A new study of German hospitals and nursing home meal plans finds overall poor nutritional quality and large environmental impact

By Jamie Hansen, Global Health Communications Manager

A person’s diet is inextricably linked with her health. Yet, the food served in hospitals and nursing homes can undermine the health of patients, rather than supporting their recovery, finds a new study published today in The Lancet Planetary Health. In addition, the study found that food served in hospitals also tends to negatively impact the environment through a reliance on red meat and dairy. Stanford LSHTM Human and Planetary Health Postdoctoral Fellow Nathalie Lambrecht, PhD, is senior author.

The study is the first of its kind to evaluate both the nutritional quality and environmental impact of food served in healthcare institutions using detailed data from meal plans and food procurement. Researchers analyzed data from two hospitals and three nursing homes of average size in Germany. 

They found that meals served in these institutions were generally of poor dietary quality and did not meet residents’ daily needs for several key vitamins and minerals. They also found that meals were lacking in nutritious plant-based foods such as whole grains, fruits, and legumes, while being too high in refined grains, sugar, saturated fat, and red meat. Specifically, institutions scored poorly on the Healthy Eating Index-2020, an indicator of diet quality based on the Dietary Guidelines for Americans, while also scoring low on the Planetary Health Diet Index, which measures adherence to a healthy and sustainable diet.

“For vulnerable populations, especially nursing home residents, this type of food service can compromise long-term health,” Lambrecht said. 

“The strongest lever for improving the healthiness and environmental sustainability of healthcare foodservice is reducing the procurement of red meat, and adding more wholesome plant-based foods,” she said. “These changes would reduce the environmental footprint, and contribute to better health.”

Although the study was conducted in Germany, the patterns observed are likely applicable across many high-income countries, including the U.S., the authors say. 

“Replicating this kind of in-depth analysis in U.S. healthcare institutions is needed to benchmark progress on healthy and sustainable foodservice,” Lambrecht said. She is now conducting a similar study at Stanford, which has been a leader in promoting sustainable and healthy food,  and plans to scale this work in the U.S. to accelerate progress on healthy and sustainable healthcare. To date, no studies have rigorously examined the health and environmental impacts of hospital food in the US.

“Hospitals can and should be leaders in supporting individual and planetary health, and food is one of the most powerful levers to start,” she said. 

Learn more by reading the publication here and the full press release from the Potsdam Institute for Climate Impact Research here.

Dr. Lambrecht’s fellowship at Stanford is supported by the Stanford Center for Innovation in Global Health and Stanford Center for Human and Planetary Health.