Healthcare food services are increasingly required to balance clinical nutrition requirements, financial sustainability, and environmental responsibility. Within New South Wales (NSW) public hospitals, HealthShare NSW Food Production Units deliver high-volume, standardised meals aligned to the NSW Agency for Clinical Innovation (ACI) Nutrition Standards. This paper outlines a pilot initiative exploring plant-based fortification as a practical, system-wide strategy to reduce environmental impact while maintaining nutrition and cost efficiency.
Food systems contribute substantially to global greenhouse gas emissions, with animal-source foods, particularly red meat, being disproportionately resource-intensive (Poore & Nemecek, 2018; IPCC, 2019). Within institutional foodservices, reducing reliance on high-emissions ingredients presents an opportunity to align healthcare delivery with sustainability objectives while maintaining nutritional adequacy. Blended protein approaches, which partially replace animal protein with plant-derived ingredients, offer a pragmatic strategy to reduce environmental impact while preserving familiar meal formats and patient acceptability (Willett et al., 2019). Evidence from hospital settings indicates that plant-forward interventions can reduce emissions and maintain patient satisfaction (American Hospital Association, 2023); however, most studies are small-scale or observational and focus on full substitution rather than blended models (Chatzipavlou et al., 2024; Wyma & Niesing, 2024). Limited implementation evidence remains.
The project evaluated a blended protein approach, whereby a proportion of animal protein was replaced with plant-derived ingredients in selected minced-based recipes. Sensory testing was conducted at multiple inclusion levels, with a 25% replacement of meat with a legume-based protein identified as optimal for maintaining product quality and acceptability. Reformulated meals were assessed for compliance with NSW ACI nutrition banding, operational feasibility within large-scale production systems, cost implications, and indicative environmental impact.
Key findings demonstrated that plant-based fortification can be implemented without compromising nutritional standards when assessed at the menu level. Protein adequacy was maintained, while measurable improvements in dietary fibre and reductions in saturated fat were observed. These changes aligned with broader public health nutrition goals, including supporting bowel health and improving overall dietary quality in hospital settings.
From an operational perspective, integration into existing food production workflows was achieved with minimal disruption. Recipe reformulation did not require significant process change, and production outcomes such as yield, consistency, and compliance were maintained. Importantly, qualitative improvements were observed in product quality, including enhanced moisture retention, improved cohesion, reduced fat separation, and improved visual presentation and mouthfeel. Additionally, partial substitution of meat ingredients may contribute to improved cost stability by reducing exposure to protein price volatility.
A critical success factor was maintaining familiarity of dishes and avoiding explicit “reduced meat” messaging, with acceptance highest when plant-based ingredients were integrated seamlessly into traditional recipes. This reinforces the importance of patient-centred design and behavioural insights in menu reform initiatives.
This work represents a real-world application of blended protein approaches within a large-scale, standards-governed hospital food service system in Australia. The findings support plant-based fortification as a scalable and practical strategy to advance sustainable healthcare food systems.