Updated 9.50am with CEO's comments

There will be no more "non nutritional" and sugary drinks on offer at Mater Dei as the hospital administration embarks on a health drive.

All food items will be restricted for patients, workers or visitors, an internal memo leaked to the media has shown. 

Suppliers and operators have been given a deadline until June 1, 2019 to eliminate the products. The government will be issuing new tenders for the shops, eateries and vending machines inside Mater Dei. 

The list of items does not include soft drinks, processed foods or the fat-laden pastizzi, a regular feature in the diet of many Maltese. Malta has one of the highest obesity rates in Europe with a poor diet and sedentary life seen as the major contributors. 

Read: 40% of Maltese children overweight or obese

The executive order was given by Mater Dei Hospital management in liaison with the Health Promotion and Disease Prevention Directorate together with registered dietitians and nutritionists.

It said it was providing a list of permissible and non-permissible food and drink items to create a healthier food environment at Mater Dei Hospital to promote health and well being. The measure also applies to vending machines. 

Mater Dei CEO Ivan Falzon admitted the new measures will trigger off a culture shock but said the initial feedback had been very encouraging.

He told Times of Malta the initiative was not intended to cut costs - on the contrary, in the medium term it will mean an added expense for the health sector.

"We're not reinventing the wheel. Hospitals around the world are taking on the role of educators, and we've started that by introducing bicycle racks, among other initiatives."

The initiative was applauded by Nationalist spokesman Ryan Callus. 

Among the non-permissible foods:

• Fried foods.
• Food coated in mayonnaise and/or salad cream.
• Full fat cheeses.
• Creamy or high fat dressings and sauces.
• Highly processed protein foods, including sausages, mortadella.  
• Pastizzi, qassatat, sausage rolls and hot dogs.
• Salted or sweetened nuts.
• Doughnuts, jam and cream cakes, iced cakes, and sweet pastrie .
• High fat, high sugar yoghurts and desserts.
• Breakfast cereals (high in sugar content)
• Bagged savoury snacks except nuts, pulses and seeds.
• Products manufactured and marketed with the intention of being used as part of a weight loss diet.

Pastizzi will be among the banned items.

List of non-permissible drinks:

• Sugar flavoured water.
• Soft drinks.
• Iced teas (with a sugar content of 10% total sugars and more)
• Energy/sports drinks.
• Processed fruit juices.
• Milk containing more than 2.5% fat and/or milk which contains artificial additives.
• Oat, rice, barley and other cereal drinks with more than 2.5% total fat, 1.5% saturated fat and more than 10% total sugars.
• Drinks containing a combination of milk, yoghurt and fruit with more than 2.5% total fat, 1.5% saturated fat and more than 10% total sugars.
• Alcoholic beverages

Among the permissible foods:

• Sandwiches: offered using also wholegrain varieties and served as fresh or toasted. To be served with a side portion vegetable salad of not less than 60g. This salad needs to be made of three types of vegetables.
• Couscous, bulgur wheat, quinoa and brown rice and wholegrain/wholemeal pasta dishes. These dishes are to be served with healthy toppings/fillings – they must contain at least three different fresh or frozen vegetables and be low salt and low fat . Each dish must consist of at least 50% of different variety vegetables.
• Ħobż Malti – Maltese bread preferably wholegrain, filled with tuna, tomatoes, onions, lettuce, beans, olives, capers, fresh herbs and a drizzle of extra virgin olive oil. To be served with a side portion vegetable salad of not less than 60g. This salad needs to be made of three types of vegetables.
• Pizzas - A selection of pizzas made preferably using a wholegrain dough base and with healthy toppings e.g. fresh frozen vegetables.

Other savoury snacks

• Nuts and seeds, not fried, without added salt or added sugars.
• Roasted/dried beans and roasted chickpeas, without added salt or added sugars.
• Plain, air-popped popcorn without added butter, salt or sugar.

Soups and hot dishes

• Soups must be made with fresh or frozen ingredients and low in added fat and low in salt. They should be free from cubes, seasonings or other similar salty products.
• 100% grilled or baked chicken/turkey/fish fillet or poached egg.
• Processed protein foods such as burgers should be freshly ground beef or pork or chicken or fish. These should be grilled and and not fried.
• A vegetarian dish – A minimum serve of 100 -250g lentil curry, vegetarian quiche, chickpea patties, kidney bean casserole. 
• Potatoes – boiled or baked or jacket potatoes with healthy fillings.

Sweet snacks:

• Fresh, frozen fruit yoghurts (containing not more than 10% sugar).
  Breakfast cereals that are not high in sugar content.
• Individually packed slice of fruit bread.
• Traditional bread pudding with no added fat, salt and sugar.