Sustainability and nutritional composition of food offer and choices in three hospital canteens in Italy

Abstract

Diet is considered one of the most important determinants of health and at the same time a cause of climate change. We conducted a cross-sectional study in three Italian hospital canteens on five consecutive working days to investigate food offer availability and user choices in terms of nutritional intake and environmental impact. Photos of lunch trays were collected by the researchers and food offer and choices were analysed using the Italian Food Composition Database for Epidemiological Studies and the SU-EATABLE LIFE dataset. A total of 1227 lunch meals were analysed. The median energy intake ranged from 646 to 900 kcal/tray. The median energy content from lipids ranged from 32 to 40 % of energy and exceeded that from carbohydrates in one canteen. The median carbon and water footprint ranged from 773 to 1338 g CO₂ eq./tray and from 847 to 1229 L H₂O/tray, respectively. Differences occurred depending on sex and typology of work. In conclusion, regardless of the differences in the number of food options offered in the three canteens, the choices tended to be suboptimal from a nutritional perspective. The most sustainable choices were made in the canteen without beef on offer. Measures should be taken to increase the variety of vegan and vegetarian options on offer and to improve food choices in terms of nutritional composition and environmental sustainability. This could be done through educational programmes focused on increasing awareness on their diet, and practical indications on how to compose a complete and low impact meal.

Keywords: Carbon footprint; Food choices; Hospital employees; Lunch meal; Nutritional composition; Water footprint; Worksite canteen.

Fig. 1

STROBE flow chart. STROBE, Strengthening the Reporting of Observational Studies in Epidemiology.

Fig. 2

Scatterplot showing the distribution of food portions according to their carbon footprint and energy content (A), and water footprint and energy content (B) by canteen (C1, canteen 1; C2, canteen 2; C3, canteen 3). Red line indicates the upper limit suggested by the SU-EATABLE guidelines for a complete meal.