When I first learned of chef and food activist Alice Waters and her farm-to-school initiative, I could see how programs that connect children to fresh local food can influence how they interact with their meal. Schools were no longer places where typical cafeteria-style lunches were served; they became places where students learned how food and health were connected.
I began to wonder why that idea stops at schools.
As a chronic disease patient who has spent significant time in hospitals, I have experienced the disconnect between hospital food and healing. Meal trays contain foods that are often processed, bland, and lacking in color. Patients often eat less, which means they do not meet their nutritional or caloric requirements, leading to delayed recovery and longer hospital stays.
When I was hospitalized for my rare disease at age nine, I did not eat my unappealing hospital meals even though I was hungry. I remember lifting off the meal tray cover and discovering a rubbery gray Salisbury steak, which I poked with my fork. Although broccoli and mashed potatoes were served with it, the broccoli appeared grayish brown and overcooked, while the mashed potatoes tasted more like paste than real potatoes. Although hungry, weak, and significantly underweight at that time, I could not eat this meal, which extended my already lengthy hospital admission.
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My experience led me to imagine an extension of the farm-to-school program: a farm-to-tray model for hospitals. In this model, hospitals would source food directly from local or regenerative farms, reconnecting patient meals to agriculture and community. Food would taste fresh, not processed, and would contribute to healing and recovery.
Studies estimate that nearly one-third of hospitalized patients are malnourished, and many consume only a small portion of the meals provided to them. Poor intake slows recovery and increases complications. At the same time, overconsumption of sugary ultra-processed foods contributes to diet-related diseases such as diabetes and cardiovascular disease, which remain among the leading causes of death in the United States.
Some hospitals are beginning to change how they feed their hospitalized patients. Institutions such as Long Island Jewish Medical Center have removed deep fryers and increased fresh fruits and vegetables in patient menus. Research shows that taste, temperature, and presentation significantly influence how much patients eat. When meals are more appealing, patients eat more, and recovery improves.
Diets rich in fruits, vegetables, and healthy fats such as Mediterranean-style diets have been linked to improved outcomes in chronic and inflammatory diseases. While food is not a cure, it can support the body’s ability to heal.
Yet hospital food systems were built for efficiency and cost, not necessarily for healing. In many hospitals, ultra-processed foods remain common because they are inexpensive and easy to distribute. In some cases, hospital cafeterias have even included fast-food chains such as McDonald’s and Wendy’s. This shows a real disconnect between health care and healing. But thankfully, there are already early efforts to rectify this problem, both in short-term recovery and in long-term health maintenance.
Teaching kitchens have emerged to educate patients so they learn how to cook after discharge. Yale New Haven Health has developed programs where patients prepare simple meals and learn how nutrition supports recovery. The “Food Is Medicine” movement also provides medically tailored meals and produce prescriptions for patients with diet-related disease.
Improving hospital food through the farm-to-tray approach also has environmental benefits. Hospitals generate significant food waste, much of it from uneaten meals. Better food quality can reduce that waste, while composting and local sourcing can further close the loop. Plant-forward meals can also lower emissions tied to food production while supporting long-term health outcomes.
At Penn State College of Medicine, a hospital partnership with a community garden turned food waste into compost that supported local food production. This program exemplifies a successful closed-loop system of food, waste, and care.
Cost is often raised as a barrier. Fresh ingredients can be more expensive, and hospital systems operate under real financial pressure. But focusing only on short-term costs misses the larger picture.
Diet-related diseases account for billions in health care spending annually, much of it driven by preventable conditions such as obesity and cardiovascular disease. If better nutrition reduces complications or readmissions, then food becomes prevention and savings, not an added expense.
Medication and surgeries are essential parts of care. But recovery also depends on whether patients are nourished enough to heal. For me, as I sat in my hospital bed desperately wanting to recover and feel good, I could not bring myself to eat the tray of food that stood in between me and discharge to home.
As a pediatric patient, I learned that medicine alone is not always enough to help someone heal. Hospitals should treat food as an essential part of treatment and begin thinking of themselves as part of a broader food and health ecosystem, one tray at a time.
Nell Choi is a high school student and patient advocate. Scott Choi is a gastroenterologist.
