There are a number of reasons why hospital food is often less than stellar. In the early 21st century, many hospitals began to recognize the infamous reputation of hospital food, and a few began pilot programs which focused on improving the quality of their food. Supporters of these programs argued that healthy, good food is a very important part of proper medical care.

Hospitals might contract out their cafeteria plans to companies that focus on quantity over quality.

Many people are surprised to learn about how unhealthy hospital food is, since they assume that the food served in a hospital would be at least healthy, if not always appetizing. One of the excuses which is trotted out to explain why hospital food tastes bad is that hospital meals are constructed with dietary concerns in mind, rather than flavor. In fact, even the meals which have been specially prepared for patients with unique needs are often unhealthy, thanks to the ingredients used and the ways in which they are prepared.

Many people are surprised to learn about how unhealthy hospital food actually is.

Most hospitals contract out their lucrative cafeteria plans to companies which specialize in preparing institutional food. The same companies make food for prisons and schools, institutions which are also infamous for having terrible food. These companies focus on producing high volumes of food at low cost, often taking advantage of extensive distribution systems which allow them to send packaged and already mostly prepared food to the hospitals they contract with. By the time this food reaches the hospital, it may be well past its peak, and it is often laden with saturated fat, sodium, and other substances which are harmful in large amounts. It is also typically made as bland as possible, so that it is inoffensive, and many things are overcooked, thanks to being cooked remotely and then reheated at the hospital.

Hospital food is often more bland to cater to as many people as possible.

Institutional food also takes advantage of bulk food costs which are often negotiated by government agencies like the United States Department of Agriculture. Commodities like corn and wheat are often provided at very low cost, along with cheaper cuts of meat, and so cafeteria plans make heavy use of these cheaper ingredients, avoiding fresh fruits and vegetables, which cost more.

Some hospitals have made a point of improving food services.

Hospital food also rarely caters to ethnic tastes, which can be difficult for people from different cultures while they are at the hospital. Because cafeteria contracts are extremely profitable, family members may be told not to bring in food, even when it is obvious that a patient refuses to eat the food for cultural or religious reasons. For people with very specific tastes, it can be a good idea to talk to a doctor about any recommended dietary restrictions and then smuggle food in to ensure that the patient eats well.

Hospital cafeterias often avoid using fresh fruit and vegetables because of the high cost of these food items.

Hospital food may be in for a makeover. Institutional food in general has made leaps and bounds since the 1990s, for a number of reasons. Consumers are often more aware of the effects of eating unhealthy foods, for example, and many consumers are also starting to demand food which is ethically and sustainably produced. Hospitals which have offered more varied fare produced on site with local, fresh products have noted the positive response, and the trend is likely to spread.