Hospital and nursing home meals are failing to meet basic nutrition needs and harming the planet in the process, according to a new study.
Researchers from the Potsdam Institute for Climate Impact Research (PIK), Charité and Stanford University assessed menus and procurement data from two hospitals and three nursing homes in Germany. The study, published in The Lancet Planetary Health, is the first to combine detailed food-level data with lifecycle assessment to evaluate both the nutritional quality and environmental footprint of health care foodservice.
“We found that meals contained too few healthy plant-based foods such as vegetables, fruits, whole grains and legumes, and too many refined grains, added sugars, salt and saturated fats,” said lead author Lisa Pörtner of PIK and Charité. “This leads to an inadequate provision of nutrients and low dietary quality.”
The analysis revealed that meals in all institutions fell critically short of recommended daily intakes for key nutrients including folate, potassium and vitamin B6. Nursing home meals also failed to provide enough protein. Calories from wholesome plant-based foods made up less than one-fifth of total energy, far below the 80% recommended by the Planetary Health Diet. At the same time, refined grains made up more than 20% of calories and red meat accounted for 10 to 17%.
Animal-source foods, particularly red meat and dairy, were also major contributors to greenhouse gas emissions, land use change and water pollution associated with these facilities’ foodservice.
“Our results indicate that food served in health care settings poses a health risk if consumed over the long term, as unhealthy diets are a major cause of chronic illness,” said co-author Nathalie Lambrecht of Stanford University. “This is particularly troubling as health care institutions should be role models for healthy diets. In addition, we find that their foodservice contributes to environmental degradation and climate change, which also threaten to undermine health.”
While this study focused on German facilities, similar concerns have been raised about hospital and nursing home meals in the United States:
A Centers for Disease Control and Prevention (CDC) report documents that many U.S. hospitals serve menus heavy in processed, high-sodium foods and often fall short of meeting recommendations for fruit, vegetable and whole grain servings.
Research from the National Resource Center on Nutrition & Aging shows that nursing home residents often fail to meet recommended daily intakes for protein, fiber and key micronutrients.
Advocacy groups like Health Care Without Harm have documented a lack of plant-based and sustainable menu options in U.S. hospitals, pushing for nationwide nutrition and sustainability standards.
Unlike school meal programs, no federal mandate currently governs nutrition or sustainability standards for foodservice in U.S. health care institutions, meaning quality varies widely by facility.
For families with loved ones in nursing homes or frequent hospital stays, experts recommend asking for sample menus, advocating for fresh produce and whole grains, and reviewing whether facilities meet basic dietary guidelines.
The researchers call for mandatory nutrition and sustainability standards for health care foodservice, alongside regular assessments of food quality and environmental impact. They stress that improving meals for patients and residents does not have to come at the expense of the planet, as both can be achieved by reducing the overconsumption of animal products and increasing healthy plant-based options.
The research was funded by the German Federal Environmental Foundation (Deutsche Bundesstiftung Umwelt).