While walking hospital hallways as a general surgery resident, Dr. Annie Lalande started to notice a pattern — stacks of meal trays laden with unfinished food. It didn’t necessarily come as a surprise. Hospital food’s reputation is no secret. Often described as basic, bland and poorly prepared, it was no wonder patients were passing it up.

But Dr. Lalande started to see an opportunity — what if we could redefine hospital food, making it not only more appealing, but also more nutritious, cost-effective and sustainable?

“Patients were telling us how much food they weren’t eating and how much that was impacting their recovery,” says Dr. Lalande, who is completing a PhD at UBC’s Institute for Resources, Environment and Sustainability at the same time as her postgraduate medical education residency.

“It really got us thinking about how we could improve the overall patient experience, and patient outcomes, by rethinking something as simple as what’s on the menu.”

With support from Vancouver Coastal Health, Dr. Lalande and a multidisciplinary team of colleagues set out on a mission to study and improve the food served in local Vancouver hospitals. So far, her research has highlighted the critical link between patient well-being, hospital nutrition and planetary health.

“Poor food quality is often the primary driver of malnutrition in hospitals,” said Dr. Lalande. “And when patients are undernourished, they are much more likely to experience complications and poorer health outcomes.”

Hospital food systems also have a significant impact on the environment. Globally, the industrial food system is responsible for one-third of all greenhouse gas emissions and puts tremendous pressures on land, water sources and biodiversity.

Hospitals need to offer a tastier, more diverse menu that gives patients more freedom to choose what, when and how much they eat. This will help improve patient nutrition while minimizing food waste.

Dr. Lalande says that up to 50 per cent of all hospital food served to patients in Canada goes uneaten.

“We’re using a lot of resources to generate food that never gets used,” said Lalande. “Land must be cleared, fertilizers must be applied, food must be processed, transported, packaged, prepared — but it’s all wasted if patients don’t eat it.”

After collecting a trove of data on patients’ experience with hospital food and what food was being wasted, Dr. Lalande and her team are designing a new hospital menu that features healthier and more sustainable options for patients.

“We need to align hospital menus with the latest evidence on healthy and sustainable diets,” says Dr. Lalande. “This means making menus plant-rich, integrating more fresh, local, seasonal items, and relying less on animal protein and dairy. It also means moving away from processed foods and towards whole foods produced through environmentally-friendly farming practices.”

But food is more than just fuel. Our relationship with food is deeply intertwined with personal preferences, along with cultural and social traditions. Dr. Lalande says that to make hospital food more appealing and accessible to patients, we need to offer a more diverse menu that gives patients more freedom to choose what, when and how much they eat. It also needs to taste good. All of this will help improve patient nutrition while minimizing food waste.

While this more customized and patient-centered approach to food service may seem like an expensive proposition, malnutrition in hospitals costs Canada’s healthcare system an estimated $2 billion annually in direct costs for longer hospital stays alone, so reform also makes financial sense.

“A healthier diet will help patients recover and live healthier lives while also benefiting the environment,” says Dr. Lalande.

“It’s a win-win solution.”