The science linking a poor diet to illnesses like heart disease and cancer is robust. This past October, the World Health Organization released a report placing processed meat in the highest-risk category for carcinogens, and declaring red meat “probably carcinogenic.” Meanwhile, the latest dietary guidelines from the U.S. Office of Disease Prevention and Health Promotion emphasized the health value of plant foods.

This fact—a plant-based diet is healthier than a meat-heavy one—isn’t exactly new knowledge. But even as medical researchers discover more about the foods that keep our bodies well, many hospitals continue to serve foods that promote disease. Last year, the Physician’s Committee for Responsible Medicine (PCRM), a nonprofit group composed of 12,000 doctors, issued a damning report about the healthfulness of hospital food in the U.S. Of the 208 hospitals surveyed, 20 percent housed fast-food restaurants like McDonald’s, Chick-fil-A, and Wendy’s on their campuses. And in a study led by Lenard Lesser, a family-medicine physician at the University of California, San Francisco, and an advisor on hospital food environments for the Centers for Disease Control and Prevention, 98 out of 233 university-affiliated teaching hospitals (around 42 percent) had at least one fast-food franchise on campus. Lesser’s findings were similar to another report published in JAMA in 2002, which found that six of the top 16 hospitals in the U.S. housed fast-food establishments.

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