Institutional Food at Hospitals, Nursing Homes May Compromise Patient Health: Study

U.S. officials also say nursing home staffing problems are contributing to poor nutrition among residents.

New research shows that food served to nursing home residents and hospital patients often fails to meet basic dietary needs, and in some cases, may even be unhealthy or unsafe.

Findings published in the journal The Lancet Planetary Health on July 23, warn that food served to patients and residents in hospitals and other care facilities contain high levels of saturated fat, added sugars, refined grains and added salt, containing less than 20% healthy plant-based ingredients. 

Researchers further stated that those ingredients are not just unhealthy, but contribute to the development of chronic health conditions like diabetes, high blood pressure and high cholesterol.

In addition to the health effects, unhealthy institutional food can also have major impacts on the environment, including increasing greenhouse gas emissions and worsening climate change, they determined.

Led by Dr. Lisa M Pörtner, researchers from the Institute of Public Health in Berlin investigated dietary quality and the environmental footprint of foodservice in two hospitals and three nursing homes in Germany.

The team reviewed meal plans and recipes, assessed dietary quality using the Healthy Eating Index-2020, and evaluated adherence to the Planetary Health Diet and other nutritional standards. They also calculated the environmental impact, including land use, greenhouse gas emissions, water pollution, acidification and water consumption.

Overall, the meals served to hospital patients and nursing home residents did not contain enough plant-based foods, like vegetables, fruits, legumes and whole grains. The meals also contained far too many refined grains, added sugars, added salt and saturated fat.

The evaluations indicated the meals also lacked adequate amounts of folate, potassium and vitamin B6. They also did not have enough protein for patient needs.

The meals scored 39 to 57 out of 100 for dietary quality and 30 to 44 out of 150 for health to the planet.

Researchers found that most of the calories in the meals came from animal sources, with less than 20% from healthy plant-based ingredients, far below the recommended 80%. These animal-based foods accounted for about 75% of the meals’ environmental impact, with meat alone contributing 38% of greenhouse gas emissions and over a third of the damage from land use changes and water pollution.

The findings highlight how poor food can impact the short and long-term health of patients as well as climate change and the environment. Researchers said the study emphasized the need to regularly assess food service in healthcare settings and implement mandatory nutrition standards.

U.S. Nursing Home Food Quality

The issue of poor nursing home nutrition was raised earlier this month during a Quality Conference hosted by the U.S. Centers for Medicare and Medicaid Services (CMS), which is responsible for nursing home care quality nationwide. Officials in attendance warn that many nursing home residents are underfed and malnourished in the U.S. as well.

The panel indicated conditions in nursing homes appear to be deteriorating, with facilities offering inadequate food intake to residents as a result.

Malnutrition is only one problem spurred by worsening nursing home staffing issues first highlighted during the COVID-19 pandemic. However, staffing shortages are ongoing and leading to worsening conditions in nursing homes across the U.S. In addition, the recent crackdown on immigration and asylum seekers is stopping the flow of essential labor for the nursing home industry.

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