For nearly 30 years, this little-known nonprofit has been cooking and delivering medically tailored meals to sick, homebound people throughout Eastern Massachusetts, today serving about 1,000 clients a day. And now spreading its wings after a $24 million expansion, with its founding concept of food is medicine gaining traction nationwide Community Servings is poised to start serving the entire state next month.
On a recent afternoon, the scent of cinnamon filled the room as Nick Bruning, a packaging manager who also has a special interest in dessert, slathered a thin piece of amber cake with cream cheese filling and curled it into Swiss pumpkin roll.
In another room redolent of roasted meat, a worker sliced a golden-skinned turkey breast; another slid a knife through a chunk of roasted ribeye. Elsewhere, a tray of pumpkin truffles coated in dark chocolate awaited packaging, and workers peeled the deep purple skin of eggplants about to be chopped and roasted.
Mission No. 1 is to make people want to eat the food were making, says executive chef Brian Hillmer, who has previously worked at such restaurants as Legal Sea Foods, Not Your Average Joes, and Tavern in the Square.
In addition to the turkey and ribeye, the Thanksgiving menu options include cranberry-apple braised chicken, roasted sirloin, spaghetti squash gratin, spiced citrus baked fish, and roasted vegetable risotto.
The clients live with conditions in which diet plays a role including diabetes, cancer, heart disease, HIV, and kidney disease and are unable to shop or cook for themselves. Most have multiple diagnoses. The average age is 53.
Community Servings provides each with two meals plus snacks for five days a week. The meals are free to patients, the vast majority of whom live below the poverty line.
The meal becomes almost like a prescription, says chief executive David B. Waters. If I said to you, Go to the store and make a meal that controls for glucose, potassium, phosphorus, sodium, and vitamin K, no matter who you are, youd probably find that impossible. For people without access to quality food or too sick to get off the couch, Waters says, the system sets you up to fail. Thats when you become that high-cost patient.
But food cant promote health if it goes in the trash instead of the stomach, and many sick people have no appetite.
Thats why the menu starts with the chef. Hillmer dreams up something delicious, and then shows his plans to Valerie Machinist, director of nutrition services, who employs a computerized recipe analysis program to break down the nutrient content.
A back-and-forth ensues between the guardians of nutrition and taste. Swapping an ingredient here, reducing a portion there, they collaborate to devise meals that are appealing, nutritious, and medically appropriate.
For example, everyone who eats meat received Thanksgiving turkey, but only breast meat with a small piece of skin. The Swiss pumpkin roll was lightened with whipped egg whites and low-fat cream cheese in the frosting.
The menus address 15 medical diets. Kidney-disease patients have the most restrictions, needing to avoid whole grains, potatoes, beans, and legumes. Heart-disease patients get dishes with little sodium and saturated fat. People with diabetes must limit carbohydrates.
Menus take into account a weeks worth of meals, rather than individual dishes. To compensate for cake, there may be fewer carbohydrates in the other components, for example.
By nutritional necessity, the food doesnt contain as much salt as the American palate has come to expect. Hillmer says the dearth of salt is one complaint he cant address.
A few days before Thanksgiving, an assembly line of workers was packing the food, weighing each component before spooning it into the container, which they then sealed in plastic, labeled, and froze. (The agency can serve only people with refrigerators to store the food and microwaves or stoves to heat it.)
Community Servings has 60 employees, their efforts boosted by about 75 volunteers a day. Additionally, much of the food preparation is done by participants in a 12-week food service training program for people emerging from incarceration, addiction, homelessness, or other challenges.
The agency has its roots the AIDS epidemic, and was founded in 1990 by the American Jewish Congress. At the time, with no treatment available, AIDS patients were dying of a wasting syndrome.
We became the only medicine, Waters said. We were trying to keep people we loved alive in hopes of a cure, in those early, scary years. A dozen similar groups sprang up across the country in the cities most affected by AIDS, but Community Servings is the only one of its kind in New England.
Though no cure ever came along, medications now enable most HIV and AIDS patients to live full lives, and in 2004 Community Servings expanded its mission to other sick people. Still, HIV patients make up a third of its clients.
In the ensuing years, Community Servings has sought to demonstrate that its charitable work also makes business sense, by partnering with food researcher Seth A. Berkowitz. He has published studies in major journals showing that Community Servings clients spend fewer health care dollars, use hospital emergency departments less frequently, and experience dramatically fewer hospital admissions.
Those findings caught the attention of health insurers, and cleared the way for Community Servings to win contracts with managed care organizations. Such arrangements have boosted its resources beyond the federal grants and charitable donations on which it has relied.
In December the agency will expand beyond the 21 communities it now serves to reach the entire state, shipping its frozen meals by UPS to the farthest reaches of the Berkshires.
At our core, says chef Hillmer, we just want to feed our neighbors and make sure theyre healthy.
Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer
Original post:
This Mass. nonprofit makes Thanksgiving feasts for people with dietary restrictions - The Boston Globe
