ITE BS V E IS I W T R O U U R O T W I E S I B V S I T E A guide to sustainable menus A step by step approach to sustainablility November 2019 Written by: Annie Marquez, RD, Manager of Food Services, CIUSSS Centre-Sud-de-l’Île- de-Montréal, Quebec Allison Gacad, BSc Candidate, Loran Scholar, University of British Columbia With the participation of members of the Nourish Sustainable Menu Collaborative Project Elaine Addison, Director of Nutrition and Food Services, Horizon Health Network, New Brunswick Kathy Berger, Manager of Food Services & Switchboard, Health Sciences North, Ontario Béatrice Dagenais, RD, M.Sc. Student, Université de Montréal Annie Dodier Desroches, RD, Food service Menu Specialist, CHU de Ste-Jus- tine, Quebec Travis Durham, Director of Dietary Services & Information Technology, Grove Park Home, Ontario Cheryl Cooke, Manager of Central Okanagan Food Services, Interior Health, BC Beth Hunter, Program Director, The J.W. McConnell Family Foundation, Quebec Josée Lavoie, Manager of Food Services, CHU de Ste-Justine, Quebec Marilyn Lo, Divisional Dietary Systems Specialist, Health Services, Long Term Care, Regional Municipality of Peel, Ontario Geneviève Mercille, Assistant Professor, Department of Nutrition, Faculty of Medicine, Université de Montréal Charlotte Pilat Burns, RD, Regional Manager in Food & Nutrition Services, Saskatchewan Health Authority Jennifer Reynolds, Institutional Food Program Manager, Food Secure Canada, Quebec Susan Taylor, RD, Provincial Manager Standards and Initiatives, Nutrition and Food Services, Nova Scotia Health Authority Linda Varangu, Executive Director, Canadian Coalition for Green Health Care, Ontario External reviews by: Olivier Boiral, Full Professor, Faculty of Business Administration, Department of Management, Université Laval, Quebec, and Canada Research Chair in Internalization of Sustainability Practices and Organizational Accountability Marie-Christine Brotherton, Research Assistant, Canada Research Chair in Internalization of Sustainability Practices and Organizational Accountability, Faculty of Business Administration, Department of Management, Université Laval, Quebec Stacia Clinton, National Director, Healthy Food in Health Care Program, Health Care Without Harm (USA) Stéphanie Côté, RD at extenso.org Pamela Mason, co-author of Sustainable Diets Colleen Thorpe, Director of Educational Programs at Équiterre Leslie Whittington-Carter, Public Affairs Manager, Health Systems, Dietitians of Canada. Stephen Jones, Freelance editor and translator Project funded by: The J.W. McConnell Family Foundation; Ministère de l’agriculture, des pêcheries et de l’alimentation du Québec; Ministère de la santé et des ser- vices sociaux du Québec. CIUSSS Centre-Sud de l’Île-de-Montréal. TABLE OF CONTENTS v1 Introduction 06 v 1 What—and who—is this guide for? 07 v 2 What is a sustainable menu? 07 v Quality v Social values v Environment v Health v Economy v Governance v 3 How to use the guide 12 v Defining a new offering for a new clientele v Improving food service functioning and equipment v Putting sustainable foods on the menu v 4 Challenges and opportunities to adopting sustainable menus 14 v Cost v Shortage of resources v Negative perception by the clientele v Lack of control v Organizational support v 5 Information you will not find in the guide 18 v2 The steps involved in creating a sustainable menu 20 v 1 Define your objectives and basic principles 21 v Objectives v Basic principles v 2 Determine types of clientele and evaluate their particular needs 23 v 3 Define the menu format 24 v Cycle menu or à la carte menu? v Menu characteristics v Typical day menu v 4 Planning nutritional and financial guidelines 26 v Canada’s Food Guide and provincial guides v Size of servings and serving utensils v Cost guidelines v 5 Creating the menu 27 v 6 Evaluate the menu 29 v Engaging eaters v Evaluation procedure v Method for gathering comments v 3 Sustainable elements in food service 2019 operation and equipment 31 — v 1 Production and distribution 32 v 2 Human resources 32 v Position structure v Training and qualification Guide to sustainable menus TABLE OF CONTENTS v 3 Sustainable equipment and storage spaces 33 v Characteristics of sustainable equipment v Sustainable characteristics of storage spaces: v 4 Production standards 36 v Service tailored to the needs of the clientele v Working method (preparation, cooking, cooling, washing) v Keep abreast of new trends v Other References 38 v4 Choosing your sustainable protein 39 v 1 Sustainable proteins 41 v 2 What are my protein standards? 44 v 3 Making sustainable protein choices 45 v Legend for charts b) and c) v What do I need to change? v How can I change? v 4 Varying protein format 56 v 5 Controlling waste (general) 57 v 6 Controlling protein waste 58 v 7 Sustainable meat 58 v 8 Learning about traditional Indigenous proteins 60 v Appendix 62 v References 64 v5 Choosing your sustainable starch 67 v 1 Sustainable starches 69 v 2 What are my starch standards? 