Noodles, pita bread, rice? How more diverse hospital menus can improve care – and reduce costs


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Koumaru/Getty Images



More than 5,400 cases of malnutrition develop in Australian hospitals each year. This means a patient doesn’t get enough nutrients during their stay for their body’s needs.

Malnutrition delays recovery, increases the risk of complications and readmission, and ultimately pushes older adults into aged care. It’s estimated to cost the health-care system A$240 million each year.

In the community, malnutrition affects about 10% of adults aged 65 and older. But in hospitals, this jumps to around 30–40%.



So, why does this happen? It may be because the food is low quality. But malnutrition can also develop when patients are dissatisfied with hospital meals and simply eat less.

In our recent study, we interviewed 30 older patients from Anglo and other cultural backgrounds about their experiences of hospital food.

We found a lack of familiar options can mean people from culturally and linguistically diverse backgrounds don’t eat properly. Here’s why this matters, and what we can do about it.

Patients are diverse – but menus aren’t​

Australia’s ageing population is growing fastest among migrants aged 65 and over, especially those from Asia, the Middle East and Sub-Saharan Africa.

Yet hospital meals often fail to reflect their cultural preferences. Australia’s national service standards for health care explicitly mention meeting patients’ nutritional needs, but don’t reference cultural differences.

Public hospital meals are typically “Western-style”: cereals, sandwiches, meat-based mains and desserts. Non-Anglo staples such as rice, pita bread, noodles and even pasta – as well as non-Anglo sauces and desserts – are often missing.

Given the scale of malnutrition in hospitals, understanding older patients’ cultural barriers to eating hospital food is crucial.


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Public hospital food is typically heavy on staples such as potato, cereal and bread. Japatino/Getty



Here’s what older patients told us​

We interviewed 30 older patients in a large public hospital in Adelaide. Of these, 15 were Anglo-Australian (with an average age of 83) and 15 came from culturally and linguistically diverse backgrounds (average age 78).

We found both groups shared a “no complaints” attitude and felt the food was “good enough”. People in both groups acknowledged the difficulties hospitals had catering for diverse groups.



But many from non-English speaking backgrounds expressed deeper cultural disconnects that affected how they ate:

Actually it is good. But the problem is that I am not used [to] it. (Ana*, 83, Indo-Fijian)

I just can’t swallow down the flavour. (Sam, 86, Greek)

I prefer if they give me some noodles, but they don’t have any noodles. (Susan, 73, Filipino)

English language barriers also made it hard for some to express dietary needs. Many relied on family members to bring in food from home.

Patients in both groups suggested adding options, rather than changing the whole menu, would help:

It would be nice, just have one option which is coming from different country […] because there’s plenty of people here, not born in Australia. (Jack, 75, Polish)

However some also told us they needed more help to eat:

It’s hard to carry up the food […] because my hand shaking and I lose the food. (Tom, 78, Congolese)

Food satisfaction affects how well you recover​

In another study from 2024, we surveyed patients in New South Wales about hospital food and their health.

We spoke to 21,900 adults (with an average age of 60) across 75 public hospitals.

Those who rated hospital food poorly were:

  • 2.7 times more likely to be dissatisfied with overall care
  • 1.4 times more likely to develop medical complications
  • 1.9 times more likely to have delayed discharge.
For non-English speaking patients from culturally and linguistically diverse backgrounds, the risks were even higher. They were:

  • ten times more likely to be dissatisfied with care
  • three times more likely to have delayed discharge.



So, what would help?​

Based on our research, here are four practical steps that could improve care for people from culturally and linguistically diverse backgrounds:

  1. Offer more culturally familiar meals: rotate menus and include at least one culturally diverse option per meal.
  2. Improve communication: include food service staff from similar cultural backgrounds as in-person interpreters or AI interpreting tools to help patients with limited English express their dietary needs.
  3. Train staff to engage: encourage proactive, friendly communication to invite patient feedback and meet cultural and nutritional needs.
  4. Screen older people: proactively identify who might be at risk – for example, at GP clinics and during hospital admission – to prevent rather than simply treat malnutrition.

The bottom line​

Hospital food isn’t just about nutrition – it’s about care. Making meals more inclusive can improve recovery and reduce costs.

Importantly, it can also enhance quality of life. As one patient in Adelaide told us:

Even when you are in hospital, you are sick, you not only eat to be alive, but eat to have some pleasure. (Jack, 75, Polish)

*Names have been changed to protect patients’ privacy.

This article is republished from The Conversation under a Creative Commons license. Read the original article.
 

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I spent a miserable week in hospital, the food was terrible, vegetables cooked to a mush, meat so dry and overcooked it was difficult to eat, raisin toast for breakfast, not toasted. The wonderful nurse went right around the ward, collecting the bread and toasted it for us. You don’t expect five star meals, but food that is so overcooked is not appetising at the best of times and when you have very little appetite it is very hard to eat. My husband used to bring me a cappuccino and a nice sandwich some fruit and a treat. The worst thing on the menu were the rubber eggs.
 
I spent a miserable week in hospital, the food was terrible, vegetables cooked to a mush, meat so dry and overcooked it was difficult to eat, raisin toast for breakfast, not toasted. The wonderful nurse went right around the ward, collecting the bread and toasted it for us. You don’t expect five star meals, but food that is so overcooked is not appetising at the best of times and when you have very little appetite it is very hard to eat. My husband used to bring me a cappuccino and a nice sandwich some fruit and a treat. The worst thing on the menu were the rubber eggs.
I was in Frankston hospital for months and the food was lovely I even put on some very much needed weight, so I have no complaints.🌞
 
I have been in the private hospital and found the food was good.
 
