When Hawaii’s prisoners sit down to Thanksgiving dinner Thursday they will be eating turkey loaf, mashed potatoes, gravy, hot vegetables and pumpkin pie. But their holiday meal will be healthier than prison meals of the past. The food will be low sodium and low fat. That’s because all 4,000 inmates incarcerated in Hawaii have been put on a Heart Healthy diet.

The Public Safety Department started serving so called “Heart Healthy” meals to Hawaii inmates last year. Prisons director Ted Sakai says the new diet was adopted to address soaring medical costs in the prisons. And also, because it is the duty of prison managers to keep inmates in good health.

Sakai says “the main health problem in Hawaii prisons used to be AIDS and hepatitis. AIDS and hepatitis are still problems, but in recent years the chief medical officer is seeing more and more diabetes, hypertension and serious heart disease. One way to address this is to change the prisoners’ diet.”

Adding to prison health woes is the population of elderly inmates locked up for long terms — the aging men and women convicts suffer from the same health problems that afflict elderly people everywhere. And beyond that is the fact that most convicted criminals are unhealthy in the first place.

Public Safety spokeswoman Toni Schwartz says when they check in to prison they are already in bad shape from drug use or homelessness and lifelong diets of cheap, junk food. “Years and years of eating plate lunches,” says Schwartz.

The Heart Healthy diet is based on the U.S. Department of Agriculture’s MyPlate dietary guidelines. The diet menus were reviewed and approved by registered dietician Dalton Cheung in a prison food review conducted from July to December 2011.

The menus call for two servings of fruit a day (usually fresh fruit, but canned fruit can be offered when fresh fruit is not available), and three servings of fresh or frozen vegetables including at least one salad a day. The diet also increases the previous amount of dietary fiber in the prison diet with more whole wheat bread and brown rice. Before, the convicts’ diet was all white rice. Now half of all rice served to prisoners must be brown.

Prisons director Sakai is in the process of closing down the special white rice bar that was set up for the 1,400 Hawaii inmates at Saguaro Prison in Eloy, Arizona. Until now, Saguaro inmates have been allowed to eat as much white rice as they wanted at breakfast, lunch and dinner.

Sakai said some Hawaii prisoners have been loading their plates at each meal with five scoops of rice doused in shoyu.

“The nursing facility at Saguaro was reporting rising rates of hypertension. We plan to gradually close down the rice bar and replace it with regulated servings of rice at meals, half of which will be brown rice,” said Sakai.

To increase calcium and protein, the Hawaii prison’s Heart Healthy diet now includes 8 ounces of skim milk at both breakfast and dinner. Before, milk was served only at breakfast. Powdered skim milk is also used in various entrees and soups to boost calcium consumption. Inmates’ meals include two servings of fish a week as part of the 6 ounces of protein a day recommended in the diet.

Male and female inmates in Hawaii’s prisons eat the same Heart Healthy meals. The menus for both populations average 2,546 calories a day, which dietician Cheung says is a recommended dietary standard for generally healthy adults aged 30 to 49 years old in a sedentary prison population.

Inmates can also opt for vegetarian meals, which include eggs and milk. All vegetarian meals and special medical and religious meals served to prisoners must follow Heart Healthy diet guidelines including the required amounts of fresh vegetables, fruits and whole grains and protein.

Sakai also is trying to encourage inmates to purchase healthier snacks in prison commissaries by raising the prices on salty foods like the ramen noodles packets he says are loved by prisoners, and candy, and decreasing prices on healthier snacks like granola bars.

Brian Watanabe, the head of the prisons’ Food Service Branch, says the main complaint from inmates about the Heart Healthy diet is they say are not getting enough food. Inmates are allowed one serving at each meal, no seconds.

During a recent visit to Halawa prison, I saw the narrow opening beside the mess hall cafeteria counter through which inmate food workers serve food to other inmates. The convict food workers are prevented from seeing whom they are serving so they don’t give their friends double portions or serve skimpy amounts to their enemies.

In a piece in the Honolulu Star-Advertiser in May 2011 before the new diet was started, three Halawa inmates said they were suffering from unwanted weight loss because of meager food portions. All three, George Rowan, Jonathan Namauu and Paul Keck are still incarcerated.

Prisons spokeswoman Schwartz said the three have not complained about the new Heart Healthy meals. But Earle Partington, the attorney for Keck and other convicts, says his clients tell him the portions are still too small.

The State Ombudsman, Robin Matsunaga and the Public Defender Jack Tonaki told me they always receive complaints from some inmates about meager food portions and they continue to receive critical reports but without specific mention of the Heart Healthy diet.

Prison food services administrator Watanabe says the 2,500 to 2,900 calories served to inmates each day is a standardized recommendation for a population that is getting very little exercise. Watanabe says to serve more food would defeat the purpose of trying to keep the prisoners healthy.

A prisoner losing weight can ask to see a doctor and the doctor can request that the inmate receive a special higher calorie-high protein diet but the prisons says that doesn’t happen very often.

The U.S. Supreme Court has consistently ruled that prisoners have the right to ample, nutritious meals, including meals required by their religion and meals to meet medical needs.

Reducing food amounts is not allowed as a way to punish inmates as many prisons did in the 1800s when unruly inmates were given only bread and water until prison authorities deemed their behavior reasonable enough for them to be served regular meals.

It is also not OK to stuff prisoners with enormous amounts of food as Alcatraz Federal Penitentiary did in the 1940s when it fed its inmates more than 5,000 calories a day in the belief that fat, lethargic prisoners would be less violent. A 1946 Alcatraz weekly menu plan posted on the San Francisco Chronicle’s food blog shows meals that included layer cakes, orange Jello, frosted cupcakes and apricot pie.

Kat Brady, whose Community Alliance on Prisons, advocates for Hawaii prisoners’ rights, says she hasn’t heard any complaints from inmates since the Heart Healthy diet started.

“I am glad they are doing a healthy diet,” Brady says. “Before this, everything the prisoners ate was kind of a beige slop. Green vegetables and fresh fruit were virtually non-existent.”

Brady says “even if the inmates don’t like the diet at first, and they are missing their Spam and loco mocos, this is showing them the prison is taking an interest in their health. This is important to the community because 95 percent of the inmates eventually will be released and if they come out in poor health, it will have a terrible effect on already overburdened community health systems.”

Prisons director Sakai says the department only started recording the Heart Healthy diet’s health effects this year so it is still too early to offer statistical proof that the diet is making a difference. But Sakai says one encouraging sign is the medical units have decreased their requests for specially prescribed medical meals for inmates by about 50 percent.

“If we can make the inmates healthier with this diet, it is a good thing,” said Sakai.

DISCUSSION: *What do you think of the prisons’ dietary restraint?

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