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Walk into a hospital cafeteria and you may think you've stumbled into a fast-food joint. French fries, poutine, deep-fried snacks and sugary drinks dominate the menus at many hospitals across Canada - a hypocritical practice that must be stopped, according to an editorial published today in the Canadian Medical Association Journal.

"Although hospitals are the front line for delivering medical treatment, health promotion and education, paradoxically, the foods they sell are frequently generic versions of fast-food staples or, worse yet, brand-name fast food," reads the editorial, co-authored by Yoni Freedhoff, medical director at Ottawa's Bariatric Medical Institute and Rob Stevenson, cardiologist at Saint John Regional Hospital.

A large proportion of food sold at Canadian hospitals contains high levels of trans fats, sodium, sugar and other ingredients that seem to run counter to the role of such organizations to promote health and wellness, according to the editorial.

In addition, an increasing number of hospitals are home to fast-food chains that may only offer dishes laden with fat, salt and sugar.

It's a significant issue that affects thousands of visitors and health care professionals who rely on the food choices available at the hospital.

At a time when more Canadians are becoming health conscious and other institutions, such as schools, are moving to eliminate unhealthy snacks, it's time for health care facilities to overhaul the types of food they offer, Dr. Stevenson said.

"I think patients and their families get confused when they're in hospital and see food served in the cafeteria and in the various retail outlets in the hospital that are less than healthy," he said. "I think if these are going to be centres of health and wellness, I think that really you need to have a consistent message throughout the institution," he said.

The authors of the editorial are urging hospitals across the country to eliminate trans fats from their menus, incorporate a wide range of healthy items and require nutritional information to be posted at the point of sale.

Dr. Stevenson and Dr. Freedhoff have held discussions with numerous Canadian hospitals and said they often encounter three arguments against changing what is for sale in hospital cafeterias and food outlets.

Many hospitals have said it's not their responsibility to monitor the quality and content of food that is available for purchase; adults have the right and freedom to choose the type of food they eat; and hospitals rely on the revenue generated by the sale of fast-food items.

But the editorial highlights the fact that hospitals that have incorporated healthy options have seen a rise in profits from the sale of food, citing the 2007 annual report from the Compass Group, a global retail and food service delivery firm.

Although many hospitals say they do offer healthy food choices, Dr. Freedhoff said they are often too limited or inadequate to be considered suitable alternatives.

"Simply providing salad bars does not mean you provide healthy options. It means you provide a salad bar," he said.

Dr. Freedhoff, who lives in Ottawa, has focused his attention on hospitals in his community to highlight this problem. His blog - bmimedical.blogspot.com - provides examples of unhealthy food, including burgers, fries and sugary drinks, on sale at medical centres in the country's capital.

The Ottawa Hospital said it has been looking at how to change its cafeteria items and plans to incorporate changes in coming months and years that will reflect the importance of healthier menu items.

"We are slated to do cafeteria renovations at the Civic campus later this year with the General following next year," Allison Neill, the hospital's director of media relations, wrote in an e-mail. "Once the infrastructure is in place we will have a wide offering of food, including healthy choices."

Dr. Stevenson is currently leading a project to identify health care institutions that have moved away from deep-fried dishes toward a variety of healthy options. The Canadian Health Hospital Cafeteria Project Survey will collect information from hospitals that have developed healthy initiatives in hopes of helping other institutions incorporate such changes.