XII: XI: X. CONTENTSIX. VIII. VII. VI. V. IV. III. II. I. Credits Advisory Councils Resources Delicious FoodChoices Case Studies:TheSellingofHealthy, Sustainable, Principles ofHealthy, SustainableMenus Science andPolicyHighlights Nutrition, Health,Sustainability, andFoodEthics: Trends, andChangingAppetites Demographics andConsumerPreferences: Issues, Risks, andOpportunities Business Imperatives:TheChangingCalculusonCosts, Impact Survey Green Shoots:DeliciousSignsofChange Executive Summary Menus ofChangein2016 University Research Collaborative Inspiration from theMenusofChange GPS: AModelforChange Our Vision Dashboard State ofthePlateandScore Key

58 56 53 50 46 41 21 16 12 11 10 9 7 6 5 4 3 2 increases to only 2º C, just below the level that would trigger the most challenging changes in our I. MENUS OF weather, water availability, and sea levels. That agreement set goals that nations can only achieve CHANGE IN this if we change the way we grow food and the foods we choose to eat, and also committed to a plan that will address the risks that climate change 2016 and water scarcity pose for food companies. This year’s report provides briefings on both water and This past year, environmental and nutrition science climate issues as well as a set of Principles of and public policy converged right at the center of Healthy, Sustainable Menus that can guide you in our plates. reducing the carbon footprint of the meals you serve. The scientific advisory committee for the 2015 Both the report of the DGAs scientific advisory Dietary Guidelines for Americans (DGAs) released committee and the COP21 agreement recognize its final report on the state of the American diet the tremendous change needed in what we choose and what we should be eating, the basis for official to serve and our customers choose to eat. As this dietary guidelines that are revised every five years. year’s Dashboard shows, changes in what we are The report raised awareness among both policy eating continue to shift in the right direction, but makers and the general public about the same the pace of change is modest. And in the past nutrition and environmental science that underpins year, the foodservice industry has begun to fully Menus of Change, citing both the health benefits recognize the rising cost from climate change, of plant-forward dietary patterns such as the water scarcity, lack of visibility into supply chains, Mediterranean diet and also the environmental and other environmental factors. While change benefits of eating a larger share of plant-based foods. has been slow in the past, the stage is now set for substantial improvements. Investors already are Also, the committee provided definitive answers pricing in the value of companies that pay attention about whether Americans are eating enough to environmental concerns and actively manage protein—we get more than we need—and what their supply chains—and they are expecting all is an appropriate limit for added sugar. Based on companies to do the same. their findings, the latest DGAs note for the first time that many Americans eat too much red meat and The Menus of Change initiative, a partnership of that adults should consume less sugar each day The Culinary Institute of America and the Harvard than is found in a typical can of regular soda. The T.H. Chan School of Public Health, aims to help 2016 Menus of Change Annual Report provides you do just this. It does the essential, difficult, executive briefings on protein as well as strategies and unprecedented work of integrating the latest for reducing meat and sugar in your menus and findings from both nutrition and environmental operations. And the menusofchange.org website science into a single set of recommendations to provides more information about how to “flip” the help foodservice and culinary professionals to role of protein on the plate to deliver delicious, make better choices and to successfully navigate healthy, sustainable, and profitable results. the rapidly changing landscape. The committee also found that Americans should This annual report is a part of that mission. It aims to nearly double the amount of fish and seafood we eat. advance a long-term, practical vision that integrates Diners choose to eat more of their fish and seafood in optimal nutrition, environmental stewardship and restaurants than in any other place, and responsibly restoration, and social responsibility within the sourcing the right types can be a complex matter. foodservice industry. This year’s annual report provides an executive briefing on fish and seafood as well as guidance to The CIA and Harvard Chan School invite businesses help you choose wisely for your customers. to use this report to measure their progress and to navigate new and complex challenges. Not all In Paris, the United Nations held its annual culinary professionals and foodservice companies Conference of the Parties (COP), which brings the will take the same path forward. But more and more world’s nations together to find ways to address have a similar goal: to lead successful businesses climate change and greenhouse gas emissions. serving healthy, sustainable, and delicious food. Remarkably, this 21st meeting resulted in the first-ever global agreement on how to reduce greenhouse gas emissions and hold temperature

3 II. EXECUTIVE SUMMARY: A TASTE OF WHAT’S AHEAD IN THE PAST YEAR, TERMS LIKE “PLANT-BASED,” “PLANT-CENTRIC,” AND “VEGETABLE-FORWARD” ALL STARTED TO ENTER THE MAINSTREAM OF THE NATIONAL LEXICON.

One of the biggest recent trends is not only menus A combination of factors is fueling this gradual but entire restaurant concepts that put plants first. transition to more plant-based diets. One is that Some of the shift revolves around a celebration consumers are starting to become more concerned of produce itself, which can be seen in the crop about the health effects of frequent consumption of decidedly plant-centric cookbooks that have of red and processed meat, in part due to the emerged from top chefs in the past year. April World Health Organization (WHO) announcement Bloomfield—best known for her cookbook A about the association with increased risk for certain Girl and Her Pig, as well as her Michelin-starred types of cancer. (Unfortunately, as described in restaurant The Spotted Pig—authored A Girl and this report’s consumer attitudes issue brief, the Her Greens, revealing her love of produce. Michael way the WHO’s findings were explained in the Anthony of Gramercy Tavern released V Is for press led to much confusion.) Second is a growing Vegetable, which Anthony has emphasized is not understanding of the environmental impacts of a vegetarian or vegan cookbook but inspiration for raising livestock. “vegetable cookery.” The book (which won a 2016 James Beard Foundation book award) aims to help Never before the past year has awareness been so consumers think about re-proportioning their eating strong about the connection between the health of habits, with meat as a sometimes accompaniment our bodies and the health of the planet with regard to a plate filled with vegetables. to food choices. A national survey released in March by the Johns Hopkins Center for a Livable Future These trends are especially inspiring in light of data and Greenberg Quinlan Rosner Research found from the U.S. Department of Agriculture (USDA) that 74 percent of American adults believe that the showing that three quarters of Americans fail to new dietary guidelines should include environmental meet the daily recommendations for fruit intake, implications and support sustainable agriculture and the same is true of fourth fifths of Americans practices. It also found that 70 percent of survey for vegetable intake. One major issue is the respondents felt that the agriculture industry has discrepancy in marketing budgets between healthy a responsibility to produce food sustainably. For foods and unhealthy foods. On the bright side, the context, only 30 percent of respondents felt the National Fruit and Vegetable Alliance’s 2015 report industry had a responsibility to provide food at low card found that the restaurant sector was much cost. Though encouraging that an agreement was better than other food sectors at increasing the reached among nearly 200 countries at the historic availability of fruits and vegetables in recent years. 2015 Paris Climate Conference (COP21), many experts were discouraged that greater emphasis was It’s not just vegetables that have earned higher not placed on the role of global agriculture. status on menus, but a wider variety of whole grains and plant proteins. The United Nations declaring For these reasons and more, the 2015 Dietary 2016 the International Year of Pulses has helped Guidelines for Americans (DGAs), which were released lentils, chickpeas, and beans leap into both the in January 2016, proved a missed opportunity to consumer and operator consciousness like never include sustainability language in this country’s official before. (Granted, they have been gaining ground guidance about what to eat. It was also a missed for some time: According to Datassential, menuing opportunity to provide a clear recommendation of chickpeas has increased by 290 percent in the to reduce red meat consumption. Both had been past decade.) These fiber-rich plant proteins offer advised by the scientific advisory committee’s report numerous nutritional benefits, and also improve for the 2015 DGAs. soil fertility through their symbiotic relationship with nitrogen-fixing bacteria that live in their roots.

4 Given the complexities of change in order to benefit mislabeling, and other failures to ensure traceability; the triple bottom line of people, planet, and profit, exposés of human trafficking throughout the Thailand the Menus of Change Annual Report is designed fishing industry, which is linked to the farmed STATE OF to give foodservice and culinary professionals the shrimp industry in the U.S.; and threats to oceanic insights and the tools to make informed decisions ecosystems that are clearly tied to climate change. about difficult issues. The report sifts through culinary For instance, a Dungeness crab fishery in California— THE PLATE trends and innovations to shed light on some of the which typically brings in $60 million per year—could How are we doing? Sometimes it’s hard to tell. The most intriguing companies and projects happening not open last fall because record temperatures in Menus of Change Dashboard on the next page the Pacific Ocean led to an algae bloom. The algae around the country, all in the name of healthier, more provides a snapshot of the foodservice industry’s produced a neurotoxin called domoic acid, which sustainable food. The Menus of Change initiative progress to improve nutrition, sustainability, and also importantly provides comprehensive advice and made its way up the food chain to crabs. On the East Coast, the collapse of Atlantic cod stocks was found profitability. Its scores on critical issues that affect strategies for menu design that support the triple the foodservice industry are updated annually to bottom line with the Principles of Healthy, Sustainable to be linked to climate change. show where progress is being made. It also creates Menus (see page 41). These guidelines outline culinary a set of standards, which are designed to be used strategies, such as new focuses on portion size, calorie Water by businesses to judge their own efforts on health quality, and plant-based foods, which are needed to The picture for fresh water is no less troubling. The and sustainability. increase the success of new business models. World Economic Forum has ranked water scarcity’s impact on drinking water and global food security as the top threat facing the planet in the next decade. The centerpiece of Menus of Change is a concise Severe drought conditions continued in much of the analysis of 16 issues at the intersection of public Dashboard Score Key: western U.S., and the impacts cost over 20,000 health, the environment, and the business of food. The score assigned to each issue indicates progress jobs and over $2 billion in revenue to the California These issue briefs synthesize the latest health and or lack thereof in the food industry and/or culinary agricultural economy alone. Many agricultural leaders environmental data to provide a clear picture of the profession over the last 12 months, as follows: are rallying in response; for instance, the Almond industry’s challenges and opportunities, as well as Board of California started a new initiative to stimulate practical next steps for foodservice operations. The agricultural practices that manage water use more 5. SIGNIFICANT PROGRESS report assigns each issue an annual score that rates efficiently. However, most food companies have yet the industry’s efforts in these critical areas. Among to fully engage in the pressing issues of water supply these 16 issues are: security, water quality protection, and water use reduction and reuse. A recent report found that only Diet and Health one-third of 37 large food companies consider water Encouragingly, the overall quality of the U.S. diet risks in their agricultural supply chain, and only two 4. GOOD PROGRESS, WITH ROOM FOR MORE has improved steadily as of 2012 compared to of those 37 were actively addressing the impacts 2000 and since the Harvard T.H. Chan School of of their operation on water quality. Clearly there is Public Health’s last report based on data through much to be done. 2010. By far, the greatest progress since 2000 was in reduction of trans fat, estimated to be about Overall, the industry is making slow but steady 3. NO SIGNIFICANT PROGRESS 80 percent, which accounted for about half of the progress: 12 of 16 issues received a score of four overall improvement in diet quality. The next greatest (making good progress) or three (holding steady), and improvement was reduced consumption of sugar- improvements were seen in improving diet quality, sweetened beverages, which decreased by about local food and the farm-to-table movement, supply 25 percent. Modest increases were also seen for chain resiliency and transparency, and healthy food 2. GETTING BETTER, BUT FAR FROM fruit, whole grains, polyunsaturated fatty acids, and versus healthcare spending and medical-culinary WHERE IT NEEDS TO BE nuts and legumes. A modest reduction was seen for educational alliances. Unfortunately, the industry red and processed meat, contributing to improved took a step back with regard to fish, seafood, and diet quality. However, the overall score remains oceans, and foodservice professionals continued to poor: below 50 out of 100 possible points. The only be underprepared for the impacts of climate change dietary component that significantly worsened was and water risks on their operations. Garnering the 1. SIGNIFICANT DECLINE OR REGRESS sodium intake. This highlights a need for foodservice lowest scores of 1 and 2 respectively, these two areas operators to address this issue more directly through remain of greatest concern. culinary strategies.

Climate Change and Fish, Seafood, METHODOLOGY and Oceans The scores were developed based on the expert opinions of the members of of the Menus of Change Scientific For the first time, the score for fish, seafood, and and Technical Advisory Council, who considered new research findings and trend data as well as innovations oceans decreased compared to the prior year. Major and changes in business practices and policies. The information was then reviewed by members of the Menus of factors include: continued underconsumption of fish Change Sustainable Business Leadership Council to ensure they reflected new industry initiatives and practices. and seafood overall paired with an over-reliance on just three species (salmon, shrimp, and tuna); fraud,

5 2013–2016 MENUS OF CHANGE DASHBOARD © 2016 The Culinary Institute of America and President and Fellows of Harvard College, aspublished in the Menus of Change SCORE 2016 SCORE 2015 SCORE 2014 SCORE 2013 culinary education. organizations and institutions.Manyofthese are startingtolinkhealthcare andhealthyeating with Innovative, interdisciplinary programs are beinglaunchedwithincreased frequency byhigh visibility level,including fromis gainingattentionattheinternational theWorld HealthOrganization. supply chainsanduse"clean" ingredients. Although theregulatory progress hasslowed,antibioticresistance A growing numberofmainstream foodservicecompaniesare committingtoreduce antibioticsintheir greens helps,butthesetrends donotyetreflect broad-ranging, consciousefforts bytheindustryas awhole. depletion affect profits andwaterscarcity isrecognized asaglobalcrisis.Consuminglessmeatandmore hardier The foodandfoodserviceindustryisbeginningtopayattention towaterissuesasdrought andgroundwater But thefoodsectorcontinuestobeamajorcontributor, anditwillbecomeonlymore difficult toadapt. precipitation impactsonfoodproduction, transportation,refrigeration, andprocessing facilities. Climate changecontinuestoaffect everyaspectofthefoodsystem,through temperature and is positive,butsubstantialexceptionspersist,and issues ofslaveryandmislabelingare concerning. emerged forbothwildandfarmedproducts. Work tolessentheenvironmental footprintofseafood There are multiplepublicandprivateefforts toimprove seafoodsustainability, andstandards have sufficient scale,andthey are stalledbypublicpolicyandtheassociatedhighproduce prices. and fruitvegetableconsumptionstillfailstomeetrecommended levels.Efforts havenotyetachieved Though publicinterestinitiativeshaveincreased, and government long-termtrends havenotbeenreversed, environmental healthaspects ofourcollectivediet. from thefinalDietaryGuidelines forAmericansisamissedopportunitytobetteralignhumanand Red meatproduction and consumptionintheU.S.isdecliningmoderately. Exclusionofsustainability limit onfat.Yet, amore fundamental focusonfood(orcalorie)quality, notjustquantity, isstillneeded. Dietary GuidelinesforAmericansincludesanewemphasisonrestricting sugarintakeandliftingtheupper point,withinterestPublic sentimentsuggestsaturning inwhole/minimallyprocessed foodsrising.The2015 and asmallincrease in whole fruits,grains,healthyfats,andnutslegumes. an importantreduction in sugar-sweetened beverages,modestreduction inred andprocessed meat, Modest improvements toward healthierdietsincludealarge reduction intheintakeoftransfats, But substantialroom for improvement remains. producers isemploying better practices,andbothpublicprivatesectorpoliciesare improving. Awareness isrisingaboutanimalwelfare problems inthelivestockindustry. Agrowing group of producing andconsuming “goodfood.” farmers, chefs(andotherbuyers),andconsumerstoaccelerategrowth insegmentsdevotedto Federal andlocalpoliciesfinallyare supportinglocalandregional food.Hopefully, thiswillenable steady barrageofinconsistentadviceandmediacoverage. Even consumersmotivatedtomakehealthierfoodchoicescan’t helpbutbeconfusedgiventhe fast-casual operations.Additionalfocusisneededonportionsize,nutrition,andplant-basedproteins. Many chefsandfoodserviceleadersare offering plant-forward options,includingnewfull-serviceand plant-forward conceptsandsustainablesupplychains. disclosure toolsandregulation. Investmentisalsoincreasing fornewercompaniesthatfeature Investors inpubliccompaniesnowlinkstockperformancewithsustainabilityandrely onnew companies are showingthathigherstandards cansupportcustomer, business,andenvironmental goals. Supply chainsremain vulnerabletofraudandcontamination.More traceabilityisneededandleading and health.Thegapbetweentheculinarytechworldsisnarrowing. Capital flowshaveincreased intofoodandtechstartups,withmore focusedonsustainability ® Annual Report on menusofchange.org. All rights reserved. 6 © 2016 The Culinary Institute of America and President and Fellows of Harvard College, as ® published in the Menus of Change Annual Report 7 on menusofchange.org. All rights reserved. © 2016 The Culinary Institute of America and President and Fellows of Harvard College, as ® published in the Menus of Change Annual Report 8 on menusofchange.org. All rights reserved. GPS: A MODEL FOR CHANGE

SHAPING CONSUMER VALUES, ETHICS, PREFERENCES / AND CONSUMER LEADING PREFERENCES THE MARKET

PUBLIC HEALTH AND NUTRITION CULINARY SCIENCE ISSUES INSIGHTS AND IMPERATIVES

INTEGRATION OF PUBLIC HEALTH CURRENT BUSINESS RISK AND AND STRATEGIES AND OPPORTUNITY SUCCESSFUL ENVIRONMENTAL MENUS ANALYSIS FINDINGS, CHANGE TRENDS, AND DRIVERS BUSINESS ENVIRONMENTAL INSIGHTS SCIENCE ISSUES AND IMPERATIVES

COST AND ECONOMIC TRENDS

© 2016 The Culinary Institute of America and President and Fellows of Harvard College, 9 as published in the Menus of Change® Annual Report on menusofchange.org. All rights reserved. III. GREEN SHOOTS: DELICIOUS SIGNS OF CHANGE

Nearly everyone has heard of chefs (including Dan Barber and Also reaching for the skies is community-supported agriculture Michael Cimarusti) who have joined AeroFarms, a company based in programs, or CSAs, but a related Dock to Dish, but organizations as Newark, New Jersey providing model is gaining traction at sea: large as Google. Given the quantities of vertical aeroponic farms that require the restaurant-supported fishery. seafood purchased by restaurants and no sunlight or soil, use 95 percent An organization called Dock to high-volume foodservice operations in less water than traditional growing Dish provides its members direct particular, this model has tremendous methods, and again no pesticides. access to a network of local small- potential for introducing diners to a new Through a patented technology, scale fishmongers, who deliver world of overlooked species. its system can grow 250 varieties freshly caught, wild, fully traceable of leafy greens and herbs, which fish that are rated as abundant and On land, urban farms are nothing they emphasize to their retail and sustainable by the National Oceanic new, but now, from the concept of foodservice customers are harvested and Atmospheric Association (NOAA), rooftop gardens have sprung rooftop at peak flavor, undergo stricter food which is the U.S. Government’s greenhouses. Enter Gotham Greens, safety measures, and have longer measure of fishery health. Dock to a series of four climate-controlled shelf life compared with conventional Dish represents a paradigm shift greenhouses occupying a total of produce. AeroFarms recently raised from a demand-driven approach, 170,000 square feet of rooftop real $20 million to expand its operation. where restaurants target popular estate in New York and Chicago, cities species, to a supply-driven approach, with both enormous populations and On the policy front, one inspiring where the fish delivered on a given tremendous challenges for providing example of change is that food waste day are the catch deemed most year-round local produce. But we aren’t has gone well beyond grassroots appropriate at the time. Those talking about a handful of herbs and campaigns and individual culinary are often the so-called “trash fish” tomatoes here; the reason rooftop or retail programs. The past year it species, such as tautog, rockfish, greenhouses are being hailed as a earned the attention of the federal and skate, long considered unsellable “game-changer” is the commercial government, with USDA and the by fishmongers because consumers volume they can produce. A variety Environmental Protection Agency would turn up their noses. This shift of types of produce, mainly leafy jointly announcing in September the is of critical importance because, as greens, are sold at grocery stores first nation-wide goal to reduce food conservationists have been lamenting and restaurants at street level just waste. The aim is to cut waste by 50 for years, overfishing of just a handful steps away. Whole Foods Market, the percent by the year 2030, through of types of seafood threatens the delivery service Maple, and Union a partnership with private sector viability of ocean ecosystems. Three Square Hospitality Group are among organizations as well as state and species—shrimp, salmon, and tuna— their customers. Environmental tribal governments. account for 60 percent of the seafood benefits transcend the local angle: Americans consume, according to the no pesticides or agricultural runoff To learn more about the outpouring of National Fisheries Institute. are involved, and the recirculating innovation the food and foodservice hydroponic growing system uses industry has witnessed over the The restaurant-supported fishery water more efficiently. Consider too past year, please see the issue brief model is also exciting because that rooftops sit on land already being on page 13. of the creativity and diversity it used for something else, making them sparks on menus from coast to an efficient use of the earth’s surface coast, exemplified by the wait list area at a time when the growing global from numerous top chefs eager to population and dwindling farmland are participate. It’s not only independent of great concern.

10 IV: MENUS OF CHANGE IMPACT SURVEY

Menus of Change is deeply committed to the measurement of change: What HOW HAVE YOU ACTED ON GUIDANCE PROVIDED BY MENUS OF CHANGE? impact is the initiative having on the foodservice leaders who engage with it, and on the industry as a whole? In its annual survey of attendees of Menus of Change leadership summits, the CIA aims to find out how operators use the 77% initiative’s guidance throughout the year. Respondents are based in locations 69% throughout the United States and represent operations ranging from quick- 62% service restaurants to K-12, from catering and healthcare/senior care to corporate dining and college and university foodservice. 39% 39% A remarkable 87 percent of respondents to the 2016 survey had acted on the 27% guidance provided by Menus of Change. Among those who had made a change 19% of some kind, 77 percent had introduced new recipes; 69 percent had revised an existing menu or dining format or concept; 62 percent had revised existing Introduced new Revised an Revised existing Introduced a new Changed our Changed our Other recipes; 39 percent had introduced a new menu or dining format or concept; recipes existing menu recipes menu or dining sourcing practices operational 39 percent had changed sourcing practices; and 27 percent had changed or dining format format or concept practices operational practices. Encouragingly, among those who had made a change, or concept 44 percent had done so across their entire operation. Another 36 percent had made the change at multiple locations. IN WHAT WAYS HAVE YOU SHARED MENUS OF CHANGE INFORMATION? Eighty-seven percent of respondents had also shared information from Menus of Change with others. For those who had shared the information, nearly two thirds 63% 63% had shared it digitally with their coworkers, and the same proportion had shared 56% 56% it with coworkers through a presentation; over half had presented to their senior leaders or owners, and the same proportion had presented to their customers or clients; a third had conducted a formal training for coworkers, and the same 33% 33% proportion had presented to their suppliers. 11% Shared the Presented to my Presented to my Presented to Conducted a Presented to Other information with coworkers senior leaders or my customers formal training my suppliers my coworkers owners or clients for coworkers

HERE ARE SOME HIGHLIGHTS OF THE CHANGES THAT HAVE TAKEN PLACE AT OPERATIONS WHOSE LEADERSHIP HAS BEEN INSPIRED BY MENUS OF CHANGE:

We have started a new concept called Roots Increased and Shoots, featuring a variety of plant-and We took an all-beef burger in a single location and replaced the non-meat grain-based salads paired with demi it with a beef and mushroom blend burger. It has been very We converted one of our smaller sandwiches. We are beginning to more menu offerings well received. We also introduced a "plant-forward" station at and made them outlets into an entirely vegetable- closely monitor the amount of meat served our salad bar, which is comprised of many composed salads, forward concept with Middle per customer. mostly vegan options. more appealing as center-of-the-plate Eastern flavor profiles. options. We've changed our menu design for our main dining hall to be more seasonal Changed all chicken and nimble. purchases to "never had antibiotics, cage free, vegetarian diet only" poultry.

11 V: BUSINESS IMPERATIVES: THE CHANGING CALCULUS ON COSTS, RISKS, AND OPPORTUNITIES

THIS YEAR, THE STARS—OR MORE ACCURATELY THE DOLLARS— HAVE ALIGNED FOR THE INDUSTRY AS BOTH DINERS WHO DRIVE REVENUE AND INVESTORS WHO SET THE VALUE FOR FOODSERVICE COMPANIES BOTH AGREE ON THE IMPORTANCE OF RESPONSIBLY SOURCING FOOD.

Financial markets now recognize that strong prior decades. And fraud in seafood as well as environmental, social, and governance (ESG) adulterating foods—such as adding wood fiber efforts are linked to better business performance. as filler in Parmesan cheese—can tarnish a brand The first standard guidance for Sustainability in moments. A few visible and painful lessons Accounting for our industry was released just have brought home both the importance of as a host of studies highlighted in this report making sure you have transparent insights into show that companies that pay attention to supply chains along with the reality that chefs and issues like water, responsible food sourcing, and foodservice companies are held responsible for labor practices have better returns for investors. what their suppliers are doing. And more stock exchanges now are requiring companies to disclose their risks from climate Innovation is also focused on providing even change and other environmental concerns. better solutions. This year’s crop of venture- backed startup businesses include both Consumers also are increasingly asking the traditional and delivery-only restaurants that have restaurants to know and share more about the their own, vertically integrated supply chains food they are served. The old adage that sunlight that reach from “farm-to-take-out” as well as is the best disinfectant has never been more their own restaurant tables. A cluster of new apt as increased transparency has led a host of companies are focused on improving the ability restaurant and foodservice companies to adopt of larger foodservice companies to do the same clean ingredient policies, phase out the use of and source locally, as well as those who continue antibiotics and other additives, as well as improve to expand the range of plant-based proteins animal welfare practices and either avoid or available to our industry. And the CIA’s recently disclose the use of GMOs. launched Food Business School is helping accelerate the efforts of today’s culinary- The risks from inattention to sourcing for both minded entrepreneurs. companies and their investors also has never been more tangible. Restaurants that pass off This section provides insights and advice lesser seafood as lobster now are confronted on innovation, investment, and supply-chain by TV cameras much as companies that resiliency to help culinary professionals and the exposed the public to toxic chemicals were in industry move more quickly in the right direction.

