Hospital food puts patients at risk - and the planet

Hospitals are meant to heal. Yet new research suggests the food many patients receive may be holding back their recovery.

An analysis of two German hospitals and three nursing homes found menus loaded with refined grains, added sugars, salt, and saturated fat. The food options were also lacking in vegetables, fruits, whole grains, and legumes.

The research was led by Lisa Pörtner of the Potsdam Institute for Climate Impact Research (PIK), in collaboration with colleagues at Charité in Berlin and Stanford University.

Hospital food impacts patient recovery

Poor diets now rank among the top drivers of chronic illness and premature death worldwide. Hospitalized people, already vulnerable, often depend entirely on institutional meals for days or even weeks at a time.

Many in-patients are older adults with higher protein and micronutrient needs, yet illness, medication, and an unfamiliar setting can blunt both appetite and taste.

When the tray arrives bland, beige, and salty, much of it ends up in the trash instead of in the patient, compounding the risk of complications.

Nutrition also affects length of stay and complication rates. Malnourished patients often face infections, slower wound healing, and longer rehabilitation – costs that ripple through families, health systems, and insurers.

Hospitals and nursing homes influence community norms well beyond their walls. If patients experience colorful, plant-rich plates during their stay, they are more likely to try the same foods at home. They may also talk about them with relatives after discharge, seeding healthier habits.

Plant foods are missing entirely

The team tallied every breakfast, lunch, dinner, and snack served over a representative week. Then, they compared the nutrient content with targets in the Planetary Health Diet, which calls for roughly 80 percent of calories from wholesome plant foods.

None of the institutions even reached 20 percent, and refined grains alone supplied more calories than all produce combined, flipping recommended proportions on their head.

“We found that meals contained too few healthy plant-based foods such as vegetables, fruits, whole grains, and legumes,” said Pörtner.

“This is particularly troubling as health care institutions should be role models for healthy diets,” said Nathalie Lambrecht of Stanford University, explaining micronutrients such as folate, potassium, and vitamin B6 fell well below recommended intakes.

Additionally, nursing home residents also missed basic protein targets needed to maintain muscle and immune function. 

Hospital food impacts climate

Food choices in hospitals not only threatened patient well-being – red meat and dairy generated three-quarters of each facility’s greenhouse gas emissions, land use, and water pollution. This echoes global data showing animal products carry the highest environmental toll.

For perspective, New York City’s municipal hospital network cut food-related emissions by 36 percent in one year simply by making plant-based dishes the default option.

Patient satisfaction climbed above 90 percent at the same time, debunking fears that greener menus hurt the dining experience.

Climate change harms human health by causing heat waves, extreme weather, breathing problems, and the spread of new diseases. It creates a feedback loop that starts with what we eat and can end with a trip to the emergency room.

Those cascading stresses land hardest on children, older adults, and people with chronic diseases.

By serving resource-heavy meat at every meal, health-care facilities unknowingly contribute to problems like respiratory illness, malnutrition, and heat-related complications. This highlights a clear conflict between their goal to heal patients and the impact of their food choices.

Aligning the plate with the pledge to “first, do no harm” takes deliberate effort.

Better food means better health

The solution for hospitals is not austere salads or unfamiliar fad foods. Flavorful legumes, nuts, seeds, and whole grains can provide enough protein to meet dietary needs. They also add fiber and important nutrients that support the immune system, brain function, and bone health.

A lentil shepherd’s pie delivers as much protein per calorie as beef, while slashing emissions and saturated fat. Swapping butter for canola or olive oil improves the ratio of unsaturated to saturated fat – a core metric in the Healthy Eating Index (HEI) that predicts cardiovascular risk.

Using seasonal produce helps lower costs, makes meals look more appealing, and supports local farms. Peanut butter, soymilk, and fortified cereals can also fill vitamin and mineral gaps without needing extra work or many ingredients. Chefs find diners respond to color and crunch just as much as to nutrition labels.

Hospital trials in the U.S., U.K., and the Netherlands show that plant-forward menus can match or beat traditional meals in taste and cost.

These results come even before factoring in long-term savings from shorter hospital stays and fewer readmissions. The savings grow larger when reduced waste and lower procurement emissions are factored in.

Contracts block healthier menus

Kitchen budgets are tight, and staff already juggle allergy requests, texture modifications, and infection control rules.

Bulk contracts often lock facilities into meat-heavy purchasing for years, making rapid change tricky and sometimes financially risky.

Policymakers could help by writing minimum nutrition and sustainability standards into reimbursement regulations, much like existing rules on hand hygiene and medication safety.

Clear targets would empower food-service directors to negotiate new contracts and track progress.

Large group purchasing organizations could negotiate discounts on lentils, chickpeas, and produce – just like they do for dairy or pork. This would help lower costs for individual kitchens and reduce supply-chain problems that concern administrators.

Contract terms that reward lower carbon intensity could accelerate the shift.

Doctors must lead change

Clinicians also have a role. When doctors prescribe plant-rich diets for diabetes or heart disease, the message sounds hollow if the cafeteria still pushes sausage and pudding at every meal, sending mixed signals to patients and staff alike.

Real change starts with measurement. Menu audits, waste tracking, and lifecycle assessment dashboards give dietitians the data they need to improve recipes and monitor progress.

The German study shows that better hospital food is not a luxury add-on. It is clinical care and climate action served on the same tray, replicated far beyond Germany.

The study is published in The Lancet Planetary Health.

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