hide
Free keywords:
-
Abstract:
Background:
Despite the key role of diets for individual and planetary health, the food offered in healthcare institutions has received very limited attention to date. An assessment of the overall healthiness of foodservice in healthcare institutions is missing, as is detailed information on its environmental footprint. -
Methods:
We investigated the dietary quality and environmental footprint of foodservice in two hospitals and three nursing homes in Germany. Average daily meals were derived from meal plans and recipes and analyzed for 1) dietary quality, using the Healthy Eating Index-2020, 2) adherence to the Planetary Health Diet (PHD), and 3) nutritional adequacy. The environmental footprint was analyzed by allocating procured foods to 50 food groups and using an environmental database to estimate impacts on land use, greenhouse gas emissions, eutrophication, acidification, and water use. -
Findings:
Dietary quality was low, with institutions scoring 39-57 of 100 points on the Healthy Eating Index-2020. Adherence to the PHD was also low, reflected in PHD Index scores of 30-44 of 150. The majority of calories were from animal-source foods (ASF) and unhealthy plant-based foods, with <20% from wholesome plant-based foods. Meals were consistently high in saturated fat and salt, and low in fiber, while protein was insufficient in nursing homes. Micronutrient provision varied, with several B-vitamins, vitamin C, potassium, and magnesium critically low in almost all institutions. ASF were responsible for three-quarters of the environmental impact, with meat alone contributing 50% of greenhouse gas emissions and 38-57% of other environmental impacts. Around 60% of procured protein was from ASF, while legumes made up <1% of procurement by weight. -
Interpretation:
Healthcare meals may compromise both short-term and long-term health of patients and residents. This highlights the urgent need to assess foodservice in healthcare settings more regularly, align it with recommendations for healthy and sustainable diets, and improve nutritional care.
