Head of Cleveland Clinic Is Attacking Big Mac

[Guest guest]

By Ceci Connolly

CLEVELAND -- The Pizza Hut is shuttered, its neon sign collecting dust on

the floor. But knocking down the Golden Arches has proved far more difficult

for Toby Cosgrove, the new head of the Cleveland Clinic.

A heart surgeon who has cleaned out a career's worth of clogged arteries,

Cosgrove didn't think Big Macs, supersize fries and inch-thick, six-cheese

pizzas belonged in the lobby of a hospital renowned for its cardiac care. So

he decreed the fast-food joints had to go.

Pizza Hut went quietly. But Mc's, halfway through a 20-year lease,

has refused to shut down a franchise that serves 12,000 doctors, nurses,

janitors, secretaries, patients and visitors each week.

" Our menu is something we're all proud of, " said Marty Ranft, a Mc's

vice president. " We've got a great relationship with the Cleveland Clinic.

We are not interested in closing " the restaurant.

In the struggle against obesity, Americans are losing. And among the

favorite targets for blame are fast-food chains such as Mc's. Studies

show that consuming large portions of high-fat, salty, sugar-laden foods has

helped create a nation in which 64 percent of people are overweight or

obese. They often land here at the Cleveland Clinic seeking treatment for

diabetes, strokes, heart failure and crippling joint pain.

" We have to set an example with the food we serve our patients and

employees, " said Cosgrove, a trim 63-year-old. " In a way, Mc's was

symbolic as much as anything else. It is not associated with heart-healthy

food; neither is Pizza Hut. "

But Cosgrove's crusade has been met with resistance from not just

Mc's executives, who say they are being singled out for a problem that

goes beyond the occasional Happy Meal, but also from staff and visitors who

resent what they consider to be a paternalistic attitude from bosses who can

afford pricier, more healthful food.

" What they have in the cafeteria is not a lot better, and it's certainly

not affordable, " said Donna Wilkison, a post-operative nurse waiting in line

for her Mc's salad with chicken. The cafeteria salad bar, priced at

$4.64 a pound, " gets very expensive. They need to bring in something else

that's more affordable. "

On its sprawling urban campus, the clinic has a Subway sandwich shop, Au

Bon Pain and Starbucks. Adjacent to the Mc's is a cafeteria that

features a large salad bar, a grill, a deli and hot entrees. The choices

range include fresh fruit and homemade mashed potatoes. At Subway, salads

begin at $3.99 and subs are about $5. Mc's salads cost $4.10.

Nutritionists such as Montefiore Medical Center's Miriam Pappo said the

Cleveland Clinic battle is akin to fights being waged in America's schools

-- and a handful of other hospitals -- over candy, soda and fast-food sales.

She said it was " appropriate " for clinic officials to act as role models,

yet Pappo sympathized with Mc's' argument that no one forces people to

eat there. " In a way, they are a scapegoat, " Pappo said. " But in other ways,

they are contributing for sure. "

Of its 13,000 U.S. locations, about 30 Mc's outlets are in hospitals,

including children's hospitals in Los Angeles and Philadelphia. The New York

City Health and Hospital Corp. does not intend to renew the Mc's

contract at its Elmhurst hospital and has not decided whether to keep the

one in the y Medical Center in the Bronx, spokeswoman Kathleen McGrath

said. The Harlem hospital closed its Mc's earlier this year.

The Cleveland debate began two years ago when one of the clinic's most

talented, most outspoken heart surgeons rose at a staff retreat to question

how in good conscience they could tempt their patients with such unhealthful

products.

" I can't tell you how many patients found this repulsive, " said cardiology

chairman Topol. " How can the Cleveland Clinic, which prides itself on

promoting health, have the audacity to have a Mc's in the main lobby? "

Some days, the scent of cooking grease wafts up the one flight to Topol's

domain, a heart center that has been ranked first in the nation by U.S. News

& World Report for 10 straight years. He has heard all the wisecracks and

not-so-amused comments about serving up a side of fries with that

angioplasty.

" If this was a strip mall or a food court in a public place, that would be

a different matter, " he said in an interview. " We're supposed to be the

icons for promoting good health. "

Margo Wootan, director of nutrition policy as the left-leaning Center for

Science in the Public Interest, said Mc's few salads, fish sandwiches

and fruit drinks do not make up for its overwhelming emphasis on fried

foods.

" They announced with a lot of fanfare they were going to change the frying

oil, and they never followed through, " Wootan said. " There's twice as much

heart-damaging fat in the french fries and nuggets and apple pies in the

lard they use. "

Mc's executives accuse Topol, Cosgrove and Wootan of opportunism and

demagoguery, targeting an easy villain rather than the individuals doing the

eating.

" If Dr. Cosgrove wants to say Mc's is inconsistent " with the health

goals of the hospital, " he needs to take a look at the vending machines with

candy bars and salty snacks, the cafeteria with deep-fried chicken, baked

pies and slabs of ribs, " said Whitman, director of U.S. media

relations for Mc's.

Mc's nutritionists point to numerous high-calorie, high-fat foods in

the clinic cafeteria. But their comparison of " typical meals " tallies a

cafeteria breakfast of orange juice, three scrambled eggs, two pork sausage

patties, two hash browns and two slices of toast against the steak, single

egg and cheese on a bagel with hash browns from Mc's.

As the burger battle has escalated, Mc's public relations gurus have

rolled out legal, political and economic arguments. They defend their food

as healthful. But they also have suggested that Cosgrove is racist for

targeting Turan Strange, the African American small businessman who owns the

franchise, raised the specter of unemployment for its 40 low-wage workers

and said that closing down will hurt Ohio beef producers.

Wilkins, a representative of the National Black Mc's

Operators Association, warned Cosgrove: " We vigorously support one another

and will not hesitate to do so with every resource available to us. "

In the meantime, business is brisk at the Cleveland Clinic Mc's, one

of four owned by Strange.

" I try to eat healthy, but for lunch I want something that's cheap, " said

Sutton, who works 5 a.m. to 1:30 p.m. in patient food service. " At 11

a.m. they're still serving breakfast in the cafeteria, but that's my lunch

break. " She eats at the Mc's a few times a week.

Nudged by his wife, engineering supervisor r walks through the

cafeteria salad bar, loading his plate with lettuce, onions, tomatoes,

mushrooms, eggs, cucumbers, cheese cubes and diced ham, which he knows is

not good for his high blood pressure. But he has also opted for Mc's

or Pizza Hut: " I can't eat salad all the time. It's rabbit food. "

Near retirement age, r doesn't want his boss telling him what to eat.

" If it's killing me, then that's my choice, " he said.

Mc's officials said they want to work with the clinic to develop more

healthful menu options. But Cosgrove did not sound interested. He suggested

a financial settlement is in the offing.

His next target: tobacco. He wants the Cleveland Clinic smoke-free by

Independence Day.