A systematic review of environmental sustainability of hospital foodservices across the food supply chain

摘要

Background: The provision of food to hospitalised patients can negatively impact the environment at every stage of the food supply chain. Aim: To systematically identify and synthesise literature on the (1) environmental and associated economic impacts of foodservice; (2) outcomes of strategies that aim to improve the environmental sustainability of foodservice; and (3) perspectives of patients, staff and stakeholders towards these environmental impacts and strategies. Methods: Eight electronic databases were searched; title/abstract then full text papers were screened for eligible studies across hospital food supply chain stages leading to patient food/nutrition provision: production/ procurement, distribution, preparation, consumption and waste management/disposal. There was no restriction on study design, language or date. The Mixed Methods Appraisal Tool was used appraise quality; data were extracted and synthesised narratively. Results: From 29 655 records identified; 80 studies met eligibility criteria, categorised into production/procurement (n = 12), distribution (n = 0), preparation (n = 6), consumption (n = 49), waste management/disposal (n = 8) and multiple food supply chain aspects (n = 5). Food waste was the most widely explored impact. Many studies focused on reducing food waste, with the aim to increase patient intake, using various foodservice models. A shared vision for sustainable foodservices was identified, although many barriers were reported by staff. Conclusions: Studies measuring environmental impacts and evaluating strategies in the distribution, preparation and waste management stages are needed. Dietitians, given their clinical and foodservice roles in hospitals, are well positioned to minimise food related environmental degradation to re-position hospitals as leaders.