetite,” company spokesperson John Koval said in a statement.
“It’s always a struggle to get people to eat. Losing weight in the hospital raises the risk of mortality,” said Mary Talley Bowden, a sleep medicine specialist, who has often sided with Make America Healthy Again causes but criticized the administration’s call to report violations on X, posting: “Give me a break Calley. A hospital snitch line for soda?”
“It’s a little tyrannical,” she said in an interview.
The focus on hospital food came in late March as part of Kennedy’s MAHA initiative, in which he has touted changes to federal dietary guidelines that emphasize protein and healthy fats while eschewing processed foods.
Kennedy has leaned heavily into his work on changing eating habits, which fits into the MAHA gestalt and polls well with both Democratic and Republican voters. Eighty-six percent of registered voters surveyed said it should be easier for every American family to access fresh fruits and vegetables, according to a poll released in September 2025 by Navigator Research.
_KFF Health News_is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at_KFF_— the independent source for health policy research, polling, and journalism.
