Why hospitals are moving towards plant-based menus

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A nurse hands a plate with a banana and an orange, along with a bowl of soup, to a smiling patient sitting up in a hospital bed, wearing a blue gown. The background shows hospital equipment. — Image by freepik

The future of healthcare catering

Across public catering, alternative proteins are gaining ground. From schools and prisons to universities, plant-based food is increasingly recognised as a practical response to overlapping health, sustainability, and operational challenges.

Hospitals, in particular, are emerging as a critical setting for this shift. Given the well-established health benefits of wholefood, plant-based diets, hospital catering is uniquely positioned to align foodservice with clinical evidence, public health priorities, and institutional mandates.

This article explores why hospitals are increasingly adopting plant-rich menus and examines real-world examples showing how this works in practice.

Why are hospitals serving plant-forward menus?

Personal health

As health-centred institutions, plant-based food is the logical catering choice.

Various animal-based foods are being increasingly recognised as harmful to human health. Processed meat is now classified by the WHO as a carcinogen, whilst red meat (i.e. mammalian meat) is classified as a probable carcinogen.

Given our evolving knowledge on the harms of these animal products, serving such foods in hospitals is becoming increasingly incongruous with the mission of healthcare providers.

In an open letter to the National Health Service, a group of doctors described serving such foods in hospitals as “the equivalent of distributing cigarettes in the pulmonary care unit.”¹

In contrast, whole foods plant-based diets have consistently been found to reduce a variety of chronic diseases, which are major sources of strain for healthcare services with ageing populations.

“Plant-based diets have been shown over and over to reduce the risk of chronic health conditions. Studies continue to show that vegans have lower rates of heart disease, Type 2 Diabetes and certain cancers. With 42% of adults living with a chronic condition and most of us spending our last decade in ill health, supporting people to adopt a plant-based diet seems a simple solution.”

Dr Shireen Kassam

Plant-Based Health Professionals

This highlights the preventive potential of hospital food. Rather than serving meals that may contribute to repeat admissions, plant-based catering can actively support better long-term health outcomes.

Public health

From a public health perspective, plant-based catering also aligns with hospitals’ best interests. Given the risks we face from antibiotic resistance, the use of antibiotics in animal agriculture is a cause for concern.

Globally, around two-thirds of antibiotics are administered to farmed animals, where routine mass medication is used to compensate for intensive production systems.² Noting how stringent many doctors are with antibiotic use on their own patients, it seems counterintuitive to allow their excessive use in the food hospitals serve.

Animal farming also increases the risk of future pandemics by creating an ideal breeding ground for the emergence and spread of zoonotic diseases. Farm animals have been linked to the outbreak of various pandemics in recent history, and zoonosis is one of the leading theories explaining the outbreak of COVID-19. Given the profound strain the pandemic placed on healthcare systems, aligning hospital food with greater pandemic preparedness is increasingly seen as prudent.

“The last 100 years have shown us that pandemics will continue unless we change the way we eat. We need to learn from our mistakes.”

Dr Shireen Kassam

Plant-Based Health Professionals

Taken together, the health and public health externalities associated with animal-based foods place a substantial and growing burden on healthcare systems. Plant-based hospital catering, therefore, represents not a lifestyle choice but a strategic public health intervention.

Climate and operational pressures

A person in a checked shirt eats at a white table with a meal tray. A small basket with artificial pink flowers and a FLOWER sign sits on the table. The background shows a bright, modern dining area.

Climate targets and operational realities add another layer of motivation. Many hospitals and public institutions now account for food-related emissions as part of climate reporting requirements, and plant-based procurement consistently delivers lower reported emissions.³

At the same time, hospitals operate within tight financial constraints. They require menus that can be produced at scale, with predictable supply, stable pricing, and consistent quality.

When integrated into standard menu cycles, rather than positioned as niche alternatives, plant-based dishes often meet these operational requirements more effectively than animal-based meals.⁴

These pressures help explain why plant-based catering is increasingly viewed as a systemic solution: one intervention that simultaneously addresses health, climate, and cost challenges.

Case study: New York’s public hospitals and plant-based defaults

The largest municipal hospital system in the United States, NYC Health + Hospitals, has become a flagship example of plant-based defaulting in healthcare.

Led by the New York Mayor’s Office as part of Mayor Eric Adams’ broader push to promote plant-based diets,⁵ the initiative was built on a Meatless Mondays programme launched in 2019. Following recipe testing and evaluation, default plant-based lunches were introduced in March 2022, before expanding to both lunch and dinner six months later (after positive feedback).

The intervention itself was intentionally simple. Inpatient menus present two default options, both plant-based, without using the word ‘vegan,’ reflecting research on consumer responses to food labelling. Only if patients decline both options – such as a Garden Bolognese with Rotini and Spinach or a Vegetable Paella with Yellow Rice – are meat-based dishes offered.

The results were striking. Before the change, just 1% of patients selected plant-based meals. After defaulting was introduced, that figure rose to 50%.⁶ The system recorded:

a 36% reduction in food-related emissions
cost savings of approximately $0.59 per meal
and patient satisfaction rates above 95%

In 2023 alone, around one million plant-based meals were served.

As Rachel Atcheson, Deputy Director of the NYC Mayor’s Office of Food Policy, explained to ProVeg: “We now have the data to show that this cuts carbon emissions and reduces costs, all while retaining patient satisfaction. It’s simple and effective.”

