October 2018 Issue

Foodservice Forum: Serving Up Better-for-You Meals
By Andrea N. Giancoli, MPH, RD
Today's Dietitian
Vol. 20, No. 10, P. 18

The American Heart Association and Aramark team up to improve the health of Americans.

The American Heart Association (AHA) and foodservice provider Aramark are closing in on year three of their five-year partner program Healthy for Life 20 by 20, an initiative to improve the health of Americans by 20% by the year 2020. "With 78% of American adults having a poor diet [based on the AHA Healthy Diet Score 2017 using 2013–2014 National Health and Nutrition Examination Survey data] and more than 70% being overweight or obese,1,2 the AHA views improving the American diet as an important pillar in efforts to reduce cardiovascular disease," says Jo Ann Carson, PhD, RDN, LD, immediate past chair of the AHA Nutrition Committee and a professor of clinical nutrition at the University of Texas Southwestern Medical Center. Carson explains that as the largest foodservice provider in the United States serving two billion meals each year, Aramark could make a significant impact; the company "had both the infrastructure and scale, as well as the desire to commit to improving American's diets and health."

Leveraging AHA's science-based criteria and Aramark's scale and business knowledge, in 2015 Aramark pledged to reduce calories, saturated fat, and sodium levels by 20%, and increase fruits, vegetables, and whole grains by 20% across all of Aramark's menus served in colleges and universities, hospitals, and workplaces by the five-year mark of the collaboration. To achieve these objectives, Aramark has revamped how they approach ingredient sourcing and its supply chain, recipe development, and menu planning, and how they serve food, all with the customer top of mind. "We have deep insight into what consumers are looking for, from everyday interaction and engagement with consumers in our locations and from extensive consumer proprietary research conducted by our consumer insights team," says Dan Wainfan, associate vice president of health and wellness at Aramark. Today's Dietitian takes a look at some of the changes and innovations Aramark has undertaken.

Ingredient Sourcing and Supply Chain Innovations
"Aramark's global supply chain and procurement teams are working with suppliers to find ways to improve existing ingredients and products while discovering new high-quality products for a healthier menu," Wainfan says. For example, in response to consumer demand for "clean" foods, Aramark has partnered with suppliers to introduce antibiotic-free turkey and sustainable seafood such as wild-caught salmon. They're also incorporating more plant-based options, partnering with suppliers known for their vegetarian and vegan products such as Morningstar Farms, Gardenburger, Ahimi, Gardein, Beyond Meat, Daiya, and Sir Kensington's.

To work toward including more sustainable choices, Aramark recently launched Open Fields, "a trailblazing software platform that enables foodservice operations at colleges, schools, hospitals, sports and leisure facilities, and businesses of all kinds to more easily source and report on sustainable ingredients and purchases," says Amy Siverling, MS, RDN, LDN, director of menu development at Aramark. Open Fields enables them to search and report on locally sourced products and purchasing using the program to "track sustainable attributes such as Seafood Watch Best Choice or Good Alternative, Fair Trade USA certified, USDA Organic, and more," Siverling explains.

Recipe Development
Aramark's chefs and menu developers are making recipes more healthful using a multitude of strategies, including the following:

  • using fruit-based sauces and dressings for salads and to complement protein dishes and entrées;
  • replacing higher-fat dairy products in recipes with yogurt;
  • using vegetables as functional components of foods (eg, cauliflower to replace mashed potatoes);
  • offering whole grain pizza crust; and
  • replacing many cream-based soups and stews with varieties that are lower in saturated fat, calories, and sodium.

In keeping with their mission to increase vegetable, fruit, and whole grain offerings, the company ensures it does the following:

  • features fresh vegetables with a variety of flavor profiles in all menus;
  • highlights seasonal produce in recipes like Winter Vegetable & Pork Stew, Eggplant & Cavatappi, Apple Cranberry Pork, Baked Acorn Squash, Seasonal Roasted Vegetables, and Green Chili Calabacitas;
  • develops vegetarian sandwiches such as Mediterranean Veggie Ciabatta, Greek Ciabatta With White Bean Spread, and Roasted Pepper & Mozzarella Ciabatta, all of which are made with whole grains; and
  • offers more vegetarian and vegan dishes such as Curried Vegetable Lentil Stew Platter, Chermula Roasted Vegetable Plate, Portobello Mushroom Tacos, and Potato & Kale Enchiladas.

