The problem of malnutrition in hospitals lengthens hospital stays by 30-40%.

'This,' Pezzana explains, 'has led to a certain loss of control on the part of the health authorities, whereas proper nutrition is a cornerstone of therapy. The costs for the health of the population and for the state coffers are very high. Prolonged hospital stays due to malnutrition have direct effects, with an increase in disease-related costs and an increase in vulnerability that often requires repeated hospitalisation. The result? The problem of malnutrition in hospitals has an estimated morbidity and mortality cost of two billion per year. Yet all it would take is better food quality control and organisation to reduce hospitalisation time (by 40%) and complications by 50%.

In France, the topic of hospital food is the subject of strong public debate. A survey conducted in 2024 showed that two thirds of patients are dissatisfied: meals are too bland, lack variety, in small portions and with poor presentation. Added to this is a worrying fact: between 20% and 40% of hospitalised patients suffer from malnutrition, resulting in longer recovery times. It is not only the quality of meals that is to blame, but also environmental factors that reduce appetite, such as the smell of disinfectants or the side effects of drugs.

On the regulatory side, standards were first addressed in 2017 by the National Nutrition Council, which suggested offering more choice and relaxing overly restrictive diets. Instead, the 2018 Égalim law requires at least 50 per cent of products to be 'quality and sustainable' and 20 per cent organic, criteria also extended to meat, poultry and fish. However, many hospitals fail to comply with these rules due to chronic shortage of funds. In short, it is not so much the presence of ultra-processed food that is worrying, but the over-rigidity and lack of resources to offer truly nutritious and enjoyable meals.

At the Hietzing Hospital in Vienna, the kitchen prepares around 800 meals daily, with menus that may include spinach strudel, roast beef or vegetarian dishes, accompanied by desserts such as banana cake or chocolate pudding. Only a quarter of the patients can choose freely; the others have to follow specific dietary regimes. The perception of food in hospital is influenced by pain, medication, odours and lack of sleep, which alter taste. In addition, for logistical reasons, dishes are often kept hot or reheated, with loss of flavour and appearance.

In Romania, the state allocates 22 lei per day (about EUR 4.5) for the three patients' meals. The menus include soups, cooked dishes, eggs, cheese, vegetables, fruit, but also cold cuts and margarine. From July 2025, it will be possible to report hospitals with bad food online. The Minister of Health has warned that non-compliant facilities may be sanctioned, reminding that respect for the patient also goes through the quality of the meals served.

At only EUR 3 per day, the quality of food in Lithuanian hospitals is often at the centre of controversy. Photos shared on social media have shown unpleasant-looking dishes, sparking outrage with derogatory comments. The Ministry of Health banned fried and unhealthy products in 2019, but recent testimonies still speak of monotonous and nutrient-poor meals: bread, hard-boiled eggs, minimal portions of meat or outdated sweets. Some patients emphasise that it is not a question of bad food, but of a minimalist conception of hospital nutrition, without attention to recovery and well-being.

There is no national standard in Bulgaria: each hospital decides for itself whether to run the kitchen in-house or outsource it. On paper, meals must meet dietary and health criteria, but in reality patients often receive watered-down soups, uninviting stews or bread with salami. Expenditure per patient ranges from 3 to 12 leva per day (1.5 to 6 euro). The lack of dedicated funds and non-transparent tenders have favoured a few large suppliers also linked to politics, resulting in a risk of corruption and widespread poor quality.

In recent years, food in Hungarian hospitals has become a political case. The media have denounced mouldy bread, expired meat and minimal portions, as in the case of the Szent János Hospital in Budapest, which was forced to terminate a contract with the supplier after a scandal. In 2023, an average of only EUR 1.39 per day was spent on ingredients: just 28 cents for breakfast, 70 for lunch and 42 for dinner. With such low figures, it was inevitable to end up with poor and sometimes unhealthy meals.

The issue has become a workhorse of the opposition, so much so that in July 2025 the government announced an increase in funding: from EUR 3.8 to EUR 10 per patient per day, to improve the quality of meals. A necessary measure, considering that hospitals had accumulated more than EUR 60 million in overdue debts during the same period. Hospital nutrition in Hungary thus remains an indicator of the broader underfunding of the healthcare system.

In Greece, hospital catering is mostly outsourced to private companies, without a national policy establishing uniform standards or nutritional requirements. Testimonies tell of very different experiences: packaged food and hard bread on the one hand, but also generous portions and discrete dishes in some hospitals. Some wards have adapted meals to the religious needs of patients, a positive sign in an overall fragile picture.

The main problem remains the lack of stable and qualified staff: many kitchens depend on precarious workers on short contracts, while the trade unions are calling for permanent recruitment. A new digital evaluation system for hospital services, introduced in July 2025, has already garnered numerous complaints about the quality of meals, confirming that hospital nutrition is an integral part of the crisis in the Greek healthcare system, which is increasingly geared towards privatisation.

In the Czech Republic, hospital food is traditionally considered unappetising, although this is slowly improving. Today, it is often possible to request meatless options, but the menu remains monotonous: white pasta and bread, meat, dairy products and fat predominate. Portions are large and a significant portion is wasted.

The Ministry of Health guidelines, updated in 2020, are binding for public hospitals and only recommended for private ones. Each facility has nutritionists in charge of assessing the dietary value of meals. In general, lunch is cooked fresh, while breakfast and dinner are often based on ultra-processed and semi-processed products.

*This article is part of the European collaborative journalism project "Pulse" and was contributed by Sarah Rost (Voxeurop, France), Christina Schmidt and Heidi Szepannek (Der Standard / Sisters of Mercy Hospital, Austria), Alina Neagu (HotNews, Romania), Eglė Kuktienė / Ieva Kniukštienė (Delphi, Lithuania), Martina Bozukova (Mediapool, Bulgaria), Lena Kyriakidi (Ef.Syn., Greece)