12 peelings from the company’s processing facility order via mobile apps. In addition, these companies in 2016. To date, the company has raised $182 INNOVATIONS to chefs and manufacturers. use technology and data science to predict demand, million in funding from prominent investors like design menus, and optimize deliveries. To date, Horizon Ventures, Bill Gates, and Khosla Ventures. Restaurant Innovations Sprig has raised $57 million in funding from investors Interestingly, Google tried to acquire the company IN THE FOOD Startups are leveraging technology and new that include Greylock Partners and Social+Capital for $200-300 million in 2015, but Impossible Foods restaurant models to make healthy, sustainable Partnership; Maple has raised $26 million and declined the offer. food more accessible, affordable, and convenient. is backed by celebrity chef David Chang; and INDUSTRY Many of these companies are establishing their own Munchery has raised $117.2 million at a $300 Investment Growth local supply chains, which has been a boon to local million valuation. Significantly more capital—$9.75 billion across 507 The foodservice industry is transforming rapidly to food producers. These companies are also raising deals—is flowing into food and ag tech startups meet consumer demand for healthy, transparent, significant capital, a strong indication of investor Innovations in Sourcing around the globe from venture and angel investors and convenient food. This seismic shift is being interest in food startups. On the supply side, a number of companies have than in previous years. In the past, investors were driven by a new, rapidly growing generation of food recently launched or expanded to make sourcing wary of investing in food and agriculture because and tech startups. From new business models to Sweetgreen, a farm-to-table salad chain with 31 locally easier. Sourcery, Dine Market, and Blue Cart, of the highly regulated and political nature of the apps and software, these companies are developing locations, for example, closed a $35 million Series for example, all offer online purchasing platforms industries, as well as the low margins, complex products and services that aim to help foodservice F round of funding, led by funds and accounts that enable restaurants and foodservice operators to supply chains, and limited adoption of technology. professionals improve margins, efficiencies, and managed by T. Rowe Price, bringing the company’s order from multiple local suppliers through a central A series of high-profile valuations, acquisitions, and sustainability. As investment in the sector grows and total funding to $95 million. Along with investments dashboard. By streamlining the sourcing, invoicing, IPOs, however, have helped to warm investors to startups mature, the divide between the technology in talent and technology—Sweetgreen already has and payment process, these services make it food. For example, meal kit delivery startup Blue and culinary worlds is beginning to narrow. a mobile ordering app that processes more than a easier to manage purchases from local producers Apron garnered a $2 billion valuation; Priceline quarter of all its transactions—the funding will be who might not otherwise be set up to handle large acquired OpenTable for $2.6 billion in 2014; and Food Waste Innovations critical as the company tries to establish a national commercial orders. Foodservice operators like Tom Shake Shack doubled its IPO price in its first day There continues to be much innovation in supply chain of local producers. Colicchio’s ‘Wichcraft, Dropbox, and Munchery use of trading, valuing the company at more than $1.6 foodservice around reducing food waste and utilizing these services. billion. The growing number of high-profile investors produce that is misshapen or slightly discolored. like Steve Case, founder of AOL and chairman and MintScraps, for example, offers a software platform Next-generation protein alternatives are aiming CEO of Revolution LLC; Danny Meyer, CEO of Union that allows restaurants to monitor and reduce to reduce our dependence on animals for food. Square Hospitality Group; and Bill Gates, founder of their waste. Using sensor technology, MintScraps A growing number of companies are employing Microsoft, also help to boost investor confidence in gives restaurants real-time waste data and helps data science and technology to create alternative the space. them identify potential cost savings. It also allows proteins that are more cost effective than animal operators to monitor for inefficiencies and waste proteins, not to mention tastier, healthier, and more Another sign of progress on this front is the growing generation patterns to help streamline operations environmentally sustainable than their predecessors. number of food and agriculture-focused investment and cut costs. Also putting surplus food to good funds. Twenty-two food and agriculture funds use, Zero Percent’s software makes it easier for Hampton Creek, a startup using data and food launched in 2016. One such firm is S2G Ventures, restaurants and retailers to donate leftover food to which launched a $125 million fund to invest in science to develop plant-based food products, is food pantries and soup kitchens. The startup even “soil to shelf” food and agriculture startups. Its one such company making waves in the foodservice handles pick-up and delivery of the food and tracks Dig Inn, a 10-unit farm-to-table fast casual chain, investments include Sweetgreen, Beyond Meat, industry. In 2015, it deepened its partnership donations for tax deductions. Mogo’s app and web is able to offer meals at an affordable price point by and Shenandoah Growers. Another growing area with Compass Group, becoming the foodservice platform connect consumers to restaurants that offer contracting directly with small farms. The restaurant of startup capital is coming from corporate venture operator’s exclusive supplier of baking mixes and leftover food at a discounted price. attracted $15 million in Series C funding in 2015 funds, like Mars, General Mills, and Unilever. dressings. The partnership will also significantly in a round led by Wexford Capital, bringing the expand Hampton Creek’s reach, as the deal puts Operators and chefs are increasingly recognizing the company’s total funding to $21.5 million. As with Finally, METRO launched the Techstars METRO the startup’s products in over 85 of US Foods’ and cost of food waste—an average of 10 to 12 percent Sweetgreen, this funding will be critical as the chain Accelerator, the first food accelerator dedicated to Sysco’s warehouses. Shaking up the industry is not of food is discarded—and looking for innovative expands and builds out its supply chain and its digital transformation in restaurants, hotels, and without opposition, however. Last year, the company solutions. In 2015, author and chef Dan Barber online and mobile ordering system and loyalty program. catering companies. Through the program, startups was sued by Unilever—though the suit was launched wastED, a month-long food waste pop-up receive €120,000 ($137,000) in investment capital, ultimately dropped—and targeted by the American serving dishes made entirely from scraps that are A new crop of companies is developing delivery-only as well as access to mentors, investors, Egg Board for labeling its eggless product a “mayo.” usually discarded. Inspired by wastED, chef Mario restaurants. Unlike traditional delivery services like and customers. Batali and Dogfish Head Craft Brewery founder Sam Seamless that deliver food from restaurants, startups Many of the alternative protein startups are working Calagione launched WasteNot, beer made from like Sprig, Maple, and Munchery make and deliver While it is encouraging to see so much capital on products that are months or years from coming waste such as overripe tomatoes, stale bread, and their own meals—often featuring locally sourced and flowing into food, some worry that startups are rotten grapefruit. Also inspired by its partnership with organic ingredients—in just 15 to 30 minutes. Each to market. Impossible Foods, for example, is overvalued and a food bubble is looming. Blue wastED, Baldor Specialty Foods—the Northeast’s day, the companies offer a limited number of lunch developing a plant-based burger that has the taste, Apron, for example, which raised $190 million at a leading distributor of fresh produce—launched and dinner options for $10-15, which people can look, and mouthfeel of a beef burger. The product is $2 billion valuation, has yet to reach profitability. SparCs, a new program that offers trim, tops, and reportedly launching through a foodservice operator

13 RECOMMENDATIONS: the production of meat. Chipotle, along with Panera food supply. Recent large-scale food contamination Consumer demand has made it clear that health, SUPPLY CHAIN Bread, were the only two restaurant chains awarded events and an increased interest in food production sustainability, and convenience present some of the a grade A from Friends of the Earth’s Chain Reaction techniques (such as the use of GMO products) greatest opportunities for growth in the foodservice report for their no-antibiotic policies in meat. This continue to increase the importance of food industry. Given increasing investment in food and RESILIENCY AND report highlighted that most of the 25 quick-service traceability for consumers. Currently, improved food agriculture innovation, and a growing array of restaurant chains surveyed do not have a policy traceability is being pursued by a few food and available tools in the foodservice industry, culinary for, or offer any transparency on, the sourcing of restaurant leaders. As public interest continues to professionals should embrace new menu techniques, TRANSPARENCY their food or information on their use of antibiotics. grow, we can expect increased calls for regulation technologies, and business models to help reduce Only a minority of restaurants is currently upfront and a rise in the role of third parties to verify food waste, enhance convenience, and source In 2015, the food industry saw advances in about this information, at a time when transparency food sourcing. locally. Foodservice operators should focus on how to how food suppliers are responding to increased demands by consumers are dramatically changing improve convenience by offering mobile ordering and consumer attention on food sourcing. Greater the marketplace. Consumers seem to value Panera’s RECOMMENDATIONS: delivery options. Additionally, operators should seek awareness among consumers has led to demands demand for antibiotic-free chicken from suppliers, Food products are 1) global in sourcing, 2) produced out partnerships with emerging companies that can for more specific food sourcing and animal treatment and other restaurants have taken note. In 2015, at a variety of standards by both large and small McDonald’s, Chick-fil-A, and many other quick- help them better meet these consumer demands. information, such as GMO and antibiotic use. The producers, 3) not easily examined or audited, 4) past year also showed that global food supply is service restaurants announced that they would easily misrepresented without strict tracing to still subject to large-scale contamination and fraud. follow Panera and remove antibiotics from chicken origin or collaboration between the producer and However, it appears that the ability to trace food- in coming years. It is evidence that consumers are retailer, and 5) subject to more sourcing inquiries borne illness has improved during acute outbreaks. paying attention to the sourcing details of food and by consumers. These features suggest that food demanding greater transparency from restaurants. traceability is needed more than ever to satisfy At the start of 2015, Chipotle made news in its customer demands. discovery, as a result of a routine animal welfare On the retail side, Whole Foods Market announced audit, that one of its major pork suppliers did not its first large-scale distribution of non-GMO- SCORE: 4 adhere to its animal welfare policies. Its handling produced pork in a partnership with American From the significant increase in capital flowing into of the case showed its commitment to the highest Homestead Natural Pork. (This non-GMO pork food and tech startups to the growth of startups standards in food supply. It elected to be very is available in Whole Foods stores in the Pacific focused on sustainability and health, the past transparent with its customers about the discovery Northwest.) There are challenges in developing food year has seen a wide range of innovative new by reducing the availability of pork carnitas in about supplies with higher standards in animal treatment, initiatives that are narrowing the gap between one-third of its restaurants, instead of sourcing but consumers are demanding those higher the culinary and the tech worlds. While there are conventional pork in its place. It also started looking standards. Kellogg’s, Cargill, Campbell’s, and Clif SCORE: 3.5 Bar, through its support of Justlabelit.org, have all more technologies, services, and business models for a new supplier that could meet its stringent Food supply chains remain vulnerable to food fraud announced support for the labeling of GMO food, available to foodservice professionals, many startups animal welfare and no-antibiotic policies. That and contamination. More traceability information is showing that food industry leaders have committed are focused on growth and have yet to reach difficult search revealed a significant challenge and needed, but courageous foodservice companies are to disclosing GMO ingredients and important profitability. It remains to be seen what happens if limitation in the global food supply. Chipotle made showing that higher standards can be established information related to food sourcing. in a manner that supports customer, business, and the bubble bursts. a reasonable compromise in the selection of a new pork supplier, Karro, a UK-based pork producer that environmental goals. follows a European model permitting antibiotic use Fraud also continues to concern consumers and IN SUMMARY: to keep an animal healthy, not for growth promotion, food companies as both diners and businesses IN SUMMARY: sometimes pay for authentic, fresh, and high • Startups are increasingly developing new and slaughtering animals after a withdrawal period Consumers demand and value information quality food ingredients but are sold something • products and services for the foodservice so that the meat from the animal treated with about the sourcing and treatment of food different. The past year’s news headlines highlighted industry, with a great number of high-potential antibiotics does not contain the antibiotic residue. ingredients. Three examples from the past year technologies coming to market. a few of the more widespread instances, which are illustrative: This example stresses the issue that the availability included adulteration of Parmesan cheese with • Chefs and foodservice leaders should embrace of food suppliers with such high standards remains wood cellulose, inaccurate labeling of low-quality ǷǷ Whole Foods Market committed to GMO and old olive oils, and passing off low-cost fish the growing number of products and services limited globally. Although Chipotle was applauded for labeling and a first large-scale launch and shellfish for lobster in both independent and now at their disposal to streamline local its admirable approach to resolving its pork supply of non-GMO pork. Firms like Kellogg’s, larger chain restaurants. With seafood fraud such Cargill, Campbell’s, and Clif Bar have led ingredient ordering, minimize waste, and issue, which appeared to have had no negative an issue, the National Oceanic and Atmospheric the cause to require GMO labeling in food improve their bottom line. impact on earnings, its multiple and unrelated incidents of E. coli contamination were poorly Administration Presidential Task Force, formed in products, showing that food suppliers can successfully embrace food labeling. handled and revealed major operational issues 2015 to specifically improve traceability and combat • Despite the significant amount of capital being across its restaurants. The contamination issues food fraud in seafood sourcing, offers promise that invested in food and agriculture startups, ǷǷ Panera Bread’s leadership in moving to weighed heavily on Chipotle’s stock price in the the industry will soon see improved transparency in some argue that companies cannot support antibiotic-free chicken is fundamentally second half of 2015. It is a reminder that food seafood sourcing. the valuations at which companies are raising altering how chicken is sourced for other safety must be a priority for all participants in the large chains like McDonald’s and Chick-fil-A. capital. Many of these startups have yet to food industry. The core benefits of improved food traceability demonstrate profitability. include providing consumers with information on ǷǷ The new NOAA Presidential Task Force to In recent years, consumers have pushed firms to where, how, and by whom their food was produced, improve traceability and combat fraud in disclose more about food sourcing, especially in and providing a means to trace contamination in the seafood was formed.

14 These guidelines clarify those ESG issues that Finally, though millennials have yet to dominate IN SUMMARY: CHANGES IN are most material (i.e. important to financial retirement investing, their investing preferences differ • Investors increasingly consider sustainability performance). Within the restaurant industry, greatly from their parents. They are twice as likely to performance an essential component of material ESG issues include: seek out a fund that confers a sustainability benefit, a food company’s financial performance. INVESTMENT and also twice as likely to divest of a particular On both the public and private sides, • Energy and Water Management company based on its ESG performance. These they have been shifting support to • Food Safety trends mimic millennial preferences for working for foodservice chains and startup food STANDARDS • Nutritional Content sustainable, inclusive companies, and for products and beverage companies that focus on healthier, • Food and Packaging Waste Management with better sustainability profiles. For restaurateurs, more sustainable, often plant-based foods. FOR THE FOOD • Fair Labor Practices these preferences show that the next generation of • Supply Chain Management and Food Sourcing investors will make ever-greater demands for ESG • Investors have agreed on industry-wide disclosure and good performance. standards for disclosure of sustainability progress INDUSTRY Second, there has been a wave of studies in annual reports filed with the U.S. Securities supporting the notion that companies that invest and Exchange Commission (known as the 10-K). in these material ESG factors, based on SASB RECOMMENDATIONS: Stock market exchanges are also embracing AMONG definitions, perform better for investors. SASB Foodservice companies and food and beverage voluntary or mandatory sustainability reporting also provides numerous examples of how strong manufacturers that put sustainability at the center of in public filings. PROFESSIONAL sustainability performance on material issues relates their businesses are increasingly attracting private to company value within the restaurant industry investment and being rewarded by public markets. • Regulatory changes no longer challenge specifically. Furthermore, when companies with They should expect even greater scrutiny over the the inclusion of sustainability-focused INVESTORS better sustainability performance are included in a years to come on these issues. Companies and funds on retirement platforms. mutual fund, performance is also generally improved restaurants should develop cost-effective, clear Until a decade ago, few investors believed that overall, incentivizing investors to pick sustainable plans for addressing the risks and opportunities a company’s sustainability performance was tied companies. For example, in a Morgan Stanley study identified by investors, and provide disclosure in to its financial performance. In past Menus of analyzing the performance of over 10,000 mutual company reports. Given the potential for brand Change reports, we have chronicled the gradual funds, those funds with a sustainability focus met or value, progress on sustainability goals should also shift towards greater acceptance of this link. In exceeded the returns of traditional funds 64 percent be shared with employees and consumers. the past year, however, the investing ecosystem of the time. has undergone a sea change; whereas the environmental, social, and governance (ESG) Third, regulatory changes made in 2015 will also performance of a company was hotly debated propel the market for “sustainable” funds. A for its impact on financial performance, this issue ruling by the U.S. Department of Labor clarifies is now largely settled. For food manufacturers that managers of 401(k)s and pension funds may and restaurateurs, this means that investors include sustainable funds, and that consideration will expect programs, policies, and reporting on of ESG factors may contribute to the financial SCORE: 4 issues such as the health and nutrition profile of performance of a given fund. This change is an Investors in publicly traded companies now more products. A number of publicly traded companies important departure from past rulings, where clearly link stock performance with sustainability have emerged as leaders in ESG disclosure and sustainable funds were required to present strategy and performance, relying on new disclosure in the incorporation of sustainability into business additional documentation, or were discouraged tools and regulation. Private investors have strategy. For example, Unilever, General Mills, and from being included on retirement platforms. As significantly increased their support for new food and Kellogg’s have established science-based targets a result, sustainable restaurants and foodservice foodservice companies that feature plant-forward for carbon emissions that align with the global target companies are now more likely to be served up in concepts and focus on sustainable supply chains. of keeping warming below 2º C. While this shift in a company pension plan. expectations is especially true of larger, publicly Large, publicly traded companies in the industry traded companies, venture capital and private equity Stock exchanges are also increasingly requiring or have typically identified major environmental and firms also increasingly consider these issues. encouraging disclosure of material ESG issues within labor risks, but challenges remain, particularly in public filing documents, such as company annual their supply chains. Wage disparity and other labor A confluence of factors is driving this change. First, reports (10-Ks). The NASDAQ stock exchange, concerns remain a weakness for the industry, the U.S.-based Sustainability Accounting Standards for example, provides guidelines and training to as labor issues may lead to work stoppages, Board (SASB) has completed industry-specific companies on ESG disclosure, and it offers 70 reputational loss, or product safety failures. guidelines for ESG reporting after meetings with sustainability-related indexes. investors, industry leaders, and other stakeholders.

15 VI. DEMOGRAPHICS AND CONSUMER PREFERENCES: ISSUES, TRENDS, AND CHANGING APPETITES

From pop-up restaurants to high-volume, solutions for consumer confusion are of multi-unit chains, and from trend-spotting critical importance given that the available magazines to the latest cookbooks, plant- information about nutrition and sustainability forward eating continues to gain prominence often contradicts the scientific evidence—and in American culture. The issue briefs in this that the information comes from an often section highlight the ever-evolving role of chefs overwhelming number of sources, from in shaping diners’ palates and preferences, government recommendations and academic as well as the nuances and challenges of journal publications to blogs and the media, shifts to greater local sourcing and greater from celebrity chefs to athletes and artists. investment in local food systems. This Finally, this section covers the most important section also explores ideas for equipping developments in the past year regarding the consumers to navigate the complex promotion of animal welfare. As the following informational contexts they inhabit in order essays illustrate, diners’ demands will continue to make food choices that benefit both their to be characterized by an only growing list of own well-being and that of the environment. not only health and environmental values but Understanding these challenges and providing ethical values.

16 la carte dining facility located at the CIA’s Student on an increasing scale over the next five years, in sustainability issues. To establish credibility, Commons in Hyde Park, menuing strategies and variations occur depending on state, city, or however, chefs must be cautious about the CHEFS’ include a general plant-forward approach (where customer base, outcomes for the health of the positions they take on these issues, and must fruits and vegetables are showcased as part foodservice industry are unclear. At a minimum, educate themselves on the topics they decide, of the plate sometimes exclusively, sometimes these regulations and consumer sentiments will or are asked, to discuss. For their own long-term INFLUENCE ON paired with a reduced portion of land-based most certainly factor into how chefs think about financial sustainability, chefs and restaurateurs must animal protein) and a daily burger selection that their positioning regarding health, sustainability, also be transparent with their customers to help always includes a blend of animal protein and menu pricing, and business strategy going them understand the new reality of running a food CONSUMER plant product (such as beef, mushrooms, and forward. Chefs and operators are also becoming business in 2016. barley; lamb and bulgur wheat; and turkey and more transparent about the pressure that these black bean). Grilled market fish is served each changes put on their operating costs, in part to ATTITUDES day with a choice of side dishes prepared with educate customers about increased menu prices. guidelines such as the use of monounsaturated Chef-driven, plant-forward menus have been on fats whenever possible and a limitation on fast- As more chefs and companies take a leading role the rise for the last two years. Today, this trend is metabolizing carbohydrates such as potatoes. All on social issues and are featured in the media rapidly emerging in fast casual and other high- the breads are blends of whole-grain and white both nationally and locally, the public will gain a volume concepts, representing a widening range flours, and all pastas are whole wheat-, lentil-, or greater understanding of the business side of the of new categories of plant-centric dining around spelt-based. restaurant industry—and likely will need to be the country and garnering appreciation as well as SCORE: 4 prepared to pay more for their food, or make other increased demand from consumers and media Many chefs and foodservice leaders are deeply Food waste continues to be a venue for creativity, trade-offs, as a result of changing policies and alike. In the National Restaurant Association’s engaged in the movement around sustainability and after the success of Dan Barber’s wastED pop- diner aspirations. At the same time, foodservice What’s Hot 2016 Culinary Forecast, which healthier food choices and are making progress up restaurant last winter in New York. Italian operators are increasingly turning to their suppliers surveyed 1,600 chefs, nine out of the top ten in offering more plant-forward menu options, celebrity chef Massimo Bottura ran the Ambrosian to challenge them to invest in increased health trends revolve around health and sustainability, including launching full-service and fast casual Refectory during Expo Milano, where a rotating and sustainability attributes in their products with some form of local sourcing occupying three operations focused on these directions. Societal cast of equally famous chefs cooked with foods without always having to pass along additional of the first four spots. changes related to elements like health insurance unused by the Expo. In Brooklyn, Saucy By costs in the form of higher prices. and minimum wage are requiring restaurants and Nature’s menu is created from leftover ingredients AL’s Place—a San Francisco restaurant by companies large and small to be more agile and its parent catering company didn’t serve at events Culinary Institute of America alumnus Aaron RECOMMENDATIONS: adapt their business models. Chefs and operators at the night before. As more chefs and operations London that presents a menu dominated by Because so much of this country’s food is prepared all levels of the industry need to place an additional continue to make reducing food waste a priority, vegetables, with meats as side dishes—topped and/or consumed outside the home, chefs and focus on portion size, nutrition, and public health, they encourage consumers to follow suit at home. Bon Appétit’s 2015 Hot Restaurant list. Semilla, high-volume foodservice leaders play a crucial and offer more plant-based proteins on menus. a Brooklyn-based restaurant serving a seven- role in aligning health, sustainability, flavor, and A growing number of chefs are also coming out course tasting menu in which animal proteins are value. While special occasion dishes still very as healthy. Just as tattoos and rowdy nightlives rare, took no. 4. Daniel Humm and Will Guidara much belong on menus, chefs and foodservice made for headlines in decades past, in recent IN SUMMARY: of Eleven Madison Park and the NoMad in New operators can positively impact their consumers’ months media have been showcasing leading • Plant-forward and food waste-based menu York announced the launch of a new fast-casual everyday diets by providing healthier everyday chefs’ fitness regimens, alcohol-free lifestyles, directions, from fine dining to fast casual, are restaurant focused on seasonal vegetables options on their menus. This includes proactively and dietary changes. While this does not always dominating media coverage and diner interest, as and grains, Made Nice. And chefs continue to reducing land-based animal-protein portions (with directly translate to what they are feeding their many chefs continue to transform their cooking make vegetables the focus of their written work a special focus on red meat) to between two customers, more often than not personal health and use those elements as creative outlets. as well: Hugh Acheson, of Five & Ten, Empire and four ounces for many main course items, practices are being reflected on menus that have State South, and other Georgia restaurants, for example, offering greater varieties of fish and become lighter and more plant driven, and can • Changing governmental regulations and published The Broad Fork: Recipes for the seafood, and devoting more of their creativity to serve as inspiration to diners who look up to customers’ mindsets are forcing restaurants and Wide World of Vegetables and Fruits; Michael vegetables and plant-based proteins (e.g., legumes these chefs. foodservice operations to adapt their business Anthony of Gramercy Tavern in New York wrote and nuts, as well as products made from these). models, which some are doing by abolishing V is for Vegetables, which won a 2016 James All the while, they must emphasize the pleasure of Beyond the purely creative, developments on tipping and paying all employees higher hourly Beard award; and Yottam Ottolenghi of London’s these healthier foods and food patterns, and use the social and policy front have been noticeable wages. Operators will need to be agile in Ottolenghis and Nopi continued his domination their appeal among the media to reinforce those in the past year, triggering their own impacts. addressing these changes so as not to limit their of the sector with the release of Nopi: The messages (either overtly or more implicitly). When Pressures from both government (new regulations ability to also increase their commitments to Cookbook, another 2016 Beard winner. cooking meat, chefs should also look to use whole health and sustainability imperatives with their affecting tipped employees, minimum wage, animals, to direct their customers toward lesser- the implementation of the Affordable Care Act, often attendant additional costs. The CIA’s widely popular pop-up restaurant known cuts of meats, reduce waste, and trim and family leave time) and customers (around Pangea, which offers a menu centered around food costs. values and ethics, as well as nutrition and the • Through creative menuing and transparency Menus of Change Principles, returned to the environment) have forced many restaurants about their business decisions, chefs and Hyde Park campus this winter. While the 2015 Chefs and operators’ perceptions of their and foodservice operations to spend more on foodservice operators must work harder at iteration featured a 10-course tasting, this year’s leadership and potential for change must be everything, from organic greens and antibiotic-free changing diners’ attitudes, so that environmental menu offers diners the choice of three courses nurtured. Organizations, including the CIA, meats to labor. With so many demands layering sustainability, social, and health issues become for $18, including such options as tomato sushi the National Restaurant Association, Chefs in all at once and more anticipated in years to ever greater factors in consumers’ dining- roll with parsnip rice and smoked haddock with Collaborative, and the James Beard Foundation, come as some of these regulations take effect out decisions. kale salad and lime yogurt. In The Egg, a new à are working to provide support to chefs interested

17 of carcinogens along with tobacco and asbestos. when faced with such inconsistencies. Research CONSUMER This was predictably misconstrued as a claim in psychology has documented that people, that processed meat was as carcinogenic as even young children, often try to make sense of tobacco, but WHO’s esoteric categorization complicated domains in terms of explanatory ATTITUDES AND system is based on the degree of evidence that principles and causal mechanisms. For example, a something is carcinogenic, not the degree of 2013 study published in the journal Psychological risk. Another problem was that the evidence was Science targeted young children’s conceptual SCORE: 2 BEHAVIORS presented in terms of epidemiological statistics— gaps and misconceptions about nutrition to Even consumers motivated to make healthier degree of increased risk—which are easily effectively teach them why we need to eat a food choices can’t help but be confused given the misunderstood by the average consumer. So the variety of healthy foods. These preschool children steady barrage of inconsistent advice. ABOUT claim that frequent consumption of cured meat then selected more vegetables to eat during snack can lead to an 18-percent increase in the risk of time. This same approach could be extended to HEALTHY AND getting colon cancer became misinterpreted as adults by focusing on specific conceptual gaps consuming cured meat puts one’s risk of getting and misconceptions they hold about nutrition. IN SUMMARY: colon cancer at 18 percent. The public should By cutting through the confusing, ever-changing • A variety of U.S. agencies are responsible for SUSTAINABLE have been told more clearly that the evidence advice about eating, this approach could provide offering nutrition advice and determining what is now overwhelming that processed meat is a a coherent framework to reason about healthy foods are considered “healthy.” Confusion carcinogen, and regular consumption can increase food choices. about what to eat is only heightened by FOOD one’s risk of colon cancer from roughly 5 percent contradictory messages and oversimplified to 6 percent. news headlines. Improving the way Americans eat depends in large part on the choices they make for themselves RECOMMENDATIONS: Contradictory headlines about nutrition continue By continuing to make healthy foods tempting, • New and existing research from the field of and their families. One bright spot is that soda unabated. Inconsistent claims abound about psychology offers conceptual and behavioral consumption has substantially decreased since delicious, readily available, and affordable, chefs the health versus risk of sodium, saturated fat, and foodservice professionals can encourage insights that can be adapted into effective 2007. Sales of soda are down 25 percent, and sugar, carbohydrates, meat, GMO foods, and healthier food choices using scientifically validated decision-making strategies for consumers more Americans report trying to avoid drinking organic foods. It can be hard not to become recommendations, such as those provided by soda. This significant progress was likely made skeptical when experts disagree, the advice is the 2015 Dietary Guidelines Advisory Committee • Chefs and foodservice leaders can help possible by it being one recommendation for contradictory, and there is little other basis on and Harvard T.H. Chan School of Public Health. minimize confusion about healthy food which there is unanimous support among which to make a decision. It is easy, then, to On the other hand, consumers are bombarded choices by referring their customers to experts and by it being easy for consumers to dismiss expert advice and just eat what you want. comprehend that soda provides nothing but by a continual flow of contradictory information scientifically validated recommendations— One of the main problems is that the information such as those offered by the 2015 Dietary empty calories and harmful amounts of sugar or most available to consumers tends to be “expert” about what is healthy. Thus, there is a need to Guidelines Advisory Committee and Harvard artificial sweeteners. advice in the form of dictates, without providing create and validate the effectiveness of materials T.H. Chan School of Public Health—and by a compelling rationale. Moreover, experts can designed to overcome specific conceptual gaps making healthy food tempting, available, Other news about the American diet is more disagree, in part because flawed research can and misconceptions adults hold about nutrition. and affordable. concerning as dietary quality remains poor and be hyped by the media and in part because, like Having such a coherent conceptual framework disparities across socioeconomic groups have not all sciences, knowledge of nutrition is continually about health and nutrition could help foster improved. This may be influenced by an increase being refined and expanded. This problem was effective decision-making. in unhealthy snack food advertising to African compounded this year by the lobbying by the American and Hispanic youth. Moreover, except food industry that took place between the Dietary Researchers and science reporters alike should for the youngest children, obesity rates appear to Guidelines Advisory Committee’s report and the take care when presenting epidemiological be holding steady or slightly increasing. January release of the new Dietary Guidelines for statistics as percent increase in risk knowing that Americans. The DGAC is made up of top experts consumers often interpret that as the level of risk Many consumers rely on mass media for who based their recommendations on the best itself. Ensuring that press releases always present information, and likely receive little more than evidence available and not the interests of the risk data along with the relevant baseline risk sound bite versions of claims about health and food industry. The original recommendations of could go a long way to avoid confusion. When nutrition. Added to the mix this year was the the advisory committee are the recommendations presenting data, researchers and reporters should World Health Organization’s conclusion that consumers can trust and should follow. also be careful to distinguish between a meta- consumption of processed meat increases the analysis—numerous studies already published, risk of cancer. The WHO’s press release spurred To equip consumers with effective decision- a cascade of articles in the popular press as the WHO report was based on—and a new making strategies, we should turn to evidence- experimental finding. attempting to clarify, deny, or ridicule the WHO’s based studies of how people reason about report. The first problem was reporting that nutrition and what governs their decision-making processed meat met WHO’s Level 1 classification

