Food served in children’s hospitals in the US state of California has been rated as largely unhealthy by a new study.

Researchers from the University of California, Los Angeles and the RAND Corporation assessed 16 food venues at the state’s 14 major children’s hospitals and found much room for improvement in their offerings and practices.

The study authors developed a modified version of the Nutrition Environment Measures Study in Restaurants (NEMS-R) as an assessment tool for the food in hospital cafeterias.

The measurement system takes into account pricing, the availability of vegetables, nutritional labelling, combination promotions and healthy beverages.

Overall, the average score for the 16 hospital food venues was 19.1, where 0 is least healthy and 37 most healthy.

Of the total 384 entrees and sandwiches the hospitals served, only 7% was classified as healthy, according to the NEMS-R criteria.

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However, nearly all the hospitals offered healthy alternatives such as fruit, less than one-third had nutritional information at the point of sale or signs to promote healthy eating.

Another key finding was that all 16 food venues offered low-fat or skim milk and diet soda and 25% sold wholewheat bread.

More than 80% offered high-calorie, high-sugar items such as cookies and ice cream near the till.

Half the hospitals did not provide any indication that they carried healthy entrees and 44% did not have low-calorie salad dressings.

Reports of the quality of food in the hospitals have not been previously documented, so researchers provided hospital administrators with their scores to encourage improvement.

University of California, Los Angeles primary investigator on the study Lenard Lesser said that they understand the connection between healthy eating and good health, and the hospitals should be role models in this regard.

"Unfortunately, the food in many hospitals is no better – and in some cases worse – than what you would find in a fast food restaurant," Lesser said.

"The steps some hospitals are already taking to improve nutrition and reduce junk food are encouraging."