Andrew Hudnall stared at his lunch and agonized about whether his doctor might be unhappy with him.

　　The 57-year-old heart patient had just bought a chicken sandwich from McDonald's - in the food court of the Cleveland Clinic, renowned for its research into heart disease.

　　"People are here for heart problems, including me. I get in here, and this is tempting," said Hudnall, who was in a hurry and didn't want to fight the crowd at other restaurants or the clinic cafeteria.

　　Even so, he said he agrees with efforts by the clinic's leading doctors to get some fast-food franchises out of the building. Pizza Hut, a division of Yum Brands Inc, has already left. Nine others remain, including McDonald's and Subway.

　　At a time when two-thirds of American adults are overweight or obese, putting their hearts and arteries at grave risk, health officials and physicians are urging people to watch their weight and eat healthier. Having french fries at a leading center for treating heart disease sends the wrong message, officials of the Cleveland Clinic believe.

　　"We are hoping we are setting some kind of a trend ... about wellness," said Angela Calman, Cleveland Clinic spokeswoman. "We're not singling out McDonald's. We're looking at every vendor on campus and asking if this represents what we are trying to present to our patients."

　　The Cleveland Clinic's patients have included royalty and leaders of foreign countries, and some of the nation's most prominent heart researchers and surgeons work there.

　　Its heart center sees more than 205,000 patients a year and performs thousands of heart procedures annually, including more than 3,800 heart operations.

　　Representatives of the clinic and McDonald's met recently to try to work out a compromise. Neither side will discuss details, saying only they plan to meet again soon.

　　Nationwide, there does not seem to be much of a trend toward ejecting fast-food companies from hospitals.

　　"We are in about 36 hospitals right now and have been for quite some time," said Ken Barun, McDonald's Corp senior vice president who oversees the company's "balanced lifestyle initiative," which promotes healthy food choices and physical fitness.

　　The head of the American Association for Health Care Service Administrators said she is unaware of any other hospitals following Cleveland Clinic's lead.

　　"It becomes a philosophical question that has to be answered in every hospital. Do we serve healthy foods because we're in a health care facility, or do we serve what the customers are interested in having?" said Joyce Hagen-Flint, president of the AAHCSA. "There are hospitals all over the country that have fast food outlets."

　　(The Associated Press)