Vegetarian and Plant-Based Nutrition in Belgian Hospitals: A Cross-Sectional Study Revealing Gaps and Opportunities for Healthier Food Environments

Background/Objective: Transitioning towards plant-based dietary patterns is essential to improve health and reduce environmental impact. Hospitals represent a key setting to implement such dietary shifts, yet data on the availability of plant-based meals in healthcare institutions remain scarce. Methods: A cross-sectional survey was conducted across Dutch-speaking hospitals in Belgium to assess the meal plans and whether vegetarian or fully plant-based meal options were available for patients. Besides availability, the frequency and perceived barriers were assessed. Furthermore, the meal plans were analyzed to get an overview of the vegetarian and plant-based food options that were offered in different types of Belgian hospitals. Results: The availability of plant-based meal options was limited across hospitals. No meaningful differences were observed between general hospitals and other hospital types, including psychiatric, rehabilitation, and specialized hospitals. While plant-based fats and oils were widely available, key protein-rich plant foods such as legumes and minimally processed meat alternatives were rarely offered in all types of hospitals. Knowledge gaps among food service staff were observed, and structural barriers—including the need to accommodate diverse dietary requirements—were reported. Conclusions: Belgian hospitals currently underutilize the potential of vegetarian and plant-based nutrition to support patient health and sustainability goals. Strengthening institutional food environments by increasing the availability of nutritionally adequate plant-based meals represents a feasible and impactful strategy to align hospital practice with dietary guidelines and preventive healthcare priorities.