18 produced food, which requires a significant amount RECOMMENDATIONS: LOCAL FOODS of effort on the part of chefs and buyers. A variety Consumer demand for locally and regionally of tools can help buyers locate desired products: produced food continues to grow, yet the steep MarketMaker, funded by land grant universities learning curve of marketing to new customers AND THE and the USDA, currently links buyers and sellers in appears to be making farmers reluctant to increase 20 partner states. Regional sourcing is facilitated production levels or shift large amounts of their through local networks (for example, New Mexico- production into local and regional markets. Supply FARM-TO-TABLE based non-profit organization Farm to Table) or limitations may dampen further growth in the market, extension services of land grant universities. These unless farmers are sufficiently convinced that the internet-based networks have significantly expanded local and regional markets are profitable in the short opportunities; yet despite marketing advances, term and the long term. To increase market supply, MOVEMENT procurement outside of the traditional channels buyers should provide farmers with a consistent remains challenging. The farm-to-table movement leapt into the market for specialized products, and at good prices. mainstream in the early 2000s, as food activists Note, however, the contradiction of supply growth Restaurants face constraints on the supply of local around the country strove to develop strong is that as supply increases farm prices are likely to food by the inherent seasonality of agricultural connections between restaurants and local farming fall. Buyer commitment to farmers, in terms of both production. While farms in California are able to communities. Consumers seek local and regional price and quantity, will reduce some of their risk of produce year-round, for most of the nation there foods not only from restaurants, but also in farmers’ entering into new local and regional markets. is little production for a portion of the year. As an markets or from their food retailers; furthermore, example, a study of the farm-to-restaurant supply many have advocated the use of local foods in the chain in Columbia County, New York, found that burgeoning farm-to-school movement. A 2015 restaurants purchased from local farms for an USDA report to Congress indicates that the use of average of 20 weeks per year. Thus, meeting intermediated channels (which includes farm-to- procurement needs is time-intensive and requires restaurant sales), in regions with thriving local food juggling multiple suppliers throughout the year, and systems, helps farmers increase sales. may mean that limited products are available during SCORE: 3.5 certain times of the year. At long last, federal and local policies are supporting The bulk of research on the farm-to-table movement local and regional food. Hopefully, the combination addresses benefits to consumers and farmers. From the farmer perspective, increasing the quantity of farmers, chefs (and other buyers), and local Locally and regionally produced food is fresher and supplied to restaurant channels may require meeting and regional food consumers in this new policy tastier when it reaches consumers. The benefits costly, specific food safety practices for on-farm environment will accelerate growth in the segment of local and regional foods extend beyond the production and handling along the supply chain. of the food system devoted to producing and consumer’s palate, as purchasing food raised The final rules for produce safety, as authorized by consuming “good food.” nearby supports local farms and can bring economic the Food Safety Modernization Act, offer qualified benefits to local communities. The relatively short exemptions to farms with sales below a $500,000 shipping distances in local and regional markets threshold (average of the past three years) that allow farmers to produce high-value heritage and IN SUMMARY: primarily sell direct to consumers and restaurants heirloom varieties of livestock and produce, which • Current Current farm-to-table trends include located within 275 miles. Buyers are able to impose are unable to maintain their quality when being restaurant gardens, local sourcing of meat and stricter requirements on farmers, such as Good shipped over long distances. produce, hyperlocal sourcing of greens, and Agricultural Practices (GAP), which small farms seasonal menus. Procurement of locally and may find costly and difficult to implement. For Farms that produce for local and regional markets regionally produced food requires a significant farmers and restaurants alike, avoiding a food safety have unique characteristics. Such farms tend to amount of effort on the part of chefs, buyers, outbreak is paramount to business viability. be smaller than the average U.S. farm, and are and farmers, including the extra steps required clustered in the Northeast and the West. Viability of to satisfy new food safety requirements. Purchasing locally and regionally can provide farmers these farms—located on the rural-urban interface— with incentives to produce varieties suited to local is dependent on selling their products for a high • Despite the popularity of “food miles,” little agro-ecosystems, which often taste better. However, price, to consumers in urban centers. Farms growing evidence supports the concept that locally and it has not been scientifically documented that locally fruits and vegetables account for 29 percent of all regionally produced food is more environmentally and regionally produced foods are better for the local food farms, and the bulk of local food sales (51 sustainable than food shipped long distances. environment, despite the idea that lower food miles percent) are for fresh produce. Farms selling to local Consumers do benefit from local and regional automatically confers a smaller carbon footprint. retailers and local restaurants through intermediated food, though, as it is fresher and tastier. At the same time, it is encouraging that despite channels typically have higher sales than the local the fundamental challenges of the farm-to-table food farms selling directly to consumers. Yet, fewer supply chain, restaurants and consumers continue • Both local and regional food contribute to than 50,000 of two million farms in 2012 sold their to participate in the experience, because through economic sustainability by supporting local products in intermediated local channels. their farm-to-table menus, restaurants may be able economies and increasing profit opportunities to raise awareness about the connections between for participating businesses. By providing The main challenge facing the farm-to-table agricultural production and fresh, tasty food. markets for farmers, chefs and foodservice movement is procuring locally and regionally professionals can be leaders in this area.

19 FDA plan to work with the livestock industry on a RECOMMENDATIONS: IN SUMMARY: ANIMAL voluntary reduction of antibiotic use when used Foodservice and culinary professionals are • Nearly all animals raised for food in the U.S. for increasing growth or feed efficiency rather than responsible for a large proportion of the demand live in concentrated animal feeding operations, treating disease. Another example was the California for meat, dairy, and eggs, and are in a position to which degrade soil, air, and water quality. WELFARE ban on battery cages for laying hens that restricted promote profound improvements in the welfare these chickens to a living space the size of an 8.5- x of animals raised for food. A small but growing • An increasing number of states have passed One hundred years ago, the country and the planet 11-inch piece of paper, 24 hours a day. consumer segment is placing greater emphasis legislation to address and prevent some of the had fewer people, eating less meat, in smaller on animal-welfare issues related to their food animal abuses, including gestation crates for portions. The demand for meat, dairy, and eggs was In 2015, a promising alternative to legislative purchases; it would be helpful to have options pigs and battery cages for egg-laying chickens. met by an agricultural system built of many more solutions emerged: Two major restaurant chains, for these customers. From a more proactive farms and ranches that were smaller than those Panera Bread and Chipotle, made commitments perspective, foodservice and culinary professionals • In the past year, several major restaurant chains that predominate in livestock agriculture today. In to better align their procurement practices with could redesign menus with a greater number including Panera Bread and Chipotle announced of meatless options and reformulate recipes to many cases, though not all, this involved practicing improved animal welfare. Panera—which has been progressive policy changes regarding sourcing use smaller amounts of meat, dairy, and eggs. A traditional animal husbandry with cows grazing on a leader in the industry for a decade working against animal foods, including commitments to use selective and informed approach to food sourcing open ranges, pigs rooting through underbrush and antibiotic use and confinement—announced that it antibiotic-free meats and cage-free eggs. Since and supply-chain management can help to support wallowing in mud, and chickens scratching through was on target to achieving 100 percent antibiotic- then, more than a dozen well-known companies and sustain producers with superior animal welfare pastures for grubs and bugs. Times have free turkey and chicken in its products by the practices. Negotiations with producers may lead and brands have made similar commitments. changed—dramatically. end of 2015. Additional efforts by Panera include some of them to transition to improved animal decreasing the proportion of pork purchased from welfare practices. If successful, such efforts could More people now inhabit the country and the planet, farms using gestation crates and increasing the make foodservice professionals a driving force in proportion of eggs from cage-free chickens, as well and they are eating more meat, in larger portions, restoring traditional animal husbandry, supporting more frequently. About 99 percent of animals raised as the proportion of beef from grass-fed and free- small farms and ranches, and improving the state of for food in the United States live all or at least range cattle. Chipotle, another industry leader, also animal welfare in the meat, dairy, and egg sectors. some portion of their lives in concentrated animal announced an antibiotic-free policy in 2015 for all its feeding operations (CAFOs). These do not include meats. Since then, more than a dozen other well- open range, underbrush, or pastures. Instead, they known restaurant companies and brands have also employ gestation crates, battery cages, debeaking, made commitments to reduce or eliminate the use of tail docking, runt thumping, dehorning, castration, antibiotics in their supply chains and to use cleaner detoeing, maceration, and billions of animals living ingredients. Similarly, members of the Menus of and sleeping in their own waste. Change community have been removing antibiotics from their purchasing. R&DE Stanford Dining, for The decline in animal welfare is inversely proportional example, has stopped buying chicken, beef, and SCORE: 3 to increases in yield and efficiency. The use of pork raised with antibiotics and only purchases Awareness is rising about the problems with animal hormones, antibiotics, and changes in feedstock cage-free eggs and humanely raised beef and pork. welfare in the livestock industry. Some alternative have led cattle, pigs, and chickens to grow faster practices are being employed by a growing group and bigger and to be slaughtered sooner. High yield The work of early pioneering companies now may of producers, and progress has been made through and efficiency are achieved by packing thousands of provide much needed data on some of the practical both public and private sector policy changes. livestock tightly together without the ability to engage logistics involved. For example, if the demand for However, there remains substantial room for in natural behaviors, such as grazing, rooting, or antibiotic-free meats and cage-free eggs continues improvement. scratching for food. Feedstock, composed primarily to increase, how quickly can the livestock and egg of corn and soy, has to be produced in massive industries respond with a change in supply? There quantities and transported to the CAFOs. The will be some initial challenges with price volatility if cheapness of the animal protein produced in CAFOs demand exceeds supply. Hopefully, these will be leads people to eat more meat than is healthful. among the critical seeds of change that could lead This high yield practice is also inextricably linked to to substantive improvements in animal rights and degradation of soil, air, and water quality. welfare. As a more engaged and informed consumer base votes with its forks and dollars for improved Small legislative steps have been made in a growing animal rights and welfare practices, chefs can play number of states to improve the welfare of some an important role in finding and supporting farmers farm animals. These include bans on: gestation who can supply this demand. crates that cage pregnant and nursing pigs so tightly they can’t turn around, crates for calves, tail docking for cattle, and battery cages to house laying hens. Previous updates for this report have addressed some of these issues. One example was a 2013

20 VII: NUTRITION, HEALTH, SUSTAINABILITY, AND FOOD ETHICS: SCIENCE AND POLICY HIGHLIGHTS

The release of the 2015 Dietary Guidelines for Americans (the first since the Menus of Change initiative was launched), the World Health Organization’s announcement about the health risks of frequent consumption of red and processed meats, and the historic global commitment to address climate change have brought new urgency to the ongoing work of Menus of Change. These measures and many other recent developments highlighted in this section underscore how much is at stake in our work to to shift the available menu options: the overall health of humans and of the natural systems that sustain life on earth. The following series of essays cuts through the complexity of nutrition and environmental science to provide clear guidance for culinary professionals. These issue briefs also suggest steps that foodservice industry professionals can take to not only address current public health and environmental challenges, but also to provide leadership in the absence of improvements in public policy. DIET AND HEALTH: RECENT TRENDS Over the last several decades, researchers have One of the most influential review processes intensively studied the relationships between has been the Dietary Guidelines for Americans, what we eat and our health, in particular which is intended to provide guidance to conditions such as cardiovascular disease, individuals, institutions, and federal policies cancer, and total mortality. This has included related to food. Mandated by Congress, experiments in animals, small controlled feeding the United States Department of Agriculture More than 90 percent of American farmland is studies in humans lasting for several weeks, (USDA) updates its guidelines every five years. The overall trend in dietary quality continues to large epidemiologic studies with decades of The USDA also created the Healthy Eating improveplanted aswith trans commodities fat is almost such gone as andcorn soda and is follow-up, and a limited number of randomized Index (HEI), a scoring system that can be used soybeans, rather than the fruits and vegetables trials in humans. While these studies have been to rate the diets of individuals, or the menus of decreasing. An important decrease in diabetes enlightening, the resulting tens of thousands foodservice operations, based on adherence incidencethat need is to an be early more pay-off. central toHowever, our diets. we of publications have, perhaps ironically, made to its guidelines. In 1995, however, researchers it incredibly complicated for the average eater at Harvard T. H. Chan School of Public Health have far to go to achieve a healthy, sustainable to read, interpret, and synthesize this vast were concerned that the U.S. guidelines national diet, and this good news should be body of knowledge into useful guidance. Other were inconsistent with the best available reason to redouble our efforts. documents have been published to review the scientific evidence. literature and develop overall conclusions. But many of these reviews also have limitations They decided to use data on dietary intakes as a result of gaps in the scientific literature reported by over 100,000 men and women to (which remains a work in progress), the limited determine whether those who adhered most perspectives of some of the committees, and closely to the federal guidelines had lower risks sometimes even conflicts of interest. of cardiovascular disease, cancer, and other

21 major chronic diseases, compared to those who blood cholesterol levels and risk of heart disease, 1. “Low fat” is not an appropriate diet goal. 3. Contamination and environmental risks adhered less well. Disappointingly, after accounting and thus could be used to create healthier breakfast Low-fat diets were all the rage in the 1980s and need to be minimized, but these should not for tobacco use, physical activity, and other factors, options compared with eggs. Unfortunately, the final 1990s. But new, strong evidence has shown that the deter consumption of seafood from a health there was little relation between adherence to the 2015 Dietary Guidelines ignored key elements of the type of fat in the diet, rather than total fat, is strongly perspective. An earlier report that fish, specifically Dietary Guidelines for Americans and the risk of Advisory Committee report. Congress ordered the linked to heart disease. Moreover, low-fat diets are farmed salmon, had been contaminated by industrial major chronic disease. Thus, these investigators USDA not to include anything about environmental not effective for long-term weight control, as shown chemicals triggered a widespread scare that led developed the Alternate Healthy Eating Index (AHEI). impacts of diet in the 2015 Dietary Guidelines. in a recent compilation of over 50 studies that lasted many people to reduce their consumption of fish. Based on the best available published literature, it Also, the final Dietary Guidelines ignored the for one year or longer. Indeed, weight loss was But there was no evidence that the amounts of the takes into account findings from short-term studies recommendations of the Advisory Committee to limit in humans on the effects of different diets on blood intake of red meat for health reasons and to reduce actually modestly better on lower carbohydrate diets chemicals found were enough to cause human cholesterol fractions and other risk factors, as well consumption of sugar-sweetened beverages. when the intensity of intervention was similar in both disease. Also, the very small risk derived from as long-term prospective epidemiologic findings. diet groups. theoretical calculations is substantially outweighed Emphasis was given to findings that were supported For the Menus of Change initiative, we have elected by the clear benefits of eating seafood. Some by both types of evidence. to use the elements of the Alternate Healthy Eating The type of fat is important. Trans fats from partially species of fish, such as swordfish, tilefish, and tuna, Index 2010 as the primary focus for evaluating hydrogenated vegetable oils should be avoided, do contain mercury, mainly from natural sources; Using the same populations in which the USDA’s healthfulness of diets. These have considerable and unsaturated fats from vegetable oils should these fish should not be consumed by pregnant or HEI had been evaluated, the Harvard investigators overlap with the USDA’s criteria but tend to be more be used to replace saturated fat when possible. lactating women. However, it is extremely important documented that better adherence to their own intuitive and most directly supported by evidence. Saturated fat itself is similar to most carbohydrates that pregnant women do eat fish in general, because alternative index did predict lower risk of major (For example, for political reasons the USDA has in its relation to heart disease; replacing it with a generous intake of omega-3 fatty acids is needed chronic disease. During subsequent five-year referred to added sugar and empty calories, while carbohydrates has no benefit, and it can be harmful for neurological development of the fetus. updates, the U.S. Dietary Guidelines have evolved the AHEI refers to soda and other sugar-sweetened if those carbohydrates are refined starch or sugar. to be closer to Harvard’s alternative index. Because beverages; the USDA has referred to solid fat, while A 2014 meta-analysis (a statistical summary of Overfishing and damaging forms of aquaculture scientific evidence has continued to accumulate, the AHEI refers to red meat.) the Harvard group updated its guidelines as the published studies) printed in a prominent medical are also serious issues. But the worries generally Alternate Healthy Eating Index 2010 (AHEI 2010), In addition, the USDA HEI does not specifically journal caused a wave of confusion by concluding concern a handful of popular commercial species and has published an analysis examining both the include trans fat. Notably, the elements of the AHEI that the type of dietary fat was unrelated to risk of such as tuna, cod, salmon, and shrimp, and these USDA HEI 2005 and the AHEI 2010 in relation to 2010 closely resemble those of the traditional heart disease, leading to a media storm epitomized species are being produced sustainably in some the risk of major chronic diseases. As expected, the Mediterranean diet, which has been associated with by The New York Times article title, “Butter is Back.” places. Eating a wider variety of fish species, both scores were strongly correlated. Now, adherence to lower risks of many adverse health outcomes. This Unfortunately, the meta-analysis was deeply flawed wild and farmed, is one simple measure that can both predicted better health outcomes, although the conclusion was reinforced by the results of a major in several ways. A recent and more complete contribute towards maintaining a healthy diet and AHEI 2010 did so somewhat more strongly. randomized trial conducted in Spain. Compared to summary of prospective studies refuted the 2014 addressing environmental concerns. In particular, a group who were assigned to a low-fat diet, men meta-analysis and confirmed the benefit of replacing both health and environmental impacts will be The USDA subsequently released the HEI 2010, and women assigned to a Mediterranean diet that saturated fat with polyunsaturated fat, which mostly improved by consumption of small wild species which is more similar to the AHEI 2010, and the emphasized healthy fats, such as olive oil and nuts, comes from vegetable oils, nuts, and seeds. As such as anchovies, sardines, and herrings that are recently issued technical report of the 2015 Dietary had a reduced risk of high blood pressure, diabetes, expected, replacing saturated fats with typical primarily used now to feed other fish or livestock, Guidelines Advisory Committee suggests that the and total cardiovascular disease. In many respects, carbohydrates had no benefit on heart disease. and in the supplement industry. Given that further official 2015 Guidelines should move even closer to the Mediterranean diet serves as a gold standard the AHEI 2010. Importantly, the Advisory Committee for a healthy diet, but understanding the key However, if saturated fat is replaced by whole grain increases in fish consumption will need to come concluded that the upper limit on percentage of elements of this diet allows its principles to be carbohydrates that are high in fiber and low in primarily from aquaculture, research on aquaculture calories from total fat should be eliminated, and that incorporated into the diets of many cultures and glycemic index, this is likely to be beneficial. methods to enhance the already efficient conversion the emphasis be on the type of fat. For the first time, with different flavors. of feed to fish, and to reduce the environmental the committee explicitly recommended reduction 2. Lean cuts of red meat are not the answer. footprint, will be a sound investment. of red and processed meats, for both health DIVERGENCE OF SCIENCE FROM Reducing saturated fat is not beneficial if replaced and environmental reasons. The limit on dietary CONVENTIONAL BELIEFS by carbohydrates, but replacement by unsaturated cholesterol was also removed, in part because Conventional wisdom is often flawed, and the fats will have multiple health benefits. Therefore, most of the U.S. population was already under widely held beliefs about healthful eating are no simply reducing the fat content of red meat the earlier limit of 300 mg/day, and large studies exception. The Harvard Alternate Healthy Eating likely will have minimal benefits because it is had not shown egg consumption to be related to often replaced by calories in the form of refined risk of heart disease, except among people with Index rates diets based on science that may not starches, potatoes, and sugar. Moreover, other diabetes. However, the committee did not actively be familiar to everyone. Several topics in particular evidence suggests that higher intake of red meat, promote egg consumption, and regarded eggs as merit explanation because of their divergence from approximately neutral; notably, some foods such as commonly held beliefs: irrespective of its total fat content, increases risks of nuts, whole grains, and plant oils can actually reduce heart disease, stroke, and diabetes if compared to poultry, fish, eggs, nuts, or legumes.

22 INDICATORS OF DIETARY QUALITY AND RATIONALE FOR THE AHEI

The elements of the Alternate Healthy Eating Index 2010 are described below, each with a brief scientific rationale. The scientific literature on each of these is large, and a more extensive discussion of these topics is beyond the scope of this report. The indicators are discussed in more detail and with additional references on the Harvard T.H. Chan School of Public Health website, Nutrition Source. (nutritionsource.org).

Vegetables: Vegetable consumption has been whole grains, which accounts for the variability of using liquid vegetable oils instead of butter, lard, such as soy, beans, and nuts. Table 1 (page 24) associated with lower risk of cardiovascular disease, the percent of grains that are whole in a range of or partially hydrogenated fats or tropical oils (e.g. illustrates the greenhouse gas emissions associated in part because vegetables are a major source of “whole-grain” products. (This variability is because palm, palm kernel, coconut oils) wherever possible. with several common protein sources and is a potassium, which reduces blood pressure, but other the U.S. Food and Drug Administration (FDA) allows Moderate use of coconut oil when the special flavor good indicator of environmental impact including components may also contribute to this lower risk. the description of “whole grain” if a product is 51 is important is reasonable, but is best not used as a energy and chemical use, soil management, and The relation between vegetable consumption and percent or more whole grain.) basic cooking fat. mechanical irrigation. Both public health and the cancer risk is much weaker than previously believed, environment will improve if restaurants decrease the but some modest benefit is likely for specific forms Nuts and Legumes: Nuts, legumes, and soy Trans Fats: Trans-isomers of fatty acids, formed by amount of red meat on menus and replace it with of cancer. Potatoes (including baked, mashed, products are valuable sources of protein and contain partial hydrogenation of vegetable oils to produce alternative protein sources. and french fries) are not included as a vegetable important constituents such as unsaturated fat, margarines and vegetable shortening, are associated because they are a major source of starch, have fiber, copper, magnesium, plant sterols, and other with higher risk of coronary heart disease, diabetes, Sugar-Sweetened Beverages: Intake of sugar- not been associated with lower risk of chronic nutrients. Nuts and other vegetable proteins have and weight gain. Fortunately, use of these has sweetened beverages, including soda and fruit disease in epidemiologic studies, and are associated been associated with lower risk of cardiovascular been greatly reduced, and we have now seen drinks, is associated with increased risk of weight with increased risk of weight gain and diabetes. disease, especially when used as a substitute for benefits in the form of improved blood cholesterol gain and obesity, cardiovascular disease, diabetes, Nutritional considerations took a step backward other protein sources, such as red meat. Nuts are fractions in national surveys of both children and and gout. The AHEI included intake of fruit juice in when members of Congress inserted a clause also associated with lower risk of diabetes and of adults. Accelerated declines in the risk of heart this category, given the positive association with in the 2014 budget agreement that the Women, weight gain. disease have been seen in cities that banned trans risk of diabetes, and the lack of beneficial effects Infants, and Children (WIC) program should consider fats in restaurants and in Denmark, which banned on cardiovascular disease or cancer, which has potatoes a vegetable, as they had previously done Fish (EPA + DHA): Two or more servings of fish trans fats nationwide. The AHEI recommends that been seen from consuming whole fruits. The large to the USDA school health standards. Corn has also per week, including species high in long-chain (n- partially hydrogenated fats be avoided completely. amounts of sugar added to other foods, in addition been associated with weight gain and should be 3) fatty acids EPA + DHA, are strongly protective In late 2015, the FDA announced that partially to beverages, are also likely to have adverse health considered as a starch rather than a healthy vegetable. against fatal cardiac arrhythmias and sudden cardiac hydrogenated fats would no longer be considered effects, but these effects have been less well death. This also may lower the incidence of other Generally Recognized As Safe (GRAS) and must documented; for this reason, other sources of added Whole Fruits: Fruit consumption has been cardiovascular diseases. be removed from the food supply by 2018, thus sugar were not included in the score. associated with lower risk of cardiovascular disease, eliminating industrial trans fat in the U.S. diabetes, and some cancers. The AHEI included Polyunsaturated Fat: Replacing saturated fats with Sodium: High sodium intake increases blood only whole fruit in its definition. Fruit juice, which is polyunsaturated fats leads to beneficial changes Red and Processed Meat: Consumption of red pressure, and salt-preserved foods are associated high in rapidly absorbed sugar, is not associated in blood cholesterol fractions, is associated with meat and processed meat is associated with greater with greater risk of stomach cancer, cardiovascular with lower risk of cardiovascular disease or cancer, a lower risk of coronary heart disease, and may risk of coronary heart disease, especially when disease, and total mortality. Further, sodium-reduced and is associated with weight gain and risk of lower risk of type 2 diabetes. In contrast, a low-fat substituted for nuts, poultry, or fish. Red meat and/ diets significantly lowered the risks of high blood diabetes. Until recently, fruits have been considered diet has had no beneficial effects on cardiovascular or processed meat are also associated with higher pressure and cardiovascular disease in clinical trials. a homogenous food group, even though they differ disease risk factors, lipid profile or blood pressure, risk of stroke, diabetes, and colorectal and other Reductions in sodium intake to 2,300 milligrams greatly in composition, and thus potentially health and has not reduced the risk of cardiovascular cancers, and total mortality. A recent report provides per day, as recommended by the U.S. Dietary effects. In a detailed 2013 analysis, specific fruits disease, breast cancer, colon cancer, or total evidence that similar replacements for red meat Guidelines, would prevent a large number of new differed greatly in relation to future risk of diabetes. mortality. One popular belief is that n-6 fatty acids, during adolescence will reduce a woman’s future risk cases of cardiovascular disease. Although further Although most fruits were associated with lower the large majority of polyunsaturated fat in the U.S. of breast cancer. A 2015 review by the World Health reduction to 1,500 milligrams per day does reduce risk, the regular consumption of blueberries was diet, increase inflammation, cardiovascular disease, Organization (WHO) confirmed the association with blood pressure, intakes this low have not been associated with the lowest risk. Eating plenty of fruits and other conditions, and that the ratio of n-6 to colorectal cancer. studied directly in relation to risk of cardiovascular and vegetables is desirable, but additional analyses n-3 fatty acids is critical. This hypothesis has been disease, and such a study would be difficult to of specific fruits and vegetables are needed to consistently refuted in many studies. Indeed, the The greater risks of cardiovascular disease are conduct. Because hypertension is a strong risk provide more precise recommendations. doubling of intake of n-6 fatty acids over the last 50 mediated in part by the higher amounts of saturated factor for cardiovascular disease, the American Heart years almost certainly accounts for a large part of fat and cholesterol in red meat, but other factors are Association and other groups have recommended Whole Grains: Greater consumption of whole the major reduction of cardiovascular mortality in the also likely to play a role. that large parts of the U.S. population who are at grains is associated with lower risk of obesity, U.S. during this time. Both n-3 and n-6 fatty acids higher risk of hypertension aim for 1,500 milligrams cardiovascular disease, diabetes, and possibly are essential, and we need adequate amounts of Environmental assessments lead to similar per day. Controversy has recently emerged about colorectal cancer, and overall mortality. Conversely, each of these; the ratio is irrelevant. conclusions about protein choices: Selecting better whether the goal for sodium reduction should be refined grains are not associated with lower risk, types of red meat or eating “nose to tail” are not 2,300 or 1,500 milligrams per day. This controversy and may increase risk of diabetes, coronary heart Monounsaturated fats also have beneficial effects on a sufficient solution because red meats have an has little practical impact because average intake in disease, and other chronic diseases. In calculating blood lipids. In practice, replacing saturated fats with outsized impact on the land, water, and climate the U.S. is about 3,500 mg per day, so it is a huge intake of whole grains, the AHEI uses grams of polyunsaturated and monounsaturated fats means compared to poultry, fish, and plant-based proteins challenge to even get close to 2,300 mg per day.

