Ultra‐processed food supply in hospitals: A cross‐sectional analysis of Australian hospitals using cook fresh foodservices

AIM: Ultra-processed foods have been associated with a range of adverse health and environmental impacts, yet their supply in health-promoting settings like hospitals remains largely unexamined. This study aimed to assess and quantify the proportion of ultra-processed foods utilised in a sample of Australian hospitals using cook fresh foodservice systems (i.e., most menu items are prepared/cooked just prior to service), and to determine types of ultra-processed foods available in each of the menu categories. METHODS: Cross-sectional data on the foods and drinks available to inpatients in Australian hospitals were collected in October and November 2023. Trained hospital dietitians recorded the standard inpatient menu (Full ward diet), short-order menu items, and oral nutrition support products for paediatric and adult patients over seven consecutive days. Australian food composition databases were used to estimate the energy content of each item. The number of items and energy contribution of ultra-processed foods was estimated by meal (e.g., breakfast, lunch, dinner) and food category (e.g., cereals, spreads, dairy). RESULTS: Six hospitals using predominantly or cook fresh only foodservice systems were included, offering 100-1200 meals per day. Ultra-processed foods contributed 51% of total energy provided, with the highest proportions observed at breakfast and afternoon tea. Bread, dessert, snack, spread/sauce, and drinks had over two-thirds of items classified as UPFs. CONCLUSIONS: Findings suggest a concerning large contribution of ultra-processed foods in Australian hospital cook fresh foodservice systems. These findings have implications for interventions aimed at promoting both public and planetary health in institutional settings.