Less than 10 per cent of entrees at children's hospitals in the U.S. were considered "healthy," a new study finds.

The researchers modified a widely-used nutrition tool to assess hospital cafeteria meals. (Jeff Baughan/Associated Press) In the study, researchers used a nutritional scale to assess meals at 12 children's hospitals in California.

"Unfortunately, the food in many hospitals is no better — and in some cases worse — than what you would find in a fast food restaurant," Dr. Lenard Lesser, the study's primary investigator and a physician at the University of California - Los Angeles family medicine department, said in a release.

In the study, published in Thursday's issue of the journal Academic Pediatrics, investigators used a nutrition tool to rate the pricing, availability of vegetables, nutrition labeling, combo promotions and healthy beverages at hospital cafeterias.

Overall the average score for the hospitals was 19.1, out of a range of 0 (least healthy) to 37 (most healthy).

"Most children's hospitals' food venues received a mid-range score, demonstrating there is considerable room for improvement," the study's authors concluded.

The researchers found that nearly all hospitals offered diet drinks, low-fat milk and fruit.

But fewer than one-third had nutrition information at the point of purchase and 30 per cent had signs promoting healthy eating.

What's more, most displayed high-calorie impulse items such as cookies and ice cream at the register, the study's authors said.

"Achieving ideal children’s hospital food environments would be one small, but significant, step in changing the quality and quantity of what our children eat and preventing the onset of dietary-related chronic diseases," the authors wrote.

They acknowledged that the study looked at a small sample of children's hospitals and that no one actually observed what people actually ate.

Hospitals also often have other places to buy food besides the cafeteria, such as candy shops and vending machines.

The researchers called on national hospital groups to establish standards for labeling, pricing, marketing and food quality in their facilities to improve the food landscape.

Since the study was conducted in July 2010, some of the hospitals surveyed have taken steps to either improve their fare. For example, some have eliminated fried food, lowered the price of salads, and increased the price of sugary beverages or eliminated them altogether from their cafeterias, the researchers said.

The Robert Wood Johnson Foundation funded the study.