23 24 DIETARY FACTORS NOT U.S., becoming almost de rigueur in salads and INCLUDED AS INDICATORS sandwiches. Cheese provides large amounts of sodium along with less healthy fats and many 1) Alcoholic Beverages: Strong evidence indicates calories. Smaller amounts of cheese and the use of that moderate consumption of alcoholic beverages alternative ways to add flavor and variety to these reduces risk of heart disease and diabetes. However, foods would be desirable. Recent data suggest even at these moderate levels, risk of breast cancer that consumption of yogurt may be associated is increased, and alcohol consumption increases with reduced weight gain and diabetes, and this risk of traffic injuries and abuse. Because of these deserves further investigation. Of particular concern competing risks and benefits, which depend in part are the large amounts of sugar added to milk and on age and family history of alcohol dependence, this many yogurts. Minimizing added sugar and using topic was deemed too complex to be useful as an the natural flavor of yogurt to advantage should be a indicator of diet quality for an overall population. goal.

2) Coffee and Tea: The health effects of these TIME TRENDS IN KEY DIETARY beverages have been studied extensively, and they INDICATORS are safe and good alternatives for sugar-sweetened beverages. Some health benefits have been seen for To judge whether American diets are becoming more coffee, including reductions in risk of diabetes and healthful for this report, investigators from Harvard premature death. But because caffeinated coffee T.H. Chan School of Public Health have applied intake is often limited by effects on sleep due to the standards established in the Alternate Healthy caffeine, and tea seems to be neutral with respect Eating Index to national survey data for the U.S. Each to health, they were not included as indicators. variable is scored from 0 to 10, with 10 being the Notably, the apparent benefits for diabetes and healthiest. Thus, for polyunsaturated fat, whole fruits, 2015 DIETARY GUIDELINES FOR AMERICANS: WHICH REPORT premature death are also seen for decaffeinated vegetables, whole grains, nuts, and legumes, a higher TO FOLLOW? coffee, suggesting that factors other than caffeine are score means higher intake. responsible for these favorable outcomes. The 2015 Dietary Guidelines for Americans (DGAs) are an improvement in some For trans fat, sugar-sweetened beverages and fruit important ways over the previous (2010) version, especially with the removal of the 3) Milk, Cheese, and Other Dairy Products: juice, red and processed meat, and sodium, a higher restriction on percentage of calories from total fat, the new limit for added sugar, Milk is widely promoted as essential for adequate score means lower intake. The total score is the sum and a shift in focus to healthy dietary patterns (versus just nutrients). Unfortunately, calcium intake and bone health. However, the basis of the individual elements; 100 would be perfect. For Congress censored the DGAs scientific advisory committee’s conclusion that red meat for the calcium requirements in the U.S. is dubious— the 2016 report, we used data for persons 20 years consumption should be reduced for reasons of planetary health; this was within the they are much higher than the WHO’s definition of of age and older from 1999 through 2012, the latest scope of the committee because it is not possible to have food security if our food adequate intake—and recent studies consistently do available data from the U.S. National Health and supply is not sustainable. However, the USDA went further and also largely ignored its not show any reduction in bone fractures with high Nutrition Examination Survey (NHANES), which is a own scientific advisory committee’s conclusion that consumption of red and processed dairy consumption by either adolescents or adults. representative national sample of the U.S. population meat should be reduced for health reasons. In addition, the clear scientific conclusion Also, high consumption of dairy products puts large [see the November 2015 paper in Health Affairs by that sugar-sweetened beverages should be singled out for reduction was eliminated amounts of saturated fat into the food supply. For Wang, D. et al]. Complex foods, such as a soup or in the final recommendations. Though the final DGAs are the official reference point for these reasons, greater consumption has not been stew, were dissected so the individual components various governmental directives that cascade from them (e.g., U.S. government–funded included as an indication of higher dietary quality. were included as red meat, vegetables, etc. Intake of feeding programs), chefs, food business leaders, food and health reporters, and the Although there is not sufficient reason to promote trans fat is not available from the NHANES, so FDA general public should focus instead on the earlier report of the 2015 Dietary Guidelines higher consumption of dairy products in general for data from the late 1990s and 2010 were used to for Americans scientific advisory committee as the far better dietary guidance document health reasons, moderate consumption of one or two estimate the national trend. based on the current state of scientific evidence. servings a day can add variety and flavor to diets and may contribute to diet quality, depending on other Encouragingly, the overall quality of the U.S. diet —Walter Willett, MD, DrPH, Chairman, Department of Nutrition, Harvard T.H. Chan aspects of a person’s diet. has improved steadily since 2000 and since our School of Public Health last report based on data up to 2010. However, the Consumption of cheese has been increasing overall score remains poor, and there is room for dramatically over the last several decades in the vast improvement. (The average score remained

25 below 50 out of 100 possible points.) By far, the conversation that hopefully will lead to more greatest progress since 2000 was in reduction of rapid improvements. trans fat, estimated to be about 80 percent, which accounted for about half of the overall improvement in diet quality. The next greatest improvement was reduction in consumption of sugar-sweetened beverages, which decreased by about 25 percent. Modest increases were also seen for fruit, whole grains, polyunsaturated fatty acids, and nuts and legumes. A modest reduction was seen for red and processed meat, contributing to improved diet SCORE: 3.5 Modest improvements toward healthier diets include quality. The only dietary component that significantly a large reduction in the intake of trans fats, an worsened was sodium intake. important reduction in sugar-sweetened beverages, modest reduction in red and processed meat, and a Using data relating AHEI scores to health outcomes small increase in whole fruits, whole grains, healthy in two large Harvard cohorts, it was estimated fats, and nuts and legumes. The FDA’s step to that the improvements in dietary quality from 2000 remove partially hydrogenated fats from the GRAS to 2012 prevented 1.1 million premature deaths category is a valuable step forward even though and resulted in 8.6 percent fewer cardiovascular most trans fat has already been removed from the disease cases, 1.3 percent fewer cancer cases, U.S. food supply. and 12.6 percent fewer type 2 diabetes cases. Consistent with these estimates, in late 2015, the Centers for Disease Control and Prevention (CDC) reported that diabetes incidence rates had IN SUMMARY: decreased by about 20 percent in the U.S., which • Progress is visible, including the FDA’s action is remarkable because this appears to be the first to eradicate trans fat from the food supply, time a country has even slightly bent the curve in the an important reduction in the consumption epidemic of this disease. Because intakes of trans of sugar-sweetened beverages, and a small fat and sugar-sweetened beverages are both clearly increase in how much whole fruits, whole related to risk of type 2 diabetes, the important grains, legumes and nuts Americans consume. reductions in these dietary components are However, the trend toward higher sodium likely key explanatory factors in the decrease in intake is troublesome and highlights a need diabetes incidence. for foodservice operators to address this issue more directly. The improvements in diet quality were not shared across groups defined by income and education; • The removal of an upper limit for percentage among the lowest socio-economic groups there of energy from total fat intake is an important was little improvement. This is troublesome because step forward that will allow reductions in the AHEI score is based on prediction of morbidity carbohydrate intake, which should focus on and mortality, so disparities in health are likely to reducing intakes of refined starches and sugar. increase. It is noteworthy that the NHANES data Replacing saturated fat with unsaturated were available only through 2012 due to delays in vegetable oils whenever possible remains an processing, and do not include the effects of many important goal. public health promotion campaigns and changes in foodservice operations since that time, which • The move by Congress to censor from the have been designed to increase consumption of Dietary Guidelines any suggestions of a link fresh fruits and vegetables and whole grains, while between dietary choices and environmental reducing intake of red meat. From the White House impacts is unfortunate because of the urgency Kitchen Garden to Meatless Monday, improving to limit greenhouse gas production and dietary quality has become a part of the national climate change.

26 There are many modifiable biological drivers of stage for overconsumption. For this reason, calorie IN SUMMARY: PORTION SIZE body weight, but the most important are hormones labeling remains an important public health measure, • All calories are not alike, so it is critical to in general, and insulin in particular. States of high not as a means to maintain an accurate accounting complement the current focus on portion size insulin secretion are characteristically associated of daily calorie balance, but to help prevent with a shift in our cultural thinking on diet quality. AND CALORIC with weight gain (e.g., excessive insulin treatment overconsumption of low-quality processed foods. in type 2 diabetes), whereas reduction of insulin • Now that trans fat has been largely eliminated levels causes weight loss (e.g., inadequate insulin from the food supply, the leading dietary cause INTAKE administration in type 1 diabetes). Diet has a major RECOMMENDATIONS: of obesity and related complications is highly impact on insulin secretion, predominantly related The foodservice industry has an unprecedented Portion sizes have increased dramatically in the processed carbohydrates—not just sugar but to the total amount and type of carbohydrate opportunity to help end the epidemics of obesity last half century: Restaurant portions ballooned also refined grains and potato products. consumed. Highly processed starches and added and related diseases. However, a paradigm shift is to lure in “value” customers, and the rate of new, sugars have a high “glycemic load” and inordinately needed. Measures that only reduce calories, without • To increase consumption of minimally processed larger portion-size introductions among a sample of raise blood sugar and insulin levels. enhancing the quality of those calories, are destined carbohydrates, healthful fats, and high quality common commercial products increased by more to fail. Instead, the focus should be on serving more proteins, changes in national policy that focus than a factor of 10 from 1970 to 1999—the period Trans-fat used to top the list of public health minimally processed carbohydrates, healthful fats, on decreasing prices of these foods relative to when obesity rates increased most rapidly—driven enemies. Happily, in recent years trans-fat has and healthful proteins, while simultaneously reducing commodities are needed. Culinary strategies predominantly by the exceedingly low cost of been largely eliminated from the food supply. high glycemic index carbohydrates. The goal is to are also needed from the foodservice industry commodities. In recent years, some manufacturers Today, increased focus on the type and amount make healthy foods in appropriate portion sizes to make these options more available on menus have repackaged highly processed foods into of carbohydrates is needed. A strong case can the most appealing options. These changes will and served in a variety of delicious ways. smaller unit sizes (e.g., the 100-calorie pack). But be made that increasing the portion size of refined require simultaneous restructuring in national food the public health impact of these changes may be starchy foods (e.g., extruded breakfast cereals, policy, to increase the amount of these products in bread, white rice, pasta, fries) and added sugars minimal, if these products are marketed in a way that the food supply, and to lower their cost relative to IN A WORD: SATIETY promotes consumption of multiple portions. (e.g., sugar-sweetened beverages, highly sweetened commodities. desserts) erodes diet quality and leads to chronic Satiety forms a critical link between diet and disease. Conversely, increasing the portion size successful weight control, one of the greatest public Although it seems intuitive to link the larger portions and serving frequency of minimally processed health challenges of our time. to Americans’ growing waistlines, the relationship carbohydrates (vegetables, fruits, legumes) and between calorie quantity and quality must be healthful fats (nuts, avocados, oil-based salad Prior nutritional recommendations encouraged low- carefully considered, to ensure that changes in dressings) will displace less healthful foods, improve fat diets in the belief that this major nutrient – with portion size produce real benefits. diet quality, and protect against chronic disease. In twice the calorie density of protein or carbohydrate addition, high-quality plant-based proteins (nuts, – would cause weight gain. However, new research Extensive research demonstrates that for many legumes, soy products) and seafood have a special indicates that calories from many high-fat foods individuals, larger portions lead to more calories role in promoting satiety and balancing the metabolic SCORE: 3 (e.g., nuts, olive oil, dark chocolate) provide greater consumed over the short term. However, there is effects of carbohydrate. Efforts to improve diet quality continue to move in a satiety than those from processed carbohydrates little evidence that changes in total calorie intake, positive direction: away from the low-fat paradigm (those derived from added sugars or refined grains). independent of dietary quality, have a meaningful All calories are not alike. The belief that they are has and a single-minded focus on calorie reduction. Optimal, evidence-based strategies to support long-term effect on body weight. When lean or produced misguided attempts to modify the food The public seems to have reached a turning point, satiety and healthy metabolic function are essential obese individuals are under- or overfed, energy supply and led to confusion and indecisiveness with demand for commodity-based industrial food to reversing and ultimately ending the world-wide expenditure and hunger change in ways that resist about what to do within the culinary profession products in decline and interest in whole/minimally obesity and diabetes crises, as well as reducing long-term weight change. In short, body weight and the foodservice industry. Simply lowering the processed foods rising. global needs for food production—and related appears to be under strict long-term control by total calories in a meal by reducing fat content will not lead to lasting benefit, if that meal is less than environmental impacts—in an era of rapidly rising biological factors. The 2015 Dietary Guidelines for Americans includes satisfying and leads to subsequent overeating. population growth. a new emphasis on restricting sugar intake and lifting Genetic make-up helps to explain individual In this context, recent initiatives for nationwide the upper limit on dietary fat. However, one concern Often repeated phrases in the public health differences in predisposition to obesity. But in the calorie labeling should be viewed as only part of the is the continuing focus on calorie balance, reflected community and media such as “balance energy focus on calories in and calories out, the importance solution. Humans have evolved to accurately match in the first guideline—despite evidence that body intake [calories] with energy expenditure” and “there of modifiable environmental factors, especially diet calorie intake with expenditure by eating whole, weight over the long term can be best controlled by are no bad foods” do not reflect current science. quality, is often lost. This is especially problematic natural foods. Intuitively, we know that 100 grams of improving diet quality, not restricting calorie intake. These arguments distract us from focusing on because diet quality strongly influences individuals’ apple will have less energy than the same weight of the paramount importance of diet quality as a risks for diabetes, heart disease, and other key determinant of long-term caloric intake and nuts. However, we cannot know how many calories Thus, though some progress has been made, a degenerative conditions associated with the metabolic health, and ultimately many food, health, might be present in processed packaged foods and more fundamental focus on food (or calorie) quality, Western diet. and environmental challenges. fast foods without explicit information, setting the not just quantity, is still needed.

27 fuel ethanol, 13 percent to exports, and 6 percent PROTEIN to produce high fructose corn syrup and other sweeteners). Feed conversion efficiencies of raising livestock vary greatly by species: By one estimate, it CONSUMPTION takes 36 calories of feed to produce one consumed calorie of beef. This ratio is 11:1 for pork, 9:1 for AND poultry meat, and about 6:1 for eggs and dairy.

Production methods certainly influence the PRODUCTION environmental impact of animal-based foods, but popular alternatives must be fully assessed The average American over age 20 consumes before being lauded as solutions. For example, between 48 percent and 76 percent more while pasture-based beef production may have protein than is recommended, for women and local benefits such as reduced soil erosion and men respectively. Animal sources account for nutrient losses, it often involves higher GHGE and approximately two thirds of this dietary protein. Yet, system energy use per kg of beef than confinement plants such as nuts, seeds, beans, peas, legumes, feeding operations. Future technical advances are grains, and cereals are also important sources of expected to improve the environmental efficiency protein. The amount and types of protein consumed of food production, but analysts project that these can have significant effects on the environment improvements will be insufficient to reach GHGE and the risk of chronic diseases and premature reduction goals, meaning shifts in eating habits are death. Culinary and foodservice professionals have needed to reach such targets. an important role to play in leading and inspiring a balance of protein sources on Americans’ plates that Meat consumption also has significant impacts is healthier for both people and planet. on human health. The science is clear that regular consumption of red meat contributes to risk of In the past several decades, meat production and chronic diseases and premature death. Dietary consumption have increased sharply worldwide, recommendations should distinguish poultry and fish especially in developing countries. Global demand from beef and pork, as diets that include substantial for livestock products is projected to increase 70 amounts of red meat and products made from percent by 2050, driven by population growth and these meats increase risk of diabetes, heart disease, rising affluence. While beef consumption in the U.S. and some cancers. Nearly one in 10 deaths could is at the lowest level in over two decades, total be prevented in the U.S. if American adults cut meat consumption (red meat plus poultry) remains their current red meat consumption of about three high: 57.1 kg per capita in 2013, the fifth highest servings to less than half a serving per day. consumption rate globally. In 2015, the International Agency for Research Animal-based foods contribute disproportionately on Cancer (IARC) of the WHO announced that to the total environmental costs of food production. processed meats such as hot dogs, bacon, and The livestock sector is responsible for over 14 sausages should be classified as carcinogenic percent of all human-induced greenhouse gas (Group 1) to humans for colorectal cancer. It was emissions (GHGE), nearly a tenth of global human estimated that each 50-gram portion of processed water use, and 63 percent of reactive nitrogen meat eaten daily increases the risk of colorectal mobilization. The main reasons for these impacts cancer by 18 percent. Unprocessed red meats are enteric emissions from ruminant animals such as were classified as “probably carcinogenic” (Group beef and milk cows, emissions to air and water from 2A) because evidence suggests a link between manure management, and the production of animal regular consumption of unprocessed red meat and feed (39 percent of the corn crop, which uses more increased risk of developing colorectal cancer, as land than any other crop in the U.S., goes to feeding well as pancreatic and prostate cancer. livestock, with the remaining 31 percent to make

28 The WHO report has significant implications for quite novel sources. From the old standards of seitan, RECOMMENDATIONS: consumption of red and processed meats because tofu, and tempeh to protein-rich grains like quinoa, Chefs and the foodservice industry at large have an these meats have already been associated with to mycoprotein-based Quorn™ and lupine, wheat, important role to play in leading and inspiring the new type 2 diabetes, cardiovascular disease, and other or rice-based food products designed to combine cultural norms about how much protein and what chronic disease, and the WHO report on increased with meats, options abound for replacing meat with kinds of protein consumers need. Research shows cancer risk further underscores the need for vegetable-based proteins. Insect-based proteins are that, when asked about changing meat consumption consumers to reduce their consumption of meats, also emerging as a potential alternative, with some habits, individuals experience complex moral and SCORE: 3 especially processed meats. restaurants in New York and California experimenting psychological barriers. Information about negative While red meat production and consumption in with insects on the menu, and numerous packaged outcomes is not enough: Eaters need leaders. Chefs the U.S. is falling moderately, it continues to grow On the flip side, eating plant-based, protein-rich goods companies using them as an ingredient should aspire to move red meat from the center of in the developing world. Climate conditions, such foods, such as legumes and nuts, reduces the risk in snacks. Also growing are the creative uses of the plate and consider its value as a condiment. as droughts throughout the American West, are of chronic diseases and premature death. In the past seaweeds and algae. A recent assessment of soy They should also ask themselves whether meat reducing supplies and raising costs, stressing the need to further lower red meat consumption. There year, new studies add further evidence to support protein isolate (SPI)—a highly processed soybean- of any kind is really key to delivering the flavor and is a maturing conversation in the academic literature the notion that replacing animal protein with plant based ingredient used in many meat alternative experience consumers seek. There are many creative on the environmental and health effects of diet protein can help prevent chronic diseases. In a large products—found that, because of the significant and delicious ways to prepare meals in high-volume change. This conversation is beginning to enter into study from eight European countries, higher intake of heating required during processing, SPI may match or foodservice operations that put plant- based proteins exceed unprocessed chicken, pork, or even beef in key policy realms, as concerns around climate change animal protein was associated with an increased risk front and center—while cutting costs, reflecting global and future food security escalate. For the first time, environmental impact categories. This is a reminder of developing type 2 diabetes, whereas vegetable cuisines, and reducing environmental damage along the 2015 Dietary Guidelines Advisory Committee that even plant-based protein sources, and especially protein was not associated with risk. The authors the way. A shift from a meat-based diet to a plant- (DGAC) report considered diet sustainability as those demanding exceptional amounts of processing, suggest that replacing animal protein with vegetable based diet will improve the health of both humans part of the evidence base to develop Dietary should be considered on a case-by-case basis. protein or other macronutrients may reduce the and the planet. Guidelines for Americans (DGAs). The 2015 DGAC population-wide risk of diabetes. recommended that the U.S. population reduce Recent years have also seen numerous studies In practice, healthy protein sources like fish, chicken, consumption of animal products, especially red and exploring the environmental effects of diet change Eggs and dairy products should also be beans, and nuts should be used in place of red meat processed meats, for both health and sustainability and the potential for diet shifts as a climate mitigation distinguished from meats. There is little evidence (including processed red meat). There is no need to reasons; after heated debate and pressure from strategy. There is clear consensus that reducing the meat industry, sustainability was declared to that moderate consumption of eggs (up to one go overboard on dairy protein: One to two servings animal-based foods in the diet can result in lowered be outside the scope of the DGAs and would be egg per day) has adverse effects on the risk of of dairy products can be recommended for people environmental impact. A 2014 study showed that excluded from the final guidelines. While the DGAC chronic diseases. However, consumption of dairy who choose to include dairy as part of a healthy the total GHGE of the recommended diet in the recommendation has raised an important discussion products may affect human health in complicated dietary pattern. 2010 Dietary Guidelines for Americans would be to the national level, exclusion of sustainability issues ways, including potential benefits and risks, which about the same as that of the current diet, despite a from the dietary guidelines is a missed opportunity to may depend on the types of dairy products. Dairy recommended 20-percent decrease in calories and better align human and environmental health aspects has been suggested to confer benefits on weight reduced meat consumption. However, the vegetarian of our collective diet. control and diabetes prevention, but the existing and vegan adaptations of the Dietary Guidelines evidence does not support this notion. In a recent reduce GHGE by 33 percent and 53 percent, study, Harvard researchers followed 41,436 men respectively. A dietary pattern aligned with the Healthy IN SUMMARY: in the Health Professionals Follow-Up Study, Eating Plate recommendations made by Harvard T. • High meat consumption has harmful effects on 67,138 women in the Nurses’ Health Study, and H. Chan School of Public Health also shows a 33 both human health and the environment. 85,884 women in the Nurses’ Health Study II. percent reduction in GHGE without eliminating meat, They found that total dairy, milk, and cheese were largely through a shift from red meat to chicken, and • New studies add to existing evidence that not significantly associated with risk of type 2 reduced dairy consumption. shifts in eating habits toward more plant-based diabetes, and that yogurt was the only dairy product proteins, fruits, and vegetables can reduce the associated with lower risk of diabetes. This study Finally, fish and seafood present an interesting dietary risk of certain chronic diseases, greenhouse gas refutes the widely held assumption that higher dairy paradox. Farmed fish often show high feed conversion emissions, and the burden on water and energy intake is beneficial for body weight and diabetes efficiencies (typically less than 2:1), and there are resources. prevention. In other words, a higher amount of dairy well-known health benefits to fish consumption. At protein is not required to achieve health benefits. the same time, overfishing has had significant impact • Through culinary strategies that make plants on wild fish stocks. Improvements to aquaculture the stars on menus, chefs and foodservice Fortunately, the market has been responding with practices mean farmed fish may become an important professionals can lead cultural shifts away from a flood of meatless protein alternatives, some from future protein source. an overreliance on animal protein in the diet.

