"Hunger-striking" Moors murderer Ian Brady makes himself toast every morning, according to his charge nurse.
Mark Sheppard, Brady's charge nurse at the maximum security Ashworth Hospital in Merseyside told Judge Robert Atherton that there was a "considerable degree of natural feeding" by Brady.
"We make food available for Ian every evening which we know he takes," Sheppard said.
"The reality is that we know Ian makes himself toast every morning. I would say most days we observe Ian eating."
Brady, 75, has brought the tribunal, which is being held in public, because he believes he is not mentally ill and wants to be transferred to a prison from maximum security Ashworth Hospital in Merseyside.
The child killer, who has been on hunger strike since 1999, has said previously he will be able to starve himself to death in a jail - currently he is assessed as being chronically mentally ill and is fed through a tube in his nose.
Brady continues to use the nasogastric tube but would throw large amounts of the food away as he took it, Sheppard added.
He said: "I think he takes small amounts of his feed most days."
The judge asked Sheppard how he viewed the appearance of him continuing to be on hunger strike.
He replied: "I think it serves some purpose for Ian. It is his continued stance that he is on hunger strike because of his perceived battle with the Home Office."
Judge Atherton asked: "Do you think he is trying to find a way out of stopping it (the hunger strike) and not losing face?"
The nurse said: "I find it hard to believe that Ian is not aware that we see him eating toast in the morning ... it (the hunger strike) serves a purpose for him."
The tribunal is sitting to determine whether he can be allowed to return to jail to continue serving his whole life sentence after he was transferred to Ashworth in 1985 when his mental health deteriorated.
During Monday's hearing, Brady continually wrote notes and read case papers but did not look up or react as various witnesses gave evidence in the room.
Sheppard also recalled an incident last September when Brady jabbed at a fellow patient with a pen. It led to fears he was carrying it around as a weapon and was later confiscated.
Sheppard said Brady also attacked him with the pen during the fracas and was so angry he was "baring his teeth" and spat at him.
"He pointed the pen towards my face with such anger that he was going to make contact with me," he said.
"I had to put my hand up and Ian's hand came over and made contact with me.
"I am absolutely convinced if I had not brought my hand up (then) his pen would have contacted with my face."
He said he had known Brady for 28 months on his time on the low-dependency ward and that he was in closer contact with him than the vast majority of the care team.
He said Brady would only be settled because of the skills of the nursing team who dealt with him.
Sheppard said he thought Brady still had delusional beliefs and that he had witnessed him having hallucinations.
Earlier in the trial a psychologist told the tribunal that the hospital treatment of Brady may have been affected by his notoriety, his mental health tribunal heard today.
Staying in the same place and with the same care team for 30 years was "exceptional" and not a "healthy position", consultant psychologist David Glasgow told the hearing.
Glasgow, called by Brady's legal team, said he thought the current nursing care provided to Brady did not amount to treatment and the hospital's overall therapeutic approach did not appear to have any goals.
He said: "My concern is that his notoriety has affected his treatment.
"There is a compelling argument that the move in 1999 (from one ward to another) irretrievably compromised his relationship with that care team.
"I was very surprised to learn that he is exceptional in that he has stayed in the same place with the same team for 30 years. This is just not a healthy position to be in."
Glasgow said it was his opinion that treatment and goals needed to be constantly changed, he said.
Brady's legal team assert he has a severe narcissistic personality disorder but is not mentally ill and could be treated in prison rather than hospital.
But Ashworth say Brady is still chronically mentally ill and remains a paranoid schizophrenic who should stay at the hospital.
He has refused medication and therapy for his mental disorders since 2000 as he is "wholly resistant" to any treatment and now tries to hide his mental illness, the tribunal heard.
The tribunal was told about an incident in October 2008 when Brady was said to have thrown tea on a nurse's trousers.
Brady threw tea from a cup as he walked on a ward and then almost poked a patient in the face with a pen he constantly carried around him in an extended position, it was said.
When confronted about the incident he responded with verbal abuse, said Eleanor Grey QC, representing Ashworth.
"He called the nurse 'a f****** c***'," said Grey.
Yet Brady said he had no knowledge of the incident in a recent conversation with Glasgow and that he was "completely baffled" by the allegations.
In another incident in 2007 he was said to have breached regulations when videotapes containing material with "violent sexually explicit elements" were found in a search of his room.
Brady told Mr Glasgow that the confiscated items did not hold "any particular significance", other than he chose to record them from television.
Glasgow said Brady told him in their interviews that he believed incidents were "embellished or invented" by Ashworth staff in order to "pathologise his behaviour" in a bid to unsettle him.
The psychologist said he accepted the diagnosis of schizophrenia on Brady in the 1980s but that did not mean he suffered from it now.
"My view is that clinical judgment is based on presentation over the last six to 12 months," he said.
He said he had seen numerous examples of Brady being thoughtful, civil and caring to staff and that he had responded positively to the use of therapy dogs.
The main immediate issues if he was allowed to return to prison would be the risk to himself and the risk to others, he continued.
Glasgow said it would be a mistake to discount Brady's previous statements that he wanted to go back to prison to end his life.
"It would be foolish to say that he does not really mean it because he is narcissistic and is working the system," he said.
In prison he would be more likely to confronted by someone who systematically wanted to kill him but Brady when asked about the subject had said: "As long as it is quick, that is fine by me."
Brady was given life at Chester Assizes on May 6 1966 - the last time he spoke in a public forum as he denied a series of child murders.
Brady and his partner, Myra Hindley, were convicted of luring children and teenagers to their deaths, with their victims sexually tortured before being buried on Saddleworth Moor.
Pauline Reade, 16, disappeared on her way to a disco on July 12 1963 and John Kilbride, 12, was snatched in November the same year. Keith Bennett was taken on June 16 1964 after he left home to visit his grandmother;
Lesley Ann Downey, 10, was lured away from a funfair on Boxing Day 1964; and Edward Evans, 17, was killed in October 1965.
Brady was given life for the murders of John, Lesley Ann and Edward.
Hindley was convicted of killing Lesley Ann and Edward and shielding Brady after John's murder, and jailed for life. She died in hospital, still a prisoner, in November 2002 at the age of 60.Suggest a correction