Every hospital stay since I got here in 2009, I've had my husband bring me sandwiches. Most of the food was skewed towards Asian. Some I do like, but I do not eat lamb in any form. 7

Yeah, I'm picky, and have always told them whau I cannot eat. I usually had cold cereal and toast for breakfast as pancakes and eggs were ice cold on arrival. Lunch was a toss of the dice. Dinner was ugh usually.


There was a French chef at the hospital for my first op here. My surgery was delayed, so hubs got the lunch they brought - Saffron chicken! I was sad he'd left before my next surgery :(
 
Every hospital stay since I got here in 2009, I've had my husband bring me sandwiches. Most of the food was skewed towards Asian. Some I do like, but I do not eat lamb in any form. 7

Yeah, I'm picky, and have always told them whau I cannot eat. I usually had cold cereal and toast for breakfast as pancakes and eggs were ice cold on arrival. Lunch was a toss of the dice. Dinner was ugh usually.


There was a French chef at the hospital for my first op here. My surgery was delayed, so hubs got the lunch they brought - Saffron chicken! I was sad he'd left before my next surgery :(
Where’d he go 🤔
 
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Hospitals aren't restaurants, contrary to skewed beliefs.

I'm considered a picky eater but the choice of hospital meals in hospitals over four states have always have an adequate choice.

I have seen many occasions where patients have kicked up a stink about meal quality and their level of care diminishes in other areas. Behave like a twit and get treated like shit.
 
I spent just 1 night in my local hospital after a problem with day surgery. What they brought me for tea was absolutely inedible. I sent it back hardly touched.
For breakfast the next morning I ordered 2 slices of toast with Vegemite & coffee. What arrived? 1 slice of toast, no Vegemite & cold coffee. I worked in hospitals for many years & ate at staff cafeteria where the food was way better than what was served to patients in a general hospital. With most of the meals cooked miles away from the hospital & delivered in plastic bags which are then reheated before serving, it is little wonder the food is unappetising.
 
  • Wow
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I spent just 1 night in my local hospital after a problem with day surgery. What they brought me for tea was absolutely inedible. I sent it back hardly touched.
For breakfast the next morning I ordered 2 slices of toast with Vegemite & coffee. What arrived? 1 slice of toast, no Vegemite & cold coffee. I worked in hospitals for many years & ate at staff cafeteria where the food was way better than what was served to patients in a general hospital. With most of the meals cooked miles away from the hospital & delivered in plastic bags which are then reheated before serving, it is little wonder the food is unappetising.
😳 Really
 
I had a experience in public hospital eat cheese or egg sandwich for 6 weeks the food was uneditable after a hip operation no care what so ever no one spoke in Australian they were rude as well if you asked for something it was to much trouble and I was called a physco the procedure I should have been in hospital for approx 6 to 7 days max but I was 6 weeks later before discharged they also go me a banned medication that left me incoherent for 2 weeks
 
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I had a experience in public hospital eat cheese or egg sandwich for 6 weeks the food was uneditable after a hip operation no care what so ever no one spoke in Australian they were rude as well if you asked for something it was to much trouble and I was called a physco the procedure I should have been in hospital for approx 6 to 7 days max but I was 6 weeks later before discharged they also go me a banned medication that left me incoherent for 2 weeks
What was the banned medication?
 
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My mum recently was in Hollywood Private Hospital in Perth at the end of August. Because she was 101 at that time and had covid, plus what she went to hospital for I had to be in isolation with her for a week. You were given menus for 3 meals and you ordered what food you wanted and it could take up to an hour for delivery (never took that long). There was plenty of choice, even vegan. Only complaint was the breakfast eggs were usually just warm. But the size of the meals were enormous but delicious. Unfortunatley she was back in hospital at JHC and the choice was not as good or edible. Know at Hollywood we had to pay $300.00 admittance fee but it was well worth. I even got free parking as I was there in isolation with her.
 
I had a experience in public hospital eat cheese or egg sandwich for 6 weeks the food was uneditable after a hip operation no care what so ever no one spoke in Australian they were rude as well if you asked for something it was to much trouble and I was called a physco the procedure I should have been in hospital for approx 6 to 7 days max but I was 6 weeks later before discharged they also go me a banned medication that left me incoherent for 2 weeks
What 🙀 no one spoke Australian really I find that hard to believe and which hospital was that 🤔 and a hip procedure would have a expected 6 week stay not days, mine was a 3 month stay.😳
 
What 🙀 no one spoke Australian really I find that hard to believe and which hospital was that 🤔 and a hip procedure would have a expected 6 week stay not days, mine was a 3 month stay.😳
I know quite a few people that have had hip replacements and are only in hospital for 6 or 7 days and start bed exercise within 24 hours of operation they are never drugged up for 2 weeks in semi coma state to start with because the don't know or can't read English
 
I know quite a few people that have had hip replacements and are only in hospital for 6 or 7 days and start bed exercise within 24 hours of operation they are never drugged up for 2 weeks in semi coma state to start with because the don't know or can't read English
Oh! So you mean the patients your wording made it sound like the hospital staff.😳
 

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