29 The problem is not primarily on the supply side. for increased fruit and vegetable promotion in initiatives, and a higher standard reimbursement FRUIT AND It is true that drought in California and other the restaurant sector. The CIA and cooperating rate for the meals themselves, to account for the environmental limitations elsewhere complicate fresh restaurants have been working since 2010 on the cost of providing healthier meals. And real money fruit and vegetable production in the “fruitful rim” of Healthy Menus R&D Collaborative. The collaborative can be put behind bold new fruit and vegetable VEGETABLE agricultural production. It also is true that uncertain operator members’ menus featured a 28 percent initiatives—such as engaging online videos from labor market conditions are a major problem in increase in the use of fruits and vegetables from the “FNV” campaign of the Partnership for a labor-intensive production industries, and the federal 2012 to 2014. NFVA’s 2015 progress report gave Healthier America. PRODUCTION government still has an unwise planting limitation the restaurant sector a summary grade of “B-“, against fruit and vegetable production on land that which at least was better than the overall score for qualifies for federal government row-crop subsidies. all sectors. However, for the sector as a whole, only AND Yet, especially when one considers imports as well 16 percent of vegetables and 4 percent of fruit is as domestic production, the United States has consumed in restaurants, and these percentages CONSUMPTION adequate capacity for long-run supply if there is have not improved over time. sufficient demand. For culinary professionals, fruits and vegetables RECOMMENDATIONS: offer a terrific opportunity for menu innovation, great On the demand side, one problem has been Because current progress has not been SCORE: 3 flavor, sales growth, and health promotion. lack of national-level marketing and advertising satisfactory, opportunities for improvement abound. Recent public interest and governmental initiative for fruits and vegetables. In 2012, the Federal around promoting fruit and vegetable consumption Few public health principles enjoy as strong a Trade Commission evaluated data on food For agriculture, the federal government should have increased. But these efforts have not yet scientific justification and as broad a base of marketing expenditures for 2006 to 2009, years repeal the planting limitations against fruit and achieved sufficient scale, and they are stalled by industry support as recommendations to enhance during which the Children’s Food and Beverage vegetable production on land that qualifies for production restrictions and the associated high fruit and vegetable consumption. Fruits and Advertising Initiative (CFBAI) sought to improve the federal row-crop subsidies. Although it might produce prices. As a result, long-term trends vegetables provide fiber, vitamins, minerals, and healthfulness of the food marketing environment. seem like a peripheral issue, a more important have not been reversed, and fruit and vegetable phytochemicals, and displace less healthy food Out of $1.8 billion in child-directed food and supply-side measure may be to steady farm labor consumption still fails to meet recommended levels. options in the diet. Yet, the United States is doing markets by reviving the sensible compromise poorly at producing and consuming more fruits positions that have been painstakingly reached, and vegetables. but never passed, in federal immigration reform. IN SUMMARY: • Despite well-documented evidence of health The unsatisfactory progress can be seen in For the restaurant sector, there is a growing benefits and strong urging from the federal diverse measures. Based on the most authoritative variety of models for success in promoting government, food intake surveys and food national food intake survey reported by USDA and fruits and vegetables, ranging from vegetarian supply data both document a failure to Department of Health and Human Services, from options to creative preparations for vegetable- increase fruit and vegetable consumption. 2001-2004 and 2007-2010, fruit intake remained loving carnivores. And high-volume foodservice relatively stable, and vegetable intake significantly operators can continue to innovate in product • Despite increased yield, efficiency, and lower declined. Three quarters of Americans fall short of sourcing for greater freshness and appeal, adding prices for many sectors of food production, fruit recommendations and more than four fifths new fruit and vegetable items to their menus, fruit and vegetable farmers receive fewer fall short of vegetable recommendations. In 2015, changing the default items in children’s meals to subsidies and face restrictions around what the National Fruit and Vegetable Alliance (NFVA)—a beverage advertising in 2009, less than one half include fruits and vegetables, and highlighting land can be used to grow their crops. coalition including The Culinary Institute of America of one percent was for fruits and vegetables. The fruits and vegetables on menu boards. (CIA), leading trade associations, prominent nutrition fraction of advertising that was allocated to fruits • Innovative food sourcing initiatives and science associations, and USDA—evaluated and vegetables fell from 2006 to 2009. Even In federal nutrition assistance programs, Congress significant increases in government programs recent progress in advancing fruit and vegetable the federal government’s semi-public generic and USDA can continue to expand pilot initiatives to incentivize produce consumption are consumption and assigned an overall grade of “D-.” commodity promotion programs offer only small such as the Healthy Incentives Pilot (HIP) in encouraging, yet still only operating at amounts of support for fruits and vegetables. These Massachusetts, and the newer Food Insecurity relatively small scale. Similarly, based on food supply data adjusted for “checkoff” programs are established by Congress Nutrition Incentives (FINI) projects at sites around food losses, there has been no improvement in the and managed jointly by producer boards and the country. These projects offer additional per capita supply of fruits and vegetables. In the USDA, with funding from mandatory assessments support for fruit and vegetable purchases by low- most recent decade of data available, from 2004 on producers. Most of this funding promotes milk, income families who otherwise might be deterred to 2013, daily fruit per capita availability was nearly other dairy products, beef, and pork. It is difficult by the prices of fruits and vegetables. unchanged, from 0.89 cup-equivalents to 0.86 for USDA’s Agricultural Marketing Service, which cup-equivalents, and daily vegetable per capita oversees the checkoff programs, to give sufficient For consumer demand, the sky is the limit. In availability fell from 1.80 cup-equivalents to 1.65 attention to fruits and vegetables in the midst of federal child nutrition programs, there can be cup-equivalents. these larger efforts. There is considerable potential continued expansion of fruit and vegetable

30 Because the vast majority of humans live on the were out of season. A prior study conducted in FISH, SEAFOOD, coast, our wastes (such as municipal sewage and season found a mislabeling rate of 7 percent. To run-off from agricultural lands) add nutrients to fight fraud, a risk-based traceability program is the waters. These nutrients help plankton grown, being developed as mandated by the Presidential AND OCEANS and this in turn feeds filter feeders. Growing more Task Force on Combating Illegal, Unreported, and filter feeders thus helps remove nutrients from the Unregulated (IUU) Fishing and Seafood Fraud. The Seafood continues to be a healthy and relatively oceans. In this case, seafood consumption can be list of at-risk species that will form the basis of the environmentally friendly choice. This year, the US truly restorative. upcoming traceability program includes: SCORE: 2.5 Dietary Guidelines Advisory Committee addressed Arriving at a single score is difficult amid myriad the role of seafood as an important source of contradictions. There are multiple public and The need for restorative food production is nutrients, and also as a way to link changes in our Abalone Pacific Cod private efforts to improve seafood sustainability, necessary because in seafood, we are seeing the diet to increased sustainability. While the concern Albacore Tuna Red Snapper and standards have emerged including that of the effects that humans can have on the ecosystem. about mercury remains ever-present (Consumer Atlantic Cod Sea Cucumber Marine Stewardship Council for wild products, and In the fall of 2015, a Dungeness crab fishery in Reports indicates that canned tuna is “the most Bigeye Tuna Sharks of the Aquaculture Stewardship Council as well as California—which typically brings in $60 million per common source of mercury in our diet”), the Food the Global Aquaculture Alliance for farmed products. year—could not open because record temperatures Blue Crab Shrimp and Agriculture Organization of the United Nations This work to lessen the environmental footprint of in the Pacific Ocean led to an algae bloom. The Dolphinfish Skipjack Tuna and the World Health Organization stated that, seafood warrants a positive score of a 4. At the algae produced a neurotoxin called domoic acid, Grouper Swordfish “Regarding contaminants, for the majority of wild same time, exceptions persist, and issues of slavery which made its way up the food chain to crabs. (In King Crab (red) Yellowfin Tuna caught and farmed species, neither the risks of and mislabeling merit a low score, suggesting further mild cases, domoic acid can cause gastro-intestinal mercury nor organic pollutants outweigh the health work. Given the variation in actions across this distress in humans, and at worse, death). On the benefits of seafood consumption.” And yet, annual RECOMMENDATIONS: diverse protein category, the overall score is 2.5. East Coast, the collapse of Atlantic cod stocks was U.S. seafood consumption remains at less than 15 As in past years, to best understand seafood, found to be linked to climate change. Acidic waters pounds per year—still half the global average. Thus, foodservices leaders must know what they buy continue to affect oyster aquaculture on the West while we need to eat more seafood, we need to do and where it is produced, and must communicate Coast, and scientific agencies such as the National it in a smarter way. To help educate us, the Seafood this information honestly and effectively to diners. IN SUMMARY: Sea Grant Program are dedicating funding to Nutrition Partnership has launched a public health Being able to accurately trace fish will increase • Despite widely demonstrated health benefits, address this issue in both fisheries and aquaculture. campaign to inform Americans about the benefits to social pressures for accurate labeling and ensuring Americans continue to underconsume seafood heart health from eating seafood. the fish we eat is from robust stocks that are both in total and in sufficient variety. While seafood can be an ecologically and socio- fished according to the best ecological and social economically sound protein choice, a myriad of Paul Greenberg, an author and preeminent seafood standards. • Chefs and foodservice professionals should issues must still be solved. One such issue that advocate, writing in The New York Times, stated reduce waste through the use of frozen fish remains a challenge is waste. Another is slavery. four simple rules for eating seafood. He suggested Food waste is a challenge because it amplifies all and reasonable portions, while also introducing Reports of human trafficking within the Thailand that we eat a) American seafood, b) a much greater resources required to produce edible food. A fish diners to seafood choices beyond the typical fishing industry affected U.S. markets in that the fish variety than we currently do, and c) mostly farmed certified as sustainable isn’t truly sustainable if it is salmon, shrimp, and tuna. Varieties such as being caught are turned to fishmeal, and then into filter feeders, and that d) some explanations are thrown away. In many situations, frozen instead of carp, clams, mussels, sand dabs, seaweed, farmed shrimp. In turn, many retailers have made in order. The last statement is one of the singular fresh fish is a good choice, since it lasts longer. So is and squid are underconsumed and yet relatively promises to enforce anti-slavery policies within their guiding principles behind seafood. It is a fact that serving appropriate portions. Finally, consider greater better for the environment. supply chains. This issue has been a bell-weather contradictions abound, and this helps explains the use of smaller fish and seafood types that are lower in 2015, and a significant number of businesses above difference between Consumer Reports and on the food chain, such as mollusks and sardines. • Significant certification efforts help identify a have made commitments to eliminate slavery FAO/WHO guidance. Overall, seafood is healthy, but (Clams are one of the most sustainable options substantial volume of product as being more and human abuses in their food chains. While there can be exceptions. With this in mind, we see because they are produced within the U.S. and environmentally friendly. The challenge is to get purchasing domestically or from countries that have that Greenberg advocates for eating seafood from have a very limited environmental impact. Yet, on more product certified, and then continue to assurances of no human rights abuse is a step, well-regulated countries (as is the United States), average, Americans eat only one-third of a pound of improve that which has attained certification. mere assurances may be an oversimplification given and striving for increased variety in order to break clams per year). Chefs and foodservice professionals that mislabeling is still pervasive within seafood. In out of the shrimp-salmon-tuna triumvirate that can both serve a greater diversity of species and our domestic wild salmon supply, Oceana recently accounts for 60 percent of all seafood consumed use their considerable influence to introduce diners found that 43 percent of samples labeled wild in the U.S. His advice to eat more farmed filter to new varieties of fish and seafood, increasing Pacific species were actually Atlantic species and feeders—oysters, mussels, clams, and especially American consumers’ understanding of how to cook thus farmed. It is important to note that this study seaweed—is a way to use food production to with more varieties at home. was conducted during winter when wild salmon decrease the impacts humans have on the oceans.

31 quality Arabica coffee, currently grown in mountainous RECOMMENDATIONS: IN SUMMARY: CLIMATE areas in more than 60 tropical countries, is threatened The foodservice industry can make a substantial • Greenhouse gas emissions continue to rise, by rapidly warming temperatures. In the short term, contribution to both mitigation and adaptation to and agriculture both contributes to that, the foodservice industry can find alternative sources, climate change through increasing the efficiency of especially from livestock production, and is CHANGE but in the long-term, technological approaches its own practices. Shifting away from menus and affected by it, especially from severe weather and plant breeding that may affect both quality and restaurant concepts that emphasizes livestock events that damage crops. The foodservice industry’s primary focus is food, a quantity will be necessary to maintain access to products, particularly red meat, can dramatically central part of the lives and culture of every American. these products. Climate change poses a critical threat to the ability of reduce greenhouse gas emissions. Also, in the • Every part of the journey that food ingredients U.S., up to 40 percent of all food is thrown away take from field to fork, through ships, trucks, the U.S. food system to deliver high quality, nutritious Multi-year droughts, such as the one currently food consistently and in adequate quantities year affecting California, are more likely to occur, without being eaten. Thirteen percent of solid warehouses, retail stores, and refrigerators, round. Over the next few decades, temperatures will particularly in arid and semi-arid regions. These waste in California’s landfills is food; when it rots, can be vulnerable to climate change, and continue to rise, precipitation patterns will change, impacts may increase competition for scarce or it produces prodigious amounts of the potent these changes will ultimately affect the and unexpected and unusual extreme events will perishable food items as farmers find them more greenhouse gas methane. As is set out in the quality and quantity of food available to the continue to occur. Direct effects on food production difficult to produce reliably from one year to the Environmental Protection Agency’s Food Recovery foodservice industry. are already being felt. However, indirect effects on next. One-sixth of global agricultural production Hierarchy, the foodservice industry can help parts of the food system beyond the farm gate— is traded internationally, which may either provide lower these emissions by reducing the volume • The foodservice industry can make a such as impacts on transportation infrastructure new opportunities for sourcing or pose challenges of surplus food generated through a variety of substantial contribution to both mitigation or changing availability or price of perishable to maintain the quality of the food we consume. techniques: reducing portion size; adopting and adaptation to climate change through products—may prove to be more important for the The foodservice industry can strengthen its efforts promotions that offer more meals rather than increasing the efficiency of its own practices, foodservice industry, including harvesting, processing, to reduce risks from climate impacts by diversifying more food at a single meal; continuing to improve particularly by shifting away from red meat and packaging, distributing, transporting, refrigerating, its food sourcing to support sustainable farms from the accuracy of demand forecasting; finding reducing the amount of food waste going to retailing, and preparing food. Much can be done multiple regions. creative uses for scraps on menus; diverting landfills through creative reuse, recycling, and to reduce the vulnerability of the industry to climate unfit scraps to animal feed and excess food to composting. threats, and actions can be taken by the foodservice Once food leaves the field, the transporting, soup kitchens and shelters; and participating in industry to reduce its impact on the climate. The refrigerating, trading, and purchasing of food by composting programs to create nutrient-rich soil foodservice industry is well positioned to encourage wholesalers and retailers may also be affected for agriculture. Efforts such as these require the the consumption of high-efficiency sources of protein, by climate and climate extremes. Each step in such as legumes, soy, chicken, and fish, which can this sequence tends to increase carbon footprint commitment of the industry as a whole as well bring substantial greenhouse gas savings through and increase potential for food waste. Extreme as collaboration within communities across changes in consumption patterns compared with precipitation events can directly affect transportation multiple sectors. eating red meat. systems through the flooding of roads, and storm surge can damage road, rail, and shipping Farmers have found that crops and livestock are infrastructure. Heat waves can increase the demand sensitive to the direct effects of climate change, for electricity, damage transportation infrastructure, particularly increasing temperatures, changes in and stress the ability of refrigeration units to maintain precipitation patterns, and increased carbon dioxide appropriate temperatures while in transit. Such events in the atmosphere, the primary cause of climate can impair just-in-time food distribution networks, change. Exceeding the optimum temperatures for impeding the ability of restaurants and food outlets crops causes more rapid maturation and increased to meet their own high standards. As atmospheric SCORE: 1 moisture stress of plants. Experiments have shown carbon dioxide increases, we can expect disruptive Climate change continues to affect every aspect that higher carbon dioxide concentrations affect the extreme heat waves and large-scale catastrophic of the global food system, through temperature nutrient content of grains and legumes, lowering their floods to become more common. and precipitation impacts on food production, protein, zinc, and iron content. These impacts should transportation networks, refrigeration and be of great concern to the foodservice industry, since Every part of the journey that food ingredients take processing facilities, and new efforts to reduce they could be accompanied by changes in taste, from field to fork, through ships, trucks, warehouses, food waste. As the climate continues to change, texture, and seasonal availability. retail stores, and refrigerators, can be vulnerable these impacts will accelerate, and it will become to climate change. Thought needs to be given to more difficult for us to adapt. The reliability and consistency of specialty crops identifying vulnerabilities and threats to the U.S. food will continue to be affected by climate extremes. system from climate change, and action should be Pests and bacterial infections whose rapid spread is taken to ensure that the foodservice industry reduces connected to rising temperatures threaten oranges its own contribution to climate change from Florida, Texas, and other states. Likewise, high- where possible..

32 At the same time, California’s groundwater resources new Sustainable Groundwater Management Act. RECOMMENDATIONS: are threatened by excess farm nutrients and pesticides Many agricultural water agencies will be participating There is no one-size-fits all sustainable food solution for WATER leaching to the water table, along with salinization due to in GSA efforts, writing and implementing Groundwater chefs and foodservice providers. Chefs and foodservice not only seawater intrusion but to groundwater systems Sustainability Plans by 2022 and beyond. The food and operators should source from growers demonstrating being recharged with ever saltier irrigation water. These foodservice industry has the opportunity to be a key sustainable groundwater and water management SUSTAINABILITY systems are being disconnected from streams that once participant in this process, which explicitly encourages practices and reduced use of agricultural chemicals and

had functioned as a natural, low-impact “salt flush.” GSAs to embrace broad stakeholder engagement. waste impacts to water quality. Menus can feature foods The World Economic Forum in 2015 ranked water Beyond California, similar impacts are seen in agricultural with lower water footprints, which often are those with the scarcity’s impact on drinking water and global food regions around the globe. Many regions have come to Over the next few years, in California and other states, smallest carbon footprints. Menu decision-makers should security as the top threat facing the planet in the increasingly rely on over-taxed groundwater resources to agriculture will become more engaged in implementing also consider quality impacts to groundwater or surface next decade. Worldwide, 40 percent of agricultural make up for ever-more erratic supplies of surface water management practices that better protect groundwater water (nitrate and other fertilizer pollutants and pesticides), production—food, feed, fiber, and (bio)fuels—depends and reduced snowpack due to global warming: the vast resources. Transparency about grower practices and so they are encouraged to consult online resources to on irrigation, either from surface water or groundwater. Ogallala aquifer system along the American High Plains, measurable improvements in groundwater quality will calculate the nitrogen footprint of various foods. Meat- More than two-thirds of global water consumption occurs regions in the Mediterranean and Middle East, in Pakistan be increasingly important to demonstrate sustainability, free Mondays, green-forward menus, and farm-to-fork in agriculture. The diversity, quality, and availability of and northwestern India, South Asia, and in China, as well partly driven through regulatory efforts, and partly driven business strategies are some promising advances, with food products in the U.S. and around the globe vitally as some areas in Latin America and Australia. through sustainability partnerships between growers flexibility to learn from and adapt menus to water scarcity depend on a steady supply of high-quality, non-saline and the food and foodservice industry (e.g., Coca-Cola, in regions that produce significant amounts of food. irrigation water in these irrigated regions. Climate change While mostly perceived as a local problem, the widespread General Mills, Unilever, Driscoll’s, and the overall farm-to- Larger food and foodservice companies may be able adds further uncertainty, so sustainability of these water threat to groundwater resources in irrigated regions around fork movement). to build outreach programs to engage with groups of resources is key to global food security. the world requires vigilant and persistent attention by local, regional, and global players to network with partners to On a global scale, a recent study underscored the need growers directly on reaching measurable outcomes regarding water supply and quality. Such programs often find locally and regionally pertinent long-term solutions. for food companies to increase their engagement in During 2015, much of the western United States require familiarity with local conditions to prioritize the most managing water risks – water supply security, water experienced continued drought conditions, lingering now promising solutions. for one-and-a-half decades with only a couple of two-year The food and foodservice industry is a large indirect user use reduction and reuse, and water quality protection. interruptions. In California, the 2014-2015 winter (the of water through its food water footprint – the virtual water The report looked at water risk management holistically state’s rainy season) turned out mostly warm and dry, embedded in foods processed, served, or sold. The – across the agricultural supply chain and into direct lacking any measurable snow-pack and leaving surface foodservice industry and restaurants in California are also operations. The evaluation of water risk management water reservoirs severely depleted. As a result of this directly impacted by the state’s mandated reductions of in 37 major food sector companies found that about fourth year of exceptional drought, nearly two million acres water use. As part of drought emergency measures, all two-thirds of these large businesses consider water urban and industrial water users were required to reduce in their own operation, about one-third also consider were left fallow in the state. That represents a 45 percent their consumption by 25 percent relative to 2013 (the water risks in their agricultural supply chain, and even increase over normal conditions. Drought impacts in 2015 second year of drought). The ambitious program was fewer operations manage water risks as part of their cost the California agricultural economy over 20,000 jobs largely successful, mostly due to reductions in irrigation of business planning and investment decision-making. SCORE: 2 and more than $2 billion in revenue. Yet, overall agricultural urban parks and lawns and some transformation to more Attention to reducing water quality impacts by agricultural The food and foodservice industry is beginning to pay production continues to increase – by 5 percent in 2014 drought-tolerant yet attractive forms of urban landscaping. producers was entirely absent, while only two of 37 attention to water issues as drought and groundwater alone, the last drought year for which statistics are available. These efforts were mirrored by some individual efforts companies were found to be actively reducing their depletion weigh heavily on profits and as water scarcity is from restaurants, food processors, and other water users operations’ waste discharge. Also, few companies recognized as a high-priority global crisis. Consuming less The ability to weather such extreme droughts without in the foodservice industry. In the California restaurant engage in active watershed protection planning efforts meat and a new preference for hardier greens help, but major production losses is partly due to growers shifting sector, not automatically serving each diner a glass of or offer financial support to growers for implementation these trends do not yet reflect broad-ranging, conscious to more efficient irrigation technologies. Much more water, sometimes mandated by local governments, has of more sustainable farming practices. Global and efforts by the industry. Culinary professionals can play importantly, the current resilience to drought relies on been a mostly symbolic gesture to raise public awareness federal initiatives are needed but have yet to engage the diverse yet critically important roles in finding sustainable California’s (and other western states’) ability to tap into of the drought. More significant water use reductions may foodservice sector at a broader scale. water solutions. large groundwater resources that replace insufficient yet be realized through reduced water use in kitchens, surface water supplies. bathrooms, processing facilities, and so on. Like other food sectors, the foodservice industry may still realize innovative solutions to reduce water IN SUMMARY: But with the cumulative rainfall deficit over the past 15 Others are taking broader measures. The Almond consumption, increase water reuse, and decrease waste • The ability to withdraw groundwater from healthy years now larger than even the largest western U.S. Board of California has embraced a new initiative called discharge, including food waste discharge. Food waste aquifers at relatively low cost is crucial for maintaining drought in recorded history—the dust bowl of the Accelerated Innovation Management (AIM). Through this in particular represents significant potential for reduced agricultural production despite drought. 1920s—groundwater reservoirs have taken a large toll, initiative to stimulate new agricultural practices that are water use, namely through the “virtual water” waste with storage being rapidly depleted and water levels falling more sustainable, it defines sustainable almond farming embedded in food’s water footprint. More importantly, • Groundwater overdraft, agricultural chemicals, animal to record lows. Some of the immediate consequences as utilizing “production practices that are economically the foodservice industry may realize even larger water waste, and salinization pose a significant threat to long- include: dry wells needing costly replacement, increased viable and are based upon scientific research, common sustainability impacts by increasing its role in diverse term global food security, and integrated approaches pumping cost, seawater intrusion, and large-scale land sense and a respect for the environment, neighbors and local, regional, and global partnerships with agricultural to managing groundwater quantity and quality and subsidence in some areas, disrupting the integrity of employees. The result is a plentiful, nutritious, safe food and food suppliers to help reduce water risks in surface water quantity and quality are crucial. California’s surface water canal infrastructure. Increased product.” The AIM initiative includes a focus on water agricultural production and move toward sustainable There is no one-size-fits-all solution for crafting menus pumping to lift groundwater from growing depths and management and efficiency and the broader sustainability farming practices. Chefs and foodservice providers can • that strongly support water sustainability. It is helpful to the replacement of dry irrigation wells cost California of water resources. Similar sustainability programs are adjust menus through understanding the impacts of food increasingly becoming part of the foodservice industry. production. Menus may favor sustainable suppliers, while menu smaller and fewer meat items, along with larger agriculture about $1 billion between 2014 and 2015. The fruit and vegetable portions. Attention to water and also minimizing the water footprint and water quality higher energy needs to meet increased pumping lifts also environmental conditions in regions that grow food, as Stakeholders in agricultural regions around California have impacts across the food portfolio that a menu represents. have a direct and substantial impact on greenhouse gas well as engagement with growers and food suppliers also initiated meetings, often professionally facilitated, emissions from the energy sector, thus further linking the on sustainable water practices, are important steps food industry to global warming. to discuss formation of Groundwater Sustainability toward finding more specific long-term solutions. Agencies (GSA), required by 2017 through California’s

33 34 shelf at the local feed store. The FDA believes that but insufficient for the same reason of antibiotic AGRICULTURE, veterinary oversight will assure that preventive use resistance. A few days after the McDonald’s is judicious, but the American Veterinary Medical announcement, Costco Wholesale, the third largest Association is closely aligned with industry U.S. retailer, said it would be phasing out antibiotics DRUGS, AND trade associations. in its chicken and other meat products but did not release a date for achieving its goal. Panera Bread In 2014, the Pew Charitable Trusts examined the now sources all of its pork and chicken products SCORE: 3 CHEMICALS USE labels of all the antibiotic products affected by from producers who do not use antibiotics, and Lack of real progress on the regulatory front is

the guidance, nearly 300 total, and found that imports beef from Australia to fulfill its commitment counterbalanced by growing demand from chefs, In 2013, the United States saw important 23 percent of the products had dosage levels for to serve only meat and other animal products foodservice professionals, and consumers for developments in the restriction of the use of organic disease prevention that fell within the range of raised without antibiotics. Bon Appétit Management antibiotic-free meats, with companies like Bon arsenicals in the production of food animals. growth promotion doses, and nearly half of those Company and Chipotle are also leaders in the Appétit Management Company, Panera Bread, Documentation of the breakdown of organic are classified by the FDA as “critically important” in movement toward antibiotic-free meat. and Chipotle applying pressure on producers. arsenicals by bacteria in the gut of poultry to yield human medicine with the remainder classified as Growing awareness of the threat of antibiotic inorganic arsenic, a Class 1 carcinogen, led to “highly important.” Pew urged the FDA to monitor A worrisome new development are the reports of resistance is stimulating serious attention to the the removal of three of the four organic arsenicals and publicly report antibiotic use in animals by colistin resistance in food animals in over a dozen problem at the international level, including the from the feed and water of poultry and swine—a species and by purpose to establish a clear target countries, not yet including the U.S. Colistin has World Health Organization. significant step forward that was fully implemented for reducing antibiotic use in animals and to been the final defense against life-threatening in 2015. The fourth drug, Nitarsone, has been evaluate the effectiveness of disease prevention gram-negative infections by bacteria with multi-drug used to prevent and treat blackhead disease in label claims. resistance. A recent Lancet publication described IN SUMMARY: turkeys. Research in 2015 found residual inorganic the discovery of colistin resistant E. coli during The FDA’s 2013 Guidance for Industry #213 arsenic in turkey meat. The Food and Drug In February 2015, the FDA released a report on drug routine surveillance for antibiotic resistant bacteria in • calling for voluntary measures has not proved Administration (FDA) urged Zoetis, the manufacturer, residues in the milk supply: About 1,900 samples food animals in China. The documentation of a new effective in reducing the amount of antibiotics to voluntarily withdraw Nitarsone from the market. were tested for 31 different drug residues, and only resistant gene and its plasmid-mediated transfer used in low doses via feed and water. This intervention was finalized in December 2015, 15 milk samples—less than one percent—were from one species of bacteria to another, coupled and there are no longer any arsenical drugs on the confirmed positive, including 11 positive samples with the reports of colistin resistance in a number Advocacy groups such as Consumers Union market in the U.S. for use in animal production. • from 953 samples of “targeted” dairies, which had of other countries just within the past year, is truly and Pew Charitable Trusts continue to urge the The final removal of arsenic from the animal portion previous tissue residue violations in culled dairy alarming. The global need is greater than ever to FDA to impose more rigorous accountability of the U.S. food supply is a significant public cows at slaughter. Unfortunately, six of the drugs eliminate all non-therapeutic uses of antibiotics measures upon the food animal industry. health advance. detected (ciprofloxacin, gentamicin, sulfamethazine, in animal production and the restriction of any tilmicosin, tulathromycin, and florfenicol) are antibiotics important to human medicine. • Because the FDA lags behind consumer In December 2013 the FDA called for the voluntary approved by the FDA for use in lactating dairy cows, demand with regard to regulatory pressure on cessation of the use of low-dose antibiotics. This so they are not routinely screened for under the RECOMMENDATIONS: producers to remove antibiotics from the meat call, formally known as Guidance for Industry Grade “A” Pasteurized Milk Ordinance for milk and The FDA is still not moving fast enough to require supply, chefs and foodservice operators are #213, was much more problematic and allowed playing an increasingly pivotal role in shifting the milk products. industry to cut the use of antibiotics, but growing for continued use of low-dose antibiotics for industry toward antibiotic-free meat. consumer demand for antibiotic-free meat appears disease prevention, with the expectation that all The last year has seen continued movement by to be forcing producers to change the way they antibiotic use was to come under the supervision producers, retailers, and foodservice operators to operate. Chefs and foodservice professionals are of a veterinarian. Manufacturers of antibiotics used eliminate the use of low-dose antibiotics in animal increasingly effective in advocating for antibiotic- in animal production were given several months to production. Responding to increasing consumer free meat. indicate their voluntary compliance with Guidance demand for meat raised without antibiotics, Perdue #213 and three years to implement the labeling Farms and Tyson Foods announced plans to stop change. Unfortunately, a mere labeling change has using antibiotics in their chicken hatcheries, while proved insufficient to prevent industrial producers reserving the prerogative to use antibiotics in feed from business as usual while claiming they are only when prescribed by a veterinarian to prevent or using low-dose antibiotics for disease prevention. treat disease. The two major chicken producers Given that the dosages and routes of administration make the usual industry claims that they don’t use through water and feed are the same for growth medically important antibiotics anyway. The science promotion and for disease prevention, Guidance of antibiotic resistance, however, shows that the #213 is proving to be a toothless tiger in the use of any antibiotic at low dose over time selects regulatory domain. Sales of antibiotics for use in for resistance genes with crossover effects on animal production actually increased in 2014, and antibiotics important to human medicine. In March preliminary 2015 data suggests that the trend will 2015, McDonald’s announced its plan to begin continue. The only change is that animal producers serving only chicken that had been raised without will no longer be able to buy antibiotics off the “medically important antibiotics,” a good first step

