To assess the amount of food produced in a hospital kitchen and the amount wasted. To assess the amount of food eaten by patients in relation to their energy needs. To assess whether the food production and wastage could be reduced by training members of the staff. The study was carried out in a general district hospital in Denmark. The amount of food produced in the hospital kitchen and returned uneaten (wasted) was determined. In a representative sample of patients, the energy expenditure was calculated and in the same patients, the energy and protein intake was determined. Following training of the hospital staff the first part was repeated. On average, 11.1 MJ and 112 g of protein were ordered per patient per day. From these amounts on average 3.1 MJ and 33 g protein were wasted per patient per day. The total average energy expenditure was calculated to be 7.5 MJ per patient per day; however, on average, the daily energy intake was only 4.5 MJ and daily protein intake 46 g per patient. Sixty percent of the patients showed evidence of malnutrition as judged from the hospital notes. However, the staff only drew attention to this in 20% of the cases. Following training of the hospital staff, a new investigation showed no significant changes in the amount of food ordered and wasted. Despite a supply of food, which was much higher than the patients' needs, the patients have only approx. 60% of their energy need covered. We suggest a reorganization of nutrition in hospitals, so that this is made the responsibility of specific staff members.

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