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Food environments are likely to be key contributors to the development of diabetes and obesity. Hospitals should strive to create a model food environment that facilitates and promotes a healthy eating behaviour among visitors, patients and staff. The study objective was to evaluate foods and beverages available for purchase in vending machines at Malta’s only state hospital. Methods An observational study gathered data regarding location, type of food and beverage items available in the vending machines found within the public areas within the only state hospital in Malta. All items on sale were categorized into ’healthy’ and ’unhealthy’ food and beverage according to pre-defined criteria. Results There were 33 vending machines: sixteen offered beverage options, and the remainder contained food items, which displayed exclusively confectionary items. The beverage machines were identically stocked so that bottled water contributed 17%, diet soft drinks 33% and regular soft drinks 50% of overall beverage choices. Fresh vegetables or fruit were not available for sale (except for 1 beverage machine offering fresh squeezed orange juice) with most items on display classified as ‘unhealthy’. Conclusions Hospital food environments should complement health professionals’ efforts in promoting healthier lifestyles, however, the majority of foods and beverages available for purchase at Malta’s only state hospital through vending machines is unhealthy. Urgent action is required to rectify the current situation. Key messages Vending machines offered ’unhealthy’ choices to patients, relatives and staff. Hospital food environment should promote healthier food and beverage options.

Do we practice what we preach? Assessing the food environment in Malta’s only state hospital