35 These sobering statistics document a 19.6-fold Fruit and Vegetable Prescription Program that allows RECOMMENDATIONS: HEALTHY increase in food expenditures over the past half- doctors to give money to families struggling with Chefs, foodservice leaders, and cooking schools century, as compared with a 110-fold increase in diet-related disease to buy fresh fruits and vegetables should explore opportunities to work with hospitals, healthcare expenditures over the same period of at local farmers markets. Kaiser Permanente runs health systems, medical/nursing/dietetic training time. Interestingly, in recent years almost a quarter of more than 50 farmers markets at its various hospitals programs, and corporations that are building FOOD VS. all preventable deaths in the U.S. were from causes and has recently launched a program to deliver and refining teaching kitchens in order to train linked to dietary risk. healthy, non-processed foods to the homes of employees, patients, and adults, kids, and families post-operative patients. “Gardens to Hospitals” is in their communities. Conversely, schools of public HEALTHCARE One reason for this shift may be the increasing an innovative “ecopreneurial” company that builds health, medicine, and allied health and policy should reliance on hyper-processed foods of white flour, and maintains hydroponic greenhouses on hospital consider partnerships with foodservice companies and trained chefs to develop novel curricula added sugar, excess salt, and unhealthy fats, as property, supplying fresh vegetables 12 months per SPENDING and programs for those they serve. Healthcare well as the decreasing amount of time Americans year. At the annual Healthy Kitchens, Healthy Lives® professionals—and their curricula—should explore spend cooking today as compared with the time educational conference at The Culinary Institute ways to incorporate knowledge about the translation AND TRENDS spent decades ago—a decrease of 50 percent of America (CIA) in 2016, more than a third of the of nutrition science into practical advice for patients. across all demographic groups between 1965 and healthcare professional attendees reported that their Ultimately, demonstration projects can lead to the 1995. Interestingly, even though this could be more hospitals and/or health systems already had built a establishment of research networks that assess circumstantial than causative, each 30 minutes of demonstration or teaching kitchen, or had plans to do the impact of these trends in medical-culinary IN MEDICAL- reduced cooking time has been associated with a so in the coming 24 months. educational alliances. The establishment, in this 0.5 increase in Body Mass Index (BMI). Regrettably, past year, of the CIA-Harvard Chan School Teaching however, physicians do not typically receive training Over the past year, considerable progress has been Kitchen Collaborative has set the stage for this next CULINARY with regard to dietary and lifestyle counseling, nor made with regard to the establishment of joint, phase of activity. are these items currently included in their required medical-culinary partnerships. Specifically, certification examinations. the CIA has partnered with the Harvard T.H. Chan EDUCATIONAL School of Public Health to launch the new Teaching Over the past two years, four studies have been Kitchen Collaborative. Composed of 25 organizations published exploring the relationship between time from the corporate, medical, community, and ALLIANCES spent cooking and the quality of one’s diet. Two educational sectors that have developed prototype In 1960, the total annual U.S. expenditures for food suggest that more time spent cooking is predictive of teaching kitchens and teaching kitchen-related were estimated at $74.6 billion. This was nearly three enhanced diet quality and one does not. This latter curricula, the collaborative has been built with the SCORE: 3 times as much as the total expenditures that same study raises the point that asking about time spent intention of establishing best practices and testing Innovative, interdisciplinary programs are being year of $27.2 billion for healthcare. Fast forward to cooking, without some clarification about what one is these across various populations. These will include cooking (e.g. family dinners vs. preparation of frequent patients, corporate employees, college and university launched with increased frequency by high visibility 2014: U.S. citizens spent $1.46 trillion on food and organizations and institutions. Many of these are desserts for family and friends), may lead to erroneous students, K-12 students, retirees, and others. (See $3.0 trillion on healthcare, flipping the ratio, with starting to link healthcare and healthy eating with healthcare spending now twice that of food. conclusions. The fourth study, a review of relevant the sidebar on page 37 for more.) culinary education. studies, suggests the need for more and better scientific inquiry regarding the impact that cooking, In addition, the Tulane University Goldring Center has for a range of purposes and including a range of developed a curriculum for medical student training IN SUMMARY: competencies, may have on health outcomes in “culinary nutrition,” and this curriculum has been • In 1960, Americans spent nearly three times as and costs. licensed by more than a dozen U.S. medical schools. much on food as they did on healthcare. Today, While formal research to assess the value, or lack Americans spend twice as much on healthcare While such controversies persist, the hypothesis thereof, of this rapidly expanding range of culinary- as they do on food. remains that teaching both healthful nutrition and medical partnerships is still in its infancy, this past • The relationships between cooking, dietary health-based culinary skills to individuals may year has set the stage for such inquiry in the choices, food purchasing patterns, and health increase their freedom to choose a healthier diet and immediate future. outcomes are just beginning to be studied lifestyle. Yet, it is rare for medical, culinary, and food formally as alliances between health and culinary industry communities—each responsible for trillions These trends and programs are exciting, early phases organizations begin to take shape. of dollars of the U.S. economy—to share data, skills, of innovation and development, and they require questions, and ideas, or partner in efforts to diminish the ongoing support of the healthcare, culinary, and • Over the past year, an increasing number of rates of obesity, diabetes, and other diet-related public health communities. The goal of enhancing innovative partnerships involving the culinary, health problems. the relationship between judicious food expenditures medical, public health, IT, and sustainability and judicious healthcare expenditures will be realized sectors began to take shape. These programs, In recent years, some interesting pilot programs have when more robust collaborations between the curricula, and pilot projects now set the stage for demonstrations and formal studies to assess emerged. Cooking Matters, a program sponsored medical, public health, culinary, and sustainability the value of such partnerships in terms of their by anti-hunger organization Share Our Strength, has communities become ever more inter-dependent ability to change behaviors predictably and taught more than 120,000 low- income people in 40 and concerted; and, when they are made replicable, sustainably; to impact health outcomes; and, states how to shop for and cook healthy food on a scalable, and shown to improve both health ideally, to lower healthcare costs and enhance budget. The non-profit Wholesome Wave launched a outcomes and costs. productivity and quality of life.

36 TEACHING KITCHEN COLLABORATIVE: ADVANCING PERSONAL AND PUBLIC HEALTH THROUGH CULINARY LITERACY AND INTEGRATIVE LIFESTYLE TRANSFORMATION

Over the past year, The Culinary Institute of By collecting and sharing information across America has partnered with the Harvard T.H. organizations, populations, and geographic Chan School of Public Health to launch the areas, the TKC will function as an accelerator Teaching Kitchen Collaborative (TKC) to to support the development of best practices bring together 26 thought-leading organizations for reproducibility, scalability, and evaluation of across 15 states using teaching kitchen emerging models and educational programs, facilities as catalysts of enhanced personal with three focus areas of research, best and public health. practices, and scalability.

The collaborative grew out of the Healthy Co-chaired by David Eisenberg (director of Kitchens, Healthy Lives® (HKHL) conference culinary nutrition at Harvard Chan School) (healthykitchens.org), which provides healthcare and Greg Drescher (CIA’s vice president for professionals with both didactic and experiential strategic initiatives and industry leadership) learning in nutrition, healthy cooking, exercise with coordination from Allison Righter (nutrition and movement, mindfulness, and health instructor at CIA’s Hyde Park campus), the coaching. Offered 12 times since 2006 and TKC is supported by generous philanthropic attended by more than 4,000 registrants in total, support from several foundations, with additional HKHL has naturally turned into an incubator support provided by member-grantors. Member for early adopters and architects of teaching organizations include community-based kitchens in various institutional settings used organizations, such as LA Kitchen and the for health promotion. However, these facilities YMCA of Pittsburgh, and primarily academic and their respective curricula are largely being and/or medical institutions, such as Cleveland funded, implemented, and piloted in isolation. Clinic, Kaiser Permanente San Francisco Medical Center, Princeton, Stanford, University of California (Berkeley, Los Angeles, San Diego, and San Francisco) and Vanderbilt.

The TKC meets twice a year at different member organization sites, while collaborating on a regular basis through virtual working group meetings that work toward developing resources that can be used both internally among members and externally with individuals and organizations across the country.

This new initiative marks a tremendous step forward in establishing strong medical-culinary partnerships and driving the use of teaching kitchens for improved public health.

37 HEALTHY MENUS R&D COLLABORATIVE: WORKING TOGETHER TO TRANSFORM MENUS IN THE VOLUME FOODSERVICE INDUSTRY

The Culinary Institute of America Healthy Menus menu options in the U.S., along with the most Gumpel, vice president of R&D for Panera Bread. (with an emphasis on beverages and whole grains— R&D Collaborative, established in 2010, is a working current contextual factors. In 2016, for instance, Collectively, operator members feed over 100 million and a new interest in sprouted whole grains), and group of volume foodservice culinary and nutrition top of mind for most members is the need to Americans every day. This means that even very strategic calorie design, members have added leaders who leverage their combined influence and comply with the new mandate from the Food and small changes can have a tremendous impact on protein quality to their list of priorities. experience with the single-minded goal of finding Drug Administration to provide calorie and nutrition public health. practical solutions that help expand the availability information in chain restaurants and retail food Member interest in advancing protein quality and sales of healthy menu choices. outlets that serve prepared foods, with a deadline Leadership and guidance from Menus of Change stemmed from research and guidance shared of May 2017. Central to the group’s exchange of has had and will continue to have a significant through the Menus of Change leadership summit Members include leaders from our nation’s top healthy menu strategies is an emphasis on leading influence on the work of the collaborative, as and annual reports as well as from increasing foodservice operations and representatives from with flavor while driving profitability. members pursue their mission: “collaboratively consumer interest in antibiotics, hormones, and food companies and commodity boards also engaging with foodservice industry leaders, resource a wide range of animal welfare issues, as well committed to providing a greater variety of healthful The membership-based collaborative includes specialists, manufacturers, and other suppliers to as growing opportunities around plant protein. food and beverage options for American diners. representation from McDonald’s, Darden, Brinker, identify and explore non-proprietary culinary insights, Members started their work in this area at the Panda Restaurant Group, Aramark, Compass applications, strategies, and solutions that can help January 2016 All-Member Meeting with a SWOT The collaborative grew out of the Worlds of Healthy Group, Sodexo, AVI Foodsystems, Yum! Brands, chain restaurants and other large volume foodservice analysis—identifying strengths, weaknesses, Flavors® invitational leadership retreat, held each Google, Subway, Dunkin’ Brands, and many other providers fulfill our customers’ desire for delicious opportunities, and threats—that will provide insights January in partnership with the Harvard T.H. Chan high-volume operators. The co-chairs of the initiative and nutritious menu choices.” into two to three protein-related areas where, School of Public Health. The retreat provides a are Deanne Brandstetter, vice president of nutrition collectively, members can have the most impact on forum for nutrition experts and foodservice leaders and health for Compass Group; Pam Smith, founder Along with focusing on reducing sodium, increasing public and environmental health. to discuss best practices for expanding healthy and president of Shaping America’s Plate; and Tom use of produce, improving carbohydrate quality

38 HEALTHY KIDS COLLABORATIVE: ACCELERATING WHAT ARE THE GREATEST OPPORTUNITIES IN SCHOOL NUTRITION AND FOODSERVICE? THE SIGNS OF PROGRESS? INNOVATION AND DEEPENING EXPERTISE IN THE AREAS MOST IN NEED? OVERALL, WHERE IS SCHOOL K-12 SCHOOL FOOD FOOD HEADING?

“The Healthy Kids Collaborative is moving school “The greatest opportunities in school nutrition nutrition from a compliance culture to with respect to Building on its long-running annual conference has confirmed that chef-enhanced school meals a culinary staff culinary education and . By being more focused on the food we center around collaborative partnerships to advance culinary-driven, healthier foods for increase the selection and consumption of culture training will be better able to meet the taste and nutrition and sharing of information. Why reinvent the wheel K-12 students, in 2015 The Culinary Institute of vegetables. Chefs can increase the palatability needs of our young guests.” when something is working well within another America launched the Healthy Kids Collaborative of foods served to children and, as a result, their —Cathy Powers, partner, Culinary Nutrition district? The Institute of Child Nutrition (ICN) (HKC): a year-round, invitational initiative consumption of healthier foods. Associates; chair, HKC is working with diverse groups of experts (i.e., designed to both accelerate innovation and school nutrition professionals, chefs, and allied deepen technical and professional expertise Aiming to address these challenges and “ is most organizations) to develop new culinary trainings for in K-12 school food. It brings together leading opportunities, the inaugural Healthy Kids The school nutrition environment assuredly a vital part of the school climate and various audiences within school nutrition. Being school nutrition professionals, school chefs, Collaborative meeting was held in December should have a positive influence on the health of a central repository of information, it’s our role to suppliers, and other stakeholders to discover 2015. It welcomed 66 corporate members and the learning environment, which does include the provide a platform of best practices so others may flavor and menu strategies, highlight successes school nutrition members including chefs and cafeteria. The noise level, the comfort and physical be able to replicate the same successes.” and best practices, and develop training directors from Sodexo, Aramark, Chartwells, structure, along with positive interactions among —Aleshia Hall-Campbell, acting executive director, protocols and resources. The goal is to share Revolution Foods, Minneapolis Public Schools, and between students and staff should remain a Institute of Child Nutrition, The University of Mississippi the insights and solutions gained with school Metro Nashville Public Schools, Detroit Public primary focus in contributing to the overall success districts across the United States. Schools, and others. Highlights of the meeting of our students, both academically and socially.” “The greatest opportunity in K-12 lies in positively included a team-building kitchen activity —Nancy Rice, state director, School Nutrition Division, impacting both student learning and student health School nutrition has shifted significantly in recent where they created new school menu items, a Georgia Department of Education; chair, HKC through healthier lifestyle habits. These healthy years from a “heat-and-serve” or “pass-through” demonstration on using intact whole grain in habits include eating more ‘real’ foods, selecting operation to more onsite food preparation. This schools, and a tasting exercise demonstrating “As school chefs and graduates of The Culinary more plants (vegetables and fruits) at meal times, brings challenges related to staff training and effective methods for reducing sodium and Institute of America, we know [that] what motivates and achieving equipment needs. Other challenges include the increasing flavor. To determine priorities and adequate hydration by drinking children to delight in . Both children and parents need many factors that influence the school nutrition work on an ongoing basis to develop resources consuming fresh fruit plenty of water is a cachet of cool, craveability, education – regarding nutrient dense/whole foods, environment, which has a discernible impact on and practical solutions, the collaborative formed and vegetables and relatability. All of these can be created by nutrition/health and wellness, and cooking skills – the amount of food students consume. Factors five working groups focused on the following promoting food literacy and wellness as an integral for positive, sustainable change.” include the amount of time students have to eat, areas: staff culinary education and training, part of curriculum. Experiential learning is critical —Michael Rosenberger, director, Food and whether recess is held before or after lunch, the produce acceptance and consumption, flavor for children to gain meaningful insights into how Nutrition Services, Irving Independent School level of engagement among staff, and facility development and sodium reduction, school food produce is grown and harvested, what it tastes District (Texas) design. Along with these challenges also come environment, and food and nutrition quality. and looks like as it goes from seed to plant, and numerous opportunities. For instance, research the changes it encounters through a range of culinary techniques and applications. That is really the best way to encourage consumption. Well, and chefs in white coats. It’s much cooler for a chef to tell you to eat your vegetables than your mom.” —Cody Williams ’02, ‘04, program manager, Sonoma Valley Unified School District (California); chair, HKC Produce Working Group —Lisa Feldman ‘91, director, Culinary Services, Sodexo—which succeeded in converting burger patties to a meat-vegetable blend at over 250 of their K-12 schools, which collectively feed two million of the 50 million children in school today— co-chair, CIA Healthy Menus R&D Collaborative Produce Working Group; and chair, HKC Vendor Relations

39 WHAT DOES ALL OF THIS MEAN FOR THE FUTURE OF SODA AND SUGAR- SWEETENED BEVERAGES IN AMERICA? WHICH ORGANIZATIONS IN THE FOODSERVICE INDUSTRY ARE LEADING THE WAY WITH REGARD TO OFFERING HEALTHIER BEVERAGE CHOICES? HERE, WE HEAR FROM FOUR OF ITS VISIONARY VOICES:

“Sodas, in public health jargon, are low-hanging “I truly believe that sugary carbonated beverages fruit—easy targets of advocacy because of their high have peaked and today’s college students are realizing sugar content and zero nutrients. It’s great that health that they need to stay hydrated, and they want a flavor advocates have gotten the word out that sugar- profile at times, but they don’t want large amounts sweetened beverages are nothing but liquid candy, of sugar.” best consumed in the smallest amounts possible. Sales —Cheryl Garner, executive director of dining, of full-sugar sodas have been declining for at least conference, and catering services, at University of 15 years, and it is no surprise that the soda industry California, Riverside considers concerns about obesity to be the number one threat to its profits. The word is out: If you are thirsty, OPERATOR SPOTLIGHT: UC RIVERSIDE drink water. I expect to see further efforts to discourage sugary drink consumption: tax initiatives, warning labels, In 2015, when University of California, Riverside was removal of the drinks from vending machines, bans on striving to follow the Menus of Change principle “reduce hospital and workplace consumption, and all of the sugary beverages,” they decided to create some niche other efforts introduced by advocates in the past few beverages not covered by their Pepsi contract. So they years. The next challenge will be introducing some curbs rolled out a line of spa waters and agua fresca for both on marketing sugar-sweetened beverages to kids. All of their residential and retail restaurants. They noticed these actions have raised public consciousness about almost immediately that most students were lining up healthy beverage intake. Foodservice providers: Take for ice from the Pepsi machine and then heading for notice!” the spa waters—bypassing the standard Pepsi —Marion Nestle, Paulette Goddard professor of beverages altogether. nutrition, food studies, and public health, New York University, and author, Soda Politics: Taking on Big Soda UC Riverside uses a “text and tell” feedback system (and Winning) throughout its operation, and it frequently receives feedback about the spa waters they serve, enabling them to gauge the relative success of different flavors. “Recent research shows that people are drinking less For example, when they tried a variation made with dried soda and more bottled water. The good news is that banana chips, vanilla, cinnamon, and orange zest, the when they choose bottled water, they are picking the text and tell system lit up with the student comment: packaged beverage with the smallest environmental “The banana foster water is amazingly satisfying!” footprint: The results of a 2014 benchmarking study by Inspired by what they were seeing from their diners, UCR the International Bottled Water Association show that the Dining representatives attending the National Restaurant amount of water and energy used to produce bottled Association’s annual gathering spoke with Pepsi water products in North America is less than all other leadership about the need for less sugary beverages. types of packaged beverages. It is also the healthiest They expressed a concern that the soda company beverage choice: Compared to sugary beverages, water was missing a huge shift in consumer beverage naturally has no artificial flavors or sweeteners to preferences. Because the Pepsi representatives there interfere with the enjoyment of food or to potentially were not convinced, UCR Dining invited one of their lead to higher risk of obesity, diabetes, or heart disease.” vice presidents out to the campus to see firsthand: The THE FUTURE OF SUGAR-SWEETENED BEVERAGES —Kristin Wilcox, vice president of government relations, vice president was asked to stand in front of the Pepsi International Bottled Water Association machine of one of the residential dining halls for 20 minutes. During that time, student after student passed One of the most important milestones of the 2015 the amount of sugar in just one 16-ounce bottle of “We are in the midst of a beverage revolution. As by the Pepsi machine and opted for a spa water. Not people learn that a 20-ounce bottle of soda has 16 one student took a Pepsi beverage. Dietary Guidelines for Americans was that, for the Coke. These include not only sodas, though, but teaspoons of sugar (imagine putting that in your morning first time, they set a specific limit on the amount energy drinks, sports drinks, sweetened coffees coffee!), they are more and more likely to drink water As a result of the visit, Pepsi agreed to supply the of added sugar Americans should consume each and teas, flavored waters, fruit drinks, and alcoholic instead sugar. What a healthy choice! People who drink campus with new equipment, adding water and day. The guidelines have long instructed Americans beverages. Furthermore, sugar consumed in water instead of soda, sports drinks, bottled teas, and carbonated water valves that could be used as a stand- to reduce their added sugar intake, but only now liquid form has more severe negative health other sugary beverages dramatically reduce their risk for alone, or an added flavoring, many without sugar. They have they put an exact value on that guidance: impacts—namely the spike in blood sugar, which diabetes and heart disease.” also brought in some less sugary beverages that had no more than 10 percent of daily calories. That is can, over time, contribute to insulin resistance and —Harold Goldstein, executive director, California Center not been available in the market before. “The big goal is approximately 50 grams of sugar, or 12 teaspoons. type 2 diabetes. For these reasons and several for Public Health Advocacy to influence Pepsi, to show them, ‘You are missing the Many Americans currently consume about twice others, consensus has pointed to replacing boat. You’re not responding to the times,’” says Cheryl Garner, UCR’s executive director of dining, conference, that amount, and the guidelines report that about sugar-sweetened beverages with water and other and catering services. “Influencing them is what makes half of their added sugar intake comes from sugar- healthier options in order to move the needle on the biggest difference.” sweetened beverages. Fifty grams happens to be Americans’ sugar consumption.

40 VIII. PRINCIPLES OF HEALTHY, SUSTAINABLE MENUS

Consumers say they want food that is healthier, sustainable, and ethically sourced, but figuring out which foods to eat is often not easy. As a result, the dining public is looking to chefs and food industry leaders to help them make the “right” choices. Culinary professionals are responding. But giving people what they want isn’t always easy either. Some diners believe that foods advertised as “farm to table” or certified with sustainability labels are also healthier. While customers don’t always purchase what they say they want, these trends are profoundly changing the landscape of the foodservice business.

The Principles of Healthy, Sustainable Menus represent unique guidance for the foodservice industry. They incorporate findings from nutrition and environmental science perspectives on optimal food choices, trends in consumer preferences, and impacts of projected demographic shifts in order to provide culinary insight and menu strategies that build on promising innovation already occurring in the sector.

The principles anticipate that fast-moving, mid- and long-term global trends—from continued population growth and increasing resource shortages to commodity price spikes and food security issues—will increasingly reframe how we think about food and foodservice in the United States. They also consider that the rise in diet-related chronic diseases suggests that many of today’s food and foodservice business models cannot remain unchanged for the long term. They outline pivotal culinary strategies designed to increase the odds that customers will reward pioneering and innovative restaurants and other industry operations with their business.

In short, the Menus of Change Principles offer a guide to optimal menu design and innovations for future culinary development to promote the foodservice industry’s abundant creativity and entrepreneurial dynamism in support of a future of tremendous opportunity.

Collectively, these principles and strategies also speak to our most vulnerable members of society. Chefs who are inspired by the possibility of delicious, healthy, and sustainable foods are working to make these flavors more accessible across America, in K-12 schools, in hospitals, and in low- income neighborhoods. Without the benefit of culinary expertise and insight, a focus on inexpensive ingredients can often be a recipe for failure, whether the customer is a child or an adult, middle- class or economically disadvantaged, healthy or sick. OUR APPROACH: DIVERSITY OF STRATEGIES Finally, the Menus of Change Principles have not been chiseled in stone; rather, they are designed Any approach to providing guidance on nutrition, and the environment than the aggregate pattern to be part of an interactive, cooperative, and evolving process. As science progresses, trends the environment, and culinary insight to business over days and weeks. Chefs and the foodservice shift, and new opportunities and challenges come to light, we will revisit and revise this document leaders must recognize that America’s $780 billion industry have an enormous opportunity to embrace annually. Please join the conversation at the annual Menus of Change Leadership Summit or online foodservice industry is as diverse as it is large and change, while still preserving a wide range of to help us further strengthen this essential guidance for the foodservice sector. You can reach us at omnipresent in our culture. Customers, quite apart options for an American public that often wants . from their interest in health, sustainability, or food someone else to do the cooking. These principles [email protected] ethics, look to different kinds of operations to fill and strategies, together with the Menus of Change a variety of needs and interests. Appetites and Annual Report, are intended to support innovation For additional guidance on sustainability and nutrition science-based dietary advice, consult the preferences vary, depending on whether the meal on the part of operators and entrepreneurs wherever CIA-Harvard Chan School Menus of Change website, menusofchange.org, and Harvard Chan is a workplace lunch, a mid-week dinner with the they are positioned in the industry, and help connect School’s Nutrition Source website, nutritionsource.org, which includes additional CIA-Harvard family, a snack on the run, or a celebratory occasion. them with their aspirations and their unique views of Chan School integrated dietary information and culinary strategies. What a diner or a family chooses to eat and order imperatives and opportunities. in a single instance is less important for their health

41 © 2016 The Culinary Institute of America and President and Fellows of Harvard College, as published in the Menus of Change Annual Report. All rights reserved.See the full version of the principles at http://www.menusofchange.org/news-insights/resources/ MENU CONCEPTS AND GENERAL OPERATIONS

1. Be transparent about sourcing 3. Reward better agricultural practices. Sourcing That said, some minimally processed foods—low- Consider menu concepts that change the value and preparation. Providing customers with sustainably grown foods is complex, but there is sodium tomato paste, wine, nut butters, frozen proposition for customers from an overemphasis abundant information about food production one important rule of thumb: the environmental cost fruits and vegetables, mayonnaise, dark chocolate, on quantity to a focus on flavor, nutrient quality, methods, sourcing strategies, calorie and of food is largely determined by how it is produced. canned low-sodium beans, 100 percent whole- culinary adventure, new menu formats, and the nutrient values, labor practices, animal welfare, The best farms and ranches protect and restore grain crackers, fresh-cut vegetables, spice mixtures, total culinary and dining experience (thereby and environmental impacts is a necessity in our natural systems through effective management yogurt, reduced sodium sauces, many kinds of mitigating potential downward pressure on check technology-driven and networked era. Consumer practices, such as choosing crops well-suited for canned fish and shellfish, among other things—can averages). Calorie quality is also important. Dishes engagement is driven by the rise in food safety and their local growing conditions, minimizing use of be incorporated into healthy meals. Processing should feature slowly metabolized whole grains, fraud alerts, a growing interest in sustainability and synthetic pesticides and fertilizers, and avoiding can also be used to extend the season of local and plant proteins including nuts and legumes, and food ethics, and a hyper-connectivity that yields the use of groundwater for irrigation. Better- sustainably grown produce and to make use of healthy oils that promote lasting satiety and create instant access to information such as impending managed farms sometimes qualify for organic cosmetically imperfect foods, especially produce. great flavors. crop failures or the latest farm-labor conditions or other sustainable-farming certifications. But across global supply chains. Consumers can learn many—including smaller farms—simply adopt about what they eat regardless of what chefs better practices. The most powerful strategies for 6. Grow everyday options, while honoring 9. Celebrate cultural diversity and discovery. The foodservice Our respect for cultural diversity and the savoring and businesses share. Given that, food operators supporting better farms include aligning menus to special occasion traditions. industry historically developed around special and preservation of family traditions and centuries- can build trust by learning about environmental emphasize fresh foods during the peak of their local and social issues in the food system and sharing growing season and shifting purchases toward farms occasion dining. Today’s industry, however, is old food cultures are as vital as our public health information about their own practices. Identifying that have responsible management programs. increasingly responsible for providing everyday and environmental sustainability. Fortunately, these the farms that grow key ingredients, for example, is food choices to a substantial segment of the U.S. imperatives are compatible with the Principles of a strategy that creates value and brand identity and 4. Leverage globally inspired, plant-based population. From a health and environmental Healthy, Sustainable Menus. Chefs collaborating one that is quickly becoming a standard practice. culinary strategies. Scientific research suggests perspective, there will always be room in the with nutrition experts and public policy leaders Going further and explaining how food is produced that the most effective way to help diners make industry for indulgence and special occasion foods. need to reimagine the role of less healthy, culturally and the rationale for sourcing decisions are the next healthy, sustainable food choices is to shift our However, the real opportunity in menu and concept based food traditions by limiting portion size, steps, while limiting or restricting information on collective diets to mostly plant-based foods. development is the expansion of everyday food rebalancing ingredient proportions, or offering hot-button consumer issues such as calories, trans Growing plants for food generally has less of a and menu choices that embrace current nutrition them less often. At the same time, many chefs fats, genetically modified ingredients, or processing negative impact on the environment than raising and environmental science, as well as emerging are reporting greater success from introducing methods are approaches not likely to survive over livestock, as livestock have to eat lots of plants to consumer values about how food is produced. new, healthier and more sustainable menu items the long term. Operators who do not adjust business produce a smaller amount of food. In fact, no other instead of reconfiguring existing items. Emerging models and strategies to anticipate the impacts of single decision in the professional kitchen—or in 7. Lead with menu messaging around flavor. demographic changes and greater global this accelerating trend risk disappointing the dining the boardrooms of foodservice companies—can To sell healthy and sustainable food choices, lead connectivity are making the American palate more public and having to play costly catch-up as such compare in terms of the benefits of advancing with messages about flavor, rather than actively adventurous, giving foodservice leaders a long-term issues assume greater urgency with the public. global environmental sustainability. From the well- marketing health attributes. Research shows that opportunity for creative menu R & D. researched Mediterranean diet to the cuisines of taste trumps nearly all, even if customers want Asia and Latin America, traditional food cultures offer 2. Buy fresh and seasonal, local and global. chefs, on some level, to help them avoid foods that 10. Design health and sustainability into For chefs, peak-of-season fruits and vegetables a myriad of flavor strategies to support innovation increase their risk of chronic disease. Messages that operations and dining spaces. Food and can help create unbeatable flavors—and marketing around healthy, delicious, even craveable cooking chefs care and are paying attention to how and from menu design are not the only ways to advance opportunities. When designing menus, draw ideas that rebalances ratios between foods from animal whom they are sourcing their ingredients—such as sustainability in foodservice. Choices that affect the and inspiration from local farmers and their crops and plant sources. by naming specific farms and growing practices way restaurants and other foodservice operations during your growing season as well as the varieties (e.g., organic)—can enhance perceptions of healthier are designed, built, and operated are also and growing seasons of more distant regions. 5. Focus on whole, minimally processed foods. food choices (if, in fact, these choices are healthier— important. These include imagining kitchens that The advantages of local sourcing include working In general, consumers and chefs should first focus i.e., that they are also consistent with guidance for support the optimal preparation of fresh, healthy with smaller producers who may be more willing on whole, minimally processed foods. Such foods to experiment with varieties that bring interest and are typically higher in micronutrient value and optimal nutrition). foods and selecting energy- and water-efficient greater flavor to the table. A focus on local foods also less likely to contain high levels of added sugars, equipment and environmentally friendly building can play an important role in building community by saturated or trans fats, and sodium. (Indeed, nearly 8. Reduce portions, emphasizing calorie quality materials. As behavioral economics studies have encouraging school children, retailers, media, and three-quarters of the sodium in the U.S. food supply over quantity. Moderating portion size is one of shown, dining-room operations and foodservice others to learn how to grow food, steward the land, is estimated to come from processed foods.) Whole, the biggest steps foodservice operators can take eating spaces also deserve more attention: design, and adopt healthier eating habits. But designing minimally processed foods are also typically slowly towards reversing obesity trends and reducing food set-up, service, and communication strategies menus to draw on in-season fruits and vegetables metabolized, preventing sharp increases in blood waste. This is different than offering multiple portion can all lead consumers towards healthier, more from more distant farms also is a key strategy for sugar that over time may lead to insulin resistance. sizes, as many diners “trade up” to bigger portions, sustainable choices. bringing fresh flavors to menus throughout the year. which they see as offering greater value.

