Nutritional Pearls: Making the Cut—At Restaurants

John is a 36-year-old man who is overweight. John does not like cooking, and gets many of his meals from the many fast food restaurants near his home and work. When asked, John says he avoids the “healthy” options on many fast food restaurants because they “don’t taste as good.”

How would you advise your patient?
(Answer and discussion on next page)

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Answer: Calorie and sodium reductions can be achieved by simply reducing the amount of 1 or more ingredients in a meal.

People believe that healthy food can't taste very good. It's well-known in the restaurant world that if you label a dish "healthy" you'll sell less of it for exactly that reason: it's as if they had labeled the dish, "doesn't taste as good as other things on the menu." Yet most restaurant chefs will also agree that they could cut the amount of fat and calories in their dishes by 10% or more and most of their patrons wouldn't notice.
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With some sources estimating that the typical American eats half of all of their meals away from home, cutting calories in restaurant food could make a huge difference in the number of overweight and obese Americans. Today's research gets the restaurants themselves involved.

The Research

The authors in this study worked with 6 nationwide restaurant chains to conduct taste testing of a total of 24 specific items on their menus in comparison with versions of the same dish with fewer calories, less sodium, or both. Although the chains are not identified in the study, the authors worked with restaurants from the fast food, fast-casual, buffet, and full service sectors. Over 1800 taste testers were recruited with assistance from each restaurant's marketing team and their customer email list. The qualified tasters were between the ages of 18 and 70 and all had previously ordered at least 2 of the menu items they were to test.

Working with the chefs of each restaurant, dietitians helped create reduced-calorie and reduced-sodium versions of 4 different menu items, taking care to ensure that these new versions were feasible for the restaurant's existing supply chain and kitchen equipment. Two new versions of each recipe were created: one termed "slightly modified" (the smallest amount of change in the nutrition information) and one "moderately modified" (with somewhat greater change in the nutrition information). This resulted in a total of 12 dishes to be tasted per restaurant.

The actual taste testing took place in each respective restaurant and each participant sampled a total of 4 menu items that were randomly selected from the 3 versions of the restaurant's 4 targeted recipes. Testers did not know the object of the study, nor were they told whether the recipes of the food they ate were altered in any way: they were simply told the name of the item and asked to take a minimum of 3 bites. Each dish was presented separately after which the tester responded to a questionnaire that measured their overall liking of the dish, whether they would choose to purchase that dish in the restaurant, and other questions. Participants received gift cards in payment for their participation in the research.

The Results

The reduced-calorie or reduced-sodium versions of 19 of the menu items were rated as highly or higher than the original versions of the items. Moreover, the moderately modified versions of 8 of those recipes were considered acceptable. Interestingly, the testers rated many of the recipes that had been targeted specifically for cutting salt as "too salty," suggesting that chefs could cut salt even further (these recipes included hummus, potato salad, chicken soup, and broccoli cheddar soup).

What’s The “Take-Home”?

The obvious first step for you as a physician is to encourage your patients to eat out less often. Second, the good news is that for this study the calorie and sodium reductions in the modified dishes were most often achieved by simply reducing the amount of 1 or more ingredients in the dish. Your patients can do the same at home by putting less cheese on a sandwich or less mayonnaise in a chicken salad. 

Reference:

Patel AA, Lopez NV, Lawless HT, Njike V, Beleche M, Katz DL. Reducing calories, fat, saturated fat, and sodium in restaurant menu items: Effects on consumer acceptance. Obesity. 2016;24(12):2497-2508.