FoodserviceFoodservice should provide nutritionalNutrition, safe, and environmentally friendly meals, especially in hospitals. In Italy, the achievement of this aim requires the adoption of the minimum environmental criteriaMinimum environmental criteria for foodserviceFoodservice. However, the application of these guidelines is necessary, but not sufficient, since it may exist a tension between sustainabilitySustainability of meals and customer satisfaction. This chapter tests a significant hypothesis for foodserviceFoodservice, namely that environmentally friendly diets may lead to greater food waste. It employs the carbon footprintCarbon footprint method to measure the environmental sustainabilitySustainability of meals in foodservice hospitals and carries out questionnairesQuestionnaire to quantify food waste among 3454 patients over a three-year period. Food waste at lunch is approximately 8.6–13.9%, whereas at dinner it increases up to 18%. The highest peak at lunch is 24.6%, and the highest peak at dinner is about 30.7%. Given that the hypothesis at the foundation of the research has been confirmed, the chapter proposes sustainable menus with the aim of pursuing either environmental sustainabilitySustainability or customer satisfaction.