43 FOODS AND INGREDIENTS

1. Think produce first. Focus on fruits and (including nut butters, flours, and milks) and 7. Serve more kinds of seafood, more often. 10. Serve less red meat, less often. Red meat— vegetables first—with great diversity across all legumes (including soy foods and legume flours) are Seafood is an important part of a healthy diet, beef, pork, and lamb—can be enjoyed occasionally meals and snacks. Recognize that customers an excellent replacement for animal protein. They and most Americans don’t eat the recommended and in small amounts. Current guidance from nutrition aren’t eating nearly enough—they should be filling also are a marketable way to serve and leverage one to two servings per week of fatty fish, which research recommends consuming a maximum half their plates with produce. Menus should feature smaller amounts of meat and animal proteins. contain higher levels of health-promoting omega- of two 3-ounce servings per week. Chefs and green leafy vegetables and a mix of colorful fruits menu developers can rethink how meat is used by and vegetables daily. Fruit is best consumed whole 3s. However, the focus on just a few species is Using plant oils and featuring it in smaller, supporting roles to healthier or cut, fresh and in season, or frozen and preserved 5. Choose healthier oils. emptying parts of the oceans of popular types of other ingredients that contain unsaturated fats, plant-based choices, and experimenting with meat without added sugar or salt. Fruit juice often seafood such as cod and tuna and now also fish such as canola, soy, peanut, and olive oils, as as a condiment. From at least some environmental contains healthy micronutrients, but it also packs like menhaden that are a key ingredient in feed for a large amount of fast-metabolizing sugar and well as featuring fish, nuts, seeds, avocados, and perspectives (e.g., GHGE, feed efficiency ratio), some types of farm-raised fish. Scientific studies should be limited to one small glass per day. Dried, whole grains, are simple ways to create healthier pork is the better choice among red meats (though unsweetened fruit is also a good choice; though it menus. Research shows that reducing saturated have found that the benefits of eating seafood not distinguishable from a nutritional perspective). contains natural sugars, it also contains fiber, which fat is good for health if replaced with “good” fats, greatly outweigh the risks and that removing or Saturated fat is one health concern associated can mitigate negative blood sugar response. especially polyunsaturated fats, instead of refined reducing seafood from the diet can have negative with red-meat consumption, but it’s not the only carbohydrates such as white bread, white rice, effects on health. Serving more seafood more issue. Chefs should strive to limit bacon and other 2. Make whole, intact grains the new norm. mashed potatoes, and sugary drinks. High-flavor often from responsibly managed sources is the processed and cured meats, which are associated Menus should offer and highlight slow-metabolizing, fats and oils that contain more saturated fat— priority. Chefs can have a positive impact on the with even higher incidence of chronic disease than whole and intact grains, such as 100 percent including butter, cream, lard, and coconut oil— unprocessed red meats. Many diners choose to whole-grain bread, brown rice, and whole grain/ environment and public health by expanding their can have a place in healthy cooking if used only splurge on red meat when they eat out, and there will higher protein pasta. Use white flour and other understanding of how to source and use a greater occasionally in limited, strategic applications. Trans always be an appropriate place for meat-centered refined carbohydrates sparingly, as their impacts on variety of responsibly managed and underutilized fats from partially hydrogenated vegetable oils, now dishes. But chefs can help to shift eating patterns health are similar to those of sugar and saturated wild-caught and farm-raised fish and shellfish. fats. Ideally, new menu items should emphasize labeled a “metabolic poison” by leading medical by building a sense of theater and value in menu whole, intact, or cut—not milled—cooked grains, scientists, have no place in foodservice kitchens. concepts that don’t rely so heavily on a starring role from wheat berries and oats to quinoa, which can 8. Reimagine dairy in a supporting role. for animal protein. For example, they might offer While there is tremendous innovation underway be used creatively in salads, soups, side dishes, 6. Go “good fat,” not “low fat.” Current nutrition delicious meat/vegetable and meat/legume blends, breakfast dishes, and more. In baking, blend milled science reverses the mistaken belief that we to improve dairy production and its impact on or smaller tasting portions of red meat as part of whole grains with intact or cut whole grains to need to limit all fat. Moderate and even high the environment, the nutrition science on dairy vegetable-rich, small-plate formats. achieve good results. levels of beneficial fats in the diet—from (most) is still unsettled and evolving. Current research non-hydrogenated plant oils, nuts, nut butters, suggests that it seems prudent for individuals to 11. Reduce added sugar. Consumers crave sugar, Potatoes have rapid 3. Limit potatoes. avocados, and fish—are associated with optimal limit milk and dairy to one to two servings per day. and the foodservice industry responds by selling metabolizing impacts on blood sugar, which is nutrition and healthy weight. Beneficial fats paired processed foods and sweets that are loaded with of special concern as they are regularly used as Chefs should leverage the flavor of cheese (high in with an abundance of vegetables, whole grains, it. But sugar’s role in spiking blood-sugar levels and a starch to fill plates. Chefs can limit their use of saturated fat and sodium) in smaller amounts and potatoes by combining small portions of them with legumes, and nuts can give our diets a baseline minimize the use of butter. Yogurt (without added increasing rates of type 2 diabetes and other chronic of slow-metabolizing, healthy foods, which are diseases means that professional kitchens should other, non-starchy vegetables or featuring them as sugar) is a good choice for professional kitchens, associated with increased satiety. A more liberal substantially restrict its use. Various strategies include: an occasional vegetable, as they do green beans, as its consumption is associated with healthy weight. broccoli, carrots, and peppers. Chefs should also usage of healthy fats, offering the potential to choosing processed foods with little or no added consider healthier alternatives including sweet deliver high-impact flavors, might represent sugar; favoring healthy oils over sugar in products potatoes, which are rich in beta-carotene and other the difference between consumers liking—or 9. Use poultry and eggs in moderation. such as salad dressings; featuring smaller portions of vitamins, and healthier side dishes that highlight not liking—healthier and more environmentally Chicken and other poultry in moderation is a dessert augmented with fruit; and substituting whole, fruits, vegetables, whole grains, legumes, and nuts. friendly foods. Even small, occasional servings good choice for healthier protein with a far lower cut, and dried fruit for sugar in recipes. There is of deep-fried foods and condiments are environmental footprint than red meat. Chefs nothing wrong with an occasional dessert; but pastry 4. Move nuts and legumes to the center of the appropriate offerings if operators use healthy, non- should avoid or minimize the use of processed chefs and dessert specialists need to take up the Nuts and legumes are full of flavor, contain plate. hydrogenated oils, and avoid potatoes, breading, poultry products, which are high in sodium, often challenge to create sweets centered on whole grains, plant protein, and are associated with increased and other refined carbohydrates in favor of fish, nuts, dark chocolate, coffee, fruit, healthy oils, yogurt, satiety. Nuts contain beneficial fats, while legume as a result of sodium pumps and brining. Eggs in crops contain fiber and slowly metabolized vegetables, legumes, and legume flour. Research moderation—an average of one per day—can be small amounts of other low-fat dairy and eggs, and, carbohydrates. Legumes also are renowned for confirms that the vast majority of people report part of a healthy diet for most people. Creative as appropriate, small amounts of beverage alcohol— helping to replace nitrogen in the soil and produce better adherence to a moderate- or higher-fat, menu items that mix whole eggs and egg whites with the addition of only small to minimal amounts of healthy diet. sugar and refined carbohydrates. impressive quantities of protein per acre. Nuts for omelets, and eggs with vegetables, are ideal.

44 12. Cut the salt; rethink flavor development Smaller portion sizes and less frequent consumption from the ground up. The foodservice and food- are steps in the right direction, but nowhere in manufacturing sectors have long been too reliant foodservice is there a greater need of creative, on salt to do the heavy lifting to create high flavor “disruptive” innovation than in the challenge impact and customer satisfaction. Single items, such to replace current soda and sugary beverage as a sandwich or entrée, might contain more than formulations with more healthful options. Operators 2,500 milligrams of sodium, well above the current should diligently research, support, and promote maximum recommended intake of 1,500 milligrams the products of entrepreneurs and emerging and to 2,300 milligrams for the entire day. Chefs should established brands that are rapidly developing focus on a range of other strategies to deliver flavor beverage solutions in this important area. Diet including: sourcing the best-quality, high-flavor sodas and other diet beverages, though lower in produce; working with spices, herbs, citrus, and calories, may reinforce an aggregate preference for other aromatics; and employing healthy sauces, sweet flavors, potentially driving down the appeal seasonings, and other flavor-building techniques of vegetables and other healthy foods. As such, from around the world. Many chefs are finding they should be consumed in smaller portions less success in focusing their innovation where they have frequently. the highest aggregation of sodium (e.g., processed meats, cheese, and bread) in a single menu item. 14. Drink healthy: from water, coffee, and tea Others are making progress in implementing an to, with caveats, beverage alcohol. Water is across-the-board incremental 10 to 20 percent the best choice to serve your customers, either sodium reduction in their preparations. Still others plain or with the addition of cut-up fruit, herbs are focusing on collaborating with manufacturing and aromatics, or other natural flavors—but no partners to reduce sodium using alternative sugar. Served plain, coffee and tea are calorie-free strategies to create desired flavors and textures. beverages containing antioxidants, flavonoids, and other biologically active substances that may be 13. Substantially reduce sugary beverages; good for health. Wine, beer, and other beverage innovate replacements. A drastic reduction in alcohol present a more complicated story of benefits sugary beverages represents one of the biggest for many individuals, with some offsetting risks. opportunities for foodservice operators to help Current nutrition guidance suggests a maximum of reverse the national obesity and diabetes epidemics. two drinks per day for men, and one drink per day Sugary beverages add no nutritional value and for women. contribute negligible satiety. Yet they are a prime source of extra calories in the diet and a principal contributor to the development of type 2 diabetes, heart disease, and other chronic conditions.

45 IX. CASE STUDIES: THE SELLING OF HEALTHY, SUSTAINABLE, DELICIOUS FOOD CHOICES

One of the unique contributions made by the 24 specific principles in deep and highly targeted ways. Principles of Healthy, Sustainable Menus is that they For this reason, attention is paid to, for instance, the provide comprehensive guidance that integrates overarching “LOHAS,” or “Lifestyle of Health and both environmental and public health imperatives. Sustainability,” movement pervading the foodservice Operators who are inspired to act upon the principles industry, along with the need for interdisciplinary food often find value in focusing on just a few at a time, systems-oriented research in order to shift eating acknowledging that their efforts will evolve over time patterns and agricultural practices at a large scale. in order to eventually address all or at least many Also highlighted are strategies for addressing a potential areas of improvement. single principle: for instance, the marketing tactic of using product placement in TV shows to make fruits This section of the report provides case studies and vegetables more appealing, or scaling a new including a new, curated compilation from the Menus fast casual model entirely focused on sustainable of Change University Research Collaborative. These seafood. In combination, the insights enclosed in this “…if you are in the restaurant business and analyses and concrete examples are meant to section should help ignite change across a broad you aren’t addressing the ‘LOHAS movement,’ inspire both the broad, all-encompassing pursuit of range of leaders committed to shaping a better healthier, more sustainable food choices and to equip future of food. you’re going nowhere.” foodservice professionals to take action to address —Paul Westra

46 1. Think carefully about your three pieces to demographic, psychographic relates to values, INVESTOR SPOTLIGHT: STIFEL of clay: the environment, the food, and hobbies, how people spend their time, and so on. the service. Stifel advises restaurateurs to find brands with Westra says the environment must be a from- which their foodservice brand can cross-pollinate, LOHAS IT OR LOSE IT scratch kitchen, with high-quality ingredients. The i.e. Athleta with Zoës, and locate new units near The focus on LOHAS doesn’t mean operators must food should be part of the LOHAS movement, those places. In December 2015, Paul Westra stood in front of a transition their menus to all vegetarian or make their because “that ties you to being part of a lifestyle National Restaurant Association meeting of chief brand 100 percent healthy, he says, but at least brand, not just a restaurant brand.” And great Ultimately, Stifel’s investment strategy comes down financial officers and declared that if you are in the elevate the emphasis on better quality ingredients, service should come from again, the how of a to that old saying of those doing good doing well. “If restaurant business and you aren’t addressing the and address the now mainstream request from company, specifically how it treats its employees. you don’t have a ‘come to Jesus’ speech for your diners to understand where food comes from. “LOHAS movement,” you’re going nowhere. Westra “People want to work for and patron brands that do employees about adopting LOHAS,” he says, “you “Whatever that means to your brand, it’s really is an equity research analyst covering restaurants things the right way…so that their consumers and should.” Because remember: LOHAS is not a fad or important in today’s marketplace for that to be a for Stifel, an investment bank based in Baltimore, employees effectively become brand ambassadors.” a trend. It’s a movement. where he works as a “glorified scorekeeper,” part of it,” Westra says. tracking who is losing and who is winning in the 2. Do more dinner sales than lunch sales; do restaurant business and why. LOHAS stands for “Lifestyle” in the LOHAS definition goes beyond more dine-in sales than takeout sales; and Lifestyle of Health and Sustainability; it includes health and the environment, he explains. Take serve more women than men. everything from fitness culture and farm-to-fork Shake Shack, for instance, which has tapped into Westra reports that these three elements are dining to green cleaning products and taglines such what Westra calls “the experience economy,” where required for a restaurant concept to make enough as “free-range,” “gluten-free,” and beyond. Stifel consumers, especially millennials, “want to be money that it’s worth building. He explains that estimates that LOHAS is already a $150-billion associated with brands that represent the values lunch is very competitive, meaning consumers supermarket business and is resonating with at they believe in, and that represent our better halves, least one third of American consumers. Stifel advises which includes how these companies treat the globe are less choosy about what they eat for lunch so hundreds of institutional clients (i.e., those managing and how they treat their employees.” Shake Shack’s they have low switching costs from one spot to mutual funds) as well as individuals who are making motto is “Stand for Something Good;” the company the next. In addition, the barriers to entry for lunch decisions about investing in the restaurant industry, expresses that through ethical and transparent are much lower than for dinner, i.e, you only need and LOHAS is at the core of their investing guidance. sourcing, donating to local communities, sustainable about $25,000 to open a food truck and make architectural design, and how it pays its employees. sandwiches. The second reason is that brands One of the restaurant brands that most embodies So Westra reports that Shake Shack does $1,500 don’t matter as much to people when eating Stifel’s LOHAS ideal (and has the stock figures in sales per square foot, and notes that people will at home, i.e, it’s rare to walk around your living to show it) is Zoës Kitchen. The fast casual wait in line for 20 minutes for a burger not because room with what he calls “that self-esteem cup of chain—which serves Mediterranean cuisine and of its nutritional value but because of how dining Starbucks.” Lastly, women make three quarters encourages customers to “taste the many ways the there becomes implicit support of the causes of dining decisions, his data suggests, so they’ll Mediterranean lifestyle inspires goodness”—attracts that Shake Shack represents. Stifel’s exact stock choose where the entire family is going to eat customers for its brand identity of sustainable, ratings for Zoës or Shake Shack will undoubtedly on a given night. “What’s really exploding on the all natural, wholesome, real food, made from change from day to day, but generally speaking, it marketplace today is counter service restaurants scratch. According to Stifel, Zoës’ sales trajectory advises clients that LOHAS is a trend with staying that can do dinner, dine-in, and women,” Westra indicates the potential for 10-fold growth, from power. It encourages clients to invest in the brands says. And what brand checks all of those boxes? that have enthusiastic consumers, or “strong local the 150 locations they have now to 1,600. To Zoës Kitchen. Stifel, Zoës is the mathematical definition “that this influencers,” who champion the brand through LOHAS movement is true.” But the power of the habits like taking selfies while holding a Shake 3. Understand your customers’ purchasing Zoës Kitchen brand, from Westra’s perspective, Shack bag in one hand. behaviors beyond food. extends beyond healthy Mediterranean food to the Westra’s consumer insights indicate that there are broader ethos of the Mediterranean lifestyle, which Stifel insists that how companies do something is far 52 types of people in America grouped by various he describes as staying in shape and spending more important than what they do—how they treat types of purchasing behaviors. His research shows time outdoors, the same “psychographic profile” their customers, their community, their employees, that most brands find that 20 percent of the types of as consumers who do yoga. Stifel points to Roti and the planet. So what does that mean, exactly? people—about 10 of the 52 types—make up over Mediterranean Grill, whose tagline is “food that Here are three rules of thumb Westra offers for 50 percent of their sales. This means that it is critical loves you back,” as one of several other examples designing a winning restaurant concept: to a foodservice operator’s success to understand of successfully leveraging the broader Mediterranean lifestyle. customers’ “psychographic profiles”: as opposed

47 MARKETING SPOTLIGHT: PRODUCE MARKETING ASSOCIATION MEETS ENTERTAINMENT RESOURCE & MARKETING ASSOCIATION

WHAT WILL IT TAKE TO SELL to designer sunglasses, but until now, the snack when January comes and everyone tries to make This is especially true for children. While Fresh CONSUMERS ON FRUITS AND and soda companies have been the ones mostly radical change it lasts two weeks; if they’re lucky, Takes is targeting all consumers, special taking advantage on the food side. Now, for to the Super Bowl. So instead of making it be opportunities exist for marketing “F&V” to VEGGIES? A FRESH TAKE. what appears to be the first time in the history this medicine message, just make it part of what children, so studios like Universal, Fox, and of Hollywood, fresh, non-branded fruits and people are already doing. When they order a especially Disney offer some of the most vegetables will start to get written into the plots hamburger, make sure they say ‘with lettuce and promising potential collaborations. For adults, the of popular TV shows: For instance, when the tomato and onion’ on it.” goal is to make it culturally normal to frequently Dunphy family from “Modern Family” is eating consume fresh fruits and vegetables; for children out at a restaurant, they might order pizza Much of the program involves building new and teenagers, it’s about that plus the cool factor. with mushrooms and green peppers instead of relationships with Hollywood’s writing teams. It’s sausage and extra cheese; or when they go out important to make these insertions as natural “When popular characters choose produce from for ice cream they might order it with fresh berries as possible, fitting with the personas and habits the store, the fridge, or the restaurant menu as on top. Produce items will also start to appear that popular television and movie characters are part of their everyday interactions, viewers will more on sets and in the background of shows already known for. The last thing Fresh Takes identify with that as the right way to eat,” said When it comes to selling food to American and movies: Again in “Modern Family”, Phil and leaders want is viewers thinking, “But Jay hates ERMA President Michael Schrager in the press consumers, fruits and vegetables don’t get the Claire Dunphy might have an argument in the to cook, he would never do that!” release. “By identifying shows with school age lion’s share of the marketing budgets. That’s a produce aisle of the grocery store, while pushing characters we hope we can help move today’s problem, because Americans on average aren’t a cart full of fresh produce; or more generally, two This innovative approach to increasing fruit and youth to a healthier lifestyle and lessen the eating nearly enough fruits and vegetables characters might have a conversation in a kitchen vegetable consumption in the United States incidence of problems such as childhood obesity.” compared to the daily recommended level with a large bowl of fruit sitting on the counter. has huge potential because humans relate and (see page 30). But an unprecedented new identify with the characters we watch on TV. partnership is betting on the potential of a With the program tagline “We supply the produce. powerful tactic in Hollywood: product placement. You supply the set,” PMA, through its members, Last fall, the Produce Marketing Association makes non-branded fresh produce items available (PMA) announced a new strategic alliance to motion picture companies, TV studios, with the Entertainment Resource & Marketing and online entertainment producers to use at Association (ERMA) to increase the appearance no charge. Given PMA’s philosophy of “More of fresh produce on television shows, movies, Matters,” Fresh Takes could build on existing and online entertainment. PMA is the leading product placement—say, when a cereal company trade association for all segments of the global is already paying to be in a scene, Fresh Takes produce industry, and ERMA is an association of can nudge directors to have the character add entertainment marketing professionals who work bananas. There are also opportunities for what with production studios. They have a track record waiters do on screen, adds Kathy Means, vice of growing demand for products by making them president of industry relations for PMA. A script ubiquitous on-screen. The idea behind their new could have waiters asking diners if they want to joint program “Fresh Takes” is to weave in more add a salad to their entree, she says, or when air time for fresh produce items so that Americans mentioning the evening’s specials, they could subconsciously start to associate these items as be reading those that make plant-centric dishes normal, as part of everyday life. sound the most irresistible. “How [characters] order, those throw-away lines could have a huge People watch an average of four hours of impact on somebody at home,” Means says. television per day; that’s just the screen time for TV, which becomes much greater when you Importantly, though, Fresh Takes does not involve add entertainment consumed online. Product a health message. Means says, “We want this placement is a tried and true strategy, from cars to be reflective of how people are. We know that

48 EMERGING CHAIN SPOTLIGHT: LUKE’S LOBSTER

TRAP TO TABLE soon as you take that lobster out of its habitat, it’s not moving the way it is supposed to; it’s not When walking into Luke’s Lobster, a “taste the in water of the correct temperature; the salinity is source” chalkboard on the wall indicates the exact off; it’s not eating its normal diet. All those things harbor where the lobster in the lobster roll was contribute to the flavor and texture of the meat. caught. The server at the counter will then explain So rather than trying to keep lobster alive as it’s that, for example, Stonington is located in Downeast shipped around the country, we cook it at its Maine, and it is named after old rock quarries, which freshest possible moment.” The tail cooks faster used to be a big part of the economy that today than the knuckles and claws, so using a convection relies more on lobstering. You’ll then hear about steamer, Luke’s cooks each piece to the texture and the sustainable fishery management practices the temperature that will lock in the best possible flavor Stonington lobstermen abide by, which include for that piece, which has been carefully graded by throwing egg-bearing female lobsters back into size. “Guests are really blown away by the level the water, but only after first v-notching their tail of flavor, the sweetness, the tender texture of the flippers. That indicates to any future lobsterman meat,” Conniff continues, “because they’re used to who pulls her up at a time when she doesn’t have eating lobster that somebody brought home and eggs that she’s a good breeder, so he’ll toss her threw the whole lobster in the pot and boiled or back as well to keep her in the population. Finally, steamed it until it was pretty red and they said, ‘OK, when you receive your lobster roll, your receipt will it’s done.’” list more information about the harbor of origin and sustainable fishing practices. Luke’s sources the lobster for all its locations from the Maine lobster fishery 70 percent of the year. The In a time of pervasive mislabeling of seafood— exceptions are May-June and December, when it and a new Presidential Task Force on Combating sources from Canadian fisheries because those are Illegal, Unreported, and Unregulated (IUU) Fishing especially active during those times of year, while and Seafood Fraud (see page 31)—this fast the Maine lobster fishery is slower. Doing so helps showcase the quality of the lobster. Health was not Do customers bristle at these price points for casual seafood restaurant group is founded on prevent over-fishing. a leading focus when Conniff and Luke Holden (co- sandwiches and salads? Initially, some did. But as the principles of sustainability and traceability. The founder and CEO) started the business. Like many diners learn everything that has gone into bringing Maine-style lobster shack was started in 2009 “Sustainability for us is about committing to other types of seafood, lobster is a healthy source them their lobster roll—the lobsterman waking up at and now has 19 locations in New York, Boston, practices that ensure the population of the of protein with omega-3 oils and other vitamins dawn, pulling up traps one by one, carefully handling Philadelphia, DC, Chicago, and Las Vegas. Luke’s species is maintained and growing at rates that and minerals. And now, they realize, especially with each lobster one by one to make sure it stays alive is a fully vertically integrated company, owning and a lobsterman’s children and grandchildren and their fast-casual format, the health benefits may be from the boat to the dock to the processing facility, carefully controlling everything that happens from great-grandchildren will have as good of a chance the secret to transforming lobster from something then the painstaking grading and cooking of each the dock to the plate. “It’s the same transparency as of making a living on that resource as a lobsterman Americans eat only on special occasions or very piece to its optimal specifications, having third party if you were in a traditional Maine lobster shack sitting today does,” Conniff says. It just so happens that infrequently to something they eat every week. and government organizations inspect for food right on the dock where the seafood was landed,” that long-sighted business incentive of ensuring the safety and quality, and finally sending the lobster out says Ben Conniff, co-founder and president. Luke’s viability of the local economy coincides with what’s In addition to lobster rolls, which are $16, the menu to restaurants, where time is invested to educate even built its own seafood processing company, best for the environment: preserving and even includes crab and shrimp rolls, soups, and a winter and train servers about sustainable fishery practices Cape Seafood, to process its five million pounds of growing the population of Maine lobster, which has “Tail & Kale” salad at $14 that was a big seller: a so they can talk with customers about what they’re lobster annually. tripled in the last 20 years. whole steamed, chilled lobster tail on a bed of baby eating—their sticker shock turns to appreciation. A kale, a scoop of hot quinoa, a scoop of chickpeas, willingness to pay “what the food is really worth,” Along with allowing greater control over quality, In the restaurants, it’s all about flavor. When Luke’s topped with roasted pumpkin seeds and pickled Conniff says. Whether that insight is a sign of where having its own processing facility also enables the team developed the recipe for its lobster roll, its onions, and dressed with poppyseed vinaigrette. In fast casual cuisine is headed more broadly, it seems company to optimize taste. Conniff explains: “As bestseller, it didn’t go light on mayonnaise or butter light of this success, Luke’s will continue to offer a the writing is literally on the wall. due to health concerns, but because it wanted to rotation of seasonal salads.