Aramark partnered with the Humane Society of the United States to train chefs in plant-based cooking.

Menu Planning
"Consumer demand for quality, health, convenience, and personalization drives every stage of our menu innovation process," Wainfan says, adding, "We take our primary research and layer in trends from industry experts and market research partners to introduce innovation to each menu, drawing on the experiences and knowledge of our chefs and dietitians for input." Aramark strives to ensure that all menus include a variety of offerings that cater to different dietary patterns and are crafted appropriately for the season and the environment. Menus are rotated with foods from a variety of cultures. Plant-forward offerings are included in every meal category served—breakfast, lunch, dinner, and snacks. Aramark also incorporates emerging food trends into its menu for a limited time, which may be integrated later into the regular menu.

Snacking is another area in which Aramark can provide consumers with healthful choices. "We recently introduced a number of snack boxes that offer a variety of fruit, vegetable, and protein options in convenient packaging," Siverling says. Aramark's Quick Eats program now includes the following choices:

  • Mediterranean Cup made with quinoa, cucumber, tomato, cabbage, parsley, scallion, and tahini dressing topped with crunchy chickpeas;
  • Cauliflower Tabbouleh featuring minced cauliflower with tomato, parsley, scallion, garlic, lemon juice, and olive oil;
  • Chickpeas & Feta incorporating roasted red peppers, celery, onion, and red wine vinaigrette;
  • Roasted Veggies including zucchini, tomatoes, red pepper, chickpeas, and Kalamata olives with red wine vinaigrette; and
  • Mango Jicama Chili Lime Snack with fresh mango, cucumber, and jicama topped with a smoky chili lemon spice mix and lime.

Foodservice
Aramark also has changed how it conducts individual foodservice operations throughout the United States; Wainfan explains that "health-inspired recipe development coming from executive chefs at the Aramark Innovation Center is built into menus that are then delivered [to] locations around the country," such as hospitals, workplaces, colleges, and universities. "New menus are created for each of these dining environments each season, and the health-inspired recipes included are varied to assure that a wide variety of new and more adventurous healthy flavors are on the menu alongside healthier takes on tried and true classics and comfort foods," Wainfan says. "Our retail, residential, and patient dining menus all feature extensive options for personalization, across all menu categories providing unlimited options for individual preferences," Siverling adds.

Successes and Progress
With all of these changes spanning their operations, Aramark reported improvements at the two-year mark of the initiative. Saturated fat levels have decreased by 15%, with approximately one-half of menu choices containing less than 10% of calories from saturated fat. Sodium levels have been reduced by 14%, with menu categories such as entrées and soups averaging less than 500 mg sodium per serving. Calories have decreased by 11%, with more than 70% of main dishes now at 500 kcal or fewer. Aramark also reports that fruit, vegetable, and whole grain consumption has increased by 5% and that 30% of the menu is now vegetarian or vegan. By 2020, Aramark expects to achieve, and possibly exceed, its nutrient and food commitments, impacting 10 billion meals served over the five-year period.

— Andrea N. Giancoli, MPH, RD, is nutrition manager for Beachbody and a freelance nutrition and health writer in Hermosa Beach, California.

References
1. Overweight & obesity statistics. National Institute of Diabetes and Digestive and Kidney Diseases website. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity. Published August 2017. Accessed July 30, 2018.

2. Obesity and overweight. National Center for Health for Health Statistics website. https://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Updated May 3, 2017. Accessed July 30, 2018.

AHA'S HEALTHY DIET SCORE

AHA's Healthy Diet Score consists of five primary components (standardized to 2,000 kcal per day). When followed, the components are associated with a low risk of developing atherosclerotic cardiovascular disease (eg, ischemic heart disease and stroke):

  • fruits and vegetables: ≥4.5 cups per day;
  • fish: ≥ two 3.5-oz servings per week (preferably oily fish);
  • fiber-rich whole grains (≥1.1 g fiber per 10 g carbohydrate): ≥ three 1-oz-equivalent servings per day;
  • sodium: <1,500 mg per day; and
  • sugar-sweetened beverages: <450 kcal (36 oz) per week.

Individuals are categorized according to Poor, Intermediate, or Ideal Healthy Diet Score based on the number of dietary components achieved: Poor = 0–1 components, Intermediate = 2–3 components, and Ideal = 4–5 components.

— ANG
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