Objective To assess trends in the nutritional quality of hospital menus and examine differences between menus used in hospitals with cook-chill or cook-fresh food services.
Design Standard patient menus were analysed against 28 criteria to assess nutritional standards and compared to results from similar studies in 1986 and 1993.
Setting Menus were collected from 80 hospitals in New South Wales, Australia, including 36 using cook-chill food service systems.
Statistical Analysis Chi-squared analysis was used to assess differences between the proportions of hospitals meeting the criteria in 2001 and 1993 and between different types of hospitals.
Results In 2001 compared to 1993 significantly more hospitals offered more than one hot choice at the evening meal, more low fat items were highlighted, and more calcium-rich foods were available. More than 90% of hospitals allowed patients to select their own menu choices, offered wholemeal breads and high fibre breakfast cereals, fresh fruit, polyunsaturated margarine, a milk dessert at least once a day and two or more hot options at the midday meal. Hospitals with cook-chill food services had menus that were more likely to meet nutritional recommendations, although they were less likely to offer a choice of serving size. A high proportion of unpopular choices were offered on menus, especially meat dishes and desserts.
Applications/Conclusion Since 1986 NSW hospital menus have improved to offer choices that conform better to dietary guidelines. Cook-chill food service may have positive and negative impacts on meal choices. The assessment criteria provide a useful way for hospitals to assess their menus.