The New York example demonstrates how behavioural design, rather than radical menu overhauls, can deliver significant impact at scale.

Case study: Hayek Hospital, Beirut

In March 2021, Hayek Hospital became the first hospital globally to serve exclusively plant-based meals. Before making the transition, the hospital introduced plant-based dishes alongside educational materials outlining the health risks associated with processed and red meat, drawing on WHO classifications and CDC data on zoonotic disease.

Following this transition period, all animal-based items were removed. The hospital framed the change as a clinical decision, citing evidence that plant-based diets can halt or reverse the progression of certain diet-related diseases.

While uncommon, Hayek Hospital provides a working example of a fully plant-based hospital food system built around whole, minimally processed ingredients compatible with clinical nutrition requirements.

Building the enabling environment: education and implementation

ProVeg Czechia and clinical nutrition education

A doctor in a white coat and face mask talks to a nurse in blue scrubs in a hospital corridor, while other medical staff and people interact in the background.

Menu change alone is not always sufficient. In August 2025, ProVeg Czechia launched Nutrition in Medical Practice, an accredited course for doctors and healthcare professionals developed with the Physicians Association for Nutrition, Czech Republic.

The programme focuses on dietary change in the prevention and treatment of chronic disease, with practical guidance on advising patients, including families and those following plant-based diets. Accredited by the Czech Medical Chamber, it allows doctors to earn continuing medical education credits.

The initiative reflects a broader shift: plant-based nutrition is increasingly treated as a clinical competency rather than a lifestyle add-on. This professional legitimacy helps explain why plant-based menus are gaining traction within healthcare settings.

ProVeg Portugal: operationalising plant-based by default

ProVeg Portugal works directly with hospitals and corporate caterers to implement plant-based by-default menus. Portugal is currently the only country mandating a daily plant-based option across public institutions, shaping a favourable policy environment.

The programme supports caterers through staff training, recipe development, carbon calculation, and operational guidance. While barriers included updating manuals, retraining staff, and adapting familiar dishes, these challenges were overcome in practice.

In Estarreja alone, the programme delivered emissions reductions of 171 tonnes CO₂e over 12 months. The model demonstrates how institutional change depends on practical tools – recipes, procurement guidance, and training – that can be replicated across sites.

Greener By Default and behavioural design

In the US, Greener By Default specialises in defaulting plant-based offerings and applying behavioural science in various foodservice settings. They partnered with NYC Health + Hospitals on the initial pilot, and currently work across the US to help hospitals, corporations, universities, and events.

Their approach focuses on menu audits and low-friction interventions that preserve freedom of choice while maximising uptake of plant-based options.

“We create custom interventions based on the foodservice environment and diner demographics to help institutions meet carbon reduction targets, serve healthier and more inclusive food, and save on food costs, all while preserving freedom of choice. We start by conducting a menu audit and then offer strategies that will be easiest to implement and have the biggest impact.”

Katie Cantrell

Co-Founder and CEO of Greener By Default

What these cases reveal

A stethoscope circles a white plate with green beans, tomatoes, tangerines, and grains on a wooden surface, symbolising the connection between healthy eating and medical care. — Image by freepik

Across these examples, different components of institutional change come into focus. New York demonstrates the power of defaults. Portugal shows how operational infrastructure enables scale. Hayek Hospital illustrates what full replacement can look like. Czechia highlights the role of clinical education in legitimising dietary change.

Together, they suggest that hospital food reform is increasingly driven by integrated systems, menu design, procurement, policy context, and professional training, rather than isolated pilots.

Once established, plant-based menus become a repeatable procurement category within highly structured foodservice systems. This creates durable opportunities for suppliers able to meet cost, consistency, allergen, and storage requirements.

Commercial implications for the plant-based sector

Hospitals and public institutions are emerging as structured, scalable markets for plant-based foods. As carbon accounting and default-based menu design expand, demand is likely to grow for legumes, pulses, dairy-free bases, culturally adaptable flavours, and cost-stable plant proteins.

Products that integrate easily into existing recipes and perform reliably at scale are particularly well-positioned.

Actionable insights

Institutional change takes time, but hospital case studies provide compelling proof of concept. Organisations such as ProVeg support healthcare institutions through tailored services, while bodies like the World Resources Institute offer research-backed behavioural nudges that complement default-based approaches.

To effectively promote plant-based catering in hospitals, ProVeg recommends:

The power of defaults

Plant-based defaults deliver a high return on investment as a method of food system change. They preserve choice, reduce political friction, and achieve substantial impact through minimal structural change.

The first default is key

From the New York team’s experience, the first default is by far the most important. Whilst they expected the second default to catch patients who rejected the first option due to taste preference, that’s not what the data showed. In reality, the vast majority of patients chose the first default, with the second proving only marginally effective. If resources are limited, having at least one default plant-based option on the menu seems most important.

Find your champions

It can be challenging to convince strained healthcare systems with limited resources to change. A key learning from the New York case study was that the support of stakeholders is key. The team behind the initiative visited all 11 of the city’s public hospitals to deliver a presentation and taste-testing session demonstrating the benefits of their proposal. Once the key decision makers were on board, there was little resistance or backlash. So, wherever possible, target those in power, and use the growing authority of the research and organisations promoting plant-based food in hospitals to your advantage. Their success to date is a powerful and convincing tool demonstrating the success of sustainable, delicious, plant-based food.

If you’d like more support, visit our website or contact ProVeg’s experts at [email protected].