49 BETTERING OUR FOOD CHOICES AND OUR FOOD SYSTEM: INSPIRATION FROM THE MENUS OF CHANGE UNIVERSITY RESEARCH COLLABORATIVE

of manufacturers that are industry leaders in • To help make whole, intact grains the norm, salads on its retail menus. Now the salads, addressing health and environmental issues. University of New Hampshire offers an oatmeal without protein, are listed as the menu item, MCURC members work to leverage the unique station every day at all dining halls and features while an assortment of proteins are listed as opportunities in the higher education sector for four different types of whole grains each day in optional add-ons. Executive Director of Dining, advancing culinary literacy and nudging young its salad bars. Conference and Catering Services Cheryl adults towards healthier, more sustainable Garner and her team were encouraged to food and lifestyle choices. They also work on • At UC Berkeley, a new café called brown’s change the defaults in part by the realization interdisciplinary, food systems–level research, was launched at the start of the 2015-2016 that 27 percent of purchases on campus are including the use of campus dining facilities as academic year with the vision of a “delicious, vegetarian or vegan. As Garner says, her team plant-forward, local, seasonal, and educational” felt it “could satisfy more people with a single living laboratories to test strategies for behavior menu and an emphasis on transparency. Cal concept this way. They can just opt in for a change. Dining Executive Director Shawn LaPean protein if they want one.” had workshopped this concept at the 2015 Since its inception, MCURC has held its first Menus of Change conference during the • Many member campuses have embraced the annual summit, produced educational resources, “Make It Work in Your Operation” breakout “Protein Flip” strategy advanced by Menus of and dedicated its research energy on three session and, following invaluable audience Change, whether through healthy bowls that specific areas of inquiry: food waste, values-based input on his approach, he and his team offer small servings of meat as a condiment or purchasing metrics, and reimagining the role of were able to transform the old campus blended burgers of meat with vegetables or animal and plant proteins on menus. Over time, its restaurant. Brown’s does not offer soda or grains. website will provide recipes, toolkits, and training other sugar-sweetened beverages, sources materials, as well as findings from multi-site, 80 percent of its ingredients from within ǷǷ At Yale, the sweet potato and quinoa patty interdisciplinary research. 250 miles, and practices primarily scratch is a top seller. cooking. Additionally, its reimagined menu What follows is a sampling of some of the exciting includes a “flipped plate” concept where ǷǷ In a partnership with the Mushroom To accelerate the move among American ways that MCURC members have been working patrons can order two plant-based options Council, Harvard University Dining Services consumers—in particular college students, faculty, to accelerate the adoption of Menus of Change and one animal protein. The menu economics (HUDS) replaced some of the meat in and staff—towards healthier, more sustainable, principles in their campus dining operations, while of $8 for the flipped plate (or $6 for a plate 10 beef-based dishes with mushrooms, plant-forward diets, The Culinary Institute of fostering research and education to advance of three plant-based sides) compared to ultimately reducing saturated fat by 31 $12 for the traditional plate nudges students percent and calories by 20 percent. They America and Stanford University have partnered a food system that supports better health for toward a plant-based plate. Sales have estimate that transitioning to “the blend” over the past year and a half to launch the Menus both humans and the environment. For a full exceeded expectations and response has been in just one five-pound meatloaf recipe, of Change University Research Collaborative overview of the initiative as well as a complete list overwhelmingly positive. served in just one meal service, lowered (MCURC). The collaborative brings together and detailed profiles of the member institutions the carbon footprint by the equivalent of campus executive chefs and foodservice directors, involved, please visit moccollaborative.org. • Many foodservice operators within and beyond taking a car off the road for six months. leaders in university administration and business, campus dining have realized that diners often Student response has been so enthusiastic and academic faculty in relevant disciplines to MENU CONCEPTS avoid the salad bar because of negative that the meat/mushroom chili is now a daily collaborate on research and education in support experiences they have had with the salads lunch feature, and a quarter of all burgers of culinary-centric, evidence-based food system Last fall, The Hartman Group reported, “College they have composed for themselves in the are blended turkey with brown rice and innovation within and beyond universities. dining halls are increasingly being seen as an past. To empower diners with better salad- vegetables. extension of the classroom where students are making skills, University of Southern California With representation from 37 colleges and being educated about healthy and sustainable posts engaging signs that offer step-by-step ǷǷ Sales of UC Riverside’s “Earth ‘N’ universities, membership ranges from Ivy League food choices.” The dining divisions of MCURC instructions for making a salad that is both Turf” burger have matched those of its schools to large state universities, along with member institutions take these responsibilities, healthy and delicious. cheeseburger. The menu board touts that supporting ex officio membership from select and these opportunities, very seriously. Developing the blended burger is 40 percent wild organizations outside of higher education. innovative menu concepts and dining stations is • As part of its “Think Produce First” campaign, mushroom, 60 percent grass-fed beef, and Sponsorship support comes from a variety one such strategy: UC Riverside made a switch in the summer “100 percent moist and delicious.” of 2015 to de-couple proteins from most

50 that the university’s dining department has Residential Dining Garett DiStefano told The • Each quarter, as part of its Seeds of Change • In UCLA’s Bruin Plate, the largest residential invested in local and sustainably produced Hartman Group blog Hartbeat, “Modeling program (its adaptation of the Menus of restaurant on campus, the concept is “fresh, products over the past decade-plus have serving sizes helps students understand that Change principles), UC Riverside’s dining delicious and wholesome food” while following significantly boosted the state’s agricultural their ‘normal’ may actually be overeating. We department does a full-throttle campaign the best practices available for sustainable economy and helped accelerate a transition to can help them understand that feeling full can around a single Menus of Change principle. foodservice operations. The LEED Silver certified more sustainable agricultural systems. be accomplished with plant-based proteins Each campaign consists not only of the given facility does not have any deep fryers or sugar- that are healthier for them.” As an example of purchasing change or menu change, and sweetened beverages (instead offering in-house • At University of Southern California, changing what is considered a normal portion rolling that out across retail, catering, and flavored waters, iced tea, and other healthy Executive Chef Eric Ernest and his team have size, UMass offers its smoothies in four- residential dining, but staff training around how drinks), and provides additional delicious choices developed a “Food Philosophy”—a thoughtful ounce cups. to communicate to students, displaying visually not often found in campus dining settings. articulation of the values system set forth by engaging marketing materials, and offering These include a nut butter bar and a dessert USC Hospitality, and their unique ways of • UC Santa Barbara’s Director of Residential educational resources and presentations station called “Sweet Bites” where students can interpreting, acting upon, and evaluating their Dining Jill Horst partnered with Professor for students and staff. For instance, with its fill large bowls with fresh whole and sliced fruit performance with respect to Menus of Change David Cleveland in the environmental studies “Choose Healthier Oils” campaign, Executive or choose from a few more indulgent options, Principles and other core beliefs. For instance, department to create a program where Chef of Retail Dining Burke Reeves created which are all 200 calories or less. Through large the document states, “Our chefs constantly students can intern in the dining department. a quick reference guide for all culinary staff, windows, soft tones, wood surfaces, low-water strive for the elevation of culinary strategy as a One project involved precise measurements of requiring mastery of key teaching points for succulent plants, and artwork such as hand- nutritional advantage. We meet our customers’ food waste. In another project, a student intern engaging students at the salad serving station, painted depictions of native culinary herbs, the needs of the present without compromising the gained a valuable new skill while addressing a describing the health benefits of trying a overall design goes hand-in-hand with the menu ability of future generations to meet their own critical need for the dining division: conducting dressing made from a variety of delicious olive concept to support the mission of fostering needs.” The USC Hospitality Food Philosophy a gap analysis, a thorough “How are we oils and vinegars. mindful eating. includes specific sourcing standards and doing?” with respect to the 24 Menus of guidance for working with smaller producers. Change principles. The analysis helped shed CURRICULAR OFFERINGS AND ǷǷ While many MCURC members aim Some of its key values include: recognizing light on many existing successes and bright to encourage mindful eating through the opportunities presented by increased spots—for instance, all of UCSB’s seafood STUDENT ACTIVITIES educational flyers, information booths and global connectivity for introducing diners to sourcing is considered “best” and “good” • A growing number of colleges and universities fairs, dedicated de-stress zones, warm greater culinary adventure; always leading by Monterey Bay Aquarium Seafood Watch are building teaching kitchens or already offering lighting and inviting furniture, they also with messages about flavor; the belief that guidelines; its shift to tray-less dining in 2009 hands-on cooking courses, nutrition education, recognize that students are busy and often “preservation of family traditions and centuries- reduced plate waste by 50 percent and saved food literacy, mindfulness, and other food- want to eat on the run. In meeting students old food cultures is as vital as public health a million gallons of water per year; and in one related life skills training through existing facilities. where they are, operators are innovating and environmental sustainability,” along of the main dining commons, whole-wheat Numerous MCURC member institutions are around hand-held, grab-and-go offerings. with a celebration of the great compatibility pizza crust is always available—but they helping to pioneer a movement with CIA-Harvard For instance, UC Riverside offers a Greek between all three imperatives; and an emphasis realized there were other areas that needed Chan School’s Teaching Kitchen Collaborative yogurt berry parfait wrap in a whole-grain on “continuing education for our culinary significant improvement. Added sugars stood (see page 37) about the importance of teaching tortilla as a to-go item all day. Several professionals that will enhance creativity, out as a spot to improve upon, specifically kitchens—developing best practices, spreading campuses are offering healthier snacks in employee engagement and increased guest breakfast cereals, soda, and desserts, so they awareness about the potential health impacts university-run convenience stores and mini satisfaction.” have made that a priority area to work on, for for participants, and addressing increasing grocery markets, and others have mobile example by using more fruit to sweeten dishes. student demand to gain cooking skills during their produce and healthy snack stands • Leaders of University of Washington’s Housing college years. These institutions include: Harvard, across campus. and Food Services Department worked with • University of New Hampshire was recently Princeton, Stanford (through licensed curriculum Coca-Cola and International Paper to develop recognized by Farm to Institution New England provided by MCURC ex officio member the first compostable soft drink cup, and (FINE) as a “Sea to Campus Case Study”: In organization Jamie Oliver Food Foundation), with Starbucks to develop their first line of 2014, a student named Spencer Montgomery STAFF TRAINING, PURCHASING, UC Berkeley, UCLA, UC San Diego, and UC compostable cups. founded a student group called Slow Fish San Francisco, as well as ex officio member AND OPERATIONAL INSPIRATION UNH to raise awareness about the need to organization Google. • University of Massachusetts, Amherst found support local fisheries. The group’s outreach • Through a program called “UM Farm to through its annual survey that 35 percent of its and educational efforts persuaded University College,” University of Montana directed over a • Faculty members are working rapidly to add more students report eating less beef since arriving leaders to sign on to Slow Fish Principles million dollars in just the past fiscal year to local food-related courses each academic year, and as at UMass, and 94 percent indicate a goal to and make a stronger commitment to not only and sustainable food purchases, representing many as 30 U.S. colleges and universities now eat more fruits and vegetables. UMass employs sourcing more local seafood but menuing more nearly a third of UM Dining (UMD)’s annual offer official degrees or minors in food studies a small plates format throughout its stations, underutilized species. Incidentally, Spencer is food budget. UMD partners with over 150 or food systems. (The number is much higher if both to reduce waste and to communicate now the Seafood Operations Manager at the different farmers, ranchers, and food producers programs in sustainable agriculture are included.) appropriate portion sizes. UMass Director of regional distributor Dole & Bailey. throughout Montana. The millions of dollars A few highlights of the course offerings:

51 sciences and agriculture, college of who also advised Cal Dining on the brown’s community—the Consortium incubates ǷǷ University of Washington offers an business and economics, and its renowned cafe concept and co-led the 2016 CIA- research collaborations such as a undergraduate course taught by Assistant Sustainability Institute. Harvard Healthy Kitchens, Healthy Lives partnership between faculty, students, and Nutritional Sciences Professor Jennifer conference (for more on this, please see Northeastern Dining to study pathways for Otten entitled “Food Studies: Harvest to ǷǷ At UC Berkeley, which offers an page 36). expanding food purchases from local and Health,” and the wait list has dozens of undergraduate minor in food systems, regional providers. students, not to mention graduate students students in the food systems organization ǷǷ University of Montana offers a sustainable trying to sit in. Attendance in her course and management course are given the food and farming emphasis through RESEARCH: SPOTLIGHT ON UCLA has more than doubled in the past three project assignment of working at a Cal the environmental studies department. While multi-site research is currently underway years, as has interest in her course “U.S. Dining facility and adapting a recipe using While it is not an official degree, both across MCURC member campuses, over the past Food and Nutrition Policy,” forcing her to the Menus of Change Principles of Healthy, undergrad and grad students may add this few years, it has been exciting to see individual find larger lecture halls. Sustainable Menus. Working in small concentration to their course of study, and colleges and universities conducting inventive cross- teams and paired with an executive chef it includes opportunities for hands-on work departmental studies on their own students and staff ǷǷ In early 2013, the UCLA Healthy Campus or manager, students must calculate the growing organic food on a local farm. in order to gain insights related to behavior change. Initiative was launched to support the immediate food costs associated with the UCLA is just one example of an MCURC institution idea of “the healthy choice as the easier menu change, as well as the menu item’s ǷǷ Northeastern University offers a new with a strong track record of doing so. choice.” It brings together campus-wide long-term financial sustainability. They minor in food systems sustainability, stakeholders to coordinate existing efforts must also think through the marketing health, and equity, and it is one of several In a collaboration between the Healthy Campus and work on new, highly focused, carefully opportunities of the menu item, portion outgrowths of its Consortium on Food Initiative and UCLA Housing and Hospitality evaluated projects in five themed areas control, equipment and kitchen layout Systems Sustainability, Health, and Equity, Services, researchers converted 38 percent of (called “pods”): MindWell, BEWell (Built needs, along with anticipated challenges a university-wide collaboration among the 105 vending machines across campus (which Environment), EatWell, MoveWell, and of making the menu change, such as faculty, students, and staff. In addition see about 2,000 total purchases per day) into BreatheWell. In order to pedagogically consumer acceptance, allergen concerns, to sponsoring talks and symposia— HCI approved machines. For machines with that strengthen the EatWell component of the staff training needs, and so on. The course over the past decade Northeastern’s designation, snacks deemed to be healthier were HCI mission, UCLA recently launched is required for the nutrition-dietetics major one-of-a-kind Xhibition Kitchen has given an “Eat Well” sticker and placed at eye level. both a food studies minor, with courses in the Nutritional Sciences and Toxicology welcomed more than 350 guest chefs and Campus-wide, prices were adjusted to incentivize for the interdisciplinary program spanning department and is taught by Registered cookbook authors to provide interactive the sale of healthier items and discourage the sale departments such as English, world Dietitian Nutritionist Kristen Rasmussen, cooking demonstrations for the campus of popular unhealthy items. Rigorous nutritional arts and cultures, environment and criteria were used to evaluate all the food products sustainability, and community health for inclusion or exclusion as “healthy,” and these sciences, and a new graduate certificate assessments were informed by healthy vending in food studies, across departments such guidelines supplied by Los Angeles County as well as anthropology, psychology, agriculture, as UCLA nutritionists. The pilot vending machines law, geographic, and natural and social sold about seven times the number of healthier sciences. They succeeded in developing items compared to the regular machines, while the latter by identifying existing food- maintaining the machines’ financial performance. related courses on campus, and formalized Supplemental survey data showed that about two it for students by making it a certificate thirds of a sample of vending machine customers felt program. It’s open to any graduate or there were not enough healthy options available on professional student on campus. It aims campus vending machines. Bolstered by the results to foster robust interdisciplinary learning, of the first year of the study, the UCLA vending team conquering the current divide seen on increased the number of healthy choices in many campuses where students studying all machines. arts and humanities speak entirely different languages and operate in completely Continuing this collaboration, starting in fall quarter different worlds from students studying 2016, HCI and H&HS will embark on a two-year sciences and engineering. study of a residential dining hall’s “flex station” to test whether the new station’s selection of enticing ǷǷ In addition to degree programs in prepared salads, slow-simmered braises, and sustainable agriculture and food systems, roasted and fermented vegetables can increase University of New Hampshire offers a dual consumption of plant-based foods and lower major in ecogastronomy, a collaboration consumption of animal protein. between the university’s college of life

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N-print.org http://bipartisanpolicy.org/wp-content/uploads/sites/default/files/Med_Ed_ Issues and Options. Rome: United Nations Food and Agriculture Organization. Report.PDF Oceana. October 2015. Oceana Reveals Mislabeling of America’s Favorite Sustainable Agriculture Initiative Platform. Saiplatform.org Tilman D. and Clark M. 2014. Global diets link environmental sustainability and Fish: Salmon. Usa.oceana.org Centers for Medicare and Medicaid Services of the U.S. Department of human health. Nature. 515.7528: 518-522. The Water Footprint Network. Waterfootprint.org Health and Human Services. National Health Expenditure Fact Sheet. Pershing A.J. et al. Oct 29 2015. Slow adaptation in the face of rapid Available at: http://www.cms.gov/Research-Statistics-Data-and-Systems/ The WorldWatch Institute: http://www.worldwatch.org warming leads to collapse of the Gulf of Maine cod fishery. Science. The White House Office of the Press Secretary. December 15 2015. 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55 MENUS OF CHANGE SCIENTIFIC AND TECHNICAL ADVISORY COUNCIL

Walter Willett, MD, DrPH Thomas Harter, PhD Eric Rimm, ScD CHAIRMAN Robert M. Hagan Endowed Chair in Water Director, Cardiovascular Epidemiology Program Professor of Epidemiology and Nutrition Management and Policy Associate Professor of Epidemiology and Nutrition and Chairman Professor of Medicine University of California, Davis Harvard T. H. Chan School of Public Health Department of Nutrition at Harvard T.H. Chan Davis, CA Boston, MA School of Public Health Harvard Medical School Marty Heller, PhD Steve Running, PhD Boston, MA Research Specialist Director, Numerical Terradynamic Simulation Group University of Michigan Center for Sustainable Systems University of Montana Lawrence Appel, MD, MPH Traverse City, MI Missoula, MT Professor of Medicine, Epidemiology, and International Health (Human Nutrition) Frank Hu, MD, PhD Frank M. Sacks, MD Johns Hopkins University Professor of Nutrition and Epidemiology; Professor of Cardiovascular Disease Prevention School of Medicine Co-Director of the Program in Obesity Epidemiology Harvard T.H. Chan School of Public Health Baltimore, MD and Prevention Boston, MA Harvard T. H. Chan School of Public Health Lilian Cheung, ScD, RD Boston, MA Barton Seaver Director of Health Promotion & Communication Director of the Healthy and Sustainable Food Program Department of Nutrition, Betty Izumi, MPH, PhD, RD Center for Health and the Global Environment Harvard T. H. Chan School of Public Health Assistant Professor Harvard T.H. Chan School of Public Health Boston, MA School of Community Health, Portland State University Cambridge, MA Portland, OR Carolyn Dmitri, PhD Michael Tlusty, PhD Associate Professor of Food Studies Greg Keoleian, PhD Director of Ocean Sustainability Science New York University Professor & Co-Director New England Aquarium New York, NY Center for Sustainable Systems, Boston, MA University of Michigan David M. Eisenberg, MD Ann Arbor, MI Russell Walker, PhD Adjunct Associate Professor & Director of Associate Director of the Zell Center Culinary Nutrition Robert Lawrence, MD for Risk Research Harvard T.H. Chan School of Public Health Center for a Livable Future Professor and Professor Clinical Associate Professor of Managerial Boston, MA of Environmental Health Sciences, Health Policy, and Economics and Decision Sciences International Health Kellogg School of Management, Rick Foster, PhD Johns Hopkins Bloomberg Northwestern University W.K. Kellogg Professor in Food, Society School of Public Health Highland, IL and Sustainability Baltimore, MD Michigan State University Parke Wilde, PhD East Lansing, MI David S. Ludwig, MD, PhD Associate Professor Professor of Pediatrics Tufts University Friedman School of Nutrition Christopher Gardner, PhD Boston Children’s Hospital Science and Policy Professor of Medicine Director Boston, MA Stanford University New Balance Foundation Obesity Prevention Center Palo Alto, CA Boston, MA

Andrew Hargadon, PhD Ellen M. Markman, PhD Charles J. Soderquist Chair in Entrepreneurship Lewis M. Terman Professor of Psychology, Senior Professor of Technology Management Associate Dean for the Social Sciences Graduate School of Management, Stanford University University of California, Davis Stanford, CA Davis, CA COUNCILS

56 MENUS OF CHANGE SUSTAINABLE BUSINESS LEADERSHIP COUNCIL

Arlin Wasserman Danielle Gould Jim Prevor CHAIR Founder and CEO, Food and Tech Connect Founder & Editor-in-Chief, Produce Business Partner, Changing Tastes New York, NY Boca Raton, FL Lenox, MA Claudia Hogue Michelle Markesteyn Ratcliffe Michiel Bakker Foodservice Marketing Director, VP, Sales and Marketing and Farm to School Specialist, Director, Global Food Services, Google, Inc. Alaska Seafood Marketing Institute (ASMI) Truitt Family Foods Mountain View, CA Seattle, WA Salem, OR

Shelley Balanko Nicolas Jammet William Rosenzweig SVP, Business Development, The Hartman Group Co-founder, Sweetgreen Dean and Executive Director, Bellevue, WA Washington, DC The Food Business School San Francisco, CA Dan Barber Michael S. Kaufman Chef/Co-owner, Blue Hill at Stone Barns Partner, Astor Group Diana Simmons New York, NY Chappaqua, NY Director of New Product Commercialization Clif Bar & Company Rick Bayless Ellen Kennedy Emeryville, CA Chef/Owner, Frontera Grill Principal, Ellen Kennedy Consulting Chicago, IL Takoma Park, MD Rafi Taherian ‘95 Executive Director, Yale Dining Stephanie Chenevert Dan Kish ‘88 New Haven, CT Global Food Program Marketing Manager, Google, Inc. Senior Vice President of Food, Head Chef, Mountain View, CA Panera Bread Kirsten Saenz Tobey Millbrook, NY Founder and Chief Innovation Officer, Gail C. Christopher Revolution Foods Vice President for Program Strategy, Arik Markus Berkeley, CA W.K. Kellogg Foundation Former Brand Chef – True Food Kitchen, Battle Creek, MI Formerly with Fox Restaurant Concepts Ken Toong Phoenix, AZ Executive Director, Auxiliary Enterprises, Sierra B. Clark University of Massachusetts Graduate, New York University, Food Studies Jehangir Mehta ‘95 Amherst, MA Washington, DC Executive Chef/Owner, Mehtaphor, Graffiti New York, NY Scott Uehlein ‘85 Amanda Cohen VP, Product Innovation, Sonic Drive In Chef/Owner, Dirt Candy Bart Minor Oklahoma City, OK New York, NY President and CEO, The Mushroom Council San Jose, CA Marc Zammit Christy Consler Partner, Changing Tastes CEO, Sustainable Leadership Advisors, Inc. Eric Montell ‘89 Los Gatos, CA Emeryville, CA Executive Director, Stanford Dining Stanford, CA Anthony Zolezzi Steve Ells ‘90 Operating Partner, Pegasus Capital Advisors Founder and CEO, Chipotle Kim Morgan New York, NY Denver, CO Vice President, Marketing, Unilever Food Solutions Lisle, IL David Feller Founder and CEO, Yummly Steven Petusevsky ‘77 Palo Alto, CA Founder and Principal, Steve M. Petusevsky Enterprises Plantation, FL COUNCILS

57 MENUS OF CHANGE ANNUAL REPORT

CONTRIBUTORS AND REVIEWERS EDITORIAL COMMITTEE (ADVISORY COUNCILS) Editor: Sophie Egan, MPH Director of Programs and Culinary Nutrition for Michiel Bakker Strategic Initiatives, The Culinary Institute of America Molly Elizabeth Brown, PhD Managing Editor: Anne E. McBride Sierra B. Clark, PhD Culinary Programs and Editorial Director for Christy Consler Strategic Initiatives, The Culinary Institute of America Carolyn Dimitri, PhD Greg Drescher David M. Eisenberg, MD Vice President for Industry Leadership and Strategic Initiatives, The Culinary Institute of America Christopher Gardner, PhD Danielle Gould Arlin Wasserman, MS, MPH Chair of the Menus of Change Sustainable Business Thomas Harter, PhD Leadership Council, Principal and Founder of Marty Heller, PhD Changing Tastes Claudia Hogue Walter Willett, MD, DrPH Frank Hu, MD, PhD Chair of Menus of Change Scientific and Technical Ellen Kennedy Advisory Council, Professor of Epidemiology and Nutrition and Chairman of the Department of Nutrition Robert Lawrence, MD at Harvard T. H. Chan School of Public Health, David S. Ludwig, MD, PhD Professor of Medicine at Harvard Medical School Ellen Markman, PhD DESIGN Jehangir Mehta Eric Montell Jason Wright J Wright Design Michelle Markesteyn Ratcliffe, PhD www.jwrightdesign.com Steven W. Running, PhD For reproduction, please contact Michael Tlusty, PhD [email protected] Russell Walker, PhD Parke Wilde, PhD

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The Menus of Change® (MOC) Annual Report and Annual Leadership Summit are co-presented by The Culinary Institute of America (CIA) and Harvard T.H. Chan School of Public Health—Department of Nutrition. The Menus of Change Scientific and Technical Advisory Council composed of leading nutrition, environmental, and other scientists and scholars (menusofchange.org/advisory-councils/stac/), together with Harvard Chan School and CIA, are solely responsible for the nutrition and environmental guidance of the report and conference. The Menus of Change Sustainable Business Leadership Council (menusofchange.org/advisory-councils/sblc/) contributes insights to parts of the report and conference designed to help translate this guidance into industry change; highlights case studies in innovation (e.g. menu research and development, product sourcing, and supply chain management, etc.); and builds industry participation in supporting healthier, more sustainable menus. Project sponsors and other commercial interests are not permitted to

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