This Mass. nonprofit makes Thanksgiving feasts for people with dietary restrictions

Meals were assembled for freezing at Community Servings ahead of Thanksgiving. The nonprofit prepares 625,000 meals annually.Lane Turner/Globe Staff/Globe Staff

Behind the soaring glass wall of a newly renovated building in Jamaica Plain, a crew has been busy doing what many of us have been doing in recent days: making Thanksgiving dinner.

But unlike the rest of us, these folks are whipping up thousands of meals — and they all meet the strict dietary requirements of people with a variety of chronic illnesses.

If the idea of mass-produced healthy meals conjures images of soggy school lunches or austere “diet food,” a visit to Community Servings would quickly dispel such notions.

For nearly 30 years, this little-known nonprofit has been cooking and delivering “medically tailored” meals to sick, homebound people throughout Eastern Massachusetts, currently 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 we’re making,” said executive chef Brian Hillmer, who has previously worked at such restaurants as Legal Sea Foods, Not Your Average Joe’s, 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.

Student Clifton Braithwaite carved roast beef. Community Servings prepares 625,000 meals annually for 2200 clients with critical or chronic illnesses. Lane Turner/Globe Staff

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,” said 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, you’d probably find that impossible.” For people without access to quality food or too sick to get off the couch, Waters said, “the system sets you up to fail. That’s when you become that high-cost patient.”

But food can’t promote health if it goes in the trash instead of the stomach, and many sick people have no appetite.

That’s 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.

Sweet potatoes were washed before being made into pies as part of the organization’s Thanksgiving preparations.Lane Turner/Globe Staff

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 week’s 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 doesn’t contain as much salt as the American palate has come to expect. Hillmer said the dearth of salt is one complaint he can’t 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.)

Meals were assembled for freezing. Community Servings’ menus.Lane Turner/Globe Staff

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,” said chef Hillmer, “we just want to feed our neighbors and make sure they’re healthy.”