Policy vs. Practice: Nutritional Quality and Menu Structure in Polish Hospitals During the "Good Meal in Hospital" Pilot Program-A Multicenter Cross-Sectional Study.

Abstract

Background: Hospital nutrition is an essential component of patient care; however, the nutritional quality of meals in Polish hospitals has raised concerns for many years. In response to these challenges, the Ministry of Health implemented a nationwide pilot program, "Good Meal in the Hospital," to improve nutritional quality by developing and implementing a model tailored to patients' needs. This study aimed to assess the compliance of hospital-standard diets with the program's assumptions. Methods: Ten-day menus from ten hospitals across different regions of Poland (a total of 100 menus) were analyzed. A quantitative assessment of energy and nutritional values was conducted by calculating the average daily intake of energy and selected nutrients (protein, carbohydrates including sugars (mono- and disaccharides), fat, saturated fatty acids, fiber, and salt) and comparing these with national recommendations for hospital diets for adults. In parallel, a qualitative assessment of ten menu structure criteria was performed using a binary scoring system (0/1). Results: None of the analyzed hospitals met all quantitative and qualitative criteria simultaneously. All hospitals complied with recommendations for protein and carbohydrate content, whereas the most frequent deviations concerned excessive intake of fat, saturated fatty acids, and salt. Qualitative scores ranged from 6 to 10 points, with the most significant shortcomings related to the frequency of legumes and fish. A particularly noteworthy finding was the discrepancy between qualitative and quantitative compliance of the menus. Conclusions: The fact that none of the analyzed hospitals met all program criteria simultaneously indicates the limited effectiveness of its implementation in its current form.