Hospital food is often criticized for being unappetizing, but dietitians say the processed meals also lack proper nutrition for recovering patients.

Carolyn Thomas of Victoria said she endured poor quality hospital food after suffering a massive heart attack in 2008. She's been in and out of hospital since then and has written about the meals on a blog.

"My first meal in the CCC, which is the intensive care for heart attack patients, was a roast beef sandwich on doughy white bread," Thomas said. "I thought I would be getting veggies and fruit."

She recalled a tray with a tub of yogurt or milk that had turned into a lump and the other side had a "meat-like substance."

That's typical of the comments CBC News received from Canadians sending stories about hospital food: frozen peas and carrots, Jell-O, and limp-looking pasta.

Hospitals spend about $8 per patient a day on food meant to nourish people who are recovering. Why should it be so unpalatable? (Courtesy of Neil Yonson)

"I recently spent four days in the Prince George, B.C., hospital," wrote Leonard Matte. "I have nothing but praise for the wonderful staff, both nurses and doctors. They are highly professional and caring people. The only issue I had was with the hospital food."

"There was a giant blob of purple vegetable matter; after a couple of reluctant tastes, I couldn't identify what it once was. I never dreamed that hospital food could be used as an incentive to check out as quickly as possible," Matte said, adding he headed for a delicious restaurant meal as soon as he checked out.

Food budgets for hospitals

"The vegetables are frozen and it is convenient, but they are so waterlogged that they are really not there," said Joshna Maharaj, a chef and healthy food advocate in Toronto. "It is just empty, spongy versions of themselves."

Hospitals often take cold processed foods such as lasagna and spoon it out onto patient trays that are heated on carts. The other half of the tray stays chilled for cold foods, said Heather Fletcher, manager of food services of St. Michael's Hospital in Toronto.

Registered dietitian Paule Bernier of Montreal's Jewish General Hospital co-authored a study documenting how patients can't stomach the food and what hospitals can do to improve it.

Most hospitals are cash-strapped and see treating patients, rather than feeding them, as a priority. Hospitals devote about one per cent of their total budget to food, which breaks down to an average of $8 per patient a day.

"When someone is ill, their need for proteins and calories is much greater than when they are well, because they have wounds to heal and tissue to repair," Bernier said.

"The challenge I see is in having the proper budget to purchase quality food, a variety of food that is healing and preparing it in a way that it retains its quality."

When Bernier surveyed about 200 surgical or medical patients at four hospitals across the country for the Canadian Malnutrition Task Force, she found:

• 34 per cent said they'd missed a meal due to medical procedures.
• 69 per cent complained of poor appetite during their hospital stay.
• 60 per cent were interrupted at least once during a meal.
• 76 per cent were satisfied with the taste and temperature of the food.

Patients said they weren't eating because of sickness, pain, tiredness, worry and depression.

When patients have a poor appetite that doesn't match their needs, they can spiral downward into malnutrition, losing weight and muscle, Bernier said.

Meal model

Malnourished patients are at higher risk of developing infections, pressure sores, pneumonia and falling, and take longer to recuperate in hospital, she noted.

As a family physician in St. John's, Dr. Monica Kidd is concerned about the welfare of her patients in hospital. When she was admitted after the birth of her son, she photographed the baked ham, cubed veggies, brothy soup, tepid tea water and seemingly day-old French toast she was served, but didn't eat it.

While researching hospital food for a magazine article, Kidd found heart attack patients are often visited by a dietitian who advises eating brown rice, more vegetables and less red meat. But then they’re brought instant white rice and processed meat subs in recovery.

"It is confusing for patients," said Kidd. "There are a lot of patients who are looking to hospital to model the type of foods they should be eating."

Kidd estimated about 30 per cent of hospital food is discarded, not only because patients have refused to eat it, but also because they’re fasting before a procedure but are still given a meal. CBC News spoke with several hospitals that gave similar figures on food waste.

On Tuesday, Melanie Nagy goes behind the scenes to see how one hospital is fixing the problem with home-cooked meals, for stories on CBC-TV, CBC Radio and CBCNews.ca.

With files from the CBC's Melanie Nagy and Melanie Glanz