Tracking Food Waste in Hospitals: Evidence from a Detailed Australian Acute Care Audit

A detailed audit of an Australian acute care hospital found that around 41% of food served to patients and nearly 88% of kitchen waste was discarded, mainly due to unserved meals and high plate waste at lunch and dinner. The study shows that poor demand forecasting, large portions, and low acceptance of texture-modified diets drive waste, highlighting the need for better menu design and ordering systems.

Food waste is a growing global problem, but in hospitals it carries an added ethical and clinical dimension. Nutritious meals are prepared for those who need them most, yet a significant share ends up being discarded. The Australian study, led by researchers from the University of Adelaide’s School of Agriculture, Food and Wine and Adelaide Business School, the End Food Waste Cooperative Research Centre, End Food Waste Australia, the Robinson Research Institute, and clinicians from the Central Adelaide Local Health Network, set out to understand exactly how and where food is wasted in an acute care hospital. Over two months, the researchers followed food from the kitchen to patient plates in a 355-bed tertiary hospital in metropolitan Adelaide, creating one of the most detailed hospital food waste audits undertaken in Australia.

How the Study Tracked Food Waste

The audit covered the entire hospital foodservice chain. Researchers measured three types of kitchen waste: spoilage, preparation waste, and uneaten food, using direct weighing. At the ward level, they measured patient plate waste from two general medicine wards and one coronary care unit using a mix of weighing and visual estimation. The study followed a full menu cycle, capturing breakfast, lunch, and dinner over several weeks. This approach allowed the researchers to see not just how much food was wasted, but which meals, food types, and diet categories were most affected.

What Was Wasted in the Kitchen

The hospital kitchen generated an average of 134 kilograms of food waste every day, equal to about 170 grams per meal produced. Surprisingly, spoilage was very low, showing that stock management and food rotation were working well. Preparation waste made up about 12 per cent of kitchen waste and was mostly edible, coming from bread crusts, salad ingredients, and vegetable trimmings.

The biggest problem was unserved food, meals that were cooked but never given to patients. This accounted for nearly 88 per cent of all kitchen waste. Dinner service produced the most unserved food, reflecting the difficulty of predicting demand in a hospital where patient numbers and diet orders change constantly. Certain foods stood out: wet cereals were heavily wasted at breakfast, while vegetables, grains, soups, and main dishes were most often left unused at lunch and dinner. Food safety rules meant these meals could not be reused, so overproduction led directly to disposal.

What Patients Left on Their Plates

Plate waste was even more striking. Patients threw away an average of 0.7 kilograms of food per day, meaning about 41 per cent of food served was not eaten. Dinner generated the most plate waste, while breakfast produced the least. Breakfast meals were simple and familiar, such as bread and cereal, while lunch and dinner meals were more complex and often less appealing to patients.

By food type, wet cereals, dairy products, and hot dishes were most wasted at breakfast. At lunch and dinner, salads, soups, vegetables, and nutrition supplements were the biggest contributors. Vegetables were especially problematic: they made up a large share of food served but also the highest share wasted. This points to issues with portion size, preparation style, and patient preferences rather than appetite alone.

Diet Types, Menus, and Solutions

Diet type played a major role in how much food was wasted. Special diets produced far more waste than regular meals, especially texture-modified diets. Pureed meals were the worst performers, with up to 72 per cent of food served left uneaten. Limited variety, poor appearance, altered texture, and swallowing difficulties all contributed to low consumption. In contrast, low-lactose diets generated less waste than regular meals, showing that higher waste is not inevitable for special diets.

The study also looked closely at individual main dishes. Traditional meat-based meals like beef pot roast and roast turkey were among the most wasted, while dishes such as vegetable curry, tandoori chicken, and chickpea casserole were eaten more consistently. These findings suggest that menu design has a strong influence on waste.

Overall, the study shows that hospital food waste is a system problem, not just a patient issue. The authors recommend better meal forecasting, shorter ordering cut-off times, flexible portion sizes, improved design of texture-modified meals, and stronger links between foodservice teams and ward staff. They also call for regular food waste monitoring and clear reduction targets aligned to halve food waste by 2030, arguing that hospitals can improve sustainability while also supporting better patient nutrition and care.