71 v 3 Making sustainable starch choices 72 v Legend for charts b) and c) v What do I need to change? v How can I change? v 4 Controlling starch waste 80 v 5 Learning about traditional Indigenous starch sources 80 v Appendix 82 v References 84 v 6 Choosing your sustainable vegetables 87 v 1 Sustainable vegetables 88 v 2 What are my vegetable standards? 89 v 3 Making sustainable vegetable choices 90 v What do I need to change? v How can I change? v 4 Seasonal vegetable table 91 2019 v 5 Controlling vegetable waste 92 — v 6 Learning about traditional Indigenous vegetable sources 92 v Appendix 94 v 98 References Guide to sustainable menus TABLE OF CONTENTS v7 Choosing your sustainable soup 101 v 1 Sustainable soup 102 v 2 What are my soup standards? 103 v 3 Making sustainable soup choices 104 v Legend for charts v What do I need to change? v How can I change? v 4 Learning about traditional Indigenous soups 107 v Appendix 108 v References 109 v8 Choosing your sustainable dessert 110 v 1 Sustainable desserts 111 v 2 What are my dessert standards? 112 v 3 Making sustainable dessert choices 113 v Legend for charts b) and c) v How can I change? v 4 Learning about traditional Indigenous desserts 117 v Appendix 117 v References 123 v9 Choosing your sustainable condiments, seasonings, sweeteners, and fats 125 v 1 Sustainable condiments, seasonings, sweeteners, and fats 126 v 2 Making sustainable condiment, seasoning, sweetener, and fat choices 127 v Legend v How can I change? v 3 Learning about traditional Indigenous condiments, seasonings, v sweeteners, and fats 132 v 4 Controlling condiment, seasoning, sweetener, and fat waste 133 v Appendix 133 v References 136 v10 Choosing your sustainable beverages and snacks 139 v 1 Sustainable beverages and snacks 140 v 2 What are my beverage and snack standards? 141 v 3 Making sustainable beverage choices 142 v 4 Making sustainable snack choices 146 v 5 Learning about traditional Indigenous beverages and snacks 152 2019 v Appendix 153 — v References 156 v11 Choosing your sustainable supplements 159 v 1 Sustainable supplements 160 v 2 Making sustainable supplement choices 160 v Appendix 163 v References 166 Guide to sustainable menus Introduction: chapter 1 This is where it all begins CHAPTER 1 This is where it all begins Executive summary What – and who – is 1 this guide for? The menus served by healthcare facilities have an impact1 not only on the health, recovery and well-being of patients, residents and staff, but on the environment and local economies as well. Each year, the Canadian healthcare system spends some $4 billion2 on food—an amount that could have a major effect on the sustainabil- ity of food production, processing, distribution and consumption if new criteria for creating menus are used. In addition to the sustainability impacts of food purchasing, there are also major sustainability impacts of food waste from healthcare facilities, 07 which is estimated at up to 50%3. Some sustainable development criteria are now included in provin- cial and national government policies, although decision-makers in healthcare facilities often lack the knowledge4 necessary to be able to take these criteria into account. The following policies are among those enabling a new direction to be taken5: • Health policies related to food in healthcare settings including menu setting, standards for food services, assessment of patient food experience, serving of Indigenous foods6, and group purchasing arrangements. • Agriculture policies defining and supporting local food promotion and procurement. • Procurement policies supporting values-based procurement to generate triple bottom-line impacts 2019 (social, economic, environmental). — 1 Ducak, K. and Keller, H. H. (2011). Menu planning in long-term care: toward resident-centred menus. Can J Diet Pract Res, 72(2), 83. doi: 10.3148/72.2.2011.83 2 V-Wilson, G. and Dover, J. (2016) Canadian Institutional Foodservice Market Report, fsSTRATEGY Inc., http://www.restaurantscanada.org/wp-content/ uploads/2016/07/2016-Canadian-Institutional-Foodservice-Market-Report-Abridged-Sample.pdf, Retrieved Fall 2017 3 Gooch and Felfel (2014) $27 Billion Revisited: The Cost of Canada’s Annual Food Waste, Value Chain Management Internationa 4 Wilson, E. D. and Garcia, A. C. (2011). Environmentally friendly health care food services: a survey of beliefs, behaviours, and attitudes. Canadian Journal of Dietetic Practice and Research, 72(3), 117-122. doi: 10.3148/72.3.2011.117 5 Reynolds, J. Nourishing the Future of Food in Healthcare: a pan-Canadian policy scan (2019). Food Secure Canada/Nourish/McConnell Foundation. Guide to sustainable menus 6 Also known as Country or Traditional foods depending on the context CHAPTER 1 This is where it all begins This document provides those responsible for setting menus in Canadian healthcare facilities with a step-by-step guide to creating sustainable menus.